Objective To observe the clinical effect of inhibition about gallstone stone after extracorporeal shock wave by Liver gallstones sheet. Methods 60 patients diagnosed gallstone stone from July 2015 to November 2016, randomly divided into treatment group and control group. he treatment group received oral treatment of liver gallstones sheet, control group without special treatment, patients were followed up and recorded gallbladder wall thickness, gallbladder function and gallstone patients were relapse situation, using statistical methods to analyze data. Results After one year observation of patients gallbladder wall thickness, gallbladder function scores were (2.79±0.34,57.70±4.80) than the control group (3.14±0.39,53.13±5.01), and the differences were statistically significant (P<0.05). After one year observation group gallstone recurrence rate was 10.0%, far lower than the control group, 43.3%, and the difference was statistically significant (P<0.05). Conclusion It is worthy of further research and application and it has a good clinical results for the liver gallstones sheet after extracorporeal shock wave lithotripsy inhibition of gallstone stone.

This paper aims to summarize the clinical application of interventional technique via portal venous system, laying stress on the necessity of reinforcing, improving and comprehensively applying this interventional technique, and to provide new conception concerning the diagnosis and therapy of the diseases involving portal venous system.

Objective To study the effects of the early diagnosis and treatment of sleeve fractu re of patella in children.Methods The retrospection study was done to a nalyse the effects of the diagnosis a nd treatment of ten samples of sleeve fr acture of patella in our hospital fro m 1993to 2001.Results The diagnosis was confirmed by the characteristic s of the tension swelling of the knee,high position of the patella and a sle eve fractured fragment in the patella.T he operations were the main initial t reatment to regain the proper reduction.After 4weeksfixation the patients did knee exerc ises.And the curative effects were q uite good.Conclusion The sleeve fracture of the patella in children is easy to be misdiagnosed o r missed because of the cartilage.So it is the more important to be able to con duct an early diagnosis and treatmen t for the better prognosis.

Objective To determine the independent risk factors for postoperative nausea and vomiting (PONV) after endoscopic retrograde cholangio-pancreatography (ERCP) under total intravenous anesthesia.Methods Ninety patients,47 males and 43 females,aged 18 years old or more,falling into ASA physical status Ⅰ-Ⅲ,undergoing ERCP under total intravenous anesthesia from July 18,2016 to August 31,2016 in Ruijin Hospital were included in our study.General information and intraoperative situation of patients were collected.The incidence of PONV within 24 h was recorded.A multivariate Logistic regression model was performed to analyze the independent risk factors of PONV after ERCP under total intravenous anesthesia.Results In total,90 patients were included in this study,with 33 patients (36.7%) suffering PONV.Logistic analyses showed that female (OR=3.73,95%CI 1.36-10.27),history of PONV/motion sickness(OR=4.39,95%CI 1.40-13.76),and serum-amylase greater than 3 times the normal value (OR=5.22,95%CI 1.30-20.95) were the independent risk factors for PONV after ERCP under total intravenous anesthesia.Conclusion Female,history of PONV/motion sickness,and serum-amylase greater than 3 times the normal value were the independent risk factors for PONV after ERCP under total intravenous anesthesia.

In order to improve the quality of teaching,stimulate students’ interest in studying medical cell biology,we performed a lot of innovation on cell biology teaching program according to the requirement of basal course and the characteristic of freshman. First,choose the contents of the study seriously. Second,introduce bilingual teaching gradually. Third,bring up the spirit of activity in their studies progressively. Last,take full advantage of tutorship to help students build up the studying confidence,master studying method and enhance self-study capability. The result shows that these methods help students conquer their fear of difficulties and achieved an expected teaching effect.

Objective To explore the correlation of urine albumin and creatinine ratio(UACR)and short -term prognosis in patients with acute ischemic stroke (AIS).Methods 112 patients with AIS were selected as the research subjects.The admission UACR and related laboratory examination indexes were detected,the US national institutes of health stroke scale (NIHSS)scores,and 28 d after admission of the modified Rankin scale (mRS) prognostic score were recorded.The NIHSS 5 or more points and NIHSS <5 points,different levels and UACR patient observation index between the different prognosis group were compared.Results NIHSS 5 or more group of patients on admission UACR level[(15.41 ±3.21 mg/g)]was higher than the NIHSS <5 patients (9.52 ±2.04)mg/g (t =12.214,P <0.001);UACR acuity 11.60mg/g group in NIHSS of 5 or more proportion of patients (87.5%),mRS score >2 points (82.1%),the proportion of the recent death patients (23.2%)than the proportion of UACR <11.60mg/g,the proportion of the group (32.1%,25.0%,7.1%;the chi -square values 33.509,34.476,5.598,all P <0.050);MRS score >2 groups of patients UACR level[(16.10 ±3.29)mg/g]was higher than that in patients with mRS score 2 points or less (8.38 ±1.95)mg/g(t =20.132,P <0.001);Pearson correlation analysis showed that the standard of UACR and NIHSS score (r =0.412,P <0.05 ),high -sensitivity C -reactive protein (hs -CRP)(r =0.473,P <0.050),white blood cell count (WBC)(r =0.442,P <0.050),fasting plasma glucose (FPG)(r =0.375,P <0.050)were positively correlated.Multiariable Logistic regression analysis showed that UACR (OR =1.587,P <0.050)was a recent independent risk factors of poor prognosis in patients with AIS. Conclusion UACR the illness severity and recent prognosis of patients with AIS is closely related to high levels of UACR may be recent independent risk factors of poor prognosis in patients with AIS.

