Objective: To comparative analysis the clinical effect of endoscopic retrograde cholangiopancreatography(ERCP) combined with endoscopic sphincterotomy(EST) and laparotomy surgery on common bile duct calculus. Methods: One hundred and forty two patients with common bile duct calculus in our hospital were randomly divided into observation group and the control group, with 71 cases in each group. The control group was treated with laparotomy surgery, and observation group was treated with ERCT and EST. To compare the stone clearance rate, complications, surgery time, stone size, anus gas time and stay length of the two groups. Results:The stone clearance rate in observation group (97.2%) compared with that in the control group(95.8%)(P>0.05).The complication rate, surgery time, stone size, anus gas time and stay length in observation group were significantly better than those in control group after treatment (P<0.05). Conclusion:ERCP combined with EST shorten the treatment time, safe and reliable to common bile duct calculus, so it is worth applying in clinic widely.

Objective To compare the clinical effects of different concentrations of low volumn of ropivacaine during MED. Methods 150 patients performed MED were randomly divided into three groups: in the first group (n=50) 0.8% ropivacaine was used, in the second group (n=61) 0.6% Ropivacaine was used and in the third group 0.4% Ropivacaine was used. First epidural needle was introduced into the epidural space. Then edpidual catheter was introduced into the epidural space and 5ml of 2% lidocaine was injected. After anesthesia planum was obtained, 5ml of ropivacained in different concentrations was iniected through the epidural catheter in different groups. The react time, the resume time and the separate anaesthesia among three groups were compared Results The blockade of sensory nerve was faster than that of motor nerve, and persistent time of sensory nerve was longer than that of motor nerve. Group two had more remarkable separate sensory and motor blockade than group one and group three (P

Objective To design a new procedure for outpatient safe infusion.Methods Aiming at the errors possibly occur in current management of hospital outpatient infusion process,modern wireless and intelligent recognition technology are applied to research and design a new infusion procedure.Results Based on its program difference from the LAN technology of fixed-point check transfusion management style,this solution truly met the needs of actual medical infusion process and achieve the dynamic information check,exchange and matching between the hospital staffs and patients.Conclusion It ensures the safety of transfusion patients,and creates a harmonious environment for treatment.

Objective:To analyze the effect of endoscopic submucosal tunnel dissection on patients with large esophageal superficial neoplasms.Methods: Chosen patients with large esophageal superficial neoplasms in our hospital as research object, randomly divided into control group treated by endoscopic mucosal dissection (ESD) and observation group treated by endoscopic submucosal tunnel dissection(ESTD), compared surgery related indicators, complications and treatment outcomes.Results: 1)Observation group patients’ tumor stripping rate (23.17±4.73)/min was significantly higher than control group patients’ (12.65±2.19)/min; Intraoperative blood loss(9.14±0.67)ml, total length of hospital stay (7.34±1.89) d, were significantly less than control group patients with intraoperative blood loss(21.38±3.14)ml, total length of hospital stay (13.21±3.05)d, t value was 4.965, 5.395, 4.932, respectively(t=4.965,t=5.395,t=4.932;P<0.05); 2)Observation group patients esophageal bleeding ESTD rate(5.26%), esophageal stricture rate(31.58%), mediastinal emphysema rate(5.26%), esophageal perforation rate of 0, were significantly less than control group patients with esophageal bleeding rate(31.58%), esophageal stricture rate(5.26%), mediastinal emphysema rate(21.05%), esophageal perforation rate (26.32%), t value were 4.378, 4.378, 4.471, 5.758, (t=4.378,t=4.378,t=4.471,t=5.758;P<0.05); 3)Observation group patients with no recurrence during the follow-up period, control group patients with local recurrence rate of 21.05%, t value 8.623,P<0.05(t=8.623, P<0.05).Conclusion: Endoscopic tunnel mucosal stripping technique can effectively improve the complete tumor removal rate, during the process of optimization operation at the same time reduce the occurrence of complications, to the improvement of the prognosis of patients with positive clinical significance.

Objective:To evaluate the clinical effect of minimally invasive extraction of impacted supernumerary teeth.Methods :35 cases of impacted supernumerary teeth were included.Excluding extraction contraindications,preoperative X-ray or dental CT examina-tion was executed to find out the location of the impacted teeth and adjacent anatomical structures.According to the location,operation approach was selected to extract the impacted supernumerary teeth using minimally invasive apparatus.Intraoperative and postoperative feeling of the patients and the complications were recorded.Results:Operation time lasted from 1 0 to 40 minutes,average 1 5 minutes. All patients maintained good comfort in the operation.8.6% patients had postoperative adverse reactions such as mild pain and discom-fort.None had serious reactions.Conclusion:Minimally invasive extraction of impacted supernumerary teeth has less complication and less uncomfort.

