Objective To evaluate the clinical efficacy of partial hepatectomy in treating intrahepatolithiasis. Methods The data of 63 cases with partial hepatectomy were retrospectively evaluated. Results All operations were successful. Mean hospital stay was 30.5d. Complications were found in 9 cases (14.3%), including 2 cases of sub-phrenic abacess,2 cases of biliary fistula,4 cases of wound infectiun,1 case of pleural effusion. Residual stones were found in 7 cases (11.1%) ,4 were in left hepatic lobe,3 were in right. 62 cases (98.4%) were followed for 6 months to 8 years. Stones recurred in 2 cases. Conclusion Partial hepatectomy is effective for the treatment of intrahepatoli-thiasis with low residual stone rate.

Objective To explore the methods for training the abitity of critical thinking of ICU nurses.Methods ICU nurses were trained in terms of knowledge training, case study, care rounds, self-reflection, case discussion, simulation training and seminars. The Chinese version of the critical thinking disposition inventory(CTDI-CV)was used before and one year after the training.Result The scores on CTDI-CV as well as the items after training were all significantly higher than that before training(P<0.05).Conclusion The knowledge and ability in critical thinking can be improved by knowledge and skills training.

Mother-to-child transmission (MTCT) is a major route of transmission of syphilis,and may occur at any time during pregnancy.MTCT of syphilis can lead to many adverse pregnancy outcomes,seriously affects maternal and infant health,and has been a severe public health and social problem.The risk of MTCT of syphilis is associated with stage of syphilis in pregnancy,stage of pregnancy,receiving or not receiving treatment,and is especially high in patients with early syphilis.With the growth of incidence of syphilis,the prevention for MTCT of syphilis has been becoming more and more important.Screening for and early treatment of syphilis in pregnancy can effectively block MTCT of syphilis.To learn the epidemiology,route,risk,and associated factors of MTCT of syphilis will undoubtedly facilitate the development of strategies for syphilis prevention and control.

Objective To investigate the anti-inflammatory effects and mechanism of durian peel extracts (DPE). Methods The in vivo anti-inflammation effects of DPE were examined by carrageenin-induced mice paw edema test and allergic contact dermatitis test induced by 2, 4-DNFB. And the in vitro anti-inflammation effects of DPE were evaluated with methyl thiazolyl tetrazolium ( MTT) assay in RAW 264.7 cell model of inflammation induced by lipopolysaccharide (LPS). Results The results of animal experiments showed that DPE groups could markedly relieve mice paw edema induced by carrageenin ( P<0.01 or P<0.001 compared with blank group). DPE could effectively inhibit the allergic contact dermatitis induced by 2, 4-DNFB in mice, showing good dose-effect relationship. The results of in-vitro test showed that DPE at the given concentrations had no influence on RAW 264.7 cell proliferation. Tumor necrosis factor alpha ( TNF-α) , interleukin 6 ( IL-6) , interleukin 1 beta (IL-1β), nitric oxide (NO) and nuclear factor kappaB (NF-кВ ) were observably inhibited, and anti-inflammatory cytokine IL-10 was enhanced by 25 and 50 mg/L of DPE. Conclusion DPE exert potential anti-inflammation effect, and the mechanism might be related to its inhibition of NF-кВsignal pathway.

Objective To investigate the efficiency, safety and application value of early utilization of nutrient of home-made formula in post-operation of gastric fundic cardia cancer patients. Methods One hundred and forty-five cases of gastric fundic cardia cancer patients were randomly divided into two groups,early enteral-intestinal nutrient formula of home-made (enteral-intestinal group,73 cases) and intra-venous nutrition (intra-venous group,72 cases). Patients in enteral-intestinal group were given home-mada nutrition-liquid plus nutrison fibre for 6-8 days from the first post-operation day, intravenous group were given venousnutrition injection for 6-8 days from the first post-operation day. The average residential day, spends,complications and recovery situation were recorded and compared between the two groups. Results The average residential day in enteral-intestinal group was less than that in intra-venous group, average spends /drugs cost were (9433.1±1024.6)/(3271.8±420.9) yuan vs (12 953.4±2919.7 )/(4832.9±872.6) yuan respectively (P < 0.01 ),the complication in enteml-intestinal group was less than that in intra-venous group (P < 0.01 ). Time of revive testinal function in enteral-intestinal group was earlier than that in intra-venous group,ALB in enteral-intestinal group was higher than that in intra-venous group (P < 0.01 ). Conclusion Early enteral-intestinal nutrient utilization of home-made formula in post-operation of gastric fundic cardia cancer patients is safe and applicable, it can improve patients' post-operation nutrition situation and intestinal function.

