Objective Abdominal pain, shoulder pain, and incision pain after laparoscopic cholecystectomy ( LC) are com-mon complaints of the patients.This study was to observe the effects of pulmonary recruitment ( PR) in reducing post-LC abdominal pain, shoulder pain, and incision pain. Methods A total of 138 patients treated by LC were randomly assigned to a PR ( n=67) and a control group (n=71).The former underwent postoperatively five 5-second-long manual inflations of the lungs by positive pres-sure ventilation with 40 cmH2 O to discharge CO2 from the abdominal cavity, while the latter received traditional passive deflation of CO2 .At 6, 12, 24, and 48 h after surgery, we recorded the incidences of abdominal pain, shoulder pain, and incision pain and as-sessed the pain intensity using the visual analogue scale ( VAS) . Results Compared with the control group at 12 and 24 h after sur-gery, the PR group showed significant decreases in the incidence rate of upper abdominal pain (90.14%vs 74.63%and 91.55%vs 73.13%, both P<0.05), with VAS scores of 4.32 ±2.73 vs 2.72 ±1.67 and 4.04 ±2.55 vs 2.67 ±1.49 (both P<0.05), as well as in that of shoulder pain (56.34% vs 47.76% and 74.65% vs 56.72%, both P<0.05), with VAS scores of 3.68 ±3.10 vs2.61 ±1.97 and 4.15 ±3.23 vs 2.78 ±1.88, both P <0.05). However, no significant differences were observed in the incidence or severity of incision pain between two groups at any time points after surgery (P>0.05). Conclusion Pulmonary recruitment can re-duce the incidence rates and severity of upper abdominal pain and shoulder pain, but has no effect in alleviating incision pain following laparoscopic cholecystectomy.

Research of cell cycle is the bas is of investigating the organism growth,development,heredity and other medical associated events. The molecular basis of cell cycle control is the regulator control system with CDK-Cyclin-CKI as the core.Protein kinase CK2 is one of the most conservative protein kinase during evolution and more and more researches have proved that protein kinase CK2 plays an important role in cell cycle control.

Objective To observe the therapeutic efficacy of low-frequency electrical stimulation (LFES) plus acupuncture in treating deglutition disorders after cerebral stroke. Method Seventy-six patients were randomized into two groups. The treatment group (38 cases) was intervened by LFES plus acupuncture;the control group (38 cases) was by LFES. Result The water drinking test scores were significantly changed after the treatment in both groups (P<0.05); after the intervention, there were significant differences in comparing the water drinking test score, improvement score, and therapeutic efficacy grading between the two groups (P<0.05). Conclusion LFES and acupuncture are both effective in treating deglutition disorders after cerebral stroke, and the combination of the two methods can enhance the clinical efficacy.

Objective To summarize the experience of 11 orthotopic allogeneic heart transplantations for patients suffering from terminal heart disease, and to discuss how to improve the selection of donor and recipient, protection for the donated heart, postoperative treatment and immune surveillance suitable for our country. Methods 1.All the donated hearts were protected by perfusing cold modified St.Thomas cardioplegia and cold oxygenated blood. 2. Orthotopic heart transplantation was performed with the standard technique of medium low temperature extracorporeal circulation. 3. FK506, mycophenolate mofetil(MMF) and steroid were given to prevent rejection. 4. Troponin I, ? 1 and ? 2 microglobulin, C reactive protein (CRP), interleukins, lymphocyte subgroups and mixed lymphocyte reaction (MLR) were employed to monitor the immune rejection reactions. Furthermore, myocardial biopsy and coronary arteriography were conducted periodically. Results Three patients died of systemic failure and infection due to hepatic failure and mental disorder after operation. All the others survived with no complications. Conclusion Strictness in selection of the recipient, high quality of donor heart, correct early postoperative treatment and sound use of immunosurppressant are key to achieving successful cardiac transplantation.

