Objective To assess the influence of full-thickness continuous suture method and layer interrupted suture method in emergency abdominal operation closure.Methods Two hundred and thirtyseven patients of emergency abdominal operation were divided into full-thickness continuous suture method group (145 cases) and layer interrupted suture method group (92 cases) according to the suture method.The rate of incision liquefaction and infection,time of incision suture were compared between the 2 groups,the patients with incision liquefaction and infection were given bacterial culture.Results The time of incision suture in full-thickness continuous suture method group was significantly shorter than that in layer interrupted suture method group [(18.37 ± 7.42) min vs.(25.92 ± 5.79) min],there was statistical difference (P ＜0.01).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between the 2 groups (P ＞ 0.05).In full-thickness continuous suture method group,the rate of incision liquefaction and infection in median incision was significantly lower than that in rectus abdominis incision [18.58％ (21/113) vs.31.25％ (10/32)],the rate of incision primary healing was significantly higher than that in rectus abdominis incision [81.42％ (92/113) vs.68.75％ (22/32)],there were statistical differences (P ＜ 0.05).In layer interrupted suture method group,there were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing between median incision and rectus abdominis incision [33.33％ (23/69) vs.26.09％(6/23),66.67％ (46/69) vs.73.91％ (17/23),P ＞ 0.05].The rate of incision liquefaction and infection in median incision of full-thickness continuous suture method group was significantly lower than that in median incision of layer interrupted suture method group,and the rate of incision primary healing was significantly higher than that in median incision of layer interrupted suture method group,there were statistical differences (P ＜ 0.05).There were no statistical differences in the rate of incision liquefaction and infection,the rate of incision primary healing in rectus abdominis incision between the 2 groups (P ＞ 0.05).The bacterial culture result in patients with incision liquefaction and infection showed positive was in 26 cases,in full-thickness continuous suture method group was in 10 cases (6.90％,10/145),in layer interrupted suture method group was in 16 cases (17.39％,16/92),there was statistical difference (P ＜0.05).The mostly bacterial of infection was Escherichia coli.Conclusions The full-thickness continuous suture in median incision can shorten operative time and reduce the rate of incision liquefaction and infection in emergency abdominal operation.Suture technique has important impact on incision healing.

Objective To observe the clinical feasibility and effects of regional nerve blockade in patients with heart failure.Methods The study enrolled a total of 10 patients,age range from 55 to 75 years old(average 64?11 years old).The subject includes 8 males and 2 females,among which 6 cases were ischemic cardiomyopathy and 4 cases were dilated cardiomyopathy.All the patients met the criteria of NYHA class Ⅲ-Ⅳ heart function with heavy fluid load unresponsive to optimal medical therapy.Patients with diabetes and renal failure were ruled out from the study.After application of local anesthesia,15 mL of 0.25% Naropin was injected inside Gerota's fascia to achieve regional nerve blockade under CT guidance.Serum and urine electrolytes,neurohormones,renal clearance of sodium and 24-hour urine volume were recorded 24 h before and after the operation.Variartions in heart rate,blood pressure and symptons of dyspnea and edema were also under monitor.Results After nerve blockade,the 24-hour urine volume and renal sodium clearance increased obviously while the level of neurohormones decreased compared with that before operation.No obvious changes in heart rate and blood pressure were recorded and the symptons of heart failure were improved in the patients after operation. No complication was recorded in the study. Conclusion Regional nerve blockade may be a feasible,safe and effective treatment for congestive heart failure patients who do not respond well to the existing optimal medical therapy.

Objective To summarize the nursing methods for patients with chronic congestive heart failure treated with local renal nerve block. Methods 10 cases of patients with chronic congestive heart failure were treated with renal nerve block. The blood and urine electrolytes, plasma neuroendocrine hor-mones, the 24-hour urine volume were measured before and after the renal nerve block to calculate the rate of excretion of urinary sodium. The changes of the heart rate and blood pressure and the improvement of the dyspnoea, swelling and other symptoms of heart failure were monitored continuously before and after the re-nal nerve block. Results There was a significant increase in the 24-hour urine volume and the rate of excretion of urinary sodium in the patients with heart failure after the renal nerve block (P<0.05),and there was a significant decrease in the amount of plasma neuroendocrine hormones after the renal nerve block (P<0.01);there was no signifieant changes in the heart rate and the average blood pressure with improvement of dyspnoea, swelling and other symptoms of heart failure. No significant complications were found. Conclusions The nursing measures taken by the nurses in the clinical application of local renal nerve block as a new treatment modality to the treatment of patients with chronic congestive heart failure are safe, effective and feasible.

