Objective To assess the operation time of laparoscopic operation for acute cholecystitis by Meta analysis.Methods The methods of computer literature retrieval and manual search were used to collect the research on the timing of laparoscopic surgery for acute cholecystitis in recent years,and the random effects model was used to conduct the Meta analyze.The quality of the literature was evaluated,and then the RevMan5.0.21 software was used to calculate the RR value and 95%CI of the operation time,bleeding volume and postoperative complications.Results A total of 13 articles were included in the Meta analysis,9 in Chinese,4 in English,2535 for a total number of cases,1401 in the early operation group,1134 in the delayed operation group,and 10 papers for low risk of bias,3 papers for bias risk.Meta analysis of the random effects model showed that the operation time of the early operation group was significantly shorter than that of the delayed operation group(P=0.00,RR=-20.25,95%CI=-24.97~15.33),and the intraoperative blood loss was also significantly reduced(P=0.00,RR=-12.58,95%CI=-29.36~5.78),then the postoperative complications were also significantly reduced(P=0.00,RR=0.63,95%CI=0.47~0.84).Conclusion The use of laparoscopic operation in the treatment of acute cholecystitis in patients with 72h could not only shorten the operation time and reduce the amount of bleeding,but also had a significant effect on reducing postoperative complications.

OBJECTIVE To analyze the pathogenic distribution and antimicrobial resistance in respiratory ward and provide the rational information to use antibiotics reasonably. METHODS All pathogens isolated from patients in a respiratory ward from 2005 to 2007 and drug susceptibility results were retrospectively analyzed. RESULTS Totally 264 strains of pathogenic bacteria were isolated,in which 68 strains of Gram-positive bacteria,165 strains of Gram-negative bacteria and 31 strains of fungi.MRSA prevalence was 77.1% and showed a trend of increase.No vancomycin-resistant Staphylococcus aureus or Enterococcus was detected.The resistance rate of Streptoccocus pneumoniae to penicillin,erythromycin and levofloxacin was 44.4-66.7%.Enterobacter and Acinetobacter baumannii showed stable susceptibility to imipenem.Pseudomonas aeruginosa strains were relatively susceptible to cefoperazone /sulbactam,amikacin,gentamicin,piperacillin/tazobactam,ceftazidine,cefepime,cefoperazone and imipenem. CONCLUSIONS The changes in pathogens and antibiotic resistance in the respiratory ward are consistent with the surveillance data in this country,Gram-negative bacteria are still the most common pathogens and the serious degree of bacterial drug resistance is increasing.Our data are useful for the guidance of rational use of antibiotics.

Objective To investigate the association between left ventricular diastolic function and arterial stiffness in patients with type 2 diabetes mellitus. Methods One hundred and two patients with type 2 diabetes( diabetic group),and 126 non-diabetic patients( control group) were selected from Jan. 2012 to Dec. 2013 in the Beijing Military General Hospital. The clinical features were recorded and free blood glucose (FBG ),blood lipids were measured. Cardio ankle vascular index( CAVI ) was measured by VS-1000 arteriosclerosis detector. Ultrasound heartbeat diagram was used to determine the left ventricular diastolic function indexes including the left atrial diameter(LAD),left ventricular early diastolicpeak velocity(E),left ventricular diastolic peak velocity(A),E/ A ratio and E peak deceleration time(EDT). Results The level of LAD,A, EDT,CAVI in diabetic patients were(39. 5 ± 5. 3)mm,(76. 6 ± 13. 5)cm/ s,(206. 6 ± 56. 3)ms,(9. 6 ± 1. 1)respectively,higher than those in control group((34. 4 ± 4. 2)mm,(71. 3 ± 13. 4)cm/ s,(185. 5 ± 34. 4)ms,(8. 5 ± 0. 9)). And E,E/ A level in diabetic group were(56. 6 ± 20. 4)cm/ s and(0. 73 ± 0. 21),significantly lower than the control group((67. 5 ± 16. 4)cm/ s and(0. 96 ± 0. 26)). The differences between the two groups were significant(P = 0. 001,0. 004,0. 002,0. 001,0. 001,0. 001). After adjusting the factors including body mass index and triglyceride,CAVI was negatively correlated with E/ A(r = - 0. 339,P< 0. 05))and positively correlated with EDT(r = 0. 314,P < 0. 05). Conclusion The diabetic patients with lower diastolic function and higher arterial stiffness,and the two factors are negatively correlation.

