Objective To discuss which drainage method is more efficient in treatment of choledocholithiasis with obstructive jaundice. Methods Compared the difference of serum total bilirubin,direct bilirubin, the variation of serum total bilirubin and direct bilirubin before and after drainage and daily biliary drainage by endoscopic nasobil-iary drainage (ENBD) and endoscopic nasobiliary drainage with continuous negative-pressure suction after three days. Results The daily biliary drainage about the patients by ENBD with continuous negative-pressure suction is much more effective than the patients by ENBD. The serum total bilirubin and direct bilirubin about the patients by ENBD with continuous negative-pressure suction is less than the patients by ENBD after three days. The variation of serum total bilirubin and direct bilirubin before and after drainage about the patients by ENBD with continuous neg-ative-pressure suction is more than the patients by ENBD. Conclusion The ENBD with continuous negative-pres-sure suction is more effective for choledocholithiasis with obstructive jaundice.

Objective To explore the ill experience of patients with deep vein thrombosis (DVT),and supply reference for making corresponding intervention.Methods The qualitative phenomenological study method was adopted in this study.Self-structured in-depth interviews were conducted with 12 patients with deep vein thrombosis and data were collected for analysis.Results After repeated refinement of the collected data,the early ill experience of deep vein thrombosis could be extracted as 4 topics.Conclusions According to the ill experience of patients with DVT,nurses can provide targeted intervention for such diseases to instruct clients to rehabilitate rapidly and improve the patients' quality of life.

Adolescent ; Anti-Asthmatic Agents ; therapeutic use ; Asthma ; blood ; drug therapy ; Child ; Child, Preschool ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Infant ; Interleukin-23 ; blood ; Male

Animals ; Female ; Gonads ; physiopathology ; Hypothermia ; chemically induced ; physiopathology ; Male ; Rats ; Rats, Wistar ; Sex Factors ; Soman ; adverse effects ; pharmacology

Objective: To investigate the epidemiological characteristics of genital Chlamydia trachomatis infections in Shaoxing City from 2012 to 2021, so as to provide the evidence for improving the control strategy of genital C. trachomatis infections. Methods: Data pertaining of patients with genital C. trachomatis infections in Shaoxing City from 2012 to 2021 were retrieved from Chinese Disease Prevention and Control Information System, and the incidence of genital C. trachomatis infections was calculated. The trends in incidence of genital C. trachomatis infections were analyzed using annual percent change (APC), and temporal, human and temporal distributions of genital C. trachomatis infections were descriptively analyzed. Results: A total of 18 235 cases with genital C. trachomatis infection were reported in Shaoxing City from 2012 to 2021, and the annual average incidence was 36.36/105. The incidence of genital C. trachomatis infections appeared a tendency towards a rise in Shaoxing City from 2012 to 2021 (APC=4.51%, t=2.663, P=0.029). The reported incidence of genital C. trachomatis infections was significantly higher among females than among males (60.46/105 vs. 12.50/105; χ2=7 935.467, P<0.001), and 76.04% infections (13 866 cases) occurred at ages of 20 to <40 years, while a high incidence rate of genital C. trachomatis infections was seen among patients at ages of 25 to <30 years (154.23/105). In addition, high incidence rates were seen in Keqiao District (57.93/105) and Yuecheng District (51.78/105). Conclusions The incidence of genital C. trachomatis infections appeared a tendency towards a rise in Shaoxing City from 2012 to 2021, and the infection predominately occurred among women and young individuals.

This article introduces the independent experiment and social investigation activities in the course of medication analy- sis set up for strengthening students' comprehensive abilities.These activities create a good study atmosphere for enhancing stu- dents' ability to do research and their humanistic qualities.

ObjectiveTo explore the psychological training methods on improving the mental adaptation and performance of recruits.MethodsAccording to army's squad establishment,372 recruits were randomly extracted and divided into intervention group (182) and control group (190).A series of special group psychological trainings,such as Warm barracks,Friendly Care,Self-awareness,Interpersonal communication,etc,was applied to the recruits of the intervention group through the squad leaders given psychological training.The effect was assessed with Psychosocial Stress Survey For Groups (PSSG),General Maladjustment Scale (GM),Social Support Rating Scale (SSRS),General Self-Efficacy Scale (GSES),Wallace Slef-Concept Scale (WSCS) and Examined Performance.ResultsThe scores of negative emotion was [(3.89±2.01) score vs (2.56±1.65) score ],negative copy was [(3.96±2.52) score vs (2.97±1.78)score],total stress was [(46.36±21.74)score vs (33.71±17.56) score],maladjustment was [(11.26±5.04)score vs (9.10±4.53)score] in the intervention group,which was significantly reduced than those in the control group(P＜0.01).But the scores of positive emotion was [(3.70±1.62) score vs (4.16±1.84) score],positive copy was [(5.21±1.94) score vs (6.93±2.17) score ],subjective support was [(21.37±3.59)score vs (22.56±3.53)score] and support utilization was [(7.03±2.16) score vs (8.92±2.44) score],self-concept was [(74.33±15.72) score vs (80.65±13.98) score],self-efficacy was [(2.44±0.56) score vs (2.91.±0.52) score ] and the examination performance was [(pull-up:(5.12±3.77) times vs (12.09±4.52) times; sit-up:(30.82±9.54) times/3 min vs (70.20±16.83) times/3min; push-up:(21.32±9.73)times/2 min vs (61.75±17.62)times/2 min; Running 3000 meters:(14.17±1.14) s vs (12.82±0.32) s; standing grade throw:(26.68±4.62) mvs (35.38±8.44) m ],which was significantly improved (P＜0.01 or P＜0.05).ConclusionsComprehensive group psychological training implemented by Squad leader could effectively improve the ability of adaptation of recruits and promote the performance.

