ObjectiveTo compare the advantages,disadvantages and clinical value of the improved loop the jejunum behalf of the stomach surgery and the P - type jejunum on behalf of stomach surgery.Methods56 patients with gastric cancer were divided into two groups by different ways of gastrectomy alimentary tract after gartrectomy.Patients in observation group( n =35 ) were given the modified loop jejunum on behalf of gastric surgery and patients in control group( n =31 ) received P-type jejunum on behalf of the stomach surgery.The clinical effects were compared between two groups.ResultsThere were no significant differences in surgical time and bleeding volume in 2 groups ( P ＞ 0.05 ).Emptying time [(61 ± 3 ) min] of observation group was longer than that of control group (37 ± 19) min]( t =3.03,P ＜ 0.05 ) ; Each food intake [( 308 ± 44 ) ml] in observation group was significiantly improved compared with control group [(262 ± 34) ml (t =2.55,P ＜ 0.05) ; The times of daily diet [(4.2 ± 1.2) times] in observation group was lower than that of control group [( 5.7 ± 2.3 )] ( t =2.46,P ＜ 0.05 ).The incidence of postoperative complications( 14.3％ ) of the observation group was significantly lower than the control group (42.9％) ( x2 =5.71,P ＜ 0.05).ConclusionOn the terms of 2 ways of digestive tract reconstruction,the improved loop the jejunum behalf of the stomach surgery is superior to the P-type jejunum on behalf of the stomach surgery,which can effectively improve the quality of life of patients and reduce the incidence of complications,but have no complex surgical procedures.

To study the clinical effect of treating the sequela of wind stroke by the traditional Chinese medicine integrated with western medicine. 80 patients were randomly recruited into a treatment group (50 cases) and a control group (30 cases). In the control group, conventional western medicines were applied, while in the treatment group traditional Chinese medicine based on syndrome differentiation was applied on the basis of the control group. The total effective rate of the treatment group and the control group was 73.58% and 54.6% respectively, demonstrating a statistically difference (X2= 6.66, P<0.01).

Objective To investigate the significance of changes of serum high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-alpha (TNF-α),interleukin 6 (IL-6) and urinary microalbumine levels in patients with diabetic kidney disease.Methods Serum hs-CRP,TNF-α,IL-6 and urinary microalbumine levels were measured with RIA in 60 type 2 diabetic patients and 20 controls.The 60 diabetic patients were divided into three groups based on urine albumin excretion rate.Group A:without alblminuria ( UAER ＜ 20 μg/ min,n =20 ) ; Group B:micro-albuminuria ( UAER ＜ 200 μg/min,n =20 ) ; Group C:macro-albuminuria ( UAER ＞ 200 μg/min,n =20 ).The serum levels of hs-CRP,TNF-α,IL-6 of patients in the four groups were measured.Results The serum levels of hs-CRP,TNF-α,IL-6 of patients in the healthy group were ( 1.21 ± 0.87 ) mg/L,( 1.27 ± 0.93 ) ng/L and ( 4.31 ± 1.72 ) ng/L,in the nonalbuminuria group were ( 2.31 ± 1.07 ) mg/L,( 1.95 ± 1.34 ) ng/L and ( 5.79 ± 1.68 ) ng/L,in the microalbuminuria group were ( 3.47 ± 1.25 ) mg/L,(2.86 ± 1.26) ng/L,(7.13 ± 1.57 ) ng/L,in the macroalbuminuria group were (4.83 ± 1.47 ) mg/L,(4.03 ±1.43)ng/L,(9.14 ±2.43)ng/L Serum levels of hs-CRP,TNF-α and IL-6 were significantly higher in all the patients with type 2 diabetes than those in the control group (P ＜ 0.01 ).Serum levels of hs-CRP,TNF-α and IL-6 were significantly higher in type 2 diabetic patients with microalbuminuria than those in patients without albuminuria (P ＜0.05).Serum levels of hs-CRP,TNF-α and IL-6 were significantly higher in diabetic patients with macroalbuminuria than those in patients with micrealbuminuria (P ＜ 0.01 ).The levels of hs-CRP,TNF-αand IL-6 were positively related to the urinary microalbumine levels ( rs =0.67,0.64,0.75,P ＜ 0.01 ).Conclusion Determination of serum hs-CRP,TNF-α and IL-6 levels might be helpful for early detection of diabetic kidney disease and monitoring the progress of the disease process.

