Objective To observe the clinical effect of treatment of duodenal trauma intubation duodenal decompression jejunostomy jointly by the duodenal catheter decompression.Methods 60 patients with duodenal trauma were randomly divided into two groups,30 cases were treated with simple duodenal catheter decompression as control group,30 cases treated with duodenal catheter decompression joint jejunum ostomy intubation duodenal decompression as the observation group,generally observed two groups of patients surgery and postoperative complications,in the day of surgery and postoperative 7d evaluation of patients with nutritional status.Results The surgical time and blood loss of the two groups had no statistically significant difference(P＞0.05),the observation group had no case of duodenal fistula and four cases in the control group(13.33％)occumed duodenal fistula.The difference between the two groups was statistically significant(x2=4.286,P＜0.05).Postoperative concurrent abdominal abscess,lung infection,wound infection had no statistically significant differences(P＞0.05).After observation group 7d body mass and right upper arm muscle circumference stability was significantly higher than that in the control group(x2=7.519,9.868,both P＜0.05).Conclusion Jejunostomy joint duodenal catheter decompression intubation duodenal decompression in treatment of duodenal trauma surgical decompression had significant effect,can significantly reduce the incidence of fistula,improve patients nutritional status,promote the duodenal wound healing.

Objective: To investigate the influence of pharmaceutical care pathway on cancer-related fatigue (CRF) and negative emotion in patients with advanced lung cancer undergoing chemotherapy. Methods: Patients with advanced lung cancer admitted to the oncology department of Yongkang first people′s hospital from January 2017 to June 2018 for chemotherapy were randomly divided into two groups:61 cases received conventional clinical pathway management (control group), and 64 cases received conventional clinical pathway combined with pharmaceutical pathway management (intervention group). Fatigue, anxiety, depression scores were compared between the two groups before and after 2, 4 cycles chemotherapy. Results: There was no significant difference in baseline condition between the two groups (P>0.05). After 4 cycles of chemotherapy, emotional, physical and cognitive fatigue scores in the intervention group were lower than control group (t=2.975, 1.512, 2.393, P<0.05). With the increase of chemotherapy cycles, scores of fatigue dimensions in control group were increased (F=44.274,21.740,29.261,7.206, P<0.05). In the intervention group, there were statistically significant differences in scores of fatigue dimensions (F=17.083, 15.902, 17.055, 10.543, P<0.01), among which, scores of behavioral and physical fatigue dimensions were increased (P<0.01), while scores of emotional and cognitive fatigue dimensions were decreased (P<0.01). In terms of negative emotions, depression scores in the intervention group were lower than those in control group at 2 cycles of chemotherapy (t=2.578, P<0.05), and at 4 cycles, anxiety and depression scores were lower than control group (t=7.004, 7.454, P<0.05). As the chemotherapy cycle increased, anxiety and depression scores in the control group increased (F=12.333, 14.819, P<0.05), while those in the intervention group decreased (F=4.992, 3.826, P<0.05). Conclusion The pathway of clinical pharmaceutical care can significantly improve the CRF and negative emotions of patients with advanced lung cancer undergoing chemotherapy.