【Objective】 To identify the main factor or factors w hich contribute to recurrent early spontaneous abortion for clinical diagnosis a nd treatment. 【Methods】 69 cases received the screening examination including inherent, endocrine, anatomical, infective, immunological and contamination hist ory poison metabolic factors, then analyses all factors. 【Results】 Analysing the single factor effecting th e recurrent early spontaneous abortion in the above 7 factors, we found the immun ological factor was 86.2%. Furthermore the immunological factor had significant difference in the various aged groups. 【Conclusion】 Immunological factor is a main factor in recurrent early spontaneous abortion. The immunological factor b ecomes significantly important as the times of spontaneous abortion increasing.

OBJECTIVE:To optimize spray drying process for the raw fruits extract of Psidium guajava. METHODS:Based on single factor,the response surface method was designed to optimize spray drying process condition,using extract rate as index and mass concentration,sampling temperature and sampling speed as factors. The contents and transport rate of total flavones and total polyphenol were determined in each step. RESULTS:The optimal process was as follows as mass concentration of 100 g/L, sampling temperature of 170 ℃,sampling speed of 180 ml/h. Under this condition,the yield of 3 batches of product was(56.08± 0.58)%(RSD=1.04%,n=3). The difference value between test value and predict value was 0.25,without significant difference (P>0.05). The powder of the raw fruits of P. guajava had high contents of total flavones [(17.80 ± 0.09)%] and total polyphenol [(1.23 ± 0.06)%]. The transport rates of them were 87.7% and 25.7%. CONCLUSIONS:Optimized process is feasible to obtain qualified product,and can be used to make medicinal solid preparation.

Objective To determine the concentration of soluble PD-1 (sPD-1) in the sera of patients with recurrent genital herpes (RCH), and to explore the significance of abnormal expression of sPD-1 in RCH. Methods Serum samples were obtained from 88 healthy blood donors, 74 patients with RCH including 34 cases of outbreak-stage RCH and 40 cases of stable-stage RCH. The serum level of sPD-1 was measured by monoclonal antibody labeling and enzyme linked immunosorbent assay (ELISA). Results A significant difference was observed in the serum level of sPD-1 between the patients with RGH and the blood donors (33.06 ± 17.5 μg/L vs. 53.07 ± 26.3μg/L, P < 0.01) and between the patients with outbreak-stage RGH and those with stable-stage RGH (27.47 ± 12.9 μg/L vs. 37.71 ± 19.6 μg/L, P< 0.01). Conclusions There is a low expression of sPD-1 in patients with RGH, which may be one of the mechanisms underlying the escape of HSV- Ⅱ from immunologic surveillance and development of immunological tolerance.

