Objective To stady the diagnosis and management of traumatic chylous ascites.Methods Retrospective analysis was conducted on the clinical dada of 11 cases of traumatic chylous ascites resulting from various causes.ResultsThere were 5 cases of open abdominal injury,2 cases of closed abdominal injury and 4 cases of operative injury.Nine cases were treated with operation.According to the location and extent of injury,patients were respectively managed by operation of direct repair or ligation.Two cases had non-surgical treatment.All of the11 patients were cured and had satisfactory result at 0.5~3 years of follow-up.ConclusionsFor traumatic chylous ascites,if the injurg occurrence on cisterna chili,the best treatmeat is primary repair;if injury occarrence on the small intestinal trunks or lumbar trunk,which can be treated with ligation;while blunt injury and cases found after operation are mainly treated conservatively.

Objective To study the value of laparoscopy in the diagnosis and treatment of infertility caused by fallopian tube factors. Methods 210 cases of infertility women caused by fallopian tube factors were studied in terms of adhesiolysis,fallopian tube plasty,fenestration,and patency test were performed.The pregnancy rate was followed up for one year. Results The false negative rate in the diagnosis of fallopian tube patency was 5.43% by hysterosalpingography.It was found that there were 3 cases of genital tract tubercle,80 cases of fallopian tube inflammation,73 cases of inflammation of fallopian tube and overy and 54 cases of hydrosalpingix.Of the later 3 kinds,pelvic inflammation was found to be responsible for 120 cases(57.1%),pelvic endometriosis for 87 cases(41.4%).The pregnancy rate after one year was 50.9%(78/153)for inflammation of fallopian tube and ovary,5.6%(3/54)for hydrosalpingix,respectively. Conclusions Laparoscopy helps to clarify infertility caused by fallopian tube factors,and to improvel the effect of treatment and pregnancy rate.

Objective To analyse the therapeutic effect of methylprednisolone combined with anterior decompression and internal fixation in the treatment of cervical spine hyperextension injury. Methods 42 patients who were diagnosed with cervical hyperextension injury in orthopaedics department of the First Hospital of Jiaxing were collected.All patients were randomly divided into experimental group and control group, 21 cases in each group.Patients in control group received anterior cervical decompression and internal fixation only , patients in experimental group received methylprednisolone combined with anterior decompression and internal fixation, after treatment, the serum levels of TNF-α, SOD and American Spinal Injury Association (ASIA) score were detected in all patients.Results After treatment, compared with control group, the serum levels of TNF-αwas lower, SOD was higher and ASIA score was higher in experimental group, and the differences were statistically significant (P<0.05).Conclusion The methylprednisolone combined with anterior decompression and internal fixation could significantly reduce the serum level of TNF-α, and increase the serum level of SOD and ASIA score in patients with cervical spine hyperextension injury, could reduce the inflammatory damage, improve the antioxidant capacity, which has a good clinical effect.

A number of studies on hospital information system (HIS) and regional information platform have been carried out in different medical institutions since HIS was defined as one ofThe 4 Beams and 8 Pillarsin 2009 , during which good results were achieved and many problems were exposed .The application of electronic medical record (EMR), a key part of HIS, is grealy concerned.The application of electronic medical record system ( EMRS) and related problems were thus described in this paper in order to provide reference for bringing it into a better play, normalizing its management, and reducing its disadvantages.

Objective To investigate the effects of different doses of ulinastatin on platelet counts and function after normothermic cardiopulmonary bypass (CPB) in rabbits. Methods Fifty lung-ear white rabbits aged 5-6 months weighing 2.3-3.0 kg were randomly assigned to one of 5 groups (n = 10 each) : control group (group C) and4 ulinastatin groups (group U~1, U_2,U_3,U_4). The rabbits received ulinastatin 1×10~4, 3×10~4, 5×10~4 and 10×10~4 U/kg before CPB in group U~1, U_2, U_3 and U_4 respectively while equal volume of normal saline was given instead of ulinastatin in group C. All rabbits underwent CPB for 30 min at perfusion flow of 72-120 ml·kg~(-1) ·min~(-1). The rectal temperature was maintained at 36.5-37.5℃. Hemodynamic parameters were recorded and blood platelet count, platelet adhesion rate and platelet membrane glycopretein Gp Ⅰ b, Gp Ⅱ b, Gp Ⅲ a receptors were determined before CPB (baseline), at termination of CPB and at 1, 2 and 3 h after CPB. Results The platelet counts were significantly decreased after CPB in all 5 groups (P< 0.05), but there was no significant difference among the 5 groups. The platelet adhesion rates were significantly decreased after CPB as compared with the baseline value before CPB in all 5 groups but the platelet adhesion rates were significantly higher after CPB in group U_4 than in group C. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors was significantly decreased after CPB in all 5 groups. The number of molecules of Gp Ⅰ b, Gp Ⅱ b and Gp Ⅲ a receptors after CPB was significantly higher in group U_2, U_3 and U_4 than in group C, and there was no significant difference between group U_3 and U_4 . ConclusionUlinastatin 3×10~4-5×10~4 U/kg administered before CPB can inhibit breakdown of platelet membrane glycoprotein receptors. Ulinastatin 10×10~4 U/kg can preserve the platelet adhesion function.

