Objective To explore the sensitivity and constancy of BNP in evaluating the therapeutic effect of congestive heart failure.Methods 80 patients made a definite diagnosis of congestive heart failure were selected and whose cardiac functional grading of NYHA,BNP and left ventricular ejection fraction (LVEF) were determined respectively pre-treatment,one week,one month and three months after-treatment.Statistical analysis on the difference of therapeutic effect was performed for each case.Results No statistical difference was found between the amplitude of BNP and LVEF in one week and on one month, three months pro-treatment by the scheme of captopril combining with metoprolol (P>0.05 ).But between the BNP and the cardiac functional grading,statistica difference was found in the fitst week pro-treament(P<0.05),when on one month and three months after treatment the statistical difference still not found(P>0.05).Conclusion BNP dynamic measuring had the hige sensitivity and constancy in quantitatively analysing the therapeutic effect of congestive heart failure which could be used as a reliable tool for evaluating the therapeutic effect of congestive heart failure.

Objective To investigate the effects of oxiracetam combined with Shuxuetong injection on hemorheology and serum Hcy levels in patients with cerebral infarction. Methods 60 patients with cerebral infarction were randomly divided into 2 groups, 30 cases in the observation group and were treated with oxiracetam combined with Shuxuetong injection. 30 cases in the control group were treated with Shuxuetong injection. The hemorheology and serum Hcy levels in the two groups were compared. Results After treatment, the hemorheological indexes and serum Hcy levels in the observation group were lower than those in the control group (P<0.05). The treatment effect of the observation group was better than that of the control group (P<0.05). The scores of neurological deficits in the observation group were significantly better than those in the control group (P<0.05). The number of complications in the observation group was 2 cases, the incidence of complications was 6.7%, which were significantly lower than 9(30.0%) in the control group, the differences between the two groups was statistically significant (P<0.05). Conclusion The application of oxiracetam combined with Shuxuetong injection in patients with cerebral infarction can effectively improve the hemorheology and reduce the serum Hcy level.

Objective To investigate the medication advancement of gastrointestinal polyposis in patients with Peutz-Jeghers syndrome(PJS).Methods Literatures about the medication advancement on gastrointestinal polyposis of PJS were reviewed and analyzed.The recent development of targeting drugs,especially the data of cyclooxygenase-2 selective inhibitors and rapamycin,were emphatically summarized.Results With the deep investigation of PJS and application of selective drugs,the medication of gastrointestinal polyposis in cases of PJS has got more advancement.The extensive use of synthetic cyclooxygenase-2 inhibitors and rapamycin in clinic developed a new way to treat gastrointestinal polyposis of PJS.Conclusion The cyclooxygenase-2 selective inhibitors and rapamycin have the following features: noninvasive,high selectivity and good curative effects.They have splendid prospects in the clinical treatment of gastrointestinal polyposis in patients with PJS and are bring the treatment of gastrointestinal polyposis in cases of PJS into a targeting therapy phase.

Objective To analyze clopidogrel combined with aspirin therapy of acute cerebral infarction the safety and efficacy of micro brain hemorrhage patients.Methods Select from May 2015 and May 2015 months in the hospital for diagnosis and treatment of 76 cases of acute cerebral infarction combined micro cerebral hemorrhage patient study,observation group in the conventional treatment at the same time giving oral aspirin and clopidogrel,the control group in the conventional treatment at the same time,only to give oral aspirin.To observe the nerve function defect National institutes of Health stroke scale score(National Institute of Health stroke scale,NIHSS)and daily life activities ability pap index,determination of patients' blood plasma viscosity,whole blood low shear viscosity,AA induction and the platelet maximum aggregation rate induced by ADP(MARAA,MARADP),observation records during the treatment patients with adverse reactions,were analyzed.Results Compared with before treatment,the observation group and control group after treatment for 2 weeks,NIHSS score,score and blood related indexes were significantly improved,statistically significant difference(P< 0.05).Compared with control group,the observation group after treatment the NIHSS score,pap score and blood related indexes were significantly improved,total effective rate increased significantly,the differences were statistically significant(P< 0.05).Two groups of adverse drug reactions occurred situation is no statistical difference.Conclusion Clopidogrel in combination with aspirin can effective treatment in patients with acute cerebral infarction combined micro brain hemorrhage,and security.

To elucidate the mechanism of Pai Pei Tang in combination with mifepristone in termination of early pregnancy, samples of apoblema (5 each) were collected from the Pai Pei Tang group, mifepristone group, Pai Pei Tang and mifepristone group (N = 68) and routine artificial abortion group (N = 22). We found that atrophy of the decidua and chorion was the utmost in the Pai Pei Tang and mifepristone group under the electron microscope. The result suggested that Pai Pei Tang could induce degenerative and atrophic changes in the decidua and affect the chorion directly.

