Objective To investigate and analyze the severe complications and their surgical managements after endoscopic sphincterotomy(EST).Method 36 patients with complications after EST such as severe hemorrhage, perforation and severe pancreatitis were analyzed,of them there were 16 cases of hemorrhage, 11 case of perforation, 6 cases of hemorrhage combined with perforation and 3 cases of severe pancreatitis combined with perforation. Results 14 cases of merely hemorrhage patients, 11 cases of merely perforation patients, 1 case of perforation combined with severe pancreatitis patient and 3 case of perforation combined with hemorrhage patient were survived while 2 case of merely hemorrhage patient, 3 cases of perforation combined with hemorrhage patients and 2 case of perforation combined with severe pancreatitis patients died.Conclusions Hemorrhage is the most common complication of EST and most complications can be healed well through expectant treatment. Once severe complications occurred, prompt operations are the keys to lower the mortality.

BACKGROUND:Hip and knee replacement is a common surgery in the clinic; the procedure is relatively complex; and the risk of surgery is relatively high, so that postoperative analgesia is not satisfactory. Perioperative pain management has been a clinical concern. To find safe and effective analgesia has become one of the important tasks of joint surgeons. OBJECTIVE:To investigate the effect of celecoxib on multi-mode analgesia after hip and knee replacement. METHODS: A total of 80 cases undergoing hip and knee replacement in the Chongqing Dongnan Hospital from September 2012 to September 2013 were enroled in this study. These patients were randomly divided into two groups. In the control group, celecoxib was not used for analgesia after replacement. In the experimental group, celecoxib was used after replacement. The pain was observed at 1-5 days after surgery in the two groups. When the analgesic pump was removed, the drug dosage and opioid analgesics use were recorded. Side effects of drug use were also recorded. RESULTS AND CONCLUSION:In terms of analgesic efficacy, the analgesic effect was better in the experimental group than in the control group (95%, 85%, P < 0.05). 95% patients in the experimental group were satisfied with the analgesia, which was significantly higher than in the control group (65%;P< 0.05). No significant difference in pain visual analogue scale score was detected between the two groups immediately, 4 and 5 days after surgery (P > 0.05). Pain visual analogue scale score was significantly lower in the experimental group than in the control group at 1, 2 and 3 days post surgery (P< 0.05). The drug dosage was significantly more in the experimental group than in the control group after surgery (P < 0.05). The frequency of opioid use in the experimental group was significantly lower than in the control group (P < 0.05). The complication rate was significantly lower in the experimental group (8%) than in the control group (18%) (P < 0.05). These findings demonstrate that the analgesic effect of celecoxib was ideal after hip and knee replacement using multi-mode analgesia, which can reduce the dose of analgesic drugs and have smal adverse reaction.

Objective To study the relationship between balance function and attention in children with attention deficit hyperactivity disorder(ADHD),and guide the clinical intervention and training of ADHD.Methods The Tetrax balance system and the CPT were conducted among 124 ADHD children (age 6.0-14 years) and the normal controls.Results (1) The balance function was different between ADHD and normal controls.In junior grade of elementary school,the Fourier score of ADHD children was significantly higher than that of the normal control group in F1,F2-F4 and F5-F6 (P＜0.05).In senior grade of elementary school,the Fourier score of ADHD children was significantly higher than normal controls in F2-F4 and F5-F6 (P＜ 0.05).There was no significant difference between ADHD and normal controls in junior high school.(2) There was correlation between balance function and attention in children with ADHD.In junior grade of elementary school,the full scale attention quotient was negatively correlated with F2-4,F5-6,F7-8 (P=0.018,0.009,0.010; rs =-0.146,-0.203,-0.189),and the visual attention quotient were negatively correlated with F1,F2-4,F7-8 (P =0.043,0.039,0.046 ; r s =-0.062,-0.071,-0.112).In senior grade of elementary school,the full scale attention quotient was negatively correlated with F5-6,F7-8 (P=0.015,0.033; rs =-0.217,-0.172),and the visual attention quotient were negatively correlated with F1,F7-8(P=0.037,0.045; rs =-0.051,-0.101).In junior high school,the negative correlation was existed between the visual attention quotient with F7-8 (P=0.038,r s =-0.114).Conclusion ADHD children have deficit balance.The balance function of ADHD children matures gradually.There is internal connection between balance and attention,especially for visual attention.

