To analyze the clinical characteristics,complications and management of Brucellosis.As a retrospective review,23 patients with Brucellosis admitted into Peking University First Hospital over a 10-year period were reviewed.Most of them were middle-aged males.Common presenting clinical manifestations included high fever,sweating,arthralgia and headache.Splenomegaly was more common than hepatomegaly.There were liver injury (n =15),transient proteinuria (n =6),secondary hemophagocytic syndrome (n =2) and renal failure with infective endocarditis,pneumonia with infective endocarditis,renal abscess (n =1).Most of them were treated effectively with combination therapy.The clinical features of Brucellosis are both complicated and atypical.

Objective To assess the efficacy of emergency hand-assisted laparoscopic hepatectomy for spontaneous rupture of primary hepatocellular carcinoma.Methods A total of 15 eases who underwent emergency hand-assisted laparoscopic hepatectomy for spontaneous rupture of primary hepatocellular carcinoma were retrospectively reviewed.Results All operations were successful.The postoperative mortality rate was.Thirteen cases were followed-up from 11 months to 56 months.The overall 1-,3-year survival rate was 84.6%(11/13),53.8%(7/13)respectively.Conclusion Emergency hand-assisted laparoscopic hepatectomy is a safe and feasible approach for pontaneous rupture of primary hepatocellular carcinoma in clinically selected patients.If the patients condition permits it,emergency hand-assisted laparoscopic hepatectomy should be the treatment of choice.

0.05);in contrast, intrathecal NMDA 2.5,5,10 ng could significantly and dose dependently decrease the HPPT(P

Objective To describe practice experience of the male nurses in obstetrics and gynecology department.Methods Phenomenological methodology was adopted in this study.In-depth interview was conducted on 12 male nurses who practiced in obstetrics and gynecology department from March 2012 to May 2013.Data were analyzed by Colaizzi's analysis method.Results The main experience included:lack of patient understanding and support,a sense of loss,decline in the enthusiasm to learn,inconvenience of live and study,dissatisfied with specialist operations.Conclusions Male nurses in obstetrics and gynecology has many adverse experiences,clinical teachers should take measures to help them successfully complete the practice and prevent occurrence of adverse experience.

OBJECTIVE To explore the method to prevent 203 patients after liver transplantation from infection.METHODS According to infective reason after liver transpantation,the strict management in every step was performed,including establishing standard of infection control,strengthening the staff management,and separating the different area.RESULTS Multi-organs dysfunction sydrome was found in 4 patients after liver transplantation because of fungal infection,and the total mortality of patients after transplantation was 1.97%.CONCLUSIONS Strengthening the nursing management can take a significant effect for patients after transplantation to control infection and decrease mortality rate.

Objective To investigate the efficacy of bend-assisted laparoseopie fight bemicolectomy for right colon carcinoma in elderly obesity patients. Methods 20 obesity eases undergoing hand-assisted laparoscopic right bemicolectomy were retrospectively reviewed, and compared with 25 obesity cases with transabdominal right hemicolectomy in the same period. The safety, recovery, eradication and stress reaction were compared. Results In hand-assisted laparoscopic group, there were less bleeding loss, rapid recovery to normal temperature and gastrointestinal function,ont of bed activity, short-time hospitalization compared with transabdominal group(P <0.01). There were no differences in operative time, numbers of lymph nodes removed, postoperative complications and length of specimen between two gronps(P > 0.05). CRP, IL-6, adrenocorticotrophic hormone (ACTH) and cortisol were more significantly increased in two groups after operation than before operation (P < 0. 05) , and this increase was moreprominent in transabdominal group than in hand-assisted laparoacopic group (P < 0.05). Conclusion Hand-assis-ted laparoscopic right hemicolectomy is a safe and effective way for elderly obesity patients,especially in postoperative recovery and physical stress reaction.

Objective To analyze inducing factors of acute left heart failure(AHF) of emergency case.Methods According to different age and gender,the inducing factors of AHF of 211 patients were retrospectively analyzed.Results Infection(42.99%) was the most important inducing factors of AHF in all the four age-groups,but as for patients elder 80,the arrhythmias was also play an important part in inducing factors of AHF.The difference of inducing factors was found among the four age-groups.but the difference of inducing factors was not found between the two gender-groups. Conclusion Since the most important inducing factors of AHF of emergency case was infection,anti-infectives is important for preventing and controlling AHF.

Objective To investigate the correlation between age and the prognosis of thrombolytic therapy in acute ischemic stroke (AIS).Methods One hundred and fourteen patients with AIS were divided into ≤60 years group,61-70 years group and ≥71 years group according to age.Thrombolysis and post-thrombolysis treatment was done in accordance with 2010 version of Chinese Acute Ischemic Stroke Treatment Guidelines standard.The United States National Institutes of Health Stroke Scale (NIHSS) score was done in patient immediately after treatment,24 h after thrombolysis and 7 d after thrombolysis,and modified Rankin scale (mRS) score was assessed 3 months after thrombolysis The spontaneous intracranial hemorrhage (sICH) and the death of 2 weeks was recorded.Results ≤ 60 years group had 22 males and 10 females;61-70 years group had 26 males and 10 females; ≥71 years group had 20 males and 26 females.In ≥ 71 years group,women accounted for 56.52％ (26/46),which was higher than that in the other 2 groups,and there was significant difference (x2 =0.685,P =0.015).The NIHSS score immediately after treatment,24 h after thrombolysis and 7 d after thrombolysis among 3 groups had no significant difference (P ＞ 0.05).The mRS score at the 3 months after thrombolysis among 3 groups was (1 ± 3),(2 ± 5) and (2 ± 3) scores,respectively,and there was significant difference(P =0.040).Mortality and incidence of sICH in 2 weeks also had significant difference (P =0.049,0.017).Conclusions Despite the differences in the mortality and incidence of sICE among different ages,thrombolytic therapy with recombinant tissue-type plasminogen activator can significantly improve the neurological deficit after 3 months in AIS patients of different ages.

