ObjectiveTo determine the diurnal variation,moon phase,and seasonal variation in the onset of stroke. MethodsThe time parameters,including the time,the moon phase and the season of the stroke occurrence for 905 in-patients from 1989-2001 were investigated.ResultsThere was a significant difference (D=0.155,P<0.01) for circadian rhythm in the onset of 321 cases with cerebral infarction,and the incidence frequency at dawn was much higher than that at other time,but the difference of the moon phase and seasonal rhythm in the onset of cerebral infarction were not significant(P>0.05).There were not diurnal variation,moon phase and seasonal rhythms in the onset for cerebral haemorrhage(P>0.05).ConclusionsThe cerebral infarction occur more frequently at dawn time.

Radical operation is very essential for gastric cancer, and the reasonable digestive tract reconstruction is an important part affecting the prognosis and quality of life of patients.After gastrectomy, the most basic requirements for reconstruction include prevention of gastrointestinal fluid reflux, keeping food storage and emptying function, physiological pathways and endoscopic inspection of biliary tract, pancreas and gastric remnant.In addition, technical level of reconstruction,safe operation, low invasion and suture technique cannot be ignored.Since complex digestive tract reconstruction can cause many complications, the method in the research stage should be carefully chosen.

Gastrectomy ; Gastroenterostomy ; Humans ; Laparoscopy ; Reconstructive Surgical Procedures ; Stomach Neoplasms

Intervention measures of a nursing student with hepatitis B carrier and situational mental disorder are reported,including inducing emotional release,helping nursing students appropriately recognize and deal with diseases,and searching effective social and family support.Related issues are also reflected on these interventions,such as to implement in-time mental nursing,stress hepatitis B related health education,deal with the conflict and balance between right of privacy and informed consent,and widespread related laws.

OBJECTIVE:To evaluate the rational use of antibiotics in perioperative period in Nanyang. METHODS:The application of antibiotics in discharge cases of various operations of 10 hospitals during Jan.～Mar.,2008 in Nanyang were sampled randomly. RESULTS:288 patients were treated with antibiotics. 225 cases of prevention medication accounted for 78%;63 cases of drug for treatment accounted for 22% . Among 225 cases of prevention medication,116 cases of rational choice of drug accounted for 52%,109 cases of irrational for 48%;68 cases of suitable administration time accounted for 30%,157 cases of inappropriate for 70%;the average time of preventive medication in type Ⅰ,type Ⅱ and type Ⅲ incision surgery were(4.61? 3.69)d,(7.15?3.93)d,(6.89?2.23)d respectively;as for active treatment,166 cases of single drug consisted of 74%,50 cases of two-drug 22% and 9 cases of three-drug 4%. Unreasonable administration of drug manifested as inappropriate choice of drug, inappropriate administration time,long course of treatment and the high probability of drug combination,etc. CONCLUSION:The application of perioperative antibiotics should be managed and monitored further more.

OBJECTIVE: To investigate the use of ?-receptor blockers,angiotensin converting enzyme inhibitors,aspirin and statins in acute myocardial infarction patients. METHODS: The general information of 119 cases of established acute myocardial infarction in 4 hospitals in Jiangbei district of Chongqing between 1999 to 2004 were analyzed retrospectively. RESULTS: The suitable use rates of ?-receptor blocker and angiotensin converting enzyme inhibitor are 79.0% and 85.7%, respectively, while their actual rates were 35.3% and 43.7%,respectively. Therefore among the suitable patients,55.3% of them did not receive the treatment with ?-receptor blockers and 49.0% did not take angiotensin converting enzyme inhibitors properly. The use rate of aspirin was high to 84.9%. The statins was not used until 2002 and its use rate was 15.1%. CONCLUSION: There exists significant gap between the practice and the requirement in“diagnositic and therapeutic guide for acute myocardial infarction” in the use of these drugs, except the aspirin. However, this situation is being changed.

Stage Ⅳ gastric cancer is defined as gastric cancer with non-curative factors,and the long-term survival rate of patients with stage Ⅳ gastric cancer is around 10％.Chemotherapy has been used for the main therapy of the patients with unresectable stage Ⅳ gastric cancer.Palliative resection of the primary tumor has been recommended only for presence of obstruction,bleeding and other surgical emergency.Debulking operation was irrelevant to the outcome that has been considered by research results.However,the patients with stage Ⅳ gastric cancer of only one non-curative factors (No.16a2,b1 lymph node enlargement;degree of peritoneal metastasis as P0 and positive peritoneal cytology;a small number of liver metastases)have good long-term survival when these patients have achieved R0 or R1 resection.In this regard,comprehensive treatment including surgical resection is the main treatment policy for the patients with stage Ⅳ gastric cancer.In recent years,some clinical studies on improvement of prognosis through surgical resection after conversion therapy have received extensive attention.

Resection of the automonic nervous system in the process of lymph nodes dissection is a major factor leading to postoperative gastrointestinal dysfunction.The era of blind expansion of the wide excision has been questioned,and safety first,radical dissection of the metastatic lymph nodes,low invasive rate and organ function-saving surgery have been highly emphasized.Preserving the gastric autonomic nerve effectively reduces postoperative diarrhea,shortens the time for weight recovery,and prevents insulin secretion disorders and postoperative cholelithiasis.In the process of laparoscopic or open autonomic nerve preservation in lymph node dissection for gastric cancer,full understanding of the anatomy of the autonomic nervous system,recognizing the landmark of the nerves,proper designing the surgical space,dissecting according to the extracellular space in the membrane of the nerve fibers and nerve plexus are factors which ensures the quality and effects of the surgery.

Objective To investigate the effect of the transpedical interbody bone grafting plus pedicle screw fixation for the treatment of thoracic and lumbar fractures.Methods 67 thoracolumbar fracture patients were treated with transpedicular vertebral body bone graft and pedicle screw internal fixation operation,preoperative,postoperative and follow-up uptake X line inspection,measurement and observation of.vertebral height has no loss,no fracture,internal fixation loosening occurred.Results Patients with neurological injury after operation were improved to different degree,the follow-up of patients with 12 ～ 36(23.8±9.3) average.After 1 year the patient fixation was not removed,internal fixation loosening,fracture,bone graft fusion better,no bone resorption and spinal physiological curvature to maintain good.Postoperative patients,followed for a mean of 36 months of anterior vertebral body height,height of vertebral body,posterior margin of the vertebral body height and the central angle Cobb operation were decreased significantly,the difference was statistically significant(P ＜ 0.05);and 1 week after operation and postoperative follow-up of an average of 36 months each index showed no significant differenec(P ＞0.05).Conclusion Transpedicular vertebral body bone graft and pedicle screw fixation for the treatment of thoracolumbar fractures has good clinical curative effect,which could effectively maintain the vertebral height of the front,with the value of clinical application.

Objective To study the constituents of Salsola collina.Methods The chemical constituents were isolated and purified by various chromatographic methods and their structures were elucidated by analyses of spectral data and physicochemical properties.Results Three compounds were isolated and identified as tricin-7-O-?-D-apiosyl(1→2)-?-D-glucopyranoside(Ⅰ),tianshic acid(Ⅱ),and n-hentriacontanol (Ⅲ).Conclusion CompoundⅠis a new compound named collinoside,compoundⅡis isolated from S.collina for the first time.