This paper summarizes the observation and nursing of patients with postoperative complications following percuta-neous transhepatic cholangogrphic drainage(PTCD) and biliary tract stent implantation for malignant obstructive jaundice. A-mong thirty-two patients,eight had postoperative complications,including two with biliary tract hemorrhage,four with biliary tract infection,one with pneumothorax and one with bile leakage. All the thirty-two patients recovered well in clinical symptoms and quality of life. To attach importance to psychological nursing and postoperative health education are the key points in nursing care of patients with PTCD,which play important roles in alleviating clinical symptoms,improving treatment outcome and pro-moting the patients' quality of life.

Abstract： Objective　To analyze and summarize the early clinical characteristics of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children, and to explore its related risk factors. Methods　A retrospective analysis was conducted on the clinical data of 518 patients with Mycoplasma pneumoniae pneumonia (MPP) admitted to the Department of Critical Care Medicine of Wuhan Children's Hospital from January 2020 to December 2023. According to the severity of the disease and treatment outcomes, the patients were divided into the RMPP group (n=127) and the general group (n=391). The differences in clinical features and laboratory indexes between the two groups were compared, and the risk factors of RMPP were screened out by logistic regression analysis. Results　There were no significant differences in gender, weight, onset season, and personal or family allergy history between the two groups (P>0.05). When categorized by age, the incidence of RMPP in the infant group (<3 years old, 18.92%) was lower than that in the preschool group (3-6 years old, 47.88%) and school-age group (>6 years old, 33.20%) (P<0.05), with no significant difference between the preschool group and school-age group. The probability of high fever, duration of fever, and duration of macrolide medication use in the RMPP group were significantly higher than those in the general group (P<0.05). The incidences of shortness of breath, diarrhea, convulsions, and rash in the two groups of children were also significantly different (P<0.05). There was a significant difference in white blood cell count, C-reactive protein, procalcitonin, lactate, blood urea nitrogen, alanine transaminase, D-dimer, interleukin-6 in the RMPP group were higher than those in the general group, with statistical significance (P<0.001). Among the 308 children in the general group who completed Mycoplasma pneumoniae DNA testing, the positive rate of Mycoplasma pneumoniae resistance sites was 57.47% (177/308), which was significantly lower than that of the RMPP group (76.38%, 97/127) (P<0.001). The rate of bacterial and viral co-infection in the RMPP group (59.84%) was significantly higher than that in the general group (P<0.001). The number of cases of pulmonary consolidation, atelectasis, and pleural effusion in the RMPP group was significantly higher than those in the general group (P<0.001). Multivariate logistic regression analysis showed that the duration of fever, bacterial co-viral infection, and positive Mycoplasma pneumoniae resistance gene loci were independent risk factors for RMPP. Conclusions　RMPP is more common in children over 3 years old and tends to occur in autumn and winter, and its early clinical symptoms are not typical. Clinical doctors should be highly vigilant about the occurrence of RMPP in patients who have prolonged fever despite macrolide treatment, bacterial and viral co-infections, or develop extrapulmonary complications (diarrhea, convulsions, rash). It is recommended that Mycoplasma pneumoniae resistance gene loci testing be performed as soon as possible, which can help to identify RMPP in the early stage.

To compare the efficiency of methods of DNA extraction from lungs of Pomacea canaliculataused in PCR assay, 80 P.canaliculata collected in field were divided into 8 groups and the lungs of each snail were separated from the soft body. Six methods of DNA extraction from lungs of P. canaliculata were used to extract DNA from lungs, i.e. With Qiagen, Tiangen,and Omega commercial DNA extraction kits, guanidine thiocyanate method, Chelex 100 resin method and Chelex-silica particle method. The 16S rDNA of C.canaliculata was amplified by PCR and the concentration of PCR-products relative to marker was determined in order to evaluate the efficiency of each method. It was demonstrated that each method was valid to extract DNA from lungs used in PCR assay, but the concentrations of PCR-products were different. The concentrations of PCR-products obtained by Qiangen kit, Omega kit, Chelex 100 resin method and Chelex-silica particle method were significantly higher than those of other 4 methods of DNA extraction, in which Qiangen and Omega kits were suitable for small sample size. In term of efficiency and cost, Chelex 100 method and Chelex-silica particle method were feasible for large sample scale, while the guanidine thiocyanate method was preferred due to its fast extraction and low cost, but on account of its toxicity, it is used in urgent status or in large scale of sample extraction.

