Objective To investigate the safety and effect of fast track surger (FTS) y in repair of upper digestive tract perforation in emergency department.Methods According to the digital table,64 patients with upper digestive tract perforation were randomly divided into the observation group (n =34) and control group (n =30).The control group received conventional perioperative treatment.The patients in the observation group were given related processing of perioperation under the guidance of the concept of fast track surgery.The C reactive protein (CRP) level preoperation,postoperative 1 day,postoperative 3 days,postoperative incidence of adverse reaction and complications,exhaust defecation time,hospital stay and cost of hospitalization were compared between the two groups.Results Postoperative 1 day and 3 days,the CRP levels of observation group were (85.8 ± 17.5)mg/L and (67.1 ±15.6) mg/L,which were significantly lower than (112.4 ± 12.9) mg/L and (92.7 ± 25.4) mg/L of the control group (t =1.043,3.189,all P ＜ 0.05).After operation,the appeared exhaust defecation time,total length of hospital stay in the observation group were (54.6 ± 5.3) h,(66.2 ± 4.8) h and (4.1 ± 0.5) d,which were significantly shorter than those of the control group (t =2.534,3.013,2.252,all P ＜ 0.05).The cost of hospitalization of the observation group was (5 900 ± 300) thousand,which was significantly less than (7 000 ± 800) thousand of the control group (t =1.641,P ＜ 0.05).No significant differences between the two groups in appeared probability adverse reaction and complication after operation (P ＞ 0.05).Conclusion FTS in the repair of emergency upper gastrointestinal perforation is safe,economic,effective,and can accelerate the progress of rehabilitation.

Overt hyperthyroidism and hypothyroidism can induce hypertension.Recent studies found that mild thyroid dysfunction including subclinical thyroid diseases and increased TSH during normal reference range also had effect on blood pressure which had not been agreed with others.The mechanism is complex and not yet very clear.The basic treatment for the patients with thyroid diseases and hypertension is to treat thyroid diseases.Beta-receptor blocking agents and diuretics are preferable drugs for hyperthyroidism.

AIM: Respiratory tract cilia are difficult to harvest and observe due to weak transparence, which results from their location in thick mucosa, so people always try to obtain ciliated cells with many methods. This study was designed to apply manual microdissection to isolate ciliated cells from guinea pig's nasal epithelium and offer pure cells to further research. METHODS: The experiment was carried out at the Institute of Otolaryngology Head and Neck Surgery in Chinese PLA General Hospital from March of November in 2007. Twenty healthy white guinea pigs were recruited in this study. The ciliated cells layer was isolated from submucous layer by instruments for microsurgery under the light microscope. The isolated mucosa and untreated mucosa layer were stained with hematoxylin-eosin in order to verify the isolated layer is mucous ciliated cells layer. The protease-treated ciliated cells layer was viewed under low magnification microscope, to count number of single ciliated cells and impure cells, as well as size of ciliated cells group. The morphology of ciliated cells was observed under high magnification microscope. RESULTS: Result of hematoxylin-eosin stain confirmed that the cell layer by manual microdissection was ciliated cells and basal cell layer, which were thin without submucous layer. Under low magnification microscope after manual microdissection, the density of isolated ciliated cells was larger, number of single ciliated cells was more and size of ciliated cells group was smaller. There were about 7 ciliated cells in a cell group, and no other cells were observed. Under high magnification microscope, the isolated ciliated cells by manual microdissection were smooth, good in light refraction, and active for cilia beat. The survival time was prolonged obviously, still 50% cells were alive 24 hours later. Compared with conventional isolation technique, manual microdissection was significantly predominant in the purity and activity of cells (P

OBJECTIVE:To prepare andrographolide phospholipid compound,optimize its formulation technology and charac-terizeit. METHODS:Andrographolide phospholipid compound was prepared with solvent method. Using compound rate as index, the effects of reaction solvent,reaction time,reaction temperature,drug concentration,the ratio of reactants and other single fac-tors on compound rate were investigated. The ratio of reactants,reaction temperature and drug concentration were optimized by or-thogonal test and validated. The dissolubilities of andrographolide,andrographolide phospholipid physical mixture and androgra-pholide phospholipid compound in water,soybean oil and Lauroglycol FCC were compared and characterized with UV and DSC. RESULTS:The optimal preparation technology was tetrahydrofuran as reaction solvent,reaction time of 4 h,reaction temperature of 50 ℃,drug concentration of 10 mg/ml,ratio of andrographolide to phospholipid 1:3. The compound rate of andrographolide phospholipid compound was 83.2%(n=3). Compared with raw material and physical mixture,phospholipid compound significant-ly improved the dissolubility of andrographolide in water,soybean oil and Lauroglycol FCC. UV and DSC showed that compound had been prepared. CONCLUSIONS:Andrographolide phospholipid compound is prepared successfully.

