Obstructive jaundice is a common disease of hepatobihary surgery,including malignant and benign ones whose treatment and prognosis are obviously different.Malignant obstructive jaundice is one of the dieseases with a worse curative effect,the surgical treatment of this disorder has made much progress in recent years.however there are also some points of disagreement.This acticle reviews the advances of the preoperative preparation,radical excision and palliative drainage in the surgical treatment of malignant obstructive jaundice by reviewing the pertiment literature of China and abroad of recent years.

Objective To analyse effects of Compound Danshen injection on acute viral myocarditis.Methods-128 patients with acute viral myocarditis were divided into two groups from May 2015 to February 2017 in Yuhang District, the Second People's Hospital.The two groups received the conventional treatment plan, the observation group was given compound Danshen injection, the evaluation of compound Danshen injection on the disease effect.Results①Total efficiency of observation group was 93.75%,higher than that of control group 76.56%(P<0.05).②Serum TNF-ɑ and IL-6 level of observation group were[(72.4±10.4), (36.15±4.68)]ng/L,lower than that of control group[(95.0±12.7), (46.23±5.24)ng/L](P<0.05).③Serum AST,CK-MB and LDHI level of observation group were[(43.19±3.25), (17.34±3.31), (168.4±13.9)]U/L,lower than that of control group[(0.47±0.08)μg/L, (9.05±1.93)mg/L)](P<0.05).Whole blood viscosity,plasma viscosity and FIB level of observation group were[(5.95±1.91)mPa·s, (1.49±0.17)mPa·s, (3.20±0.58g/L)],lower than that of control group[(52.09±4.61), (25.55±3.86),(201.5±15.4)U/L](P<0.05).④There was no obvious adverse reaction in the control group and the observation group had 3.13% adverse reactions.ConclusionCompound Danshen injection can reduce the level of inflammation in patients with acute viral myocarditis,protect myocardial cells and improve treatment effect.

Objective:To explore the depressive symptom of nurses and its relationship with trait coping style,role perceive and personal control.Methods:425 nurses in the 2nd Hangzhou general hospital completed a battery of questionnaires consisted of part items of SCL-90,Trait Coping Style Questionnaire(TCSQ) and Role Perceive and Personal Control Scale.Results:There are significant correlation among the SCL-90 score,the coping styles,and the control feeling and role conflict.Based on depression factor ,factors of negative coping style,control feeling,role conflict and positive coping style were included in stepwise regression equation.Conclusion:Depressive symptom of nurses was related to trait coping style,role perceive and personal control.

Objective:To investigate the relationship among college student’s depression symptoms, problem solving appraisal and perceived stress.Methods:275 college students completed questionnaires, including CES-D, Chinese Perceived Stress Scale (CPSS) and Chinese Problem Solving Inventory (CPSI). Results: Among these students, 52% reported on the level of health risk stress (HRS), 55.3% had depression symptoms. There were significant correlation among depression symptoms, perceived stress and problem solving appraisal. The causal relationship between them were identified with the path analysis method, problem solving in special, seems to have both direct and indirect effect on the prediction of depression and on perceived stress. Conclusion:There is a high level of college student perceived stress and depression symptoms. Problem solving appraisal is an important factor for both of them.

In order to explore the significance of cardiomyocyte apoptosis in coronary heart disease (CHD), the TUNEL and transmission electron microscopic (TEM) techniques were performed. The results showed that the permillage of cardiomyocyte apoptosis in infarct area in patients of sudden death from CHD was significantly higher than that in control group (557.94? 144.10‰ VS 34.30?20.68‰, p

Objective To understand the causes of death in children and adolescents at 5-19 years of age from 2004 to 2013 in Cixi City. Method According to data of diseases surveillance in Cixi City during the 10 years, the health indexes of mortality, potential years of life lost (PYLL), potential years of life lost rate (PYLL‰), standardized potential years of life lost (SPYLL), standardized potential years of life lost rate (SPYLL‰) were applied to analyze the causes of death and evaluate the burdens of mortality. Result The total mortality of the children and adolescents was 25.56/105, and standardized mortality was 25.26/105. Boys had higher mortality (33.20/105) than girls (17.91/105), and there was statistical significance in the prevalence between male and female. Death of injury&poisoning (13.77/105) and tumors (5.78/105) respectively ranked at the first two leading causes, accounting for 76.46%of total deaths. PYLL was 24 624 years, standardized PYLL was 37 417.02 years, and the rate of PYLL was 2.59‰. Conclusion Injury, poisoning and tumors were the major risk factors among children and adolescents aged 5-19 years in Cixi City. Therefore, effective measures should be taken to strengthen the preventive force and promote the development of comprehensive mental and physical pediatric care.

BACKGROUND:Diabetic cystopathy is one of the most common chronic diabetic complications. The establishment of animal models of diabetic cystopathy wil provide experimental animal platform for relevant research.
OBJECTIVE:To establish a guinea pig model of diabetic cystopathy and to evaluate its urodynamic characteristics.
METHODS:Fifty short-hair Britain female guinea pigs were randomly divided into two groups, 42 as the experiment group and the other 8 as the control group. The experiment group was intraperitoneal y injected with streptozotocin to induce diabetes. The control group received injection of blank citric acid buffered solution. Diabetic guinea pigs were detected by urinary dynamics test at 9 and 12 weeks. Diabetic guinea pigs were further assigned into diabetic cystopathy subgroup and compensated subgroup. The urodynamic parameters of three groups were compared.
RESULTS AND CONCLUSION:Twenty of 42 guinea pigs were successful y induced diabetes by the injection of streptozotocin. At 9 weeks after the injection, bladder function compensation was present in six diabetic guinea pigs while bladder function was decompensated in another three diabetic guinea pigs. At 12 weeks, bladder function compensation was present in one diabetic guinea pig, while another eight guinea pigs were confirmed with diabetic cystopathy (88.89%). In the diabetic cystopathy subgroup, the residual urine volume was increased (0.72±0.08) mL, maximal detrusor pressure was decreased (0.63±0.05) kPa, maximum bladder capacity was increased (2.01±0.05) mL, and bladder compliance was increased (0.34±0.04) mL/kPa. There were significant differences compared with the compensated subgroup and the control group (P<0.001). Diabetic cystopathy occurs at 12 weeks after diabetic models are successful y established in guinea pigs, and urodynamic changes are mainly the increase of residual urine volume.

