Objective To investigated the percutaneous transhepatic gallbladder drainage combined laparoscopic cholecystectomy in the treatment of purulent cholecystolithiasis for serious patients.Methods Our hospital in the past two years,76 underwent lap-aroscopic cholecystectomy in the acute calculous suppurative cholecystitis of elderly patients with clinical data were retrospectively analyzed.Patients could be divided into group A(surgery)within 72 hours after admission,group B(conservative treatment after percutaneous puncture drainage of the gallbladder,again)elective surgical procedures,A total of 2 groups.Comparative analysis of two groups of patients with complications of surgery,laparotomy rate and total effective rate.Results A,B two groups of postoper-ative complication rates were 36.11% and 15.00% respectively,each postoperative complication rates had significant difference(P<0.05);A,B two groups of transit open rate was 13.89% and 15.00%,A,B two groups of operation time,transit open rate had no significant difference(P>0.05),the total effective rate was lower than that in group B,group A statistically significant differ-ence(P<0.05).Conclusion PTGD combined LC is simple and effective treatment in high-risk acute purulent cholecystolithiasis.

AIM: To explore the mechanism of immune tolerance to experimental autoimmune myasthenia gravis (EAMG) in nasally tolerized rats and Wistar rats. METHOD: [ 3H] thymidine incorporation and solid-phase ELISPOT assay were used. RESULTS: The stimulative index of lymphocyte proliferation responses to acetylcholine receptor (AChR) in popliteal and inguinal lymph nodes (PILN) of EAMG rats was higher than that of nasally tolerized rats on week 3, 5 and 7 post immunization (PI) with AChR plus complete Freund′s adjuvant (CFA), and was higher than that of Wistar rats on week 7 PI ( P

The aim of this article is to explore the dual-system of German geriatric nursing, curriculum of geriatric nursing, concept of major and evaluation mode, which could provide references and reflection for national geriatric nursing development.

Objective To explore the mechanism of IL-6 in EAE. Methods 25 female Wistar rats were randomly divided into 2 groups, EAE group( n=15 ) and normal control group( n=10). The expression of IL-6, TNF-αtand TGF-β of the two groups rots were ob-served by immunohistochemistry staining, and then correlation analysis of the expression of IL-6, TNF-αtandTGF-β was made. Results There was negative correlation between gray scale of IL-6 and symptom scores( r=-0.953, P＞0.05). IL-6 and TGF-β had no statistical-ly significant correlation ( r=-0.492, P＞0.05). There was negative correlation between gray scale of TNF-α and symptom scores( r=-0.978, P＜0.05), and both of the correlation between TNF-α and TGF-β ( r=-0.502, P＞0.05), TGF-β and scores( r=0.470,P＞0.05 ) were not statistically significant. Conclusions IL-6 may participate in EAE as a inflammatory factor.

Objective To investigate the effects of recombinant tissue-type plasminogen activator (rt-PA) combined with mild hypothermia on the hemorrhagic transformation after cerebral ischemia-reperfusion within or out of the therapeutic time window in rats.Methods The focal cerebral ischemia-reperfusion 3 and 4 hours models of rats were established by middle cerebral artery occlusion (MCAO) 3 or 4 hours. The rats were randomly divided into the normal saline group (group NS), normothermia rt-PA group (group rt-PA), rt-PA combined with hypothermia group (group rt-PA +HT), and sham-operation group. Brain mild hypothermia was achieved after ischemia reperfusion and maintained 3 hours. Rats were sacrificed 24 h after ischemia reperfusion, and the amount of bleeding was measured.Results The amount of bleeding significantly reduced in the group rt-PA+HT compared with group rt-PA, which obviously increased in the group rt-PA compared with group NS ( P<0.05); there was a significant difference between rt-PA groups MCAO 3 hours and 4 hours ( P<0.05).Conclusion rt-PA can increase hemorrhagic transformation volume; hemorrhagic transformation volume is higher if treated by rt-PA within 3 h therapeutic time window than treated beyond the time window; mild hypothermia should possibly prevent the development of hemorrhagic transformation and prolong the therapeutic time window of thrombolytic intervention in ischemic stroke.

Objective To investigate the cell compatibility of polystyrene(PS) plate chemically modified with RGD peptides.Methods PS surfaces were carboxylated by permanganate oxidation in diluted sulfuric acid,and carboxyls were activated with water-soluble carbodiimide to graft with gelatin,collagen and RGD peptides.IR,X-ray photo-electronic spectroscopy (XPS) and dynamic contact angle were used to characterize the surface modification of PS surface.Results XPS results confirmed the existence of nitrogen element from protein molecules and the covalently binding of proteins to PS surfaces.Dynamic contact angle measurement indicated hydrophilicity of PS surfaces was improved obviously after grafting modification.The cell culture results showed that the cell adhesion and proliferation was better on modified surfaces than the initial.Conclusion The cell compatibility of PS surface was great improved after modification with RGD peptides,which would provide a potential strategy to improve the culture of purified endothelial progenitor cells isolated by immunomagnetic beads.

