Objective To investigate the 5-year efficacy of laparoscopic sleeve gastrectomy for the treatment of morbid obesity.Methods The clinical data of 31 patients with severe morbid obesity and related complications who were admitted to the Shengjing Hospital of Chinese Medical University from January 2006 to December 2007 were retrospectively analyzed.The 31 patients received laparoscopic sleeve gastrectomy and were followed up for 5 years to observe the perioperative condition,incidence of long-term complications,application of hypoglycemic drug and insulin before and after operation,the body mass index (BMI) was detected 6 months,1,2,3,4,5 years after operation,and the decrease of excess weight loss (EWL) was analyzed.The remission rate of complications,incidence of complications and the patient satisfaction score were recorded.The count data were analyzed using the chi-square test or Fisher exact probability.Repeated measurement data were analyzed using the repeated measure ANOVA,a Greenhouse-Geisser adjustment was used to correct serial dependency.Results Twenty-five patients were followed up for 5 years postoperatively.Of the 25 patients,4 (16.0％) had gastroesophageal reflux disease,and were cured by medical treatment; 1 patient (4％) had anastomotic stenosis; the percentage of EWL of 2 patients (8.0％) was under 60％ ; 4 patients (16.0％) had occasional obdominal pain.The percentage of patients with diabetes mellitus was decreased from preoperative 9.7％ (3/31) to postoperative 4.0％ (1/25),with a significant difference (P ＜ 0.05).The percentage of patients with fatty liver was decreased from preoperative 93.5％ (29/31) to postoperative 32.0％(8/25),with significant difference (x2=19.10,P ＜ 0.05).The percentage of patients with hyperlipidemia was decreased from preoperative 77.4％ (24/31) to postoperative 12.0％ (3/25),with significant difference (x2 =35.51,P ＜ 0.05).The level of BMI was decreased from preoperative (38.8 ±4.2) kg/m2 to postoperative (28.5 ± 3.1) kg/m2,with significant difference (F =113.36,P ＜ 0.05).The percentage of EWL was increased from preoperative 42％ ± 11％ to postoperative 69％ ± 16％,with significant difference (F =41.71,P ＜0.05).There was no significant difference in the patient satisfaction score between each year within the 5 years (F =0.92,P ＞ 0.05).Conclusions Laparoscopic sleeve gastrectomy is effective in losing weight with few long-term complications.

Objective To examine whether ghrelin has beneficial effect on survival of pancreatic INS-1 beta cell.Methods Rat INS-1 cells were cultured separately in 5.6 mmol/L glucose (NG group),33.3 mmol/L glucose (HG group),33.3 mmol/L glucose plus 10 nmol/L acylated ghrelin (HG+AG group),and 33.3 mmol/L glucose plus 10 μmol/L unacylated ghrelin(HG+UG group).After being incubated for different hours,cell suvival rate was determined by MTT.Activity of caspase-3 was estimated by spectrophotometry,activity of GRP78,and cytochrome c was analyzed by confocal microscopy.Results Both acylated ghrelin and unacylated ghrelin inhibited the rise in activity of GRP78,caspase-3,and cytochrome c induced by sustained high glucose.Conclusions These findings indicate that ghrelin is able to inhibit endoplasmic reticulum stress and mitochondrial dysfunction of INS-1 β-cell caused by persistent high glucose,and the effect of ghrelin is not affected by acylation.

Objective To understand the status quo of human papillomavirus (HPV) infection and its genotypes distribution a-mong gynecological outpatients in Chengdu region .Methods The DNA microarray technique combined with PCR and DNA reverse hybridizatio technology was used to detect the genotypes of HPV infection .The data were analyzed by the SPSS 13 .0 software .Re-sults A total of 5 052 samples of cervical exfoliated cells among gynecological outpatients were detected ,and the total positive rate of HPV infection was 17 .52% .The differences of HPV infection among various age groups were statistically significant ,especially the positive rate of HPV infection in the 20-25 years age group was higher than that in the 26-30 years age group and the 31-35 years age group(P<0 .05) ,and which in the 36 -40 years age group was also higher than that in the 26 -30 years age group (P<0 .05) .The positive detection rate of high risk HPV subgenotypes was 18 .1% ,which was higher than 5 .5% of low risk sub-genotypes with statistical difference (P<0 .01) .HPV 52 was the most frequent subgenotypes in high risk subgenotypes ,accounting for 15 .03% ,followed by HPV 16 and HPV 58;HPV 81 was the most frequent subgenotypes in low risk subgenotypes ,accounting for 7 .98% .Conclusion The positive rate of HPV infection among gynecological outpatients is higher ,and the majority of geno-types are high risk .It is suggested that the routine examination of HPV subgenotypes detection focused on different age groups should be recommended .