Objective To explore the influence of intermittently inhaled budesonide on wheezing improvement and recurrent in infants,assess their body height and weight development status.Methods 138 wheezing infants were selected.They were randomly divided into the treatment group and the control group,69 children in each group.The treatment group received budesonide therapy when upper respiratory infection symptoms infection,the control group was given ribavirin injection spray treatment.After two weeks treatment,the number of severe wheezing and systemic corticosteroids were observed,the asthma relapse frequency in one year and height and weight were assessed.Results The severe wheezing number and the application of systemic corticosteroids number of the treatment were 1 case (1.50%)and three cases (4.35%),which were lower than the control group 8 cases (11.59%)and 11 cases (15.94%).The difference was statistically significant (χ2 =8.71,P <0.05).The frequency of wheezing within one year of the treatment group was (2.39 ±0.41)times,which was lower than (4.56 ±0.45)times of the control group, the difference was statistically significant (t =9.06,P <0.05).Comparison of height and weight of the two groups after one year,the differences was not statistically significant (t =1.45,1.18,all P >0.05).Conclusion Budesonide in the treatment of intermittent wheezing infants can significantly improve the wheezing and reduce the use of systemic corticosteroids,reduce the relapse rate.It has no effect on the growth and development of infants.

Objective To investigate the prevalence and influencing factors in senile cataract in Huzhou city.Methods 1 680 cases of healthy physical examination elderly population were selected as the research subjects in Huzhou city.To investigate the prevalence of cataract in the elderly population.The correlation of the prevalence of senile cataract,visual impairment and sex,age was studied.The correlation of the prevalence of senile cataract and diabetes,hypertension,smoking was analyzed.At the same time,Logistic regression analysis was used to analyze the influence factors of senile cataract.Results In 1 680 cases of elderly people,299 cases of cataract,the prevalence rate of cataract was 17.79%.With age increased,the prevalence of senile cataract was gradually increased.The preva-lence of cataract in female was 21.80%,which was higher than 15.82% in male,and the difference was statistically significant (χ2 =9.083,P <0.01).The visual acuity of senile cataract patients would increase with age.Moreover, the visual acuity of female patients was higher than that of male patients.The prevalence of cataract in diabetic group was 64.58%,which was higher than 17.89% in non -diabetes group,the difference was statistically significant (χ2 =65.457,P <0.01 ).The prevalence of cataract in hypertension group was 61.48%,which was higher than 14.31% in non -hypertension group,and the difference was statistically significant (χ2 =163.538,P <0.01).The prevalence of cataract in smoking group was 80.39%,which was higher than 16.94% in non - smoking group,the difference was statistically significant (χ2 =130.046,P <0.01).Logistic regression analysis showed that gender,age, diabetes,hypertension,smoking,and so on were the factors affecting the incidence of cataract in the elderly popula-tion.Conclusion The prevalence of cataract in the elderly population in Huzhou city need to pay attention to the local health department.

Objective To summarize the clinical effect of urethroplasty using acellular dermal matrix patch for the treatment of anterior urethral stricture caused by lichen sclerosus.Methods The clinical data was analyzed retrospectively from 15 patients with anterior urethral stricture caused by lichen sclerosus treated with aeellular dermal matrix patch.Results The patients were followed up for 8-40 months.The urethral silicone stent was removed 4 weeks after operation in 15 cases and all the patients voided well 2 months after operation.The urinary peak flow rates ranged from 17.6 to 41.7 ml/s(mean,28.6ml/s).Urethral stricture occurred in 2 patients 3 months after operation undergoing discontinuous dilatation within 3 to 6 months,the patients voided very well.Conclusion It is feasible,safe and relatively simple to use acellular dermal matrix patch for anterior urethral stricture caused by lichen sclerosus.