Objective To observe the effect of porphyra yezoensis polysaccharide (PYP) on cerebrum tissue of diabetic rats and apoptosis. Methods 60 Wistar rats were randomly divided into normal control group, diabetic model group, and treated groups respectively with PYP (0.25 g/kg × d), PYP (0.5 g/kg × d), and PYP (1 g/kg × d). The cerebrum pathologic changes were observed by HE staining method, and the number of apoptotic cells was observed by electrophoresis and the mRNA expression of p53 and bcl-2 was confirmed by RT-PCR. Results PYP improved the cerebrum pathologic changes of diabetic rats. With comparison to the diabetic model group, the cerebrum pathologic change in the treated groups also improved. And the number of apoptotic cells, the expression of p53 in cerebrum tissue decreased and expressions of bcl-2 rose. Conclusion PYP can decrease the expression of p53 in cerebrum tissue and rise expressions of bcl-2 so as to protect brain tissues from cerebral ischemia.

Objective To understand brucellosis infective status of Shapotou District, Zhongwei City of Ningxia. Methods The methods of stratified random sampling of epidemiological survey were used among high risk groups in 2008, who underwent erythromycin red plate cohesion test(RBDT) and test-tube agglutination test (SAT), in accordance with the diagnostic criteria for confirming cases of brucellosis(GB 15988-1995). Results Totally an occupational group of 2480 brucellosis in 10 townships were investigated, and 604 sera were tested. Tweenty eight cases were infected, the infective rate was 4.64%(28/604), 15 cases were diagnosed as brucellosis patients, prevalence rate was 2.48% (15/604); cattle attendants had the highest infection rate of 6.45% (26/403). Conclusions Brucellosis epidemic in Shapotou District, Zhongwei City of Ningxia, and it is place related to vocation.

Cardiovascular disease, with high morbidity and mortality, has been threatening the health of human beings. Therefore, expecting to find a more effective therapeutic method, a plenty of researchers devote themselves to the study of the cardiovascular disease all the time. Since discovered on the heart, M3 receptor of muscarinic acetylcholine receptor (mAchR, M receptor) became a new starting point of the research of the cardiovascular disease. With more and more investigation, many people found that M3 receptor could protect the heart from kinds of cardiovascular disease, which may make it a new hopeful therapeutic point. So, expecting to give support to the reference and encouragement for the study of disease related to M3 receptor in future, this review expounds M3 receptor on the heart from the main following aspects: the effect on the heart, the influence on the cardiovascular disease and the mechanism of M3 receptor involved.
Cardiovascular Diseases ; prevention & control ; Heart ; physiology ; physiopathology ; Humans ; Receptor, Muscarinic M3 ; physiology

Background Pseudoexfoliation syndrome (PEX) has a high incidence in Uygur population and usually leads to secondary glaucoma and complicated cataract.The abnormal change of lens tissue and degeneration of zonular fibers bring a lot of difficulties for phacoemulsification (phaco) with intraocular lens implantation,especially stop-and-chop phaco technique.Prechop technique is a new choping technology,but its application in PEX with cataract is less.Objective This study was to compare the efficacy and safety of pre chop phaco technique and stop-and-chop phaco technique for PEX combined cataract.Methods A randomized controlled Clinical trial was designed.Forty-one eyes of 41 patients with PEX combined cataract of Ⅲ degree of nucleus were enrolled in People's Hospital of Hetian District from March 2015 to January 2016.The patients were randomized into the prechop group and stop-and-chop group according to random nubmer table,and cystotome-assisted prechop phaco surgery and stop-and-chop phaco surgery were performed in different groups,respectively.The effective phaco duration,corneal endothelium loss rate,cornea edema eye number after operation,vision outcomes and complications were compared between the two groups.Results The mean effective phaco duration was 14.0 (13.0,16.5) minutes and 18.5 (16.5,24.0) minutes in the prechop group and stop-and-chop group,with a significant difference between them (Z =17.354,P ＜ 0.01).The corneal endothelial cells were (2 101.90 ± 209.08)/mm in the prechop group,and the number was similar to (2 002.30 ± 207.04)/mm of the stop-and-chop group (t =-1.530,P =0.134).Corneal endothelial cell lossing rate was (8.27±2.23)％ in the prechop group,which was lower than (13.09±4.26)％ in the stop-and-chop group (t =3.810,P =0.001).The BCVA was better in the prechop group than that in the stop-and-chop group in postoperative day 3 (P =0.044),and the corneal edema degree was not signigicantly different in postoperative day 1 and day 3 between the two groups (P=0.221,0.446).Intraoperative complication was rapture of zonule and occurred in 1 eye and 2 eyes in the prechop group and stop-and-chop group,respectively.Conclusions Compared with the stop-and-chop phaco technique,the prechop phaco tequnique can decrease intraoperative complication,lighten the postoperative damage of corneal endothelial cells and accelerate visual rehabilitation in PEX combined with cataract patients.

