Bilioenterostomy with a wide variety of techniques is a common surgical operation in digestive surgery.Each of these surgeries has its own advantages and disadvantages.At present,Roux-en-Y choledochojejunostomy seems to be the dominant surgery,while other operations are used in some particular circumstances.Furthermore,some modified surgeries for bilioenterostomy have been conducted with the deepening understanding of the complications.Additionally,different kinds of new facilities and techniques have been applied to bilioenterostomy.Despite the controversy on specific issues,reasonable choice of bilioenterostomy should follow thc principles of specific purpose,correct choice and reliable effect.In other words,whether or not using bilioenterostomy should be considered correctly from the whole system,and then surgical methods should be accurately chose for patients,and finally avoiding the technical errors and guaranteeing the surgical effects.

One of the aims of biotechnological pharmaceutics is to educate innovative highquality medical talents.The second classroom activities can be used as a complementation to ensure the teachiug effectiveness of the course.This study focuses on the experience of carrying out the second class of biotechnological pharmaceutics and tends to provide references for teachers who are going to carry out the second class.

Moyamoya disease is a rare cerebrovascular disease,its etiology remains unknown.The genetic factor may play an important role during the course of the disease,This article reviews the advances in genes-related to moyamoya disease in recent years,hoping to provide new ideas for future research.

Integron was a novel bacterial resistance gene horizontal transmission element.In recent years, many researchers made a lot of research on the resistance mechanism of pathogen.In this paper, the detection and the novel discovery of the integron gene cassette were summarized , including Enterobacteria, Acinetobacter baumanii, Pseudomonas aeruginosa and other bacteria , on the basis of the multidrug resistance mechanism mediated by integron.The prospect the research was descixbed and more attention should be paid to the prevention and control of multidrug resistant bacteria.

The technique of Radiofrequency ablation (RFA) has been widely applied as alternative treatment for non resectable hepatocellular carcinoma (HCC) and has equivalent efficacy in prognosis.However,because of the restriction of current heat ablation technique and tumor's special location in liver,it is difficult for some physicians to obtain the ideal of one-off complete ablation.Therefore,incomplete destruction of tumor and multiple ablation processes resulted in miserable consequence in prognosis.So,to achieve one-off complete ablation,it is essential to evaluate the anatomy location of the tumor before RFA procedure and to establish the specified approach and adjuvant method.This article is to systematically analyze the theoretical hypothesis of this technique and to explore possible strategy for a safe approach based on characteristics of liver anatomy and combined with the professional advantages of hepatobiliary surgery.

Diagnostic Techniques and Procedures ; instrumentation ; Humans ; Pathology, Clinical ; instrumentation ; methods ; trends ; Referral and Consultation ; Reproducibility of Results ; Sensitivity and Specificity ; Telepathology ; instrumentation ; methods ; trends

Objective Using stem tip of Gymnadenia conopsea in this experiment to investigate somatic embryogenesis and plant regeneration in vitro.Methods Uniform dedign for the most suitable media for embryogenic callus induction and embryogenic cell complex,development of somatic embryo and plant regeneration were screened.Results The results showed that Chaturvedi and Mitra(CM)+6-BA 1.0 mg/L+IAA 2.0 mg/L+2,4-D 0.1 mg/L was fit for embryogenic callus and embryogenic cell complex induction.Percentage was 98%;The medium of development of somatic embryo and plant regeneration was CM+6-BA 1.00 mg/L+IAA 0.10 mg/L.Percentage was 100% and converted into plantlets with shoots and roots after 50 d culture on the same medium.Conclusion The observation of morphostructure and ultrastructure proves the process of somatic embryogenesis of G.conopsea.

Objective To understand the status quo of medical graduates' professional faith and to evaluate the education methods. Methods Questionnaire survey combined with expert inter-view were conducted from two aspects: professional faith condition and educational methods. Medical graduates from an affiliated hospital of a university in Shanghai were investigated in this survey and 392 copies of effective questionnaires were analyzed comparatively. Results 92.6%(363/392) students regarded extreme events as the main factor that influence their further employment. 14.8%(58/392) students had career planning. 79.6%(312/392) students achieved self-improvement from strengthening learning and training. Salary was the main factor that affect medical graduates' career choice (4.47 points). 75.5%(296/392) students considered that the existing professional faith education was out of fashion. 85.5%(335/392) of students thought that education methods should be improved. Strengthen-ing relevant education career planning was considered as the most valuable content (4.22 points) and the most effective form was group learning (4.53 points). Conclusions The main reasons for devia-tion and dissatisfaction are:social factor, lack of professional faith, unique status and obsolete way of education. Professional faith education should take the above factors into consideration.