Objective: To analyze the effect of human papillomavirus (HPV) detection and cervical cell basal fluid on the early diagnosis of cervical precancerous lesions. Methods: From January 2016 to January 2017, 223 patients in the Maternal and Child Health Care Hospital of Yongkang who received gynecological cervical cancer precancerous lesions screening were selected.All patients into the outpatient screening categories were given cervical liquid-based cytology (TCT) examination and HPV detection, 61 patients with test results of double positive received colposcopy cervical biopsy histopathological examination, the final diagnosis of 49 patients with epithelial cell changes.The accuracy and sensitivity of different detection methods were compared. Results: The detection rates of high risk HPV infection in cervicitis, CINⅠ, CINⅡ-CINⅢ and cervical cancer patients were 16.22%, 39.29%, 71.43% and 100.00% in 223 cases of this study.The total positive rate of TCT was 28.57%.The total positive rate was 44.44% in HPV group and 75.51% in combination test.The positive rate of combined detection was higher than TCT (χ²=21.63, P=0.000) and HPV (χ²=25.51, P=0.000), the difference was statistically significant.For ASC patients, the sensitivity of TCT, HPV and combined detection was 57.14%, 64.29% and 85.71%, respectively.The accuracy of TCT, HPV and combined detection was 64.29%, 71.43% and 92.86%, respectively.The sensitivity of combined detection was similar to TCT (χ²=2.13, P=0.140) and HPV (χ²=1.25, P=0.260). The accuracy of combined detection was similar to TCT (χ²=2.33, P=0.130) and HPV (χ²=1.39, P=0.240). For LISIL patients, the sensitivity of TCT, HPV and combined detection was 56.25%, 62.50% and 87.50%, respectively, the accuracy was 68.75%, 75.00% and 93.75%, respectively.The sensitivity of the combined test group was higher than that of TCT (χ²=3.86, P=0.049) and HPV (χ²=4.57, P=0.033), and the accuracy of combined test was higher than that of TCT (χ²=3.902, P=0.048) and that of HPV (χ²=4.13, P=0.034). For HISIL typing patients, the sensitivity of TCT, HPV and combined detection was 57.89%, 63.16% and 89.43%, respectively, and the accuracy was 73.68%, 78.95% and 94.74%, respectively.The sensitivity of the combined test group was higher than that of TCT (χ²=4.89, P=0.027) and that of HPV (χ²=3.99, P=0.047), and the accuracy of combined test was higher than that of TCT (χ²=3.99, P=0.048) and that of HPV (χ²=5.34, P=0.027). Conclusion High-risk HPV detection combined with TCT in the screen of cervical cancer precancerous lesions is simple and efficient, taking into account the accuracy and sensitivity, it can reduce the rate of missed diagnosis, has a positive effect on prevention and control of cervical cancer.

Objective To observe the characteristics of electromyography of sphincter of Oddi (SO) in patients with cholelithiasis after common bile duct exploration,and investigate new methods for detecting the motility of SO.Methods The basal pressure of SO(SOBP)and electromyography of SO were detected in 33 patients with cholelithiasis who were reexamined at the Southwest Hospital from January to October,2010.All patients were divided into low SOBP group,normal SOBP group and high SOBP group.The amplitude,frequency and duration of SO spike burst(SOSB)of the three groups were compared.Results The numbers of patients in the low SOBP group,normal SOBP group and high SOBP group were 14,13 and 6,respectively.The mean SOBP of the low SOBP group,normal SOBP group and high SOBP group were(3.1±1.2),(18.5±7.6),(39.8±4.8)mm Hg (1 mm Hg=0.133 kPa).The amplitude,frequency and duration of SOSB were(41±27)μV,(5.8±1.6) times/minutes and(2.7±0.6)s in the low SOBP group,and(150±71)μV,(6.9±1.4)times/minutes and (3.4±0.7)s in the normal SOBP group,and(301±109)μV,(7.8±1.2)times/minutes and(4.2±0.7)s in the high SOBP group,respectively,with significant difference among the three groups(F=50.751,4.293,13.159,P<0.05).Conclusion The results of electromyography of SO could reflect the function of SO,and it is possible to be a prospective method in the clinical research of SO.

Objective To understand the cause of chest pain (precordium indisposition) in children and explore the thread of thought in its analysis.Methods Clinical data of 314 children with chest pain who visited the cardiovascular department for children of our hospital were collected and analyzed to study its causes.Results The cause could be attributed to organic cardiac diseases in 43 of 314 children (13.7%) with chest pain,to non-organic cardiac diseases in 108 (34.4%),to psychiatric-psychological factors in 60 (19.1%) and to unknown cause in 41 (13.1%).Average age of children with organic cardiac diseases was younger than that of children with other causes (P<0.05).Symptoms accompanied simultaneously in children with organic cardiac diseases were much more frequent significantly than those in them with non-organic cardiac chest pain and unknown causes (P<0.05).Conclusions Chest pain in children could be caused by a few causes,which was non-specific symptom for organic cardiac diseases,so, more should be taken into account in analyzing the cause of chest pain in children.

A total of 121 patients with metabolic syndrome (MS) and 120 normal subjects were recruited for exploring the association of serum adipokines with MS. The levels of resistin and adipocyte fatty acid-binding protein (A-FABP) increased, while adiponectin decreased gradually ( all P<0.05 ) in normal control group, MS without abdominal obesity group, and MS with abdominal obesity group. In MS group, resistin was positively correlated with body mass index ( BMI), waist circumference, systolic blood pressure, fasting plasma glucose, and A-FABP ( P<0.05 or P<0.01 ). Adiponectin was positively correlated with high-density lipoprotein-cholesterol and negatively correlated with BMI, waist circumference, fasting insulin, triglyceride, and homeostasis assessment of insulin resistant index.

