Bile dut injury (BDI) is one of the severe complications of laparoscopic cholecystectomy (LC).The classification,diagnosis and treatment of the BDI caused by LC are partly controversial.The most efficient classification of the BDI is Strasberg-Bismuth's classification and the three modes and four classes developed by the Biliary Surgery Group of Surgery Branch of Chinese Medical Association.Although the success rate of intraoperative diagnosis for the BDI is very low,in most cases,the BDI is diagnosed by clinical manifestations and assistant examinations.Accurate classification and early diagnosis could help us to make a specific one for each patient according to certain situation.In this review,we focus on the classification,diagnosis and treatment of the BDI caused by LC.

Objective:To explore the effectiveness and recurrence prevention of esomeprazole at different doses in the patients with reflux esophagitis ( RE) . Methods:Totally 240 patients with RE were divided into mild or severe group with 120 cases in each accord-ing to the illness severity. The two groups were respectively divided into four groups according to the random number table, namely the full dose treatment group, half dose treatment group, intermittent treatment group and on-demand treatment group. The groups were fol-lowed up for 6 months, and GERD-HRQI scores, the recurrence rate and incidence of adverse reactions in all the groups were com-pared. Results:After the 6-month follow-up, the differences in the GERD-HRQI scores, recurrence rate and incidence of adverse re-actions among the groups with different doses were statistically significant (P<0. 05). The GERD-HRQI scores and RE recurrence rate in on-demand treatment group were significantly higher than those in the other groups(P<0. 05), and the incidence of adverse re-actions in the total dose treatment group was significantly higher than that in the other groups (P<0. 05). Conclusion: Intermittent treatment with esomeprazole at small dose can effectively prevent RE recurrence, reduce the incidence of adverse reactions and treat-ment costs, which is worthy of promotion.

Objective By measuring the concentrations of serum IL-2,IL-4,IL-8 and TNF-αin chronic bronchitis patients before and after the acupoint sticking therapy which was also called winter disease treated in summer to investigate the effect of therapy on serum concentrations of IL-2,IL-4,IL-8 and TNF-α.Methods 30 cases of patients diagnosed with chronic bronchitis in paracmasia and did not recieve other related treatment were randomly divided into acupoint application therapy group (treatment group)and the control group.The treatment group was giventhree Fuacupoint sticking therapy,the control group was given thecomfortacupoint sticking therapy.Serum IL-2,IL-4,IL-8 and TNF-αconcentrations were compared between the 2 groups before and after treatment.Results In the treatment group,the serum IL-2 concentration of patients after treatment was significantly higher than that before treatment(P <0.05),IL-8 and TNF-αconcentrations were significantly lower than those before therapy(P <0.05).Af-ter treatment,serum IL-2,IL-4 levels were significantly higher than those in the control group(P <0.05 )while IL-8 and TNF-αwere significantly lower than those of the control group(P <0.05 ).Conclusion Acupoint sticking therapy in summer for winter diseases effectively increase the concentration of serum IL-2 in patients with chronic bronchitis,reduced IL-8,TNF-α concentra-tions,and enhance their own immunity ability,reduce the degree of inflammation.

Currently refractory and relapsed mantle cell lymphoma (MCL) continues to develope a poor prognosis, and the treatment remains a significant clinical challenge. The use of bortezomib in clinic provides a novel method for the treatment of refractory and relapsed MCL. This review summarizes the mechanism and efficiency of bortezomib in the treatment of MCL and the strategies for overcome of bortezomib resistance.

According to Traditional Chinese Medicine, the functional structure of human body is composed of five functional subsystems which are based on the five-organs concept, and the relationship between them could be expatiated with Wu-Xing (Five-Elements) theory. Wu-Xing system is taken as our research object. The dynamic model has the characteristic of self-organization. There is only one stable point with local stability in the five-dimensional space. There exists an instability domain in the five-dimensional space. The stability domain is unbounded; it contains some special subdomains, including rectilineal subdomains, ray subdomains and line subdomains. In some ray subdomains, there exists comeback summits, the peak value of the comeback summit is comeback threshold. The existence of the comeback threshold means that, if the human body wants to go back to the healthy state from a certain special state which corresponded to the initial conditions located in a domain with comeback summit, it has to get across the comeback threshold. The comeback threshold is the division of the healthy state and the sub-healthy state. Some research work is done to investigate the response of the Wu-Xing dynamic model to the impact stimulation, and results in the decrease of the system's comeback threshold. There are 3 manners to achieve this goal, and they tally with the principle of the Wu-Xing system and the experimental rules in clinic.