This study was aimed to optimize the extraction process conditions of lycopene in tomato. Ketchup was used as raw material. Method verification, single factor experiment and orthogonal method were used in the study on extraction process of lycopene. The results showed that the best optimization process conditions of lycopene extraction with ethyl acetate: extraction temperature at 50℃, extraction time for 40 min, ethyl acetate concentration of 80%, solid-to-liquid ratio of 1?2 (g·mL-1). Under these conditions, the extraction rate of lycopene reached 15.564 mg·100g-1. It was concluded that the extraction process of lycopene can provide experimental basis for further development and utilization of lycopene.

Objective To analyze the relationship between Arg -1 expression and the clinical pathologi-cal factors ,proliferation and prognosis value in patients with colorectal cancer .Methods The expression of Arg-1 was observed in normal tissues ,chronic inflammatory tissues ,and adenomas inflammatory carcinoma tissues of mice.At the same time,Arg-1 expression was observed in human colorectal cancer adjacent tissues ,inflamed tis-sues and colorectal cancer tissues .Arg-1 expressed in 20 cases colorectal inflammation -cancer model in mice . Arg-1 expressed in 20 normal colorectal tissues .Fiftheen colitis tissues and 110 colorectal cancer tissues were examined by Immunohistochemistry .Statistical analysis was used to analyze the changes of Arg -1 expression in different groups of mice and human colon tissue cases .Results Arg-1 protein expression in normal tissues of mice was gradually increased in colon ,chronic inflammatory tissues,adenomas,inflammatory carcinoma,with sta-tistical significances(P<0.05).Arg-1 expression in para -carcinoma tissue,colitis tissues,colorectal cancer tissues was gradually increased with statistical significance (P<0.05).Conclusion Arg-1 protein is associat-ed with colorectal cancer TNM stage .Arg-1 protein may be involved in occurrence and development process of inflammation-associated colon tumor and may be a candidate of proliferated and prognostic biomarker in patients with colorectal cancer .

Objective To investigate the effect of DRAM1 on the acute ischemic injury of H9C2 cardiomyocytes. Methods H9C2 cardiomyocytes were treated with Oxygen-glucose deprivation (OGD) after DRAM1 adenovirus transfection. MTT assay was performed to detect cell viability and Annex V/PI staining was used to analyze the cell apoptosis. Western blot was performed to measure the expression of P62. Results DRAM1 overexpression increased the H9C2 cardiomycytes viability after OGD treatment for 12 hours. DRAM1 overexpression was attenuated, while siRNA-AD-DRAM1 exacerbated the apoptosis rate of H9C2 cardiomycytes after OGD treatment for 12 hours by Annex V/PI staining. P62 protein expression was increased in the H9C2 cardiomycytes after OGD treatment for 12 hours, which was reversed by DRAM1 overexpression. Conclusion DRAM1 may protect H9C2 cardiomycytes against OGD injury due to the improvement of the autophagy flux.

In order to promote the integration between disciplines, the convergence between basic course and clinical teaching, increasing students ability including the active learning and life-long learning ability, finding problem and solving problem ability, teamwork spirit and so on. After nearly 3 years preparation, Hebei Medical University successfully carried out the PBL teaching in Seven-year Clinical Medicine Science. Combining with the teaching activities, formative assessment was carried out, and PBL teaching website was established. The reform has already achieved initial results, got good responds from teachers and students. Through the study, it has been confirmed that the PBL teaching method in Hebei Medical University is effective and worthy to reference.