Objective To analyze the genotype distribution of human papillomavirus( HPV) strains and their epidemiological characteristics in cervixes of Chinese females. Methods Pertinent litera-tures published during 2004 to 2013 were screened from PubMed,China National Knowledge Infrastructure (CNKI)and Wanfang database for data analysis. Results There were 245 studies screened out for the me-ta-analysis. A total of 661 658 cases met the inclusion criteria,ranging from 16 to 87 years old. All prov-inces and territories of China were covered by the data. The overall rate of HPV infection in cervix was 25. 0% among Chinese females. The predominant high risk genotype of human papillomavirus strains was HPV16,followed by HPV52,HPV58,HPV18,HPV33 and HPV31. HPV52 and HPV58 genotypes were more prevalent than HPV18 genotype. HPV35 and HPV45 genotypes were less popular. Conclusion The study suggested that the HPV infection showed obvious regional differences in genotypes. The genotype dis-tribution of HPV infection in China was different from that in other regions of the world. There were differ-ences with genotype distribution of HPV strains among seven geographic regions of China.

Objective:To investigate the imaging and clinical feature of leukoencephalopathy with hearing loss first complaint.Method:The head MRI and clinical feature of 7 cases leukoencephalopathy with hearing loss first complaint were retrospectively analysed,including their place,shape,range and blood plasma very-long-chain fatty acid(VLCFA).Result:The head MRI of 2 cases shows symmetry distributed long T_1 and T_2 signal like butterfly aliform in white matter beside both cornu posterious ventriculi lateralis.The head MRI of 5 cases shows abnormal long T_1 and T_2 signal in different part in Alba.The pathological changes often located in white matter of frontal lobe and secondly beside both eornu posterious ventriculi lateralis.The shape shows little patching in 7 cases.The range only shows beside cornu posterious ventriculi lateralis in 2 cases.The range only shows in frontal lobe in 1 cases.Two or more than two parts shows in the rest 5 cases.The result of VLCFA is normal in 3 cases.The rest 4 cases refused to have examination of VLCFA. Conclusion:The patient who firstly complained of hearing loss should be routinely done head MRI.The head MRI imaging could clearly show abnormal white matter in order to avoid omitting existent pathological changes.

BACKGROUND:Deep vein thrombosis after total knee arthroplasty has attracted increasing attention in recent years,but how to detect deep vein thrombosis in the early time in clinical practice remains unclear.Whether it is necessary to perform type-B ultrasonic or other invasive examination in lower limbs has become a hot issue.OBJECTIVE:To explore the significance of D-Dimer and fibrin degradation products in the prediction of deep vein thrombosis after total knee arthroplasty.METHODS:56 patients received total knee arthroplasty were colected from Department of Orthopedics,The 306th Hospital of Chinese PLA,between December 2012 and February 2014.The D-Dimer and fibrin degradation products were dynamicaly monitored before operation and at 1,3,5,7,10 days post-operation.Al the patients received type-B ultrasonic examination in double lower limbs at 10 days post-operation,and divided into thrombus group and non-thrombus group.The D-Dimer and fibrin degradation products in the two groups were compared.RESULTS AND CONCLUSION:Deep vein thrombosis was found in 13 cases by ultrasonic-B postoperation,D-Dimer and fibrin degradation products showed no significant difference between the two groups at 1 week after operation (P＞0.05),but the difference was significant at 10 days (P＜0.01).D-Dimer and fibrin degradation products index should be monitored dynamicaly for at least 10 days after operation,which is helpful for the earlydiagnosis of thrombosis.

The enantiomers separation of thirteen drugs collected in Ch.P2010 was performed on chiral stationary phase of cellulose ramification (chiralpak OD and chiralpak OJ) by high performance liquid chromatographic (HPLC) methods,which included ibuprofen (Cl),ketoprofen (C2),nitrendipine (C3),nimodipine (C4),felodipine (C5),omeprazole (C6),praziquantel (C7),propranolol hydrochloride (C8),atenolol (C9),sulpiride (C10),clenbuterol hydrochloride (C11),verapamil hydrochloride (C12),and chlorphenamine maleate (C13).The mobile phase consisted of isopropanol and n-hexane.The detection wavelength was set at 254 nm and the flow rate was 0.7 mL/min.The enantiomers separation of these thirteen racemates on chiralpak OD column and chiralpak OJ column was studied,while the effects of proportion of organic additives,alcohol displacer and temperature on the separation were studied.And the mechanism of some of racemates was discussed.The results indicated that thirteen chiral drugs could be separated on chiral stationary phase of cellulose ramification in normal phase chromatographic system.The chromatographic retention and resolution of enantiomers could be adjusted by factors including column temperature and the concentration of alcohol displacer and organic alkaline modifier in mobile phase.It was shown that the resolution was improved with reducing concentration of alcohol displacer.When concentration of organic alkaline modifier was 0.2％ (v/v),the resolution and the peak shape were fairly good.Most racemates mentioned above had better resolution at column temperature of 25 ℃.When racemates were separated,the temperature should be kept so as to obtain stable separation results.