Since 2004,provinces and cities began to implement the national policy that gave the poverty advanced schistosomiasis patients some temporary assistance.The central and local government arranged special funds to provide medical assistance.This paper reviewed the policy of the assistance,the necessity of performance evaluation and research status of advanced schistosomiasis.Finally,it put forward some suggestions on the implementation of performance evaluation of advanced schistosomiasis,so as to provide reference for the government to allocate limited health resources reasonably and optimally and perfect relevant policies.

OBJECTIVE: To sum up the advantages and disadvantages as well as application prospects of several kinds of new devices in airway management, including the laryngeal mask airway (LMA), esophageal-tracheal combitubes (ETC),fribreoptic stylet laryngoscope (FOS), video Macintosh intubating laryngoscope system (VMS) and GlideScope(R) videolaryngoscope(GSVL).DATA SOURCES: Using the terms "airway management", we searched Medline for airway management device-related articles, which were published during January 1990 to February 2006 in English.STUDY SELECTION: The materials were firstly selected. Successful rate of intubation, intubation-related complications and incidence in studying tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen. Inclusive .criteria: ① Randomized and controlled study of adult cases. ② Clinical studies or case report. ③ Including the studies of general airway or difficult airway. Exclusive criteria: ① Study of intubation in children. ② Repetitive study.DATA EXTRACTION: Eighty-six articles about tracheal intubation with LMA, ETC, FOS, VMS and GSVL were chosen, among which, 36 were included in this study, and 50 were excluded due to study on intubation in children or repetitive study.DATA SYNTHESIS: Correct placement does not affect vocal cord movement, so patients may vocalize while an LMA is in place. Its successful rate is over 90%. Its most attractive advantages are increased speed and ease of placement by both inexperienced personal and experienced anesthesiologists, low frequency of cough and low incidence. The esophageal tracheal combrtube is a supraglottic airway device that functions as an effective alternative to ventilization via mask and tracheal intubation in both the esophageal and tracheal position. It is successful when emergency occurs, but it is only suitable for adults. The flexibility of FOS allows for intubation of patients, without the need for head and neck manipulation. The main disadvantages of FOS are their limited field of view and the high cost of purchase and maintenance. Observation and manipulation in using VMS can be performed in one axis. GSVL provides a clear view of larynx on the monitor instead of directly viewed by the operator.CONCLUSION: These new devices of airway management can relatively decrease the intubation difficulty, increase the successful rate and lead to lower complication incidence. The skills of these new airway management devices should be included in the modern anesthesia residency program.

It is a consensus to place stent after cutting bile duct in the hepatobiliary surgery in the past.However,as the development of bile physiological research and surgical technique,especially the raise of medical concepts of rapid recovery,the negative effects which are caused by the placement of stent have been taken seriously gradually.Up to now,whether the stent should be placed after the bile duct is cut has no definite answer yet.

Objective To know about the status quo and influencing factors of undergraduate nurses' psychological empowerment at present,and provide a theoretical basis for nursing administrators so as to take measures to raise the level of psychological empowerment of undergraduate nurses.Methods General information questionnaire for nurses,Psychological Empowerment Scale were used to survey 207 undergraduate nurses in 3 first class teaching hospital of Dalian City.Results Undergraduate nurses' psychological empowerment score was (43.890±6.515) points,four dimensions whose scores from high to low were self-efficacy,job significance,autonomy and job impact.There was statistical difference in terms of ages,working length,working positions,professional titles,working purposes and training opportunities.Among them,working position and working purpose were the most important influencing factors of psychological empowerment.Conclusions Psychological empowerment of undergraduate nurses needs to be improved,managers should pay attention to the role of psychological empowerment,and actively cultivate and correctly guide undergraduate nurses in order to stimulate their potential in work,and finally,promote the sustainable development of a solid nursing career.

Objective To analyze nursing intervention and digoxin treatment of elderly heart failure patients taking digoxin drug compliance reasons. Methods Select Red Cross Hospital of Hangzhou on March 21, 2015 to March 21, 2016, 110 cases of senile heart failure patients as the research object, take the envelope random grouping scheme, divided into normal group and experimental group two groups, each group are occupying 55 cases. Among them to digoxin therapy on conventional therapy alone, in the experimental group were markedly drug treatment and corresponding nursing intervention, compared two groups of patients' medication compliance and quality of life score. Results the patients in the experimental group were 98.18% and 81.82% respectively, and the comparison groups were significantly different(P<0.05). The experimental group after treatment the patient's quality of life score of each dimension (physical function, psychological state, the doctor-patient relationship, independence, social relations, the personal faith and the general quality of life) were significantly better than the conventional group(P<0.05). Conclusion For elderly patients with heart failure to take scientific and reasonable method for nursing to improve the adherence of digoxin drugs, improve the quality of life, is worth popularizing practice.