Objective To investigate the key points of nursing during the course of breast tumor excision by endoscope. Method Summarized the nursing points of 24 patients who have accepted the breast tumor excision by endoscope. Results The key points of successful operation were sufficient preparation before the operation, the special skills of nurses, exactly and quickly transfer instruments and expert cooperation. Conclusion Paving attention on psychological nursing, the correct and skillful nursing care can reduce the operation time, and then make sure the successful operation.

Objective To investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of pulmonary cryptococcosis.Methods 15 patients who were diagnosed as pulmonary cryptococcosis were retrospectively studied,all of them were examined by sputum smear,X ray,CT and EBUS-TBNA.Results 15 patients who received EBUS-TBNA were diagnosed pulmonary cryptococcosis by pathological methods and germiculture,during the process no complication was detected.Conclusion EBUS-TBNA is a safe and effective means in the diagnosis of pulmonary cryptococcosis for pulmonary cryptococcosis patients hard to be diagnosed clinically.

Chronic constipation(CC)is one of the most common gastrointestinal disorders. Treatment of CC includes drug and non-drug treatment. Biofeedback(BF)is a psychological behavior therapy and has become the first-line therapy of CC. However,the efficacy of BF reported varied substantially. This article reviewed the evaluation of efficacy of BF on CC.

Fetal hydrocephalus is a kind of congenital malformation,which is characterized by the enlargement of the ventricular system and the obstruction of cerebrospinal fluid.It is not accompanied by a primary brain atrophy,with or without the increase of head circumference.Early diagnosis and early treatment is very important.Without the timely inter-vention,most of the patients will die during the perinatal and infant period,and even the survivors often suffer from cere-bral palsy and mental retardation.However,the long -term prognosis and clinical course of patients with hydrocephalus is not yet fully understood.There is controversy on the factors which influence the long -term outcome,such as the timing of diagnosis of hydrocephalus,the severity of ventricular dilatation,the basic disease and accompanying anomalies.So,should establish comprehensive protocols to avoid and decrease fetal hydrocephalus,as well as pay attention to the clinicopatho-logical research,prenatal diagnosis,perinatal management and early treatment of fetal hydrocephalus.

Objective To explore the effects of micro channel (mPCNL)and standard channel percutaneous lithotripsy (sPCNL)on hemodynamics and blood gas analysis in patients with renal calculi.Methods From March 2007 to June 2015,180 patients with kidney stones were selected as the research subjects,through digital said method,the patients were randomly divided into MPCNL group and sPCNL group,the former F16 plastics through established channels of percutaneous nephrolithotomy.The latter F24 plastics through established channels of percuta-neous nephrolithotomy.The changes of hemodynamics and blood gas analysis were observed and compared in the two groups during perioperative period .Results In MPCNL group ,theoperation time was significantly shorter in sPCNL group(t =-6.018),the perfusion fluid was higher than that of sPCNL group(t =20.506,P <0.05).The perfusion of MAP and CVP of the two groups were significantly lower than those before anesthesia,and irrigation flow after dif-ferent time and postoperative were significantly higher than those before hemoperfusion,60 min,120min,after opera-tion MAP value of MPCNL group,test value was as follows(t60min =5.878,t120min =6.802,tpostoperative =7.070,all P <0.05);60min,120min,after operation CVP value of MPCNL group,test value was as follows (t60min =5.987,t120min =6.505,tpostoperative =7.180,all P <0.05).60min,120min,postoperative MAP value of sPCNL group,test value was as follows (t60min =5.613,t120min =7.238,tpostoperative =7.170,all P <0.05);60min,120min,postoperative the CVP value of sPCNL group,test value was as follows (t60min =7.682,t120min =7.135,t[postoperative]=9.218,all P <0.05). Blood gas analysis showed that the two groups of postoperative Na +,Cl - compared with before anesthesia had no sta-tistically significant difference(P >0.05).Two groups of postoperative K +,pH,BE,Hb were lower than before anes-thesia,the differences were statistically significant (P <0.05).The two groups of patients with no postoperative urina-ry sepsis and other serious complications.Conclusion With the increase of operation time filling fluid absorption on hemodynamics and arterial blood gas analysis of influence gradually increased;in heart,lung and normal renal function patients,due to the compensatory organ function,caused by MPCNL and sPCNL irrigation fluid absorption differences in the amount is not enough to cause different hemodynamics and blood gas analysis.

Objective To compare clinical value of peripheral blood collection and venous blood collection methods in blood tests.Methods 467 patients who received blood test were selected.The venous blood and peripher-al blood were collected,the indicators of blood test were detected,and the test results were analyzed.Results The white blood cell count (WBC),red blood cell count (RBC),platelet count (PLT),red blood cell hematocrit (HCT),hemoglobin (HB)of venous blood were (5.7 ±1.2)×109 /L,(3.72 ±0.48)×109 /L,(218.0 ±57.5)× 109 /L,(41.8 ±19.8)g/L,(115.7 ±13.8)g/L respectively,those of peripheral blood were (6.7 ±3.4)×109 /L, (3.62 ±0.72)×109 /L,(204.0 ±87.7)×109 /L,(32.7 ±20.7)g/L,(103.6 ±19.6),the differences were statis-tically significant (t =5.994,2.497,2.885,6.865,10.908,all P <0.05).The mean red cell hemoglobin concentra-tion (MCHC),mean red cell volume (MCV),mean erythrocyte hemoglobin (MCH)and other indexes had no signifi-cant differences(all P >0.05).Conclusion The test results in patients with venous and peripheral blood was quite different,venous blood test results obtained with greater value in clinical use,it is recommended that routine blood test used venous blood.

