Objective To probe into the clinical application value of ERCP stent implantation in treatment of elderly patients with malignant obstructive jaundice. Methods From January 2014 to December 2015, 97 elderly patients with malignant obstructive jaundice were selected in our hospital as study objects. According to the different treatment, the patients were divided into study group (n = 50) and control group (n = 47) randomly. The patients in study group were treated with ERCP biliary stent implantation. The patients in control group were treated with PTCD biliary stent implantation. The surgical treatment, clinical symptoms, liver function, immunologic function and incidence of complication of the patients between the two groups were compared and analyzed. Results Compared with control group, the patients in study group, the rate of successful operation was 96.00% (48/50), there was increased, but the differences were not significant statistically (P > 0.05); the patients in study group, total efficiency rate was 94.00% (47/50), there were increased significantly, the differences were significant statistically (P < 0.05); the patients in study group after 2 weeks treatment, TBIL were (110.24±60.05) μmol/L, DBIL were (82.43 ± 46.19) μmol/L, ALT were (86.79 ± 39.30) IU/L, AST were (53.65 ± 35.81) IU/L, ALP were (216.83 ± 127.74) IU/L, GGT were (196.52 ± 100.64) IU/L, there were improved significantly, the differences were significant statistically (P < 0.05);the patients in study group after treatment, the levels of CD3+ was (70.24 ± 5.62)%, CD4+ was (37.74 ± 3.85)%, CD4+/CD8+ was (1.35 ± 0.12) and CD8+ was (27.96 ± 3.14)%, there was reduced significantly, the differences were significant statistically (P < 0.05); the patients in study group, the incidence of total complication was 8.00% (4/50), there was decreased significantly, the differences were significant statistically (P < 0.05). Conclusion ERCP stent implantation has very important clinical significance in improving the treatment effect, liver function and immune function for elderly patients with malignant obstructive jaundice.

BACKGROUND:Several studies have confirmed that bone marrow mesenchymal stem celltransplantation exerts a certain neuroprotective role in cerebral infarction. Edaravone is a novel potent smal-molecule hydroxyl radical scavenger, which play a protective role in the brain by eliminating free radicals and inhibiting nerve celldamage after cerebral infarction. OBJECTIVE:To explore the influence of bone marrow mesenchymal stem cells combined with edaravone on expressions of aquaporin-4, Bcl-2, and brain-derived neurotrophic factor after cerebral infarction in rats. METHODS:Eighty Wistar rats were selected to establish models of cerebral infarction by right middle cerebral artery occlusion, and then randomly divided into control group, bone marrow mesenchymal stem cells group, edaravone group and edaravone+bone marrow mesenchymal stem cells group (combination group). After 6 hours of modeling, rats from these four groups were respectively injected via the tail vein with PBS, bone marrow mesenchymal stem cells, edaravone and edaravone+bone marrow mesenchymal stem cells. After 72 hours, the rats were decapitated to take brain tissues. Consequently, expressions of aquaporin-4, Bcl-2, and brain-derived neurotrophic factor mRNA and protein were determined by RT-PCR and western blot methods. After 12, 24 and 36 hours, TUNEL method was used for the determination of cellapoptosis. RESULTS AND CONCLUSION:The expressions of Bcl-2 and brain-derived neurotrophic factor were higher in the combination group than the other three groups (P<0.05), but the expression of aquaporin-4 was lowest in the combination group (P<0.05). The number of apoptotic cells in the combination group was significantly lower than that in the other three groups. These findings suggest that the combination of bone marrow mesenchymal stem cells and edaravone can improve expressions of Bcl-2 and brain-derived neurotrophic factor in the injured site, and significantly inhibit neuronal apoptosis. Meanwhile, the combination therapy can decrease expression of aquaporin-4 and mitigate cerebral edema, which is superior to bone marrow mesenchymal stem celltransplantation and edaravone alone.

The design of field medicine automobile is discussed from the aspects of its structural form and functional features.The kind of field medicine automobile which is made to supply medicine timely and efficiently to meet the demand of field battle,can improve the effectiveness of medical supply and management with standardization,informationization,ordering and facilitation.