Objective To investigate the therapeutic effect and safety of albumin combination furosemide in treatment of eld cerebral hemorrhage patients,and provide evidence for clinical treatment of eld cerebral hemorrhage patients.Methods Two hundred eld cerebral hemorrhage patients were divided into control group (110 cases) and observation group (90 cases) by systematic sampling method.The two groups were given the monitor of vital signs,support of organ function,reduce of intracranial pressure and other conventional treatment,on the basis of which albumin (10 g,2 times/day) and furosemide (20 mg,intravenous injection) were given to observation group for 10 days.The levels of arterial blood lactate and vein serum C reactive protein (CRP) of 2 groups were compared at admission,treatment for 7 and 14 days.Moreover,the mortality rate of 2 groups at 14th day of treatment was also compared.Results There were no statistical differences in the condition of patients between the 2 groups at admission (P ＞ 0.05).The levels of arterial blood lactate of control group at treatment for 7 and 14 days were significantly higher than those of observation group [(2.56 ± 0.63) and (1.98 ± 0.65) mmol/L vs.(1.91 ± 0.70) and (1.28 ± 0.68) mmol/L],there were statistical differences between the 2 groups (P＜0.05).The levels of vein serum CRP of control group at treatment for 7 and 14 days were significantly higher than those of observation group [(120.02 ± 40.65) and (48.75 ± 30.11) mg/L vs.(60.52 ± 30.83) and (13.45 ± 6.02) mg/L],there were statistical differences between the 2 groups (P ＜ 0.05).The mortality rate at 14th day of treatment of control group was significantly higher than that of observation group [22.73％ (25/110) vs.13.33％ (12/90)],there was statistical differences between the 2 groups (P ＜ 0.05).Conclusion Albumin combination furosemide in treatment of eld cerebral hemorrhage patients can relieve the inflammatory reaction and decrease the mortality rate,it is expected to become the routine treatment in eld cerebral hemorrhage patients.

Objective To compare the anesthetic effects of remifentanil and fentanyl in elderly patient undergoing transurethral electro-vaporization of the prostate.Methods Eighty cases of the elderly patients (age ≥60 years) with transurethral resection of the prostate operation in the hospital were randomly divided into remifentanil group(R group,n =40) and fentanyl group (F group,n =40).Patients in R group and F group were administrated remifentanil and fentanyl respectively for induction and maintenance of anesthesia.The following indices were recorded including the changes of emodynamics (lood pressure,heart rate) in before-and after-anesthesia,postoperative recovery (spontaneous breathing recovery time,open the recovery time,extubation time) and the adverse reaction within 24 hours after operation (awareness during operation,nausea,vomiting).Results Blood pressures,heart rate of after-anesthesia in R group were lower than that in before-anesthesia and F group,the difference were significant(Blood pressures:F within group =58.306,P within group =0.000,F interactive group =142.450,p interactive group =0.000,F between group =7.417,P between group =0.010;heart rate:F within group =41.512,P within group =0.000,F interactive group =269.103,P interactive group =0.000,F between grouP =39.703,P between group =0.000).Spontaneous breathing recovery time,opening eye time and extubation time in group R were significantly shorter than that of F group (Spontaneous breathing recovery time:(7.5 ± 1.3) min vs.(10.7 ± 3.1) min,t =3.011 ; Opening eye time:(13.5 ± 3.2) min vs.(18.3 ± 5.2) min,t =2.611 ; Extubation time:(24.4 ± 5.5) min vs.(29.2 ± 7.1) min,t =2.696 ; all P ＜ 0.05).No significant differences were found in R and F group in terms of intraoperative awareness postoperative nausea,vomiting (P ＞ 0.05).Conclusion Remifentanil used in elderly patients with transurethral electro-vaporization of the prostate was safer and more effective than fentanyl.Meanwhile postoperative recovery in Remifentanil patient was more rapidly.Therefore Remifentanil was ideal drug during the process clinical anesthesia.