Objective:To observe the change of blood endotoxin level after external biliary drainage with bile extracorporeal bypass in patients with malignant obstructive jaundice.Methods:The external biliary drainages with bile extracorporeal bypass were undergone in 14 patients with malignant obstructive jaundice,peripheral blood endotoxin levels were measured in perioperative period, other 15 cases internal biliary drainage and 20 cases external biliary drainage as contrast.Results:The changes of endotoxin level were not significant in external biliary drainage group,however,the endotoxin level was decreased signficantly in internal biliary drainage or external biliary drainage with bile extracorporeal bypass at postoperation.Conclusion:The external biliary drainage with bile extracorporeal bypass can decrease postoperative blood endotoxin level in patients with malignant obstructive jaundice.

The molecular weight of matrix metalloproteinase (MMP)-9 is the largest in MMP family which comes mainly from macrophage and neutrophil.MMP-9 is considered to be involved in the occurrence and metastasis of colorectal cancer.It also provides a new way for colorectal cancer in clinical prevention and treatment.

Objective:To observe the emergency treatment effect of levosimendan combined noninvasive mechanical ventilation on acute heart failure during emergency treatment period .Methods :According to random number table , 120 cases with acute heart failure were randomly and equally divided into routine treatment group and levosimendan group (levosimendan + noninvasive mechanical ventilation ) .Improvements of arterial blood gas [partial pressure of carbon dioxide and oxygen (PaCO2 ,PaO2 ) ,pH etc .] after 72h ,change of N terminal pro brain natriuretic pep-tide (NTpro-BNP ) level 4d after hospitalization and mortality rate were observed and compared between two groups .Results:After treatment ,PaO2 ,mean arterial pressure and NTpro-BNP level of the two groups significant-ly improved compared with before treatment ;compared with routine treatment group ,there was significant rise in PaO2 [ (78.2 ± 9.4) mmHg vs .(86.2 ± 10.5) mmHg] and significant reductions in mean arterial pressure [ (86.3 ± 8.2) mmHg vs .(82.2 ± 9.0) mmHg] and NTpro-BNP level [ (4340.5 ± 540.7) pg/ml vs .(4012.1 ± 426.3) pg/ml] in levosimendan group , P<0.01 all;total effective rate of levosimendan group was significantly higher than that of routine treatment group (86.7% vs .76.6% , P=0.047);after three-month follow-up ,mortality rate of le-vosimendan group was significantly lower than that of routine treatment group (11.7% vs .20.0% , P= 0.026 ) . Conclusion:Emergency treatment effect of levosimendan combined noninvasive mechanical ventilation on acute heart failure is significant ,which is worthy of further research and extension .

Objective To explore the clinical effect of hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps.Methods 126 patients with abnormal uterine bleeding of endometrial polyps were selected,and they were selected and randomly divided into control group and research group according to the digital table,63 cases in each group.The control group received traditional curettage surgery, the research group received hysteroscopic eletrosurgery.The intraoperative blood loss,operative time,length of hospital stay,postoperative menstruation recovery time,therapeutic effect and complications were compared between the two groups.Results The intraoperative blood loss and operation time of the research group were significantly lower than those of the control group (t1=7.44,P1<0.01,t2=7.78,P2<0.01).And there were no statistical differences between the two groups in length of hospital stay and postoperative menstruation recovery time(t1=1.82,P1=0.07,t2=1.71,P2=0.09).The total cure rate of the research group was 100.00%,which of the control group was 92.14%,the difference was statistically significant(x2=8.18,P=0.00).The incidence rate of complications of the research group was 3.17%, which of the control group was 17.50%,the difference was statistically significant(x2=11.08,P=0.00).Conclusion Hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps has remarkable clinical effects and low incidence of complications,and it is worthy of clinical application.

Objective To investigate the positive influence of telephone follow-up on primiparas′exclusive breastfeeding during puerperal period. Methods By using convenience sampling method, 90 primiparas were selected who had given birth in the integration ward of our hospital from October to December 2015 as the control group, and 60 primiparas were selected who had given birth in the integration ward of our hospital from December 2015 to January 2016 as the experimental group. For the experimental group, every 2 weeks, a telephone follow-up was executed according to primiparas′parturition time after leaving hospital. For the control group, telephone follow-up was not executed. The influence of periodic telephone follow-up on primiparas′ exclusive breastfeeding was observed. Results The exclusive breastfeeding rate of primiparas in the experimental group was increased as the telephone follow-up was executed. It was up to 91.7%(55/60) 6 weeks since parturition. The exclusive breastfeeding rate of primiparas in the control group was 71.1% (64/90). The difference was significant (χ2=9.28, P<0.01). Conclusions Periodic telephone follow- up according to necessity provides breastfeeding publicity and guidance after parturition, maintaining the continuous education and caring for the primiparas after leaving hospital which efficiently increased the pure breastfeeding rate of primiparas during puerperal period.

In new era,field medical equipment gives full scope to the development of medical equipment and fulfillment of daily operation.Meanwhile,to meet the requirements of military reform,basic sanitation service needs to grasp characteristics of medical equipment and to improve management capability of medical equipment.

