Objective To investigate the effect of abdominal breathing combined with acupoint massage to relieve abdominal distention after laparoscopic surgery.Methods One hundred and eighty patients with abdominal distention after laparoscopic surgery were randomly divided into control group and observation group with 90 patients in each group. The control group was given conventional perioperative nursing and the observation group combined with acupoint massage including Zusanli, Shangjuxu,Xiajuxu,and Neiguanxue based on the use of abdominal breathing to relieve postoperative abdominal distension. Result The abdominal distension of the observation group was significantly lower than that in the control group,the recovery time of intestinal peristalsis and anus exhaust time were significantly shorter than those of the control group after 3 d(all P<0.01).Conclusion Abdominal breathing combined with acupoint massage can relieve abdominal distension of patients after laparoscopic surgery and promote intestinal function recovery.

Objective That decline of estradiol in serum of postmenopausal women can result in dry eye has been accepted at present. However, the change of estradiol in tear of postmenopausal women has been not reported ever. This study was to discuss the relationship between dry eye syndrome and estradiol in tears and serum of postmenopausal women. Methods Total 62 eyes of 62 women were collected in this trial. The aim of this trial was informed orally and the informed consent was obtained from all the subjects. The 32 right eyes were from menopausal women for more one year and 30 right eyes were from premenopause women. The dry eye was diagnosed based on the abnormalities of tear break-up time (BUT), Schirmer I test, corneal fluorescence and subjective symptom of patients. The periphery blood specimen was collected from all the subjects, and tear specimen was obtained and quantified using filter paper. Estradiol contents in tears and serum were determined by chemiluminescence method. The bulbar conjunctiva was obtained by impression cytology, and the microstructure of conjunctiva was observed under the scanning electron microscopy. Results In comparison to the premenopause group, the content of estradiol in tears and serum in menopause group was significantly reduced(73. 50 ±24.47 vs 17. 43 ± 10. 92) (U = -6. 396, P =0. 001). In the premenopause group, the estradiol content between tear and serum showed the positive correlation (r = 0. 838, P = 0. 001) . However, no statistical correlation was found in estradiol content between tears and serum in menopause group(r =0. 127, P = 0. 487). The maicrostructure changes were seen in the dry eyes of postmenopausal women, and decrease of goblet cell and loosen of intercellular junction were found under the electron microscope. Conclusion The content of estradiol in tears in menopause group is significantly lower than that in the premenopause group. Estradiol content in tears and serum of the postmenopausal women showes insignificant correlation. This result indicates that the topical substitute therapy with estradiol is possible in dry eye.

Objective Previous researches demonstrated that pyrroledithiocarbomate (PDTC), an inhibitor of nuclear factor, results in specific inhibition on nuclear factor-κB and therefore suppress cataract formation. The aim of this study was to explore the effect of nuclear factor-κB inhibitor on cataract formation after alkali burn in rats. Methods Ocular surface alkali burn models were established in the right eyes of 40 SPF Wistar rats by putting the 7 mm filter paper with 1 mol/L NaOH in the central cornea for 60 seconds. PDTC (2 mg/mL, 0. 1 mL) was subconjunctivaly injected everyday in 20 model eyes and the equivalent amount of normal saline solution was used in the same way in other 20 model eyes. The rats were killed in the first, third, fifth and seventh day after alkali burn and lenses were obtained for the histopathological examination, and immunochemistry and polymerase chain reaction were used to detect the expression of nuclear factor-κB in lens epithelial cells. The experiment and use of animal followed the Standard of Association for Research in Vision and Ophthalmology. Results After alkali burn, lens epithelial cells namely fell off in control group but those of experimental group were complete in the first day. In the third day, the lens cortex was obviously condensed in both two groups. In the fifth and seventh day, the lens epithelial cells fell off and lens cortex was obviously briquetted. Lots of vacuole and fragments could be seen in both groups. The gray scale value of nuclear factor-κB in lens epithelial cells were significantly higher in 1 day and 3 days after alkali burn in PDTC group compared with control group(t =2. 836, P =0. 036; t =4. 932, P =0.004) . The nuclear factor-κB /p-actin values were considerably lowed in 1 day and 3 days after alkali burn in PDTC group compared with control group (t = 31. 563, P = 0. 000; t = 17. 837, P = 0. 000). No statistically significant difference were found in gray scale values of nuclear factor-κB and nuclear factor-κB/p-actin values in 5 days and 7 days after alkali burn between PDTC group and control group (P＞0. 05). Conclusion Early usage of inhibitor of nuclear factor plays a suppressive role in cataract formation after ocular surface alkali burn of rat model.

