Objective:To observe the effect of acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) on gastrointestinal function of patients after laparoscopic cholecystectomy. Methods:Totally 120 patients undergone laparoscopic cholecystectomy were randomized into an acupoint injection group, a muscular injection group, and a blank control group at 1:1:1 by random number table, 40 cases in each group. The blank control group was intervened by conventional post-operation treatment, the acupoint injection group was by acupoint injection with Neostigmine Methylsulfate 2 mL at bilateral Zusanli (ST 36) in addition to the treatment given to the blank control group, and the muscular injection group was by muscular injection with Neostigmine Methylsulfate 2 mL in addition to the treatment given to the blank control group. The two injection groups both received injection twice a day, totally for 3 d at most. The restored time of bowel sounds, initial flatulence time, defecation time and clinical efficacy were observed. Results:After treatment, there were significant differences in comparing the restored time of bowel sounds among the three groups (F=17.30,P<0.05), the acupoint injection group and muscular injection group were significantly different from the blank control group (P<0.05), and there was a significant difference between the acupoint injection group and muscular injection group (P<0.05); there were significant differences in comparing the initial flatulence time among the three groups (F=19.12,P<0.05), and the acupoint injection group was significantly different from the muscular injection group and the blank control group (P<0.05); there were significant differences in comparing the initial defecation time among the three groups (χ2=21.23,P<0.05), while the difference between the acupoint injection group and muscular injection group was statistically insignificant (P>0.05). The total effective rate was 87.5% in the acupoint injection group, versus 72.5% in the muscular injection group and 60.0% in the blank control group, and there were significant differences among the three groups (P<0.05). Conclusion:Acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) can shorten the restored time of bowel sounds and flatulence time in patients undergone laparoscopic cholecystectomy, and the efficacy is more significant compared to muscular injection with Neostigmine Methylsulfate.

Ageing of population is now a phenomenon of the world and has considerable consequences for public services.Ageing is always accompanied with dysfunction of multiple organs,including hypothalamic-pituitaryadrenal axis.Here,we summarized alterations of hormone secretion of adrenal glands in the elderly and their relationships with Alzheimer' s disease.Moreover,we discussed characteristics of pheochromocytoma,primary aldosteronism,and Cushing's syndrome in the elderly.Lack of typical manifestations usually makes difficulty in diagnosis.

This paper investigates 240 cases of medical disputes and interviews involved patients with questionnaires,explores patients′ behaviors,attitudes,and complaints in medical disputes,and analyzes the reasons and motivations for those behaviors and attitudes,in order to provide reference for reduce medical disputes and improve physician-patient relationship.

Objective:To explore the solutions to enhance the professional skills and humanistic quality of neurosurgery in theprimary hospitals, and to improve the neurosurgery medical care level.Methods: a comprehensive analysis of the literature retrieval as well as information collected in practice the first hospital of Zhangjiakou in, extract the problems of neurosurgeon training in primary hospital, to carry out grading treatment requirements, explore the basic path to improve the clinical ability of primary hospital neurosurgeon, and through the establishment of standard clinical operating procedures and systems to ensure the quality of medical service.Results: from Wanfang database retrieved from 2006 to 2015 research journals in Chinese on improving grassroots doctors ability of 819 papers, bibliometric analysis shows that the trend is increasing year by year, in 2015 issued a number is 5.21 times in 2006. There are 28 papers including neurosurgery area, accounting for 3.42% of the total number of papers; the hot topics focus in the mode of training neurosurgery doctors in primary hospitals,transfer the technology of minimally invasive neurosurgery and spreadmodern neurosurgery theory and knowledge.Conclusion: to improve the ability of doctorsof primary hospitals should be combined with the characteristics of local diseasesand primary hospital neurosurgeon status, from making training plan, appropriate to establish the corresponding clinical standard, promote the essential neurosurgery technology, in order to ensure implementation of the tiered diagnosis and treatment .

Idiopathic hypogonadotropic hypogonadism (IHH) is characterized by delayed or absent puberty and lowered sexual function as a result of impaired pulsatile gonadotropin-realeasing hormone (GnRH) secretion.Identification of TAC3/TACR3 mutations as the culprits of IHH revealed that neurokinin B (NKB) signaling pathway was involved in the regulation of pulsatile GnRH secretion.This review focuses on the involvement of NKB signaling in pulsatile GnRH release,the discovery of TAC3/TACR3 mutations and the phenotypes,and treatment of patients who carry TAC3 or/and TACR3 mutations.

This paper presents a case of hyperthyroidism with myasthenia gravis (MG),diagnosed by neostigmine-test.Thyrotoxicosis and clinical manifestations of MG were controlled by acetylcholinesterase-inhibitor and immuno-suppressive medicine.Being followed for more than 2 years,the patient had been free of clinical symptoms of MG and his thyroid function was normal.

