Cholecystolithiasis with choledocholithiasis (CCL) is a common disease.The removal of common bile stone is a challenge for the surgery.This paper discussed the clinical application of three stone removal techniques including direct stone removal,irrigation and stone extraction by basket under cholangioscopy in order to take the stones effectively and safely,shorten the procedure time,avoid the injuries of common bile duct wall caused by the repetition of a single method such as biliary endoscopic stone extraction,reduce the difficulty of taking stone and enhance recovery of patients.

Chemosensory proteins (CSPs) are identifiable by four spatially conserved Cysteine residues in their primary structure or by two disulfide bridges in their tertiary structure according to the previously identified olfactory specific-D related proteins. A genomics- and bioinformatics-based approach is taken in the present study to identify the putative CSPs in the malaria-carrying mosquito, Anopheles gambiae. The results show that five out of the nine annotated candidates are the most possible Anopheles CSPs of A. gambiae. This study lays the foundation for further functional identification of Anopheles CSPs, though all of these candidates need additional experimental verification.

Objective To investigate the effect of nursing intervention in prevention of pulmonary infection in emergency intensive care unit.Methods A total of 75 patients who were treated in EICU from June 2014 to July 2015 were selected as control group,given routine nursing,and another 78 patients from August 2015 to October 2016 were selected as experimental group,given nursing intervention for pulmonary infection.The incidence of pulmonary infection,pulmonary infection time,EICU stay,adverse events,and nursing work satisfaction of two groups were compared.Results The experimental group had lower incidence of pulmonary infection,shorter pulmonary infection time and hospital stay,and lower incidence of wound infection than that in the control group(P ＜0.05).The total incidence of adverse events in the experimental group was 10.3％,which was significantly lower than 26.7％ in the control group (P ＜ 0.05).The satisfaction of the experimental group was 91％ (71/78),which was higher than 91.0％ (56/75) of the control group.Conclusion The prevention of pulmonary infection nursing process in EICU can significantly reduce the incidence of pulmonary infection,shorten the length of hospital stay,so it is worthy of popularization and application.

Objective To investigate the effect of nursing intervention in prevention of pulmonary infection in emergency intensive care unit.Methods A total of 75 patients who were treated in EICU from June 2014 to July 2015 were selected as control group,given routine nursing,and another 78 patients from August 2015 to October 2016 were selected as experimental group,given nursing intervention for pulmonary infection.The incidence of pulmonary infection,pulmonary infection time,EICU stay,adverse events,and nursing work satisfaction of two groups were compared.Results The experimental group had lower incidence of pulmonary infection,shorter pulmonary infection time and hospital stay,and lower incidence of wound infection than that in the control group(P ＜0.05).The total incidence of adverse events in the experimental group was 10.3％,which was significantly lower than 26.7％ in the control group (P ＜ 0.05).The satisfaction of the experimental group was 91％ (71/78),which was higher than 91.0％ (56/75) of the control group.Conclusion The prevention of pulmonary infection nursing process in EICU can significantly reduce the incidence of pulmonary infection,shorten the length of hospital stay,so it is worthy of popularization and application.

ObjectiveTo investigate the relationship between gastrointestinal dysfunction and both severity and prognosis in patients with heatstroke (HS).Methods A retrospective analysis was conducted. Clinical data from 39 patients with HS seeking for treatment in Department of Critical Care Medicine of Chinese PLA General Hospital from January 2013 to September 2014 were enrolled. The patients were divided into two groups: gastrointestinal dysfunction group and non-gastrointestinal dysfunction group. The acute physiology and chronic health evaluationⅡ(APACHEⅡ) score within 24 hours of admission and 28-day mortality were compared between two groups. In gastrointestinal dysfunction group, the gastrointestinal dysfunction score, the duration days of gastrointestinal dysfunction, the length of intensive care unit (ICU) stay, and the duration of mechanical ventilation were collected. Pearson correlation analysis was used to analyze the relationship between gastrointestinal function and the severity of the ailment as well as the prognosis.Results Among 39 patients with HS, 32 of them showed gastrointestinal dysfunction with an incidence of 82.05%. In gastrointestinal dysfunction group, the gastrointestinal dysfunction score was 2.3±0.8, the duration of gastrointestinal dysfunction was (17.3±15.2) days, the length of ICU stay was (37.8±25.0) days, and the duration of mechanical ventilation was (27.8±14.0) days. APACHEⅡ score in gastrointestinal dysfunction group was significantly higher than that of the non-gastrointestinal dysfunction group (26.30±6.00 vs. 17.40±6.00, t = 3.555,P = 0.001). The 28-day mortality in gastrointestinal dysfunction group was slightly higher than that of the non-gastrointestinal dysfunction group without statistically significant difference [43.75% (14/32) vs. 14.29% (1/7),P = 0.216]. It was shown by Pearson analysis that gastrointestinal dysfunction score was positively correlated with APACHEⅡ score (r = 0.727,P = 0.000), and the duration of gastrointestinal dysfunction was positively correlated with the length of ICU stay (r = 0.797,P = 0.000) and the duration of mechanical ventilation (r = 0.634,P = 0.000). Conclusion The results suggest that gastrointestinal function in patients with HS reflects the severity and prognosis of the ailment.

The incidence of ischemic stroke in the pregnancy is low and the mortality is high.The clinical and imaging data of a pregnant woman with atrial septal defect complicated with stroke after a-wakening were reviewed to explore the imaging manifestations,pathogenesis and treatment strategy of pregnancy-related stroke.The aim of this study was to improve the understanding of acute stroke in pregnant women with atrial septal defect,and to provide reference for clinical diagnosis and treatment.

The incidence of ischemic stroke in the pregnancy is low and the mortality is high.The clinical and imaging data of a pregnant woman with atrial septal defect complicated with stroke after a-wakening were reviewed to explore the imaging manifestations,pathogenesis and treatment strategy of pregnancy-related stroke.The aim of this study was to improve the understanding of acute stroke in pregnant women with atrial septal defect,and to provide reference for clinical diagnosis and treatment.