Objective To explore the diagnosis and surgical treatment of primary intestinal tumors, and improve the level of treatment. Methods Retrospective analysis of the clinical was made on the 68 cases of primary small intestinal tumors confirmed by pathological examination in our department in recent 20 years. HZ Results 34.8%(21/68) was benign tumors in 68 cases, and 69.1%(47/68) was malignancies. The common clinical prevsentations were abdominal pain (69.1%,47/68). gastrointestinal he morrhage (41.1%,28/68) and abdomen mass (13.2%,9/68). The preoperative misdiagnosis rate was 70.5%(48/68) .All the 68 cases performed operation, and no death. The 1 ,2 and 5 years survival rates of malignant tumors were 65.8%,42.1% and 29.3% respectively. Conclusions The clinical presertation of primary small intestinal tumor is non-spectific and the misdiagnosis rate is high. Kinds of diagnosis examinations should be done for the cases whose diagnosis are uncertain, and laboratory examinations should be considered if it is need. The main choice of treatment is surgery and the chemotherapy is necessary for malignant tumors also.

Background:Personality characters will influence the future career planning and development of medical students.Therefore,it will be important in the field of medical education to survey their personalities.Study design:The personality questionnaire was developed according to the Big-Five characters.The content validity and consistent reliability were assessed.A total of 124 undergraduate medical students participated in this 44-item self-evaluation about their personalities.Results:The inter-item consistency reliabilities of the 44-items of Big-Five personality questionnaire were analyzed and discordant items were deleted(Crobach's Alpha from 0.484~0.782 before selection to 0.67~0.82 after selection).The content validity of this five dimensions ranged from 0.8 to 0.9(P

Objective:To promote hospital medicalmetrology and quality control management. by using information management mode.Methods: Through the analysis of our hospital medical equipment measurement and quality control management present situation, put forward the necessity of metrology and quality control management of Xinxi sanitary equipment,introduces the application situation of our hospital dynamic health equipment metrology and quality control management system.Results: The medical equipment metrology and quality control management system perfect the medical equipment measurement and quality control of management process, improve the qualified rate of equipment.Conclusion:Application of sanitary equipment measurement and quality control management platform to improve the delivery rate of equipment, ensure the equipment unqualified clinical use.

Objective To evaluate the therapeutic effect and application value of laparoscopy combined with holmium laser in the treatment of intrahepatic and extrahepatic bile duct stones.Methods Retrospectively analyzed the clinical data of 22 cases with intrahepatic and extrahepatic bile duct stones who treated with laparoscopy choledo-choscopy combined with holmium laser lithotripsy(the observation group),and 21 cases who treated with laparoscopy combined with choledochoscopic lithotomy(the control group).The clinical curative effect was compared between the two groups.Results In the observation group,the residual stones completely removed in 21 cases(95.4%),the mean operation time was (130 ±13)min,the intraoperative bleeding volume was (85 ±20)mL,the average hospitali-zation time was (8.3 ±2.0)days,without conversion to open surgery,no incision infection,1 case had residual stones after operation,through T tube sinus tract choledochoscopy took a stone again.In the control group,took net calculi in 13 cases(61.9%),the average operation time was (135 ±20)min,the intraoperative hemorrhage volume was (70 ± 15)mL,the average hospitalization time was (14.5 ±2)days,6 cases converted to laparotomy,incision infection in 2 cases,8 cases had residual stones after operation,through T tube sinus combined with choledochoscopy again take stone,which 2 secondary mirror lithotomy in 6 cases,3 cases of 2 stones.The differences of the two groups in stone from the net rate,conversion rate,average hospitalization time were statistically significant(χ2 =2.203,2.897,t =4.293,P =0.033,0.006,0.017).The differences of mean operation time,intraoperative hemorrhage had were not statistically significant(t =1.176,1.629,P =0.246,0.111).Conclusion It is safe,effective and minimally invasive for the treatment of intrahepatic and extrahepatic bile duct stones with holmium laser combined with endoscopic holmi-um laser.

