Obesity and related comorbidities have become serious health threats all over the world. Bariatric surgery has been shown to be an effective method for severe obesity in both the short and long term. Patients experience significant and sustained weight loss after bariatric surgery. Moreover, the preexist obesity associated comorbidities have been improved or resolved in most patients. A series of clinical researches have demonstrated the safety and validity of bariatric surgery. The clinical applications of surgery therapy provide an alternative for obesity and related comorbidities.

Objective To summarize the strategies for perioperative nursing of the patients with radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy.Method Eighteen patients with radical resection of esophageal carcinoma were treated with a combination of thoracoscopy and laparoscopy and their histories were retrospectively reviewed.Results Before the operation,nursing care focused on psychological nursing and preparations of operating room and various operating instruments.During the operation,the key nursing points included position care,proper cooperation with doctors,strict aseptic procedures and non-tumor techniques to reduce postoperative infections and dissemination of tumor cells.All the patients lived through the successful operations,their recovery satisfactory.The blood loss ranged from 100 mL to 300 mL,averaged(225.00±24.30)mL. Conclusions Radical resection of esophageal carcinoma under the combination of thoracoscopy and laparoscopy is technically feasible and safe.The perioperative nursing care is important for the improvement of operative success.

Objective To evaluate gastric bypass on relieving type 2 diabetes mellitus. Methods From September 2009 to September 2010,Thirty two cases of type 2 diabetes mellitus patients underwent gastric bypass operation in Xijing Hospital.Preoperative FBG,2hPG,HbAlc,weight,blood pressure and fatty liver were compared with that on 1 month,6 months,12 months after operation. Result There was no significant postoperative complications.FBG on 1 month,6 months,12 months postop and preoperative level was respectively 7.8 ± 2.2,7.7 ± 2.2,7.2 ± 1.8 and 11.1 ± 2.7 ( mmol/L),P ＜ 0.05.2hPG was 10.2 ± 2.6,10.5±2.8,10.5 ±3.1 and 14.0 ±3.5 (mmoL/L),P＜0.05.HbAlc was 7.6％ ±1.4％,7.5％ ± 1.7％,7.1％ ±1.9％ and9.0％±2.3％,P＜0.05.FBG[(6.9±1.5) mmol/L],2hPG[(10.0±3.2) mmol/L] and HbAlc[ (6.9％ ± 1.9％ ) ] on 12 months after operation were lower than preoperative[ FBG ( 10.7 ± 2.9 ) mmol/L,2hPG ( 14.3 ± 4.1 ) mmol/L,HbAlc ( 8.8％ ± 2.0％ ) ] in patients with BMI ＜25 kg/m2 (P ＜ 0.05 ).In patients with preoperative BMI ≥ 25 kg/m2,FBG ( 7.5 ± 2.3 ) mmol/L,2hPG ( 11.3 ±2.9) mmol/L HbAlc (7.3％ ± 1.9％ ),12 mos pest were lower than that of preoperative levels of [FBG(11.7 ±2.3) mmol/L,2hPG(13.5 ±2.4) mmol/L,HbAlc(9.2％ ±2.7％)] (P ＜0.05).Postoperative blood pressure became normal in 5 out of 6 patients complicating preoperative high blood pressure as evaluated on 12 months after operation. Fatty liver ameliorated in 8 out of 17 patients.Conclusions Gastric bypass significantly improves glycometabolism and comorbidity in type 2 diabetes patients.

Objective:To review clinical experience of PICC parenteral nutritoin in the acute and severe patients.Methods:Basilic vein,median vein and brachiocephalic vein were selected for PICC.Results:Insertion and use of PICC were successful in 56 cases with success rate of 93.33%.The parenteral nutrition was carriedout in 32 cases.There was no infection and phlebitis.2 cases failed in puncture. Conclusion:There was important clinical significance with the use of PICC in acute and severe patients.

Objective To investigate the relationship between plasminogen activator inhibitor(PAI) activity and coronary artery disease(CAD) in elderly patients. Methods Plasma samples from 93 patients with CAD were analyzed for the PAI activity, plasminogen activator(t-PA) activity, serum levels of cholesterol and triglyceride. The values of these parameters were compared between the CAD and the control groups. Results Higher plasma PAI activity 〔(810?360) AU/L vs. (640?300) AU/L,P

Objective:Evaluate the role of reactive oxygen species production and the differential expression of Rac2 and RhoGDI of neutrophils in pathogenesis of coronary heart disease.Methods:Reactive oxygen species production was measured by chemiluminescence method,the mRNA expression of Rac2 and RhoGDI was detected by quantitative RT-PCR.Results:The reactive oxygen species production by neutrophil is significantly increased in the coronary heart disease group,and the increase is related to the inflammatory cytokines in plasma.There is a significant increase of Rac2mRNA expression in coronary heart disease group than that of the control,while the expression of RhoGDImRNA in two groups are not significantly different.The ratio of Rac2mRNA to RhoGDImRNA is correlated to the production of reactive oxygen species of neutrophils.Conclusion:Netrophils are involved in the pathogenesis of coronary heart disease through their reactive oxygen species production,and the abnormal expression of Rac2 and RhoGDI is an important cause leading to the increased reactive oxygen species production.

