Objective To compare the clinical effect of different percutaneous endoscopic removal of nucleus pulposus vertebral plate gap into the road in the treatment of L5 and S1 lumbar intervertebral disc protrusion.Methods 120 cases with lumbar intervertebral disc protrusion in our hospital were randomly divided into group A and group B,60 cases in each group.Group A was given the intervertebral foramen mirror vertebral plate gap into the way,group B was given the posterior intervertebral disc mirror reserves the yellow ligament treatment.The operation time,number of perspective,intraoperative blood loss,length of incision,visual analogue scale (VAS),hospitalization days,Oswestey disability index (ODI) before and after surgery were compared between two groups.The curative effect was evaluated by the Macnab criteria.Results The operation time,number of perspectives,intraoperative blood loss,surgical incision length,VAS score,hospitalization days in group A were (58.69±5.26)min,(2.56±0.52)times,(80.23±20.45)mL,(1.63±0.33)cm,(2.95±0.77)points,(4.98±0.84)d,respectively,those in group B were (60.36±5.31)min,(2.55±0.48)times,(75.69±2.96)mL,(1.56±0.21)cm,(2.98±0.69)points,(5.01±0.86)d,the differences between the two groups were not significant (all P＞0.05).Immediate postoperation and postoperative 3 months,the ODI scores of group A were (36.96±10.58)points,(9.26±0.23)points,(6.35±0.44)points,respectively,and those of group B were (37.02±9.85)points,(9.42±0.65)points,(6.30±0.39)points,immediately after operation,postoperative 3 months,the ODI scores of the two groups were lower than before operation,compared with immediate postoperation,the ODI scores of postoperative 3 months were significantly reduced,the difference was statistically significant (P＜0.05).At immediately after operation,postoperative 3 months,the ODI score between the two groups had no significant difference (P＞0.05).The excellent rate of group A was 90.00％,which of group B was 91.67％,the difference between the two groups was not obvious (P＞0.05).Conclusion Intervertebral foramen mirror the vertebral plate gap into the road and posterior intervertebral disc mirror reserves are yellow ligament in treatment of L5 and S1 lumbar intervertebral disc protrusion will achieve good operation effect,no obvious difference was found between the two methods,before undergoing surgery for the patients'' individual condition and indications for judgment,and to choose appropriate surgical method.

Objective To explore the influencing factors of degenerative lumbar spondylolisthesis (DLS).Methods Sixty-one DLS patients (DLS group) were enrolled in this study.The control group was formed by 61 patients with same gender and age matched.The lesion position was L4 in two groups.The correlation of intervertebral joint angle,degeneration degree,lumbosacral angle and lumbar spondylolisthesis were analyzed.Results The intervertebral joint and sagittal angle in DLS group was less than that in control group[(37.11 ± 7.52)° vs.(42.44 ± 7.61)°] (P ＜ 0.01).The lumbosacral angle between two groups had no significant difference (P ＞ 0.05).The degeneration degree between two groups had significant difference (P ＜ 0.01).Conclusion Intervertebral joint and sagittal angle and intervertebral joint degeneration degree have important roles in DLS.

OBJECTIVE:To establish quality control system by using modern scientific idea and advanced method in in?patient pharmacy.METHODS:Under the situation o f running authentication of ISO9001quality control system in our department,inpatient pharmacy should take the patients as focus to offer good and normative services to patients and clinical departments and continue to make our work better.RESULTS&CONCLUSION:Implementation of ISO9001quality control system has standardized the management of quality of inpatient pharmacy as well as increased the patients'satisfaction.And satisfactory social and economical benefits have been obtained and self-perfect and continuous improvement have been realized in the inpatient pharmacy.

Hepatic artery stricture (HAS) after liver transplantation can lead directly to transplanted liver function exhaustion and complications of biliary system. The early diagnosis and treatment are crucial for better prognosis. Doppler ultrasound is the first method of choice, and angiography can give further clear dignosis. The balloon dilatation is still effective for hepatic arterial stenosis. With the more adaptable usage of oronary stent, if possible, would reveal more promising result especially for tortuous stenotic hepatic artery. The vascular reconstruction or repeated liver transplantation is still the effective therapeutic methods.

Objective To investigate the sensitivity and variability factors that were assessed on the forced swimming test (FST) using BALB/C and Kunming mice. Methods The immobility time of FST was compared using Kunming and BALB/C mice in different experimental conditions including circadian rhythm ( day and night) ,gender and water temperature ( 12,22 and 32℃ ) . Results (①) The immobility time of BALB/C during the daytime( ( 142.42 ± 33.58) s) was significantly increased than that at night ( ( 104.89 ± 34.33 ) s). (② The immobility time of Kunming mice( (91.95 ± 40.32) s) was significantly decreased than that of BALB/C mice ( ( 142.42 ± 33.58 ) s). (③)The immobility time under the water temperature of 22 C ( ( 92.24 ± 25.81 ) s) was significant longer than that under the water temperature of 32C ( (60.72 ± 11.11 ) s). Conclusion BALB/C stain,male mice,daytime and water temperature of 22℃ should be chosen in the FST.

