Objective To investigate the effect of comprehensive nursing intervention on postoperative pain of patients undergoing general surgery.Methods 100 patients undergoing general surgery with postoperative pain were divided into the observation group and the control group with 50 patients in each group.The control group received routine nursing,and the observation group received comprehensive nursing intervention.The nursing effect was compared between two groups.Results The number of cases using the PCA and analgesics in the observation group was fewer than those in the control group,and there were significant difference between them.The cases of pain level Ⅰ in the observation group were more than those in the control group,and the cases of pain level Ⅲ in the observation group were fewer than those in the control group,and there were significant difference between them.The satisfaction degree of the observation group were more than those in the control group,and there were significant differences between them.Conclusions The effect of comprehensive nursing intervention in cases with postoperative pain undergoing general surgery is obvious,so it is worth being used.

The concept of modern medicine in treating chronic heart failure (CHF) has changed markedly in recent years. To improve the quality of life and prolong life, the treatment goal is no longer just temporary improvement of symptoms, more importantly, is to prevent and delay the occurrence and development of ventricular remodeling. Long-term chronic over-activation of sympathetic system, renin-angiotensin-aldosterone system and other neuroendocrine factors promotes myocardial remodeling, increases myocardial injury and deteriorates cardiac function. Despite short-term use can significantly improve the blood flow dynamics, long-term use of beta-adrenergic receptor stimulators and phosphodiesterase inhibitors does not prolong life, but increases the rate of sudden death caused by cardiac arrhythmia. Angiotensin converting enzyme inhibitors and beta-blockers have become the preferred drugs in treating chronic heart failure. In fact, after long-term use, beta-blockers can significantly improve ventricular remodeling, enhance ventricular function and reduce the incidence of sudden death of patients with CHF. In traditional Chinese medicine practice, short-term use of drugs for warming yang and reinforcing qi can improve symptoms of CHF, but long-term use may have adverse effects, for these medicines can stimulate sympathetic system. Early treatment with medicines of cold and cool property may be more favorable to patients with CHF, except the advanced patients who need special intervention. Eliminating heat and nourishing yin may play more active role in controlling the occurrence and development of CHF. Drugs with good efficacy and value in treating CHF may be developed from the Chinese herbal medicines with eliminating heat and nourishing yin property.

Objective To study changes of serum IL-17 and IL-35 levels in patients with heart failure. Methods 60 patients with heart failure (observation group)were selected as research subjects.60 patients accord-ing to different severity were divided into acute period heart failure (34 cases)and stable stage heart failure (26 ca-ses);60 patients graded according to the NYHA standards were divided into 24 cases of heart failure with grade Ⅱ, 20 cases of grade Ⅲ ,16 cases of grade Ⅳ.According to the different primary diseases :expansion cardiomyopathy group (20 cases in group A),the coronary heart disease group (group B,24 cases),hypertensive heart disease group (group C,16 cases).During the same period,42 healthy elderly people in our hospital were selected as control group. The serum IL-17,IL-35 levels were tested,and the serum IL-17,IL-35 levels in patients with heart failure were ana-lyzed.Results Serum level of IL-17 in the observation group was higher than the control group,and the difference was significant [(15.61 ±4.02)pg/mL vs (9.49 ±3.96)pg/mL,t =9.018,P <0.01].Serum level of IL-35 in the observation group was significantly lower than that of the control group,and the difference was significant[(52.78 ± 4.29)pg/mL vs (61.49 ±4.81)pg/mL,t =11.963,P <0.01].The level of serum IL-17 in acute stage of patients with heart failure was higher than that of stable heart failure,and the difference was significant (t =6.278,P <0.01);IL-35 level in serum of patients with heart failure in acute phase was lower than that of stable heart failure,the difference was significant (t =9.529,P <0.01).With the increase in heart failure grade,serum IL-17 level showed a rising trend,and the differences among three groups had statistical differences (F =6.098,P <0.01);serum IL-35 level decreased,and the differences among three groups had statistical differences(F =8.978,P <0.01).The serum IL-17 level of A group was higher than that in B group and C group,there were significant differences (F =6.096, P <0.01),the serum IL-17 level between B group and C group had no statistical difference (t =0.172,P >0.05). The serum IL-35 level of A group was lower than that of B group and C group,there were significant differences (F =8.978,P <0.01),the serum IL-35 level between B group and C group had no statistical difference (t =0.208,P >0.05).Serum IL-17 and serum IL-35 level was negatively correlated (r =-0.429,P =0.009).Conclusion High expression of IL-17 in elderly patients with heart failure,while IL-35 decreased in elderly patients with heart failure, IL-17,IL-35 are closely related to the senile congestive heart failure and the severity of illness.Serum IL-17 is nega-tively correlated with the level of serum IL-35.

