Objective To explore the clinical efficacy of laparoscopic resection for large volume of adrenal tumor.Methods Eighty patients with adrenal tumor who were treatment by laparoscopic resection were divided into large volume group (diameter ≥ 6 cm) and small volume group (diameter ＜ 6 cm) according to the size of the tumor.The intraoperative and postoperative complications of the two groups were compared.Results The operation time,intraoperative bleeding volume and postoperative hospitalization time of large volume group were significantly higher than those in small volume group:(187.4 ±39.2) min vs.(153.7 ± 31.6) min,(458.2 ± 87.3) ml vs.(105.9 ± 25.1) ml and (10.9 ± 2.7) d vs.(7.3 ± 1.5) d,and the difference were statistically significant (P ＜ 0.05).The postoperative complications in two groups had no significant difference:10.3％ (4/39) vs.7.3％ (3/41),P ＞ 0.05.Conclusion The laparoscopic resection for large volume of adrenal tumor have the advantages of less invasion,faster recovery and less complications,and it has become the main mode of treatment.

Objective To investigate the clinical significance of the expression of lymphocytes and cytokines in patients with laryngeal tuberculosis.Methods 96 cases of laryngeal tuberculosis were selected as the research objects.Of which 42 cases of infiltrating type,31 cases of ulcer type,mass type in 23 cases,the other 50 cases of healthy persons were selected as the healthy control group,all the research objects,extracting the morning fasting venous peripheral blood for detection of T lymphocyte subsets and cytokines were detected,and the results were compared.Results Invasive laryngeal tuberculosis CD3+ index (63.10 ± 5.33) ％ (t =1.922),CD4+ (40.32 ± 5.06) ％ (t =1.758),CD8+ (24.41 ± 4.59) ％ (t =1.710),compared with the control group,CD4+,CD3+ index significantly reduced,CD8+ index increased significantly,the differences had statistical significance (t =1.922,1.758,1.710,all P ＜ 0.05),and the ulcer type and mass type results compared with invasive had significant difference(all P ＜0.05).In the analysis of laryngeal tuberculosis pathological types,reduced the mass type CD3+,CD4+ T index and CD8+ index of lymphocyte increased obviously the most significant;all laryngeal tuberculosis in patients with IL-4,IL-10 and TNF-alpha significantly increased compared with the control group,while the IFN-gamma was significantly reduced,and the mass in the type of change was the most significant,the differences had statistical significance(all P ＜ 0.05).Conclusion The use of lymphocytes and cytokines detection can improve the laryngeal tuberculosis patients with the clinical diagnosis rate,with the detection results of different degree and different pathological types of laryngeal tuberculosis patients,can be used for preliminary assessment of laryngeal tuberculosis disease and pathological type,the choice of treatment modality for patients with guidance value,with in-depth clinical study and promotion application of value.

22 cases of chronic gastritis,8 cases of gastric cancer,and 3 cases of other gastric diseases.10 hea'thy adults were also studied to serve as the control.According to the diagnostic criteria of Chinese traditional medicine ,58 cases with epigastric pains out of the 80 were categorized into the group of spleno-gastric asthenia (SGA) of 35 cases and the group of hepatogastric incoordinatin (HGI) of 23 cases.The basal pressure and rhythmic contractions of the stomach in response to a definite volume loading were recorded.It was found that 60% of SGA cases and 56.8% of PU cases showed only a few low-amplitude or no contractions in response to all varieties of volume loading,which were significantly higher than that in HGI cases (26%) and the control (10%).In the interval between the contractions and relaxations of the proximal stomach the intra-gasrric pressure was significantly lower in SGA and PU cases than in HGI cases and the control.These findings indicate that the tension and contractility of the mesculature of the proximal stomach are markedly reduced in patients with PU and SGA.

0.05). Conclusion Keloid mainly contains collagens of types Ⅰand Ⅲ, which is different in arrangement and content of collagens from that in scar. Compared with immunohistochemical technique, sirus red staining and polarization microscopy is a ideal method in analysis of the collagen formation and its content in human keloid.