Objective To compare and discuss the clinical application effect of the end-to-end anastomosis of pancreatic and intestinal anastomosis,binding type of pancreatic and intestinal anastomosis,end-to side pancreatic duct anastomosis and modified pancreatic duct jejunum anastomosis.Methods Collected pancreatoduodenectomy in 95 cases,the end-to-end pancreatico duodenal sleeve type anastomosis in 23 cases,binding type pancreatic enteric anastomosis in 18 cases,end to side pancreaticojejunostomy anastomosis in 28 cases,improvement of the pancreatic duct jejunum end to side anastomosis in 26 cases,compared with four groups of patients with pancreatic enteric anastomosis time and postoperative complications.Results Anastomosis time:A group (34.0 ± 4.6) min,B group (31.0±5.8) min,C group (32.0 ±6.3) min,D group (14.0 ±4.2) min(P=0.037,P＜0.05).And the incidence rate of postoperative pancreatic fistula,bile leakage,abdominal cavity or digestive tract bleeding had no significant difference (P ＞ 0.05).Improvement of the pancreatic tube jejunum end to side coincident with a low incidence of pancreatic fistula,but different pancreatic enteric anastomosis way pancreatic fistula rate difference was not statistically significant,improvement of the pancreatic duct and jejunum mucosa end side group pancreatic enteric anastomosis anastomosis time significantly shorter in the three groups,the difference was statistically significant (P ＜ 0.05).Conclusion Improvement of pancreatic duct jejunum end to side anastomosis with short operation time,low incidence of pancreatic fistula,and the operation is simple and practical,safe.

Objective To investigate the factors affecting the stability of the volatile oil extracted fromYinqiaosan Decoction.Methods The main chemical compositions and the extraction repetitiveness of the compound volatile oil were determined by GC-MS, and the stability of multiple extracted volatile oil was studied. Absorbance of the compound volatile oil was used as the evaluation index, and the factors affecting the stability of the of the compound volatile oil were investigated, such as illumination, temperatures and pH values of volatile oil solution and metal ions.Results The results of the GC-MS chromatograph indicated that the main chemical compositions of the compound volatile oil extracted fromYinqiaosan Decoction twice were the same. The results of the stability of the volatile oil showed that the preservation temperature and illumination affected the stability of the volatile oil to a certain extent. The absorbance values of the compound volatile oil changed slowly when it was stored at a relatively low temperature (4℃) and shielded from light, and it was less stable when stored in normal temperature and under illumination. Meanwhile, the absorbance of the compound volatile oil changed quickly in acid or alkaline solutions and was in instability. The metal ions, such as Cu2+ and Fe3+, have chemical reactions with the compositions of the compound volatile oil and there was a big change in the UV-Vis spectrum of the compound volatile oils.Conclusion The compound volatile oil should be stored at a relatively low temperature (4℃) and shielded from light. At the same time, it should be stored avoiding acids, alkaline and the metal ions, such as Cu2+ and Fe3+, to guarantee its stability. This study provides a reference for the preservation conditions and the preparation conditions of the compound volatile oil extracted fromYinqiaosan Decoction.

Objective To investigate the clinical characteristics of children with refractory Mycoplasma pneumoniae pneumonia (RMPP),and to analyze the related risk factors. Methods Clinical manifestations,laboratory indexes and image features of 628 children with Mycoplasma pneumoniae pneumonia (MPP) from January 2012 to October 2016 were retrospectively analyzed, and stepwise logistic regression analysis was performed for risk factors of RMPP. ROC curve was mapped to analyze the predictive value of independent risk factors in RMPP. Results Compared with 486 cases of general Mycoplasma pneumoniae pneumonia (GMPP), 142 cases of refractory MPP was older, and durations of fever and hospitalization, azithromycin treatment days were longer, pulmonary complications, lesions in the right lobe and right upper lobe, pleural effusion, lobar atelectasis, pulmonary consolidations, and pleural thickening ratio were higher, the percentage of neutrophil, CRP, LDH, CK-MB, IL-6, IL-10, IFN-γ and IgA levels were also higher (all P<0.05). Stepwise logistic regression analysis showed that CRP, LDH, IL-6, IL-10, IFN-γ were the independent risk factors of RMPP. ROC curve analysis showed that CRP, LDH, IL-6, IL-10 and IFN-γ has a good value for identification of children with RMPP and GMPP, the best threshold value of 15.3 mg/L, 402 IU/L, 13.82 pg/mL, 5.07 pg/mL, and 13.84 pg/mL, respectively. Conclusions The clinical symptoms and imaging findings of the lung are severer,and the levels of serum CRP, LDH, IL-6, IL-10, and IFN-γ are significantly increased, which is helpful for the early identification of RMPP.