Objective To investigate the drug resistance of Staphylococcus haemolyticus and provide basis for selection of clini‐cal drugs .Methods A total of 59 strains of Staphylococcus haemolyticus were isolated from patients ,and analyzed the clinical dis‐tribution and drug resistance of them .Results Staphylococcus haemolyticus were mainly isolated from the sputum and oropharyn‐geal swabs in pediatric and ICU .The patients were mainly newborns .Staphylococcus haemolyticus mainly included methicillin re‐sistant Staphylococcus haemolyticus (MRSH) ,accounting for 89 .8% (53 strains) .MRSH showed high‐drug resistance and multi‐drug resistance .However ,it was sensitive to vancomycin ,teicoplanin and linezolid ,the antibiotic sensitive rate was 100 .0% .Conclu‐sion Staphylococcus haemolyticus is an important coagulase negative staphylococci ,mainly including MRSH ,which shows high‐drug resistance and multi‐drug resistance .

AIM: To investigate the effect of adrenomedullin on the fibrogenic action of TGF? 1 and the cellular mechanism in renal tubular epithelial cell line (HK-2). METHODS: Total collagen synthesis and secretion were reflected by -proline incorporation and the radioactivity of -hydroproline in the culture medium; ELISA method was used to detect the level of secreted fibronectin (FN); the expression of FN mRNA, collagen IV mRNA and TIMP-1mRNA were determined by RT-PCR; western blot was used to detect the expression of Smad2 and Smad6 proteins. RESULTS: (1) AM could antagonize the expression of collagen and FN stimulated by TGF? 1 in both transcription and translation level; (2) AM down-regulated the TGF? 1-induced TIMP-1 mRNA expression; (3) AM had no effect on the over-expression of Smad2 stimulated by TGF? 1; but could up-regulate the expression of Smad6 inhibited by TGF? 1. CONCLUSION: AM could antagonize the fibrogenic effect of TGF? 1 through up-regulating Smad6 expression in HK-2 cell line.

Objective:To collect and analyze the quality control data of ventilator, so as to apply these statistical data to guide the maintenance and management of ventilator.Methods: The displayed value and monitoring value of the tidal volume, respiratory frequency, inspiratory oxygen concentration, inspiratory pressure level and positive end expira tory pressure (PEEP) under different setting of 50 using ventilators in hospital were collected by using PF-300 gas analyzer, and then each parameter was analyzed as classification.Results: The total quality rate of ventilators was 80%, the ranking of quality rate as different brand was: brand B>brand A>brand C, and it was as different department: department 5>department 4=department 3>department1>department2, and the quality rates of less than 3 years and more than 3 years were 87% and 77%, respectively, as service life of ventilator. And the ranking of quality rates as parameters of ventilator was: PEEP=respiratory frequency >peak pressure>tidal volume >oxygen concentration. It was as accuracy of monitoring: brand A>brand C>brand B. It was as stability of monitoring: brand A>brand B=brand C. On the other hand, it was as the accuracy of displayed value: brand A>brand B>brand C, while it was as the stability of displayed value: brand A>brand C>brand B.Conclusion: The analysis of quality control data only suits to the ventilator which is used in our hospital. The engineer can targeted to strengthen the ventilator maintenance work and improve the quality and safety of equipment, so as to give the better service for patients according to quality control data of using ventilators in hospital.

Objective To evaluate the efficacy and safety of transvaginal hydrolaparoscopic ovarian drilling for treatment of the polycystic ovary syndrome(PCOS)in clomiphene citrate-resistant infertile women.Methods Between February 2008 and November 2008,11 clomiphene citrate-resistant anovulatory women with PCOS mean age:(29.3?3.7)years,mean body mass index:(24.3?8.3)kg/m2] were enrolled in this study.Transvaginal hydrolaparoscopy using a F5 bipolar needle was performed on the patients to create 5-15 holes with a free length of 0.8 cm and a diameter of 0.2 mm in each ovary(electrocoagulation time 10-15 sec).Results A mean of(17?6)holes were made in both the ovaries in the patients.No surgical complications occurred.The levels of LH,FSH,and androstenedione dropped from(14.7?4.5)IU/L,(7.1?6.4)IU/L,and(12.2?4.4)nmol/L to(10.5?3.7)IU/L,(6.4?1.7)IU/L,and(8.9?3.0)nmol/L(t=2.389,P=0.027;t=1.007,P=0.326;and t=2.104,P=0.048)respectively after the operation.The patients were followed up for 2 to 9 months,during the period 6(54.5%)patients recovered spontaneous menstruation,among which 3 recovered ovulatory cycles(27.3%)and 2(18.2%)had spontaneous pregnancy.In the other 8 patients who didn't recover spontaneous menstruation,5 cases received CC or FSH(one of them was pregnant after the treatment);1 case was not pregnant though received IVF;and 2 are still in follow-up.Conclusions Transvaginal hydrolaparoscopic ovarian drilling is safe and effective for clomiphene citrate-resistant infertile women.

