Objective To evaluate the existence of occult peritoneal metastasis,Douglas′ pouch biopsy was undertaken intraoperatively in patients with gastric cancer. Methods From April 1998 to August 1999, Douglas′ pouch biopsy was performed in 16 cases of gastric cancer during laparotomy in which obvious distant peritoneal metastasis was not found by inspection or palpation.[WT5”HZ] Results Occult peritoneal metastasis in Douglas′s pouch was established in 5 out of the 16 cases,while the invasion depth of primary tumor were all under S stage category and the numbers of regional lymph node metastasis were 7 and up.Conclusion[WT5”BZ] At stages when gastric cancer invaded the visceral serosa, peritoneal biopsy in Douglas′ pouch must be performed as routine procedure in order to detect occult distant peritoneal metastasis.

Objective To evaluate the effect of the tention free repair on patient with abdominal insicion hernia. Methods 15 cases of abdominal insicion hernia were reviewed, all of them were repaired with polypropylene mesh. The mesh was overlaid on the defect, continuously monofilament nonabsorbable suture was used to fix the mesh on the edge of the defect and the mesh must be overlapped 2 cm on fascia abdominal layer and fixed by suture. Prophylactic antibiotics was used routinely in single dose. Result No relapse was found in follow up(rang 15～38 month). Conclusion The tension free hernia repair with polypropylene mesh in patient with abdominal incision hernia is a safe and simple operation with minimal postoperative pain.

Objective To observe the effects of Taohechengqitang combined with danazol on CA125 and gonadal hormone in the treatment of patients with endometriosis.Methods 77 cases from July 2014 to January 2015 in department of obstetrics and gynecology of Daqing Longnan hospital were selected and divided into observation group of 40 cases and control group of 37 cases according to double-blind randomized.The observation group were treated with Taohechengqitang joint danazol treatment, and the control group were treated with danazol alone.The estradiol ( E2 ) , progestogen (P), cancer antigen 125 (CA125), thromboxane B2 (TXB2), endometrial cysts size and dysmenorrheal score pre-and post-treatment between two groups were compared.Results The contents of E2 and P post-treatment in observation group were lower than those in control group (P<0.05).The serum TXB2 and CA125 levels post-treatment in observation group were lower than those in control group (P<0.05).The endometrial cysts size and dysmenorrheal score post-treatment in observation group were lower than those in control group (P<0.05).The total efficacy in observation group was higher than that in control group (P<0.05).Conclusion Taohechengqitang combined with Danazol could reduce the CA125, E2 and P levels, relieve symptoms of dysmenorrhea and reduce the cyst volume, whose efficacy is exact.

0.05) when all cases were put together. But the observed morbidity in group B (20%) was less than that in group A (40%) with the difference being statistically significant (?~2=4.41,P=0.036). ConclusionsThe POSSUM methodology allows satisfactory prediction of mortality and morbidity rates in patients undergoing colorectal tumor surgery.

Objective To investigate the relationship between coronary artery lesions and multiple risk factors in the patients with metabolic syndrome (MS) and coronary heart disease (CHD). Methods Totally 429 patients were definitely diagnosed with CHD by coronary arteriography and their BMI, BP, FBG, TG, HDL-c as well as age, gender, smoking, TC, LDL-c, UA were recorded. All patients were divided into two groups: CHD with MS, CHD. Results BMI, BP, FBG, TG, HDL-c, TC, LDL-c and UA were significantly higher in CHD with MS group than those in CHD group (P

Objective To investigate the risk factors for coronary artery lesions (CALs) in children with Kawasaki disease (KD) in Lanzhou. Methods One hundred and seventy-four children with diagnosed KD were divided into CAL group and non-CAL group based on the existence of concurrent CALs. The age, gender, fever duration, intravenous immunoglobulin (IVIG) start time, IVIG dose, C-reactive protein (CRP), serum albumin, erythrocyte sedimentation rate (ESR), platelet (PLT), red blood cell count (RBC), hemoglobin and so on were compared. Results Among the 174 children, 46 children (26.44%) were complicated by CALs and 128 children were not. The differences of average fever duration, IVIG starting time, IVIG dose, PLT, CRP, ESR and RBC were statistically signiifcant (P<0.05). Conclusions When KD children has the fever durations>10 d, start of IVIG af-ter 10 days of fever, increase of PLT, CRP and ESR and decrease of RBC, clinicians should be alert to the risk of concurrent CAL.

Objective To explore the significance of Community Mental Health Service funded by the government, organised by the Health Department and participated by the Community Psychiatric Service, which consists of community case managers, policemen, community health station, doctors, nurses and family of patients.Methods 150 patients, having the tendency to cause trouble or disturbance in their psychotic episodes, were placed in a case management system, monitored and treated throughout the year, gathered statistics for their number and extent of violence every month, and scored according to Social Disability Screening Schedule (SDSS).Results After one year's monitoring and treatment, the total number of occurrence of violence 5 grade among the 150 patients decreased from 20 person-times to 0 person-times; violence 4 grade decreased from 68 person-times to 2 person-times; violence 3 grade decreased from 66 person-times to 4 person-times; violence 2 grade decreased from 258 person-times to 12 person-times; violence 1 grade decreased from 432 person-times to 24 person-times. The number of patients who lost their violent tendency increased from 0 person-times to 72 person-times.Conclusion To establish community case management systems, monitor, treatment, conduct follow-up studies and providing appropriate recovery guidance for schizophreniac patients through the Community Psychiatric Service, are the effective ways to decrease the rate of causing trouble or disturbance, reduce the patients' social disability, and facilitate the patients' recovery of social functions.