Objective: To reveal the neuropathways of acupuncture effect on regulation of autonomic functions, treatment of diseases and the relationship between treating acupoint and certain target tissue or organ. Methods: it is reviewed for the authors' studies of characteristics of afferent nerve response, somato-sympathetic reflex (one of the somato-autonomic reflexes) and glutamate derived central modulation, target tissue and organ responses to somatic stimulation of acupuncture or electrical shock in rats and mice. Results and Conclusion: An electrical discharge from the nerve afferent serving Zusanli (ST 36) was recorded by applying manual acupuncture or electroacupuncture to Zusanli (ST 36). Such process could be replaced by applying electric shock directly to the afferent nerve assumingly. Somatic electrical stimulation of the afferent nerve e.g. tibia nerve can reflexively elicit an electrical discharge from autonomic efferent nerve e.g. sympathetic nerve that is defined as somato-sympathetic reflex. The reflex can be modulated by an excitatory neurotransmitter of glutamate in the central pathways. On the other hand, somatic stimulation of Zusanli (ST 36), etc. by electroacupuncture showed that them were inhibitory modulation of somatic sensory input from target tissue of the inflammatory pain in the hind paw of the mouse and visceral sensory input from target organ of the colorectum hyperagesia in the irritable bowel syndrome (IBS) rat. Spinal GABA and NMDA receptors were proved to be involved in the former and latter processes, respectively.

0.05). Conclusion The improved puncture drainage of lateral ventricle for treating tuberculous meningitis was better than the traditional one, and was worthy of popularization.

Objective The authors report nurse and patient communicate circumstances be short of 30 inexperienced nurses in paediatrics of pediatrics,answer ability accident when they encounter clamant circumstances.Letter press be dead against be short of bring forward measure,acquire approve of effect. Methods Accept ways of give lessons,selective examination,assess and extend invalid questionnaire,strengthen nurse knows in nurse and patient communicate importance and dispute correlation concept,advance ethics level,answer skill and handle skill,accordance relation of nurse and patient. Results After nurse act norm,approve of patients have advanced,bring a lawsuit against of patient have cut down. Conclusion Cut down nurse dispute depend on look up cause of dispute,betimes build up flaw.

Objective To discuss the influence of different dose α-lipoic acid on blood glucose and C-reaction protein(CRP) in type 2 diabetic patients with macroangiopathy.Methods Seventy-two cases type 2 diabetic patients with macroangiopathy were divided randomly and voluntarily into the conventional dose group(n=36) and high dose group(n=36).The patients of conventional dose group were given conventional dose α-lipoic acid(300 mg/d) based on glucose treatment while high dose group were given high dose α-lipoic acid (600 mg/d) based on glucose treatment,the courses were all 15 d.The fasting blood glucose(FBG),2 h postprandial blood glucose(2 hBG),serum CRP of before and after treatment of between the two groups and safety during the treatment were compared.Results The FBG,2 hBG and CRP of before and after treatment were respcetively (9.24±2.18) mmol/L and (8.18±1.38) mmol/L,(13.26±3.17) mmol/L and (11.26±1.63) mmol/L,(21.52±4.17) mg/L and (14.72±3.73) mg/L;(9.26±2.04) mmol/L and (5.82±1.27)mmol/L,(13.52±2.45) mmoL/L and (8.92±1.04) mmol/L,(22.65±4.67) mg/L and (8.61±1.52) mg/L,all groups decreased obviously,the differences were statistically significant compared to that of before treatment(t=4.265,4.654,4.956 and 5.562,6.254,7.654,P＜0.05),and the high dose group showed more lower (t=5.353,5.783,6.257,P＜0.05).After treatment,ALT ((37.26±9.64) U/L),AST ((38.22±7.04) U/L),BUN((7.25±1.52) mmol/L) and Scr((55.25±11.25) mmol/L) of all groups increased obviously than pretreatment((33.53±6.37) U/L,(33.15±7.16) U/L,(5.43±4.67) mmol/L,(53.15±13.65) mmol/L),but the differences were no statistically significant compared to that of before treatment (t=-2.061,-2.165,-1.455,-0.689,P＜0.05),and there were also no statistical significance between the two groups(t =2.125,3.026,1.235,1.035,P＜0.05).Conclusion α-lipoic acid can obviously decrease the blood glucose and CRP in type 2 diabetic patients with macroangiopathy,which has a significant dose effect relationship,and is safe and worthy of clinical application.

