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.

OBJECTIVE:To evaluate the intervention effects of standardized pharmaceutical care on clinical treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients. METHODS:A total of 127 AECOPD patients were col-lected from respiratory medicine department of our hospital during Sept. 2014-Mar. 2015,and then divided into control group(63 cases)and observation group(64 cases)according to random number table. Control group only received traditional medical service and drug therapy. Observation group was additionally given standardized pharmaceutical care provided by clinical pharmacists ac-cording to AECOPD clinical pharmacy pathway on the basis of control group. The patients were followed up 1 month after dis-charge. The use of antibiotics during hospitalization,medication adherence,the occurrence of ADE,patient satisfaction and medica-tion bias during hospitalization and after discharge,the rates of ADR awareness and return visit after discharge were compared be-tween 2 groups. RESULTS:In both groups,1 patient withdrew from the study during hospitalitation;33 patients didn't complete return visit after discharge. During hospitalization,the rate of medication adherence and the total satisfaction of traditional medical procedures and medication guidance in observation group were significantly higher than control group;the utilization ratio of antibi-otics and combined use of antibiotics,AUD,the incidence of ADE,the proportion of medication bias were significantly lower than control group,with statistical significance(P<0.05). After discharge,the rate of ADR awareness and the total satisfaction of medi-cation guidance in observation group were significantly higher than control group,and the incidence of ADR was significantly low-er than control group,with statistical significance(P<0.05). There was no statistical significance in the rate of medication compli-ance,the rate of return visit,the proportion of medication bias between 2 groups after discharge(P>0.05). CONCLUSIONS:The standardized pharmaceutical care can significantly improve medication compliance and satisfaction of inpatients,contribute to ratio-nal use of antibiotics,reduce the incidence of ADE and medication bias,but have no significant effect on medication compliance, the rate of return visit and medication bias of discharged patients.

Objective To understand the natural lighting in houses in constructed in different times island city and the influential factors in Dinghai, Zhoushan. Methods 3 districts, 92 families living in the buildings with 4-6 floors were chosen in Dinghai, Zhoushan, the daylight factor and the ratio of the window and the floor were determined, the subjective evaluation such as good, common, worse, the worst was done among 323 person according to the Code of Housing Design,GB50096-1999, Daylight Code of Building Design, GB50033-2001, Design Code for Planning City Residential Areas, GB50180-1993. Results The daylight in all the investigated houses met the requirement in GB50180-1993. The ratio of the window and the floor in the living room, bedroom, kitchen was larger than 1/7, that of the dinning room was more than 1/10, which met the requirement in GB50096-1999, in addition, the ratio of the newly buildings was higher than that of the old. The total qualified rate of the lowest daylight factor was 58.2, the main bedroom ranked the best, the living room ranked the worst, significant different results were seen in the houses constructed in different times, in 1980s, 1990s and 2000, it was 43.3%, 54.7% and 76.7% respectively. 91.9 percent of people who living in the first floor think the natural lighting worse, even the worst. Conclusion All the natural lighting designs for the involved houses in the island city can meet the requirements in the national standard of China, some people still complained the bad natural lighting, especially those who living in the lower floors.

The data of 1 case diagnosed with hyperphenylalaninemia (HPA) combined with Cornelia de Lange syndrome (CdLS) by neonatal screening in Newborn Disease Screening Center, Liaocheng Maternal and Child Health Hospital in February 2018 were analyzed retrospectively.The patient was a girl, 22 months old, with clinical features of specific facial appearance, excessive body hair (especially on the forehead and face), dark and thick hair on the head, a low hairline, a heavy and straight brow, lower ear positions, a small nose, a shallow philtrum, a simian line, strong and rhythmic heart sounds, no murmur in the precordial area, clear respiratory sounds of both lungs, purple marbling patterns on the whole body skin, a soft abdomen, and high muscle tension of limbs.The gene mutation c. 1256A>G(p.Q419R) of the polyclonal antibody( PAH) originated from the patient′s mother, while the mutation c. 4421G>A(splicing) derived from the patient′s father. SMC1A gene was X-linked dominant inheritance, and c. 1979_1980insTGAA was a spontaneous mutation.In this paper, the diagnosis and treatment of HPA and clinical and genetic variation characteristics of 23 CdLS cases in China were reviewed, so as to improve the knowledge of doctors about HPA combined with CdLS.

