Objective To investigate the role of endoscopic nasobiliary drainage ( ENBD) of bile duct instead of T tube drainage during laparoscopic common bile duct exploration (LCBDE). Methods All the patients accepted ENBD before LCBDE / laparoscopic cholecystectomy (LC) + LCBDE. During the operation the stones were extracted by choledochoscopy or crashed with electrohydraulic lithotripsy. After removing all of the biliary stones, the nasobiliary tube still remained in the common bile duct, then primary closure of the exploration wound on the duct wall was made, and with routine abdominal drainage. After operation , radiography of the nasobiliary tube was taken to investigate if there were any residual stones or leakage in the bile duct remained. Subsequently the drainage tube and nasobiliary tube were respectively removed as indicated. Results Totally 43 cases accepted ENBD preoperatively, after 6. 1 days LCBDE was performed, in 36 cases (83. 7% ) the operation was successfully using nasobiliary drainage and primary closure of the duct wound. Postoperative radiography of the duct system through the nasobiliary tube showed only in one case (2. 6% ) a small stone left which was then extracted under ERCP. There were no bile duct stricture and bile leakage, so the nasobiliary tube was removed smoothly. Seven cases ( 18. 6% ) were transferred to open abdominal exploration, 2 of them still kept the nasobiliary tube and the choledochal incisions were primary closed. Totally 38 patients (88.4% ) were successfully drained by ENBD. The abdominal drainage and nasobiliary tubes were removed in average of 3.2 and 6.7 days respectively without complications. Conclusion ENBD is an effective and safe procedure for bile duct drainage in LCBDE. It has the advantage of minimal trauma, short drainage period and rare complications. It suggested that this procedure should be a new satisfied way in treatment of bile duct stones.

Objective To observe the analgesic effects of patient-controlled intravenous analgesia (PCIA) and continuous infusion of morphine into epidural space(CIEA) after suprapubic transvesical prostatectomy. Methods Seventy-five patients undergoing suprapubic transvesical prostatectomy were randomly assigned to PCIA group,CIEA group and control group. In PCIA group, 2 0mg/h morphine as a recommended dose would be injected intravenously by the patient through a self-controlled analgesic delivery system in which another 1 mg morphine could be injected whenever patient felt pain until the pain relieved. The lockout time was 20 minutes. In CIEA group, 0 08 mg/h morphine was injected into epidural space. 50～75mg of pethidine was injected whenever the control group patients felt pain. VAS(vision simulate score), frequency and duration of bladder spasm, discontinuance time of bladder irrigation and BP were observed. Results The CIEA and PCIA group were superior to the control group with characteristics of stable analgesic effect, shorter duration and lower frequency of bladder spasm and shorter time of bladder irrigation(P0 05); but the PCIA group had longer gastrointestinal function recovery time(P

Objective　To study the effects of recombinant BCG-Sj26GST vaccine of schistosoma japonicum of TNF-α and IL-1 produced by spleen cells of mice.Methods　In experiment 1,BALB/C mice were immnized subcutaneously by 106 and 108 CFU vaccine respectively,challenged with Sj cercariae on 8 w of immunization and killed on 6 w of infection to separate spleens,PBS served as control;in experiment 2,after immunized subcutaneously and intravenously by 106 CFU vaccine respectively,4 mice were killed to separate sleens on 0,4,8,10,14 and 16 w of immunization,spleen cells were stimulated by Sj26 or mitogens,the level of TNF-α in supernatant of spleen cells were detected by ELISA,that of IL-1 by fibroblast proliferative response.Results　Levels of TNF-α and IL-1 increased obviously by immunization with the vaccine against challenge with Sj cercariae;dynamic observation showed that TNF-α and IL-1 in the subcutaneous group reached the highest level on 4～8 w;that in the intravenous group on 16 w and 4～8 w respectively.Conclusions　Recombinant BCG-Sj26GST vaccine of schistosoma japonicum may promote spleen cell of mice to secrete TNF-α and IL-1 early,these cytokines may play an important role in protective immunity against schistosomiasis.

Objective To investigate the clinical characteristics of gliomas in children,and assess the value of CT and MRI for diagnosing glioma.Methods Fifty-three children under 14 years old who were admitted into department of neurosurgery of Henan Provincial People's Hospital from Jan.2001 to Dec.2006 were diagnosed as glioma.Their age and sex distribution,clinical symptoms and signs,imaging examinations and pathological examinations were retrospectively analyzed.Results 1.There were 35 males and 18 females.2.The common symptoms and signs were headache and dizziness(32 cases,60.4%),nausea and vomiting(32 cases,60.4%),balance function disorder(31cases,58.5%),episodic convulsion(6 cases,11.3%) and fundus changes(33 cases,62.3%).3.There were 24 gliomas located at supratentorial and 29 gliomas located at infertentorial in this group.4.Thirty-three cases had a CT examination(1 case was wrongly diagnosed) and 28 cases had a MRI examination(all cases were positive);The positive rate of CT for displaying these tumors was 97%,MRI was 100%.5.Pathological examination revealed gliomas in 42 cases after operation.The most common histologically confirmed tumor type reported was astrocytoma,which accounted for 40.5%(17 cases),and the second was medulloblastoma,which accounted for 31.0%(13 cases).Conclusions 1.Glioma are more frequently affected in males than females in children.2.It often occurs in cranial posterior fossa and midline,which causes the symptoms of intracranial hypertension including headache,dizziness,nausea,vomiting,fundus changes,and so on.3.It often occurs in infertentorial,which causes the symptoms of balance function disorder,since it can invade cerebellum directly or indirectly.4.CT and MRI play an important role in the diagnosis of glioma in children.MRI is more valuable than CT in glioma diagnosis.5.Histological types of glioma in children are significantly different from adults.The most common histological types are astrocytoma and medulloblastoma.

