Objective To investigate the treatment effect of minimally invasive excision in intrahepatic bile duct stones. Methods Ac-cording to different treatment methods, 280 patients with intrahepatic bile duct stones were divided into the treatment group (180 cases) and the control group(100 cases). The control group were given open hepatic lobectomy while the treatment group were given minimally invasive treatment of hepatic lobectomy by laparoscopy. Results All patients had successfully completed surgery and the stones were removed. Compared the operation time,intraoperative blood loss,and blood transfusion of the two groups,and there were no statistically significance (P>0. 05). The postoperative hospitalization,time of drainage tube remove, time of analgestic drug use in treatment group were obviously lower than those in control group,which had statistically significance (P<0. 05). The common postoperative complications of the two groups were bile leakage,wound infection,pleural effusion and subphrenic abscess,et al. The complication rate of treatment group was 2. 2%, while it was 10. 1% in the control group, which had significant difference (P<0. 05). All the patients were followed-up for 6 months, and there was no death in patients. Conclusion Intrahepatic bile duct stones in progress could be treated by hepatic resection surgery. Laparoscopic techniques could accelerate the recovery of patients and reduce the complication rate,and it would become a new treatment option.

Epigenetics is a researching hot topic of worldwide now.Increasing evidence shows that the pathogenesis of human diseases is not only influenced by the abnormalities of genetic factors but also by epigenetic mechanisms.Recent technological advances in epigenomic profiling has led to further understanding of the role epigenetic factors played in development,inflammation,aging,immunity,angiogenesis,tumorigenesis,and stem cell biology.The researchers in ophthalmology should pay close attention to the current research of major epigenetic mechanisms and their involvement in human diseases,especially ocular diseases.Moreover,the potential application of epigenetic drugs in the treatment of common human diseases also should be understood.Finally,the challenges and future perspectives underlying epigenetic research are discussed in this editorial paper.

Objective To investigate the present status of the emergency nursing training to form the curricula system for emergency nursing training of nurses (including course projects,class hour,teaching form,training aim).Methods Based on the actual investigation,literature research,using Delphi method,the training course system of emergency nursing was established.Results Cronbach's α coefficient was 0.943 and the expert authority coefficient was 0.868.Emergency training should be included in the nursing training program,and the four modules courses were built.With reference to emergency management requirements of home and abroad and the training model of foreign troops as well as combining the reality of our country to set up the training objectives,to improve class hour,enrich teaching form,and adjust the training content to set up the emergency training evaluation model.Conclusions The results of this study supply basic guarantee for nurses to increase coping ability of emergency affairs as well as training basis and reference with clear structure and content,reasonable design and reliable results.

Objective:To survey the periodontal status of patients with metabolic syndrome in a Beijing community,so as to evaluate the relationship between periodontal status and metabolic syndrome.Methods:152 metabolic syndrome(MS)patients,106 post-acute myocardial infarction patients,211 hypertension patients and 56 healthy subjects were involved.Mesial buccal and distal lingual sites per tooth were examined.The periodontal status including plaque index(PLI),bleeding index(BI),probing depth(PD)and attachment loss(AL)as well as missing teeth number were recorded.Results:In male patients,PLI,BI and PD in MS group were higher than that in the other three groups although the mean age and smoking percentage of MS group were the lowest(P

Unplanned extubation (UEX) is defined as premature removal of the indwelling catheter tube by a patient (deliberate unplanned extubations) or by staff during nursing and medical care (accidental extubations). UEX, either deliberate or accidental, can cause severe damage of patients, with the increasing of hospital costs and medical disputes. Identifying high-risk patients is the key point of reducing UEX. This review conclude risk assessment tools reported for UEX.

Lung cancer is the most common malignant tumor globally, with the highest incidence as well as mortality in China. Absence of the effective screening method for early detection results in the high mortality. Five-year survival rate in patients with advanced cancer decreases remarkably compared with that in patients with early stage disease. Hence, the early detection of lung cancer is of vital importance. DNA methylation has close correlation with the initiation and development of tumor genesis. With the improvement in DNA methylation, aberrant DNA methylation has been identified in lung cancer. Detection of methylation in the specimens, such as tissue, bronchoalveolar lavage fluid, serum or plasma, sputum and urine, contributes to the early detection and improvement in the prognosis and treatment of lung cancer.