Objective To explore the clinical feasibility and safety of early intervention for severe stenosis of non-infarct related artery(non-IRA)in patients with acute ST-segment elevation myocardial infarction(STEMI) and multi-vessel disease(MVD)after successful primary percutaneous coronary intervention(PCI)for infarct-asso-ciated artery(IRA). Methods From May 1st,2011 to December 30th,2016,165 patients with STEMI and MVD were enrolled in our study. After the completion of primary PCI in IRA ,75 patients still in the hospital agreed to undergo a second staged PCI in severe stenosis of non-infarct arteries. We analyzed the in-hospital adverse events ,the length of hospital stay and clinical outcomes during the follow-up in the study population. Results There was no significant difference in the incidence of adverse events between the two groups during hos-pitalization. However,compared to patients treated with the IRA-only PCI,those treated with early intervention for severe stenosis of non-IRA was associated with greater benefits for clinical outcomes(including rehospitalization for heart failure,rehospitalization for ACS,recurrent angina pectoris,necessity for reintervention)during the follow-up except for the all-cause mortality. Conclusion Early intervention for severe stenosis of non-IRA is a feasible and safe procedure in patients with acute STEMI and MVD after successful primary PCI.

Objective:To explore the potential serum biomarkers of patients with lupus nephritis(LN)by using two-dimensional electrophoresis combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF/TOF MS),so as to lay the foundation for illuminating pathogenesis.Methods:A total of 40 LN patients were divided into two groups,the active LN group and the inactive LN group,with 20 in each.In addition,20 IgA nephritis patients and 20 healthy volunteers were enrolled as IgAN group and healthy control group.Two-dimensional gel electrophoresis was used to separate and analyze the serum proteins,and MALDI-TOF/TOF MS was applied to the identification of the differentially expressed pro-teins.Results:A total of fifty differentially expressed proteins were identified.Compared with that in healthy control group,23 differentially expressed proteins were discovered in active LN group and inactive LN group,among which,8 proteins were up-regulated and 1 5 proteins were down-regulated.And 1 8 differentially expressed proteins,compared with IgA nephritis group, were found in active LN group and inactive LN group,including 13 up-regulated proteins and 5 down-regulated proteins.Fur-thermore,the number of up-regulated and down-regulated proteins in active LN group,compared with those in inactive LN group,were 4 and 5,respectively.Among the 50 identified differentially expressed proteins,the expression of serum amyloid protein A(SAA )in active LN group was higher than that in the other groups while the expression of complement component C4A in active LN group was lower than that in the other groups.And the expression of chain B (solution structure of double super helix model)in the inactive LN group was higher than that in the other groups.Compared with that in healthy control group,the expression of vitamin D-binding protein isoform 1 precursor,chain A(crystal structure of uncomplexed vitamin D-binding protein)and chain B (a covalent dimer of transthyretin that affects the amyloid pathway)was up-regulated in both ac-tive LN group and inactive LN group,while the expression of the vitronectin precursor,ficolin-2 isoform a precursor and chain A (crystal structure of the catalytic domain of human complement C1 s protease)was down-regulated.Compared with that in IgA nephritis group,the expression of lipoprotein CIII and vitronectin precursor was up-regulated in both active LN group and inactive LN group.Conclusions:Combination of two-dimensional gel electrophoresis and MALDI-TOF/TOF MS is effective for screening and identification of differentially expressed proteins in serum from LN patients.These differentially expressed pro-teins could be used as biomarkers for noninvasive diagnosis and evaluation of LN.Further study on these proteins would be conducive to understanding the pathogenesis of LN.

Objective:To evaluate the discrimination, reliability and validity of the evaluation system of clinical nurse training based on post competency in hospitals of traditional Chinese and Western medicine.Methods:From August 2018 to January 2019, 271 clinical nurses from a three-A hospital were selected by convenient sampling method. The competency of clinical nurses was assessed on the spot by case tracking method. The discrimination, reliability and validity of the evaluation system were tested by item analysis, Cronbach's α coefficient and confirmatory factor analysis.Results:The evaluation system had good discrimination, reliability and validity. Among the four scales of the evaluation system, there were significant differences in the high score and the low score of all items ( P < 0.05). The Cronbach's α coefficient of each dimension of the four scales was 0.769-0.898. Four structural equation model diagrams were established, the AVE (average variance extracted) of each dimension was 0.51-0.74, factor load was 0.53-0.93, C.R. (composite reliability) was 0.79-0.91, and the discrimination validity was up to the standard. Conclusion:This system provides a reference for the establishment of scientific, objective, measurable and homogeneous clinical nurse training evaluation tools.