Objective To investigate the expression of autophagy and the effect of complement C5a/C5aR pathway on autophagy induced by renal ischemia reperfusion injury (IRI).Methods MaleWT and C5aR gene knockout (BALB/C background) mice were selected.The model of renal IRI was established by occluding bilateral renal pedicles with microaneurysm clamps.Mice were divided into wild type BALB/C (WT) group and C5aR gene knock out (C5aRKO) group.The pathology of kidney was assessed by HE staining.The levels of BUN and KIM-1 were detected 24 h after reperfusion.The expression of the autophagy-associated protein (LC3 Ⅱ/LC3 Ⅰ and P62) was measured by Western blotting and immunofluorescence.In vitro,human renal tubular epithelial cells (HK2) were cultured.The expression of LC3 in HK2 cells was investigated by immunofluorescence and Western blotting after being treated with recombinant C5a or C5a combined with C5aR antagonist (C5aRA).Results As compared with WT group,the severity of kidney injury was obviously reduced in C5aRKO group (P＜0.05).After ischemia-reperfusion,the expression of autophagy-related protein LC3 gradually increased with the reperfusion time prolonged.The level of autophagy induced by ischemia-reperfusion was significantly reduced in C5aRKO group as compared with WT group (P＜0.05).In addition,the expression of autophagy-related protein LC3 Ⅱ in HK2 cells was increased with the augment of C5a stimulation concentration in vitro.Blockage of C5aR pathway by C5aRA led to a significant decrease in autophagy (P ＜ 0.05).Conclusion Complement C5a/C5aR pathway promotes renal IRI-induced autophagy.

Objective To understand the influencing factors of professional adaptability for college nursing students and the mechanism. Methods A group of 1 105 college students from grades 2010 and 2011 were surveyed with questionnaire for professional adaptability. The data were analyzed with SPSS 16.0. Measurement data were expressed as x±s while enumeration data were expressed as percentage. t test and variance analysis were used to compare the differces among groups of different grades and genders. Results The professional adaptability mean score of college nursing students was (102.66 ± 14.93) and significant differences in professional adaptability were observed between different grades and genders (P=0.004 3, P=0.001 5). The possible influencing factors professional adaptability were different sources of students, family location, family income, etc. There were statis-tic differences in professional promise between arts and science students and between rural an urban students (P=0.029 8, P=0.007 0). Conclusion Grade and genders are the main influencing factors for professional adaptability of college nursing students while other factors exert little effect on it.

Objective To investigate the impact of high plasma LDL-C level with or without metabolic syndrome(MS) on the incidence of stroke in Chinese adults. Methods Totally 42 626 subjects (25 -75 years old) from Chinese National Health and Nutrition Survey in 2002 were stratified four groups based on plasma LDL-C level: < 2. 00 mmol/L group, 2. 00 -2. 50 mmol/L group, 2. 51 -3.31 mmol/L group, and ≥ 3.32 mmol/L group. The prevalence of MS (with 2005 International Diabetes Federation criteria) and stroke and the risk factors of stroke were compared among the four groups. Results ( 1 ) The prevalence of MS and stroke increased with rising of LDL-C level. The prevalence of MS in LDL-C≥3. 32 mmol/L group increased 2. 5 times (7, 9% vs 20. 1% ) as compared with that in LDL-C < 2. 00 mmol/L group and the prevalence of stroke increased 4. 2 times(0. 5% vs 2. 1% ), all P <0. 01. (2) In subjects with similar LDL-C level, the prevalence of stroke was significantly higher in a subgroup with MS than that without (P <0. 01 ). (3) After adjustment for age, sex and smoking, logistic regression analysis showed that both LDL-C level and MS were positively associated with the development of stroke; the odds ratio (OR) was 2. 35 and 3. 15 ( P < 0. 0001 ), respectively. (4) Compared with the subgroup of LDL-C < 2. 00 mmol/L without MS, OR for stroke in the subgroups of LDL-C 2. 00 -2. 50 mmol/L, 2. 51 -3. 31 mmol/L, and ≥ 3. 32 mmol / L without MS was 1.03, 1. 89, and 2.08, whereas the OR for stroke in the subgroups with MS and similar level of LDL-C was 4. 38, 5.23 and 6. 15 ; this indicated that the risk of stroke in subjects with MS increased by 3 - 4 times compared with subjects without ( P < 0. 0001 ). Conclusion Both high LDL-C level and MS are independent risk factors of stroke, but the risk of stroke will be further increased in the presence of high LDL-C level plus MS. It is suggested that combined intervention therapy of LDL-C and MS will play an important role in the prevention of stroke.

