Optimization of surgical treatment of biliary dilatation (BD) depends on reasonable clinical classification and standardized classification-based treatment strategy.Due to increasing limits and defects of classic Todani classification,a new classification named Dong-classification has been proposed,which was based on a large series analysis from a single referral center.Some important parameters including anatomical location and range of BD,pathogenic factors,and different surgical managements were main considerations in the new classification.After practical application and evaluation,Dong-classification has been improved step by step.It is believed that Dong-classification may contribute to improving surgical treatment decision and selecting reasonable operative plan.

OBJECTIVE:To provide reference for the application of antibiotics based on susceptibility test.METHODS:The problems appeared in the use of antibiotics based on susceptibility test in clinical pharmacy were analyzed and summarized.RESULTS & CONCLUSION:The antibiotics should be used rationally based on susceptibility test so as to improve the rational use of antibiotics.

Objective To investigate the role of annexin A1 (ANXA1) in human pulmonary arterial smooth muscle cells (PASMCs) proliferation induced by hypoxia.Methods Primary cultured human PASMCs were randomly divided into 5 groups ( n =60 each):normal oxygen group (group N) and hypoxia 2,8,12 and 24 h groups(groups H1-4).Group N was treated with 21％ O2 for 24 h,and groups H1-4 was treated with 3％ O2 for 2,8,12 and 24 h respectively.ANXA1 mRNA and protein expression was determined by RT-PCR and Western blot.Proliferation of PASMCs were determined by MTT and 3 H-TdR methods.Results ANXA1 mRNA and protein expression was down-regulated,proliferation of PASMCs was enhanced in groups H1-4 as compared with group N (P ＜ 0.05).ANXA1 mRNA and protein expression was down-regulated gradually,proliferation of PASMCs was enhanced gradually in groups H1-4 ( P ＜ 0.05 ).Conclusion The expression of ANXA1 is down-regulated in human PASMCs during hypoxia treatment,which might be the mechanism of human PASMCs proliferation induced by hypoxia.

Objective To explore the effects of different intrauterine adhesion (IUA) classification systems on predicting the IUA prognosis.Methods One hundred cases were selected as the subjects in present study from those diagnosed with IUA and underwent surgery in Zhujiang Hospital of Southern Medical University from Jan.2010 to Jan.2017,and were followed up for two years.According to the actual situation,all patients were scored by March,AFS,ESGE and Chinese classification for comparing the effects of different IUA classification systems on predicting the pregnancy rate,live birth rate and effective rate within 2 years after surgery.Results ESGE classification had a good effect on predicting the postoperative live birth rate and effective rate,and a certain predictive effect on pregnant rate,with the area under curve (AUC) of 0.722,0.754 and 0.635,respectively.March classification had a certain effect on predicting the postoperative live birth rate and effective rate with AUC of 0.635,0.754,respectively,but had a poor effect on predicting pregnant rate.AFS classification and China classification had poor effect on predicting the IUA prognosis.Conclusion ESGE classification system is better than the other systems including March,AFS and Chinese classification,on predicting the IUA prognosis,but further verification in large sample size is still required.

Objective To investigate the fear and attitude of the common people to some threatening diseases .Methods Accord-ing to the age and sex structure of the whole nation ,500 common people were randomly enrolled in the public places of Chongqing main urban area .Firstly ,the respondents were asked to name three diseases they feared most .Then their fear degrees to eight im-portant diseases were performed the questionnaire survey .Results The top ten diseases that common people fear most by their own words were cancer ,AIDS ,heart disease ,hypertension ,stroke ,leukemia ,chronic liver diseases ,diabetes mellitus ,dementia and de-pression successively .Meanwhile ,their fear to the eight important diseases ,which was determined by the ratio of people who did fear to all ,were cancer(94 .2% ) ,traffic accidents(89 .2% ) ,heart disease(85 .0% ) ,AIDS(79 .4% ) ,tuberculosis(76 .8% ) ,hepatitis B(76 .6% ) ,Alzheimer′s disease(73 .4% ) and depression(69 .0% ) .Further analysis showed that such fear was significantly influ-enced by age ,sex and education level .Conclusion The knowledge and perception of common people about certain diseases is one-si-ded ,and their health awareness should be improved .

Objective To solve part of executive problems by analyzing and editing the control files of brachytherapy.Methods By recording the sources of radioactivity,the time when patients were treated and using the program designed by the C language,the source location and the time treated in this location were tracked to the source urgently.By editing the control files,the follow-up treatment files were produced and then tested with a solid water measuring model.Results For the point A,B defined in the measure model,the deviation between Dose A4 and Dose A1 was 6.12％,the deviation between Dose B4 and Dose B1 was 2.09％.For the planar dose measure in the MapCheck,Plane Dose 4 and Plane Dose 1 rendered as pear-shaped dose distribution,and the dose difference less than 4％ reached 93.8％.The point dose and plane dose meeted the clinical standards.Conclusions The follow-up treatment files can complete the part of the unfinished brachytherapy plan exactly and achieve requirements of the dose distribution.

