Objective To investigate the effects of Huoxue yiqi runchang decoction in the treatment of chronic intractable constipation in colonic dynamics.Methods 68 cases patients of chronic obstinate functional constipation from October 2013 to June 2016 in linhai traditional chinese medicine hospital were selected and randomly divided into two groups,34 cases in each group,two groups received reasonable diet and lifestyle guidance and general treatment, and the control group received oral mosapride,and the experiment group received more with Huoxue yiqi runchang decoction.Levels of serum MTL and SP,the score of line Wexner constipation and GIQLI,colon motility examination,and clinical efficacy were compared.Results Compared with before treatment,levels of serum MTL and SP in two groups were increased (P<0.05),score of Wexner constipation decreased (P<0.05),and score of GIQLI increased (P<0.05),and transmission time of RCTT,LCTT and RSTT decreased (P<0.05).Compared with the control group,levels of serum MTL and SP in the experiment group were higher,score of Wexner constipation were lower (P<0.05),score of GIQLI were higher(P<0.05), and transmission time of RCTT,LCTT and RSTT was lower ( P <0.05 ) , and the clinical efficacy was higher ( P <0.05 ) .Conclusion Huoxue yiqi runchang decoction can improve clinical symptoms in patients with chronic constipation, and enhance the gastrointestinal motility,and improve the clinical efficacy.

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P ＜ 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P ＜ 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

A novel genomic island (GI) in Streptococcus suis serotype 2(SS2) was identified, which resided in the highly virulent strains but not in the hypo-virulent strains or avirulent strains of SS2 of the Chinese isolates. This newly discovered GI strain was designated as SSGI4 and its whole length of genome was 11 269 bps, sharing the typical properties of pathogenicity islands, such as the distinct G+C content, a mosaic architecture characteristics and the specificity for virulent isolates. There were 11 genes within SSGI4, in which some genes were putative cell surface protein genes and others were amino acid-binding protein genes. Our finding sheds light on the investigation of horizontal gene transfer in SS2 and their influence on pathogenicity.

Objective To investigate the safety of the laparoscopic pancreaticoduodenectomy (LPD) in 70 years of age or older patients.Methods The retrospective cohort study was conducted.The clinicopathological data of 40 patients (age ≥70 years old) who underwent pancreaticoduodenectomy in the West China Hospital of Sichuan University between January 2012 and December 2016 were collected.Twenty patients undergoing LPD were allocated into the LPD group,and 20 receiving open pancreaticoduodenectomy (OPD) who were selected by random number table during the same period were allocated into the OPD group.Observation indicators included:(1) intraoperative situations;(2) postoperative situations;(3) follow-up situation.Follow-up using outpatient examination and telephone interview was performed to detect the patients' survival after discharge and tumor recurrence and metastasis up to March 2017.Measurement data with normal distribution was represented as x±s,and comparison between groups were evaluated with the t test.Measurement data with skewed distribution were described as median (range) and comparison between groups was analyzed using the nonparametric test.Comparison of count data was analyzed using the chi-square test.Comparison of ranked data was analyzed by non parametric test.Results (1) Intraoperative situations:1 patient in the LPD group was converted to open surgery,with a conversive rate of 5.0％ (1/20).Operative time and volume of intraoperative blood loss were (463 ± 10) minutes,210.5 mL (152.5-300.0 mL) in the LPD group and (332± 25) minutes,420.0 mL (350.1-493.8 mL) in the OPD group,showing statistically significant differences between the 2 groups (t =5.48,Z =-3.98,P＜0.05).Cases with intraoperative blood transfusion and pylorus preservation were respectively 4,14 in the LPD group and 6,10 in the OPD group,showing no statistically significant difference between the 2 groups (x2=0.53,1.67,P＞0.05).The results of intraoperative rapid frozen pathological examination showed negative margin of the 40 patients.(2) Postoperative situations:cases in ICU,cases with postoperative analgesia,time for out-of-bed activity,time to anal exsufflation and time for intake were 17,7,(2.2±0.7)days,(4.2± 0.9)days,(4.8±0.7)days in the LPD group and 6,15,(3.6±0.8)days,(5.7±0.9)days,(7.1 ± 2.7)days in the OPD group,showing statistically significant differences between the 2 groups (x2 =12.34,6.47,t=-6.18,-6.55,-3.65,P＜0.05).Pancreatic fistula,delayed gastric emptying (Grade B),postoperative bleeding (Grade B),biliary fistula,pulmonary infection,intestinal obstruction,wound infection,reoperation and major complication were respectively detected in 2,3,1,1,3,1,0,2,3 patients of the LPD group and 2,4,1,1,4,1,2,3,4 in patients of the OPD group,showing no statistically significant difference between the 2 groups (x2 =0.00,0.17,0.00,0.00,0.17,0.00,2.11,0.23,0.17,P＞0.05).Results of postoperative pathological examination showed that duodenal adenocarcinoma,ampullary carcinoma,lower bile duct carcinoma,pancreatic ductal adenocarcinoma and pancreatic cystic tumor were respectively detected in 8,2,5,3,2 patients of the LPD group and 10,2,4,2,2 patients of the OPD group,showing no statistically significant difference between the 2 groups (x2 =0.53,P＞0.05).Duration of postoperative hospital stay in the LPD and OPD groups were (19± 13) days and (15±7) days,respectively,showing no statistically significant difference between the 2 groups (t =1.28,P＞ 0.05).Results of postoperative oncology showed that tumor diameter,number of lymph node dissected,number of positive lymph nodes,cases with negative margin,cases in T1N0M0,T2N0M0,T3N0M0,T3N1M0,T4N0M0,T4N1M0 of TNM staging were respectively (2.4±0.7)cm,15.4±2.3,2,20,2,7,8,2,1,0 in the LPD group and (2.8±0.9)cm,14.4±2.5,3,20,1,8,5,2,3,1 in the OPD group,with no statistically significant difference between the 2 groups (t =-1.64,1.32,x2 =0.23,0.00,Z =-0.69,P＞ 0.05).(3) Follow-up situation:1 patient died respectively in both groups within the postoperative 30 days.Thirty-eight patients were followed up for 1-26 months,with a median time of 14 months.During follow-up,2 patients had tumor recurrence and 1 died of myocardial infarction in the LPD group;3 had tumor recurrence and 1 died of tumor recurrence in the OPD group.Conclusion LPD in 70 years of age or older patients is not only safe and feasible,but also significantly reduce volume of intraoperative blood loss and demand of analgesia,as well as quickly resume normal diet and activities.