Objective To investigate the effect of infection on the expression of substance P(SP) and Th1 cytokine on colonic mucosa in patients with irritable bowel syndrome(IBS).Methods Mucosa biopsy samples were obtained in descending colon and rectum from 77 patients(20 post-infective-IBS cases)and 30 controls by colonoscopy.The expressions of SP,interleukin(IL)-2,interferon(IFN)-?were determined by immunohistochemical staining.Results Compared with controls,expressions of SP,IL-2 and IFN-?were significantly increased in IBS patients with diarrhea-predominant(P＜0.05),and expression of SP in post-infective-IBS patients with cytokines positive(IL-2 and IFN-?)were also signifi- cantly increased(P＜0.05).There were no significant differences between non post-infective-IBS and controls.Conclusions Expression of SP was significantly increased in post-infective-IBS.SP upregulated the expression of Thl cytokines(IL-2 and IFN-?).Gastrointestinal infection may involve in the patho- genesis of IBS through neuroimmune mechanism.

ObjectiveTo determine the changes in tumor necrosis factor-α (TNF-α) and interleukin-lβ (IL-1β)expression after bone marrow mesenchymal stem cells (BMSCs) transplantation in a rat pup model of hypoxic-ischemic brain damage (HIBD) and discuss the anti-inflammatory mechanism of BMSCs transplantation in the repair of HIBD.MethodsThree-day-old Sprague-Dawley rat pups were randomly divided into three groups: the transplantation group, in which a model of HIBD was established by ligation of left common carotid artery and hypoxia for two hours followed by the injection of 2μl BMSCs (2×105 cells) into the lateral ventricle; the HIBD model group, in which HIBD model was established and 2μl phosphate saline buffer was injected into the lateral ventricle; and the sham-operation group, in which no intervention was given. Histological changes in the brain were detected by HE staining and the number of cells positive for ectodermal dysplasia-1 (ED-1) staining, which is a specific marker for activated microglia, was detected by immunohistochemistry. The protein and mRNA levels of TNF-α and IL-1β were determined by enzyme-linked immunosorbent assay and reverse transcription-polymerase chain reaction. One-way analysis of variance and LSD test were applied for statistical analysis.ResultsHE staining showed that cellular edema and necrocytosis was not observed in cerebral white matter on the 7th post-transplantation day in the transplantation group, but observed in the HIBD model group. In the sham-operation group, cerebral white matter was normal. The number of ED-1 positive cells in the transplantation group (26.3±2.5) was significantly lower than that in the HIBD model group (33.0±4.0), but higher than that in the sham-operation group (2.3±0.6) (LSD test, allP<0.05). The contents of TNF-α and IL-1β both in the transplantation group and the HIBD model group increased and peaked 24 h after transplantation, then gradually decreased, but did not reach normal levels (sham-operation group) on the 7th day. The contents of TNF-α and IL-1β in brain tissue in the HIBD model group [TNF-α: (3.03±0.10), (5.57±0.19), (7.78±0.19), (4.39±0.20), (2.70±019)μg/L; IL-1β:(293.1±7.9), (369.8±17.5), (303.6±23.9), (226.7±21.6), (183.9±33.4) ng/L] were significantly higher than those in the transplantation group [TNF-α: (2.84±0.20), (3.80±0.14), (4.63±0.17), (3.56±0.03), (1.99± 0.17)μg/L; IL-1β: (267.6±14.5), (323.5±26.9), (211.2±24.9), (140.8±7.4), (100.2±8.3) ng/L] at 6, 12, 24, 48 h and 7 days after BMSCs transplantation, respectively. The contents of TNF-α and IL-1β in the sham-operation group [TNF-α:(1.03±0.02), (1.13±0.03), (1.05±0.02), (1.09±0.02), (1.07±0.02)μg/L; IL-1β:(63.6±13.0), (64.0±11.3), (60.8±10.0), (67.9±13.5), (66.2±11.7) ng/L] were significantly lower than those in the transplantation group and HIBD model group (LSD test, allP<0.05). TNF-α and IL-1β mRNA at 24 h after transplantation in the HIBD model group (TNF-α: 2.69±0.43; IL-1β: 3.07±0.38) were significantly higher than those in the transplantation group (TNF-α: 1.61±0.29; IL-1β: 1.08±0.11) and those in the sham-operation group (TNF-α: 0.94±0.16; IL-1β: 1.08±0.11) (LSD test, allP<0.05).ConclusionsBMSCs may play an important role in the recovery of preterm HIBD and the mechanism may involve the inhibition of microglia activation and down-regulation of the expression of inflammatory factors.