Objective To observe the therapeutic effect of liver-soothing and spleen-strengthening herbal medicine for metabolic syndrome(MS).Methods Ninety-three MS patients were randomized into group A(N=51)and group B(N=42).The two groups received the basic treatment including dietary control and exercises.Group A received liver-soothing and spleen-strengthening herbal medicine(such as Radix Bupleuri,Rhizoma Atractylodis Macrocephalae,Radix Paeoniae Alba,Radix Angelicae Sinensis,Poria,Radix Rehmanniae,Radix Astragali,Rhizoma Alismatis,Semen Coicis,Cortex Moutan,Rhizoma Dioscoreae,Radix Glycyrrhizae,etc.)additionally.The treatment course lasted 3 months.After treatment,the therapeutic effect was evaluated,and the changes of blood pressure,body weight index(BWI),blood glucose(BG)and insulin levels,insulin sensitivity index(ISI),and the blood lipid levels were observed.Results After treatment,23 patients were cured,26 effective,2 ineffective,and the total effective rate was 96.08% in group A;in group B,12 were cured,21 effective,9 ineffective,and the total effective rate was 78.57%.The therapeutic effect in group A was better than that in group B(P0.05).Fasting BG,2-hour BG and BWI were decreased in the two groups(P0.05).Total cholesterol(TC)and triglyceride levels decreased,and high density lipoprotein cholesterol(HDLC)increased in the two groups(P0.05).Conclusion Liver-soothing and spleen-strengthening herbal medicine exerts an effect for metabolic syndrome,not only decreasing blood pressure,blood lipid levels and body weight,but also improving insulin resistance and increasing ISI.

Objective To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients.Methods The patients with mechanical ventilation (＞48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome.T-piece spontaneous breathing (SBT),airway occlusion pressure at 0.1 sec (P0.1) and maximal inspiratory pressure (MIP),rapid shallow breathing index (RSBI) and P0.1/MIP were measured or calculated.During the period of the 1 st hour SBT,the excursion of diaphragm was measured with ultrasonography.The predictive value of each parameter to weaning was evaluated with ROC curve.Results A total of 98 patients were enrolled in this study,including 74 successfully weaning and 24 failed.There were significant differences between two groups (success group and failure group) in P0.1 [(2.00 ± 2.00) cmH2O (1 cmH2O =0.098 kPa) vs (3.00 ±2.75)cmH2O,P ＜0.05],RSBI (39.14 ± 16.81 vs 52.00 ± 19.18,P ＜0.05),left diaphragmatic excursion [(1.12 ± 0.97) cm vs (0.69 ± 1.00) cm,P ＜ 0.001],right diaphragmatic excursion(1.87 ± 0.75) cm vs (1.17 ± 0.76) cm,P ＜ 0.001] and mean value of left and right diaphragmatic excursion [(1.57 ± 0.52) cm vs (0.83 ± 0.53) cm,and P ＜ 0.001].The ventilation time [2.00 (2.00-4.00) d vs 4.00 (2.00-5.00) d],ICU hospital lengths of stay [4.50 (3.00-7.25) d vs 8.50 (6.25-15.25) d] and total hospital lengths of stay [20.00 (15.00-25.25) d vs 25.00 (20.25-37.25)d] were also statistically significant in success group and failure group respectively (all P ＜ 0.05).The cutoff value of diaphragmatic excursion for predicting successful extubation was determined to be 1.14 cm by ROC curve analysis.The sensitivity of diaphragmatic excursion to predict successful weaning was 89.2％ and the specificity was 75.0％,the AUCROC was 0.849.Conclusion As an early predictor of diaphragmatic dysfunction,diaphragmatic excursion is probably superior to the traditional parameters in predicting weaning from ventilator in ICU patients.

Abstract: Objective To establish a method for detecting sdaB virulence gene of Streptococcus pyogenes with loop mediated isothermal amplification (LAMP). Methods According to the conserved sequence of Streptococcus pyogenes sdaB gene published in GenBank (GenBank: 69901515), LAMP primers were designed with Primer Explorer V5.0 software. Main components of LAMP reaction system were optimized including of fluorescent dye, MgSO4, betaine, deoxyribonucleosidetriphosphate (dNTP), and Bst DNA polymerase, with the concentration of MgSO4 from 0 mmol/L to 12 mmol/L, betaine from 0 mol/L to 2.4 mol/L, dNTP from 0.2 µmol/L to 2 µmol/L, forward inner primer (FIP) and backward inner primer (BIP) from 0.2 µmol/L to 2 µmol/L respetively, forward outer primer (F3) and backward outer primer (B3) from 0.2 µmol/L to 0.4 µmol/L, Bst DNA polymerase from 0.16 U/µL to 0.96 U/µL, fluorescent dye from 0.2 µmol/L to 2 µmol/L. With the optimized system, the methodological specificity and the minimum detection limit were evaluated on the ABI7500 real-time fluorescent quantitative PCR analyzer, and 13 standard strains including Group A Streptococcus, Group B Streptococcus, Group C Streptococcus, Group G Streptococcus, Streptococcus pneumoniae, Streptococcus viridis, Enterococcus faecalis, Enterococcus faecium, Neisseria gonorrhoeae, Lactobacillus acidophilus, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa were detected. Finally, 103 clinical samples were tested. Results The optimized reaction system contained 25 µL reaction mixture, including 0.8 µL of 25 µmol/L fluorescent dye, 1 µL of 100 mmol/L MgSO4, 6 µL of 5 mol/L betaine, 1.4 µL of 25 mmol/L dNTP, 2 µL of 20 µmol/L FIP and BIP, 0.5 µL of 20 µmol/L F3 and B3, 1 µL of 8 U/µL Bst DNA polymerase, and 2 µL of template. After adding deionized water, the mixture was incubated at 63°C for 45 min to complete the reaction. The limit of detection (LOD) was 500 pg/µL. All 12 non-S. pyogenes strains tested were negative. Compared with the culture method, the clinical sensitivity and specificity were 100.0% (16/16) and 96.6% (84/87), respectively, for 103 clinical samples. Conclusions This LAMP assay is reliable for the detection of Streptococcus pyogenes in clinic and is suitable for field detection with good specificity and sensitivity, as well as simply operation.

