Objective To analyze the effect of duodenal endoscopy in the treatment of common bile duct stones.Methods 70 patients with common bile duct stones in our hospital were randomly divided into the observation group (35 cases) and the control group (35 cases) by the random number table method.All the patients were treated with the treatment of duodenal endoscopy, and the perioperative clinical nursing, the control group was nursed by conventional nursing,the observation group was nursed by quality care.The surgical effect of the two groups was evaluated,the incidence of postoperative complications was analyzed,and the nursing satisfaction of the two groups was investigated.Results The average operation time, postoperative anal exhaust time, out of bed activity time and hospitalization time of the observation group were shorter than the control group (t=6.535,7.884,10.228,12.192, all P<0.05),and average intraoperative bleeding volume was less than that of the control group (t=5.984,P<0.05).The total incidence rate of biliary tract infection,bleeding,bile leakage,bile leakage,bile duct stricture and complication was 8.58%in the observation group,which was lower than 22.85%in the control group (χ2 =7.464, P<0.05).In the observation group,the patients′satisfaction to the comprehensive nursing,humanized nursing and nursing quality were 94.29%,91.43% and 94.29%, which in the control group were 80.00%,77.14% and 77.14%,the differences between the two group were statistically significant (χ2 =7.435,8.245,7.446, all P<0.05).Conclusion High quality nursing care to patients with common bile duct stones who received endoscopic therapy perioperatively is helpful to improve the effect of operation,prevent postoperative complications and improve the patients'satisfaction.

BACKGROUND: At present, the clinical application of amplified neural stem cells in the treatment of nervous system diseases is stil in exploratory stage. OBJECTIVE: To investigate efficacy and safety of neural stem cel transplantation for the treatment of Parkinson’s disease. METHODS: The embryonic brain tissues aged 12 weeks were obtained for proliferation in vitro, then the brain tissues (5×106-2×107) were prepared into the 4-6 mL suspension. The suspension was injected into 30 cases of Parkinson’s disease through lumbar puncture and carotid injection, once a week, continuously for 3 weeks. Unified Parkinson’s disease rating scale, Hoehn-Yahr scale and Schwab & England Activities of Daily Living Scale scoring were performed prior to and after transplantation. Blood and urine routine, liver function, renal function and adverse reactions were detected and evaluated prior to and after transplantation. RESUTLS AND CONCLUSION: The 12-week-old embryos cultured neural stem cells could be stably amplified in vitro with the capacities of differentiation into neurons, astrocytes and oligodendrocytes. The fol ow-up results showed that neural stem cel transplantation could effectively control the pathological process of Parkinson’s disease, restore the damaged brain function, and improve the patient’s neurological function without significant complications. It is feasible and effective to use the in vitro long-term amplified human neural stem cel transplantation in the treatment of Parkinson’s disease.

Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that plays a critical role in the folate and homocysteine metabolism.MTHFR mutation leads to decreased 5-methylenetetrahydrofolate synthesis.Consequently, it influences the conversion of homocysteine to methionine causing homocysteine accumulation.Homocysteine has been considered as an independent risk factor for a variety of diseases such as cardiovascular diseases , neurological and psychiatric disorders as well as cancers .The study on the correlation between methylenetetrahydrofolate reductase gene polymorphisms and diseases and the discovery of its clinical value is getting more and more attention.

Objective · To develop a new hybrid tissue-engineered vascular graft (HTEV) with excellent mechanical properties and biological functions. Methods · Decellularized rat aortas (DRAs) were prepared. Then, electrospinning nano poly (1,3-diamino-2-hydroxypropane-co-polyolsebacate) (ES-APS) was used to sheathe DRAs in order to improve the mechanical properties. After that, the intima of HTEV scaffold was modified with heparin coating. HTEVs were implanted in rat models in vivo to evaluate their biological functions. Six weeks later, vascular ultrasound and micro-CT angiography were carried out. Results · The donor aortic vessels were successfully decellularized. The total DNA content of DRA group [(115.4±10.9) ng/mg] significantly decreased compared with natural aorta group [(398.6±14.6) ng/mg] (P=0.000). But collagenous fibers and elastic fibers of decellularized vessels were severely injured. Mechanical tests of scaffolds showed that ES-APS significantly enhanced the mechanical properties. The wall thickness [(187±11) μm], suture retention strength [(0.51±0.06) N] and burst pressure [(2103±232) mmHg] of HTEV group all significantly increased compared with DRA group (P<0.01). Heparin coating modification of HTEV significantly reduced the number of adhesive platelets. Vascular ultrasound and micro-CT angiography showed all grafts were totally patent 6 weeks after implantation in rat models. ES-APS sheath successfully prevented the occurrence of vasodilation and aneurysm formation. Conclusion · DRA sheathed with ES-APS on adventitia and coated with heparin on intima is a new kind of HTEV, which possesses increased tensile strength and improved biocompatibility.

