Laparoscope has been widely recognized as a treatment of distal gastric cancer.Totally laparoscopic distal gastrectomy and laparoscopy-assisted distal gastrectomy are two main types of laparoscopic distal gastrectomy.Apart from a smaller incision,some other advantages which totally laparoscopic distal gastrectomy has is the key point for further study.The thesis aims to compare totally laparoscopic distal gastrectomy to laparoscopy-assisted distal gastrectomy,and to analyze the characteristic in the aspect of operation time,the degree of pain,postoperative complications and the time of gastrointestinal recovery via collecting a great quantity of literatures.

In order to improve the quality of humidification in patients with artificial airway during the mechanical ventilation, ensure the quality of artificial airway nursing. From the way of humidification , the choice of humidification liquid, the volume of humidification liquid control, the temperature of humidification liquid and the evaluation of humidification effect to research the present situation of humidification of artificial airway during mechanical ventilation. Put forward best way of patients with artificial airway nursing during the mechanical ventilation is wetting by temperature humidity of the Breathing machine′s and at the same time to strengthen the monitoring of the airway of humidification effect.

Mesenchymal stem cells (MSC) is able to differentiate into a variety of epithelial cells,such as alveolar epithelium,tubular epithelium and corneal epithelial cells in vivo and in vitro under the given condition.After transfusion,MSC can effectively repair the injured lung epithelial cells,and relieve inflammation.MSC can also repair the renal tubular cell damage by reducing renal interstitial infiltration of inflammatory cells,promoting regeneration of renal tubular epithelial cells and inhibiting of apoptosis; Biological cornea can be available constructed by using MSC,which can availably repair the injured ocular surface.In the other hands,MSC can express keratinocyte growth factors and other cytokines,promoting limbal stem cell proliferation.In addition,MSC can also differentiate into pancreatic ductal epithelial cells,endometrial epithelial cells,spermatogenic epithelium and human retinal pigment epithelium.MSC has great application potential in epithelial diseases,and provide a good and effective choice in treatment of some epithelial diseases.

Primary hypophysitis includes 3 subtypes:lymphocytic,granulomatous and xanthomatous hypophysitis. The primary hypophysitis has a low morbidity and the final diagnosis is mostly determined based on the pathological findings after operation.Now it is considered as an organ specific autoimmune disease.Its clinical manifestations and imaging features are similar to hypophyseal tumor,but the endocrine and pathologic features are different.Glucocortieoid pulse therapy and surgery are the two methods of treatment.

Anticonvulsants ; pharmacology ; therapeutic use ; Epilepsy ; drug therapy ; genetics ; Humans ; Pharmacogenetics

Aim To explore the concentration range of organic solvent which can both effectively increase solubility of the difficult soluble medicine monomer, and have low toxicity to cells, and to clarify the influence of different concentration of ethanol on curcumol efficacy.Methods Different DMSO and ethanol concentrations were diluted in culture medium and incubated with cells A549, NCI-H460, NCI-H1299, NCI-1650, LTEP-a2 and SPC-A1 for 12 h, 24 h, or 48 h, cell viability was tested by a colorimetric assay with 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide(MTT), and different concentrations of ethanol with/without different concentrations of curcumol were also prepared with culture medium, then incubate with A549 and NCI-H460 cells for 24 h, and cell viability was tested by MTT as well.Results Within 48 h the solution with 0.008(V/V) DMSO or less had no significant effect on the cell A549 compared with control group, for NCI-H1650 the concentration was 0.004(V/V) or less, for NCI-H460 the result turned to be 0.002(V/V) or less, and the solution with DMSO below 0.001(V/V) had significant effect on the three other cells, NCI-H1299, LTEP-a2 and SPC-A1.While within 48 h, the liquor with 0.004(V/V) ethanol or less did not exhibit significant cytotoxic effect on the cell A549, for NCI-H460 and NCI-H1650 the result of ethanol concentration became 0.002(V/V) or less, for NCI-H1299 the data was 0.001(V/V) or less, and the liquor with ethanol below 0.001(V/V) showed significant cytotoxic effect on LTEP-a2and SPC-A1.When the proportion of ethanol in solution was below 0.01, it has no cytotoxic on cell A549 and NCI-H460, and the curcumol solution prepared with this kind of ethanol solution only represented the efficacy of curcumol on the cells.Since the solution with 0.01(V/V) ethanol dissolved the curcumol better, the cell viability changed from about 100% to about 35%.Conclusions Different organic solvent expressed different toxicity to the same cell, and the sensitivity of different cells to one organic solvent is dissimilar.and DMSO could be the optimum solvent for A549 and NCI-H1650, while the optimum solvent of NCI-H1299 is ethanol, for NCI-H460 it could be both and DMSO and ethanol, and DMSO and ethanol is not suitable for LETP-a2, SPC-A1 to be solvent.