Objective:To evaluate efficacy of tympanic membrane PE tube placement combined with oral endoscopic adenoidectomy in treating otitis media with effusion(OME) in children. Methods:Selected 87 cases(102ears)patients of secretory otitis media as research subjects between January 2012 to August 2014, in department of Otolaryngology in Heilongjiang Province, randomly divided into observation group(45cases, 55ears) and control group(42cases, 47ears),observation group used tympanostomy tube siphon drainage method combined with adenoidectomy for treatment, control group alone tympanostomy tube siphon drainage therapy, postoperative complications recorded data of patients later from the hospital after six and twelve months. Results:Two groups of patients after six months treatment and after twelve months(x2=5.705, x2=7.460;P<0.05), the results were statistically significant(P<0.05);in the middle ear effusion time, recurrent ear number, the number of ear infections, the results were also statistically significant(t=7.662, x2=4.197, x2=4.752;P<0.05). Conclusion:Under the ear drum using endoscopic drainage siphon tube method combined with adenoidectomy can effectively reduce postoperative complications in patients with quick, injury, etc, with high short-term and long-term efficacy, worthy application.

Objective To explore the effects of PBL teaching method on classroom atmosphere of basic nursing course.Methods Two classes of nursing sophomore were enrolled and were divided two groups,60 as PBL group and other 60 as traditional group.Students in two groups were evaluated by questionnaire of classroom atmosphere.Data were statistically analyzed through t-test,P＜0.05 standing for statistical significances.Results There were statistical differences in classroom atmosphere between two groups (P ＜ 0.05) ; class democracy,elicitation in teaching and student cooperation in PBL group were significantly better than those of traditional mode (P ＜ 0.05).There was no significant difference in learning autonomy between the two groups (P ＞0.05).Conclusions PBL teaching is conductive to stimulating students' learning potentials,culturing their cooperative learning,raising the efficiency of classroom learning and improving the classroom atmosphere.But learning autonomy of students needs to be further improved.

Objective To study the significance of Helicobacter pylori (Hp) infection and the expression of caudal-related homeobox transcription factor 2 (CDX2),mucin 2 (MUC2) proteins in gastric cancer,and elucidate the prognostic significance of CDX2,MUC2 proteins in gastric cancer.Methods Ninety cases of gastric cancer were available for the study.Hp was studied by Warthin-Starry bacterium stain and CDX2 and MUC2 proteins were studied by immunohistochemical stain.Results There was no Hp infection and no expression of CDX2 and MUC2 proteins in normal gastric mucosa.The positive rate in the cases of intestinal-type gastric cancer was 67.86%(38/56) for Hp,75.00% (42/56) for CDX2,and 66.07%(37/56) for MUC2,respectively,and it was higher than that in the cases of diffuse-type gastric cancer,which was 35.29%(12/34),41.18%(14/34) and 38.24%(13/34) respectively (P<0.01 or < 0.05).In intestinaltype gastric cancer,the positive rate of CDX2 and MUC2 proteins was also higher in Hp positive cases than that in Hp negative cases,and it was the same as CDX2 protein in diffuse-type gastric cancer.Higher positive rates of CDX2 and MUC2 proteins were observed in the cases of early gastric cancer than those in the cases of advanced gastric cancer (P < 0.01 or < 0.05),also it was observed in the cases of no lymph node metastasis than in the cases of lymph node metastasis (P < 0.01 or < 0.05).Moreover,the positive rate of CDX2 protein in the cases of stage Ⅰ～Ⅱwas higher than that in the cases of stage Ⅲ～Ⅳ (P < 0.05).Conclusions Hp infection and the expression of CDX2 and MUC2 proteins are related with gastric cancer,and has close relationship with intestinal-type gastric cancer.The expressions of CDX2 and MUC2 proteins may inhibit the infiltration and metastasis of gastric cancer.

Based on collecting, arranging, analyzing the literature, the most widely used assessment tools in caring behavior, caring ability and nursing caring characters were introduced. The problems were found out from its application at home and abroad. The aim was to provide the reference that developing and revising the assessment tools of nurses′humanistic that fit for the Chinese local culture.

Objective To study the protein binding rate of brucine in plasma of rats.Methods The plasma balance dialysis was used.HPLC was performed for the quantitative determination of brucine,and then the protein binding rate of brucine in rats plasma was calculated.Results The protein binding rate was 59.679 %,59.935 %,and 56.387 %when the concentration of plasma brucine was 2.5,1,and 0.4 ?g?mL-1 respectivley.Conclusion The HPLC method used to determine brucine is simple,rapid,and sensitive,and with good specificity,precision and accuracy.Brucine has medium capacity in binding to plasma protein.