Long-segment tracheal defects are difficult to be managed by conventional surgical means,which often requires tracheal transplantation.Studies have confirmed that the capacity of tissue engineering techniques in restoration of extensive tracheal defects in animals and human.Decellularized tracheal matrix has attracted widespread attention for its advantages,such as excellent biocompatibility.Re-epithelialization of the tissue engineered trachea,which remains the major obstacle in tracheal transplantation,plays an important role in protecting the grafts from infection and restenosis.To date,some research focuses on the re-epithelialization of the tissue engineered trachea,but achievements are still far from desired,and further studies are needed to ensure the visibility of the application of tissue engineered trachea.

Objective To study new method of nursing care of total mesorectal excision with colon-rectum anastomoses through laparoscope during operation period.Methods 4 cases of total mesorectal excision with colon- rectum anastomoses were well prepared before the surgical operation,the good nourishment appearance,was estab- lished the mental nursing state was enhanced,the complications after operation were observed,and the anus was kept clean,diet was regulated,and anus function was guided.Results The surgical operation is smooth.No complications occurred during operation period and function of defecation was recovered smoothly.Conclusion The nursing of high quantity can reduce the complications.Specialty nursing during the surgical operation period is an important guarantee for the success of surgical operation surgical operations.

OBJECTIVE To investigate and control the occupational exposure of HBV.METHODS A retrospective analysis and comparison of the control of anti-HBV were conducted among 16 medical persons who occurred occupational exposure from 2005 to 2006.RESULTS It was discovered that high risk factors related with HBV infection in occupational exposure were as following:the peculiar areas of the hospital,the special period of time,the particular sites of the body where were easily exposed,vaccinating or not and so on.CONCLUSIONS The effective measures to prevent and control HBV after occupational exposure among medical staff are standardized work procedures,anti-HBV vaccination and anti-HBV immunoglobulin injection after exposure.

Objective The aim of this study was to determine whether Helicobacter infection was associated with cholangiocarcinomas in human. Methods Resected liver tissues from 11 patients with cholangiocarcinoma were subjected to polymerase chain reaction(PCR) analysis using two sets of Helicobacter-specific 16S ribosomal RNA primers, and each sample was amplified twice. Control group included two cavernous hemangioma cases and four cyst cases. Results The expected 400-bp and 300-bp fragments of Helicobacter 16S rRNA were amplified from 6/11(55%) and 7/11(64%) cholangiocarcinoma samples, 6 samples were both positive for the two sets primers. The 6 control specimens were negative. The difference between the two groups was significant( P

Objective To summarize the experiences of the diagnostic and therapeutiec approach of hepatic trauma.Methods Referencing to the literature of recent years,we retrospectively analyzed the clinieal data of 55 cases of liver trauma.Results Among the 55 cases.18 eases of stage Ⅰ～Ⅱ.1 5 cases of stage Ⅲ,17 eases of stage Ⅳ and 5 cases of stage V,Thirty-one cases received non-operative treatment.and 24 cases reeeived operative therapy.In non-operative treatment group,the cure rate was 100%.In operation Ireatmenl group the cure rate was 91.7%.Conclusions Focused abdominal sonography for trauma (FAST) and diagnostic peritoneal paraeentesis are the initial methods for diagnosis of liver trauma and are largely used nowadays.When the patient is hemodynamically stable,CT scan or simuhaneous contrast-enhanced scan are important to decide for conservative ur surgical treatment.Today.treatment of hepatic lesions takes in account mainly two aspects:hemodynamically stability and the mechanism for trauma(blunt or penetrating).Liver injmy score of patienlS is not as important as the hemodynamie status for determining conservative management.Nonoperative management under close continuous observation for the hemodynamically stable patients with stage Ⅰ and Ⅱ and some eases of stage Ⅲ blunt hepatic injury has become the stamlard of care.The decision for surgical intervention should be given in time according to the variance of hemodynamically stability and the presence of trauma (blunt or penetrating).Some cases of stage Ⅲ and all cases of stage Ⅳ to Ⅴ hepatic injury shouht preferably undergo surgieal treatment.The effective preventive measures to decrease mortality in patients with severe hepatic trauma include early remedy to henmrhagie shock.effective hemostasis,complete abdominal drainage and prevention of pnstoperative enmplieations.

Objective To discuss the pressure level of nurses in Shenzhen special administrative region (SAR) and its influencing factors and adopt selective psychological intervention to alleviate their working pressure,increase working efficiency and nursing quality. Methods The investigation by questionnaires was carried out by reference of working stress scale in 250 nurses and the results were analyzed.Results The main sources of working pressure include being afraid of making mistakes during work,frquent shift-work, low wages and other benefits,the character and social status of nursing work,less chances of advanced study and continuing education,lower recognition by patients,family and society.The working pressure was different in nurses with different position,time length of nursing work and education background. Conclusion Great working pressure existed in nurses in Shenzhen special administrative region(SAR).It is suggested that the management department should lessen or eliminate nurses'working pressure sourcs.Besides, they should practice measures to alleviate nurses'working pressure according to selective conditions.

