Objeetive To investigate the clinical effects and nursing interventions of endoscopic sphincterotomy(EST)for treating elderly patients with choledocholithiasis.Methods The clinical data of 73 cases of patients operated by EST were retrospectively analyzed.Before surgery the psychological nursing,examination and preparation were meticulously performed,the changes of vital signs and nursing were closely observed during surgery,the respiratory tract nursing,cardiovascular disease and diabetes nursing,pain nursing and complications treatment were performed after surgery.Results There were 69cases of 73 patients were successful,the success rate was 94.5%;8 cases of concurrent hyperamylasemia were given conservative treatment and had clinical recovery;2 cases of fever occurred and white blood cell count elevated and were treated by effective antibiotic treatment;there was no perforation,wound bleeding and death.Conclusions Using the EST to treat the choledocholithiasis of elderly patients has good clinical effects and low risk;through careful observation and nursing,can reduce complications,promote the patients'early recovery and improve quality of life of elderly patients with choledocholithiasis.

Humans ; Mining ; Noise, Occupational ; statistics & numerical data ; Occupational Exposure ; statistics & numerical data ; Work Schedule Tolerance

Objective To investigate the antitumor and immunologic activities of Laurencia extract(LET) in Sarcoma 180(S 180).Methods The content of total terpenoids in LET was detected by RP-HPLC and its toxicity(LD 50) was estimated by Horn assay. Tumor inhibition rates, index of thymus and spleen, proliferation of spleen lymph cells, IgA,IgG,IgM were detected. The data were analyzed by SPSS software. Results The content of total terpenoids in LET was proved to be 63.29%. LET showed low toxicity with its LD 50 more than 3160mg?kg -1. Tumor inhibition rates of test groups were significantly higher than those of the control group. LET could obviously increase the levels of index of thymus and spleen. LET increase the multiplication of spleen lymph cell.Concentrations of IgA、IgG and IgM in plasma of the test groups were higher than those of the control group. Conclusion LET rich in terpenoids is safety to be taken orally. The alga extract showed obvious antitumor activities and immunologic functions.

One of the major responsibilities for medical students is to save lives and to popularize emergency medical treatment knowledge for the masses of society.Based on research analysis,systemic training of cardiopulmonary resuscitation program including lectures,simulation education and social practice were performed for medical students.After practice activities,these students could proficiently apply the basic knowledge and skills of cardiopulmonary resuscitation in practical work and spread what they have learned to the public.Furthermore the program could improve students' abilities in social practice and team spirit and it is of great social significance.

Child ; Critical Care ; Humans ; Intensive Care Units, Pediatric ; Medical Records ; Severity of Illness Index

Objective To investigate the effect of Hedysarum Polybotys saccharide(HPS)on insulin resistance rats.Methods The model of type 2 diabetic-insulin resistance rat was successfully made by STZ and high caloric diet.Then the rats were intervene by Metformin(MT)and HPS.Results Compared with the model group,the level of blood glucose,INS and CP were lowered,ISI were improved and FFA were restrained by HPS.Conc(?)sion HPS can reduce the insulin resistance in multiple ways.

Combunung wuth fluorescence excutatuon-emussuon matrux ( EEM ) spectra and parallel factor analysus, suze exclusuon chromatography ( SEC ) equupped wuth multu-excutatuon/emussuon scan model fluorescence detector was used for the analysus of the composutuon of dussolved organuc matter ( DOM) usolated from landfull leachates wuth dufferent ages. The analytucal results showed that the two leachate-deruved DOMs both comprused proteun- and humuc-luke substances. However, there were four kunds of proteun-luke matter un young landfull leachates, u. e. , proteun wuth hugh molecular weught, proteun-luke matter bound to humuc-luke substances wuth hugh or low molecular weught, and peptude/amuno acuds. Whule there were only two kunds of proteun-luke matter un old landfull leachates, u. e. , proteun wuth hugh molecular weught and proteun-luke matter bound to humuc-luke substances wuth hugh molecule weught. Compared wuth SEC, EEM spectra coupled wuth parallel factor analysus could udentufy the proteun-luke matter bound wuth humuc-luke substances or those presented as non-humuc-luke substances, though ut could not udentufy the proteun-luke matter presented as proteun and that presented as peptude/ amuno acuds. The experumental results demonstrated that EEM spectra coupled wuth PARAFAC analysus and SEC could be used to characteruze proteun- and humuc-luke matter presented as dufferent specues.

