Objective To discuss the feasibility and superiority of EST combined with LC in treating cholecystolithiasiswith common bile duct stones.Methods Patients underwent LC(laparoscopic cholecystectomy) preceded by EST(endoscopic sphincterotomy) and removal of common bile duct stones.ENBD(Endoscopic nasal biliary drainage tube)was placed if EST failure and then the patient underwent LC+laparoscopic biliary duct exploration(LCBDE),or open operative bile duct exploration.Results In 91 of the 99 cases,LC preceded by EST and stone removal was successful,while EST following LC was successful in 3 cases,and stone removal by EST was unsuccessful in 3 cases.Two cases less than 15 years of age underwentLC+LCBDE through the cystic duct and did not undergo EST.Three cases,who had EST failure,underwent LC+LCBDE with primary suture of the common bile duct or LCBDE with T-tube drainage of commonbile duct,or open bile duct exploration with primary suture of the common bile duct(ENBD was in place).All patients were discharged from hospital without serious complications.Conclusions EST combinedwith LC in treating cholecystolithiasis with common bile duct stones is a safe and effective method.Combination of endoscopic and laparoscopic procedures fully reflects the advantage of minimally invasive therapy.

0.05], whereas it is significantly decreased in ACEI group[(69.3?14.6)ml?min-1? (1.73 m2)-1 vs (63.5?16.4)ml?min-1?(1.73m2 )-1,P

Now medical undergraduates are faced with a series of problems in the clinical practice.Instructors should work well on students' education work to improve the effect and quality of clinical practice.

According to the training of all levels and all kinds of personnel during our hospital's digital construction and implementation process,this article discussed the training char-acteristic of computer skill and the teaching principle for doctors and nurses

Objective To realize the isolation of multidrug-resistant organisms (MDROs)from ward environment, and provide evidence for clinical prevention and control of MDRO transmission.Methods Patients with MDRO in-fection in a stomatology hospital from September 2012 to July 2014 were as trial group,12 randomly selected pa-tients without MDRO infection were as control group,environmental object surface in patients’ward were taken specimens and performed culture,isolated organisms were identified and performed antimicrobial susceptibility tes-ting.Results Of 44 patients with MDRO infection,13 patients’surrounding environment were detected MDROs,the total detection rate was 29.55%(13/44).The detection rate of methicillin-resistant Staphylococcus aureus (MRSA),multidrug-resistant Acinetobacter baumannii (MDRAB),and methicillin-resistant Staphylococcus epidermidis (MRSE)were 45.45%(5/11),66.67% (2/3)and 66.67%(6/9)respectively.Detection rates of MRSA from nasal cavity and hands of MRSA-infected patients were 72.73% and 54.54% respectively,from nasal cavity and hands of patients’caregivers were 36.36%and 18.18% respectively.The difference in bacterial count between trial group and control group was not significantly dif-ferent (all P >0.05).Conclusion Isolation rate of MDROs from ward environment of MDRO-infected patients is higher than that of non-MDRO-infected patients,monitoring,cleaning and disinfection for MDRO-infected patients’surrounding environment should be strengthened,so as to prevent the spread of MDROs in hospital.

OBJECTIVETo explore the rhythm regulatory mechanism of interleukin-6 (IL-6) in the process of moxibustion for rheumatoid arthritis (RA).

METHODSA total of 144 Sprague-Dawley (SD) rats were randomly divided into a blank group, a model group, a moxibustion group, a sham operation group, an operation group, an operation+moxibustion group, 24 rats in each one. Each group was divided into 4 time points (0:00 am, 6:00' am, 12:00 am, 6:00 pm), 6 rats in each time point. The Light-Dark 12 : 12 was given in all rats for light-dark cycle. Except the blank group, rats in the remaining groups were treated with intracutaneous injection of freund's complete adjuvant at right-side foot to establish the model of RA. After the model establishment, bilateral adrenal, glands were removed in the operation group and operation + moxibustion group, while those in the sham operation group were not removed with identical operation procedure. Rats in the moxibustion group and operation + moxibustion group were treated with grain-sized moxibustion from 7:00 am to 9:00 am at "Shenshu" (BL 23) and "Zusanli" (ST 36) once everyday, 6 times were taken as one session and 3 sessions were required tatclly, while rats in the remaining groups received identical fixation without moxibustion. The general health state and foot volume of rats were measured before model establishment, after establishment and after treatment. After treatment, rats were sacrificed at each time point to collect the blood sample and measure the content of IL-6 by using enzymne-immunoassay method.

RESULTSCompared with the blank group, the foot swelling in the model group was obviously increased (P<0. 05); the IL-6 maintained circadian rhythm (P<0. 05), but the peak phase had a backward trend, famplitude had an increased trend and the median was significantly lifted (P<0. 05). Compared with model group, !the foot swelling in the moxibustion group was obviously decreased (P<0. 05); the IL-6 maintained circadian. rhythm (P<0. 05), and the peak phase had a forward trend, amplitude had a decreased trend and the median was significantly reduced (P<0. 05). Compared with the moxibustion group, the foot swelling in the operation--moxibustion group was obviously increased (P < 0.05); the IL-6 maintained circadian rhythm (P < 0.5), but the peak phase moved forwrd, and the median was significantly elevated (P < 0.05).

