Objective To investigate and compare the clinical efficacy and safety of laparoscopic and traditional open surgery in the rectal cancer surgery.Methods From March 2007 to February 2013,86 patients with radical resection of rectal carcinoma in General Surgery Department of Pinggu District Hospital of Beijing were selected as research objects,according to random number table method,they were divided into laparoscopic group(n=43) and laparotomy group(n=43).The laparoscopic group was given laparoscopic radical resection of rectal cancer,the laparotomy group was given traditional open surgery.The baseline data,operative incision length,intraoperative blood loss,operative time,postoperative hospital stay,total number of lymph nodes cleaning,exhaust time,time to get out of bed,hospitalization expenses,VAS score and postoperative complications between the two groups were observed and compared.And the survival rates of the two groups were compared.Results.The operative incision length of laparoscopic group was shorter than laparotomy group((4.20±1.15) cm vs.(16.53±4.62) cm),the intraoperative blood loss was less than laparotomy group((167.43±16.24) ml vs.(220.74±22.53) ml),postoperative hospital stay,exhaust time,time to get out of bed were shorter than laparotomy group((8.26±2.09) d vs.(13.52±2.97) d,(3.24±1.42) d vs.(4.23±1.60) d,(3.07±0.84) d vs.(4.23±1.29) d),the hospitalization expenses was higher than laparotomy group(all P<0.05).The VAS score and postoperative complication rate of laparoscopic group were lower than laparotomy group((5.32±1.18) points vs.(8.16±1.25) points,2.33%(1/43) vs.20.93%(9/43),P<0.05).There were no significant differences inoperative time and total number of lymph nodes cleaning between the two groups(P>0.05).The 5 year overall survival rate of laparoscopic group was 52.6%,the laparotomy group was 47.4%,there was no significant difference between the two groups(χ2=0.465,P>0.05).Conclusion The clinical efficacy of laparoscopic and traditional open surgery in the rectal cancer surgery are the same,and laparoscopic radical surgery is safe and effective,it has the advantages of less trauma,less complications and quick recovery,is worth popularizing.

Objective To investigate the charge nurses' leadership style perceived by nurses and nurse's self-efficacy,and then analyze the relationship between them.Methods Totally 368 staff nurses from 3A hospitals in Sichuan were investigated with questionnaires.The results underwent analysis.Results The score of charge nurses' transformational leadership style was 58.06±12.10,from high to low in turn was intellectual stimulation (3.10±0.69),inspirational motivation (2.92±0.73),idealized influence (2.88±0.67) and individualized consideration (2.71±0.74).The score of charge nurses' transactional leadership style was 35.77±8.58,from high to low in turn was contingency reward (3.11±0.71),passive exemplary management (3.09±0.75) and active exemplary management (2.75±0.90).The score of nurses' self-efficacy was 83.51±11.62.The transformational leadership style had positively predictive impact on nurses' selfefficacy.Conclusions Nursing managers should apply transformational leadership to improve nurses selfefficacy,promote the physical and mental health of nurses and the long-term development of hospital.

Objective To investigate the calbindin D\|28K (CB) neurons that receive the visceral nociceptive information in the interstitial nucleus of the spinal trigeminal tract (INV) directly project to the nucleus of the solitary tract (NTS). Methods Triple\|labeled methods of fluorogold (FG) retrograde tracing combined with Fos and CB proteins immunofluorescence histochemistry after formalin stimulating upper alimentary tract. Results Most of FG\|retrograde labeled neurons distributed in the paratrigeminal nucleus (PaV) and the dorsal paramarginal nucleus (PaMd) of INV ipsilateral to the FG injection. About 71\^2% of FG\|retrograde labeled neurons contained CB and 31\^5% of FG/CB double\|labeled neurons exhibited positive Fos\|immunoreaction in INV.Conclusion The results suggested that a part of neurons containing CB in INV receive the visceral nociceptive information and directly project to NTS. CB neurons might play an important role in transmitting visceral nociceptive information from INV to NTS. [

Objective To analyse the causes of complications and accidents of arthroscopy and a discussion of the preventive measures. Methods 1 540 cases of arthroscopy were carried out from May 1980 to May 1999, including 1 426 cases of the knee, 59 of the ankle, 17 of the wrist, 21 of the first metatarsophalangeal joint, 8 of the hip, 6 of the elbow and 3 of the shoulder. Results Surgical instruments (blade, tip of forceps) broken in the articular cavity took place in 8 cases, injury of the normal tissue including the cartilage, meniscus, and ligaments happened in 40 cases, nerve branch and vascular injured around the inlets in 11 cases, water seeping out in 13 cases, infection following the formation of hematoma in 5 cases, refracture of patella during operation in 1 case, myocardial infarction after operation in 1 case, totally, complications and accidents were seen in 79 cases (5.1％ ). Conclusion Arthroscopic complications are mainly related to unskillful manipulation of the instruments, poor team work, inadequate exposure of intra-articular structure and negligence of timely replacing the nearly worn parts of the apparatus. The complications can all be prevented by improving above mentioned points.