Objective To analyze the common causes and clinical features associated with hoarseness in chil-dren of different ages. Methods The data of 2 500 children suffering from hoarseness were analyzed with electronic [aryngofiberscopy retrospectively. Results There were 1 746 males and 754 females. The top 5 causes of hoarseness were vocal cord nodules(44.2%, 1 105 cases), vocal hypertrophy (38.2% ,955cases), acute and subacute laryngitis (6.5 %, 163cases), the paralysis of vocal cord(6.82 %, 141cases), and laryngeal papilloma(1.6 %, 40cases). These five diseases were common in children with hoarseness with 2 404 out of 2 500. 37.12% of the children were under school ages as the largest age group and the ratio of male and female was 2.32 : 1. The top five diseases were statisti-cally distributed in different age groups (P<0.01) . Conclusion The main causes of hoarseness were different in different age groups. The preschoolers made up the largest group (928/2 500), showing the greatest incidence of hoarseness in children . The incidence for male patients was higher than female and the vocal cord nodules was the top disease (1 105/2 500 cases,44.2%). Hoarseness in children was different from that of adults so that to under-stand the characteristics of this disorder in children will be beneficial to the proper diagnosis and effective treatment.

Objective To investigate the diagnosis and treatment of latent perforation of peptic ulcer (LPPU) during laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 13 cases of LPPU diagnosed during LC from January 1994 to November 2005. Results All the 13 cases were misdiagnosed before the LC and clarified as having LPPU during the LC. Three cases of anterior duodenal bulbar perforation (0.4~0.5 cm in size) were laparoscopically repaired, whereas conversions to open repair were performed in 5 cases of duodenal perforation (0.5~1 cm in size) and 5 cases of gastric perforation (0.6~1 cm in size) because of severe adhesion or difficult performance. No surgical complications occurred. Twelve cases were followed for 6~36 months (mean, 27 months). The symptoms disappeared and gastroscopy showed healed ulcer. No recurrence of perforation was found. Conclusions Underestimation of LPPU leads to misdiagnosis, and preoperative gastrosopy can prevent it. For small perforation, laparoscopic repair and abdominal drainage can be employed. But in most cases, a conversion to open surgery is required. It is necessary to give regular internal medicine for peptic ulcer after operation.

Objective To investigate laparoscopic treatment of hepatic cysts in the right posterior lobe.Methods A four-port laparoscopic fenestration and drainage was performed in 35 patients with symptomatic hepatic cysts in the right posterior lobe(the lesion was located at the segment Ⅳ in 21 patients and at the segment Ⅶ in 14 patients) from January 1998 to December 2005.For cysts located at the superior segment of the right posterior lobe,the operation was performed through the suprahepatic approach. The liver was pressed along the anterior and inferior direction by using a pair of traction tongs for the exposure of hepatic cysts.Then the cyst was fenestrated and filled with pedicled greater omentum.For cysts located at the inferior segment of the right posterior lobe,the operation was conducted through the infrahepatic approach.The hepatocolic ligament,right triangular ligament,and connective tissues between the liver and the kidney were opened by using a harmonic scalpel.The liver was lifted with the traction tongs,and the cyst was fenestrated and filled with greater omentum.Results Laparoscopic fenestration and drainage was accomplished in all the 35 patients,without conversions to open surgery.The suprahepatic approach was adopted in 15 patients and the infrahepatic approach,in 20 patients.The operation time was 30～95 min(mean,46 min).No surgery related complications occurred.Pathological examinations in the 35 patients showed congenital cysts of liver.After operation,patients' symptoms all disappeared.The postoperative hospitalization time was 2～5 days (mean,3.8 days).All the 35 patients were followed for 6～36 months(mean,34 months).The cyst did not completely disappeared but significantly subsided in 2 patients(suprahepatic approach),without remarkable symptoms.The cysts were not obviously enlarged within 6 months.Conclusions Laparoscopic fenestration and drainage via suprahepatic or infrahepatic approach is an effective treatment for hepatic cysts in the right posterior lobe.

OBJECTIVE To reinforce the management of occupational risks among cleaner employec to lower the occurrence of job related exposure.METHODS Set up a survey to estimate the level of the awareness and knowledge among the cleaner employec about job related exposure and protective procedures in the three medical facilities of Yueqing City.RESULTS From 183 cleaner employec,sharp object cuts accounted for 89.6% per year;45.4% of them only had elementary education or less;39.3% of them wore protective gloves voluntarily during daily work.No one followed the hand hygeine procedures.It showed that the contracted cleaning workers had a huge potential occupational risks.CONCLUSIONS Cleaner employec are the weaker point of occupational exposure protection in the hospitals.Enforceing the mandatory immunization and monitoring their occupational risks and exposures can prevent incidence.

Objective To analyze the common causes and clinical features associated with hoarseness in children of different ages.Methods The data of 2 500 children suffering from hoarseness were analyzed with electronic laryngofiberscopy retrospectively.Results There were 1 746 males and 754 females. The top 5 causes of hoarseness were vocal cord nodules(44.2%,1 105 cases),vocal hypertrophy (38.2%,955cases),acute and subacute laryngitis(6.5%,163cases),the paralysis of vocal cord(6.82%,141cases),and laryngeal papilloma(1.6%,40cases). These five diseases were common in children with hoarseness with 2 404 out of 2 500. 37.12% of the children were under school ages as the largest age group and the ratio of male and female was 2.32:1. The top five diseases were statistically distributed in different age groups (P