Objective To study the clinical effect of laparoscopy-assisted improved Soave operation for treating neonatal congeni-tal megacolon .Methods 68 cases of neonatal congenital megacolon treated in our hospital from March 2010 to July 2013 were di-vided into 2 groups .The treatment group(34 cases) was performed the laparoscopy-assisted improved Soave operation after the sys-tematic examinations ,while the control group(34 cases) was given the conventional operation therapy .The postoperative curative effects were observed and compared between the two groups .Results The effects of intraoperative bleeding amount ,operative time and the pain score in the treatment group were superior to those in the control group with statistical difference between the two group(P<0 .05);the postoperative hospital stay ,postoperative intestinal peristalsis recovery time and fasting time in the treatment group were superior to those in the control group with statistical difference between the two group (P<0 .05) .Conclusion Laparo-scope-assisted improved Soave operation has better effect for treating neonatal congenital megacolon and should be widely used in clinic .

The procedure of geriatric rehabilitation should consist of function assessment and treatment.Geriatric function assessment covers three levels:impairment,activity limitation and participation restriction.The most important goals of geriatric rehabilitation are to improve the older patients' activity of daily living,keep their independence,and finally to improve their quality of live.

The significance and principles of comprehensive evaluation system which is configurated for large medical equipment were discussed in this paper.Through literature analysis and Delphi method and questionnaire,comprehensive evaluation index and the corresponding weights were fixed.And the comprehensive evaluation system was designed in order to provide guidance for investment decision-making and scientific management.The data of the comprehensive evaluation system should be improved and perfect in practice.

Objective To study the effect of maternal hypertensive disorders complicating pregnancy on brain development of the neonates. Methods Insular area,circle and cerebral gyri width of lobus frontals were measured in 56 neonates of the mothers with hypertensive disorder complicating pregnancy(HDCP)by ultrasound and were compared with those of 53 neonates of the mothers without HDCP(control group). Results In the control group,the cerebral gyri width of term neonates was narrower than that of preterm neonates,while the insular circle was longer and the insular area was larger in the term neonates(P<0.01).Insular circle was significantly shorter and the insular area was significantly smaller in neonates of HDCP mothers [term:(87.43±10.21)mm,(413.60±90.05)mm2;preterm:(72.59±7.50)mm,(285.71±48.62)mm2]than those of the corresponding neonates in the control group[term:(102.14±9.97)mm,(557.08±98.89)mm2:preterm:(78.42±10.14)mm,(356.01±93.07)mm2].Cerebral gyri width were significantly wider only in the full term neonates.The incidence of small gestational age neonates was 30.36%(17/56)in hypertensive disorder complicating pregnancy group.The neonatal behavioral neurological score of hypertensive disorder complicating pregnancy group was significantly lower than that of control group (P<0.01). ConclusionsMaternal hypertensive disorder complicating pregnancy may result in poor development of brain of their neonates,which could be evaluated by cerebral ultrasound.

Objective To explore the clinical effect and influence on cardiac function of losartan joint tar-trate metoprolol on heart function in patients with coronary heart disease ( CHD ) and chronic heart failure ( CHF ) . Methods 76 patients were randomly divided into two groups with double blind method ,control group adopted tartrate metoprolol treatment ,observation group on the basis of the losartan treatment ,compared two groups of cardiac function changes and clinical curative effect .Results After treatment,changes of DP/dtmax,DP/dtmax,LVEDP were greater than those of the control group ,the difference was statistically significant ( t=9.141,75.458,9.141,75.458,all P<0.05);compared with control group , the differences in LDH, SOD, NO were statistically significant ( t =6.951, 15.694,6.951,P<0.05);Observation group effectiveness was 89.47%,control group effectiveness was 78.95%, the difference in efficient between the two groups have statistical significance (Ridit=16.951,P=16.951);the rate for incidence of major adverse cardiovascular events in observation group was 7.89%;control group was 10.53%, there was no statistically significant difference in two groups (χ2 =0.695,P=0.695).Conclusion Curative effect of losartan with tartrate metoprolol treatment of coronary heart disease (CHD) is distinct,combination may be considered in clinical application and can improve cardiac function in patients adjusting the nerve -endocrine disorder from differ-ent mechanism .