Objective To investigate ASPS induced G_2/M arrest in lung cancer cell line H446 and its effect on ERK MAP kinase signal transduction pathways. Methods Cell cycle phases were inspected by flow cytometery (FCM) ; Western blot analysis was used to inspect the proteins of ERK, p-ERK. Results Compared with control group, G_2/M phase cells increased with concentration significantly, G_0/G_1 phase cells were not different, G_2/M phase cells and G_0/G_1 phase cells were not different when pre-incubated with PD98059 prior to exposure to ASPS of different concentrations, protein of p-ERK was significantly increased, expression of ERK was no different. Conclusion ASPS may induce G_2/M arrest of H446 cells possibly by activation ERK MAP kinase pathways.

Objective:To investigate the curative effect of hysterectomy and lymph node dissection with laparoscope or laparotomy on elderly patients with cervical cancer.Methods:60 elderly patients with cervical cancer were enrolled in our hospital from January 2014 to January 2016 and randomly divided into two groups.Group A (n=30) accepted hysterectomy and lymph node dissection with laparotomy,and Group B (n=30) adopted same surgery with laparoscope,the operation condition and postoperative recovery were compared between two groups.The intraoperative and postoperative complications of all patients were recorded and analyzed,and the quality of life of patients was evaluated in the following-up period.Results:The number of lymph node dissection in Group B was significantly more than that of Group A (P＜0.05);the intraoperitive blood loss and the times of using postoperative analgesia pump in Group B were significantly fewer than those in Group A (P＜0.05).The time of postoperative exhaust,bladder function recovery,drainage tube retention and hospital stay in Group B were all shorter than those in Group A(P＜0.05).The incidence of massive hemorrhage during operation and postoperative urinary retention and lymphatic cyst in Group B were significantly lower than those patients in Group A (P＜0.05).After operation 3 and 6 month,the I-QOL and FACT-G scores of patients in Group B were significantly higher than those in Group A (P＜0.05).Conclusions:Hysterectomy and lymph node dissection under laparoscope had remarkable curative effect on the elderly patients with cervical cancer,which improved the postoperative recovery and the quality of life of patients.

Objective To explore the bacterial flora distribution characteristics and drug resistance of pus bacterial culture in a‐cute mastitis and to analyze thechange trend of drug resistance spectrum to provide a evidence‐based basis for the rational use of an‐timicrobial agents in clinic .Methods The pus collected from 207 cases of acute mastitis was conducted the bacterial culture .The bacterial identification and antibacterial susceptibility test were performed by adopting the manual experiment combined with the DL‐96 system .Partial drug susceptibility test was performed by combining with the K‐B method .Results Among 207 specimens , 82 strains of pathogenic bacteria were detected with the detection rate of 39 .6% ,including 51 strains (62 .2% ) of staphylococcus aureus ,7 strains (8 .5% ) of pseudomonas aeruginosa ,4 strains (4 .9% ) of staphylococcus intermedius ,4 strains (4 .9% ) of staphy‐lococcus epidermis ,3 strains (3 .7% ) of acid‐producing klebsiella bacteria and each 1 strain of staphylococcus hemolyticus and other 13 kinds of bacterium .The resistance rates of staphylococcus aureus to azithromycin ,erythromycin and clarithromycin were 92 .2% ,84 .3% and 84 .3% respectively ,indicating that macrolides drugs had a higher overall drug resistance rate and were not suitable for selection and use;the resistance rates of moxifloxacin and ciprofloxacin were 3 .9% and 4 .1% respectively ,the MRSA detection rate was 27 .5% .The resistance rates of Pseudomonas aeruginosa to ticarcillin/clavulanic acid was 85 .7% ;the drug resitance rate of cefoperazone was 83 .3% ;which of gentamycin and amikacin was 71 .4% ;which of aztreonam was 14 .3% ;which of ceftazidime was 28 .6% and which of meropenem was 28 .6% .Conclusion The majority of detected bacteria in pus from the pa‐tients with acute mastitis are Staphylococcus aureus ,followed by pseudomonas aeruginosa ,which is different from that reported by other literatures ,showing the bacterial distribution has regional difference .Staphylococcus aureus has high resistance rate to macrol‐ides antibacterial drugs ,but is highly sensitive to ciprofloxacin and moxifloxacin;Pseudomonas aeruginosa has higher resistant rate to ticarcillin/clavulanic and cefoperazone ,but it is highly sensitive to aztreonam ,ceftazidime and meropenem .Empirical medication should be comprehensively considered by combining with drug resistance spectrum of Staphylococcus aureus and Pseudomonas aeruginosa ,and the sensitive drugs should be selected according to the drug susceptibility results after the antimicrobial susceptibili‐ty test for conducting the targeted medication .

Objective To understand the nursing working environment and working-family conflict in the operating room nurses,and analyze the correlation between the two.Method Tolly 190 nurses in the operating room were surveyed by general information questionnaire,PES-NWI (the practice environment scale of the nursing work index) and Work-Family Conflict Scale.Results The total nursing work environment (95.48 ± 6.34) averaged (3.08 ± 0.44),and the total score of working-family conflict was (56.67 ± 4.56),averaged (3.15 ±0.48).There was a negative correlation between nurses' perceived nursing work environment and work-family conflict(P＜0.05).Conclusions Nurses in the operating room think that the operating environment of the operating room is at the middle-high level;the nurses'working and family conflict is at the middle-high level,and the nurses' perceived nursing work environment is the main factor that affects the work-family conflict of the nurses in the operating room.Nursing managers should pay attention to the creation of good nursing work environment,improve the operating room nurses recognition of the work environment,so as to effectively alleviate the conflict of nurses work and family.