with social changing rapidly and the multiple-value in family therapy, family therapists gave up the exploration for the value forms and turned to study on the developing valuing. The value's evolution in the family therapy depends on interactions and base on evolving epistemology. The valuing course can be essentially defined as negotiation, which gives us the important suggestion for indigenous practice of family therapy.

FJ, with 9.7 times difference between the highest and the lowest. CONCLUSION: Prepared with different base materials, the permeation ability of of the preparation will be different.

Objective To investigate the surgical method,safety,and clinical effect of laparoscopic left lateral hepatectomy in the treatment of intrahepatic bile duct stones.Methods A total of 30 patients with intrahepatic bile duct stones who were admitted to our hospital from January 2015 to December 2016 were enrolled,and according to the surgical procedure,these patients were divided into conventional group (15 patients) and laparoscopic group (15 patients).The patients in the conventional group were treated with open left lateral hepatectomy,and those in the laparoscopic group were treated with minimally invasive laparoscopic left lateral hepatectomy.Surgical indices were observed,and postoperative complications and liver function parameters were compared between the two groups.The t-test was used for comparison of normally distributed continuous data,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data.The chi-square test was used for comparison of categorical data.Results The laparoscopic group had significant reductions in the time to passage of gas by anus (1.02 ± 0.51 d vs 1.98 ± 0.36 d,t =5.956,P ＜0.001) and length of postoperative hospital stay (8.83 ±0.81 d vs 11.83 ± 0.42 d,t =5.830,P ＜ 0.001) compared with the conventional group.Compared with the conventional group,the laparoscopic group had a significantly lower alanine aminotransferase level (125.8 ± 91.9 U/L vs 214.1 ± 99.6 U/L,t =2.52,P =0.02) and a significantly higher serum albumin level (33.2 ± 3.7 g/L vs 28.9 ± 4.3 g/L,t =2.94,P =0.01) at 5 days after surgery.Conclusion Compared with conventional open surgery,laparoscopic left lateral hepatectomy has the features of litde trauma,rapid postoperative recovery,and little influence on liver function in the treatment of intrahepatic bile duct stones and has a marked clinical effect.Therefore,it holds promise for clinical application.

0.05). However, in 33%(3/9) patients with normal serum AFP (

OBJECTIVE:To compare the percutaneous absorbency between imported and domestic5%doxepin cream.METHODS:In a cross design,8health male volunteers were enrolled in the study.Determination was performed by HPLC with chlorimipramine as internal standard.RESULTS:The same dose of domestic and imported doxepin cream was topically applied to the forearm skin of the volunteers for8consecutive days.The blood drug levels were very low in both groups without significant difference.CONCLUSION:The percutaneous absorbency of domestic5%doxepin cream can reach that of imported ones and the domestic cream is safe and effective.

The paper analyzes the problems of the specialized databases and search engines during document retrieval and the reasons for constructing retrieval thesaurus in the field of medical field,and establishes a retrieval thesaurus jointly reviewed by sci-tech novelty assessment and subject specialists by taking sci-tech novelty report of the sci-tech novelty station of the Ministry of Education since 2014 as the data sources.The thesaurus applies to sci-tech novelty assessment,document retrieval teaching and other fields,which can also be promoted in other fields.

Object This experiment was conducted to study the relationship between CFTR gene expression in the intestinal tissues and secretory diarrhea.Methods Twenty-four Kunming mice were selected, half male and half female, and were randomly divided into 3 groups ( n=8 in each group):control group with intraperitoneal injection of 0.2 mL nor-mal saline, and the experimental group of mice by intraperitoneal injection of lipopolysaccharide(LPS) (6 mg/kg· bw). The mental state and intestinal morphology of the mice at 1 h and 8 h after LPS injection were observed to assess whether the secretory diarrhea model was successfully established.The expression of CFTR gene segments of intestine tissue was de-tected by fluorescence quantitative PCR.Results LPS induced secretory diarrhea.CFTR gene was expressed in the mouse duodenum, jejunum, ileum and colon tissues with different expression abundance.It was highest in the colon, but the difference was not significant between intestinal segments.Compared with the control group, LPS up-regulated the tran-scription level of CFTR gene in the duodenum, jejunum and ileum, and down-regulated the transcription of CFTR gene in the colon.Conclusions The results of our study suggest that the changes of the transcriptional level of CFTR gene are closely related with the diarrhea induced by LPS and the effects in different intestinal segments on the diarrhea is different. The jejunum plays a crucial role and the colon plays a least role in the Cl-secretion.