Objective To explore the differences in clinical features between the latent autoimmune diabetes in adults (LADA) and type 2 diabetes mellitus (T2DM) in the elderly.Methods Clinical features of 41 cases with LADA and 49 cases with T2DM were retrospectively analyzed and compared.Results (1) Body mass index (BMI),fasting and postprandial levels of cpeptide,triglyceride (TG) and serum albumin were lower in LADA patients than in T2DM patients.(2) The levels of fasting and postprandial blood glucose were higher in LADA patients than in T2DM patients.(3) There were no statistically significant differences in the disease course,blood pressure (BP),and the functions of liver and kidney between LADA and T2DM patients.Conclusions As compared with T2DM patients,LADA patients have higher blood glucose level,lower BMI and TG level,and poorer function of islet B cell.But there is no significant difference in the chronic complications between two groups.

[ ABSTRACT] AIM:To observe the effect of high glucose on the protein expression of calreticulin ( CRT) and its association with cell apoptosis and mitochondrial dysfunction in the cardiomyocytes.METHODS: AC-16 cardiomyocytes were randomly divided into normal glucose group, high glucose group, high glucose+CRT siRNA group and isotonic con-trol group.The cell apoptotic rate, reactive oxygen species (ROS), mitochondrial membrane potential level, respiratory enzyme activity, and protein expression of CRT were observed.RESULTS: Compared with the cardiomyocytes in normal glucose group, the apoptotic rate and ROS production of cardiomyocytes increased in high glucose group, accompanying with the decreases in the mitochondrial membrane potential level and enzyme activitiy of the respiratory chain.The protein expression of CRT was significantly increased in high glucose group.However, compared with high glucose group, high glucose+CRT siRNA decreased the expression of CRT and attenuated the damage of mitochondria, but CRT siRNA did not reduce the ROS level in cardiomyocytes.CONCLUSION:High glucose brings about CRT over-expression to induce mito-chondrial injury, thus increasing myocardial apoptosis.

Objective To explore the changes of cardiac structure and function in streptozotocin (STZ)-induced diabetic cardiomyopathy (DCM)rats so as to detect the level of angiotensinⅡ (AngⅡ)in blood and the myocardium and illuminate the role of AngⅡ in DCM.Methods We randomly divided 30 SD rats into control group and DCM group (which received a single injection of streptozotocin,65 mg/kg).The changes of cardiac structure and function were observed by ultrasonic cardiogram at the end of 16 weeks after injection.Then the changes in the myocardium were also analyzed by using hemotoxylin and eosin staining and Sirius red staining.The level of AngⅡ in blood was tested by radioimmunoassay.The expression of AngⅡ in the myocardium was detected by immunofluorescence. Results Compared with those of the controls,the hearts were dilated in DCM rats accompanied with cardiac dysfunction.There were significant increases in LVEDd,LVESd,LVEDv,and LVESv but decrease in LVEF (P <0.05).There were arrangement disorder and hypertrophic cardiomyocytes in DCM.Then the fibrosis area of DCM was significantly increased compared with that of the controls.The level of AngⅡ in blood and myocardium was significantly higher in DCM than in controls.At the same time,Pearson analysis revealed that the level of AngⅡ in blood was positively related to the collagen content of myocardium (r =0.907,P <0.05).Conclusion Our study provides experimental evidence that AngⅡ plays an important role in myocardial fibrosis of DCM.