Learning guidance in pathology teaching can help to improve the students' learning ability. Learning guidance can be mainly done in two aspects:developing and fostering the students' learning ability on their own and guiding the students to review scientifically.

The clinical data of a child with perianal necrotizing fasciitis admitted to the Department of Pedia-trics of Guangzhou First People′s Hospital were retrospectively analyzed.The child, girl, more than 5 months old, the clinical features of the onset of fever and diarrhea, only 10 days after the onset, the child′s skin progressed from redness and swelling to perianal skin and soft tissue ulcers, fat liquefaction, visible rectum exposure.After surgical incision, thorough debridement and drainage and selection of sensitive antibiotics, the child recovered and was discharged.Perianal necrotizing fasciitis is a rare necrotizing soft tissue infection caused by a variety of bacterial infections.Because its early performance is difficult to distinguish, the symptoms are serious, and the mortality rate is high.It should been pain attention in clinical work.

Objective To establish the system of qualified training standard and allocation criteria in pain specialist nurses.Methods Thirty-two experts were invited to a two-round consultation to establish the system of qualified training standard and allocation criteria. SPSS and Yaahp software were applied to determine the level Yaahp indicators mean, coefficient of variation and weights.Results The system had six primary indicators and twelve secondary indicators. There were four major contents including professional theory(basic knowledge and theories), professional skills(pain care skills, pain specialist equipment use and pain specialist drug use), professional qualities(professional ethics, teamwork spirit, management skills and critical thinking), and professional development capacity(ability of research, teaching and further development). The ratio of doctors and nurses was 1︰1.29. The staffing level for nurses was approximately 90%. Conclusions Professional theory and professional skills are important parts of the qualified training standard and allocation criteria system in pain specialist nurses. The allocation ratio for doctors and nurses should be controlled at 1︰1.29. The staffing level for nurses is approximately 90%.

Objective The investigation was done in one level three class A cancer hospital in Henan province to understand the nurses′master level of cancer pain and whether nurse have the right concept of cancer pain management. Methods Through cluster sampling, self-designed nurses pain knowledge questionnaire was used to investigate 580 nurses for the master level of cancer hospital in a level three class A cancer hospital in Henan province. Results Among 580 nurses, the cancer related knowledge investigation score were 318 nurses acquired excellent (54. 8%), 27 nurses acquired pass (35. 7%) and 55 nurses obtained fall (9. 5%). There were 373 nurses ( 64. 34%) understood the cancer three stages pain management plan. The nurse′s ages, occupational titles and work experiences of cancer nursing had positive correlation with the score of cancer related knowledge (r=0. 211, 0. 268, 0. 207;P<0. 01). Conclusions At present, the cancer hospital nurse′s master of knowledge related cancer pain is not enough, so we should enhance nurse′s pain related knowledge level, establish the correct concept of pain management, promote cancer patient′s quality of life by the continuous study and updated concept, knowledge and practice, so as to meet the demands of clinical.

Objective To analyze the levels of IgE,TNF-α and FeNO in children with acute attack of bronchial asthma and their correlation with the severity of bronchial asthma, so as to provide theoretical basis for clinical evaluation of bronchial asthma. Methods A total of 547 children with acute bronchial asthma treated in Chengdu Women and Children's Central Hospital from January 2020 to December 2020 were selected and divided into mild group (n=287), moderate group (n=186) and severe group (n=74) according to the severity of their disease. All the children's symptoms were controlled after treatment. The serum IgE, TNF-α and FeNO levels in the experimental group were compared between the acute attack stage and the clinical control stage. Spearman correlation analysis was used to analyze the correlation between the serum IgE, TNF-α and FeNO levels and the severity of the disease. ROC curve of children with bronchial asthma was drawn to analyze the differential diagnosis value of serum IgE, TNF-α and FeNO levels in children with acute bronchial asthma. Results The levels of IgE, TNF-α and FeNO in acute stage were significantly higher than those in clinical control stage (P<0.05). The levels of serum IgE, TNF-α and FeNO in severe group were higher than those in mild and moderate groups significantly (P<0.05). The levels of serum IgE, TNF-α and FeNO in moderate group were higher than those in mild group significantly (P<0.05). Spearman correlation analysis showed that serum IgE, TNF-α and FeNO water were positively correlated with the severity of bronchial asthma (r=0.419 , 0.438 , 0.502 , P<0.05). ROC curve analysis showed that the AUC, sensitivity, accuracy and specificity of serum IgE, TNF-α and FeNO levels combined in diagnosing the severity of bronchial asthma in patients with acute attack was 0.938 (95% CI: 0.912-0.982 ), 83.47%, 92.06%, 94.28%. Conclusion The level of serum IgE, TNF-α and FeNO in children with acute attack of bronchial asthma is closely related to the severity of the disease, and combined detection of the three can be used to evaluate the severity of the disease in children.