Aim To investigate the preventive effect of Polygonum Multiflorum (PM)on the deteriorated mi-cro-structure and biomechanical properties induced by prednisone.Methods Ninety 6-month-old male Sprague-Dawley rats were randomly divided into nine groups,which were control,prednisone,CAL,30%ethanol eluent of the PM(H,M,L),PM(H,M,L). Prednisone was gavaged to rat for 21 weeks as model group of osteoporosis.Meanwhile,tested herbal ab-stract were orally administrated to the modeled rats in-duced by prednisone.At the end of the experiment, the right femur was collected for micro-CT scanning, three-dimensional reconstruction and biomechanical test.Results Compared with the control group,mod-el group showed destruction of bone microarchitecture, BV /TV fell 28.6%(P <0.05),bone biomechanical parameters decreases,and stiffness fell 29.7%(P <0.01 ). Compared with the model group, positive group had significantly improved effect on bone micro-architecture,and biomechanical parameters,BV /TV increased 46.7%(P <0.01 ),and stiffness increased 25.9%(P <0.01 ).30% ethanol eluent of the PM (M,L)dose may improve bone microstructure by in-creasing BV /TV 46.7% (P <0.01 ),40.0% (P <0.05)respectively,PM(H)may improve the biome-chanical parameters by increasing stiffness 24.7%(P<0.05),and 30% ethanol eluent of the PM(H)and PMhigh-dose may improve the biomechanical parame-ters,but not as positive group.Conclusions Predni-sone reduces biomechanical properties of rat femur and deteriorates femoral microstructure.30% ethanol eluent of the PM(M,L)and PM(H)plays a preventive role in the changes of micro-structural and biomechanical properties by prednisone,and increases BMD,whereas other groups have no significant preventive effect.

Objective To analyze the knowledge and perceptions of brucellosis and human behavior in different populations in Jingyuan County Gansu Province,and to provide a scientific basis for carrying out health education and prevention accurately on brucellosis.Methods In 2015,using two-stage cluster sampling method,nine towns with more accumulative incidence of brucellosis in the past 3 years in Jingyuan Country were selected,5 villages were selected from each town,occupational exposure and patients with brucellosis were selected in each village as respondents.A questionnaire survey was carried out to collect basic information,brucellosis related knowledge,population's behavio.Results The overall awareness rate of prevention and control knowledge on brucellosis was 44.10％ (12 943/29 348),included 809 people with the occupation exposure population and 203 patients with brucellosis,among them,the rate of patients with brucellosis knowledge was 50.40％ (2 967/5 887),occupational exposure population was 42.52％ (9 976/23 461);There were significant differences in the awareness rate of knowledge on prevention and control of brucellosis in population of different gender,age,education and years of work experience (x2 =84.413,166.100,207.200,16.822,P ＜ 0.01);of the following parameters:shared water,peel dead lamb,How to deal with flow products,treatment of abortion without gloves,masks,not wearing gloves,masks when lambing ,to give livestock vaccines and drugs,eat dead cow,lamb,and sale of diseased,dead livestock,slaughter livestock,there were statistical significant differences between patients with brucellosis and exposure people (x2 =13.940,27.965,30.031,19.575,22.597,21.139,14.524,436.450,8.482,P ＜ 0.05).Conclusions The occupational exposure population has a low knowledge awareness rate;high risk behaviors have higher risk of brucellosis infection in Jingyuan County.We should carry out health education and high-risk behavior intervention in targeted population.

Objective To enhance the management in identifying the surgical sites to comply with national standards.Methods A nurse-physician collaboration management team was set up to investigate the current identification of surgical sites in every operating room which violates regulations,with the causes analyzed and countermeasures proposed.Working hand in hand,doctors and nurses figured out the management details for preoperatively identifying the surgical sites and reengineering of the surgical process.With the responsibilities clarified and training enhanced,the surgeons,anesthesiologists,ward nurses and operating room nurses were held responsible for the process and improvements of identifying the surgical sites.The number of patients with unreasonable identification of surgical sites was calculated before and after establishment of nurse-physician collaboration management team.Results The reasonable identification rates of surgical sites were 37.94% before the reform and 80.94% after;incorrect use of all types of the surgical site identification can be minimized in the reform.Conclusion The management of nurse-physician collaboration is conducive to enhancing the reasonable identification rate of surgical sites,thus improving the quality of care and correctness of operations.

To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment.