Objective To evaluate the efficacy of the operation in the treatment of postoperative re-hemorrhage after splenec-tomy with periesophagogastric devascularization for advanced schistosomiasis. Methods Forty-three re-hemorrhage patients,who received varicose ligation combined with pericardial devascularization through left thoracic cavity with esophageal incision from Oc-tober 2002 to October 2011,after splenectomy with periesophagogastric devascularization due to portal vein hypertension,were in-vestigated retrospectively and followed up for 1 to 9 years. Results Forty-three re-hemorrhage patients operated included 27 cas-es of selective operation and 16 cases of emergency operation. The mean follow-up time was 6.8 years. The hemostasis rate was 100%. 0ne died after the operation because of engaging in heavy labor,two had melena and were completely relived with the con-servative treatment,and all the rest had a good recovery. Conclusion The operation of varicose ligation combined with pericardi-al devascularization through left thoracic cavity with esophageal incision in the treatment of postoperative re-hemorrhage after sple-nectomy with periesophagogastric devascularization for advanced schistosomiasis has a satisfied efficacy.

Objective To explore clinical nursing pathway(CNP) teaching method for nursing practice students.Methods Nursing practice students ( n =120 ) were randomly divided into two groups:experimental group and control group.CNP teaching method was applied in experimental group while traditional teaching method was used in control group.The test results of theory,operational skill,comprehensive quality,patient's satisfaction degree and nursing mistake between the two groups were compared.Results The results of theory,operational skill,comprehensive quality,patient's satisfaction degree in experimental group were obviously better than those in control group(P ＜0.05),the result of nursing mistake in experimental group was greatly decreased compared with that in control group(P ＜ 0.05).Conclusion CNP teaching method is superior to traditional teaching method and it greatly improve the teaching quality.

Objective To investigate the effect of interferon-α (IFN-α) on expression of major histocompatibility complex (MHC) class I chain-related protein A (MICA) in the malignant hematopoietic cell lines.Methods The myeloid leukemia cell lines K562 and B-cell lymphoma cell line Raji were treated with IFN-α.The expression of MICA was measured by RT-PCR and immunohistochemical staining at mRNA and protein level.The cytotoxicity of human NK cells to the IFN-α treated malignant hematopoietic cells was detected by MTT method.Results After being treated with 1000 U/ml IFN-α,up-regulation of MICA mRNA in Raji and K562 cells were respectively found in 24 h and 48 hours (t =17.016,P ＜0.05; t =5.616,P ＜0.05).After being treated with IFN-α 72 hours,up-regulation of MICA mRNA in K562 and Raji were found at the dose of 500 U/ml and 1000 U/ml dose (t =6.622,P ＜0.05; t =9.071,P ＜0.05).The mRNA and protein expression of MICA were up-regulated by IFN-o in the two malignant hematopoietic cells in a time and dosedependent manner.After being treated with 1000 U/ml IFN-o for 72 hours,the susceptibility of the two malignant hematopoietic cells to NK cytolysis was significantly increased (t =20.016,P ＜0.05; t =7.969,P ＜0.05).Moreover,the up-regulated susceptibility can be blocked by anti-MICA antibody.Conclusion IFN-α can up-regulate the MICA expression in the malignant hematopoietic cell lines and thereby enhance the susceptibility to cytolysis of NK cells.

Objective To study the determining method of trace amounts of Pb?Cd in nature water body. Methods Pb, Cd in nature water body were concentrated by on-line chelate resin, and concentration was determined by concentration-AAS. Results The Pb and Cd detection limit of the present method were 0.500,0.02 ?g/L respectively, RSD were 2.3%,1.7% respectively and the rates of recovery were 94%-104.4%. Conclusion Using on-line chelate resin concentration technic and atom absorption,the sensitivity will increase two order of magnitudes compared to concentration FAAS,the precision will be better than that of GAAS. The present method can be used for quick determination of trace Pb?Cd in nature water body.

Objective: To investigate the molecular transmission network characteristics of HIV-1 among men who have sex with men (MSM) in Shaoxing City, Zhejiang Province, so as to provide insights into AIDS prevention and control among MSM. Methods: Newly reported HIV/AIDS cases among MSM in Shaoxing City were selected from January 2021 to September 2023. Plasma samples before the antiviral treatment were collected. The HIV-1 pol gene was amplified using reverse transcription PCR and nested PCR to construct phylogenetic trees for gene subtype analysis. The HIV-TRACE method was used to construct a molecular transmission network with a genetic distance of 1.5% to analyze clustering and the characteristics of cases within molecular clusters. Results: A total of 216 HIV/AIDS cases among MSM were included, and 179 qualified sequences were obtained. The predominant HIV-1 subtypes were CRF07_BC and CRF01_AE, with 95 and 66 cases, respectively. At 1.5% genetic distance, 20 molecular clusters were formed, with 61 nodes and 58 edges. A total of 61 sequences were connected to the transmission network (34.08%). HIV/AIDS cases among MSM from all the counties (cities, districts) in Shaoxing City were included in the network. There was the largest molecular cluster with ≥10 nodes, involving 12 cases from five counties (cities, districts), 3 medium-sized molecular clusters with 4 to 5 nodes, and the 16 small-sized molecular clusters with 2 or 3 nodes. Seven cases with high risk of transmission, each with ≥4 edges, were all CRF07_BC subtypes. Among them, two cases were from the large molecular cluster, and five cases were from the same molecular cluster composed of cases from Shengzhou City and Xinchang County. Conclusions The predominant HIV-1 subtypes among MSM in Shaoxing City were CRF07_BC and CRF01_AE. There was cross-regional HIV transmission, and potential transmission risk might exist in Shengzhou City and Xinchang County.