Objective To compare the knee of patient controlled subcutaneous injection of morphine analge-sia after hip joint replacement ( PCSA ) and intravenous morphine patient-controlled analgesia ( PCIA ) effect and safety of postoperative analgesia.Methods 60 patients undergoing artificial total knee arthroplasty patients were selected and randomly divided into PCIA group of 30 cases,30 cases in group PCSA, two patients were completed under epidural anesthesia in the operation.Group PCIA and group PCSA single dose divided into 1mg/and 2.5mg/, lock time divided into 5min,20min,in the postoperative pain perception,from the patient's own pain medication.After 4h,8h,12h,24h record patient morphine dosage,frequency,pain score (VAPS),mean arterial blood pressure and re-spiratory rate,compose degree,analgesic effects were compared between the two groups.Results In group PCSA after 24h treatment for the total dose was (30.41 ±10.00) mg,significantly higher than that of group PCIA (18.03 ± 6.04)mg,there was significant difference between the two groups (t=3.98,P<0.05);but after each time point of the two groups of patients the average dosage had no statistically significant difference (P>0.05).PCIA group after 0-4h and >4-8h analgesia and sedation were better than those in PCSA group (t=3.4,3.2,3.5,3.7,all P<0.05), PCIA group,the incidence rate of nausea and vomiting was 30%,higher than 12%in the PCSA group,there was sig-nificant difference between the two groups (χ2 =5.76,P<0.05).Conclusion The two kinds of methods of analge-sia has a good analgesic effect,but PCSA analgesia is slower,less adverse reactions,should be given a loading dose at the beginning before PCSA,in order to improve the early analgesia effect.

Objective To analyze the changes of bone mineral density (BMD) and the incidence of osteoporosis in elderly people in Xuzhou area by measuring BMD, and provide reference to osteoporosis prevention and control. Methods From 2005 to 2008, BMD were measured in 1204 elderly people by dual energy X-ray absorptiometry (DEXA). The measurement included the neck of femur and L2-4 of lumbar. All subjects were divided into multiple sections with every 5 year interval. Osteoporosis was diagnosed according to the criteria of BMD peak minus 2. 5 SD. BMD values and the incidence of osteoporosis were analyzed among different age and gender groups. Results BMD of different sites decreased year by year in both male and female in Xuzhou area. After 55years of age BMD decreased more in female than in male ( P ＜ 0. 01 ). The incidence of osteoporosis in female was higher than that in male. Conclusions We should reinforce the health education on osteoporosis prevention. Intervention should be conducted in females older than 55 years and males older than 65 years to decrease the occurrence of osteoporosis.

Objective To evaluate the feasibility and efficacy of suspended method in scar hidden technology in laparoscopic appendec-tomy ( LA) . Methods 27 patients underwent scar hidden laparoscopic appendectomy with the aid of suspended method. Silver probe was pierced abdominal cavity,bended into a hook shape and fixed appendix,then underwent appendectomy. Results 27 patients finished surgery successfully,the operative time was 25~100 min ( mean, 45 min) ,the blood loss during operation was 10~50 mL ( mean,20 mL) ,the hos-pital stay was 3~8 d ( mean,4 d) . Conclusion Scar hidden technology in laparoscopic appendectomy with the aid of suspended method is safe,feasible and further improves the cosmic result.

Abstract: The first-line drug artemisinin is widely used against malaria. Commercially available artemisinin is extracted from plants. However, the lack of sufficient raw material, artemisinin and the cost associated with the drug's manufacture have limited the supply of ACT to most malaria sufferers in the Developing World. As such, it is important to develop a low cost, fine to environment and high-quality method to supply sufficient and reliable quantities of artemisinin in the future. The field of synthetic biology, which utilizes cell factories to manipulate microbial metabolism to enhance the production of artemisinin and its intermediates, has a particularly strong impact by providing new platforms for chemical production. After a brief introduction of the artemisinin biosynthetic pathway, the present review focuses on the introduction of artemisinin biosynthetic genes, such as the genes encoding amorpha-4, 11-diene monooxygenase, NADPH: cytochrome P450 oxidoreductase, artemisinic aldehyde delta 11(13) reductase and aldehyde dehydrogenase. The review also addresses general considerations for potential contributions of synthetic biology to artemisinin production, with an emphasis on factors influencing interest compounds production in chassis cells.

ObjectiveTo evaluate the effect of the comprehensive rehabilitation training, including multi-joint isokinetic muscle strength, balance, and weight-support training, on the senile patients after total hip arthroplasty. Methods50 patients after total hip arthroplasty were divided into group A (n=25) and group B (n=25). The group A received the comprehensive rehabilitation training combined with the 3 systems, while the group B received the routine rehabilitation training. They were assessed with the Harris scale and the life satisfaction before and 4, 8 and 12 weeks after rehabilitation. ResultsCompared with that before rehabilitation, the Harris score of all the patients improved 8 weeks after rehabilitation (P<0.05), while it improved more in the group A than in the group B (P<0.05). The incidence of hip joint recovery was more in the group A than in the group B as well (P<0.05). The life satisfaction improved in both groups 4 weeks after rehabilitation (P<0.01), and it was more in the group A than in the group B 12 weeks after training (P<0.05). ConclusionThe rehabilitation combined with isokinetic, balance, weight-support training can promote the functional recovery after total hip arthroplasty