Objective To investigate neutrophil lymphocyte ratio (NLR) in early-stage diabetic nephropathy and its clinic significance. Methods The 145 subjects were divided into two groups:the healthy control group (n=54) and early stage diabetic nephropathy group (n=91). The numbers of neutrophils (N) and lymphocytes (L) as well as the NLR values of peripheral blood and other biochemistry index were examined. Factors of early stage diabetic nephropathy were calculated us?ing variance and logistic regression analysis. Results Creatinine(Cr), total cholesterol(TC), triglyceride(TG), LDL-C, neu?trophils number and CRP in DN group were significantly higher than those of the control group and lymphocytes numbers of DN group were significantly lower than that of the control group (P<0.05 respectively);NLR values were significantly higher in diabetic nephropathy group compared with those of healthy control group(2.52±0.57 vs 1.82±0.60,t=6.997, P<0.01). Lo?gistic regression analysis showed that the risk factors of DN include NLR, TG and total cholesterol. NLR ( P <0.001, OR=8.951, OR 95%CI:3.595-22.287) was significantly associated with DN. Conclusion High NLR values may be a predic?tive and reliable marker ofearly-stage DN.

Objective:To explore the analgesic efficacy of preoperative local injection of ropivacaine for patients receiving single port laparoscopic cholecystectomy .Methods:From December 2011 to August 2013 ,60 patients ,who received single port lapa‐roscopic cholecystectomy ,were randomly divided into experimental group and control group ,with 30 patients in each group . The difference in general information between the two groups was not statistically significant .Patients in two groups received education on visual analogue scale(VAS) one day before surgery .Patients in experimental group received preemptive analgesia with ropivacaine before the surgery and the detailed method was :2 mL 0 .375% ropivacaine was injected in the skin and subcu‐taneous tissue of umbilical incision;6 mL was injected to infiltrate fascia and muscle ,extraperitoneal space and parietal perito‐neum ;2 mL was locally injected in the tissue clamped by towel forceps on the both sides of the incision .Patients in the control group did not receive any treatment before surgery .Both two groups were identical in methods of the medication of anesthesia and the maintenance of anesthesia ,as well as the general anesthesia intubation .Patients’ vital signs and oxygen saturation was monitored with electrocardiogram monitor after surgery .VAS was evaluated at the moment when patients got fully awake after anesthesia ,and 2h ,4h ,8h ,12h ,24h after surgery .The postoperative application of analgesic and adverse events were recor‐ded .Results:The analgesic efficacy 0h ,2h ,4h ,8h after anesthesia recovery in experimental group was superior to that in con‐trol group(P<0 .05) ,and the times of application of analgesic in experimental group was less than that in control group(P<0 .05) .The difference in analgesic efficacy between the two groups was not statistically significant .The differences in surgery nausea ,vomiting and bronchospasm between the two groups were statistically significant (P<0 .05) .The differences in inci‐dence rates of dizziness ,drowsiness and respiratory depression between the two groups were not statistically significant(P>0 .05) .Conclusions:Preemptive analgesia with ropivacaine ,which is applied in local incision before surgery ,showed good anal‐gesic efficacy for patients who received single port laparoscopic cholecystectomy under general anesthesia .

This article summarizes the unique viewpoints and experience application of the famous and veteran Chinese medicine practitioner,Professor Wang Xinzhi,in treating emotional diseases from the perspective of gallbladder theory.Based on the physiologi-cal functions and characteristics of the gallbladder in Chinese medicine,it is proposed that the"heart mind-gallbladder-viscera"axis dominates the generation and changes of emotions,and it is believed that gallbladder failure is the key pathogenesis of emotional disor-ders.The treatment of clinical syndromes should be based on the type of gallbladder,and emotional diseases can be divided into types of insufficient gallbladder qi,unfavorable Shaoyang,gallbladder and heat excess,timidity-deficiency,and heart-gallbladder indeci-sion,according to clinical manifestations;based on the basic principle of adjusting the functions of the heart,spleen,liver,gallblad-der,kidney and other organs,treatment methods such as tonifying the spleen and kidneys,increasing gallbladder qi,resolving Shaoy-ang,clearing gallbladder heat,warming yang and replenishing qi,calming the mind,resolving phlegm and removing blood stasis should be used,highlighting the joint treatment of the heart and the gallbladder,and the simultaneous regulation of the liver and gall-bladder,so that the mind can be at ease,the gallbladder can be decisive,and the emotions can be harmonious.