Although the surgical procedure and approach of da Vinci robotic surgical system-assisted radical resection of gastric cancer are gradually mature,it is rarely used for the resection of gastric stump cancer because of the complexity and low resection rate.In November of 2012,resection of gastric stump cancer using da Vinci robotic surgical system was performed in the Southwest Hospital.The short-term efficacy was satisfactory after the follow-up for 12 months.Da vinci robotic surgical system has the advantages of clear vision,easy manipulation of abdominal adhesion detaching,flexible operation and stable traction during resection of gastric stump cancer.

Objective To investigate the clinical value of a new anvil inserting method for esophagogastrostomy or esophagojejunostomy during laparoscopic radical proximal gastrectomy or radical total gastrectomy for gastric cancer.Methods The clinical data of 21 patients with gastric cancer who received laparoscopic radical proximal gastrectomy or radical total gastrectomy at the Southwest Hospital from March 2010 to February 2011 were retrospectively analyzed.Five trocars were inserted through the abdominal wall of the patients.After perigastric lymphadenectomy and mobilization of esophagus,an incision was made on the esophagus above the tumor,and then the anvil with drawn wire attached was inserted into the esophagus.An endo-cutter was applied to cut the esophagus adjacent to the incision left the drawn wire untouched,and then the stem of the anvil was pulled out by the drawn wire for laparoscopic anastomosis. Results The operations were successfully accomplished under the laparoscope with no conversion to open surgery.Fifteen patients received laparoscopic radical total gastrectomy and 6 received laparoscopic radical proximal gastrectomy. The mean operation time,volume of blood loss,time to off-bed activity,passage of flatus and postoperative duration of hospital stay were (257 ± 38) minutes,( 119 ± 32) ml,(2.5 ± 0.5 ) days,( 3.7 ± 0.8 ) days and (7.5 ± 2.6) days,respectively.No perioperative mortality,anastomotic bleeding or anastomotic fistula was detected.One patient was complicated with pulmonary infection + pleural effusion and was cured by conservative treatment; 1 was complicated with anastomotic stenosis which was alleviated by gastroscopic balloon dilation; 1 was complicated by incisional infection and was cured by medical treatment after drainage.No cancer cells were detected at the anastomotic ring or resection margin of the specimen.There were 4 patients with well-differentiated adenoma,8 with moderate-differentiated adenoma and 9 with poor-differentiated mucinous adenoma.There were 5 patients in stage Ⅰ,10 in stage Ⅱ and 6 in stage Ⅲ (UICC staging).Twenty-one patients were followed up for a mean period of (11 ±4) months (range,6-17 months ),no tumor recurrence or metastasis was detected. Conclusions The new technique for anvil insertion is safe,effective and easy for manipulation and learn.It offers a new approach for laparoscopic digestive tract reconstruction.

Objective To evaluate the protection of 3-aminobenzamide (3-AB),an inhibitor of Poly (ADP-ribose) polymerase (PARP),on severe acute pancreatitis associated adenohypophysis injury in rats.Method Forty Wistar rats were randomly divided into 4 groups:sham operation group (SO group,n=8),SAP group (n=12),3-AB pretreatment group (n =12),drug control group (n =8).The bilepancreatic duct was cannulated through the duodenum and SAP model was induced by a standardized pressure-controlled retrograde infusion of 5％ sodium taurocholate (0.1 ml/100 g) into the bile-pancreatic duct.In 3-AB group,3-AB (20 mg/kg) was administered via femoral vein 30 min prior to the operation;other procedures were identical to SAP group.In SO group,pancreas was flipped several times only.In drug control group,3-AB (20 mg/kg) was administered via femoral vein 30 min prior to the operation.Serum amylase,lipase were measured.Pancreas and pituitary tissue were taken for pathological examination under light microscope.PARP and NF-κB antibodies for adenohypophysis immunohistochemical stains.Adenohypophysis cell was observed under electronic microscope.Result Serum amylase,lipase and pancreas pathological scores were significantly higher in 3-AB group compared with SO group (P ＜ 0.05),but lower than that in SAP group (P ＜ 0.05).Adenohypophysis pathological injury was less severe in 3-AB group.Expressions of PARP and NF-κB in adenohypophysis cells were significantly higher in 3-AB group compared with SO group,but lower than that in SAP group (P ＜ 0.05).Ultrastructural change of thyrotroph cell was relieved in 3-AB group.No significant difference was observed between SO group and drug control group in PARP and NF-κB expression nor adenohypophysis pathological injury.Conclusions 3-AB exerts the protective effect against acute pancreatitis associated adenohypophysis injury by inhibition of PARP and NF-κB.

