Objective To examine the surgical treatments for obstructive jaundice caused by bile duct strictures after hepat-ic transcatheter arterial chemoembolization(TACE).Methods Clinical data were retrospectively analyzed of 9 patients who de-veloped bile duct strictures among 229 patients after TACE between June 1994 and March 2011 in People’s Hospital of Zhe-jiang Provincial and the Second Affiliated Hospital of Zhejiang University.There were 6 cases of primary liver cancer,and 3 ca-ses of metastatic liver cancer.Obstructive jaundice occurred 5 to 16 months after TACE treatment.The median time was 8 months.Results All the nine patients with bile duct strictures suffered different degrees of obstructive j aundice,which was cured after surgical operations or PTC + stenting in 7 patients and significantly relieved by percutaneous transhepatic cholangic drainage(PTCD)in 2 ones.Two patients with obstructive j aundice after TACE for primary liver cancer were followed up for 3 years,and no recurrence of hepatic carcinoma and bile duct obstruction was found.The other 7 patients were followed up for 3 to 13 months,and they all died of deterioration of primary disease.Conclusion Patients with obstructive jaundice caused by bile duct strictures after TACE benefit from surgical operations or intervention treatment.Different surgical strategies are selected based on the characteristics of primary disease,the site and extent of bile duct stricture.

Objective To observe the effects of Suoquan Wan(SQW) on the endocrine and immune function of the polyuria rats with kidney-yang deficiency. Methods The model rats were induced by gastric infusion of adenine(250 mg/kg) for 4 weeks, then treated respectively with SQW (at low, middle and high dose respectively), Shenqi Wan and desmopressin for another 4 weeks. The bodyweight and organ index were recorded, and serum cortisone concentration were detected. T cell subsets in peripheral blood were determined by flow cytometry. Results The bodyweight of rats in model group was lower than that in the normal control group. And the bodyweight of rats in desmopressin group, middle-and high-dose SQW groups differed from that in the model group (P < 0. 05 or P < 0. 01). The decreased organ indexes of pituitary, adrenal and thymic glands were found in the model group (P < 0. 05 or P < 0. 01 compared with the normal group). The thymus index was elevated in all the medication groups except the low-dose SQW group (P < 0. 05). The elevated organ indexes of pituitary and adrenal glands were only found in Shenqi Wan group and high-dose SQW group (P < 0. 05). In the model group serum cortisone concentration was decreased (P < 0. 01). In Shengqi Wan group and middle-and high-dose SQW groups, the cortisone concentration was significantly increased (P < 0. 05 or P < 0. 01, compared with the model group). In the model group, the percentages of CD3+ and CD3+/CD4+ T cell subsets in pe-ripheral blood were decreased, and the percentage of CD3+/CD8+ T cell subset was increased (P < 0. 05 or P < 0. 01 compared with the normal group). Compared to the model group, the percentages of CD3+ and CD3+/CD4+ T cell sub-sets were increased and the percentage of CD3+/CD8+ T cell subset was decreased in SQW group and Shenqi Wan group. But the differences of T lymphocyte subsets were insignificant between desmopressin group and the model group. Conclu-sion SQW can regulate the endocrine and immune function of the polyuria ratwith kidney-yang deficiency.

OBJECTIVE To discuss the management methods of sputum sample retained clinically based on the praxiology,and aim at improving the quality of the sputum retained. METHODS Through investigating the quality of sputum sample retained routinely from the department of internal medicine in a general hospital at the duration from Sep 2004 to Feb 2005,the intervention effect was evaluated by carrying out the measure of praxiology intervention. RESULTS The qualification rate was 23.7% for the sputum sample retained routinely from the hospital at the duration from Sep 2004 to Feb 2005,after carrying out the measure of praxiology intervention,the qualification rate was 30.1% at the duration from Apr 2005 to Aug 2005.Statistic data showed that there was no significant difference. CONCLUSIONS The quality of the sputum sample retained routinely is poor,and the measure of praxiology intervention failed to improve the quality of the sputum sample.Microscopy is the most important measure to ensure the quality of the sputum sample for the cytology test before cultivating the sample,and should be a routine test in hospital.The study on praxiology intervention will be further carried out in the future.

