Objective To evaluate the long term results of regular hepatic resection for hepatolithiasis.Methods Five hundred and fourteen patients with hepatolithiasis underwent hepatic resection from Jan. 1975 to Dec. 1998 in Southwest Hospital. The indications included stones confined to one segment or one lobe of the liver, significant atrophy of the portion of the liver harboring the stones from repeated episodes of obstruction and infection, multiple strictures of the ducts in the affected portion of the liver. Resection of S 2 and S 3 was performed in 284 patients, S 2, S 3 and S 4 in 98 patients, S 6 and S 7 in 26 patients, S 5, S 6, S 7 and S 8 in 37 patients; both of the left and right hepatic lobes were partially resected in 23 patients. Additional biliary procedures including choledochojejunostomy and common bile duct exploration were performed in 296 patients.Results The operative mortality was 2 1%, and the morbidity rate was 8 4%. The majority of complications were biliary fistulas (2 9%), subphrenic infection (4 5%), peritoneal abscesses (0 4%) and liver failure (0 6%). Long term follow up on 436 patients at a median of 9 1 years showed that 75 9% were symptom free, 14 5% had occassional mild attacks of cholangitis, 9 6% had severe cholangitis requiring further surgical intervention.Conclusion Anatomic hepatic resection is the most effective treatment and the therapy of choise to eradicate intrahapatic stone foci in cases of hepatolithiasis .

Objective · To investigate the prevalence of passive smoking among pregnant women in Shanghai and to analyze its influencing factors and to provide the basis and suggestion for making related intervention measures to reduce the harm of secondhand smoke on the health of pregnant women. Methods · From July to October 2014, pregnant women and their spouses were recruited for a questionnaire investigation at the antenatal care clinics of 3 maternity hospitals and 3 community hospitals in Shanghai. The questionnaire included demographic information, family basic situation and cognitive status of passive smoking. Results · The passive smoking rate before pregnancy in the 2831 pregnant women, who were involved in the investigation, was 17.1%. The passive rate during pregnancy was 7.8%. The difference between these two rates was statistically significant (P<0.05). 71.0% of the pregnant women have passive smoking for 15~59 min each day. Relative to home and work place, the passive smoking rate of pregnant women in public place was the highest (P<0.05). The passive smoking rate of pregnant women was significantly associated with the educational level of smoking spouses and the attitude of pregnant women when they faced the smokers. Conclusion · The passive smoking rate of pregnant women is influenced by the educational level of their spouses and the pregnant women's feedback to the smokers face to face. Public places are the most important exposure places to secondhand smoke for pregnant women. In order to reduce the harm from passive smoking to pregnant women and their fetuses, the related measures of smoking control at home education and smoking ban in public place should be made.

OBJECTIVE: To prepare clomipramine hydrochloride sustained release tablet and study its in vitro release rate.METHODS: Orthogonal experiment was carried out to optimize the formulation and the preparation was prepared taking by the formula dosage of HPMC,lactose and amylum pregelatinisatum as factors and the in vitro release rate as index.The in vitro drug release rate was investigated as well.RESULTS: The optimal formulation was as follows: HPMC 45 mg,lactose 35 mg,and amylum pregelatinisatum 40 mg.The preparation prepared in the optimal formulation had a sustained release of 24 h and the release behavior of the tablets followed the zero order equation.CONCLUSION: The formula of the sustained release tablets is reasonable and which had satisfactory sustained release efficacy.

Objective To provide useful information on reducing risky drinking for the Dept.of Public Health taking a county in Yunnan province as an example to explore the risk factors related to risky drinking.Methods A total of 574 participants identified as Miao,Yi and Han People at or older than 12 years old,who had been living there for 6 months or more were selected and surveyed in 5 townships in the county through stratified sampling.Alcohol consumption was collected using the beverage-specific quantity frequency (BSQF) method and analyzed using binary logistic regression and chi-square test.Results The number of drinkers in the family,undesirable drinking environment among friends and enculturation (β =0.073) could increase the likelihood of risky drinking.Risky drinking pattern was positively associated with age (β =1.006),and negatively associated with gender (β =-2.947) and awareness of risky drinking among rural residents.Conclusion The important measures to control risky drinking behavior in terms of health promotion and education include reducing the number of drinkers in the family,and preventing from undesirable drinking environment among friends and harmful drinking culture.These measures are crucial to prevent early onset of alcohol drinking among teenagers and to reduce risky drinking among middle aged and aged population.