Serum adipocyte fatty acid-binding protein (A-FABP) was raised in metabolic syndrome (MS)patients (n= 121) as compared with age-matched healthy subjects [n = 120, (14.7±4.8 vs 6.8 ±3. 0) μg/L,P<0.001]. It reached higher level in MS subjects with visceral obesity [(15.7±4.2 vs 12.6±5.1) μg/L, P<0.001]. Serum A-FABP concentration was positively correlated with body mass index, waist circumference, waist-tohip ratio, fasting insulin, homeostasis assessment for insulin resistance (HOMA-IR), fasting glucose, triglycerides,total cholesterol,and mean arterial blood pressure, whereas negatively correlated with HDL-C (r =-0. 448, P< 0.001).

Objective To evaluate the efficacy of multislice helical CT(MSCT) in the diagnosis of coronary artery disease Methods 30 patients were studied with MSCT CT data were reconstructed to demonstrate the abnormalities of coronary artery and the results were compared with that of angiography Results In patients with heart rate less than 60 BPM, there was no difference to show the main branch of left coronary artery and left descending artery compared with more than 60 BPM( P =0 197 and 0 128,Fisher′exact);and obvious differences in showing left circumflex artery (? 2=5 88, P

Objective To evaluate the expression of G250 mRNA in patients with renal cell carcinoma (RCC) and its clinical significance. Methods A semi-quantitative reverse transcription (RT)-PCR was developed to assay the levels of G250 mRNA obtained from 7 normal renal tissues and 33 cases of RCC.Of the 33 RCC cases,28 had clear cell carcinoma and 5 had non-clear cell carcinoma.By UICC staging, 8 cases were diagnosed with T_1 stage carcinoma,13 with T_2 and 12 with T_3.Pathological grading showed 11 cases of G_1,15 of G_2,and 7 of G_3. Results Among the 33 cases of RCC,G250 mRNA expression was present in 28 cases (84.8%).However, it was absent in all the 7 normal renal tissues.There was a significant difference between the 2 groups (P0.05);while they were 0.48?0.32,0.23?0.16 and 0.11?0.11,respectively,in RCC cases of G_1,G_2 and G_3,which showed that the expression of G250 mRNA was inversely correlated with tumor grades(P

Objective To compare the accuracy of placement of ventricular shunt tube,the efficacy and complications of the neuronavigation-assisted ventriculoperitoneal shunt (group A) and traditional ventriculoperitoneal shunt (group B).Methods A retrospective study was made on 40 cases of hydrocephalus managed with neuronavigation-assisted ventriculoperitoneal shunt or ventriculoperitoneal shunt from January 2012 to June 2016.There were 18 cases [12 males,6 females;(47.5 ±8.5) years of age] in group A and 22 cases [14 males,8 females;(44.5 ± 7.5) years of age] in group B.Therapeutic effect and complications were analyzed postoperatively.The accuracy rate in ventricular end shunt placement that was free from the frontal horn of lateral ventricle and flush the Moro hole had also been studied.Results The position of ventricular shunt of all the patients were postoperative timely review of the CT view,and hospital outpatient follow-up periodical for 3-24 months after discharge from hospital.Patients with postoperative timely review of head CT and found that group A of ventricular end of the shunt tube position reach a set position in 16 cases,2 cases had not reached the set position,the accuracy rate was 88.89％.There were 8 cases in group B reach to the set position and 14 cases did not and the accuracy rate was 36.36％.After the statistical analysis there were significant differences (P ＜ 0.05).The total efficiency of A and B groups (excellent + effective) were 94.4％ and 86.4％ (P ＞ 0.05).Postoperative complications included bleeding,infection,obstruction of the shunt,excessive shunt,shunt insufficiency and so on.During follow-up,group A appeared excessive shunt in 1 case;group B incision infection in 1 case,4 cases of shunt obstruction,excessive shunt in 1 case,2 cases of deficiency of shunt.Two groups of patients were recovery well through the drainage tube pressure adjustment or set it once again.The incidence of complications in group A was 5.56％,group B was 36.36％.There was no significant difference between group A and group B (P ＞ 0.05).In group A,there was no obstruction of shunt tube,ventricular end of the shunt tube blockage occurred in 4 cases in group B,the incidence rate was 18.18％ (P ＞ 0.05).Conclusion Neuronavigation guided ventriculoperitoneal shunt placement to the accuracy of position setting has significant advantages over traditional ventriculoperitoneal shunt in the ventricular end of the shunt tube and it has some advantages in reducing postoperative complications.