Objective To investigate the effect of intraperitoneal local anesthetic on patients undergone laparoscopic cholecysteetomy (LC).Methods Thirty-six patients (ASAⅠ-Ⅱ),who were undergoing selective LC were randomly divided into there groups.GroupⅠreceived preoperational anesthetic spary with 30 ml of 0.5% ropivacaine.GroupⅡwas given the anesthetic at a same dosage after the operation.While groupⅢwas set as a control by using 0.9% NaCl instead of ropivacaine.The LC was completed under general anesthesia.After the operation,visual analog scale (VAS) was recorded at 6,24,and 48 hours to evaluate the degree of postoperative pain.Meanwhile,the number of the patients who received anesthetics after the surgery,as well as the incidence rates shoulder or back pain and nausea or vomiting were recorded.Results Postoperative VAS of the groupⅠwas significantly lower than that of the other two groups,while the VAS of groupⅡwas significantly lower than that in groupⅢ(both P0.05). Conclusions Intraperitoneal local anesthetic can significantly reduce postoperative pain after LC.It is more effective to give local anesthetic at the end of the procedure than using it before operation.

Objective To study the relationship between lumbar and proximal femoral bone mineral density (BMD) with gender,age and body mass index (BMI) in adolescents ranged from 12 to 19 years of age in Tianjin city,and provide preliminary reference to understand the bone health status of adolescent in the city.Methods The BMD values of lumbar spine (L1-L4,),femoral neck and total hip were detected by the dual-energy X-ray absorptiometry (DXA) in 221 adolescents from Tianjin Hospital,and the Z value was used for clinical diagnosis standard.Simultaneously the height and weight of adolescents were measured,and BMI was calculated.The differences of BMD values in the lumbar,femoral neck and total hip were compared between different age,gender and BMI groups.Results The BMD values of femoral neck and total hip were significantly higher in males than those in females (P ＜ 0.01).The BMD values of lumbar spine,femoral neck and total hip were gradually increased with age.The BMD was correspondingly increased in adolescents with higher BMI in the lumbar spine,femoral neck and total hip.Conclusion There is a close relationship between BMD with age,gender and BMI in adolescents.We should pay more attention to the nutrition health and the level of BMI in adolescents.

Objective To investigate the correlation between serum lipoprotein-associated phospholipase A2 (LP-PLA2) and homocysteine (Hcy) level change with cerebral infarction,and clinical value of combined detection of serum LP-PLA2,Hcy and blood lipid level in the diagnosis and differentiation diagnosis of cerebral infarction.Methods The serum lipoprotein-associated phospholipase A2,homocysteine and blood lipid in sixty-five cases of cerebral infarction(cerebral infarction group) and contemporaneous 64 healthy persons qualified in physical examination(health control group) were selected as the research subjects.The levels of serum LP-PLA2,TG,HDL,LDL,CHO and Hcy were detected.The differences were compared among various groups.Results The TG and LDL levels had no statistically significant difference between the health control group and cerebral infarction group(P>0.05),but the LP-PLA2 and Hcy levels in the cerebral infarction group were higher than those in the health control group(P<0.01),while serum HDL and CHO levels were lower than those in the health control group(P<0.01).Serum High Hcy and LP-PLA2 levels were the independent risk factors for cerebral infarction,however,high HDL was a protective factor for cerebral infarction.In the combined detection,the combined detection of LP-PLA2 and Hcy was superior to single index detection and other combined detection mode.Conclusion Serum LP-PLA2 and Hcy levels in the patients with cerebral infarction are significantly higher than those in the health control group,indicating that it may be involved in the occurrence of cerebral infarction,and may become an early biological marker for predicting cerebral infarction occurrence.The combined detection of serum LP-PLA2 and Hcy has highly clinical value in the diagnosis of cerebral infarction.

Objective: To investigate the effect of FOCUS(F:find; O:organize; C:clarify; U:understand; S:select)-PDCA on reducing the adverse event rate caused by junior nurses. Methods: A historical control design was used, traditional method to manage adverse events among junior nurses from January to June 2017. Interdisciplinary team combined with FOCUS-PDCA courses was established from July to December 2017. In the course problems were found and analyzed, the present procedures and standard were issued and improved. And these data were summarized and analyzed to improve the quality of management continuously. Results: Before applying the FOCUS-PDCA model, the total incidence of adverse events caused by junior nurses, bachelor′s degree or above, nurse practitioners, and working career of 1-3 years were respectively as follows: 42.66%(285/668), 46.67%(112/240), 40.54%(105/259), 51.61%(176/341). After using this model, the above four indicators were 33.04%(229/693), 33.33%(84/252), 27.04%(73/270), 38.97%(136/349) respectively. There were significant differences before and after the FOCUS-PDCA (χ²=4.20-13.39, P<0.01 or 0.05). Conclusions Multidisciplinary team-based FOCUS-PDCA management reduces the adverse event rate caused by junior nurses and improves the quality of management continuously.