Objective To evaluate the practical value of 99m Tc-MIBI scintimammography and breast X-ray in the detection of breast cancer. Methods 100 female patients with 106 suspected focuses of breast cancer on clinical examination underwent 99m Tc-MIBI scintimammography and breast molybdenum target X-ray, and the results were compared with the pathological diagnosis. Results Compared with the histopathologic diagnosis , the sensitivity of molybdenum target X-ray for detecting primary breast cancer was 44.6% and the positive predictability was 31.7%. The specificity of 99m Tc-MIBI was 87.8% and the positive predictability was 76.9%. Conclusions In comparison with breast X-ray, 99m Tc-MIBI scintimammography is of greater clinical value in the diagnosis of breast cancer.

Objective:To approach the in unce of wild chrysanthemum on some neuroendoerine factors in ventricular remodeling induced by abdominal aortic banding(AAB)in rats.Methods:Myocardial hypertrophy,ventricular remodeling model was induced by abdominal aortic banding(AAB)in rats.After 35 days' treatment,the systolic blood pressure(SBP),diastolic blood pressure(DBP) and mean arterial pressure(MAP) were measured.Then the ratios of LVW/BW(1eft ventricle weight/ body weight),HW/BW(heart weight/body weight)were Calculated.The Angiotensin II(Ang II) content in heart tissue and the Aldosterone(ALD),Tumor Necrosis Factor(TNF-?)concentration of blood plasma were determined by radioimmunoassay.Results:The experimental data demonstrated that wild chrysanthemum could decrease SBP,DBP,MAP and the cardiac indexes of LVW/BW and HW/BW,significantly reduce the content of Ang II,ALD and TNF-?,decrease the Hydroxyproline content(P

Objective To study a series of tests to the IMRT planning system RayStation,and verify the feasibility of this Standard.Referring to the standard Performance and test methods for intensity modulated radiation therapy (IMRT) treatment planning system (Standard).Methods Referring to the Standard,the tests include:dose goals used for planning,point dose calculation accuracy and dose distribution calculation accuracy.And test phantoms include:AAPM TG119 report's test cases and solid water phantom for verification,and IMRT test cases include:multitarget,mock prostate,head/neck and CTshape (easier version and harder version) and so on.Referring to the Standard,we optimize and calculate doses of interest in RayStation,and use the common measurement equipments and tools,such as an ionization chamber,films,a detector array,and etc,to measure the doses on the accelerator,then calculate and analyze the errors between them.Results The results of dose goals for five different mock plans meet the requirements of the Standard.And the point dose ionization chamber measurements are in line with the requirements of the Standard,and the total error of the mock plans was (0.83 ± 1.65) ％.The γpass rates of per-field measurements using detector array are all greater than 99.0％,and the γpass rates of composite film measurements are all greater than 92.5％.Conclusions The results of three trials to IMRT performance of RayStation are in full compliance with the requirements of the Standard.And also it is an evidence for the feasibility of this Standard.