Objective To Research the efficacy and side effects of intra-abdominal chemotherapy immune to the abdominal cavity after colorectal cancer liver metastasis and local recurrence.Methods 172 eases of colorectal cancer patients after radical operation were randomly divided into conventional regulation 86 cases of abdominal chemotherapy group(control group) and the immune abdominal chemotherapy group of 86 cases(observation group).The control group received 5-FU1.0,MMC8mg intraperitoneal chemotherapy The observation group at the grass-rcots level to add IL-2 50 million U.Results Observation group effective rate .was 70.9% higher than 55.8% (P ＜0.05) ;the obsenation gionp the three-year survival rate 83.7%,dlsease-free survival rate was 44.2% higher than the 62.8%,22.1% (P＜0.05) ;observation group three-year recurrence rate of 25.6% and 34.9% lower than the rate of liver metastases in the control group of 37.8%,48.9% (P＜0.05) ;two groups of gastrointestinal reaction,ⅠⅡ or degree of bone marrow suppression,liver function mildly abnormal ( elevated alanine amiuotransferase) had no difference.Conclusion For advanced colorectal cancer patients with early immune abdominal chemotherapy,the effective prevention and treatment of abdominal cavity and liver metastasis planting to improve the survival rate,side effects of light,fewer complications,the extension of survival,worthy of clinical application.

BACKGROUND: The urinary fistula rates following kidney transplantation are varying in each center, which lack of unified classification criteria and treatment standard. OBJECTIVE: To explore optimal treatments for urinary fistula following kidney transplantation by retrospective analyzing the characteristics, etiological factors and therapeutic efficacy of urinary fistula. METHODS: Totally 68 patients with urinary fistula were collected, including 42 males and 26 females, aged 21-57 years. The urinary fistula occurred at days 1-17 after operation. According to the location of urinary fistula, patients were divided into stomas fistula and ureter fistula groups. The location of fistula was determined by cystography, magnetic resonance hydrography (MRH) or operation research. In both groups, conservative treatment was first adopted, namely, placing a negative pressure drainage tube draining the wounds and placing a double-J catheter or a urinary canal in, however, if invalid, a surgical repair was performed. There were 45 patients underwent surgery. The location, onset period, therapeutic efficacies of urinary fistula was analyzed. RESULTS AND CONCLUSION: Among the 68 cases of fistula, 20(29.4%) were stomas fistula and 48 (70.6%) were ureter fistula. The onset period was (5.1±2.5) and (8.8±5.5) days after transplantation, respectively (P < 0.05). Fifteen of 20 stomas fistula (75.0%) were cured successfully by conservative treatment. Whereas, for the remaining 5 cases (25.0%), we attempted open surgery, among which 4 were cured, free of recurrence, and 1 case underwent nephrectomy because of acute rejection. For the 48 cases of ureter fisula, only 8 (16.7%) were cured by conservative treatment, but the other 40 (83.3%) must accept further open surgery, among which 35 were cured (including 6 cases of recurrent fistula). Three cases underwent nephrectomy failure of repair owing to acute rejection, besides 2 died of pulmonary infection. The achievement ratio of conservative treatment in lower fistulae was significantly higher than that of upper fistulae (P < 0.01). It is necessary to determine the location of urinary fistula following kidney transplantation. Compared to ureter fistula, stomas fistula occurred earlier with great leaked volume. Conservative treatment can first selected for stomas fistula, only if it is invalid can we resort to open surgery. However, for. ureter fistula, it is wise to adopt open surgery as soon as possible.