Objective To investigate the different effects of internal and external biliary drainage on the levels of TNF-α,NO in blood serum and NO,inducible nitric oxide synthase(iNOS) in gastric mucosa with obstructive jaundice and explore the mechanism of gastric mucosa damage and compare the quality of internal and external drainage.Methods To establish the animal model:one hundred male adult Sprague-Dawley rats were randomly assigned to five groups:obstructive jaundice for 7 days group (OJ-7 d group),obstructive jaundice for 14 days (OJ-14 d group),internal biliary drainage group(ID group),external drainage group(ED group)and sham operation group(SH group).The OJ-7 group rats were executed 7 days after the first operation,the rest four groups were executed 7 days after the secondary surgery,leaving serum and gastric mucosa.Tested the levels of INF-α,NO in blood serum and NO,iNOS in gastric mucosa and did pathological biopsy of gastric mucosa.Results The levels of TNF-α,NO in blood serum and NO,iNOS in gastric mucosa significantly increased in OJ-7 group.The levels of TNF-α,NO in blood serum and NO,iNOS in gastric mucosa continued to rise in OJ-14 group,and was significantly higher than OJ-7 group,the gastric mucosa was obviously impaired.The levels of TNF-α,Internal drainage can significantly NO in blood serum and NO,iNOS in gastric mucosa were significantly lower in ID group,gastric mucosal damage significantly reduced.Conclusions After internal drainage,iNOS expression was inhited in gastric mucosal,NO production was significantly reduced,led to protect the gastric mucosa,which provide experimental basis for choice in OJ clinical treatment.

Energy-based surgical instrumentation (ESI) are surgical devices ablating or cutting tissues via the application of electrical,luminous,acoustic or other energy.High frequency electrotomes are widely used due to the low price,but they produce smoke in the process of surgery and incisions heal slowly.Ultrasonically activated scalpels' cutting performance is satisfying with easily healing incisions while its coagulating capability is poor.Laser scalpels are qualified for both cutting and coagulating in spite of the need of novel technology to overcome the characteristic that tissues absorb laser wavelength selectively.

Objective To establish a duplex fluorescence PCR for detection of HIV proviral DNA and to evaluate its application for early diagnosis of HIV infection in infants .Methods A duplex fluores-cence PCR system was set up based on TaqMan technology for detection of human ribonuclease P ( RNase P) gene and long terminal repeat ( LTR) region of HIV.A recombinant plasmid containing the targeted gene fragment , pTG19-T, was constructed by TA cloning technique and used as the template for evaluation of sen -sitivity of the assay .Blood samples from 11 healthy individuals and 98 HIV-infected patients were collected and detected to validate the assay specificity .The assay of duplex fluorescence PCR was then carried out to detect 96 infant blood samples collected from several maternal and child health hospitals in Zhejiang province from January 2011 to September 2012 for early diagnosis of HIV infection .The results were compared with those by using the Roche HIV DNA qualitative detection kit .Results The established duplex fluorescence PCR could specifically detect HIV proviral DNA with a specificity of 100%and a detection sensitivity of 100 cps per reaction .The coincidence rate between the established assay and the Roche HIV DNA qualitative de -tection kit was 100%in the detection of 96 blood samples .Conclusion The duplex fluorescence PCR as-say showed advantages of cost-effectiveness , convenience , good specificity and accuracy with high sensitivi-ty.It could be used for early diagnosis of HIV infection in infants and also as a general technical platform for the detection of HIV proviral DNA .

Objective To explore causes and high risk electrocardiogram expression of cardiac syncope caused by malignant rapid ventricular arrhythmia.Methods Forty-eight patients were analysed, they had cardiac syncope once or more that after which were admitted to the hospital. Results The basic causes of cardiac syncope were individed following types in 48 patients: coronary heart disease with acute or dated myocardial infarction,dilated or hypertrophic cardiomyopathy,hypokalaemia were ordinarist inducer.Torsade de pointes(TdP) were most common type of malignant rapid ventricular arrhythmia.They had some high risk electrocardiogram expression: secondary long QT syndrome,Brugada's syndrome,idiopathic abnormal J wave,complex ventricular ectopic beats,acute myocardial infarction with ST-T electrical alternation; or extensive anterior myocardial infarction with tombstone ST segment elevation,dilated cardiomyopathy with advance QRS complex low voltage.They were different electrocardiographic and clinical characteristic. Conclusion The cardiac syncope caused by malignant rapid ventricular arrhythmia is not single and independent clinical entity, which presents different the causes and high risk electrocardiogram expression.

Objective To explore the necessities and clinical value of acute intestinal obstruction with com-puted tomography of whole abdomen in over 80 years old patients.Methods 50 patients with acute intestinal obstruc-tion were diagnosed in department of emergency surgery and underwent the abdominal CT examinations.The clinical data,CT and surgery pathology of all patients were compared and analyzed.Results All cases were verified by surgi-cal operation and pathological diagnosis,including colorectal cancer(n =21)and incarcerated abdominal external her-nia(n =21),appendicitis(n =2),adhesive intestinal obstruction(n =2),intestinal volvulus (n =2),and intestinal intussusception(n =1)and stercoral intestinal obstruction(n =1),12 cases were accompanied by bowel necrosis and perforation.12 patients were treated by laparoscope surgery,38 cases by open laparotomy,48 patients acquired good recovery,and 2 cases died from extensive bowel necrosis and multi -organ failure.Conclusion CT examination in whole abdomen could rapidly and accurately diagnose the cause of intestinal obstruction,evaluate complications and risks,so as to provide reasonable treatment choice and time,making patients acquired the effective effects as soon as possible,reducing the bad consequences.