Objective To investigate the causes of intractable abdominalgia after simple choleystectomy and analyse the therapeutic effect of endoscopic sphincterotomy (EST).Methods 84 patients undergoing EST were retrospectively viewed from 1987 to 1998. Results Sixty five out of 84 patients were followed up, in which the clinical signs disappeared completely in 51 cases (78%), and there were 6 cases with relapsing symptom(9%),3 cases with intermittent relapsing symptom (4%). Therapy was ineffective in 5 cases. The intractable abdominalgia is a specific sign of postcholecystectomy syndrome. EST is effective in removing the nervous structure in duodenal papilla submucosa and sphincter muscle layer responsible for abdominal pain, therefore eliminated or relived the pain.Conclusion EST has a significant effect on intractable abdominalgia after simple cholecystectomy in the majority of patients.

Objective:To explore the communication problems among nursing students in early clinical prac-tice, and to provide reference for clinical nursing education .Methods:Introspecting diary of the clinical communi-cation in nursing students were classified and analyzed by using qualitative research method .Results:5 themes were extracted as following: barriers for communication between nurses and patients , reflection on patient , nurse occupation , clinical teaching and critical reflection on public opinion .Conclusion:Introspecting diary is important to help teachers in teaching , to guide and cultivate nursing students to develop their interpersonal communication competence .

Objective To explore the pathogeny, pathology, ultrasonic and clinical expression of upper extremity deep venous flow obstruction and superior vena cava syndrome. Methods Retrospective analysis and summarize the disease changes of 10 cases in recent 5 years. Results 7 patients of 10 cases were superior vena cava syndrome, in which 4 cases caused by upper right lung malignant tumor, 3 cases caused by upper and media mediastinal malignant tumor. 2 patients of 10 cases were found thrombosis in right subclavian vein caused by duct of artificial pacemaker. The left 1 patient was no reason thrombosis in right axillary vein. Conclusion Ultrasonography combine with color and spectral Dopper image can evaluate the clinical development and therapeutic efficiency, which is a useful and effective non-invasive examination.

10.3969/j.issn.1007-3969.2013.05.011

Objective To investigate the contamination of Cd,Pb,Cu and Cr in the sediment of Guangzhou reach in Pearl River.Methods The sediments were collected in Yagang spot in April,2006.The content of heavy metals were determined,the heavy metals in the sediment were extracted with Tessier five stage sequential extraction procedure,and AAS was applied to determine the concentration of heavy metals in the sediment and extracts.Results The level of Cd,Pb,Cu,Cr were 2.29 mg/kg,217.97 mg/kg,320.60 mg/kg and 124.44 mg/kg respectively in the sediment in Yagang spot.They were higher than the background values of soil of Guangdong,and different heavy metals had different values of five forms.Cd existed as exchanged form mainly,and Cr,Pb existed as stable form mainly,so,Cd was easy to be resolved into water,Cr,Pb were relatively stable in the sediment.Conclusion The ecological risk of the four heavy metals is assessed with Hakanson potential ecological harmful index,the ecological risk of Cd is high,Cr,Pb is lower,Cu is moderate.

Objective To evaluate the effect of early clinical interference strategies on preventing the conversion of acute pancreatitis to the severe form and aggravation of severe acute pancreatitis(SAP).Methods The patients with acute pancreatitis admitted to this hospital were divided into two therapeutic phases by different therapeutic methods from January 2001 to December 2008.Patients in the first phase(from January 2001 to December 2004) were treated by the routine management,and the second phase(from January 2005 to December 2008) by the routine management combined with early clinical interference strategies.Then,the ratio of conversion from acute pancreatitis to SAP and prognosis of SAP between two phases were compared.Results Compared with the first phase,the rate of aggravation of acute pancreatitis was significantly decreased in the second phase(4.48% vs.21.18%),the average healing time of SAP,the incidences of systemic and local complications and the mortality of pancreatitis were reduced(P

The C-terminal tail of opioid receptor is important for opioid receptor phosphorylation,desensitization and internalization after opioid agonists treatment.The C-terminal point mutant and truncated mutant of amino acid residues of ?opioid receptors such as T394A,T383A,T357A,S355A affect the function of the opioid receptor obviously.The identical results could be seen in the C-terminal point mutant S363A of ?opioid receptor and S369A of ?opioid receptor.It is well known that opioid receptor requires interaction with other proteins for function,regulation and trafficking.Although proteins such as PPL,FilaminA,PLD2,PKCI,GASP and EBP50/NHERF have been identified to interact with C-terminals of opioid receptors,the role of interaction of these proteins with opioid receptor in the dependence,tolerance and addiction of opioids is dubious.Therefore,looking for the proteins specifically interacting with the C-terminals of opioid receptor may be important to understand the mechanism of opioids addiction.

Aim To study the effects of luteolin on the expression of TGF-?1 mRNA in rats with pulmonary fibrosis, and elaborate the molecular mechanism of luteolin in pulmonary fibrosis therapy. Methods The model of pulmonary fibrosis was established through instilling bleomycin intratracheally. After luteolin treatment, the pulmonary index and the content of hydroxyproline (HYP) were observed. The levels of TGF-?1 mRNA in pulmonary tissues were determined with RT-PCR. Results The pulmonary index and the content of HYP decreased markedly in pulmonary fibrosis rats treated with luteolin. Furthermore, luteolin inhibited evidently the expression of TGF-?1 mRNA in lung tissues with pulmonary fibrosis. Conclusion The molecular mechanism of luteolin in pulmonary fibrosis therapy was associated with inhibition of the expression of TGF-?1 mRNA.

Defecography was performed in 110 patients without any anorectal symptoms which included 57 male and 53 female with an average age of 43. 15. Normal defecography was found in 82 cases and abnormal one in 28. The normal features of defecography in 82 patients were as follows;1.There was an increase of anorectal angle during defecation. The increase was 21. 27 degrees measured-with precise axis method and 36. 72 degrees with approximate axis method.2. Reduction or obliteration of the impression of the puborectal muscle.3. There was a shortening of the anal canal by 1. 20 cm and a widening of the caliber of the anal canal to an average of 2. 23 cm.4. The resistance of the pelvic floor was good and the decending of the perineum was smaller than 3 cm during straining. The rectovaginal septum of female subjects was not deformed during straining.5. The barium paste in the distal rectum was largely or totally evacuated with an average e-vacuation rate of 90. 55%.

Objective To explore the value of exhaled nitric oxide evaluate the condition of children with asthma in clinical remission stage .Methods A total of 214 asthmatic children were divided into treatment group and control group .Tests of bronchial provocation and FeNO were performed at the same time .Results FeNO in treatment group was significantly lower than in control group ,while the level of PC20 FEV1 did not have obvious difference in two groups .The level of PC20 FEV1 was negatively correlated with FeNO ,regression equation was Y=35 .883-1 .074X(X= PC20 FEV1 ,Y= FeNO) .Conclusion FeNO is a reliable indicator to evaluate the control situation of non‐specific inflammation in asthmatic children .Combined with bronchial provocation test ,the diag‐nosis rate of asthma in clinical remission stage will significantly raised .