Objective To observe the effects of Suoquan Wan(SQW) on the endocrine and immune function of the polyuria rats with kidney-yang deficiency. Methods The model rats were induced by gastric infusion of adenine(250 mg/kg) for 4 weeks, then treated respectively with SQW (at low, middle and high dose respectively), Shenqi Wan and desmopressin for another 4 weeks. The bodyweight and organ index were recorded, and serum cortisone concentration were detected. T cell subsets in peripheral blood were determined by flow cytometry. Results The bodyweight of rats in model group was lower than that in the normal control group. And the bodyweight of rats in desmopressin group, middle-and high-dose SQW groups differed from that in the model group (P

ObjectiveTo investigate the mechanism of anti-inflammatory effect of diallyl sulfide (DAS) in protection against acute lung injury (ALI) in rats with paraquat poisoning.Methods Eighty male Wistar rats were randomly divided into four groups, namely: control group, model group, dexamethasone (DXM) treatment group, and DAS treatment group, with 20 rats in each group. The model of paraquat poisoning was reproduced by single does of 70 mg/kg given by gavage, while the same volume of normal saline (NS) was given in same manner in control group. 100 mg/kg of DAS, the same volume of NS, or 1 mg/kg DXM injection were given respectively in DAS treatment group, model group, or DXM treatment group intraperitoneally after exposure to paraquat, once a day for 14 days. Five rats in each group were sacrificed at 1, 3, 7, 14 days, respectively. The inferior lobe of right lung was harvested, and the degree of lung injury was observed with hematoxylin and eosin (HE) staining under optical microscope; the upper lobe of right lung was used to determine the lung wet/dry weight (W/D) ratio and for evaluation of the degree of pulmonary edema. The expression of nuclear factor -κB (NF-κB) in the middle lobe of right lung was assessed with immunohistochemistry. The expression of tumor necrosis factor -α (TNF-α) mRNA in the left lung was determined with the reverse transcription-polymerase chain reaction (RT-PCR).Results① The pulmonary structure in control group was found to be intact. However, in the model group there were progressive pathological changes in lung, including marked edema and thickening of alveolar walls, collapse of alveoli, infiltration of inflammatory cells, alveolar wall, and obvious bleeding in the local lung tissue, and formation of transparent membrane in alveolar space. Less infiltration of inflammatory cells and no obvious destruction were found in alveolar structure in the DAS and DXM treatment groups.② Lung W/D ratio: lung W/D ratio of model group was apparently higher than that in control group at every time point, and peaking on the 3rd day (6.15±0.54 vs. 4.15±2.10,P< 0.05), and the ratio of lung W/D of DAS and DXM treatment groups was obviously lower than that in model group at every time point, especially on the 3rd day (3.99±1.26, 4.30±0.70 vs. 6.15±0.54, bothP< 0.05), but there was no significant difference between DAS and DXM treatment groups in this regard.③ The immunocytochemistry analysis revealed minimal NF-κBp65 expression in the cell nuclei of the control group, while extensive NF-κBp65 expression was found in model group. Minimal NF-κBp65 positive expression in the cytoplasm and even less positive expression in the nucleus was found in the DAS and DXM treatment groups, and integralA value was significantly lower in the DAS and DXM treatment groups than that of the model group, especially on the 3rd day [(17.98±0.06)×107, (18.53±0.04)×107 vs. (28.85±0.61)×107, bothP< 0.01], but there was no significant difference between DAS and DXM treatment groups.④ It was shown by RT-PCR that the expression of TNF-α mRNA in lung tissue of the model group was significantly higher than that in the control group on the 3rd day (gray value: 3.63±0.62 vs. 0.51±0.13, P< 0.05). The expression of TNF-α mRNA in lung tissue was significantly decreased in DAS and DXM treatment groups compared with model group (gray value: 2.49±0.57, 2.02±0.26 vs. 3.63±0.62, bothP< 0.05), but there was no significant difference between DAS and DXM treated groups.ConclusionTreatment with an intraperitoneally injection of DAS is capable of attenuate the extent of PQ-induced ALI in rats by alleviating pulmonary edema, inhibiting the expression of NF-κB and TNF-α in lung tissue, and ameliorating pathological changes in lung tissue.

