Objective To compare the effects of different surgical time for the recovery of elderly patients with acute cholecystitis and provide reference for its clinical treatment. Methods Clinic data of 79 elderly patients with acute cholecystitis from January 2008 to September 2013 were analyzed retrospectively. Patients were divided into two groups according to different surgical time, 42 cases having surgery within 72 h as early surgery group, and 37 cases having surgery later than 72h as delayed surgery group then the curative effects of two groups were compared and analyzed. Results The success rate of early surgery group reached 97.6%, and that of delayed surgery group 91.9%, which showed no statistically significant difference (P > 0.05); with shorter operative time, less blood loss, shorter length of hospital stay and less medical cost, patients recovered better in early surgery group than those in delayed surgery group and there were statistically significant differences between two groups (P<0.05), while the postoperative discharge time of two groups had no significant difference (P>0.05).The complication rate of early surgery group was 2.4%, and that of delayed surgery group 18.9%, which indicated statistically significant difference (P<0.05). Conclusions Early surgical treatment for elderly patients with acute cholecystitis has a good therapeutic effect and is beneficial to the early rehabilitation of patients.

Objective To research for a new method of arthroscopic total meniscectomy with simple instru- ments. Methods One hundred and sixty nine cases were followed up for short period that had been operated on with a forward knife, a back cutting knife, a punch and a 30?scope from Nov. 1992. to Aug. 1998. Results The av- erage time of operation was 78 minutes. The operations had no injury to cartilage and ligament. It is necessary for only 7 .9 percent of patients to take analgesic intramuscularly after operation. Eight patients had a transient tourniquet paral- ysis. All of them could begin to work and exercise after postoperative 2 weeks. Conclusion As compared with the method introduced by David Sisk ,this method has the advantages of simple instruments, fewer ports and complications and minimal trauma Either lateral meniscus or medial meniscus can be cut off by the same method. This method is a safety and a better way to arthroscopic meniscectomy.

Objective Aprotinin has been suspended in cardiac surgery since risks factors associated with mortality and other adverse events in western Literatures.This study was to investigate the effect of aprotinin on short-term outcomes in cardiac surgery in Chinese patients.Methods Two groups of patients who underwent cardiac surgery during equal period just before and after aprotinin was suspended in China.Aprotinin groupp(n=1699) was defined as operations from june 19,2007 to Dec 18,2007,when aprotinin was used in all the patients.Control group(n=2225)was defined as operations from Dec19,2007 to June 18,2008,when aprotinin was not umed.Postoperative outcomes between the two groups,including blood loes and transfusion requirement,in-hospital mortality and major adveme outcome events were compared,using univariate analysis and mulfivariable logistic regression analysis.Results Aprotinin group had less postoperative blood loes,transfusion requirement and reoperation for bleeching as compared with the control group.Application of aprotinin did not increase the risk of in-hospital mortality (0.5%vs.10%,P=0.08)and other major ad-verse events,including renal dysfunction,renal failure requiring dialysis,low cardiac output syndrome (LCOS),neurological and pulmonary complications.Aprltinin group also had and shorter mechanical ventilation time(P=0.04),a lowwer rate of delayed mechan-ical ventilation time(P=0.04)and a higher PaO2/FiO2 in the bolld gas analysis(P<0.001).which presented a better respiratory function.Multivariable Logistic regression analysis got identical results with univariate analysis.Conclusion The use of aprotinin in cardiac surgery could reduce blood loss and transfusion requirement significantly,and showed a protective effect on the lungs.In the mean time it did not increase the risk of mortality or major complications.We suggest further studies should be performed to make a decision of continuing or stopping the use of aprotinin in cardisc surgery in Chinese or Asian population.

Objective To elucidate the features of the expression of P53,proliferation and apoptosis in gestational trophoblastic tumor(GTT).Methods Ten cases of normal placenta,10 cases of complete hydatidiform mole(CM),20 cases of invasive hydatidiform mole(IM)and 19 cases of choriocarcinoma(CCA)paraffin-embedded tissues were studied.P53 and PCNA were detected with immunohistochemistry,apoptosis was detected with terminal deoxy-nucleotidyl transferase-mediated dUTP-biotin nick end labeling(TUNEL).Results In NP,CM,IM and CCA,the P53 indexes(P53-Ⅰ)were 4.12%,21.68%,39.61% and 27.39% respectively with significant differences among them(P

Objective To observe the clinical efficacy of thermal electroacupuncture therapy in treating lumbodorsal myofascitis. Method Sixty-two patients with lumbodorsal myofascitis were randomized into a treatment group of 30 cases and a control group of 32 cases. The treatment group was intervened by thermal electroacupuncture therapy, while the control group was by orally taking Meloxicam tablets. The Visual Analogue Scale (VAS) was observed before and after treatment, and the clinical efficacies were compared.Result The total effective rate was 100.0% in the treatment group versus 78.1% in the control group, and the difference was statistically significant (P<0.05). The VAS scores were significantly changed after treatment in both groups (P<0.05). After treatment, the VAS score in the treatment group was significantly different from that in the control group (P<0.05).Conclusion Thermal electroacupuncture therapy is an effective approach in treating lumbodorsal myofascitis.

