Objective To explore the impact of using large dose norepinephrine on the anastomotic healing after esophagectomy.Methods Clinical data of data of 148 cases patients with esophageal cancer who were treated in Wuwei Tumor Hospital of Gansu Province with surgery from January 2014 to June 2016 were retrospectively analized.There were 7 patients who were used 25-67 mg ((32.6 ± 2.3) mg) norepinephrine because of the low blood pressure and other factors during the first 4 d postoperative as research group,and the other 141 patients who had not applied or applied the small dose were set as control group.The patients of two groups with postoperative anastomotic healing and fistula incidence were compared.Results There were 3 cases and 7 cases of postoperative patients appeared anastomotic fistula in the research group and the control group,the rate of anastomotic fistula were 42.86％ (3/7) and 4.96％ (7/141) respectively,the difference was significant (x2=9.78,P =0.001),and 2 cases appeared varying degrees residual gastric necrosis in the research group,all of them occurred in the patients with large dosage and long time.Conclusion There are great risk on the anastomotic fistula and residual stomach mecrosis if long time and large dose norepinephrine was used after esophagectomy,it should be caused enough attention for surgeons.

Objective Two insect resistance genes Bacillus thuringiensis(Bt) crystal protein gene CryIA(c) and cowpea trypsin inhibitor gene CpTI were introduced into tetraploid Isatis indigotica to enhance the resistance to moths.Methods I.indigotica was transformed with a plasmid,pGBI121S4ABC,containing CryIA(c) Bt and CpTI and the selectable gene(Npt-Ⅱ) driven by the CaMV35S promoter via Agrobacterium tumefaciens LBA4404 mediated transformation.Then PCR and Southern blotting assay were conducted followed by moth bioassay test.Results Co-transgenic rate of the two genes in tetraploid I.indigotica was 16.67%.The integration and expression of introduced genes in T0 regenerated transgenic plants were confirmed by Southern blotting assays.Insect bioassay test demonstrated transgenic lines had significant inhibition to moths,compared with wild type control.Conclusion Co-transformation of Bt and CpTI genes is an effective strategy to enhance the resistance to moths for tetraploid I.indigotica.

OBJECTIVE:To strengthen the supervision of clinical antibiotics use through establishing electronic consultation system. METHODS:Based on hospital information system(HIS)and antibiotic management system,consultation system for anti-biotics of special use(ASU)was established,and the effects of the system after used(Jan. 2014)were also evaluated. RESULTS:Real-time consultation of ASU medical orders and related consultation results inquiry and statistics could be achieved through de-signing ASU consultation application form,establishing consultation experts and confirming their working content,adding statistics function,etc. The consultation have been finished 8275 times from 2014 to 2015. The inspection rate for pathogenic microbes in ASU patients rose from 78.68% in 2013 to 83.90% in 2015. CONCLUSIONS:The establishment and application of ASU consulta-tion system can improve consultation efficiency and quality,so as to promote rational use of antibiotics in the clinic.

Objective To analyze the advantages and surgical experience of laparoscopic anatomical surgery for adrenal tumors.Methods A total of 156 patients with benign or malignant adrenal tumors admitted to our hospital from April 2012 to September 2016 were enrolled and underwent laparoscopic anatomical surgery in the study.The curative effect and advantages of the operation were analyzed,and surgical experiences of laparoscopic anatomical surgery for adrenal tumors were summarized.Results Laparoscopic adrenalectomy was successfully completed in 155 of the 156(99.4％)patients and 1 patient with pheochromocytoma underwent open surgery due to pneumothorax caused by an accidental diaphragm injury.Postoperative pulmonary embolism occurred in 1 case and hematoma in right adrenal region in 6 cases,all of whom were completely relieved after intervention.Postoperative surgical specimen of adrenal glands in 54 patients were histopathologically examined,the results of which showed the negative boundaries in all patients.Patients were followed up for a mean of 11.6 months(range,4 to 26 months).All patients had a good recovery after surgery without recurrence of malignant tumor in local or trocar site.Conclusions As compared with open surgery,the transperitoneal laparoscopic adrenal surgery provides a larger operation area for good orientation and vision,and has such advantages as shorter hospital stay,fewer postoperative complications and better prognosis in patients with malignant adrenal tumors,which is worthy of clinical selection.