Objective To evaluate the immunogenicity of group A and C meningococcal polysaccharides conjugates using different proteins as carriers. Methods Heat-labile enterotoxin B subunit (LTB)pentamer form was expressed in E. coli. The target protein was identified and purified by cation-exchange chromatography. Then biological activity of rLTB was tested using GM1-ELISA. GCMP was conjugated to rLTB with the chemical method (ADH). Furthermore, the mice were immunized with GAMp-TT/GCMP-TT conjugates and GAMP-TT/GCMP-rLTB conjugates via peritoneal. Finally the anti-polysaccharide antibody was detected. Results The GAMP-TT/GCMP-rLTB conjugate elicits remarkably higher serum antibodies in mice than GAMP-TT/GCMP-TT conjugate. Conclusion These results indicated that polysaccharide conjugates using different proteins as carriers were superior to those using only one protein as carrier.

Objective To conclude and compare the technical characteristics and clinical efficacy of retroperitoneal and transperitoneal approach for robotic partial nephrectomy.Methods 418 patients received robotic partial nephrectomy conducted by one surgeon in the urology department of PLA General Hospital from 2013, December to 2015, October, including 157 cases in retroperitoneal approach and 261 cases in transperitoneal approach.There were no significant difference between the transperitoeal and retroperitoneal approach in patient age(51 years, 51 years, P=0.593), BMI(25.5 kg/m2,25.6 kg/m2, P=0.331), gender(male/female:111/46,186/75,P=0.184), location(left/right,80/77,123/138,P=0.575), tumor size(3.1cm,3.5cm,P =0.356), comorbidities, proportion of solitary kidney(11.5%, 9.6%,P=0.253) or bilateral tumors(1.3%,3.4%,P=0.179), RENAL score(6(5-8),6(5-8),P=0.083), ASA score(2 vs.2)(P=0.310) and preoperative serum creatinine(74.7 μmol/L,76.7 μmol/L, P=0.736).Patients in the retroperitoeal approach group were more likely to have abdomen surgery history (21.7%,14.2%,P=0.049).there was significant difference between two approaches in tumor location in the kidney ( anterior/posterior/others: 9/140/8, 212/36/13, P <0.001 ) Results The operation time (105min, 115min, P =0.041 ) and warm ischemia time ( 15min, 20min, P <0.001 ) were shorter and estimated blood loss(50ml,75ml,P<0.001) was less in the retroperitoneal group.No significant difference was observed in postoperative 24h blood loss(45ml,50ml,P =0.093), intraoperative transfusion rate (2.5%,6.5%,P=0.072) and collective system injury(24.8%,27.6%,P =0.539) between the two groups.Peritoneum break occurred in 25 cases in retroperitoneal group, which were repaired by Hem-o-lock.One intestinal injury occurred in transperitoneal group and was repaired intraoperatively.Three and nine cases in the retroperitoneal and transperitoneal group were converted to radical nephrectomy.One case in the transperitoneal group was found positive margin and received laparoscopic radical nephrectomy.Two liver injury and five spleen injury occurred in the transperitoneal group.For postoperative food intake(1 day, 2 days, P <0.001 ) , the length of indwelling drainage ( 3 days, 4 days, P <0.001 ) and the length of postoperative stay ( 5 days, 6 days, P =0.001 ) , the retroperitoneal group had one day shorter than the transperitoneal group.With the median following-up time of both group, 11 months (IQR:6-16) in RPRPN group and 12 months ( IQR: 7-19 ) , no subject with a tumor recovery or metastasis.Conclusions Retroperitoneal robotic partial nephrectomy is feasible and effective, which is similar to transperitoneal approach.The retroperitoneal approach is superior to transperitoneal approach for posterior, lateral and superior renal tumors.

Objective To evaluate the immune effects of virus-like particles ( VLPs) of VP1 pro-teins derived from norovirus GⅠ. 1 and GⅡ. 4 genotypes expressed in Hansenula polymorpha expression sys-tem. Methods SDS-PAGE and Western blot assay were performed to detect the purity of GⅠ. 1 and GⅡ. 4 VP1 proteins after purification. Morphologies of the recombinant VLPs were observed under transmission electron microscopy ( TEM) . Sizes and distributions of the VLPs were analyzed by dynamic light scattering analyzer. BT50(50% of blocking titer) was detected by HBGA (histo-blood group antigen) blocking assay in BALB/c mice immunized with different regimens. Results SDS-PAGE analysis of the purified recombinant GⅠ. 1 and GⅡ. 4 VP1 proteins showed that their purity were greater than 90%. Western blot assay con-firmed the specific bands of VLPs. TEM images showed that the sizes of purified GⅠ. 1 and GⅡ. 4 VP1 VLPs were at a mean diameter of 30-50 nm with clear border and high homogeneity, which was similar to that of wild virus. BT50 significantly increased in the groups, in which Al( OH) 3 was used as adjuvant. Con-clusion Animal studies have shown that administration of GⅠ. 1 and GⅡ. 4 VP1 VLPs in the presence of Al( OH) 3 induces detectable HBGA-blocking antibody, indicating that GⅠ. 1 and GⅡ. 4 VP1 VLPs are promising candidates for norovirus vaccine.