Objective To measure the present situation of medical students' learning adaptability and find the influencing factors in order to revise Learning Adaptability Scale for medical students.Methods A stratified sampling method was used to collect 1 180 medical students from Harbin Medical University.Using the internal consistency reliability test,the reliability of the revised student learning adaptability scale was verified.Five common factors were extracted by the exploratory factor analysis of the principal analysis method,and Logistic regression was used to analyze the influencing factors of medical student learning adaptability.Results The revised Student Learning Adaptability Scale (Cronbach's Alpha=0.914) consists of 27 measurement items.It includes five dimensions,namely self-directed learning,information utilization,environment choice,stresses response and goal orientation.The results showed that the adaptability of medical students was moderate (3.28 ± 0.52),and the influencing factors included job position (OR =1.496,95％ CI=1.114-2.009),academic achievement (OR =1.638,95 ％ CI=1.386-1.936),satisfaction with learning (OR=2.160,95％CI=1.745-2.673),professional satisfaction (OR=1.369,95％CI=1.092-1.718),professional interest (OR =1.426,95％ CI=1.186-1.715) and employment prospects (OR =1.526,95％ CI=1.251-1.862).Conclusion The reliability and validity of the Student Learning Adaptability Scale is appropriate.Medical students' learning adaptability is influenced by many factors.

Objective To describe the clinical features,diagnosis and treatment of osteomyelitis caused by Burkholderia pseudomallei.Methods Three cases of osteomyelitis caused by B.pseudomallei were treated in Haikou People's Hospital affiliated to Xiangya Medical College of Central South University from April 2007 to April 2017.The clinical data were reviewed and analyzed retrospectively.Relevant reports of osteomyelitis due to B.pseudomallei in China and abroad from 2007 to 2017 were comprehensively reviewed.Results The clinical manifestations included hot feeling,redness,swelling,and pain at site of infection.The infection usually occurred in tibia,femur,and skull bone.There were usually multiple lesions,frequently involving spleen,soft tissue and joints.The main imaging finding was osteomyelitis.The diagnosis was confirmed by bacterial culture in all patients.Antimicrobial therapy combined with surgical intervention was the most common approach in the stage of intensive treatment.Ceftazidime,trimethoprim-sulfamethoxazole and carbapenems were the mostly used antibiotics.However,in the stage of bacterial eradication,trimethoprim-sulfamethoxazole and doxycycline were used.The duration of treatment was very long in both stages.The recurrence was low after standard treatment.Conclusions The osteomyelitis caused by B.pseudomallei lacks specific clinical manifestation.Imaging techniques can identify the site of infection,and bacterial culture helps confirm the diagnosis.Timely and effective antimicrobial therapy combined with surgical intervention can reduce mortality.Full course and standard anti-infective therapy may prevent recurrence.

Objective: To construct the evaluation index of follow-up assessments on TCM (traditional Chinese medicine) health management of female. Methods: The evaluation indicators and score criteria were extracted for the efficacy evaluation of diseases and syndromes related to irregular menstruation in The criteria of diagnosis and therapeutic effect of diseases and syndromes in Traditional Chinese Medicine and Guidelines of clinical research of new drugs of Traditional Chinese Medicine; The health behaviors related to the onset of irregular menstruation diseases, such as diet, emotion, exercise, etc. were collected to build index of health behavior of irregular menstruation. Results: A comprehensive index system of follow-up assessments on TCM health management of female composed of disease curative effect, syndrome curative effect and health behavior score was constructed. Conclusion: The evaluation index system helps to dynamically track the effectiveness of interventions and management, and helps users to adjust the intervention plan and avoid the unhealthy behaviors.