Public hospitals and other non-profit or profit-oriented institutions can engage in external cooperation by way of management, technology, talents and information, and achieve medical resource sharing, complementary advantages, and maximal benefits. In December 2019, a university carried out the whole process audit on 75 external cooperation projects which were carried out from January 2016 to June 2019 by 4 affiliated public hospitals through the " two overall planning" management mode (i.e., overall planning audit projects and overall planning organization). The audit found that there were some problems in the external cooperation projects of public hospitals, such as lack of consistency and scientificity in the management system and decision-making mechanism, lack of standardization and preciseness in the conclusion of contracts, and the inadequate supervision of the implementation of contracts and the insufficient of project effectiveness evaluation and dynamic adjustmont. It is suggested to establish a comprehensive audit path for external cooperation projects of public hospitals, innovate the audit management mode, scientifically and reasonably allocate audit forces, expand the breadth and depth of audit supervision, and strictly implement problem rectification.

Objective:To investigate the characteristics of newly diagnosed patients with chronic obstructive pulmonary disease (COPD) in Shenzhen primary care.Methods:Random sampling was conducted in 10 jurisdictions of Shenzhen, permanent residents who were over 40 years old and lived for more than 6 months were included for lung function test, COPD Population Screener (COPD-PS) questionnaire and information survey, the prevalence of COPD was estimated, and statistical comparison was made between the two groups of subjects with newly diagnosed and previously diagnosed COPD.Results:Among 3 916 subjects, 3 591 had completed the whole screening process. The results showed that 280 COPD patients were diagnosed and the estimated standardized prevalence of COPD was 5.92% (95% CI: 4.05-8.34). Among them, 251 (89.64%) were newly diagnosed COPD patients and 29 (10.36%) were previously diagnosed COPD patients. Compared with previously diagnosed COPD, the proportion of female in the newly diagnosed COPD was higher (50.20% vs 10.34%, P<0.001), educational level in the newly diagnosed COPD was lower (the proportion of primary school and below was higher, 42.23% vs 20.69%, P=0.023), the proportion of those with frequent wheezing symptoms in the newly diagnosed COPD was lower (4.78% vs 51.72%, P<0.001), the proportion of those with mild degree of airway obstruction (GOLD 1) in the newly diagnosed COPD was higher (81.67% vs 20.69%, P<0.001). The detection rates of COPD-PS in newly diagnosed COPD and previously diagnosed COPD were 43.03% and 41.38% respectively. The area under the receiver operating characteristic curve of COPD-PS was 0.705. Conclusion:The phenomenon of insufficient diagnosis of COPD in Shenzhen primary care is common and we should vigorously popularize pulmonary function examination.