Objective To study whether Clonorchis sinensis eggs were involved in the pathogen esis of gallbladder stones.Method From March to August 2011,the gallbladder stones from 183 patients were studied using microscopic examination and FTIR spectroscopy.Twenty egg-positive and 20egg-negative gallbladder stones found under microscopic examination were chosen randomly and analyzed through real-time fluorescent PCR and scanning electron microscopy.Results Eggs were detected in 118 of 183 gallbladder stones.The eggs were preliminarily diagnosed as Clonorchis sinensis eggs using the morphologic characteristics under light microscope.The results of real-time fluorescent PCR showed eggs in the gallbladder stones were Clonorchis sinensis eggs.The 118 egg-positive gallbladder stones were composed of 97 pigment stones,21 mixed stones and no cholesterol stones.The detection rate of Clonorchis sinensis eggs in pigment stones were the highest among the three types of gallbladder stones (P＜0.001).The 20 egg-positive stones were observed by scanning electronic microscopy:dozens or even hundreds of Clonorchis sinensis eggs were visible under 400 times magnification; and a dozen or even dozens of Clonorchis sinensis eggs and the surrounding particles were adherent to or parceled with each other under 1000 times magnification.While under 3000 times magnification,uneven texture was seen on the surface of eggs with pieces being shed from some eggs.Some eggs were hollow or without cover.Most of them were adherent to or wrapped with amorphous particles or mucoid matter.Conclusions A large amount of Clonorchis sinensis eggs were detected in gallbladder stones.Clonorchis sinensis eggs were associated with the formation of gallbladder stones,especially with pig ment stones.

Objective:To explore the lipid-regulating effect and safety of atorvastatin combined fenofibrate therapy in patients with coronary heart disease (CHD)complicated diabetes mellitus (DM).Methods:A total of 100 pa-tients with CHD complicated DM were enrolled.Based on routine treatment,patients were randomly and equally di-vided into statin group (n=50,received 20mg atorvastatin,once/night)and combined treatment group (n=50,re-ceived 20mg atrovastatin once/night,combined fenofibrate 200mg once/d).Serum levels of total cholesterol (TC), triglyceride (TG),low density lipoprotein cholesterol (LDL-C)and high density lipoprotein cholesterol (HDL-C) were measured before,six and 12 weeks after treatment,levels and standard-reaching rates of above blood lipid were observed before and after treatment;adverse reactions and clinical events were recorded.Results:Compared with before treatment after six-week treatment,there were significant reductions in serum levels of TC,TG and LDL-C in both groups,and they further decreased after 12-week treatment (P <0.05~ <0.01),compared with statin group after 12-week treatment,there were significant reductions in levels of TC [(4.35±0.71)mmol/L vs. (4.09±0.56)mmol/L],TG [(2.35±0.62)mmol/L vs.(1.65±0.49)mmol/L]and LDL-C [(2.01 ±0.39) mmol/L vs.(1.85±0.22)mmol/L]in combined treatment group,P <0.05 or <0.01;HDL-C level significantly rose in both groups after treatment,and it′s more significant after 12 weeks,but there was no significant difference between statin group and combined treatment group (P >0.05).After 12-week treatment,standard-reaching rates of LDL-C,TG,HDL-C,all standard-reaching of above three indexes and non HDL-C (70%,68%,80%,58% and 70%)in combined treatment group were significantly higher than those of statin group (50%,46%,48%,10% and 48%)respectively,P <0.05 or <0.01. No severe adverse reactions were observed in two groups during treatment. Conclusion:Atorvastatin combined fenofibrate treatment is more effective than atorvastatin monotherapy in patients with coronary heart disease complicated diabetes mellitus.It can improve blood lipid level more comprehensively, contribute to comprehensive standard-reaching of blood lipids,and possess better safety and tolerance.

BACKGROUND:Spine, due to its complicated structure and special functions, is always the difficulty and emphasis in clinical practice and medical education. It is an interesting top how to apply modern software in clinical teaching. OBJECTIVE:To investigate the application of Spine Decide software in clinical teaching of spine surgery. METHODS:Teachers can actively guide students to learn the diagnosis of spine diseases and to design surgery program using Spine Decide software. Then the students wil participate in the surgical operation of the patients, which helps them better understand the diagnosis and treatment of spine surgery disease and the occurrence and development of spine diseases. RESULTS AND CONCLUSION:The students actively participated in the process of learning through Spine Decide software, which helps them learn systematical y, structural y the pathogenesis, diagnosis, treatment and prognosis of spine diseases in a short period. Application of Spine Decide into teaching activities has greatly improved the students’ abilities in self-learning and clinical analysis. Their enthusiasm to the learning and creativity has been greatly improved compared to traditional teaching methods;innovation and exploration have breakthrough improvement, final y achieving a good teaching effect.