Objective To explore and analyze the application and problems of esophageal cancer radical opera-tion by thoracoscopy combined with laparoscopy. Methods From July, 2011 to December, 2014, clinical data of 40 patients undergoing esophageal cancer radical operation by thoracoscopy combined with laparoscopy were analyzed retrospectively. Results Except 2 cases being relayed to assisted small thoracic incision because of 1 case with clear tumor invading to trachea and 1 case with obvious tumor invasion to thoracic aortic artery, the remaining 38 cases were successfully completed operation. There were 2 cases with postoperative anastomotic fistula in the neck, 2 cases of anastomotic stenosis and 1 case of hoarseness, there was no perioperative death. Follow-up was within 36 months, 2 patients died 10 months and 24 months after surgery respectively, due to tumor local recurrence. 1 patient with supraclavicular lymph node metastasis underwent local radiation therapy. The remaining was all survival with re-lapse-free. Conclusions Esophageal cancer radical operation by thoracoscopy combined with laparoscopy is a good method with safety and reliability, minimal invasion, fast recovering, and satisfied recent curative effect. It is worthy of applying clinically.

Objective To explore effects of doctor-nurse integrated care management model on fast track (FT) perioperative management of colorectal cancer patients.Methods Between January 2014 and September 2014,112 colorectal cancer patients (innovation group) underwent doctor-nurse integrated care and FT management in West China Hospital were analyzed retrospectively;who were compared with 96 patients (control group) underwent FT management from the same period of 2011.Early postoperative rehabilitation indicators,length of hospital stay,30d readmission rates,total hospitalization costs and patients satisfaction were compared.Results Innovation group of patients for the first time of post-operative flatus,defecation,oral feeding,ambulation,gastric and drainage tubes removal time were all earlier than those in control group,P ＜0.05,while the difference of urinary catheter tube removal time between the two groups was not statistically significant,P ＞ 0.05;the length of hospital stay in innovation group(6.05±2.05) d was significantly shorter than that in control group (7.85±3.22) d,P ＜ 0.05;preoperative hospital stay in innovation group was (1.35±0.45) d,shorter than that in control group (2.56±0.63)d,P ＜ 0.05;the patients satisfaction points in innovation group was (94.t2±3.12) points,which was higher than that in control group (86.36±5.51) points,t=2.589,P ＜0.05.Conclusion Doctor-nurse integrated care management model can improve postoperative rehabilitation effects,can reduce average hospital stay,total hospitalization costs and improve patients satisfaction.

BACKGROUND:Pasteurization is a perfect method for albumin virus inactivation, which may not be required for virus inactivation validation. However, there are no systematical reports concerning virus inactivation of hemoglobin blood substitutes. OBJECTIVE:To explore the effects of pasteurization on the physicochemical properties and biological function of hemoglobin blood substitutes. METHODS:Appropriate cord blood samples were taken fol owed by centrifugation, washing blood, rupture of membranes, stabilizer treatment. In the control group, the samples were placed in 55℃water bath, and when the temperature of hemoglobin solution reached (55±1)℃, a heat treatment began and lasted for 2 hours. In the pasteurization group, the samples were placed in 60℃water bath, and when the temperature of hemoglobin solution reached (60±1)℃, a heat treatment began and lasted for 10 hours. The heating process was under continues nitrogen protection. Then, the hemoglobin solution was placed in ice bath and cooled to below 4℃fol owed by low-speed centrifugation and filtration via microporous membrane, purification and viral inactivation thereby to obtain cord blood hemoglobin. RESULTS AND CONCLUSION:The products in the pasteurization group were al red clear liquid. There was no significant difference between the two groups in the yield, methemoglobin concentration, and oxygen-carrying capacity. The purification of the two groups was more than 98%. Two kinds of purification methods had no effects on the oxygen-carrying capacity of hemoglobin. Therefore, pasteurization method can replace thermosensitive purification method of 55℃, 2 hours. The pasteurization method wil not only ensure the physicochemical and biological properties of hemoglobin, but also achieve the purpose of virus inactivation.