Objective To determine the best time to operate on elderly patients with acute severe cholangitis (ACST).Method The time to operate was analysed in 36 elderly patients with ACST.Result With active preoperative anti-shock treatment,the mortality rates for emergency surgery within and after 8 hours were 8.3％ and 33.3％,respectively.Conclusion Early operation for elderly patients with ACST markedly reduced mortality.

This article deals with the rehabilitative technology speciality launched in polytechnic,discusses its education orientation and cultivation pattern,explores the cultivation rule of professionals of rehabilitative technology and gives some beneficial complementarities for the cultivation of professionals of rehabilitative technology.

Natural products were the material basis of drug discovery and drug screening, and high-performance techniques were the important prerequisite of earning hits. In this paper, we reviewed the current situation and future prospects of drug screening, including the pharmaceutical environment, the challenges facing drug discovery, the screening tools and the methods of generating analogs.

AIM:To investigate the clinical effect of pills of six ingredients with rehmannia combined with ginkgo biloba leaf table in the prevention and treatment of early retinopathy in patients with type 2 diabetes mellitus.METHODS:A total of 82 patients (82 eyes) with type 2 diabetes mellitus who were treated with endoscopy from January 2013 to January 2015 were randomly divided into observation group and control group according to the random number table method.The control group was given conventional western medicine treatment, the observation group in the control group was given pills of six ingredients with rehmannia combined with ginkgo leaf table treatment besides the control group treatment.The diabetic retinopathy was assessed in both groups, as well as changes in blood glucose, blood pressure, and glycosylated hemoglobin.We recorded the occurrence of adverse reactions during and after treatment.RESULTS: The new diagnosed rate and the progress rate of observation group were lower than those of the control group, remission rate was higher, and the difference was statistically significant (P<0.05).There was no significant difference of the two groups on blood glucose, blood pressure and glycosylated hemoglobin before and after treatment (P>0.05).The incidence of adverse reactions between the two groups was not statistically significant (P>0.05).CONCLUSION: Type 2 diabetes mellitus patients treated with pills of six ingredients with rehmannia combined with ginkgo biloba leaf table can effectively control the rate of retinopathy, the rate of progress, improve the rate of remission with high drug safety, and have the significance of further clinical research.

Objective: To establish an HPLC method for determination of chlorogenic acid, baicalin, emodin and chrysophanol contents in Kangjunxiaoyan tablet. Methods: After removing the coating, the powder of Kangjunxiaoyan tablet was extracted by 50% methanol for 30 min using the following condition: analytical column, Agilent Eclipse Plus-C18 column (4.6 mmX250 mm, 5 μm); mobile phase: A, 0.1% (v/v) phosphoric acid-water, B, methanol, C, acetonitrile with gradient elution. The flow rate was 0.8 ml/min; the detection wavelength was set at 254 nm; the temperature of column was 30°C; and the injection volume was 10 μl. Results: The title compounds were separated at baseline within 45 min with good linear, with the regression being Y = 12.89X-12.66, r = 0.9999 for chlorogenic acid, Y = 13.96X-1.013, r=1.0000 for baicalin, Y=35.82X-4.923, r=0.9999 for emodin, and Y=44.16X-3.280, r=0.9999 for chrysophanol. The intra-day and inter-day precisions and the limits of detection were all within the normal range. The recovery rates (n=3) were: chlorogenic acid 101.5% (RSD=1.6%), baicalin 103.4% (RSD=1.4%), emodin 99.3% (RSD=2.0%), and chrysophanol 98.1% (RSD=1.7%). Conclusion: HPLC is a simple, accurate, stable, and reliable method in determining the contents of chlorogenic acid, baicalin, emodin, and chrysophanol in Kangjunxiaoyan tablet, and it can be used for quality control of this preparation.

Objective To summarize the experience in the management of incarcerated umbilical hernia in cirrhotic patients with aseites. Methods The operative methods, perioperative management and fellow-up data of 15 patients diagnosed incarcerated umbilical hernia in the setting of cirrhosis and ascites were studied retrospectively. All the patients underwent emergency operation to remove necrotic umbilical skin and hernial content, including incarcerated greater omentum (6 cases) and strangulated segment of small bowel (5 cases). After debriding the operating field thoroughly, the umbilical hernia was repaired with polypropylene mesh, among those Sublay repair was used in 11 cases with the longest diameter of hernial ring more than 3 cm and Onlay repair in 4 cases with the longest diameter of hernial ring less than 3 cm. During the perioperative period, albumin and fresh frozen plasma transfusion, as well as diuresis and ascites paracentesis, was adopted to treat eirrhosis and ascites. Results All the patients underwent operation successfully. The operative time was 90～185 min, averaging at 122 min. Seroma formation in 2 cases and incision infection in one were cured with conservative therapy. One patient died of multiple organ dysfunction after the operation. During the fellow-up of 1～5 years, 1 patient died of liver function failure and there was no hernia recurrence. Conclusion With appropriate perioperative management and correct operative method, polypropylene mesh could be adopted in the emergency repair operation of incarerated umbilical hernia in the setting of cirrhosis and ascites.