Objective:To explore the efficacy and safety of ornidazole in the treatment of trichomonal vaginitis. Methods:Totally 112 cases of trichomonal vaginitis from February 2011 to December 2012 in our hospital were selected and randomly divided into the ob-servation group and the control group with 56 cases in each. The control group was treated with metronidazole tablets 200mg, po,tid, and the observation group was treated with ornidazole tablets 500mg, po,bid. The treatment course was 7 days. The clinical effect, score of clinical symptoms and incidence of adverse reactions of the two groups were compared. Results:The total effective rate of the observation group was 96. 4%, which was higher than that of the control group (82. 1%), and the difference was statistically signifi-cant (P<0. 05). The symptom scores of the two groups were significantly improved after the treatment (P<0. 05), however, the score between the two groups showed no significant difference (P>0. 05). The incidence rate of adverse reactions in the observation group was 10. 71%, which was significantly lower than that in the control group (37. 5%), and the difference was statistically signifi-cant (P<0. 05). Conclusion:The clinical curative effect of ornidazole in the treatment of trichomonal vaginitis is notable with faster onset, shorter treatment course, lower adverse reaction rate and better patient tolerance,which is valuable in the clinical promotion.

Objective To observe the clinical efficacy of acupuncture with elongate needle plus red light radiation in treating post-herpetic neuralgia.Method Seventy patients with post-herpetic neuralgia were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by acupuncture with elongate needle plus red light radiation, while the control group was by orally taking Pregabalin capsules. Visual Analogue Scale (VAS) and Quality of Life (QOL) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate was 97.1% in the treatment group, versus 71.4% in the control group, and the difference was statistically significant (P<0.05). After treatment, VAS and QOL scores were significantly changed in both groups (P<0.05). The VAS and QOL scores in the treatment group were significantly different from that in the control group after treatment (P<0.05).Conclusion Acupuncture with elongate needle plus red light radiation is effective in relieving post-herpetic neuralgia.

BACKGROUND: Research has proved that nifedipine can improve the functions of vascular endothelial cells. However, it still needs further study on its mechanism on dilating vessels.OBJECTIVE: To observe the effects of controlled-release nifedipine to nitrogen monoxide(NO) and induced nitric oxide synthase(iNOS) in spontaneously hypertensive rats(SHR).DESIGN: Comparative observational study based on experimental animals.SETTING: Experimental animal centre in a medical college.MATERIALS: This study was completed in Experimental Animal Centre of Shandong University during April to May 2002. Twenty-one recombinant inbred rats of clean class with body mass of(300 ± 2) grams were provided by Experimental Animal Centre of Shandong University. They were randomly divided into three groups: control group, normal group and low dose group,each with 7 rats.METHODS: Saline(10 mL/kg), 10 mL/kg and 3 mL/kg controlled-release nifedipine solution(0. 3 g/L) were poured into stomach to rats in control group, normal dose group and low dose group once everyday for 15 days respectively. Eyeball was removed to collect blood and heart and lung were removed at the same time to test the content of NO and iNOS in serum after last administration.MAIN OUTCOME MEASURES: Content of NO, comparison of iNOS activity between groups.RESULTS: There was significant difference on NO content between normal dose group and control group, low dose group after 15 days' administration ( P < 0. 01 ) . Compared with control group and low dose group, there was significant difference on the iNOS activity in heart and lung of normal dose group(P <0.01, P <0.05).CONCLUSION: While nifedipine reduces the blood pressure, it can also improve the content of NO and resist the increasing activity of iNOS casued by increased blood pressure.

Objective To develop a new method with using surgical procedures for multiple correction of nasal deformity with cleft lip and palate.Methods Our operation procedures included elevation of the nasal floor depression in cleft side with the transplantation of autogenous cancellous bone, frustration and elevation of the nasal bone and part of the frontal process of maxilla, and replacement of septum between alar cartilages.Through these procedures, the nasal deformity could be multiply corrected.Results Postoperative follow up for 1～8years in 45 patients demonstrated satisfactory results. Conclusion Multiple correction is a new method of treatment for nasal deformity with cleft lip and palate.

Objective To investigate the different clinical behavior and the diagnosis and trearment of primary hyperparathyroidism(PHPT). Methods Clinical data of 53 patients with PHPT treated in Beijing Jishuitan Hospital from May 1977 to April 2004 were collected and analyzed. Results 53 patients with PHPT were confirmed by operation and pathology. The majority of the patients were aged 20~50 years. There were more female than male patients. There were various clinical manifestations, and the duration of illness was (protracted). Many cases were misdiagnosed. There were bone pathologic changes of varying extent in all (patients), stones in urinary system plus bone pathology in 11 cases, serum level of calcium was raised in 51 patients(96.2%) and (parathyroid) hormone (PTH) was elevated in all examined 48 cases. Ultrasound, MIBI and CT were done before operation after 1991, and accurate preoperative localization diagnosis was (obtained). Minimally invasive (parathyroidectomy) (MIP) was successfully completed in 39 of 45 cases, and the primary operation cure rate was 97.4%. At postoperative follow-up of 10 months to 10 years, with the (exception) of 15 cases of severe bone deformity that had no obvious improvement, the other symptoms and signs were all relieved to varying (extents), the laboratory markers returned to normal, and there was no permanent hypoparathyroidism or (recurrent) nerve injury or other complications.Conclusions Early diagnosis of PHPT and effective early (treatment) by surgical removal of the pathologic lesion can alleviate the occurrence of severe bone changes and deformity. The preoperative combined use of imaging localization technique and overall assessment can improve the accuracy of diagnostic localization of the lesion.