Objective To evaluate the value of detecting HCMV-DNA in urine in the diseases of newborn babies ,by comparing the result between HCMV-DNA in urine and HCMV-IgM antibody in blood in different diseases of the newborn babies .Methods The urine and blood samples were collected from 1 520 infants who were in hospital of the neonate department from January 2013 to December 2014 .The HCMV-DNA in urine was examined by fluorescence quantitative polymerase chain reaction(FQ-PCR) .And HCMV-IgM antibody in blood was examined by the method of chemiluminescence(ECL) .Results In the 1 520 cases ,153 had de-tectable HCMV-DNA in their urine samples with a positive rate 10 .07% ,while only 4 cases were positive of the HCMV-IgM anti-body in blood with a positive rate 0 .27% .The two groups was statistically significant difference (P<0 .05) .In the infant diseases of 1 520 cases ,the positive rate of HCMV-DNA in urine was 82 .6% of the hepatitis syndrome while the positive rate of HCMV-IgM antibody in blood was 3 .85% .The positive rate of HCMV-DNA in urine was 8 .95% in the jaundice symptoms ,while the posi-tive rate HCMV-DNA in urine was 4 .62% in the pulmonary infection .Each group of disease was statistically significant difference in the positive rate of HCMV-DNA (P<0 .05) .Conclusion The detection of HCMV-DNA in urine is more beneficial to the diag-nosis of HCM V infection of infants than the detection of HCM V-IgM antibody in blood ,especially in hepatitis syndrome ,neonatal jaundice and pulmonary infection .

Objective To explore the sonographic features of intrascrotal adenomatoid tumor.Methods The sonographic features of 21 cases with intrascrotal adenomatoid tumor confirmed by surgery and pathology were retrospectively analyzed.Results Twenty-one cases with intrascrotal adenomatoid tumor could be typed into 3 ultrasonic patterns:(1) The homogeneous echo type:15 cases,their ultrasonic features were homogeneous echo,including 5 cases with low echo,8 case with equal echo,and 2 case with high echo;5 cases with testicular albuginea adenomatous tumors were also homogeneous echo,2 cases of equal echo,2 cases of low echo and 1 case of high echo that was posterior echo attenuation slightly.(2) The edge halo type:4 cases,they showed the epididymis or testis sheath round or oval nodules,of which the middle was low echo and the edge is high echo halo ring.(3) The mixed echo type:2 cases,they showed cystic mixed echo of epididymis nodules,1 case with irregular cystic areas and poor sound transmission,while the other one with good sound transmission cystic areas and a small papillae on the wall.Conclusions Sonography is a valuable method for diagnosis of intrascrotal adenomatoid tumor.The edge halo type has sonographic features.

Objective To explore the way of contrast-enhanced ultrasound(CEUS)and quantitative analysis technology to assess testicular microvascular ischemia-reperfusion inj ury.Methods Twenty-four healthy adult rabbits were randomly divided into the control group and the microvascular mild,moderate, serve ischemic inj ury group (group Ⅰ,including group Ⅰ1 ,Ⅰ2 ,Ⅰ3 ).The spermatic cord of the control group were threaded but not ligated.The group Ⅰ1 ,Ⅰ2 ,Ⅰ3 were reperfused 2 h after 2 h,4 h,6 h complete testicular ischemia respectively.The ultrasound contrast angiographic parameters of each group were analyzed by the quantitative analysis techniques,including peak intensity(PI),time to peak(TP),slope,mean transmit time(MTT),DT/2 and area.The levels of plasma vWF,NO and ET-1 were tested after the CEUS. The pathological changes of the ipsilateral testicular were observed by the HE and immunohistochemical staining.Statistical analysis was performed by SPSS 13.0 software.Results Preoperativeiy,each parameter of the experimental group and the control group showed no statistical significance (P > 0.05 ). Postoperatively,the PI,slope,area of the group Ⅰ1 increased significantly,while the TP,MTT were prolonged(P <0.05).Contrast time-intensity curve was significantly higher peak and retrusion.The groupⅠ2's PI,slope,area increased further,DT/2 was significantly prolonged,but TP significantly reduced (P <0.05).The contrast curve significantly increased,forward and decreased slowly.The contrast curves of the group Ⅰ3 was approximate a straight line.The vWF,NO,ET-1 levels of each experimental group were significantly higher than those in control group (P <0.05),among them,the levels of group Ⅰ2 were the highest (P <0.05 ).With the aggravation of ischemia,the testicular capillaries expansion,erythrocyte sedimentation,leakage,infiltration of inflammatory cells,MMP-9 expression in vascular basement membrane gradually increased.Conclusions The CEUS and quantitative analysis techniques can effectively evaluate testicular microvascular inj ury.

Objective To detect high-frequency ultrasound and clinical features of acute scrotum in children. Methods High-frequency ultrasound and clinical manifestations of 112 children with acute scrotum were analyzed and compared with the final diagnosis and therapeutic regimen.Results Torsion of appendage with uneven echo nodular near the upper pole of testis or head of epididymis, accompanying secondary reactive inflammation or not were detected in 65 children. Complete testicular torsion was found in 21 children who had the whirlpool sign and absent flow in the affected testicle. There was incomplete torsion in 4 patients with winding courser sign and some flow with low resistant index. Flow increased in 22 children with acute epididymo-orchitis, except 1 with suppurative orchitis. The ultrasonic diagnose accordance rate was about 98.21% (110/112). The clinical manifestations of acute scrotum had some characteristics though partial overlapping exited. Fifteen children with torsion of appendage, 25 with complete torsion and 1 with acute orchitis received operation, and the other received expectant treatment.Conclusion The objective and precise emergency ultrasonic diagnosis combined with the overall and profound analysis of related clinical data may provide important information for the diagnosis and treatment of acute scrotum in children.