Background Macular edema is one of the serious complications of central retinal vein occlusion (CRVO),and the present therapies are laser coagulation and intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs.Conbercept is humanized-monoclonal VEGF antibody and used for the treatment of retinal vascular diseases.However,fewer studies were focused on its application in macular edema secondary to CRVO.Objective The aim of this study was to compare the effectiveness and safety of conbercept with triamcinolone acetonide(TA)by intravitreal injections for macular edema secondary to CRVO. Methods A non-randomized controlled study was carried out under the approval of the informed consent of patients.Sixty eyes of 60 patients with macular edema secondary to CRVO were included in Weifang Yidu Central Hospital from March 2012 to August 2013.The eyes were divided into the conbercept group and TA group with 30 for each group.Conbercept and TA of 0.05 ml were intravitreally injected in different groups,and the best corrected visual acuity(BCVA),central macular thickness(CMT)measured by OCT,intraocular pressure(IOP)and relavant complications were examined before injection and 1 week,1 month,3 months and 6 months after injection.The treatment outcomes were compared intergrouply and along with time. Results The BCVA was evidently better in 1 week,1 month,3 months and 6 months after injection than that before injection both in conbercept group and TA group(all at P＜0.01),and the BCVA of TA group was better than that of conbercept group 1 week after injection(P＜0.05).The CMT values of Conbercept were(572.00± 100.01),(325.12±91.55),(280.00±92.37),(258.65 ±88.65),(300.00±87.64)μm,and those of TA group were(570.00± 102.21),(345.12±89.31),(290.00±80.27),(309.65 ±84.13)and(303.00±90.59)μm,and CMT value after injection was significantly lower in 1 week,1 month,3 months and 6 months after injection than that before injection both in the conbercept group and the TA group(all at P＜0.05),and CMT value was evidently reduced in the conbercept group compared with the TA group 3 months after injection(P＜0.05).The IOP was(15.20±3.52),(21.20±3.80),(26.40±4.00),(23.60±3.73)and(21.50±3.27)mmHg in the TA group before injection and 1 week,1 month,3 months and 6 months after injection,showing significnatly elavation after injection(all at P＜0.05),and the IOP at different time points was higher in the TA group than that in the conbercept group(all at P＜0.05).However,there was no considerable change of IOP before and after injection in conbercept group(all at P＜0.05). Conelutions Both conbercept and TA are effective for macular edema secondary to CRVO by intravtreal injection.Compared with TA,conbercept is much safer because of less risk of IOP rising after intravtreal injection.

Objective To observe the effects of ginkgolide B (GB) on mRNA expression of foxgl and proliferation of cells in brain tissue of newborn rats with hypoxic-ischemic brain damage (HIBD).Methods A total of 128 clean 7-day-old healthy SD rats were randomly divided into sham operation group,the model group,the low-GB dose and the high-GB dose treatment groups.Classic Rice method were used to establish HIBD models in the latter 3 groups.Four hours after operation,and GB in dose of 5 mg/kg and 10 mg/kg was given to rats in the low and the high dose treatment groups by intraperitoneal injection postoperatively,once a day for 5 days,while sham operation and model groups were treated with equal physiological saline.All groups were respectively sacrificed on 3 d,7 d,14 d,28 d respectively.Quantitative real-time fluorescent polymerase chain reaction was employed to detect expression of Foxg1 gene.Then the number of 5-bromodeoxyuridine positive cell in subgranular zone was investigated by immunolluorescent stairning.Results The Foxg1 mRNA expression was observed 3 days after HIBD,peaked on 7th day,and then declined gradually; the levels of Foxg1 mRNA in the 2 treatment groups were higher than that of the HIBD group (all P ＜ 0.01) ; The expression of Foxgl at 7 d,14 d,28 d,in high-dose group were higher than those in the low-dose group (all P ＜ 0.01).The number of 5-bromodeoxyuridine positive cell was increased after HIBD,and the levels in the low-and the high-dose treatment groups were all higher than that of the model group (all P ＜ 0.05) ; the number of positive cell in high-dose treatment groups were higher than that in the low-dose treatment groups (P ＜ 0.05).Conclusions GB can promote the expression of Foxg1 gene and improve the proliferation of cells in Brain tissue after HIBD,which shows more significant efficacy in high-dose group than in low-dose group.

Objective To explore the value of hydronephrosis volume measured by 64 slice CT scan, evaluating renal function in patients with obstructive hydronephrosis.Methods The patients performed with both single photon emission computed tomography(SPECT) renal dynamic imaging and 64 slice CT scan in three days were chosen, 176 cases included finally.The images of renal dynamic imaging were divided into normal renal function group, mild renal impairment group, moderate renal impairment group and severe renal impairment group according to glomerular filtration rate (GFR) measured by SPECT.At the same time, CT three-dimensional reconstruction technique has been used to measure the volume of hydronephrosis, compare the differences of hydronephrosis volume among these groups, and future analyze the correlation of hydronephrosis volume with renal GFR value.Results The hydronephrosis volume of the four groups were respectively (31.47±3.81) cm3,(83.43±7.81) cm3,(208.53±15.47) cm3 and (577.31±61.32) cm3.There was statistical significance among these groups (P<0.01),except between normal renal function group and mild renal impairment group.The volume of hydronephrosis showed positive correlations with renal GFR (r=-0.614).Conclusion The volume of hydronephrosis measured by 64 slice CT has positive correlation with GFR measured by SPECT, which could reflect renal function to some extent.