Objective To assess quantitatively the association between smoking and the risk of disease and death from pulmonary tuberculosis(TB) by a meta-analysis. Methods Both Chinese and English literatures published from Jan. 1999 to Jun. 2010 about the case-control study of the association between smoking and pulmonary TB were retrieved by searching the electronic resource databases. A meta-analysis was then performed on the comparison and synthesis of findings from included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a software RevMan 4.2. Finally,possible publication bias was tested and a sensitivity analysis was conducted. Results The meta-analysis for total 22 high-quality case-control studies found a pooled OR of 2.56 (95% CI 1. 80 ～3.64) with a random-effects model. Sensitivity analysis showed that pooled OR was 2.56 (95% 1.76 ～3.71 ) by removing two papers of nested case-control study. The OR were 2.13 (95% CI1.76～2.58) and 4.60 (95% CI 1.81～11.69) for disease and death from TB,respectively. After confounding factors,including age and gender,had been controlled the OR was 2.53 (95% CI 1.27 ～5.03 ) whereas 1. 99(95% CI 1.54 ～ 2.56 ) without control of them. Conclusion Smoking can increase the risk of incidence and death of TB. TB control programs and treatment of patients might benefit from interventions aimed at reducing tobacco exposure.

Objective To investigate the application effects of milk protein challenge test and serum specific IgE antibody de-tection in children with milk protein allergic diseases.Methods 76 cases of children with milk protein allergic diseases of North Hospital of the People’s Hospital in Urumqi City from January,2013 to December,2015 were treated with milk pro-tein challenge test.The clinical characteristics,results of milk protein challenge test and serum IgE antibody detection,and the value change of routine blood indexes were analysed and compared.Results Diarrhea and hematochezia were the most common clinical features,vomiting,hematemesis and abdominal distention were rare.47 cases (61.8%)showed positive re-sults in milk protein challenge test,and 29 cases (38.2%)showed negative results.42 cases of positive children had delayed allergy,and 5 cases showed rapid allergy.Compared with the negative group,the positive rate of serum specific IgE antibody in positive group didn’t change obviously,the difference was not statistically significant (14.9% vs 6.9%,χ2=0.466,P>0.05).The neutrophil count in positive group was higher after challenge than that of before challenge (t=2.480,P<0.05). The number change of blood cell,neutrophil and platelet in positive group were no statistical differences compared with those in negative group (t=0.500,1.395,0.296,all P>0.05).Conclusion Diarrhea and hematochezia were the most commom disease of digestive tract in children with milk protein allergic diseases.It is necessary to perform milk protein challenge test in clinical practice,however,serum specific IgE antibody is not considered as its diangnosis basis.

Vaccination in children suffering neurological diseases is a troublesome issue that people es-pecially pediatricians are reluctant to mention. Due to worrying about the emergence of adverse reactions and concerning on the heat induced seizure,doctors and parents tend to cancel or do not recommend these children to be vaccinated. Additionally,the heat sensitive seizures,such as febrile seizure( FS) ,generalized epilepsy with fe-brile seizure plus(GEFS+),Dravet syndrome account for the largest proportion of the seizure related disease and epilepsy syndrome. Their pathogenesis has been proved relating to the mutation of SCN gene of the sodium channel. For children with FS,GEFS+,and Dravet syndrome,vaccination may lead to fever,which even may bring about convulsions,but it will not result in worse prognosis.

Objective To investigate the diagnostic method,microsurgical operation time and effect of brain arteriovenous mal-formation(AVM)rupture hemorrhage in childhood.Methods 72 children (≤16 years old)of AVM hemorrhage from 2003 to 2013 were retrospectively analyzed.Results The CT diagnosis rate was 48.6%(35/72),the MRI diagnosis rate was 78.3%(47/60),56 cases were performed the early whole brain DSA under the condition permitting,its diagnosis rate was 98.2%(55/56).All the cases were performed the hematoma clearance plus the pertinent lesion resection.70 cases were re-examined by DSA/CTA/MRA during postoperative perioperation period.The lesion resection rate was 91.5%,the partial resection rate was 8.6%.60 cases(85.7%) were successfully followed up for 6 months to 6 years and assessed by the Glasgow outcome scale,5 points in 5 5 cases,4 points in 2 cases,3 points in 2 cases and 2 points in 1 cases.Conclusion DSA is the main detection measure for early diagnosing AVM hem-orrhage and the microsurgical operation in the acute stage can reduce the fatality and improve the prognosis.