With the standardization and promotion of laparoscopic technology,totally laparoscopic radical gastrectomy(TLRG) has been applied widely.The main difficult points of TLRG focus on digestive tract reconstruction.The common methods of digestive tract reconstruction in TLRG include circular stapler,linear stapler and manual suture.Compared with the circular stapler method and manual suture method,the linear stapler has the advantages of simple operation,better field of vision and larger caliber of anastomotic stoma.This article introduces and evaluates the common anastomotic methods of digestive tract reconstruction with linear stapler in TLRG.

Objective To summarize and discuss the therapy of patients with tentorial herniation due to post-traumatic acute diffuse brain swelling around operations to improve the therapeutic efficacy.Methods A retrospective study was accomplished on 70 patients with tentorial herniation due to post-traumatic acute diffuse brain swellin around operations.Results According to Glasgow outcome scale,44 of 70 cases got favorable outcome,including 37 cases good recovery and 7 cases moderate deficit.The 26 of 70 cases got unfavorable outcome,including 6 cases severe deficit,5 cases persistent vegetable status and 15 cases dead.Conclusions This comprehensive therapy improves the efficacy of patients with tentorial herniation due to post-traumatic acute diffuse brain swelling around operations,which is worth spreading and applying.

OBJECTIVE:To provide reference for standardizing off-label drug use and guaranteeing clinical rational use of drugs. METHODS:2400 prescriptions were collected from outpatient department of our hospital during Jan.-Mar. 2016 at regular interval, and then divided into super-indication drug use, out-of-dose drug use, out-of-administration route drug use and out-of-group drug use. The out-of-label drug use were analyzed by reseaching package inserts,domestic and foreign guideline,do-mestic and foreign literature,MICROMEDEX Health Care Series database. RESULTS:There were 219 (9.1%) prescriptions of off-label drug use,involving 12 drug types and 38 items of off-label drug use. In mainly manifested as out-of-indication drug use (219 prescriptions,100%),out-of-group drug use (4 prescriptions,1.8%). All off-label drug use were supported by evidence, among which 9 items(23.7%)of off-label drug use were included in MICROMEDEX. Of all the related off-label drugs,Estradiol valerate tabletes(22.8%),Metformin hydrochloride tablets(17.4%)and Ethinylestradiol and cyproterone acetate tablets(12.3%) were the most common. CONCLUSIONS:All off-label drug use are supported by evidences in outpatient department of our hospi-tal. There are difference in the quality of those evidence. If off-label drug use is necessary in the clinic,it is suggested to fully weigh the advantages and disadvantages and establish related clinical management system and procedure to avoid medical risks and guarantee the safety of drug use.

Objective To develop cadres' stress scale for the Chinese people' s armed police forces.Methods Based on the stress theory and principles of the psychometrics,combined with characteristics of armed police forces. The cadres' stress scale was developed by ourselves. 802 cadres were evaluated as samples and statistic the data by item analysis ,factor analysis, reliability and valid analysis. Results The scale included four dimensions: task stress, economy stress, interpersonal stress and development stress. The internal consistency reliability was 0.893 ,the split-half reliability coefficient was 0.812. Retest reliability coefficient was 0.813. The criterion related validity to the stress scale and SCL-90 was good and the correlation coefficient with somatization, anxiety,depression, interpersonal sensitivity was 0. 376,0. 383,0. 396,0. 387 individually (P ＜ 0.05 ). Conclusion Cadres stress scale for cadres of Chinese people's armed police forces has good reliability and validity.

Objective To explore the impact of the systematic social skills training on recovery of in -patients with chronic schizophrenia.Methods A total of 78 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group on the basis of random number table. The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and the patients in the intervention group received group social skills training for 12 weeks.IPROS and SSSI were respectively used to evaluate two groups before the intervention,trained for 12 weeks.Results After 12 weeks'of systematic social skills training,social function defect levels SSSI score in the intervention group was apparently higher than that in the control group,and the difference was significant (χ2 =8.952,P <0.05 ).Compared with the control group (19.4 ± 4.5)points,(16.5 ±4.7 )points,(13.6 ±4.1 )points,(5.5 ±3.1 )points,(18.2 ±4.2 )points,(73.2 ± 16.3)points,in the intervention group public medical situation (10.3 ±5.5)points,life ability(12.1 ±5.7)points, social ability(6.2 ±3.5)points,antiseptic ability (3.3 ±3.3)points,concern and interest (9.6 ±4.5)points as well as the total score of IPROS (44.6 ±20.4),the differences were significant(t =7.760,6,188,8.165,2.568, 6.632,8.259,all P <0.05).Compared with before intervention,each factor in IPROS and the total score in the inter-vention group had statistically significant differences (t =8.890,7.923,8.321,3.195,8.21,9.852,all P <0.01). Conclusion The systematic social skills training can greatly promote the recovery of in -patients with chronic schiz-ophrenia,improve their social skills and life qualities.Compared with control group,the social function of patients in the intervention group has recovered positively.

