This paper summarizes the observation and nursing of patients with postoperative complications following percuta-neous transhepatic cholangogrphic drainage(PTCD) and biliary tract stent implantation for malignant obstructive jaundice. A-mong thirty-two patients,eight had postoperative complications,including two with biliary tract hemorrhage,four with biliary tract infection,one with pneumothorax and one with bile leakage. All the thirty-two patients recovered well in clinical symptoms and quality of life. To attach importance to psychological nursing and postoperative health education are the key points in nursing care of patients with PTCD,which play important roles in alleviating clinical symptoms,improving treatment outcome and pro-moting the patients' quality of life.

Abstract： Objective　To analyze and summarize the early clinical characteristics of refractory Mycoplasma pneumoniae pneumonia (RMPP) in children, and to explore its related risk factors. Methods　A retrospective analysis was conducted on the clinical data of 518 patients with Mycoplasma pneumoniae pneumonia (MPP) admitted to the Department of Critical Care Medicine of Wuhan Children's Hospital from January 2020 to December 2023. According to the severity of the disease and treatment outcomes, the patients were divided into the RMPP group (n=127) and the general group (n=391). The differences in clinical features and laboratory indexes between the two groups were compared, and the risk factors of RMPP were screened out by logistic regression analysis. Results　There were no significant differences in gender, weight, onset season, and personal or family allergy history between the two groups (P>0.05). When categorized by age, the incidence of RMPP in the infant group (<3 years old, 18.92%) was lower than that in the preschool group (3-6 years old, 47.88%) and school-age group (>6 years old, 33.20%) (P<0.05), with no significant difference between the preschool group and school-age group. The probability of high fever, duration of fever, and duration of macrolide medication use in the RMPP group were significantly higher than those in the general group (P<0.05). The incidences of shortness of breath, diarrhea, convulsions, and rash in the two groups of children were also significantly different (P<0.05). There was a significant difference in white blood cell count, C-reactive protein, procalcitonin, lactate, blood urea nitrogen, alanine transaminase, D-dimer, interleukin-6 in the RMPP group were higher than those in the general group, with statistical significance (P<0.001). Among the 308 children in the general group who completed Mycoplasma pneumoniae DNA testing, the positive rate of Mycoplasma pneumoniae resistance sites was 57.47% (177/308), which was significantly lower than that of the RMPP group (76.38%, 97/127) (P<0.001). The rate of bacterial and viral co-infection in the RMPP group (59.84%) was significantly higher than that in the general group (P<0.001). The number of cases of pulmonary consolidation, atelectasis, and pleural effusion in the RMPP group was significantly higher than those in the general group (P<0.001). Multivariate logistic regression analysis showed that the duration of fever, bacterial co-viral infection, and positive Mycoplasma pneumoniae resistance gene loci were independent risk factors for RMPP. Conclusions　RMPP is more common in children over 3 years old and tends to occur in autumn and winter, and its early clinical symptoms are not typical. Clinical doctors should be highly vigilant about the occurrence of RMPP in patients who have prolonged fever despite macrolide treatment, bacterial and viral co-infections, or develop extrapulmonary complications (diarrhea, convulsions, rash). It is recommended that Mycoplasma pneumoniae resistance gene loci testing be performed as soon as possible, which can help to identify RMPP in the early stage.

From 1993 to 1995,117 patients with breast masses were admitted to Ji Shun Tan Hospital. Among these patients,there were 69 cases of cancer and 48 benign lesions. Both were verified by operation and pathology. All of these cases were examined by infrared light scanning(ILS) and color doppler flow image(CDFI) before operation. The diagnostic accuracy rate increased from 62.4% to 86.3% by ILS with CDFI comparing with clinical palpation. The misdiagnostic rates of ILS with CDFI were of 4.3% on cancer and 6.3% on benign lesion. The reasons of misdiagnoses were analyzed in the paper.

Objective To explore the role of TGF-βand TGIF in the pathogenesis of endometriosis. Methods The expression of TGF-β and TGIF was detected by immunohistochemistry method in the ectopic and eutopic endometrium of 30 cases with endometriosis (ec-topic endometrium group and eutopic endometrium group) and in the normal endometrium of 40 cases without endometriosis (control group). Result The expression of TGF -β in ectopic endometrium group was significantly higher than that in eutopic endometrium group and control group (P < 0.05). There was no significant difference in the expression of TGF- βbetween eutopic endometrium group and control group(P > 0.05). The expression of TGIF in ectopic endometrium group was significantly lower than that in eutopic endometrium group and control group( P <0.05). There was no significant difference in the expression of TGIF between eutopic endometrium group and control group(P > 0.05). There were negative correlation between the expressions of TGF - β and TGIF in ectopic endometrium group and eutopic endome-trium group(rs= - 0.769, - 0.549, P < 0.05). Conclusion The abnormal expression of TGF-β and TGIF in ectopic endometrium of pa-tients with endometriosis may be associated with the genesis and progression of endometriosis.