Objective To evaluate the potential influencing factors associated with pathologic complete response ( pCR) after neoadjuvant chemoradiotherapy for locally advanced rectal cancer ( LARC) . Methods A retrospective analysis was performed on the clinical data 265 patients with stageⅡandⅢ( the 7th version of AJCC) rectal cancer admitted to our hospital from 2011 to 2013. All patients underwent neoadjuvant concurrent chemoradiotherapy ( CCRT ) followed by surgery with/or without induction chemotherapy during the interval between the complete of CCRT and surgery. The predictors associated with pCR were analyzed by univariate and multivariate logistic regression analyses. With the use of the independent predictive variables for pCR from multivariate analysis, a clinical risk score model was established according to the following criteria:no?risk group (0 factor);low?risk group (1 factor);high?risk group ( 2 factors) . Results Among these 265 patients, 50( 18. 9%) achieved pCR. The univariate analysis showed that carcinoembryonic antigen ( CEA) level before CCRT ( P=0. 017) , T stage before CCRT ( P=0. 001), interval between complete of CCRT and surgery (P=0. 000), and the maximum tumor thickness before CCRT ( P=0. 040) were significantly associated with pCR. The multivariate analysis showed that pre?CCRT CEA level ( P=0. 021 or 0. 446) and interval between the complete of CCRT and surgery ( P=0. 000 or 3. 774) were significant predictors of pCR. When stratifying for smoking status, only low pre?CCRT CEA level was significantly associated with pCR in the non?smoking patients ( P=0. 044) . For the prediction of pCR by the clinical risk score model, the sensitivity was 0. 805, the specificity was 0. 460, the area under the receiver operating curve was 0. 690 ( 95% CI= 0. 613?0. 767 ) , the positive predictive value was 35 . 4 9%, the negative predictive value was 8 6 . 5%, and the predictive accuracy was 7 3 . 9%. Conclusions For locally advanced rectal cancer, pCR can be achieved in some patients after neoadjuvant therapy. Low pre?CCRT CEA level and long interval time between CCRT and surgery are independent factors associated with pCR, and only low pre?CCRT CEA level is an associated factor in the group of nonsmokers. The clinical risk score model based on pre?CCRT CEA level>5 ng/ml and time interval from CCRT completion to surgery≤8 weeks can be used to predict pCR after neoadjuvant chemoradiotherapy for LARC.

Objective To study the relationship between the number of outpatient complaints and the time or the outpatient amounts.Methods A retrospective analysis of 1289 cases of outpatients' medical complaints with basic records since 2009 in our hospital was carried out.The time regularity of the number of outpatient complaints,or the complaint rate was analyzed.And the correlation between the outpatient amounts and the number of outpatient complaints,or the complaint rate was also analyzed.Results In our hospital,the mean monthly number of outpatient complaints was (23.44±8.41)cases; the mean monthly outpatient account was (246 000±27 417)cases.The differences among monthly outpatient complaints,outpatient accounts and monthly complaints rate among every years were statistically significant.Within one year,the outpatient complaints numbers were lowest in February and January.And the outpatient complaints rate was low in November,January,February and December.There were statistically significant correlation between the monthly outpatient complaints and monthly outpatient accounts,and between the monthly outpatient complaints rate and monthly outpatient accounts.Conclusions There was time regularity in the outpatient complaints rates in one year.And there was certain correlation between the outpatient complaints rate and the outpatients' accounts.

Objective To explore the short‐term effect of chronic periodontitis patients after implant treatment .Methods Selected 60 cases of tooth loss in chronic periodontitis patients as research group ,a total of 75 implants were placed ,and 50 cases of periodontal healthy teeth missing patients as control group ,a total of 67 implants were placed .Compared two groups of modification sulcus bleeding index(mBII) ,papilla index score(PIS) ,modification plaque index(mPLI) and probing depth(PD) 6 months after op‐eration ,and detected implant sulcular fluid IL‐2 ,IL‐8 content in two groups before and after operation .Results Research group 75 implants had 2 off on their own ,implant loosening degrees 0 ,implant survival rate was 97 .3% ;the control group had no implant failure ,implant loosening of implant survival rate was 100% ,two groups of implant survival rate was no significant difference(χ2 =2 .737 ,P= 0 .098) .The mSBI ,PIS ,mPLI ,PD in research group and control group had no statistically significant(P > 0 .05) .Re‐search group sulcular fluid IL‐2 ,IL‐8 content was significantly higher than those in control group before and after the operation (P< 0 .05) .Conclusion The short‐term effect of implant treatment in chronic periodontitis patients is satisfactory ,without increas‐ing the risk of peri‐implantitis ,and worth of clinical promotion .