Objeetive To investigate the clinical effects and nursing interventions of endoscopic sphincterotomy(EST)for treating elderly patients with choledocholithiasis.Methods The clinical data of 73 cases of patients operated by EST were retrospectively analyzed.Before surgery the psychological nursing,examination and preparation were meticulously performed,the changes of vital signs and nursing were closely observed during surgery,the respiratory tract nursing,cardiovascular disease and diabetes nursing,pain nursing and complications treatment were performed after surgery.Results There were 69cases of 73 patients were successful,the success rate was 94.5%;8 cases of concurrent hyperamylasemia were given conservative treatment and had clinical recovery;2 cases of fever occurred and white blood cell count elevated and were treated by effective antibiotic treatment;there was no perforation,wound bleeding and death.Conclusions Using the EST to treat the choledocholithiasis of elderly patients has good clinical effects and low risk;through careful observation and nursing,can reduce complications,promote the patients'early recovery and improve quality of life of elderly patients with choledocholithiasis.

Adenocarcinoma, Papillary ; complications ; Adult ; Ear Neoplasms ; complications ; Endolymphatic Sac ; pathology ; Facial Paralysis ; etiology ; Humans ; Male

OBJECTIVE: To study the effects of total saponin of Rhizoma Dioscreae Nipponicae (TSRDN) on the expression of vascular endothelial growth factor (VEGF), angiopoietin-2 (Ang-2) and receptor Tie-2 in synovial tissue of collagen-induced arthritis (CIA) rats, and to investigate the antiangiogenesis mechanism of TSRDN in treating rheumatoid arthritis. METHODS: After the CIA rat model was successfully established, the rats were randomly divided into 5 groups: normal control group, CIA model group, TSRDN group, tripterygium group, and diosgenin group. Real-time PCR was used to detect VEGF mRNA expression in synovial tissue of CIA rats, and immunohistochemical staining was used to observe angiopoietin-2 and receptor Tie-2. RESULTS: VEGF mRNA, Ang-2 and Tie-2 expressions in synovial tissue of CIA rats were obviously higher than normal control group (P < 0.01). After treatment with TSRDN, tripterygium, and diosgenin, the expressions of VEGF mRNA and Ang-2 were obviously lower than those in CIA model group (P < 0.01). But Tie-2 expression showed decreasing trend, and there was no obvious differences between each treatment group. VEGF mRNA expression in TSRDN group was much lower than that in tripterygium group and diosgenin group. CONCLUSION: TSRDN can inhibit angiogenesis in synovial tissue by down regulating expressions of VEGF, Ang-2 and receptor Tie-2.

Objective To evaluate the relationship between the cervical length,the test of fetal fibronectin and premature birth in pregnant woman.Methods Fetal fibronectin in sample of cervical secretion was tested using the reagent box of FFN manufactured by the ADEIA company of the United States and enzyme-labeled immunosorbent assay(ELISA) methods in 110 pregnant women.They were divided into two groups:first group,there were 60 cases who had symptom of aura prematurity and cervical lengths ≤30 mm monitored by trans-perineum ultrasound.second group was 50 normal pregnant women.Results The postive rate of fetal fibronectin was higher significantly in first group than that in second group.Conclusion The measurement of cervical lengths by the trans-perineum ultrasound and the test of Fetal fibronectin in pregnant women who has symptom of aura prematurity are of certain clinical value in predicting preterm birth.

Objective　 To probe into the operative methods, effects and reasons of failure for retinal detachment with choroid detachment.Methods　Thirty-one cases (31 eyes) with choroid detachment and proliferative vitreous retinopathy (PVR) were given vitreoretinal surgery, stripping of pre-membrane and injection of inert gas or silicone oil into vitreous body. Results　The retina was totally reattached in 22 cases (22 eyes), partly reattached in 5 cases (5 eyes),unattached in 4 cases (4 eyes),which was accounted for 70.9%,16.1% and 12.9% in 31 cases (31 eyes) respectively. Visual acuity improved in 25 eyes and no change in 5 eyes and decreased in 1 eye. The main cause of operation failure was possibly related to the severe anterior PVR. Conclusion　Vitreoretinal surgery can improve the successful rate of retinal detachment with choroid detachment.

Objective To observe the climical significance of controlling plasma glycemia in pregnant women with gestational diabetes mellitus( GDM ) for improving the pregnant result and reducing the complications of maternal and fetus.Methods 120 pregnant women with GDM were dioided into two groups according to the information of plasma glycemia control,including 86 cases with well-controlled plasma glycemia ( A group) and 34 cases with poorcontrolled plasma glycemia( B group).50 cases normal pregnancy were selected as control group.The differences in complications of maternal and fetus were observed.Results Only the morbidity of PIH of A group was higher than that in normal pregnant women( x2 =5.920,P ＜ 0.05 ),while the morbidity of PIH,polyhydramnios,fetal macrosomia,premature labor,and newborn asphyxia in B group were higher than those in A group( all P ＜ 0.05 ).Conclusion Paying more attention on screening GDM in pregnant women,early diagnosis and control of blood glucose was essential for reducing the incidence of maternal and fetal complications.

Objective To study the effects of Rhodiola herb on behavior and the expression of Bcl-2 and Bax protein in hippocamps of vascular dementia rat induced by chonic cerebral ischemia.And the protective effect of Rhodiola herb was studied.Methods VD model was formed by adopting the permanent occlusion of bilateral carotid arteries in Wistar rats to produce the forebrain ischemia.Cognitive ability of rats were studied with the Morris water maze.The expression of Bcl-2 and Bax protein in the hippocampus were determined with immunohistochemical staining.Results VD model may decrease cognitive ability(P

Objective To study the intervention effect and mechanism of integripetal rhodiola herb (IRH) on Alzheimer’s disease model rats. Methods Alzheimer’s disease model was made by injecting D-galactose (10 mg/mL) in abdominal cavity and taking AlCl3 (20 mg/mL) by intragastric administration, and injecting scopolamine. Morris water maze testing system was undertaken to observe the change of learning and memory ability in rats, biochemical indicator tested was to contrast the state of oxidative stress, common HE staining and immunohistchemistry staining were to observe the morphology change of the hippcampus and cortex cell. The model rats were administrated IRH by means of intragastric administration contrasting with hydergine to compare the effect. Results The memory ability of model group was obviously decreased, cellula nervosa were damaged badly. A? and senile plaques appeared on hippcampus and cortex. All of the test indexes in Morris water maze showed that the abilities of space search, learning and memory in different groups remarkably improved compared with that of the model group (P