Objective To investigate the different clinical behavior and the diagnosis and trearment of primary hyperparathyroidism(PHPT). Methods Clinical data of 53 patients with PHPT treated in Beijing Jishuitan Hospital from May 1977 to April 2004 were collected and analyzed. Results 53 patients with PHPT were confirmed by operation and pathology. The majority of the patients were aged 20~50 years. There were more female than male patients. There were various clinical manifestations, and the duration of illness was (protracted). Many cases were misdiagnosed. There were bone pathologic changes of varying extent in all (patients), stones in urinary system plus bone pathology in 11 cases, serum level of calcium was raised in 51 patients(96.2%) and (parathyroid) hormone (PTH) was elevated in all examined 48 cases. Ultrasound, MIBI and CT were done before operation after 1991, and accurate preoperative localization diagnosis was (obtained). Minimally invasive (parathyroidectomy) (MIP) was successfully completed in 39 of 45 cases, and the primary operation cure rate was 97.4%. At postoperative follow-up of 10 months to 10 years, with the (exception) of 15 cases of severe bone deformity that had no obvious improvement, the other symptoms and signs were all relieved to varying (extents), the laboratory markers returned to normal, and there was no permanent hypoparathyroidism or (recurrent) nerve injury or other complications.Conclusions Early diagnosis of PHPT and effective early (treatment) by surgical removal of the pathologic lesion can alleviate the occurrence of severe bone changes and deformity. The preoperative combined use of imaging localization technique and overall assessment can improve the accuracy of diagnostic localization of the lesion.

Objective To discuss the effect and the method of treatment of anti-cardiolipin antibody (ACA),ANA and ENA on abnormal delivery women,and their relationship with abnormal delivery.Methods The concentrations of plasman ACA,ANA,ENA and the times of abortion in abnormal delivery for 193 cases of abnormal delivery women and 100 cases of normal pregnancy were quarnlitatively detected and satistically analyzed.The 81 ACA positive patients were treated orally with aspirin,25 ACA and ANA/ENA positive patients were treated with aspirin combined with prednisone,and 3 ANA/ENA positive patients with prednisone treatment oral.Results The number of ACA and ANA positive patients was closely related to the types of abmormal delivery. The ANA and ENA positive patients was related to the times of abortion. There was no difference in the outcome of treatment between both therapies of aspirine and aspirine combined with prednisone in abnormal delivery women.Conclusions ACA is an important factor in causing abnormal delivery. No matter what ANA and ENA are in ACA positive patients,their can be treated with aspirin alone.

Objective To develop a new method with using surgical procedures for multiple correction of nasal deformity with cleft lip and palate.Methods Our operation procedures included elevation of the nasal floor depression in cleft side with the transplantation of autogenous cancellous bone, frustration and elevation of the nasal bone and part of the frontal process of maxilla, and replacement of septum between alar cartilages.Through these procedures, the nasal deformity could be multiply corrected.Results Postoperative follow up for 1～8years in 45 patients demonstrated satisfactory results. Conclusion Multiple correction is a new method of treatment for nasal deformity with cleft lip and palate.

Objective To observe the clinical efficacy of acupuncture with elongate needle plus red light radiation in treating post-herpetic neuralgia.Method Seventy patients with post-herpetic neuralgia were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by acupuncture with elongate needle plus red light radiation, while the control group was by orally taking Pregabalin capsules. Visual Analogue Scale (VAS) and Quality of Life (QOL) were observed before and after intervention, and the clinical efficacies were compared between the two groups.Result The total effective rate was 97.1% in the treatment group, versus 71.4% in the control group, and the difference was statistically significant (P<0.05). After treatment, VAS and QOL scores were significantly changed in both groups (P<0.05). The VAS and QOL scores in the treatment group were significantly different from that in the control group after treatment (P<0.05).Conclusion Acupuncture with elongate needle plus red light radiation is effective in relieving post-herpetic neuralgia.