In 1989, Fitz defined and classified severe acute pancreatitis (SAP) and he thought that surgical treatment of SAP is feasible. Since then, the strategy of treating SAP was a controversial issue over past decades. Currently, relevant literatures reported that medical or minimally invasive treatments are superior to surgical treatment, while it is too early to make the final conclusion because of the complexity of SAP. From 1989 to 2008, 1852 patients with acute pancreatitis were treated at the General Hospital of PLA, and the clinical data of 18 patients who died of SAP were retrospectively analyzed. Based on the analysis, we concluded that medical conservative therapy and surgical operative therapy should not be opposed to each other. Selecting ideal timing and appropriate operation on the basis of pathological changes of retroperitoneum and pancreatitis should be considered seriously, and the new concept of "miniaturization of trauma" should also be introduced in treating SAP.

OBJECTIVE To provide references for clinical diagnosis of catheter-related bloodstream infections(CRBSIs) and focus on studying the spectras of pathogenic bacteria and the drug sensitiveness. METHODS A total of 137 patients enrolled from Jan 2005 to Dec 2007 in our hospital with positive catheter cultures were admitted to our retrospective analysis.Pathogenic bacteria,contaminant bacteria and the drug sensitiveness of main pathogenic bacteria were analyzed. RESULTS From them 80 patients were diagnosed CRBSIs.Among 92 strains of pathogenic bacteria,43(46.7%) strains were Gram-positives,31(33.7%) coagulase negative staphylococci(CNS) strains,31(33.7%) Gram-negative bacilli strains and 18(19.6%) were Candida strains. CONCLUSIONS CNS are the most common bacteria of CRBSIs,and the second are Candida.The common pathogen show multi-drug resistance.

Objective To study the diagnosis and treatment of hepatocellular adenoma(HCA).Methods The preoperative imaging findings,pathologic specimens and surgical treatment of 18 patients with HCA who were admitted in our hospital from January 1990 to April 2007 were retrospectively analyzed.Results Most patients were male(male-to-female:11/7)and only 1 female patient had oral contraceptive history.Six patients presented with pain in the right upper quadrant.Contrast-enhanced CT and contrast-enhanced MRI both displayed that most lesions were characterized by homogeneous enhancement on arterial phase,except the lesions affected by irregular hemorrhage or fatty degeneration,and by washout on portal venous phase and delayed phase.All patients received resection.Hemorrhage in the lession was found in 10 patients and precancerous lesion in 2after operation.All patients were alive and well with no recurrence till December 2007.Conclusion The enhanced CT or MRI scanning for HCA has special features.Complete resection is the first choice for HCA.