OBJECTIVE To measure the dexamethasone concentration in the cochlear tissue after postaurical and intramuscular administration. METHODS After bilateral adrenalectomy,animals were divided into three groups:postaurical injection group,intramuscular injection group,and physiological saline injected blank control group.At 0.25,0.5, 2.5,5,12,24,72 h after injection(1mg/100g), cochleae together with the intact endolymphatic sac were removed and homogenated.After that, the dexamethasone was detected by enzymelinked immunosorbent assay(ELISA).RESULTS The dexamethasone levels in the cochlear tissue in postaurical injection group were significantly higher than that in the intramuscular injection group.In the postaurical administration group,a mean peak cochlear tissue concentration of(175.2?36.0) ng/ml was detected at 0.25 h after injection,then declined obviously 12 h and was below detection limits by 24h.While in the intramuscular administration group, a mean peak concentration was observed 2.5 h at the concentration of(141.1?8.9) ng/ml,then rapidly declined from 5h and beyond detection by 24 h.CONCLUSION Compared with intramuscular administration,the dexamethasone levels in the postaurical injection group were significantly higher, with peak concentration reached earlier,and last longer.

Although the percentage of preterm infants developing intraventricular haemorrhage (IVH) has been greatly re-duced in the past three decades, increased survival of extremely preterms has meant that severe IVH with subsequent posthae-morrhagic hydrocephalus is still one of the serious unsolved problems for managements of preterms. Therapeutic interventions for posthaemorrhagic hydrocephalus include serial lumbar punctures, repeated aspiration through a ventricular access device, ventriculoperitoneal shunting, drainage, irrigation and fibrinolytic therapy, diuretic therapy treatment to reduce cerebrospinal fluid production, intraventricular fibrinolytic therapy, etc. This review summarizes the current concepts on the pathophysiology, inter-vention indications, and the effectiveness and safety of different interventions of subsequent posthaemorrhagic hydrocephalus.

Objective To investigate the clinical value of low molecular weight heparin (LMWH) as prophylaxis against venous thromboembolism after rectal cancer surgery.Methods The clinical data of 120 patients who received rectal cancer surgery at the Tianjin People's Hospital from October 2008 to October 2010 were retrospectively analyzed.All patients were divided into the test group (50 patients) and the control group (70 patients).Patients in the test group received subcutaneous injection of 0.4 ml of LMWH (4100 U) at 8-12 hours after operation,and then once a day thereafter until mobilization.LMWH was not given to patients in the control group.Patients in the 2 groups who experienced venous thromboembolism (VTE) and postoperative bleeding were recorded and compared.The clinical data of patients with VTE were proceeded with risk factors analysis.All data were analyzed using the t test,chi-square test or by calculating Fisher exact probability.All factors influencing VTE formation were analyzed using Logistic regression analysis.Results The incidences of VTE in the test group and the control group were 2.0％ (1/50) and 14.3％ (10/70),respectively,with a significant difference between the 2 groups (x2=3.915,P ＜ 0.05).The incidences of postoperative blood loss in the test group and the control group were 6.0％ (3/50) and 2.9％ (2/70),respectively,with no significant difference between the 2 groups (x2=0.149,P ＞ 0.05).Varicose veins of lower limbs,previous cardiopulmonary diseases,obesity and age ＞ 65 years were the independent risk factors of VTE (OR =2.3,2.5,1.4,2.1,P ＜0.05).The number of patients with VTE increased as the increase of the risk factors.Conclusion Early injection of LMWH after rectal cancer surgery is safe and effective in preventing VTE.

Objective To analyze the clinical characteristics of drug-induced liver injury (DILI) from Chinese literatures published in Chinese Periodical Full-text Database (CNKI) from 2007 to 2011.Methods Using drug-induced liver injury as key words,the literatures in CNKI were searched,and the data of age,gender,medication,clinical manifestation and prognosis were analyzed.Results In search of CNKI,281 literatures were collected; finally 111 relevant papers were obtained.Total 10 693 cases of DILI were included with a male/female ratio of 1.14:1 and a mean age of 45.6 y ranging from 7 months to 93 y.Among 1093 cases with the age grouped,the highest incidence of DILI was in age 41-60 y(38.52％)and 20.68％ patients were over 60 y.Among 6592 cases with clinical manifestation recorded,43.51％ patients were asymptomatic and abnormal liver function was detected in health check-up; and others presented nonspecific gastrointestinal symptoms,including fatigue,nausea,vomiting and jaundice.In 9340 cases with medication recorded,the 6 most common drugs inducing DILI were antituberculotics (32.74％),Chinese herbs(22.12％),antibiotics(9.18％),antineoplastics(6.34％),NSAIDs (4.80％)and antithyroid drugs (4.37％).The most common type of toxicity was hepatocellular injury (63.66％,4438/6971).In general the prognosis was good with a fatality rate of 1.67％.Conclusions Antituberculotics and Chinese herbs are the main causes of DILI.Some DILI patients have occult onset and others have nonspecific gastrointestinal symptoms.Most patients have good prognosis if they are treated timely.