Objective To discuss the effect of alprostadil combined with irbesartan in patients with early diabetic nephropathy.Methods Ninety-six patients with early diabetic nephropathy were divided randomly and voluntarily into the control group (n =48) and observation group (n =48).All patients were given regular treatment,the patients of the control group were given irbesartan (150 mg,oral) based on regular treatment while the observation group were given alprostadil(intravenous drip alprostadil 10 g with saline 250 ml,1 times a day)based on treatment of the control group,the course was four weeks.The blood rheology,serum albumin,24 hours urinary albumin excretion rate (UAER) and urea nitrogen (BUN),serum creatinine (Scr) and clinical effect between the two groups were compared.Results After treatment,the whole blood midst shear viscosity values,whole blood low shear viscosity values and whole blood high shear viscosity values of observation group were respectively (5.32±1.16) mPa · s,(8.73±2.15) mPa · s and (3.52±0.52) mPa · s,significantly lower thanof control group((6.74± 1.92) mPa · s,(9.96±2.43) mPa · s,(4.53±0.64) mPa · s),the differences were statistically significant (t =4.627,4.728,4.226;P＜0.05).The Alb of observation group was (36.36±7.24) g/L,obviously higher than that of control group (29.73 ± 5.36) g/L,the difference was statistically significant (t=5.336,P＜0.05),while the UAER,BUN and Scr of observation group were respectively (375.84±24.24)mg/L,(9.61 ± 1.42) mmol/L and (136.36 ± 26.73) μmol/L,obviously lower than that of control group ((636.42± 43.56) mg/L,(13.45 ± 3.14) mmol/L,(176.32 ± 41.62) μmol/L),the differences were statistically significant (t =6.738,4.628,6.662;P＜ 0.05).The total effective rate of observation group was obviously higher than that of control group,the differences were statistically significant (93.75％ (45/48) vs.66.67％ (32/48);x2 =6.637,P＜ 0.05).Conclusion Alprostadil combine with irbesartan can effectively improve the blood rheology and renal function in patients with early diabetic nephropathy and improve the living quality,the effect is better than irbesartan only,it is worth popularization and application.

OBJECTIVE: To clarify the pathogens in plateau hospital-acquired pulmonary infection and their antimicrobial susceptibility so as to provide scientific basis for clinical first-line treatment in the rational use of antibacterial drugs. METHODS: The bacteriological culture and drug susceptibility experiment on sputum and bronchial douche fluid collected from 1 396 patients with hospital-acquired pulmonary infection in our hospital from 2004 to 2006 as well as the filed medical records were analyzed retrospectively. RESULTS: 789 positive bacteria were isolated, of which, 77.82% (614/789) were gram-negative bacilli (GNB), with Klebsiella spp showing the highest percentage, accounting for 53.91% (331/614); 21.04% (166/789) were gram-positive bacteria, with staph showing the highest percentage, accounting for 46.99% (78/789).Most of the GNB were sensitive to imipenem, sulbactam/cefoperazone, then to aminoglycosides. The susceptibility rate of Gram-positive bacteria to vancomycin was 90.36%. CONCLUSION: Gram-negative bacilli were the main hospital infection pathogens, which were sensitive to imipenem, sulbactam/cefoperazone but highly resistant to ceftazidime, which calls for attention in the clinic.

Under socialism market economy, the construction of medical moral engineening directed by theory of system engineering should be based on political education, conveyed by competition .combined with administration and led by the reasearch of theory.