Objective To investigate the effect of dopamine receptor in intestinal mucosal barrier function after brain injury in rats.Methods Twenty-four rats were allocated to control group,brain injury group,dopamine receptor group,and dopamine antagonist group according to the random number table,with 6 rats per group.Feeney' s weight-drop model was introduced to generate rat models of brain injury.Intestinal mucosal specimens were harvested at postoperative 7 days to evaluate intestinal mucosal morphology by HE staining,expressions of dopamine receptor D1 (DRD1) and dopamine receptor D2 (DRD2) by immunohistochemistry,and mRNA and protein expressions of DRD1 and DRD2 by real-time PCR and Western blot.Meantime,urinary samples were collected to measure lactulose to mannitol ratio (L/M) by high performance liquid chromatography (HPLC).Results Intestinal villus integrity was disrupted in brain injury group and dopamine receptor group when compared to control group,but it remained relatively intact in dopamine antagonist group.Ratio of L/M in brain injury group and dopamine receptor group was similar (0.192 ± 0.080 vs 0.183 ± 0.090,P ＞ 0.05),far higher than 0.037 ± 0.008 in control group (P ＜0.01),but it was reversed in dopamine antagonist group (0.071 ± 0.008,P ＜ 0.01).Real-time PCR showed DRD1 and DRD2 mRNAs expressed in brain injury group and dopamine receptor group were similar (0.764 ± 0.074 vs 0.718 ± 0.065,0.439 ± 0.051 vs 0.408 ± 0.090,P ＞ 0.05),far higher than 0.189 ± 0.008 and 0.076 ± 0.011 in control group (P ＜ 0.01),but both lowered in dopamine antagonist group (0.386 ± 0.071,0.270 ± 0.092,P ＜ 0.01).estern blot analysis showed DRD1 and DRD2 proteins in brain injury group and dopamine receptor group were similar,but both were far higher when compared to control group (P ＜ 0.01).Conclusion Impaired intestinal mucosal barrier may be relate to the up-regulated dopamine receptor in intestinal mucosa after brain injury in rats.

Objective:To study on regional differences of technical efficiency under medical and health system in China, and analyze on the influence factors of technical efficiency. Methods: Based on the provincial panel data from 2002 to 2011, the stochastic frontier production function of healthcare system was established for empirical analysis. Results and Conclusion: Overall, the average technical efficiency of medical and health system in China presented an increasing tendency, however, a significant difference was found in regional efficiency. The non-efficiency of medical and health system in different areas could be reduced by the proportion of tertiary hospitals in all medical institutions, the ratio of profit-making medical institutions in all medical institutions and the population density;while the influences of highway density and per capital education year on technical efficiency in different areas are different.

The occurrence and development of tumor depends not only on the tumor itself,but also depends on the soil survival of tumor cells,that is the tumor microenvironment.Studies confirm that the changes of blood vessels and hypoxic of tumor microenvironment maintain the stemness of cancer stem cell,and further strengthen the ability of tumor invasion and metastasis.Studying the molecular mechanism of tumor development from angiogenesis and lack of oxygen can provide new ideas for the clinical targeted therapy.

Objective To study the effects of Tongxinluo capsule and Shen Mai injection in treatment of patients with acute myocardial infarction and its effects on level of left ventricular ejection fraction (LVEF),high sensitive C-reactive protein (hs-CRP),natriuretic peptide (BNP) and QT in acute decompensated heart failure ( QTcd) .Methods 82 patients with acute decompensated heart failure were selected in our hospital from May 2014 to April 2015, those patiens were divided into observation group and control group according to the method of lottery, 41 cases each group.The control group was treated with basic treatment and Huangxin injection, and the obsevation group was treated with Tongxinluo capsule on the basis of the control group.The changes of blood pressure, heart rate, LVEF, hs-CRP, BNP and QTcd were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the observation group was significantly higher than the control group [92.68% (38/41) vs 60.97%(25/41)](P<0.05).The heart rate of the observation group was significantly lower than the control group (P<0.05), but the blood pressure level of the two groups had no significant difference.The levels of BNP, hs-CRP and QTcd in the observation group were significantly higher than the control group [(45.98 ±4.57)% vs(39.07 ±3.12)%](P<0.05) L, BNP, hs-CRP and QTcd were significantly lower than the control group [(2432.12 ± 114.32)ng/L,(17.32 ±1.87) mg/L, (34.76 ±3.02) ms vs (3565.87 ±174.76) ng/L, (14.08 ±1.23) mg/L,(38.45 ±3.86)].Adverse reactions were not observed in the observation group and the control group.Conclusion Tongxinluo capsule combined with Shen Mai injection can effectively increase the left ventricular ejection fraction and reduce hs-CRP, BNP and QTcd in patients with acute decompensated heart failure.The clinical curative effect is good and the safety is high.

Objective To analyze themonitoring results of environmental hygiene inthe Blood Purification-Center and explore the management. Methods Hospitalinfection control personnel carried on the environmental hygiene monitoring in the blood purification center from 2010 January 2010 to December 2014. A total of 656 sampleswere examined , with monitoring covering airindex , surface of objects , hands of medical staffs and dialysis water. The infections from temporarydouble lumen catheteration were analyzed during the period. Results Of the 656 examinedsamples, 613 were qualified, with the overall pass rate of 96.4%. All the monitoring samples basi-cally achieved the qualified standard, with zero detection rate of the pathogen. The temporarydouble lumen catheterinfection rate was decreased from 8.6% to 3.4% during the period andthe difference was statistically sig-nificant between 2014 and 2010 (χ2 = 7.73, P < 0.01). Conclusion Strengthening the environmental hygiene monitoring may help increase the dialysis treatment and nursing work , decrease the infection rate of temporary dou-ble lumen catheter in hemodialysis patients and improve their quality of life.

Objective To observe the efficacy and safety of oral ibuprofen suspension in treatment of neonatal patent ductus arteriosus. MethodsFrom January 2006 to December 2009 in our hospital,128 cases with neonatal patent ductus arteriosus were accepted as the observation group,treated with oral Ibuprofen Suspension:from January 2003 to December 2005 in our hospital,92 cases with neonatal patent ductus arteriosus were accepted as the control group,treated with lndomethacin.Efficacy and adverse reaction of two groups were compared. ResultsThe closure of the observation group was better than the control group,and the incidence of adverse events was less than the control group,the differences between two groups were statistically significant(P＜0.05). ConclusionOral ibuprofen suspension in treatment of neonatal patent ductus arteriosus had satisfactory effect and less adverse reaction,it was worthy of clinic application.