Objective:To study the genetic characteristics and genetic evolution of echovirus 30 (ECHO30) isolates in Yunnan Province, China.Methods:Virus isolation was performed on nucleic acid-positive samples for hand, foot, and mouth disease pathogen surveillance in Yunnan Province, and VP1 gene sequencing was performed. The sequences of eight ECHO30 isolates from Yunnan Province and the gene sequences of the VP1 region of the ECHO30 reference strain downloaded from GenBank were compared and analyzed using MEGA 5.0 software, and then a phylogenetic tree was constructed to measure the homology of nucleotides and amino acids between the isolates.Results:The ECHO30 virus was distributed in Wenshan, Qujing, Chuxiong, and Kunming in Yunnan Province. The ECHO30 virus was relatively common in Wenshan. ECHO30 isolates belonged to the H2 subtype of the H genotype, which was close to the local reference strain LC120939 in Yunnan Province. On the VP1 gene at site 5, the amino acid change ratio was more active, the amino acids were diverse, and mutations also occurred at sites 54, 156, 258, and so on. Nucleotide and amino acid homology were 84.0% - 100.0% and 98.4% - 100.0%, respectively.Conclusions:ECHO30 isolates from Yunnan Province have certain geographical characteristics and belong to H2 of the H genotype. The nucleotide differences in virus sequences among subtypes are small and have a close genetic relationship.

Objective: Investigate the pulmonary surfactant autotransfusion effect on the recovery of respiratory function in patients with whole lung lavage, to provide theoretical basis for the clinical application. Methods: We taken 30 patients of pneumoconiosis treated by whole lung lavage as the subjects. We extracted the pulmonary surfactant from lavage fluid, after single postoperative lung lavage for the first time; after one weeks when the second times of lung lavage were performed to the other side of the lung of patients, we put PS into the right side. We taken the patients the second times of lung lavage who were put PS into the right side as returning group, the first times of lung lavage who were not put PS into as on returning group. We observed indi-cators, such as expiratory resistance, respiratory work, lung compliance, airway pressure, PO₂, the pulmonary function recovery time and other indicators, comparing with the changes of pulmonary function before lung la-vage for the first time and at 0、60、90、120 min after the pulmonary surfactant autotransfusion. Results: Com-pared with the no returning group, the expiratory resistance of the returning group decreased significantly at 90 min、120 min after the pulmonary surfactant autotransfusion; the respiratory work and airway pressure of the re-turning group decreased significantly at 60、90、120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups (P<0.05, P<0.01). Compared with the no returning group, the lung compliance and the PO₂ of the returning group increased significantly at 60 min、90 min、120 min after the pulmonary surfactant autotransfusion, there was statistically significant in the difference between different groups (P<0.05, P<0.01). The lung function recovery time of returning group was (155.7 ± 35.2) min, the lung function recovery time of no returning group was (183.71±41.81) min, there was statistical-ly significant in the difference between different groups (P<0.05). Compared with the no returning, there were not statistically significant in the difference of the Heart rate、the systolic blood pressure and the diastolic blood pressure about the returning at 60、90、120 min after the pulmonary surfactant autotransfusion.There was no ad-verse reactions such as pulmonary infection, pulmonary infection and so on. Conclusion The pulmonary surfac-tant autotransfusion may reduce expiratory resistance, work of breathing, airway pressure; improve lung compliance, alveolar ventilation function; increase oxygen partial pressure and decrease the surgery recovery time in patients with pneumoconiosis.