CONCLUSIONThe IL-6 in plasma maintains significant pathological circadian rhythm in RA rats; with the complete hypothalamic-pituitary-adrenal axis, moxibustion is likely to regulate the circadian rhythm of IL-6 to play an important role of anti-inflammatory effect in RA rats.

Acupuncture Points ; Animals ; Arthritis, Rheumatoid ; metabolism ; physiopathology ; therapy ; Circadian Rhythm ; Disease Models, Animal ; Female ; Humans ; Hypothalamus ; metabolism ; Interleukin-6 ; metabolism ; Male ; Moxibustion ; Pituitary-Adrenal System ; metabolism ; Rats ; Rats, Sprague-Dawley ; Time Factors

BACKGROUND:Studies have shown that the finite element method could preferably simulate the biomechanical analysis for the object with complicated structures and irregular shapes. The similarities for the finite element model have great influences on the results of the analysis. However, to construct an ideal model is the most time-consuming and complicated portion for the finite element analysis. OBJECTIVE:To construct a finite element model for the maxilary first molar and the periodontal tissue, and to provide a basis of biomechanical researches of the maxilary first molar. METHODS: A volunteer with complete mandibular dentition and healthy periodontal tissue was selected in this study. Cone-beam CT was scanned. The images were saved as DICOM format. These images were imported to the medical modeling software Mimics. The surface model for the maxilary first molar and the alveolar bone was constructed. The model was then imported to GiD for pre-processing. Thus, the complete three-dimensional finite element model for the maxilary first molar and the periodontal tissue was constructed. RESULTS AND CONCLUSION:A finite element model for bilateral maxilary first molar, periodontal ligament and maxilary alveolar bone was constructed, including 896 035 nodes and 4 881 067 elements. This model has restored the geometric shape and the structure of the research object. This study successfuly constructed finite element models of maxilary first molar and the periodontal tissue, which can be a basis of biomechanical researches for the maxilary first molar and the periodontal tissue under the effect of different clinical orthodontic forces.

A Ni-based rare-earth perovskite LaNiTiO3 nanoparticles was synthesized and its catalytic activity was investigated. Based on this, a simple and quick nonenzyme electrochemical sensor was fabricated with stable and reliable performances for the determination of hydrogen peroxide (H2 O2 ). The techniques of X-ray diffraction, FT-IR spectra, transmission electron microscopy, X-ray fluorescene spectroscopy and scan electronmicroscope were used to characterize the composition, structure and morphology of as-synthesized sample. The sensor based on this nanomaterial was investigated and optimized by cyclic voltammetry and current-time techniques. The results showed the working electrode modified with LaNiTiO3 (0. 5 g / L, 8. 0μL) in 0. 1 mol/ L NaOH exhibited good catalytic properties for H2 O2 . Under the optimum conditions, the sensor performed excellent properties, such as quick response time ( about 2 s ), a wide linearity (0. 2 μmol/ L -8. 0 mmol/ L), a low detection limit of 0. 05 μmol/ L ( S / N = 3 ), a high sensitivity of 957 μA (mmol/ L) -1 cm-2 , good reproducibility and anti-interference ability, which was better than those of some other biosensors reported recently. So, it may be used for the analysis and detection of H2 O2 in practical samples such as biomedicine.

ObjectiveTo summarize the experience of nursing patients with heat illness combined with respiratory failure. Method The nursing records of 13 patients with heat illness combined with respiratory failure were reviewed for summarizing the nursing measures.Result After treatment and nursing care,12 of them were discharged and 1 died from multiple organ dysfunction. Conclusions Rapid cooling is key to the success of rescue.The nursing measures include keeping respiratory tracts unobstructed and preventing complications from artificial airway and mild hypothermia therapy.

Objective To explore the effect of sodium cantharidinate and vitamin B6 injection on plasma D-dimer level in patients of advanced esophageal cancer after chemotherapy and the relationship between plasma D-dimer level and clinical pathological parameters thereof. Methods Fifty-eight patients with advanced esophageal cancer confirmed by path-ological examination were randomly divided into two groups. Twenty-nine patients (experimental group) received chemother-apy (PF chemotherapy) combined with sodium cantharidinate and vitamin B6 (0.5 mg once daily). Twenty-nine patients (con-trol group) received same volume of saline. And there were 20 healthy volunteers as the normal control. The plasma D-dimer level was determined one day before the first cycle of chemotherapy and the third cycle of treatment. Results The plasma D-dimer level was significantly higher before chemotherapy in patients with advanced esophageal cancer than that in normal control group (P<0.05). There were no significant differences in plasma D-dimer level between patient gender, age, clinical stage and pathological levels. The D-dimer level was significantly down-regulated after chemotherapy. The D-dimer level was significantly lower in experimental group than that in control group (P<0.05). The incidences of digestive and hemato-logical adverse reactions were much lower in experimental group than those in control group. Conclusion The elevated plasma D-dimer level was found in patients with advanced esophageal cancer, and which was down-regulated by chemother-apy. The chemotherapy of sodium cantharidinate and vitamin B6 can further reduce the D-dimer level, and relieve the ad-verse reactions of chemotherapy.