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.

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 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 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 Through carries on propaganda educates and synthesizes the intervention to some bank staff about hypertension,diabetes mellitus etc.Enhances the service crowd health consciousness,the self control skill and the quality of life.Methods After phvsical examination and so on comprehensive collection service crowd's healthy information,carries on the health risk to appraise,simultaneously adopts the way which the companion educates to guarantee the health management the long-term characteristic,the validity,and regularly carries on the appraisal to the health management effect.Results Through to service object health management,hypertension,the diabetes elementary knowledge knows insufficient rate from 60%enhances to 90% above,its main harm knows rate from 29.52%(31/105)enhances to 83.81%(88/105).Conclusions Enhanced service correlation states-of-art and self-control ability and so on crowd's hypertension,diabetes through the health management,active control hypertension,diabetes and so on disease incidence rate,reduce complication,reduce death rate,improved the service crowd's 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.

The growth associated protein(GAP 43) and neural cell adhesion molecule (NCAM) play an important role both in promoting neurite outgrowth and synaptic plasticity. GAP 43 is a neuron specific phosphoprotein that is highly expressed during the development of the central nervous system, nerve regeneration and the modulation of synaptic function, and it is frequently used as a marker for sprouting. GAP 43 may be involved in G protein interaction, membrane binding, calmodulin binding and protein kinase C phosphorylation. The various interactions, specified by the structural domains, are thought to underlie the role of GAP 43 in synaptic plasticity, participating in membrane extension during neuritogenesis, in neurotransmitter release and long term potentiation. NCAMs involve in the intracellular signaling cascades and stimulate the axonal growth, GAP 43 function is essential for NCAM stimulated neurite outgrowth and that much of this appears because of the phosphorylation of GAP 43 via the FGF receptor dependent stimulation of arachidonic acid. NCAM can accelerate the phosphorylation of GAP 43.

This thesis analyzes the current problems in the medical morality and ethics among medical staff,including the insufficiency of service conception,excessive emphasis on personal economic benefits,and the absence of basic morality,and points out the importance of medical morality and ethics construction.Concrete suggestions are also raised from the aspects of strengthening the moral education of serving the people,establishing an overall supervision mechanism,and generally improving medical service quality.