Objective To explore the effect of macrolide antibiotics(erythromycin) on tumor necrosis factor(TNF)-α and interleukin(IL)-8 in hyperoxia-induced lung tissue of premature newborn rats,and to study the intervention effect of erythromycin on hyperoxia-induced lung injury.Methods One-day old preterm Sprague Dawley rats were randomly divided into four groups by random number table method:air + sodium chloride group,air + erythromycin group,hyperoxia + sodium chloride group,hyperoxia + erythromycin group.Hyperoxia groups were continuously exposed to oxygen (oxygen ＞ 0.85) and air group in room air.After 1,7,14 days of exposure,the preterm rats of four groups were sacrificed,whole lung of these rats were isolated,the lung histological changes were observed by hematoxylin-eosin staining,TNF-α and IL-8 in pulmonary tissue homogenate were detected by ELISA.Results The results showed that:(1) Compared with air + sodium chloride group,TNF-α and IL-8 expression in hyperoxia + sodium chloride group were significantly increased(P ＜ 0.05) after 1,7 days of exposure [1 d:TNF-α:(16.163 ± 0.574) ng/ml vs.(21.923 ±2.066) ng/ml,IL-8:(18.214 ±3.649) ng/ml vs.(23.546 ± 5.240) ng/ml ;7 d:TNF-α:(15.940 ±0.821) ng/ml vs.(19.688 ±0.764) ng/ml,IL-8:(18.541 ± 4.114) ng/ml vs.(24.255 ±4.692) ng/ml],in particular,TNF-α expression appeared to increase earlier,their expression became significantly weak in 14 days (P ＜ 0.05).(2) Compared with hyperoxia + sodium chloride group,TNF-α and IL-8 expression in hyperoxia +erythromycin group became significantly weak after 1,7,14 days of exposure(P ＜0.05) after the intervention of erythromycin [1 d:TNF-α:(21.923 ± 2.066) ng/ml vs.(18.903 ± 1.851) ng/ml,7 d:IL-8:(24.255 ±4.692) ng/ml vs.(23.508 ±3.543) ng/ml,14 d:TNF-α:(16.443 ±5.466) ng/ml vs.(14.453 ±0.963)ng/ml],but their expression became weaker in 14 days than that in 1,7 days.Conclusion The release of inflammatory mediators TNF-α and IL-8 induced by oxidation outbreak participates in the development of hyperoxia induced lung injury,erythromycin may regulate immune function,inhibits the levels of oxidant-mediated TNF-α and IL-8 induced by oxidation outbreak,and alleviate hyperoxia lung injury in premature rats.

To investigate the cellular immunity abnormalities of patients with rheumatoid arthritis(RA), peripheral blood lymphocytes subpopulations, interleukin 2 (IL-2) production and natural killer (NK) cell activity were determined in 9 patients with RA. The results showed that there were a remarkable decrease in NK cell activity and poor response to IL-2 stimlulation. IL-2 production and.the expression of membrane-bound IL-2 receptor were increased in RA patients. The percentage of T4 positive cells and the ratio of T4/T8 were also increased in patients with RA. The results indicate that there are severe cellular immunity abnormalities in patients with RA.

Objective To investigate the off-label use status in obstetrics ward so as to provide references for carrying out obstetrics pharmaceutical care and promoting safe medication use in pregnant and parturient women. Methods The prescriptions for pregnant and parturient women from January to June, 2015 in obstetrics ward were investigated. According to drug instructions, the off-label drug use of prescriptions of all selected patients was analyzed in the following aspects:the category of off-label drug use, and drugs use information. In addition, a logistic regression was conducted that modeled the odds of receiving an off-label prescription as a function of the following possible risk factors:pregnant, parturient women and the rank of doctors. The clinical results including the unreasonable drug application, abortion rate and birth defect were compared between the off-label drug use and on-label drug use groups. Results Total of 384 patients were selected, and 5330 prescriptions involving 50 drugs were analyzed. The rate of off-label drug use was 68. 5%, 27. 7% and 24. 0% in patients, prescriptions and drug categories, respectively. The main categories of off-label drug use were super solvent use ( 76. 6%) and indication (14. 3%). The top 3 drugs of off-label use were those for urinary and reproductive (56. 2%), alimentary tract (46. 9%) and traditional Chinese medicine (43. 4%). In addition, there was no significant correlation between the risk of off-label drug use and maternal status and the level of doctors. And no significant difference between the two groups in the unreasonable drug application, abortion rate and birth defect was detected. Conclusion The off-label drug use in obstetrics ward is common in this hospital and most of them are supported by clinical evidence. Due to the lack of more authoritative evidence-based medication, the doctors are suggested to use the drug according to provisions of the drug instructions. When off-label drug use is really needed, it should be based on the surpport of evidence basde medicine,so as to ensure the drug safety for pregnant and parturient women and avoid professional risks.