Objective To highlight the diagnose and treatment of stationary paraganglioma in retroperitoneum.Methods Ten cases of stationary medullary chromaffinoma of retroperitoneum proven pathologically from 1997 to 2007 were reviewed and sutdied.Hypertension were not observed in all patients,who were admitted to hospital through routine phisical examination.Endocrine secretion examinations,B-US,CT,MRI,131IMIBG,and octreotide were used to dianose the diease.Among all 10 patients,4 cases took ?-receptor blocker for 2～4 weeks preoperatively.3 were operated laparoscopically,7 were operated with lumber incision.Results Hypertension and urinary catecholamine was usually normal or elevated lightly in stationary medullary chromaffinoma of retroperitoneum.131and octreotide have high sensitivity and accuracy in diagosing medullary chromaffinoma.4 were near renal hilum,6 was in para-aorta.They were from 3 cm to 15 cm in size.The results of pathology were paraganglioma in 7 and malignant paraganglioma in 3.Tumor markers were positive,such as cgA,syn,NSE and s-100.There was 1 case metastasis 1 years later.Conclusion Once the correct diagnosis is made,surgical treatment should be carry out on the basis of correct drug preparation.Intimate follow-up is necessary and important.

Chronic renal failure is clinical syndrome manifested as hypoactivity of renal function that can be caused by manifold diseases. CRF is difficult to be treated and has bad prognosis. In recent years, according TCM physiological and pathological mechanism, doctors have achieved good effects in preventing and delaying CRF in its early and middle stage by adopting the therapeutic principle of expelling toxin, strengthening body resistance, and promoting blood circulation to dissipating blood stasis.

ObjectiveTo study the effect of Rehabilitative Ankle-Foot Orthoses training program on walking function of hemiplegic patients after stroke .Methods95 patients were randomly divided into two groups: observed group (49 cases) and control group (46 cases). The patients of control group were trained by routine rehabilitation training program, the patients of observed group were trained by Rehabilitative Ankle-Foot Orthoses and routine rehabilitation training program.ResultsAfter training, either observed group or control group showed significant improvement at walking function and ADL(P<0.01), but the improvement on observed group were more marked than coutrol group(P<0.01 and P<0.05). ConclusionsThe ability of walking in acute stroke patients were obviously improved, and the degree of the disability of them was decreased by Rehabilitative Ankle-Foot Orthoses.

Private cloud is an internal cloud featuring multi-tenant,dynamic configuration and optimization infrastructure,which enables developers to achieve service self-deployment and self-hosting within security coverage of the enterprise data center.This paper introduced the concept of cloud computing.Then it went on to present the private cloud architecture of the hospital by analysis of problems in the hospital including information construction costs,management and maintenance,and information expansion.In the end,the authors analyzed the cloud computing service model,hospital private cloud architecture,along with outcome analysis for hospital private cloud implementations.

Objective To find deficiencies in the existing students' teaching evaluation by in-vestigation and to improve the work in teaching evaluation. Methods Totally 787 students and 261 teachers were investigated by the questionnaire. Contents of questionnaire include interference factors of students' teaching evaluation, experts and teachers' initiatives, students' opinions on how to play the role of evaluation, feedback from experts, etc. Results were analyzed by SPSS 17.0 t test and sta-tistical description. Results Teacher exerted less impact on students' initiative of teaching evaluation and 221(84.7%) teachers said that they would never relax requirements for students because of the evaluation. 37.0%(291/787) students said that experts took the initiative to understand the teaching condition and 65.9%(519/787) students said that teachers took the initiative to understand the study condition. Students thought that teaching evaluation can help improve teachers' teaching ability but lack of powerful guidance after evaluation, insufficient recognition on evaluation opinions and delayed feedback affected the progress of the evaluation work. Conclusions Teaching assessment is very im-portant. Therefore, we should improve the enthusiasm of students in the assessment and make use of student's academic performance rationally in order to make the teaching evaluation play a greater role in improving teaching quality.

The resting cells of Citrobacter freundii 48003 3 expressing high tyrosine phenol lyase activity under the inducing of L tyrosine were used for L DOPA synthesis from catechol, pyruvate and ammonia In this paper, the effects of temperature, pH and substrate concentrations on the synthesis of L DOPA were studied At the optimal conditions of reaction, 9 5g/L of L DOPA was obtained in 12h