Objective To investigate the clinical effect of different local anesthetic epidural anesthesia for cesarean section. Methods 60 maternal intended to be carried out cesarean section by epidural anesthesia were randomly divided into two groups. A group(n =30 cases) was administrated with 0.5% ropivacaine to anesthesia,and B group(n = 30 cases) was administrated with 0. 5% bupivacaine to anesthesia. The changes of hemodynamic were monitored,and the analgesic effect and adverse reactions were observed in the two groups. Results The differences of blood pressure, heart rate had no statistical significance between the two groups (all P＞0.05);Compared to B group, the anesthesia onset time, anesthesia time between the start of fetus, analgesic effect, adverse reactions of A group were significantly different (t = 4. 347,4. 528, x2 = 3. 834, 6. 429, all P ＜ 0. 05 ) ; Neonatal Apgar score showed no significant differences between the two groups ( P ＞ 0. 05 ). Conclusion Anesthesia with 0.5% ropivacaine for cesarean section had satisfactory anesthesia effect,and less adverse reactions.

Acid polysaccharides in pinecone were determined quantitatively by sulfuric acid-carba zole colorimetry and the influence of amount of sulfuric acid carbazole, reaction temper ature and time forcolor-reaction were investigated. The maximum abstrption was found to be at 520nm. The absorbance was a linear function of concentrations between 0 and 7 ?g/ml acid polysaccharides (r = 0.9999, n = 7). Analytical recovcry was 91.0%～99.8% . RDS was 1.3%～2.3% (n = 6 ). The minimum detectable concentration was 0.05?g/ml.

T)of PTCH2 were identified and 9 polymorphisms (3 of which were novel) were determined in the present series. Conclusion: Although not as frequent as PTCH1 mutations, PTCH2 germline mutations were detectable in a subset of NBCCS patients with KCOTs. The pathogenetic role of these PTCH2 mutations is yet to be clarified.

Objective:To establish a method of in vitro cultivation of epithelial cells of keratocystic odontogenic tumors(KCOT).Methods: Tissue block and enzyme digestion techniques were used for primary cultivation of KCOT cells.The cells were grown in keratinocyte-serum free medium(K-SFM).The biological characteristics of the cultivated keratinocytes were identified by phase microscopic observation and by immunohistochemistry of cytokeratin,vimentin,cytokeratin10 and 14.Results: KCOT keratinocytes could survive for 30-50 days in K-SFM after passing 2-4 generations.Cells were polygon and showed typical slabstone-like appearance.Immunostaining showed positive staining for cytokeratin antibody,and negative for vimentin.Conclusion: KCOT epithelial cells could be serially cultured in vitro in K-SFM by techniques suggested in this study.

Objective To access the practicality and safety of a new type Balloon dilatation combined with flank supine position in percutaneous nephrolithotomy.Methods Clinical data of 60 kidney stones patients were collected and retrospectively analyzed.This group of patients had been admitted and selected according to the inclusion criteria in our institute from July.2012 to Sep.2013.There was no obvious difference in sex,age,body mass index (BMI),stone location and size.According to the surgery approaches,this group of patients was divided into ballon group (dilated by balloon dilatation) and Amplatz group (dilated by Amplatz fascial dilation) and in each group there were 30 cases.All these patients received the surgery by the same group of surgeons.We collected the data of one-time success puncture rate,success puncture time,puncture complications (kidney calices fracture,perinephric fluid collection and postoperative delayed hemorrhages etc.),removing stones time and stone free rate.Results Compared with Balloon group,Amplatz group had a significant difference (P＜0.05) in one-time success puncture rate [100％ (30/30) vs 90％ (27/30)],success puncture time [(6.1±2.3)min vs (13.3±3.6)min],puncture complications [3％(1/30) vs 13％(4/30)] and removing stones time [(11.7±2.0)min vs (21.5±3.1)min]; but no significant difference (P＞0.05) in stone free rate [87％ (26/30) vs 83％ (25/30)].Conclusions Balloon dilatation combined with flank supine position in percutaneous nephrolithotomy is easy for surgery.It can establish the surgery access more accurately and faster,decreases removing stones time and reduces operative complications.

Objective:To study the effect of learning plan guidance based on clinical nursing pathway applied in the teaching of surgical nursing.Methods: The nursing specialty students from two classes of grade 2010 were divided into experiment group and control group for the research randomly. Learning plan guidance based on clinical nursing pathway was performed in experiment group, while traditional teaching method was performed in control group. Students were evaluated by teacher during the course; Theoretical examination was carried out after the course. The students in the experiment group were required to fill in questionnaire.Results: Attitude of students in the experiment group is positive. Experimental group was excelled control group obviously in theoretical examination, and the difference was statistically significant (P<0.01).Students in the experiment group made a positive evaluation for teaching effect.Conclusion: Learning plan guidance based on clinical nursing pathway is suit for the reform in teaching of surgical nursing. It can improve the student nurses' comprehensive abilities.