Objective:To summarize the perioperative nursing experience of a patient with hemophilia arthritis complicated with hepatitis C undergoing unilateral hip and knee arthroplasty at the same time.Methods:In August 2018, a patient with hemophilic arthritis complicated with hepatitis C was admitted to the first hospital of Lanzhou University. Preparations for health education, functional exercises, examination and evaluation before operation was made. Unilateral hip and knee arthroplasty were performed at the same time, strengthen the management of incisions and catheters after the operation, actively prevent complications, and guide patients to perform functional rehabilitation exercises under the conditions of good pain management and safe coagulation factor activity; pay attention to the nursing of coagulation factor replacement treatment in the whole perioperative period.Results:After careful nursing, no serious complications occurred during the patient's hospitalization, and the position and force line of the prosthesis were satisfactory by imaging examination before discharge.Conclusion:The perioperative care of this patient proved that the above-mentioned nursing measures are effective for hemophilic arthritis patients with hepatitis C undergoing unilateral hip and knee arthroplasty at the same time.

Objective To explore the clinical efficacy of CT-Guided radioactive 125I seed implantation in treating retroperitoneal lymph node metastases. Methods Eighteen patients with retroperitoneal lymph node metastases (20 lesions in total) received CT-guided radioactive 125I seed implantation. Treatment planning system (TPS) was used to formulate the therapeutic protocol. The radioactive activity of 125I particle ranged from 1.11 × 107-2.96 × 107 Bq (0.3-0.8 mCi) and the matched peripheral dose (MPD) was 60 -100 Gy. Postoperative dosimetry was routinely performed for all the patients in one week. Postoperative D90 (90%dose received by target volume) was 53 -107 Gy. The patient’s clinical benefit response (CBR), two-month local tumor control rate and one-year survival rate were evaluated, and the complications were recorded. Results All the patients were followed up for 2 -15 months with a median time of 5 months. The one-year survival rate was 22.2%. The clinical benefit rate, overall effective rate and two-month local tumor control rate were 72.2%, 70.0% and 90.0% respectively. No serious complications occurred in all patients. Conclusion For the treatment of retroperitoneal lymph node metastases, CT-guided radioactive 125I seed implantation is mini-invasive with satisfactory short-term effect and fewer complications. Therefore, this technique is a relatively safe therapeutic means.

Objective To investigate the relationship between urinary iodine level and thyroid disease.Methods The study used a case-control design.One hundred and nine patients with thyroid disease from the Affiliated Hospital of Shanxi Institute for Endemic Disease Control were selected as case group from 2011 to 2012,and these patients were divided into three groups:Graves's disease (GD) group (n =48),chronic lymphocytic thyroiditis (HT) group(n =34) and thyroid nodules group(n =27).Sixty-two healthy people from the same region were selected as a control group.Urinary iodine was determined using arsenic cerium catalytic spectrophotometry,thyroid autoantibody (TRAb) and thyroid peroxidase antibody (TPOAb) was detected using electrochemiluminescence,while iodine absorption rate was measured using thyroid function analyzer,and thyroid volume was measured using type-B ultrasonic method.The relationship between urinary iodine level and patients with thyroid disease was compared with that of control group.Results Urinary iodine levels of patients with GD,HT,thyroid nodules and control groups were 313.95,375.20,220.20 and 196.50 μg/L,respectively.Urinary iodine levels of patients with GD and HT groups were higher than that of control group(Z =3.238,4.275,all P ＜ 0.0125).Urinary iodine level of patients with HT was higher than that of thyroid nodules(Z =3.762,P ＜ 0.0125).Iodine uptakes of GD,HT,thyroid nodules and control groups were (84.20 ± 16.90)％,(23.51 ± 6.72)％,(28.34 ± 8.02)％ and (29.31 ± 8.41)％; TRAbs of patients with GD,HT,thyroid nodules and control groups were (58.57 ± 20.31)％,(2.54± 1.00)％,(2.98 ± 0.83)％ and (3.01 ± 1.21)％; TPOAbs of patients with GD,HT,thyroid nodules and control groups were (117.03 ± 57.21)％,(251.00 ± 98.20)％,(16.81 ± 9.87)％ and (15.00 ± 7.23)％.Iodine uptake,TRAb and TPOAb of GD group were higher than those of control group(P ＜ 0.05).TPOAb of HT group was higher than that of control group(P ＜ 0.05).Urinary iodine levels of GD group and HT group were positively correlated with TPOAb(correlation coefficient were 0.462,0.478 all P ＜ 0.05).Conclusions Excessive iodine intake is found in patients with GD and HT.Determination of urinary iodine is helpful for individualized iodine supplementation.