ObjectiveTo explore the contrast-enhanced ultrasonography features of postpartum placenta implantation and its clinical value in diagnosis of postpartum placenta implantation.MethodsBetween April 2009 and May 2013, twelve patients with clinically suspected placenta implantation underwent contrast-enhanced ultrasonography in Hubei Maternal and Child Health Hospital. The location and extent of intrauterine lesions and perfusion features of contrast agent were observed. The contrast-enhanced ultrasonography features of postpartum placenta implantation were analyzed and compared with postoperative pathological diagnosis.ResultsIn twelve patients with placenta implantation, eleven showed enhancement. Only one lesion showed no enhancement, which was diagnosed as placental degeneration and calcification on postoperative pathology. One case was placenta adhesions conifrmed by postoperative pathological diagnosis, which presented with a hyperenhanced lesion in uterine cavity with a clear boundary to myometrium. Six cases were placenta implantation confirmed by postoperative pathological diagnosis, which presented with a residual placenta surrounded with extremely thin or evendiscontinuous uterine serosa. Five cases were placenta penetration confirmed by postoperative pathological diagnosis, which presented with a residual placenta penetrating the uterine serosa and contrast agent spilling out. All cases in this study were cured by operation.ConclusionsContrast-enhanced ultrasound could diagnose placenta implantation via the difference of tissue perfusion. The lesion of placenta implantation showed enhancement after injection of contrast agent. If discontinuous uterine serosa and contrast agent spilling was observed, placenta penetrating uterine serosa should be considered. Contrast-enhanced ultrasound has important clinical value in diagnosing postpartum placenta implantation and observing postoperative recovery processes of uterine rupture.

Objective To investigate the effect of dexmedetomidine on postoperative renal function of patients with rheumatic heart disease following valvular heart surgery. Methods Fifty patients following valvular heart surgery were randomized into experimental group and control group,with 25 cases in each group. The patients in experimental group receiveddexmedetomidine 0.5 μg/kg infusion 15min before induction, and then 0.5 μg/(kg·h) infused to the end of surgery, while those in control group received the same amount of saline in the same way. Blood from central venous was collected before surgery, at the end of surgery, 24 h and 48 h after surgery in order to detect Src, BUN and Cys C and the length of ICU duration was also recorded. Results Src and Cys C of the patients in both groups obviously elevated 24h after surgery when compared with pre-operation , while BUN elevated at both 24 h and 48 h after surgery(P < 0.05). Compared with those in control group, Src, BUN and Cys C were lower in experimental group ( P < 0 . 05 ) , and the length of ICU duration was shorter (P < 0.05). Conclusion Dexmedetomidine could improve the postoperative renal function after valvular heart surgery and lead to a better prognosis.

Objective To evaluate the methods for the prevention of internal jugular vein malposition of peripherally inserted central catheter (PICC) in patient with limited neck motion.Methods 210 patients who underwent PICC placement using ultrasound-guided modified Seldinger technique were divided into observation group (n =106) and control group (n =104) with a random number table.Ultrasound probe compression on the internal jugular vein was used in the observation group,while finger compression was used in the control group.The 2 groups were compared in terms of incidence of internal jugular vein malposition,accuracy of PICC tip position in X-ray,and incidence of complications.Results Incidence of PICC malposition was significantly lower in the observation group than the control group [3 (2.8％) vs.36 (34.6％),P =0.000].The accuracy of PICC tip position in both groups was 100％.No complication was observed in the observation group,while the rate of complication in the control group was 4.8％,with a statistically significant difference (P =0.022).Conclusion The ultrasound probe compression method can significantly lower the incidence of internal jugular vein malposition of PICC and is safer than the finger compression method.

Objective:To study the relationship between gingival thickness(GT)and the underlying alveolar bone thickness(BT)in maxillary anterior region and the distance from cemento-enamel junction(CEJ)to alveolar crest.Methods:30 young volunteers with healthy gingiva were included.GT was measured at 2mm below the CEJ,buccal BT were measured at 3 locations:2,4 and 6 mm below the alveolar crest respectively,the distance from CEJ to alveolar crest were measured by CBCT and clinical direct measure respectively. Results:The correlation coefficient (r)values between GT and BT at 2,4 and 6 mm below alveolar crest were 0.493,0.383 and 0.342 (P <0.001 )respectively,the r value between GT and the distance from CEJ to alveolar crest was -0.21 3(P <0.01 ).No statistically significant difference was observed between CBCT and clinical measurements(t =-0.521 ,P =0.603).Conclusion:There is positive correlation between GT and BT at 2,4 and 6 mm below alveolar crest and negative relation between GT and the distance from CEJ to alveolar crest.