Objective To analyze the language structure of nursing records and the application of defined vocabulary in nursing records of community child care,and to explore the possibility of structuralization and standardization of community nursing records by researchers' consulting International Classification of Nursing Practice (ICNP(R)2.0).Methods Convenient sampling method was used.A total of 432 handbooks about child health care were extracted from three community health service centers in Liaoning province.By analyzing the nursing records,the vocabulary was selected,and a coding book was built.Then researchers compared them with ICNP(R)2.0 Chinese version.Results Totally 567 terms were extracted.All phrases in nursing records about community child health care can be classified into three categories and seven shafts,which were nursing phenomenon,nursing action and nursing outcome.Our community nursing records about child health care could not fully meet shaft level of nursing record writing requirements from the International Council of nurses.Only 146 records were labeled as perfect fit with ICNP(R)2.0 terminology,223 records as not fit at all.The difference of different levels of suitability distribution about nursing phenomenon,nursing action and nursing outcome had statistically significant difference.Words of able to adapt and can't adapt about nursing action had larger proportion.Words that can't adapt about nursing phenomenon and nursing outcome had larger proportion.Conclusions There is still certain gap between domestic nursing records and ICNP(R)2.0 terminology.The list of terms from comparison nursing records about community child health care with ICNP(R)2.0 can lay the foundation for nursing language system structure and perfect community nursing record language in our country.

Objective To analyze the correlation between fluid equilibrium and oxygen index in patients at early stage (within 2 weeks) of severe acutepancreatitis (SAP),and to discuss the effects of fluid equilibrium after resuscitation on the prognosis.Methods A clinical study was conducted.Ninety-seven patients with SAP admitted into Shengjing Hospital of China Medical University directly or transferred into intensive care unit (ICU) in 24 hours after admission between March 201 1 to October 2013 were studied.Finally,65 patients were enrolled in statistical analysis,and those with termination of treatment prematurely were excluded.The patients received treatment protocol formulated by the same physician in ICU.Patients were divided into improved group and death group according to the outcome.The differences in fluid equilibrium on 1,2,3,7,14 days after admission of ICU between the two groups were compared.The correlation between fluid equilibrium and oxygen index was analyzed with curve fitting.Results Among 65 patients enrolled,53 of them were improved after intensive care and were transferred into ordinary wards.However,12 patients died in ICU.Patients in the improved group showed delayed positive fluid equilibrium,and some patients even showed negative fluid equilibrium.Patients in death group needed more fluid to achieve fluid equilibrium.There was a significant difference in the need of fluid to reach an equilibrium between improved group and death group [1 day:1 814.5 (905.2,2 152.8) vs.3 891.0 (2 524.2,5 714.5),Z=-3.303,P=0.001; 2 days:2 469.0 (1 456.0,3 696.0) vs.6 498.0(4 617.8,8 763.5),Z=-4.431,P＜0.001 ; 3 days:3 234.0 (1 098.0,4 295.5) vs.9 533.5 (6 748.8,10 689.0),Z=-4.684,P＜0.001 ; 7 days:3 234.0 (1 033.0,5 162.0) vs.13 986.5 (8 045.8,14 518.0),Z=-4.718,P＜0.001 ; 14 days:3 234.0 (978.5,4 924.0) vs.13 436.5 (8 045.8,14 518.0),Z=-4.769,P＜0.001].There was no correlation between fluid equilibrium and oxygen index in improved patients within 3 days of ICU admission (R 2=0.000,P=0.827),and it fit the logistic curve in a relatively low level after 3 days of ICU admission (R 2=0.036,P＜0.001).Conclusions Early fluid resuscitation could help maintain hemodynamics stability in SAP patients.Those SAP patients who showed a negative equilibrium in early stage showed a better prognosis,and the fluid equilibrium and oxygen index in improved patients fit the logistic curve after 3 days of ICU admission.

Anxiety and depression are common conditions among patients with irritable bowel syndrome(IBS)which may induce or aggravate intestinal symptoms. Psychological factors are considered to be involved in the pathogenesis of IBS via both central and peripheral pathways,and functional magnetic resonance imaging(fMRI)revealed that several brain areas,such as anterior cingulate cortex and prefrontal cortex,are associated with IBS,anxiety and depression. This article reviewed the use of fMRI for studying the correlation of IBS brain activity with anxiety and depression and its role in the central pathogenesis of IBS.

Objective To make early diagnosis of occupational bladder cancer in benzine-exposured worker in China. Methods An epidemicological investigation was made for a total of 1 796 benzidine-exposured worker.All the urine sample were tested for cytology,DNA G-Actin and M344 tumor associated antigen by PaP and QFIA methods.Clinical studies were then carried out for the high risk workers. Results 30 cases of bladder cancer and 1 pelvic cancer were found(1.73%),all of which were transitional cell carcinoma.There were 3 grade Ⅰ tumors,10 grade Ⅱ,18 grade Ⅲ.For the high risk workers,the time elapsed for the occurrence of clinical cancer was 18 months in average and the average patent time of occupational bladder cancer was 21.2 years (5～30 years). Conclusions Pap cytology and QFIA are beneficial to the early diagnosis and screening of occupational bladder cancer.