Objective To explore the cause,treatment and prognosis of delayed massive haemorrhage (DMH) after pancreatic resection.Method Clinical data of 1554 patients undergoing pancreatectomy in our hospital from Aug 2003 to Aug 2013 were retrospectively analyzed.Results 16 patients suffered from DMH,including 13 patients who had undergone pancreaticoduodenectomy,and 3 patients who had had resection of pancreatic body and tail.Gastrointestinal haemorrhage occurred in 6 patients,intra-abdominal haemorrhage occurred in 10 patients,respectively.Reoperations were performed in 11 patients,transcatheter arterial embolization (TAE) undertaken in 2 patients,and endoscopic treatment in 3 patients.10 patients recovered after treatment,6 patients (6/16) died.Conclusions The mortality of DMH after pancreatic surgery is high.Postoperative pancreatic leak and gastrointestinal stress ulcer are the most possible risk factors,intra-abdominal arterial haemorrhage is the main cause of death.

Objectives:To investigate the effect of early EN on mucosal structure and absorption function of allograft after living-related small bowel transplantation.　Methods:Early enteral nutrition was used.The image analysis,D-xylose absorbtion test and blood culture were used to measure the villus height and area,D-xylose absorption and bacterial translocation in blood.　Results:The morphometric examination showed that villus height and villus area were decreased on the 7th postoperative day,began to increase on the 12th day after transplantation and had been the 80% of normal level.The percentage of D-xylose absorption was gradually increased and reached the normal level on the postoperative 38th day.Postoperative blood cultures were always negative.　Conclusions:Early EN support can improve the mucosal structure and absorption function of small bowel allograft after living-related small bowel transplantation.

OBJECTIVE:To observe the efficacy and economy of omeprazole and esomeprazole in the treatment of brain trauma and cerebral hemorrhage complicated with upper gastrointestinal hemorrhage. METHODS:The data of 110 patients with trauma cere-bral hemorrhage complicated with upper gastrointestinal hemorrhage were retrospectively analyzed and divided into omeprazole group (56 cases)and esomeprazole group(54 cases). All patients were given conventional treatment. On this basis,omeprazole group was treated with Omeprazole for injection 40 mg by intravenous infusion;esomeprazole group was treated with Esomeprazole injection 40 mg by intravenous infusion,twice a day. The treatment course for 2 groups was 5 d. The efficacy and economy of patients were com-pared. RESULTS:The total effective rates in esomeprazole group were significantly higher than omeprazole group higher,the cost-ef-fectiveness in esomeprazde group(1 397.71)were significantly lower than omeprazole group(1 512.09)(P<0.05),andΔC/ΔE=91.52. CONCLUSIONS:Esomeprazole has good efficacy,safety and economy in the treatment of brain trauma cerebral hemorrhage compli-cated with upper gastrointestinal hemorrhage.

Objective To evaluate the management of biliary complications (BC) following orthotopic liver transplantation (OLT). Methods From Feb 1999 to Feb 2004, 236 cases underwent OLT with end-to-end choledocho-choledochostomy. Biliary anastomosis was performed by intermittent suture with T tube placement in 96 cases, without T tube in 39 cases, by continuous suture in posterior wall and intermittent suture in anterior wall and without T tube in 101 cases. Results Thirty-two (13.3%) patients developed BC, with incidences in group 1, 2 and 3 of 17.7%, 15.4% and 7.9%, respectively. The incidence of hepatic hilar and/or intrahepatic bile duct strictures was 8.3%, 2.6% and 1.0%, respectively. BC incidence in group 3 significantly decreased. Twenty patients with biliary stricture underwent endoscopic and/or radiological interventions, and stricture resolution was achieved in 90% of patients with anastomotic strictures and 60% of patients with hepatic hilar and/or intrahepatic strictures. Conclusions Modified biliary tract reconstruction technique contributes to the decrease of BC. Endoscopic and/or radiological interventions should be used for non-ischemic anastomotic biliary strictures or simple hepatic hilar strictures.