Objective To evaluate the occurrence and risk factors for healthcare-associated infection(HAI)in pre-mature infants.Methods The occurrence of HAI among premature infants who were born in a hospital from Janu-ary 2011 to June 2015 and admitted in the neonatal intensive care unit within 24 of birth were investigated prospec-tively,the related risk factors and intervention measures were analyzed.Results 644 premature infants were inves-tigated,32(4.97%)had HAI,the main infection site was lower respiratory tract (n=18,56.25%).34 pathogenic isolates causing HAI were detected, 24 (70.59%) were gram-negative bacteria, the major was Klebsiella pneumoniae (n=14);10 isolates were gram-positive bacteria(29.41%).Logistic regression analysis revealed that small for gestational age, low birth weight, severe amniotic fluid pollution, mechanical ventilation, feeding intolerance,indwelling gastric tube,irrational antimicrobial use,and long length of hospital stay were risk factors for HAI in premature infants (all P < 0.05).Conclusion Risk factors for HAI in premature infants are multiple, targeted interventions,such as shorten the length of hospital stay,reduce unnecessary invasive operation,use antimicrobial rationally,improve the feeding tolerance,are helpful for reducing the risk factors for HAI in premature infants.

Objective Through discussing application of case analysis to improve the comprehensive quality of nursing staff,and promote their implementation of high quality nursing care for the patients.Methods all 61 nurses in general wards were trained by daily half-hour case analysis method.After the training,questionnaire was given to investigate the nursing staff's evaluation on case analysis training,and at the same time compared before and after the training,the patients' satisfaction survey result,the monthly examination result of the nursing department,nursing paper quality and the number of nursing adverse events.The relevant data was done by t test orx2 test.Results After the implementation for half an hour case analysis training,most nurses think their own various ability was improved.After the training,the patient satisfaction was (t=-0.391),the monthly assessment score of the nursing department(t=3.823),the quality of care increased(x2=5.495),while the nursing adverse events reduced(x2=6.441),and the difference was statistically significant compared with before the training(P＜0.05).Conclusion Daily half-hour case study method can improve the nursing staff comprehensive quality and scientific research ability,the patients' satisfaction,and reduce the nursing adverse events,which is helpful to clinical practice.

Objective To investigate the effect of different doses of propofol on cytokines-tumor necosis factor-? (TNF-?), interleukin-6 ( IL-6 ), interlenkin-8 ( IL-8 ), during systemic inflammatory response syndrome (SIRS) .Methods Fifty-six male Wistar rats weighing 190-220g were anesthetized with intraperitoneal 2.5% pentobarbital 30mg.kg-1 . The animals were randomly divided into 4 groups of 14 animals each: group A received intraperitoneal saline 10ml.kg-1 followed by intravenous infusion of saline (2ml.h-1 ); group B received intraperitoneal LPS 1mg.kg followed by intravenous infusion of saline(2ml.h-1 ) ; in group C propofol was infused iv at 75?g.kg-1.min for 4h after intraperitoneal LPS injection; in group D propofol was infusion iv at 150?g.kg-1 .min-1 for 4h after intraperitoneal LPS injection. Blood samples were taken before experiment and 1, 2, 3, 4h after saline or propofol infusion for determination of serum TNF-? (cytotoxin stain method) and IL-6, IL-8 (ELISA) concentration.Results Serum concentrations of TNF-?, IL-6 and IL-8 induced by LPS increased significantly in group B as compared with those in group A. Propofol decreased the level of cytokines and delayed the peak values of TNF-? and IL-8. Conclusion Propofol used in the early stage of SIRS has some protective efficacy.

Objective: To explore the effect of health education and supportive therapy on neuroses. Methods: Fifty six subjects were assigned into two groups according to the sequence of hospitalization. Both groups received the same drug treatment, average dosage: in experiment group fluoxetine 20～30mg/d (9 cases), Amitriptyline 75～150mg/d(8 case), Alprazolam 1.6～ 2.8mg/d(13 cases), received the health education and supportive therapy for 38 to 60 days in addition to drug treatment. In control group, fluoxetine 20～30mg/d(11 case), Amitriptyline 75～200mg/d(5 cases), Alprazolam 1.2～2.8mg/d(10 cases) were used. The Symptom Checklist 90 was used for assessment before and after treatment and cure rate was evaluated by clinical standard at discharge in both groups. Results: Cure rate was higher in the experimental group (94%) than control group (71%, P<0.05). The total score of the Symptom Checklist 90 and main factors were lower in the experimental group than the control group (P<0.01). Conclussion: Early health education and supportive therapy can improve the treatment outcome of patients with neuroses.