The teaching practiceof cell biology experiments for oversea medical students in School of Medicine of Tongji University was reported in the present article, and the teaching principles of careful plan, clear contents, concise textbook, flexible scheme, full preparation, earnest trial-lecture, orderly implementation and formative assessment were put forward.Based on the different teaching object, the paper mainly explained the differences and the basis of the experimental teaching process of the foreign students and the domestic medical students to provide experience for improving the teaching mode of this kind of course.

Objective To explore the impact of the systematic social skills training on recovery of chronic schizophrenia patients with negative symptom and social skills defects.Methods A total of 82 cases of long -term hospitalized patients with chronic schizophrenia were randomly divided into intervention group and control group by digital table,41 cases in each group.The two groups received psychiatric routine therapy and nursing,and general entertainment therapy,and systemic social skills training was conducted in the intervention group for 12 weeks.PANSS and SSC were respectively used to evaluate the two groups before and after the intervention.Results After 12 weeks of systematic social skills training,the total score of SSC[(24.5 ±4.5)points]in the intervention group was apparently lower than that in the control group[(29.2 ±5.2)points],and the difference was statistically significant(t =3.212, P <0.01).Compared with the control group[(20.5 ±4.3)points,(27.2 ±4.2)points,(59.1 ±9.5)points],in the intervention group the score of negative symptom mental pathology and total score of PANSS were (14.9 ± 3.7)points,(24.5 ±3.5)points,(52.8 ±7.1)points.The differences of total score between the two groups were sta-tistically significant(t =5.199,3.317,3.239,all P <0.01),while the positive symptoms score was not statistically significant(P >0.05).Compared with before intervention,in the negative symptom table,the differences of total score N2,N3,N4,N6 had statistically significant differences(t =4.533,5.413,4.501,4.668,all P <0.01).Conclusion The systematic social skills training can greatly promote chronic schizophrenia patients with negative symptom and social skills defects,improve their social skills and life qualities.

Objective To design and synthesize derivatives of wanpeinine A, the main steroidal alkaloid isolated from the plant Fritillaria shuchengensis, and further study on the structure-activity relationship of the steroidal alkaloid. Methods Acylation and alkylation were used to synthesize the derivatives and their structures were identified via NMR and MS.Results The acylation of wanpeinine A (1) produced 3β,6α-diacetylwanpeinine A (2), 3β,6α-dipropionylwanpeinine A (3), 3β,6α-dichloracetylwanpeinine A (4), 3β,6α-dibenzoylwanpeinine A (5), and 3β-methoxyacylwanpeinine A (6). The alkylation of wanpeinine A formed 3β,6α-dimethoxymethylwanpeinine A (7). Conclusion All compounds are new except for 3β,6α-diacetylwanpeinine A.

AIM: To study the effect and mechanism of Baogan Xiaoshi Capsule(BXC) (Rhizoma Coptidis,Fructus Evodiae,Rhizoma Alpiniae Officinarum,Rhizoma Cyperi ,Rhizowa Atractylodis Macro cephalae,Fructus Aurantii Immaturus,Fel Bovis) preventing lithogensis of pigment gallstones in guinea pigs. METHODS: Feeding guinea pigs on lithogenous diet,BXC was taken for 3 months at the same time.In the end,the gallstone formation rate,biochemical indicators and liver morphology were observed. RESULTS: The gallstone formation rate was 76.92% in model group,and in BXC group,at middle or upper dose,it was 25%,20% respectively.BXC could increase the concentration of conjugated dilirubin and glycocholic acid,and decrease that of unconjugated dilirubin,Ca~(2+) and H~+.It could weaken the activity of endogenous ?-Glucuronidase and Ca~(2+)Mg~(2+)-ATPase,and also could strengthen that of Na~(+)K~(+)-ATPase.It could improve the fatty degeneration of liver. CONCLUSION: The results show that BXC could prevent pigment gallstone formation and the fatty degeneration of liver.The mechanism may be that BXC can weaken the activity of ?-Glucuronidase and decrease [Ca~(2+)].

AIM:To study the chemical constituents of leaves of Streblus asper Lour. METHODS:The constituents were isolated by column chromatography and their structures were elucidated through spectroscopic analysis. RESULTS:Seven compounds were isolated and identified as salicylic acid(1),?-sitosterol ( 2 ),?-daucosterol(3),oleanolic acid(4),magnolol(5),quercetin(6),taxifolin(7). CONCLUSION:The compounds are all obtained from the leaves of Streblus asper for the first time.