Objective To investigate the clinical value of the subfascial endoscopic perforator surgery (SEPS) combined the endovenous laser on venous ulcer in lower extremities.Methods Subfascial endoscopic perforator surgery was applied to 32 patients (34 limbs) of varicose veins with venous ulcers,aided by endovenous laser treatment of great saphenous veins and varicose veins.Results All branch limb varicose veins disappear,leg heaviness significantly reduce soreness,leg ulcers were healed up in 2 to 8 weeks after surgery.All patients were followed for 1 year to 5 years,no recurrence of varicose veins and ulcers formed.Conclusion The method of endoscopic perforator surgery combined the endovenous laser for venous ulcer in lower extremities is simple operation,small trauma,quicker recovery,should be widely applied.

Objective To monitor the resistance of Streptococcus pneumoniae following the 2004 in Qingdao area, and to provide a reasonable basis for clinical application of antimicrobial agents. Methods Collecting respiratory tract, blood, cerebrospinal fluid and other specimens from out-patient and in-patients of some hospital in Qingdao from January 2005 to December 2008. According to the recommendation of NCCLS, antibiotic resistance analysis of 11 kinds of antibiotic to the isolated 231 Streptococcus pneumoniae by micro-agar dilution method, and analysis resistance trends and age differences. Results The results showed that the rate of Streptococcus pneumoniae not sensitive to penicillin is 23. 38% (PRSP: 9.52% , PISP: 13. 85% ) , resistant to cefotaxime is 9. 96% (23/231), resistant to amoxicillin is 12. 55% , resistant to erythromycin is 90. 48% (209/231). PRSP rate of patients younger than 14 years of age 27. 91% (12/43), significantly higher than that of the PRSP rate of adults 5. 38% (10/186). Conclusion The rate of resistant to penicillin Streptococcus pneumoniae increased significantly from 2004, and an increasing trend year by year, the resistance of Streptococcus pneumoniae is also a rising trend year by year. For patients infected low penicillin-resistant Streptococcus pneumoniae in this region, cefotaxime, amoxicillin are preferred drugs.

Objective To study the diagnostic value of porphobilin staining of gastric mucus for primary pathologic duodenogastric reflux (DGR). Methods A total of 58 DGR patients diagnosed from January, 2007 to April, 2008 were recruited to the study as DGR group, and 21 healthy volunteers as control.All subjects underwent 24-hour intragastric bilirubin monitor and gastroscopy. Bilirubin absorption value of 0. 25 and median reflux time of 23.60% were taken as thresholds to differentiate low reflux group ( reflux time ＜ 23.60% ) and high reflux group (reflux time ≥23.60% ). Porphobilin staining of gastric mucosa was quantitatively analyzed. Results Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in primary pathologi DGR group was significantly higher than those in healthy group (P ＜0. 05 ). The occurrence of atrophic and intestinal metaplasia of gastric antrum in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05). Deposition of porphobilin in mucosa of gastric antrum, gastric angle and gastric body in high reflux group was significantly higher than that of low reflux group (P ＜ 0. 05 ). The New Sydney system pathological scores of gastric antrum and angle of high reflux group was higher than that of low reflux group ( P ＜ 0. 05 ). The deposition of porphobilin in mucosa of gastric antrum and gastric angle was positively correlated with New Sydney system pathological scores in primary pathological DGR group (r=0.59, P=0.041 andr=0.73, P=0.038). Conclusion Porphobilin staining of mucosa in gastric antrum can reflect the severity of bile reflux, and is positively correlated with the extent of gastric mucosal lesion, which may be helpful in diagnosis of primary pathological DGR.

Objective To quantitatively investigate the effect of low-dose ionizing radiation on the frequencies of chromosome aberrations and micronucleus-containing cells of radiation workers.Methods Nine electronic databases were systematically searched on the basis of the published studies evaluating the effects of low-dose ionizing radiation on the frequencies of chromosome aberrations and micronucleuscontaining cells.Of the 195 studies searched,21 studies were identified with a total of 1 970 626 cells under studying.Cochrane' s Q and I2 statistics were used to evaluate heterogeneity among studies and pooling odds ratio (OR) with 95％ confidence intervals (CI) were calculated using random-effect models or fixed-effect models,and publication bias were also calculated.Meta-analysis was performed using Stata 12.0.Results The pooling OR of chromosome-type aberrations [OR =3.03 (2.59,3.56)],dicentric plus centric rings [OR =4.12 (2.99,5.67)],translocations [OR =2.73 (1.67,4.46)],micronucleuscontaining cells [OR =1.70 (1.40-2.06)] were higher for radiation workers when compared with control group.Conclusions The frequencies of chromosome aberrations and micronucleus cell of peripheral lymphocytes are significantly high in radiation workers who were occupationally exposed to low-dose ionizing radiation.It should be noted that the radiation protection of radiological workers be enhanced.