BACKGROUND:At present, the most common materials for clinical hemostasis are absorbable tampons and Vaseline gauze. OBJECTIVE:To compare the packing effects of absorbable tampons and Vaseline gauze in functional endoscopic sinus surgery. METHODS:Totaly 100 sinusitis patients, 57 males and 43 females, aged 16-61 years, with a history of 5 months to 23 years, were randomized into two groups: patients in the observation group were treated with absorbable tampons and patients in the control group treated with Vaseline gauze during functional endoscopic sinus surgery. Patient's discomfort, bleeding when the filer was extracted at 48 hours, and nasal bleeding within postoperative 24 hours were compared between the two groups. RESULTS AND CONCLUSION: No adverse reaction related to absorbable tampons occurred in the observation group, indicating that the absorbable tampon has better histocompatibility. Patient's discomfort, bleeding when the filer was extracted at 48 hours after operation, and nasal bleeding within postoperative 24 hours were significantly improved in the observation group compared with the control group (P < 0.05). These findings suggest that the absorbable tampons has a better hemostatic function, which can effectively reduce postoperative nasal bleeding and relieve postoperative discomfort in patients with sinusitis.

Objective To investigate the role of Survivin gene in the pathogenesis of colorectal adenocarcinoma and its correlation with VEGF in tumor metastasis. Methods The expressions of Survivin mRNA and VEGF protein were detected by RT-PCR and immunohistochemical staining, respectively, in 42 colorectal adenocarcinoma samples. Results Survivin mRNA expression was positive in 23 cancer samples(54 8%), while no expression was detected in adjacent normal tissue. The expression of Survivin gene significantly correlated with histological differentiation and Dukes stage, but not with gender or lymph node metastasis. The expression of VEGF significantly correlated with lymph node metastasis. The expressions of Survivin and VEGF were coincident. The colorectal adenocarcinomas which expressed both the Survivin and VEGF were more inclined to occur lymph node metastasis. Conclusions Survivin gene expression significantly correlated with the clinico-pathologic characteristics and biologic behavior in colorectal adenocarcinoma. Detection of Survivin expression may be valuable for diagnosing colorectal adenocarcinoma, and evaluating malignancy extent and prognosis.

Aromataseinhibitors(AI)aretheleadingcarefortheadjuvanttreatmentofhormone responsive carcinoma of the breast as demonstrated in a number of large international phase III randomised tri-als.Aromatase inhibitor-associated arthralgia (AIA )was a somewhat unexpected side effect of this class of agents and has proven to be potentially problematic in clinical practice.The pathogenesis of AIA is not very clear currently,with the cause of most research focusing on estrogen deprivation,immune abnormalities,tenosy-novial changes and joint effusions.It is extremely urgent that we evaluate this syndrome and select appropriate therapeutic strategies to reduce the incidence of AIA,thereby improving breast cancer-related outcomes.

Objective To probe the lung lesion of rats inhaling cooking siritch oil fume(CSOF). Methods The male SD rats were randomly divided into exposure group and negative control group, 18 rats per group, then each group was randomly divided into 3 subgroups for dynamic observation, 6 rats per subgroup. The rats in exposure group were dynamicly inhaled with (44.44?18.68) mg/m3 CSOF and negative control group were dynamicly inhaled with fresh air at temperature of 20-22 ℃. The activities of superoxide dismutase (SOD) and the concentration of malondialdehyde(MDA) in serum and lung tissue, the activities of nitric oxide synthase (NOS) and the levels of nitric oxide (NO) in lung tissue were determined, the body weight and pathomorphological varians of lung tissue were observed in rats of exposure group and negative group at the 15th, 30th, 50th day of CSOF exposure. Results In the exposure group, the rats' body weights were lower than those in negative control group (P