Objective To improve the diagnosis of tuberculosis ( TB) by analyzing Mycobacterium infection in fine-needle aspiration biopsy specimens from children with tuberculous lymphadenitis .Methods Fine-needle aspiration biopsy was performed on 269 children with tuberculous lymphadenitis diagnosed by Shanghai Public Health Clinical Center from January 2011 to September 2013 .The needle aspiration biopsy specimens were processed for acid-fast bacillus (AFB) smear test, mycobacterial culture and Mycobacterium identification ( p-nitrobenzoic acid inhibition test ) .Results Cytological diagnosis of tuberculous lymphade-nitis was made for 269 patients.The positive results by AFB smear test were detected in 63.19% of 269 specimens (n=170) and 40.15%(n=108) specimens were positive in mycobacterial culture .The differ-ence between the two tests were significant (P<0.01).The positive rate of Mycobacterium detected by using BACTEC MGIT 960 automated system and L?wenstein-Jensen culture method were 38 .66% ( n=104 ) and 28.99%(n=78), respectively, showing the significant difference between two tests (P<0.05).AFB smear test in combination with mycobacterial culture could precisely diagnose 70.63% of tuberculous lym-phadenitis in children.Of the 108 clinical isolates, 105 strains (97.2%) were Mycobacterium tuberculosis complex and the rest were non-tuberculous Mycobacterium strains (2.8%).Conclusion The positive rate by AFB smear test was significantly increased in fine needle aspiration biopsy specimens after a series of treatments including sample digestion , centrifugation and precipitation , but the positive rate of mycobacterial culture was reduced .Diagnostic accuracy could be significantly improved by using BACTEC MGIT 960 sys-tem.Mycobacterium tuberculosis complex was the predominant pathogenic bacterium in children with tubercu-lous lymphadenitis .

Objective The present study analyzed the performances of hearing impaired children and normal hearing children at age 3 on the open set monosyllables test to provide reference for rehabilitation .Methods 30 typi-cal children and hearing impaired children at age 3 were randomly selected and tested using the open -set monosylla-ble test in evaluation of auditory response to speech (EARS) .Results ① There were significantly differences be-tween different test items in both groups ,the decreasing order of the score was tone> vowel>consonant>word(P<0 .01) ,and the scores on vowels ,consonants and words of hearing -impaired children were respectively signifi-cantly lower than that in normal hearing children(P<0 .001) .②There were similarities and differences between the mistakes of typical children and hearing impaired children .Blade-palatals and laterals in both groups achieved the lowest accuracy .While the accuracies on bilabials ,labiodentals ,nasals and plosives were highest in typical children , the accuracy on velar was highest in hearing impaired children .And the accuracies of consonants and nasal vowels on each place and manner of articulation in hearing -impaired children were significantly lower .Conclusion The study showed that the performances on vowels ,consomants and words of hearing -impaired children aged 3 in the open set monosyllables test were poorer than that in normal hearing children .The main errors were between the same places or methods of articulation ,especially for Blade -palatals and laterals .It is possible related to the deficiency of lan-guage input with the hearing impairment and the age with HA/CI .

Objective To explore the ultrasound imaging characteristics of thyroid papillary carcinoma complicated cervical lymph node tuberculosis, and to elucidate the key points of ultrasound diagnosis and to distinguish with cervical lymph node metastasis of papillary thyroid carcinoma.Methods In total, 1 5 well-documented cases of papillary thyroid carcinoma diagnosed definitely were selected, and there were 6 cases of concomitant lymph node metastasis. The ultrasonography of lymph node enlargement was analyzed, and the differences of the ultrasonographic characteristics between lymph node tuberculosis and metastatic lymph node including the location, swelling, calcification, blood flow and regional nodal liquefaction. Results Thyroid papillary carcinoma complicated with cervical lymph node tuberculosis was often found in the areas of Ⅲ,Ⅳ and Ⅴ, especially in the area of Ⅴ. Variety of echo was mixed in tuberculous of lymph node, and the echo was inhomogenous. The tuberculosis of lymph node calcification was patchy inhomogeneous distribution.The echo in part of liquefaction of lymph node tuberculosis was cottony weak. The flow signal of tuberculous lymph appeared the surrounding or internal punctate distribution,and the soft tissue was echogenic and disorder around the lymph node tuberculosis. Conclusion When ultrasonography examination is performed in the patients with the thyroid papillary carcinoma complicated with cervical lymph node enlargement, the history should be considered to analyze the ultrasound characteristics to dignose by observing the lesions of the surrounding soft tissues.