Objective To evaluate the role of CCAAT/enhancer-binding protein homologous protein (CHOP) in ischemia-reperfusion induced lung injury, and clarify the potential molecular mechanism.Methods Fifty mice of C57BL/6J were randomly divided into five groups, 10 mice in each group, including Sham operation group(sham group),ischemia/reperfusion group (I/R group), I/R +PBS+Lipofectamine group(I/R+PBS+Lipo group) , I/R+scramble siRNA group( I/R+siRNASCR group) , I/R+CHOPsiRNA group( I/R+siRNACHOP group).The content of total lung water (TLW), wet-to-dry weight ratio (W/D) of lung and index of quantitative assessment of histologic lung injury (IQA) were detected, CHOP mRNA and protein expression were detected by RT-PCR and Western blot.Results Compared with Sham group, W/D, TLW and IQA were significantly elevated in I/R group,I/R+PBS+Lipo group and I/R+siRNASCR group (P<0.05).Moreover, the W/D,TLW and IQA reduced with CHOP-siRNA treatment, respectively(P<0.01).Compared with Sham group, CHOP mRNA and protein expressions were significantly elevated in I/R group,I/R+PBS+Lipo group and I/R+siRNASCR group, Moreover, the CHOP mRNA and protein expressions reduced with CHOP-siRNA treatment, respectively(P<0.01). Conclusion I/R could cause excessive unfolded protein response in lung tissue, and induce apoptosis by CHOP signal pathway, damage lung tissue. The inhibition of CHOP pathway could alleviate lung ischemia-reperfusion injury.

Objective To observe the effect and safety of pleural effusion treated by closed thoracic drainage with micro-catheter. Methods A total of 64 cases with pleural effusion were randomly divided into conventional therapy group ( control group ) and closed thoracic drainage with micro-catheter group ( treatment group) , each group including( 32 cases ). Control group were treated with drainage of thoracic puncture interruptedly while treatment group treated by closed thoracic drainage with micro-catheter. Results Both two therapeutic methods could reduce pleural effusion, but obvious effective rate of treatment group was higher than that of control group( P ＜ 0.05 ). Meanwhile, the rate of pleural reaction and treatment cost in treatment group were lower than that in control group. Conclusion Closed thoracic drainage with micro-catheter was effective, lower treatment cost and lower complications. Moreover, it could reduce medical risk.

Objective To systematically assess the detection of K-ras gene mutation at codon 12 in pancreatic juice for diagnosis of pancreatic cancer.Methods A comprehensive electronic searching was performed to retrieve relevant studies on K-ras gene mutation in pancreatic juice for diagnosis of pancreatic cancer.Data on accuracy of included studies were extracted,Meta-DiSc1.4,Stata10.0,was applied for further heterogeneity exploring,meta-analysis and publication bias testing.Results Fifteen studies met the inclusion criteria.Heterogeneity was not found among these studies,including threshold effect,different test methods,randomization and blind.Pooled accuracy indicators like sensitivity,specificity and diagnostic odds ratio(DOR) were 0.61(95%CI 0.56-0.66),0.82(95%CI 0.77-0.86) and 6.28(95%CI 4.42-8.91),respectively.Area under curve(AUC) of SROC(summary receiver operating characteristics) was 0.8207 and Q index was 0.7542.Publication bias had little influence on meta-analysis with the fail-safe number of 694.0108.Conclusions This meta-analysis demonstrates that the detection of K-ras gene mutation in pancreatic juice has moderate effect for diagnosis of pancreatic cancer.It is not enough to be an early diagnosing or screening indicator for pancreatic cancer,but it can be used clinically as an important adjunct to cytology,imageology and enzymology in the diagnosis of pancreatic cancer.