BACKGROUND: Compared with ordinary preparation, nano-drug carriers have the advantages of prolonged drug effects, increased therapeutic effects and small toxicity. However, reports concerning the application of nanoparticles, nano-liposomes, polymer micelles, nano-smart drug, polymer nano-body medicine, Dendrimers and other nanoscale drug carriers are few. OBJECTIVE: To summarize the characteristics, types and preparation methods of nano-drug carriers, and to elucidate its research progress. METHODS: The Medline database was searched by computer with key words of "Nano-drug carriers, nanoparticles,nano-liposomes, clinical application" to find literatures published between January 1991 to December 2009, and the language was limited to English. Simultaneously, articles published from January 1994 to December 2009 were searched in Chinese Journal Full-text database with the same key words,and thelanguage was limited to Chinese.Inclusion criteria: ①Articles are closely related to the research of nano-drug carrier. ②Related researches published on core journals in the lates years were preferential in selection.Exclusion criteria: ①Repeatability study. ②Meta analysis. RESULTS AND CONCLUSION: A total of 360 documents were seized by primary screen, finally 28 sub-standard literatures entered further analysis, including 25 reviews and 3 clinical or basic experiments. The nano-drug carriers are characterized by specificity, targeting, accurate and absorbable, which can be used in preventing and curing disease. The combination of nano carriers and specific drugs can promote the development of nano-biotechnology, and provide a reliable basis for clinical diagnosis and treatment.

Objective:To investigate the clinical application of and critically ill patients received comprehensive nursing interventions during mechanical ventilation effect value. Methods:Ninety eight patients were selected in 2012 July~2013 year in July in our hospital, were treated with mechanical ventilation, were randomly divided into observation group and control group, 49 cases in each group, the control group using ICU routine care, the observation group in the control group on the basis of comprehensive nursing intervention, observation and nursing effect of the two groups. Results:The group of patients with mechanical ventilation time, hospitalization time was shorter than the control group, comparing the data between the groups, the difference was statistically significant(t=8.3678, t=5.9103; P<0.05). The observation group patients with unplanned estuation, ventilator-associated pneumonia was lower than the control group, the mortality rate was lower than the control group, comparing the data between the groups, the difference was statistically significant (x2=5.0178, x2=10.2424, x2=5.9905;P<0.05). Conclusion:in critically ill patients were given comprehensive nursing intervention can shorten the duration of mechanical ventilation and hospitalization in patients with mechanical ventilation, to reduce the unplanned extubation and ventilator-associated pneumonia, reduce mortality, it is worth promoting in clinical use.

Objective:To analyze the participation of clinical pharmacist in the process of diagnose and treatment of typical critical patients and summarize the clinical and pharmaceutical thoughts of clinical pharmacist in pharmaceutical care in order to provide better service for clinics .Methods:Through the participation of clinical pharmacist in the process of diagnose and treatment of one patient with hypernatronemia complicated with demyelination after liver abscess drainage , and combined with the results of laboratory tests and imaging examination and drug treatment regimen , clinical pharmacists analyzed the radical causes of apostasies and feasible therapeutic measures, and then provided the reasonable suggestions for the medication .Results: Clinical pharmacist paid close attention to the medication history and disease evolution of the patient , assessed the therapeutic efficacy timely , communicated and discussed with clin-ical doctors actively , and then made out individualized treatment schedule for the patient , which obtained promising effects .Conclu-sion:Clinical pharmacist should grasp the principal contradictions and pay attention to details , which can play an important role in the treatment course of severe patients .

Objective To investigate the function of entecavir to γ‐interferon induced monokine(Mig) for chronic hepatitis B pa‐tients .Methods The 40 cases of chronic hepatitis B patients were treated with entecavir tablet .The Mig level were detected by ELISA in 40 patients in the time before and after treatment of 12 weeks and 24 weeks ;HBsAg ,HBeAg level were analyzed by using electrochemiluminescence and HBV‐DNA was tested by using real‐time quantitative PCR (FQ‐PCR) .Results Mig and HBsAg , HBeAg ,HBV DNA levels were significantly lower than before treatment in the 40 patients(P< 0 .05) .Compared with those in the time of 12 weeks after treatment ,those indexes after treatment 24 weeks were significantly decreased(P< 0 .05) .Conclusion Ente‐cavir treatment can reduce the level of Mig ,HBsAg and HBeAg ,HBV DNA ,and help to control disease progression in chronic hep‐atitis B .

Objective:To discuss the situation and the rationality of antibiotics use in general surgery during perioperative period.Method:311 cases of patients used antibiotics during Perioperative period was retrospectively analyzed.Results:Antibiotics was used in 308 patients.Of all antibiotics used,202 patients received antibiotics in two hours before the operation.Quinolones were used most frequently,nitroimidazoles were the second,then were cephalosporins.64.3% of patients received single antibiotics treatment,and 37.4% and 1.0% of all patients received 2 and 3 kinds of antibiotics combined therapy respectively.24.4% of the patients were treated with antibiotics formore than 7 days.Conclusions:It is common that antibiotics are used to prophylacte surgical infection in general surgery.It is important to strengthen the management of antibiotics use during perioperative period.