Objective To investigate the effects of avastin combined with As2 O3 on rabbits corneal neovas-cularization (CNV)induced by alkali burn.Methods A total of 48 Japanese rabbits were induced the CNV models by middle alkali burns.The rabbits were randomly divided into four groups.A group was subconjunctivally injected 0.5mL 1mg/mL of As2 O3 and 0.5mL normal sodium,B group was subconjunctivally injected 0.5mL 25mg/mL of avastin and 0.5mL normal sodium,C group was subconjunctivally injected 0.5mL 1mg/mL of As2 O3 and 0.5mL 25mg/mL of avastin,D group was subconjunctivally injected 1.0mL normal sodium,after corneal alkali burn,respec-tively.CNV area at 6 days,12 days,15 days,21 days and 28 days after burns were calculated,the expression of IL -1β,VCAM-1 and VEGF in corneal tissue at 7 days,14 days,28 days after burns were detected by immunohisto-chemical staining.Results Alkali burn after 28 d,the CNV,IL -1β,VCAM-1,VEGF expression rates of A group were (50.28 ±30.26)mm2 ,(6.83 ±1.74)%,(1.52 ±0.91)%,(5.02 ±0.82)%,respectively,which of B group were (55.19 ±20.03)mm2 ,(6.88 ±1.94)%,(1.41 ±0.94)%,(2.91 ±0.84)%,respectively,which of C group were (10.03 ±5.98)mm2 ,(1.96 ±0.99)%,(0.38 ±0.57)%,(1.08 ±0.77)%,respectively,which of D group were (83.18 ±33.05)mm2 ,(10.16 ±2.17)%,(3.74 ±0.83)%,(7.69 ±1.33)%,respectively.The differences among four groups were statistically significant (F =25.33,3.64,13.13,7.23,all P <0.05 ).Compared with D group,the CNV area and the expressions of IL -1β,VCAM-1 and VEGF were significantly decreased in A,B,C group(qCNV =40.294,34.281,89.590,qIL -1β =4.078,4.017,10.043,qVCAM-1 =2.719,2.854,5.791,qVEGF =3.270,8.238,11.392,all P <0.05);Compared with C group,the CNV area and the expressions of IL -1β,VCAM-1 and VEGF were significantly decreased in A,B group (qCNV =49.296,55.309;qIL -1β =5.965,6.026;qVCAM-1 =1.965,1.775;qVEGF =6.790,22.413,all P <0.05);Compared with B group,the CNV area and the expressions of IL -1βand VCAM-1 were not significantly different in A group (P >0.05);Compared with B group,the expression of VEGF was significantly increased in A group (q =4.03,P <0.05).Conclusion Avastin combined with As2 O3 can inhibit the growth of CNV induced by alkali burning in rabbits effectively,and reduce the expressions of IL -1β, VCAM-1 and VEGF in CNV.It has better efficacy than single drug,and it opens up a new way for the prevention and treatment of CNV.

Objective: To observe the therapeutic effect of nicorandil on microvascular angina pectoris (MAP). Methods: A total of 60 MAP patients were randomly divided into nicorandil group (n=30) and routine treatment group (n=30), and they were treated for 12 weeks. Onset times and duration of angina pectoris, changes of related parameters of ECG treadmill exercise test before and after treatment, and total effective rate were compared between two groups. Results: Compared with before treatment, there were significant reductions in onset times and duration of angina pectoris and maximum depression extent of ST segment (P<0.05 or <0.01) and significant increase in total exercise time (P<0.01) after treatment in both groups; compared with routine treatment group, there were significant reductions in onset times of angina pectoris [(10.3±1.6) times/week vs. (9.6±1.7) times/week] and maximum depression of ST segment [(0.8±0.3)mm vs. (0.6±0.2)mm], and significant increase in total exercise time [(7.8±1.4) min vs. (9.4±1.6) min] and total effective rate (73.3% vs. 93.3%) in nicorandil group, P<0.05 or <0.01. Conclusion: Nicorandil possesses significant therapeutic effect on microvascular angina pectoris, and it is worth further study.

Many countries have developed standard strategy under the tendency of the economic globalization.TCM international standardization faces more and more competitions.This article analyzes the competitors and competitive status of TCM international standardization by the research methods of competitive intelligence,competitor analysis and SWOT analysis,and puts forward corresponding strategic measures in details.

Objective To investigate the safety and efficacy of transvaginal hydrolaparoscopic pelvic adhesiolysis (THLPA) treatment in the infertile women.Methods From May 2007 to Sep.2008,30 infertile patients underwent THLPA.The dye-test,hysteroscopy,and dye-test using catheterization of tubal ostium by hysteroscopy were performed at the same time.Pelvic adhesions were scored according to the revised American Fertility Society classification of endometriosis (1985).The adhesions were graded as mild (score 1-9),moderate (10-19),and severe (≥20).Twenty-four cases were in mild adhesions,5 moderate adhesions,and 1 severe adhesion.The duration of the operation and discharge,pelvic adhesions score,tubal patency,complications,and pregnancy rate were investigated.Results (1) THPLA:the majority of pelvic adhesions in all patients were successfully performed adhesiolysis.Only a little filmy adhesions of proximal peritube of 7 tubes and proper ligament of 5 ovaries and cohesive adhesions of 4 ovaries did not underwent surgical lysis.(2) Tubal patency:35 tubes were of proximal occlusion by dye-test,of which 21 (60%,21/35) were unobstructed and 4 (11%,4/35) were partly unobstructed after the dye-test using catheterization of the tubal ostium by hysteroscopy.(3) The duration of operation:the overall operative time were (32±6) minutes in mild adhesion,(52± 6) minutes in moderate adhesion,and 83 minutes in severe adhesion.Of which the time of THLPA were (11±5) minutes in mild adhesion,(35±7)minutes in moderate adhesion,and 62 minutes in severe adhesion,respectively.(4)The duration of discharge:the postoperative discharge time was 120-175 minutes.No complications occurred.(5)The rate of pregnancy:in the (15.8±4.3) months' follow-up,the rate of pregnancy was 45% (13/29),which one patient lost follow-up.Conclusions THLPA is safe,efficacious and not being hospitalized management.When compared with laparoscopy,it is simpler,more economic,and less minimally invasive approach.The appropriate indication of THLPA is to treat filmy,especially mild pelvic adhesions.It could partly avoid transabdominal operative laparoscopy for the infertile women.