Objective To investigate the changes of gut barrier function under glucocorticoid, so as to understand the reasons of gut-derived infection and bacteria infection.Methods Fifty-six Wistar rats were divided into control and methylprednisolone (Mep, 100 mg/kg, i.p., once every day) groups, and there were four time points in each group (0, 3, 5, 7 day). At each time point the rats were subjected to general anaesthesia and blood, mesenteric lymph nodes, enteric content and ileal tissue were obtained for determination of serum D-lactic, DAO, intestinal microecosystem, apoptosis index of mesenteric lymph nodes and bacterial culture. Results At the latter three time points, compared with control group, serum D-lactic and DAO, and apoptosis index of mesenteric lymph nodes in MeP group were significantly increased (P 0.05) from the day 3 after administration,the positive rate of organs bacterial culture in MeP groups at the No7 day is much higher than that in control group(P

Objective:To study the trace injection pump in the application of the common problems and treatment measures.Methods: 246 cases of general surgery patients were used trace injection pump problems for retrospective analysis, in order to propose the improvements about engineering and management.Results: The incidence rate of non-standard operation procedures or the incidents are 6.1%, injection pump failure and infusion speed is 2.03%, mismatched injection pump attachments is 1.22% and phlebophlogosis is 0.41%. The non-standard operation procedures and imperfect trace injection pump management are the major problems. Therefore, some solutions are proposed, which includes strengthening technical training for medical staff, standard operation procedures, regular quality monitoring and healthy education to the patients.Conclusion: The operation procedures of trace injection pump should be standard and programmatic. It is of great significance to clinical application of the trace injection pump and to work properly by strengthening operation personnel quality, dealing with problems timely and correctly.

Objective To explore the size of access channel that may influence the intrarenal pelvic pressure during percutaneous nephrolithotomy.Methods From April 2014 to July 2015,83 patiens with unilateral renal calculus,ranged from 20 to 40mam were divided into 2 group randomly.40 cases underwent F24 channel PCNL and 43 cases underwent F16 channel PCNL.There was no statistically significant difference between the groups in preoperative variables,such as age,gender,preoperative status of infection,status of hydrpnephrosis,size and location of stone (P ＞ 0.05).We used a 6Fr ureteral catheter positioned into the renal pelvic,and the intrarenal pelvic pressure was measured by anesthesia monitor IBP channel during PCNL in different stages (entrance into the collecting system,calculi fragmentation,and termination)for all patients.Removing calculus time,postoperative hemoglobin changing,fever rate,procalcitonin abnormal rate,white blood cell counts and calculi clearance rate were recorded and compared.Results The intrarenal pelvic pressure in different stages on F24 channel and F16 channel were (7.5 ± 1.3)、(22.5± 4.3)、(14.0 ± 2.7) mmHg and (10.3 ± 1.1)、(34.6 ± 4.1)、(23.0 ± 3.6) mmHg,respectively.There was statistically significant difference between 2 groups (P ＜ 0.05).Compared with F16 channel,F24 channel had significant differences in removing calculus time [(12.8 ± 3.7) min vs.(23.3 ± 3.6) min],fever rate [17.5％ (7/40) vs.39.5％ (17/43)],procalcitonin abnormal rate [15.0％ (6/40) vs.34.9％(15/43)] and white blood cell counts abnormal rate [10.0％ (4/40) vs.27.9％ (12/43)] (P ＜ 0.05).However,no significant difference in postoperative hemoglobin changing [(11.8 ± 4.4)g/L vs.(13.7 ±4.7)g/L] and calculi clearance rate [87.5％ (35/40) vs.81.4％ (35/43)] (P ＞0.05).Conclusions Compared with F16 channel,the F24 channel PCNL maintains lower renal pelvic pressure,which is less than reflux limit,during calculi fragmentation,It might be contributed to reduce the postoperative fever rate.It can short time for removing calculi and achieve the better effect.

Objective To access the safety and efficacy of balloon dilation in percutaneous nephrolithotomy for staghorn stones.Methods Clinical data of 64 patients with staghorn stone according to the inclusion criteria in our institution from April 2013 to April 2014 were collected and analyzed retrospectively.According to the dilation methods,the patients were divided into balloon dilation group (dilated to 24 F by balloon dilator,31 cases) and fascial dilation group (dilated to 16 F by Amplatz fascial dilator,33 cases).There was no significant difference in sex,age,body mass index between the 2 groups.The data of duration of percutaneous access,one-attempt success rate of dilation,puncture complications (kidney calices fracture,perinephric fluid collection and postoperative delayed hemorrhage etc.),removing stones time,stone free rate,hemoglobin drop after surgery and number of patients who experienced postoperative fever ＞37.5 ℃ were recorded.Results Compare to fascial dilation group,balloon dilatation group had significant differences in terms of duration of percutaneous access [(5.6± 2.1) min versus (9.4± 1.7) min],oneattempt success rate of dilation[100％ (31/31) versus 88％ (29/33)],removing stone time[(32.4±3.4) min versus (49.5±3.7) min],stone free rate [84％ (26/31) versus 61％ (20/33)],hemoglobin drop after surgery [(16.7±3.3) g/L versus (28.4±2.6) g/L],renal intrapelvic pressure[(19±3) mmHg versus (25±6) mmHg] and rate of patients who experienced postoperative fever ＞37.5 ℃ [16％ (5/31) versus 39％(13/33)] (P＜0.05).No injury of adjacent organs,including pleura,liver,spleen,or bowel was noted in all patients.Conclusions Balloon dilation is quick and safe with less hemorrhage when building percutaneous renal channel.And it has higher stone free rate and less complication rate in percutaneous nephrolithotomy with staghorn stones.