The incidence of intrahepatic bile duct stones as primary cholelithiasis varies in different regions,though it decreases to some ex-tent.Minimally invasive hepatectomy is the correct procedure for treating early intrahepatic bile duct stones.However,there are still many problems concerning the surgical treatment of end-stage liver disease caused by complex intrahepatic bile duct stones.The multidisciplinary mode should be recommended to provide comprehensive treatment,and studies on the prevention,etiology,and pathogenesis of intrahepatic bile duct stones should be strengthened,so as to improve the treatment of intrahepatic bile duct stones.

Objective To evaluate the efficacy and toxicity of gimeracil and oteracil porassium capsules combined with nedaplatin in the treatment of the patients with distant metastatic nasopharyngeal carcinoma.Methods Fourty cases were randomly divided into the observation group and control group by random digital table.19 cases in the observation group were treated with oteracil potassium capsules combined with nedaplatin.21cases in the observation group were treated with gemcitabine combined with nedaplatin.The response rate,response rate(RR) and progression free survival(PFS),toxicity were evaluated according to response evaluation criteria in solid tumors (RECIST).Results The response rate were 52.6％,52.3％ respectively,the median progression-free survival were 5.5 and 5.2 months,respectively.Grade Ⅲ an Ⅳ platelet supression were 10.5％,38.0％ between the observation group and control group.It was statistically significant between the two group(x2 =4.89,P ＜ 0.05).Conclusion Oteracil porassium capsules combined with nedaplatin is similar with gemcitabine combined with nedaplatin in the distant metastatic nasopharyngeal carcinoma,the adverse reaction was lighter than that of the control group.

Objective:To explore if the therapeutic effect can be enhanced, the dose of levodopa-like medications can be decreased and the complications can be reduced by acupuncture treatment in the patients with Parkinson's disease (PD) who took levodopa-like medications for a long time. Methods: thirty cases of the patients, most of whom were noticed with the decreased therapeutic effect and drug-induced complications, were treated by puncturing Shuigou (GV 26) and Baihui (GV 20), by reduction of Madopa dose, and the patients' conditions and complications were evaluated six months later. Results:After treatments for six months, the physiological functions were improved and the dose of Madopa was reduced and the total effective rate was 66.7%. Conclusion: After acupuncture treatments in PD patients, the therapeutic effects of levodopa were enhanced, with its dose and complications reduced.

Treated 50 cases of renal colic with electroacupuncture and compared the results with those in two control groups. Total effective rate in the treatment group, control group Ⅰ and control group Ⅱ was 98.0%,90.0% and 92.0% respectively.

Objective: To observe the effect of warm needling therapy plus acupuncture on third lumbar vertebra transverse process syndrome.
Methods: Sixty cases of third lumbar vertebra transverseprocess syndrome were randomly divided into a warm needling groupor an acupuncture group, 30 cases in each group. Cases in the acupuncture group were treated by routine points and needle sticking manipulation, while those in the warm needling group were treated by moxibustion plus needling as same as the acupuncture group. Japanese orthopedic association scores (JOA) in the two groups were observed and compared after 2 treatment courses.
Results: After treatment, the JOA score in the warm needling group was higher than that in the acupuncture group (P<0.01); subjective symptom, clinical syndromes, activity of daily living (ADL) in the warm needling group were all higher than those in the acupuncture group (allP<0.05); the score of pain in the warm needling group was significantly lower than that in the acupuncture group (P<0.01); the total effective rate in the warm needling group was 76.7%, versus 70.0% in the acupuncture group, showing a statistically significant difference (P<0.05).
Conclusion: Warm needling therapy is more effective thannormal acupuncture in treating third lumbar vertebra transverseprocess syndrome.

Inherited metabolic disorder is a major class of clinical diseases with complexity and dififculty of being di-agnosed. Current clinical diagnosis has to rely on the metabolite analysis, gene analysis and enzyme activity (protein function) analysis of these three techniques. We analyse the features of the three diagnostic methods and clinical application of analysis, comparison and induction, to provide some experience and reference that help clinicians to better use of these three techniques. These three ways should be organically combined to form a diagnostic platform for inherited metabolic disorders.

Objective:To explore the relationship between serum uric acid (SUA) level and restenosis after percutane-ous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) .Methods:A total of 389 patients , who were diagnosed as ACS and received PCI in our hospital from Jan 2010 to Dec 2013 ,were selected .The 82 pa-tients with hyperuricemia were regarded as hyperuricemia group ,and the remaining patients with normal SUA level were treated as normal SUA group (n= 307) .Clinical condition and restenosis after PCI were observed and com-pared between two groups .Results:Compared with normal SUA group ,there were significant rise in percentages of hypertension (41.04% vs .58.54% ) ,Killip> class Ⅰ (16.61% vs .26.83% ) and multi-vessel coronary disease (50.16% vs .64.63% ) ,restenosis rate after PCI (9.12% vs .15.85% ) in hyperuricemia group ,P<0.05 all .Con-clusion:Serum uric acid level is closely related to restenosis rate after PCI in ACS patients ,which is worth attention .

Objective To investigate and analyse the status and influential factors of nurses' palliative care knowledge in Shanghai city.Methods Using cluster sampling method,a questionnaire survey using Palliative Care Quiz for Nursing (PCQN) was conducted on 973 nurses in 9 hospitals of Shanghai city.Results 939 nurses completed the survey whose scores were 8.88±2.51.The status quo of palliative care knowledge of Shanghai nurses were not very desirable.The scores of palliative care philosophy and principles and psychological,social and spiritual support were 0.376±0.009 and 0.310±0.008.The scores of knowledge of the pain and symptomcontrol was 0.496±0.005,which was better than the other two aspects.There were differences between dimension 1 and dimension 2,3 (t=-1 1.78,5.465,P＜0.01),and also between dimension 2 and 3 (t=19.673,P＜0.01).Conclusions Lacking of education and training,insufficient recognition of related institutions and the limit of traditional ideas caused the defect in the knowledge structure of palliative nursing.

Retrospective analysis of 30 cases of penetrating keratoplasty in children followed- up 3 months to 3 years found that 46.7% of the grafts were clear and 53.3% were failures.The younger the children,the higher was the risk of failure,especially amo- ng cases of combined operations.

Objective] To discuss the calendar background of Five Yun and Six Qi and know the background basis of Five Yun and Six Qi from the calendar feature of “ Nei Jing”. [Methods ] Using the method of documents index and collection and research to explore the form of calendar and the relationship between the manifestation mode and Five Yun and Six Qi in “ Nei Jing”, application of Yun Qi theory. [Results] The ancient calendar was created on the basis of astronomical phenomena,showing the change rule of the universe.The calendars in “ Nei Jing”conclude Taichu,Sifen,October Taiyang.Yun Qi theory flexibly uses the October Taiyang which is unified with Taichu and Sifen.The ways “ Nei Jing” display calendar are criterion measurement,clepsydra measuring time,sixty Jai Zi and so on.[Conclusion ]Five Yun and Six Qi built on the basis of calendar Taichu, Sifen, October Taiyang and the interpretation of calendar background has great significance on the study of Yun Qi theory.