OBJECTIVE: Superoxide dismutase is one of the families of enzymes which is ubiquitous, and efficiently catalyzes the dismutation of superoxide anions.There are three superoxide dismutases in human brain that are of benefit to ischemic damage. In recent years, transgenic and knockout mutant mice has been widely used in the researches of superoxide dismutases for its protective effect in cerebral ischemia.DATA SOURCES: Using the terms "Chan PH and superoxide dismutase and cerebral ischemia", the relative articles published in the English from January 1991 to December 2003, were identified by searching the MEDLINE database with computer.STUDY SELECTION: The trials with transgenic and knockout mutant mice were identified preliminarily, then all remainders were searched in full content and were divided into intervention group and controlled group, the random cases were accepted, non-random excluded.DATA EXTRACTION: A total of 38 fully studies related to cerebral ischemia and superoxide dismutase were collected, among them, 13 random cases were accepted, and 25 excluded which included 15 repeated studies and 10 irrelevant studies.DATA SYNTHESIS: Reactive oxygen species involved in redox signaling pathways in ischemic cerebral, it can also cause oxidative damage of some macromolecules cell such as lipids, proteins and neucleic acid. In the ischemic brain tissue, overproduced oxygen radicals and consumption of superoxide dismutases lead to tissue damage. Copper-zinc superoxide dismutase, manganese superoxide dismutase and extracellular superoxide dismutase have the same function which can decompose superoxide anion radicals to form H2O2 that are scavenged further, thereby ameliorate edema formation,infarction and cell death, improve the function of ischemic cerebral tissue further.CONCLUSION: Increased oxygen free radicals is an important mechanism in ischemic cerebral damage, all three SOD can ameliorate cerebral ischemia. The protect effect of three superoxide dismutase is related to DNA repairing enzyme, transcription factor, apoptosis proteins and signal transduction pathway.

Objective To observe the clinical effects of Shenqi Fuzheng Injection in treatment of sepsis in children and its effect on the serum levels of high mobility group protein-1 and tumor necrosis factor-α, lactic acid, C reactive protein, procalcitonin levels.Methods 140 patients with sepsis were chosen, and randomly divided into two groups, the observation group and the control group.Two groups were given treatment by the national standard of sepsis, while the control group only received basic treatment, the observation group on the basis of conventional treatment combined with Shenqi Fuzheng injection.Two groups of clinical curative effect and the levels of serum HMG-1, TNF-α, LA, CRP, PCT level were observed. Results After treatment, the observation group total effective rate (95.71%) was significantly higher than control group (70.00%),χ2 =16.29, P<0.01.Two groups before treatment, TNF-αand HMG-1 had no statistically significant difference.After treatment, 2 groups of HMG -1, TNF-αsignificantly lower than before treatment (P<0.01),which HMG-1,and TNF-αreduced significantly in observation group (P<0.01).Serum HMG-1 were positively correlated with TNF-αbefore and after treatment (P<0.05).After treatment, LA, CRP and PCT in 2 groups were significantly different compared with before treatment (P<0.01), and the observation group decreased significantly than control group (P<0.01).Conclusion The effect of Shenqi Fuzheng Injection in the treatment of children with sepsis is significant, which is worthy of clinical application.

Objective To improve the recognition of intrahepatic biliary cystadenoma.Methods The clinical manifestations,radiologic features,diagnosis and surgical treatment of 18 patients with intrahepatic biliary cystadenomaadmitted in our hospital during the recent 8 years were retrospectively analyzed.Results Four cases were discovered by general medical examination,while the other 14 patients had varying symptoms that included right upper abdominal discomfort or pain in 11 cases,abdominal mass in 3 cases,and jaundice accompaniedby fever in 2 cases.B ultrasound and CT scan showed intrahepatic cystic occupying lesions consistingof multilocular or single cyst,and usually with papillary structures in the cyst wall.All of 18 cases received surgical resection.The patholgic dingnosis was intrahepatic biliary cystadenoma in all the 18 cases,and 6 of them showed malignant change.The average survival time of maligmant patients was 35(27-58)months.Conclusions Preoperative diagnosis of intrahepatic biliary cystadenoma is difficult.Intrahepatic biliarycystadenoma is easy to develop into cystadenocarcinoma.Early surgical resection is necessary,and can effectively prevent recurrence or malignant transformation.

OBJECTIVE To analyze the prevalence of pathogens in liver abscess and their resistance.METHODS All specimens of liquor puris were collected from patients with liver abscess by liver puncture in Union hospital,Fujian Medical University from Jan 2002 to Dec 2007.Pathogens were isolated,and followed by antibiotics resistance assay.RESULTS The key pathogens of liver abscess were Gram-negative bacteria.The main Gram-negative bacteria were Escherichia coli and Klebsiella pneumoniae.The main Gram-positive bacteria were Streptococcus,Enterococcus and Staphylococcus.The resistance of K.pneumoniae was increased in recent years.CONCLUSIONS The bacterial species in the liver abscess are varying in recent six years,the ESBLs are the important factor of the resistance to antibiotics.