OBJECTIVE:To determine the contents of Pb,Cd,Hg,As and Cu in Panax notoginseng,Angelica sinensis,Ligus-ticum chuanxiong,Fallopia multiflora and Rheum palmatum commercially available in Tangshan. METHODS:Microwave diges-tion-inductively coupled plasma mass spectrometry(ICP-MS)and single factor index and Nemerow comprehensive index were used to evaluate the heavy metal pollution in TCM powder samples;and the heavy metal limiting values in Green Trade Standards of Im-porting & Exporting Medical Plants & Prescriptions were used to evaluate the pollution of heavy metal samples. RESULTS:In the samples in 12 batches of 5 TCM powders,there were 2 heavy metal exceeded samples (P. notoginseng-3 and L. chuanxiong-2), the exceeded rate was 16.7%,exceeded indexes were Cd and Hg with the exceeded rates of 16.7% and 8.3%,respectively;heavy metals with Single factor index greater than 1 were Hg and Cd in P. notoginseng-3,and Cd in L. chuanxiong-2 with the composite indexes of 1.06 and 0.81,and pollution levels were slightly polluted and reaching warning level,respectively. CONCLUSIONS:Certain heavy metal pollution is found in TCM powder commercially available in Tangshan. Therefore,it is necessary to carry out more strictly control over the heavy metal content in Chinese herbal medicines.

Objective To systematically evaluate the performance of the Sysmex CS2000i Automatic Blood Coagulation Analysis System .Methods According to the standards of the Clinical and Laboratory Standards Institute (CLSI) ,the precision ,accuracy ,lin‐earity ,biological reference interval and carry‐over rates of the Sysmex CS2000i Automatic Blood Coagulation Analysis System were detected ,meanwhile the detections of 5 clinical specimens were compared between this system and the Sysmex CA 1500 Automatic Blood Coagulation Analysis System .Results The intra‐assay precision coefficient of variation (CV) ,inter‐day precisions CV carry‐over rate ,accuracy and linearity of plasma prothrombin time ,activated partial thromboplastin time ,fibrinogen and D‐dimmer detec‐ted by the Sysmex CS2000i Automatic Blood Coagulation Analysis System were all consistent with the quality target requirements of our laboratory .Conclusion The Sysmex CS2000i Automatic Blood Coagulation Analysis System has better performance in vari‐ous aspects ,the detection results could be used for the clinical diagnosis and treatment of related diseases .

Objective To study the relationship among hepatitis B viral genome (HBV‐DNA) ,hepatitis Be antigen(HBeAg) and liver function in chronic hepatitis B patients ,and to provide the reference for clinical treatment .Methods The quantitative levels of HBV‐DNA ,HBeAg ,alanine aminotransferase (ALT) and aspartate aminotransferase(AST) in 401 patients were analyzed and the correlation analysis between HBV‐DNA and HBeAg was performed .The grouping was performed according to the HBV‐DNA and HBeAg quantitative levels and the differences of ALT and AST levels were compared among the groups .Results (1) The correla‐tion existed between HBV‐DNA and HBeAg positive rate ,r=0 .671(P<0 .01);(2)when HBV‐DNA load reaching 105 copies/mL , serum ALT and AST levels showed significantly increased compared with the HBV‐DNA negative group and low load group ,the difference was statistically significant (P<0 .05);(3)when HBV‐DNA load was equivalent ,the difference of ALT and AST activity had no statistically significant difference between the HBeAg‐positive and HBeAg‐negative groups .Conclusion (1)HBeAg has a correlation with HBV‐DNA ;(2)the patients with higher HBV‐DNA load are easy to develop the liver function abnormality ;(3)the HbeAg existence situation has no obvious relation with the liver function .