0.05). The duration of normoglycemia in experimental group was 23～65 days (mean 48 days), while 3～6 days (mean 5 days) in control group, with the difference being very significant between the two groups (P

Objective To analyze the situation of medical social support and self-perceived burden in elderly patients with chronic obstructive pulmonary diseases (COPD) in Chengdu,explore the influence of medical social support for patients with family oxygen cure.Methods A convenient sampling was conducted in 4 hospitals in Chengdu,and selected totally 124 elderly patients with COPD in January 2013 as the research object.Results Those patients' average daily life ability score was (20.19 ± 7.10) points,42 cases' daily life ability was normal,44 had deficiency in daily life,38 had obvious flaws;16 cases received medical social support condition at a critical level,66 at a general level,42 in good condition;the difference of the ability of daily life between actual support and other supports was statistically significant (P＜ 0.05);the difference in patients with self-perceived burden and medical social support was not statistically significant (P ＞0.05).Patients with long term oxygen therapy had higher self-pereeived burden than patients without oxygen therapy at home [(18.65±3.97) points vs.(17.69±6.24) points,t=6.015,P＜0.05],but patients with long term oxygen therapy had better medical and social support condition than those without oxygen therapy at home [(282.11±37.47) points vs.(262.26±61.14) points,t=6.624,P＜0.05].Conclusions The level of medical and social support in elderly patients with COPD need improve.Nurses need to provide better guidance for patients with long term oxygen therapy,ensure them obtain adequate information,improve their emotional support and social interaction,enhance their medical social support condition.

A novel chemiluminescence (CL) reaction was based on the oxidizing reaction of luminol by the trivalent copper-periodate complex (K5[Cu(HIO6)2], DPC) in alkaline medium. The CL intensity could be enhanced in the presence of amikacin sulfate (AKS). A new CL method was developed for the determination of AKS by coupling with flow injection (FI) technology. Because of the distinctive oxidative effect of DPC, the luminol-based CL reaction could occur at a low concentration of 10à7 M. The relative CL intensity was proportional to the concentration of AKS in the range of 4.0 ? 10à9-4.0 ? 10à6 g/mL with the detection limit of 1.2 ? 10à9 g/mL. The relative standard deviation was 2.1% for 8.0 ? 10à9 g/mL AKS (n?9). The proposed method was successfully applied to the direct determination of AKS at the level of ng/mL in serum samples. The recovery varied from 97.0% to 106.3%. A possible mechanism of the CL reaction was discussed in detail by relating to the CL kinetic characteristics and electrochemical activities of the oxidant DPC.

Objective　To investigate the influence of pretr eatment with anti-B lymphocyte serum on the immunogenecity and endocrine functi on of islet preparations.Methods　Porcine ICCs were pretre ated with anti-B lymphocyte serum which was produced using the mixed adult porc i ne B lymphocyte as antigen.The immunogenecity of islet was measured by mixed isl et lymphocyte culture (MILC) and SLA-DR positive cell number within the islet and the islet function was assayed with insulin release test.Results 　The cpm value of MILC of the group pretreated with anti-B lymphocy te serum and the MHCⅠ antigen and SLA-DR antigen positive cell numbers was mar kedly decreased in comparison with that of control group (P＜0.001).There wa s no significant difference in insulin release of additional different groups.[ WT5”HZ Conclusion　The pretreatment of islet preparation with anti -B lymphocyte serum may decrease the immunogenecity of islet preparation,while there is no marked influence on its insulin release function.

Objective To preliminarily evaluate the effect of endoscopy in treatment of subcutaneous hematoma in the limbs. Methods From March 1998 to October 2001, endoscope techniques were ferformed in 7 cases of old subcutaneous hematoma, among which were 2 cases of subcutaneous hematoma on the lateral femur, 1 on the medial knee joint, 1 on the traumatic prepatellar bursa and 3 on the anterior tibia. The area of the biggest hematoma was 20 cm?5 cm and that of the smallest 4 cm?6 cm. Results All the patients were followed up with a time range of 3-16 months and got sound healing with no scar in the skin and deeper tissues, pain or dysfunction. Conclusions The endoscope for larger subcutaneous hematoma in the limbs has the advantages such as smaller incision, less scar, accurate manipulation,mild postoperative reaction and fast recovery. Therefore, it can not only obtain similar curative effect to that of the traditional open operation but also avoid the shortcomings of the traditional operation. Endoscope techniques should be the first alternative to hematoma of over 5 cm or hard subcutaneous hematoma in the limbs.

Objective To explore the possibility of differentiation of bone marrow mesenchymal stem cells(MSCs)into alveolar epithelial cells and bronchial epithelial cells.Methods MSCs were isolated from a male SD rat and were labeled with DAPI before injection.75 female recipient SD rats were divided randomly into five groups:lung injury group,MSCs treatment group,MSCs control group,mononuclear cells control group and normal control group.One,two and four weeks after the engraftment,five rats in each group were sacrificed and their lungs were harvested.Alveolar structure was observed by HE staining,and immunofluorescent examination was carried out to detect the positive staining of pan-cytokeratin.Results Some blue DAPI-labeled cells could be seen in alveolar wall in MSCs treatment group one,two and four weeks after MSCs engraftment,and some of these blue DAPI-labeled cells were found to express pan-cytokeratin.It was also found that some blue DAPI-labeled cells could be found in bronchial wall two weeks after MSCs engraftment and some of them were pan-cytokeratin positive.However,these phenomena were not found in other groups.Conclusion Rat MSCs could differentiate into alveolar epithelial cells and bronchial epithelial cells in injured lung induced by bleomycin exposure.