Objective To describe the clinical application of microvascular anastomotic device in head and neck reconstruction.Methods From July,2013 to November,2013,microvascular free flaps were transferred to reconstruct the defects simultaneously after tumor resection of head and neck region in 12 cases in Department of Oral and Maxillofacial Surgery,Peking University School of Stomatology.Microvascular anastomotic coupling devices (MACD) were used in vascular anastomosis.The clinical data were collected and analyzed,including the selection of free flap,diameter of donor and recipient vessels,type of MACD,time of anastomosis,instant patency of anastomosis.The flap was monitored closely after operation and the final survival rate was calculated.Results Twelve microvascular free flaps were done in this series,including 6 fibula flaps,4 forearm flaps and 2 anterolateral thigh flaps.Totally 17 MACD were used by end-to-end anastomosis in this series,including 5 arterial anastomosis and 12 venous anastomosis.The anastomose time using MACD was from 4 to 10 minutes,with a median time 6.8 minutes.The instant patency rate of anastomosis was 100％.There were some blood leakages near the anastomotic stoma in 1 arterial anastomosis using MACD.It was resolved successfully by changing a new MACD.Conclusion Our primary clinical experience showed that the MACD was well suited to the microvascular reconstruction of head and neck defect.The feasibility and reliability was confirmed by our clinical cases.It should be recommended as a safe,fast and reliable adjuvant anastomotic instrument for free tissue transfer.

Objective To evaluate perioperative management of MEN 2A patients with medullary thyroid carcinoma after bilateral pheochromocytomas removal.Methods Seven cases of MEN 2A from three families were diagnosed as medullary thyroid carcinoma and adrenal pheochromocytoma by biochemical tests and imaging examinations.All had histories of operations due to medullary thyroid carcinoma and contralateral adrenal pheochromocytoma.Direct sequencing of entire exons was performed in all patients.Firstly they underwent laparoscopic surgery for pheochromocytoma, then after stetoids replacement they underwent total thyroidectomy and bilateral cervical lymph nodes dissection.Results One family had the combined C634Y/D707E mutations of RET mutation.The other two families had C634Y mutation and C634R mutation separately.All patients had histories of adrenal insufficiency because of bilateral laparoscopic adrenal pheochromocytomas removal.They suffered from medullary thyroid carcinoma at the same time and needed to do total thyroidectomy and bilateral cervical lymph node dissection.Under perioperative steroids treatment and closely monitoring, they successfully went through the surgery.No adrenal crisis or related complications happened.Conclusions MEN 2A patients in this study had RET mutations and D707E mutation is a newly discovered mutation.Patients of adrenal insufficiency face the risk of adrenal crisis after a major operation.Correct perioperative monitoring and management can avoid complications.

Objective To investigate the radiosensitization effects of the combination treatment of clioquinol (CQ) and zinc on human cervical cell line HeLa in vitro.Methods Cells were divided into the 4 groups:controls,drug,radiation,and combined drug and radiation group.Cytotoxic effect of CQ and zinc on cell viability was determined by CCK-8 assay.Radiosensitization effect of CQ and zinc on HeLa cells was detected by colongenic assay,and the single-hit multi-target model was used to stimulate the doseresponse curve of survival and to calculate radiosensitization parameters.The cell cycle and apoptosis of HeLa cells were analyzed with flow cytometry.Luciferase reporter assay was used to study NF-κB activity of HeLa cells.Results The combination of CQ and zinc inhibited cell growth in a dose-dependent manner (F =188.00,P ＜ 0.01).The mean lethal dose was 3.16 and 2.04 Gy for radiation group and combined drug and radiation group,respectively,and hence the SER was 1.55.Compared with the radiation group,the ratio of G2-phase cells in the combined drug and radiation group decreased(t =10.39,P ＜ 0.05),the apoptosis rate increased at 24 h post-irradiation (t =5.64,P ＜ 0.01),and the NF-κB activity decreased (t =21.42,P ＜ 0.05).Compared to the control group,the NF-κB activity increased in the radiation group(t=6.23,P＜0.05),but decreased in the drug group(t =12.48,P＜0.05).Conclusions The combination of CQ and zinc could increase the radiosensitivity of HeLa cells by decreasing the ratio of G2-phase cells,increasing apoptosis and the inhibiting of NF-κB activity.