Objective To investigate the diagnosis and prognosis evaluation value of neutrophil elastase (NE) in ventilator-associated pneumonia (VAP).Methods A retrospective analysis was conducted.The data of patients undergoing mechanical ventilation admitted to Department of Central Intensive Care Unit (ICU) of Boai Hospital of Zhongshan City Affiliated to Southern Medical University from September 2012 to October 2015 were enrolled.The patients were divided into two groups according to whether they suffered from VAP or not.The content of NE in serum and bronchoalveolar lavage fluid (BALF) at the time of mechanical ventilation start,VAP diagnosis (the worst value from 48 hours after mechanical ventilation start to weaning in non-VAP patients),and at the time before mechanical ventilation weaning,as well as inflammation parameters,clinical pulmonary infection score (CPIS),duration of mechanical ventilation and prognosis were recorded.Receiver operating characteristic curve (ROC) was used to analyze the predictive value of NE on VAP diagnosis and prognosis.Results Finally 38 patients were enrolled in the VAP group,and 40 in non-VAP group,and baseline data was similar between the two groups.There was no significant difference in the content of NE in serum and BALF between VAP group and non-VAP group [serum NE (μg/L):67.04 (63.00,75.75) vs.69.00 (63.75,75.00),BALF NE (μg/L):96.26 (85.26,176.01) vs.95.26 (86.76,107.11),both P ＞ 0.05].From continuous monitoring,no significant change in the content of NE in serum and BALF during mechanical ventilation was found in the non-VAP group,but the content of NE in serum and BALF at the time of VAP diagnosis in VAP group was significantly higher than that at mechanical ventilation start [μg/L:157.00 (153.04,165.75) vs.67.04 (63.00,75.75),178.04 (153.00,188.25) vs.96.26 (85.26,176.01),both P ＜ 0.05],and NE content in serum and BALF was significantly decreased at the time after VAP clinical recovery and before mechanical ventilation weaning [μg/L:75.67 (64.51,110.55) vs.157.00 (153.04,165.79),95.50 (66.56,183.02) vs.178.04 (153.00,188.25),both P ＜ 0.05].The NE in the start time of VAP in VAP group was divided into four groups according to quartile,it was found that with the increase of NE content in serum and BALF,the CPIS was increased,the duration of mechanical ventilation was prolonged,and the prognosis was poor (all P ＜ 0.01).Compared with non-VAP group,white blood cell count (WBC),neutrocyte proportion,C-reactive protein (CRP),and procalcitonin (PCT) in VAP group were significantly increased (all P ＜ 0.01).NE in BALF was significantly positively correlated with WBC,neutrocyte proportion,CRP and PCT (r value was 0.507,0.432,0.779,and 0.519,respectively,all P =0.000),among which the highest correlation was CRP.NE in BALF used for VAP diagnosis has good accuracy,with sensitivity of 87.4％,and specificity of 90.6％,and sensitivity and specificity of NE in serum for VAP diagnosis was 78.6％ and 79.2％ respectively.Conclusion NE can be used as one of the indicators for VAP diagnosis,and it is related to the prognosis of VAP.

ObjectiveTo investigate the clinical and pathological features of Hirschprung disease (HD), intestinal neuro-nal dysplasia (IND) and hypoganglionosis (IH) in children.MethodsThe clinical data and pathologic slices from 238 children with intestinal dysganglionosis were retrospectively analyzed. The age, sex, involved intestinal length of children and prognosis were compared.ResultsIn 238 patients, 138 (58.0%) were diagnosed by rectal mucosal biopsies. There were 122 HD patients whose median age at diagnosis was 9 months and the ratio of male to female was 4.3:1, without involvement of whole colon. There were 45 IND patients whose median age at diagnosis was 14 months and the ratio of male to female was 1.05:1, and the whole colon of 33.3% patients was involved. There were two male IH patients whose ages at diagnosis were 12 years and 18 years respectively, and their whole colon was involved. There were 59 patients with HD complicated by IND whose median age at diagnosis was 13 months and the ratio of male to female was 5.56:1 and the whole colon of 16.9% patients was involved. There were 10 male patients with HD complicated by IH whose median age at diagnosis was 11.5 months and the whole colon of 80.0% patients was involved. The ages at diagnosis, the sex ratio, the rates of whole colon involved, and the cure rates among 5 groups were signiifcantly different (allP<0.01).ConclusionsThe rectal mucosal biopsy was the main method in diagnosis of intestinal dysganglionsis in children. Patients with HD had higher incidence and mild condition and favorable prognosis. Patients with IH or patients with HD complicated by IH had lower incidence rates and severe condition and poor prognosis, followed by patients with IND or patients with HD complicated by IND.