Objective To investigate the changes of poly-ADP-ribose polymerase (PARP) and NF kappa B (NF-κB) in adenohypophysis in rat model of severe acute pancreatitis (SAP),and their role in the mechanism of adenohypophysis injury in SAP.Methods Forty Wistar rats were randomly (random number) divided into 5 groups:the sham operation group (SO group,n =8),SAP 1 h,3 h,6 h and 12 h groups (n =8 in each group).SAP model was induced by retrograde injection of 5％ sodium taurocholate into the biliopancreatic duct.Serum levels of amylase,lipase and ascites were measured.After sacrifice of experiment rats,pancreas and adenohypophysis tissues were taken for pathological examination under light microscope.Adenohypophysis cells were observed under electronic microscopy as well.PARP and NF-κB expressions in adenohypophysis cell was studied by using immunohistochemisty assay.Results After modelling,serum levels of amylase,lipase and ascites in SAP group increased gradually,which were higher than those in SO group (P ＜ 0.05).Adenohypophysis cell swelling and partial necrosis were observed under light microscope.As the time prolonged,their nuclei became dark and pyknotic more and more,and the endoplasmic reticulum and mitochondrial swelling in adenohypophysis cells were observed under electronic microscopy.The expressions of PARP and NF-κB in SAP group increased gradually,which were higher than those in SO group.Conclusions Significant pathological and ultrastructural injuries were observed in adenohypophysis cells in severe acute pancreatitis.These changes might correlate with PARP and NF-κB signaling pathway.

Objective To investigate the incidence and major risk factors of preterm birth in urban hospitals in China so as to provide evidence for effective interventions to reduce preterm birth.Methods Postpartum women delivered between 22 and 37 weeks of gestation were selected from 15 urban hospitals in Beijing,and Guangdong,Hu'nan,Hubei,Sichuan and Shaan'xi Province.Between April 2012 and March 2013,data of 10 days were collected every 3 months.Questionnaire was obtained under informed consent from 9 143 cases,including 958 cases of preterm birth and 8 185 cases of term birth.Demographics,history of pregnancy,prenatal care,and incidences of complication and/or comorbidities,lifestyle and dietary habit during pregnancy were included in the questionnaire.Chi-square test for univariate analysis and logistic regression multivariate analysis were used for statistics.Results The incidence ofpreterm birth was 9.9％(10 986/111 095) in the 15 hospitals.Among the 958 preterm birth cases,2.3％(22/958) were in gestational weeks ＜28,22.7％(217/958) in ≥ 28-＜34 gestational weeks,and 75.1％(719/958) in ≥ 34-＜37 gestational weeks.Univariate analysis showed that the influencing factors related to preterm birth included(preterm birth groups vs term birth group):maternal age ＞40 years or ＜18 years[1.6％(15/958) vs 1.2％(100/8 185),0.6％(6/958) vs 0.1％(7/8 185),22=18.515,P=0.000],ethnic Han [97.7％(919/941) vs 96.3％(7 811/8 115),22=4.819,P=0.028],less educated (lower than junior middle school) [27.1％(257/950) vs 14.9％(1 215/8 132),22=91.879,P=0.000],unmarried status[2.8％(27/955) vs 1.3％(110/8 154),22=12.609,P=0.000],family income ＜5 000 yuan(RMB)/ month [40.5％(380/939) vs 30.8％(2 479/8 060),22=40.457,P=0.000],being preterm born [14.2％(134/942) vs 2.6％(211/8 099),22=349.801,P=0.000],adverse obstetric history [12.9％(72/958) vs 8.5％(346/8 185),22=12.009,P=0.001],previous preterm delivery [50.0％(36/72) vs 17.1％(59/346),x2=36.840,P=0.000],fetal malformation history[4.2％(3/72) vs 18.8％(65/346),22=9.351,P=0.002],reproductive technology assisted conception [7.7％(72/930) vs 2.1％(172/8 037),x22=98.816,P=0.000],antenatal visits ＜5 times [21.0％(195/930) vs 12.0％(966/8 037),22=68.634,P=0.000],second hand smoking [24.5％(235/958) vs 19.6％(1 603/8 185),x2=13.573,P=0.000],unpleasant events during pregnancy [27.6％(264/958) vs 22.0％(1 802/8 185),x2=15.213,P=0.000],folic acid supplementation before and during pregnancy [before pregnancy:39.1％(375/958) vs 49.0％(4 007/8 185);during pregnancy:61.2％(586/958) vs 67.0％(5 485/8 185),x2=31.842,11.667,P=0.000,0.001],multivitamin supplementation during pregnancy [43.4％(416/958) vs 48.1％(3 937/8 185),x2=7.393,P=0.007],and pregnant complications,including anemia,premature rupture of membranes,intrauterine infection,pregnancy complication heart diseases,oligohydramnios,placental abruption,placental previa,fetal distress,multiple gestation,etc [59.9％(574/958) vs 38.9％(3 184/8 185),x2=156.47l,P=0.000].Logistic regression multivariate analysis showed that the following factors were significantly associated with preterm birth:antenatal visits ＜5 times (OR=1.916,95％CI:1.060-3.462),intrauterine infection (OR=5.441,95％CI:1.723-17.176),severe preeclampsia during pregnancy (OR=11.220,95％CI:1.041-2.149),premature rupture of membranes (OR=3.188,95％CI:1.916-5.305) and placenta previa (OR=6.607,95％CI:2.919-14.801).Conclusions There are multiple factors for preterm birth in urban hospitals in east-northern part of China,and quality of antenatal care should be improved and pregnant complications should be closely monitored and managed timely.