Background:The incidence of ulcerative colitis (UC)in developed countries is higher than that in developing countries,which may be related with westernized lifestyle,especially high animal protein and low complex carbohydrate diet. With the increased high fat and meat intake,synthesis and secretion of bile acid in liver is also increased,which may have an impact on the occurrence of UC. Aims:To investigate the expressions of farnesoid X receptor (FXR)and G protein-coupled bile acid receptor 5 (TGR5)in patients with UC. Methods:Thirty patients with active UC from January 2013 to June 2016 at the Affiliated Jiangning Hospital of Nanjing Medical University were enrolled,and 30 healthy subjects were served as controls. Expressions of FXR and TGR5 were determined by immunohistochemistry. Results:Compared with control group,expression of FXR was significantly decreased in UC patients (4. 63 ± 2. 07 vs. 6. 91 ± 2. 62,P =0. 00),however,no significant difference in expression of TGR5 was found between the two groups (6. 70 ± 2. 90 vs. 6. 11 ± 2. 44,P = 0. 40). Expression of FXR was significantly increased in right hemicolon colitis than in left hemicolon colitis (P < 0. 05). Conclusions:There is a significant decrease in FXR in active UC patients,indicating that FXR may have some role in the pathogenesis of UC,however,TGR5 may have no obvious effect in the pathogenesis of UC.

Objective To study the mutations of outer-membrane porin gerte (oprD) in imipenem-resistant Pseudomonas aeruginosa.Methods The PCR was applied to detect the oprD gene from the 34 clinical imipenem-resistant Pseudomonas aeruginosa.DNA sequence was proceeded to analysis the nuclentide sequence of the oprD gene and the deduced amino acid sequence.To analysis the mutation and the function of the oprD domain,those mutations were compaired with the standard Pseudomonas aeruginosa ATCC27853 and 2 clinical imipenem-susceptibility isolates.Results oprD gene mutation was wide and diverse.The rate of the mutation was 92.3% (12/13),mutations were concluded dot mutation,deletion mutation and insert mutation,those result in the amino sequence change and frame shift in L2 and L3 loops of outer membrane protein D,hampering the combine of oprD and imipenem.Some new mutations were found.They were 1 079,1 114,1 196,1 206,1 288,1 300,1 301 bases and 115,127,154,158,185,189 aminos.All above mutations were not deteced in ATCC 27853 and 2 clinical imipenem-susoeptibility isolates.Conclusions The wide and diverse mutations in oprD gene result in amino acid change and/or frame shift L2 and L3 loops,hampering the binding of IMP and oprD.Those may result in resistance to imipenem in Pseudomonas aeruginosa.

Objective To investigate whether the amount of blood transfusion affects the lengths of stay (LOS),costs,and outcomes of hospital patients or not,and to prepare for the execution of patient blood management.Methods The data of hospital patients,who had been administrated with blood in our hospital during 2016,were collected.And the influence of blood transfusion volume on LOS,costs and outcomes of patients was analyzed retrospectively.Results LOS,costs and outcomes of patients vary significantly with the amount of blood transfusion (P＜0.01).There were positive correlations between the total amount of blood transfusion and LOS,costs,and outcomes of patients.The Spearman correlation coefficient was 0.317,0.497,0.290,respectively (P＜0.01).Plasma preparation transfusion volume has a great influence on LOS,costs,and outcomes than red blood cell (P＜0.05).The transfusion volume of death patients was significantly higher than that of the survival (P＜0.01).In particular,the amount of transfused plasma and precipitation was distinctly higher than that in death patients(P＜0.01).Conclusion Blood transfusion volume affects LOS,costs and outcomes of hospital patients.The administration of plasma preparations should deserve more attention.

BACKGROUND:IPS e.max Presshas an excelent biocompati bility and corrosion resistance, which obtains satisfactory clinical outcomes on dental veneers, inlay and onlay restorations. But little is reported on molar monolithic restoration by IPS e.max Presscrown.
OBJECTIVE:To evaluate the clinical effects of IPS e.max Press crown on molar repair after root canal therapy.
METHODS:Totaly 215 patients with 324 affected molars, including 88 males and 127 females, aged 22-58 years old, were enroled for repairing with IPS e.max Presscrown. Then the color, shape, fracture and edge coloring of the restoration, marginal discrepancy, secondary caries and gingival health status were assessed after a 3-year folow-up.
RESULTS AND CONCLUSION:During the folow-up, 324 dental restorations met the class A standards for color, marginal discrepancy, shape as wel as secondary caries. In addition,3restoration swere fractured, 14 restorations had margin coloring, and 8 restorations appeared to have gingival inflammation. More than 95% restorations were scored grade A. These results indicate that IPS e.max Press crown applied to molar repair after root canal therapy can achieve ideal outcomes.