Objective To investigate the clinical pregnancy outcomes of laparoscopic treatment for different degrees of tubal adhesion and tubal distal occlusion.Methods Clinical information of 41 infertile patients from April 2001 to December 2005 was reviewed.According to the extent of tubal and pelvic lesion,the patients were classified as stage Ⅰ in 10 patients,stage Ⅱ in 10,stage Ⅲ in 17,and stage Ⅳ in 6.After a diagnosis was made by hysterosalpinggography(HSG),all the patients received a salpingostomy and adhesionlysis under laparoscope.Results No abnormal findings were detected by hysteroscopy and bilateral tubes were patent after operation in all the 41 patients.The 10 patients at stage Ⅰ were followed up for 12~21 months.Four of them got pregnant in six months and 1 got pregnant in 1 year because of intermittent separation,all the 5 patients being intrauterine pregnancy.The 8 patients at stage Ⅱ were followed up for 12~26 months.Three patients got pregnant,including intrauterine pregnancy in 1 and ectopic pregnancy in 2.The pregnancy occurred at 15,16,and 26 months after operation,respectively.The 17 patients at stage Ⅲ were followed up for 3~48 months.Four had pregnancy,at 3,4,12,and 14 months after operation,respectively,including intrauterine pregnancy in 1 and ectopic pregnancy in 3.The 6 patients at stage Ⅳ were followed up for 12~36 months and no pregnancy was observed.Among the 12 patients with pregnancy,8 got pregnant within 12 months and 3 at 13~18 months after operation,the pregnancy rate within 18 months being 91.7%(11/12). Conclusions Clinical pregnancy outcomes are related with the degree of tubal lesion and adnexal adhesion.Patients at stage Ⅰ~Ⅱ have better pregnancy outcomes than patients at stage Ⅲ~Ⅳ.

ObjectiveTo explore the key problems facing health record management and put forward effective strategies.Methods Questionnaires survey was performed among county medical staff,country doctors and rural residents who had medical records.Fishbone diagram was used to justify the results.Results At Chongyi count,rural residents got 20-Yuan subsidy per person for medical examine,although the establishment of a health file cost at least 55.5 Yuan,including 42.7 Yuan for medical examination.Only 60 of 108 villages were equipped with computers.Medical staff account for 1.49/1000.The awareness and use of health records were insufficient.ConclusionOur data suggest that it should be necessary to increase financial investment,enhance knowledge on health records,put electronic information system into practice,and strengthen personnel training in the future.

Objective To set up the experimental animal model of the filial rats exposed clozapine in the pregnant clay and expect to know what is the effect on the offspring exposed the antipsychiatrie in gestation.Methods Female Wister rats were divided into both the control group (n=17)and elozapine group (n=2.5) which were intraperitoneally injected saline and clozapine respectively from pregnant day 6 to day 15,and their pup rats were examined development indexes such as the physical growth ,neural reflex,neural behavior and the expression of MAPK44/42 in brain in neonatal stage.Results it was shown that clozapine- exposed in pregnant day lead to the retardation of the weight of filial rats in earlier age such as postnatal day 4 (PND4) and PND7(F=12.56/7.51,P=0.001/0.008).As for neural reflex,the time of cliff avoidance of rats was significantly delayed in PND 3 and day 9 (F=4.969/4.348 ; P=0.03/0.041),and the ratio of positive response of air righting decreased compared with the control group in PND13 and PND15 (F=7.959/6.475,P=0.007/0.016).There was no difference between two groups on the behavior of the filial rats in the open field of filial rats.The expression of PhoMAPK44/42 in hippocampi of exposed-clozapine offspring in PND15 was significantly lower than the control' s(F=18.729/23.824,P=0.001) ,however,no difference was demonstrated on the expression of MAPK44/42 in hippocamaias well as the expression of both Pho-MAPK44/42 and MAPK44/42 in forehead cortex in two groups.Conclusion The resuits suggest the aberration of both physical and mental development of filial rats exposed clozapine in gestation.