Objective To summarize clinical experience in application of nail-bed lengthening operation for fingertip injuries.Methods From September 2003 to May 2007,36 patients (25 men and 11 women) aged 16 -45 years (26 in average) with nail defect by fingertip injuries underwent reconstruction operation using nail-bed lengthening at Orthopaedics and Traumatology Hospital of Taizhou,with the thumb involved in 15 cases,the index finger in 10 cases,the middle finger in eight eases and the ring finger in three case.A skin rectangle with thickness of 2 - 3 mm and width as that of the nail was resected at the skin edge 5 -6 mm distant from the epenychium,without damage to underlying subcutaneous vascular network, and U-shape skin flap was delicately slid proximally with its ends sutured.Results All surgical operations for nail lengthening were uneventful and clinically satisfactory,and the appearance of the thumb or other fingers was good during follow-up for six months to three years (19 months in average).Conclusions Nail lengthening for fingertip injuries with nail defect is a simple and effective surgical operation which could improve the appearance of the thumb and other fingers.

0.05).The 2 -year and 3-year survival rates were 91.7 %,89.2 % and 85.8%,86.1% in all patients for either gr oup. The 2 -year and 3-year survival rates were 84.2%,81.8% and 72.9%,77.1% in p atients with positive axillary lymph nodes for the two groups, with the differen ces insignificant (Logrank test P=0.663, P=0.9 19).There were no differences in the 2-year and 3-year survivals for patients with stage Ⅲ and over receiving ch est wall irradiation or not and patients who received different doses of chest w all irradiation (Logrank test P=0.449, P=0.764 ). Conclusions Locoregional recu rrence is not reduced and survival rate is not improved by chest wall irradiatio n in this study. The prognostic impact of chest wall irradiation and the optimal target of radiotherapy remains to be substantiated by more randomized trials.

Objective: To understand and compare the differences in help-seeking behavior among junior high school students and senior high school students and their association with non-suicidal self-injury to provide a basis for the prevention and control of non-suicidal self-injury among middle school students. Methods: Three middle schools in Nanchang were selected,and the survey were conducted among 4 434 students through the General Situation Questionnaire, the Ottawa Self-injury Judgment Entry, and the Middle School Students Help Seeking Behavior Questionnaire, and SPSS 22.0 was used for statistical analysis. Results: The NSSI detection rate among middle school students was 33.3% , and junior high school students detection rate(36.0%) were higher than high school students(29.6%) (χ 2=19.41，P<0.01). Differences in willingness to ask for help, asking for help from family and teachers, and talking face-to-face for help were statistically significant (all P<0.01) among NSSI participants and non-NSSI participants, for both junior high school and high school students. Females (OR=1.45), class cadres (OR=1.26), urban household registration (OR=1.45), frequent scolding by elders (OR=1.98) and a high academic burden (OR=1.39) all possible increased the risk of NSSI in junior high school students, while assistance to family members (OR=0.95) or teachers (OR=0.95) possible reduced the risk of NSSI in junior high school students. Females (OR=1.50), class cadres (OR=1.34), only children (OR=1.45), fathers with college education and above (compared to junior high school and below) (OR=1.56), frequent scolding by elders (OR=2.08), frequent corporal punishment from elders (OR=4.12) and high academic burden (OR=1.38) possibly increased the risk of NSSI among high school students, while willingness to ask for help (OR=0.82), asking for help from family (OR=0.95) and teachers (OR=0.96) possible reduced the risk of NSSI among high school students. Conclusion There are some differences in help-seeking behavior between junior and high school students, and school and parents should actively focus on middle school students help-seeking behavior and encourage them to seek help.

OBJECTIVETo study the chemical constituents in fresh fleshyscaleaf of Lilium lancifolium.

METHODThe constituents were separated. by various kinds of chromatography and their structures were identified on the basis of spectral analysis.

RESULTTen compounds were identified regaloside A (1), regaloside C (2), methyl-a-D-mannopyranosid (3), methyl-ca-D-glucopyranoside (4), (25R, 26R) -26-methoxyspirost-5-ene-3p-yl-O-ca-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->6)]-beta-D-glucopyranoside (5), (25R)-spirost-5-ene-3beta-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyranosyl-(1-->6)]-beta-D-glucopyranoside (6), (25R, 26R)-17alpha-hydroxy-26-methoxyspirost-5-ene-3beta-yl-O-alpha-L-rhamnopyranosyl-(1-->2)-[beta-D-glucopyra nosyl-(1-->6)]-beta-D-glucopyranoside (7), daucosterol (8), adenoside (9), berberine (10).

CONCLUSIONAll compounds except 1 and 3 were isolated from this species for the first time, and berberine was first reported in genus Lilium.

Berberine ; chemistry ; isolation & purification ; Lilium ; chemistry ; Plant Leaves ; chemistry ; Plants, Medicinal ; chemistry ; Saponins ; chemistry ; isolation & purification

Objective: To investigate the intervention effect of electroacupuncture on post-withdrawal anxiety and depression of those with heroin dependence. Method: One hundred and twenty heroin dependence cases were randomly allocated into 4 groups, including acupuncture group 1 using Jiaji (Ex-B 2) points and Shenshu (BL 23), acupuncture group 2 using points in the four limbs, simulation and control groups. Then the SAS and SDS changes were observed before the treatment and 4th, 8th and 10th week after. Result: At the 4th, 8th and 10th week, the SAS and SDS scores in acupuncture group 1 and 2 showed significant differences with the control group (P<0.01, P<0.05). There were significant differences between SAS changes in acupuncture group 1 and 2 but there was no significant difference in SDS changes. Conclusion:Electroacupuncture can improve the post-withdrawal anxiety and depression in heroin addicts.Jiaji (Ex-B 2) points showed significantly better effects in improving anxiety than points in four limbs but no significant difference in improving depression.