Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) for acute cholecystitis. Methods Clinical records of 79 cases of acute cholecystitis treated by LC from September 2002 to August 2003 were respectively reviewed. Results Intraoperative cholangiography (IOC) was successfully conducted in 75 cases, 6 of which were found common bile duct stones. Of the 6 cases, 4 underwent LC combined with intraoperative endoscopic sphincterotomy and 2 underwent a conversion to open choledochotomy with T-tube drainage. The rest of 73 cases were diagnosed as simple gallbladder stones: LC was successfully accomplished in 70 cases and a conversion to open surgery was required in 3 cases because of serious inflammatory adhesion. In the study no severe complications occurred. Conclusions LC can be performed safely in the majority of cases of acute cholecystitis.

Objective To study the effect of Dahuang-Mudan decoctionby retention enemafor the thepatients with acute pelvic inflammation disease (APID) and toxic heat flourishing type. Methods Ninety patients with APID (toxic heat flourishing type) were randomly divided into treatment group and control group (45 case per group). The patients in both groups were given cefamandolenafate injection and tinidazole injection;and the Dahuang-Mudan decoction by retention enema was added to the treatment group.The C-reactive protein (CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and clinical symptoms scores in both groups before treatment and after 2 weeks of treatment were observed. Results After treatment, CRP (3.16 ± 1.25 mg/L vs. 8.68 ± 1.45 mg/L, t=19.126), TNF-α(4.02 ± 1.06 ng/L vs. 9.64 ± 2.08 ng/L, t=15.966), IL-6 (60.34 ± 14.35 ng/L vs. 88.24 ± 12.16 ng/L, t=9.839), temperature recovery time (3.22 ± 1.13 d vs. 4.73 ± 1.36 d, t=5.638), abdominal pain disappeared time (5.26 ± 1.43 d vs. 7.45 ± 1.32 d, t=7.418), leukocyte recovery time (7.34 ± 2.06 d vs. 9.58 ± 2.26 d, t=4.834), hospital stay time (10.24 ± 3.42 d vs. 13.43 ± 4.38 d, t=3.791) in the treatment group were significantly lower than those in the control group (P<0.01). The clinical effect rate (77.27% vs. 48.84%, χ2=7.562) in the treatment group were significantly higher than that in the control group (P<0.01). Conclusions The treatment of APID (toxic heat flourishing type) with Dahuang-Mudan decoction by retention enema can reduce the inflammatory response of pelvic, promote the absorption of exudate and adhesion in pelvic.

[Objective]To study the pathogenesis,clinical manifestation and surgical treatment of the posterior margin separation of lumbar vertebral epiphysis.[Method]Sixteen patients suffering from the posterior margin separation of lumbar vertebral epiphysis were followed up.The clinical manifestation and radiologic examination were analyzed and results of surgical treatment were evaluated.[Result]The patients were usually young and manifested with the sign and symptom of lumbar disc herniation and/or lumbar stenosis.CT was helpful for the accurate diagnosis of this disease.The different surgical measures were taken for the treatment according to the type and range of protrusion.[Conclusion]The posterior margin separation of lumbar vertebral epiphysis were divided into three types:end plate separation and moving into posterior margin,Schmorl node and avulsion fracture.The good results can be obtained with surgery.

Objiective To observe the morphological changes of rabbits' retina at different time points at which seawater was injected into the vitreous of rabbits. Methods Twenty-five New-Zealand white rabbits were randomly assigned to five groups, as 30 minutes, 2 hours, 6 hours, 12 hours and 24 hours group following the seawater injection in the vitreous. The right eyeball served as experimental eyeball and the left one as control in each group. 0.5ml artificial seawater was injected into the intermedius of rabbits right vitreous. 0.5ml balanced salt sdution was injected into the left vitreous in teh same way. At different time points following the eyeball injury, the morphological changes of retina were observed with light microscope and transmission electron microscope. Results The retina of control eyeballs had clear layers and regular cell shape in retinal structures with conventional staining. For the experimental eyeballs, the ganglion cell layer began to swelling after 30 minutes of seawater injection. The nerve fiber swelled obviously and the mitochondria vesiculated and swelled in the inner segment at 2 hours of seawater injection. The cell population of the inner nuclear layer began to reduce in 6 hours. At 12 hours of seawater injection, the retinal damages included disorganized cell nuclei, decreased cell population in ganglion cells and inner nuclear layer. Mitochondria vesiculated in photoreceptor cells, nuclear membrane shrank and sank inward. The vesiculation on inner and outer segments increased obviously. Conclusions Seawater may cause the morphological changes of rabbits' retina at early stage, and the histological damages become aggravation following the time prolongation. The damages would be unrecoverable 6 to 12 hours after seawater injury.

Objective To evaluate the value of admission test of fetal heart rate and artificial rup-ture of membrane in predicting fetal distress in labor. Methods 658 pregnant women who had been pregnant for 33+5 to 43 weeks and delivered spontaneously in 24 hours were divided into low risk group(598 cases) and hign risk group(60 cases) according to their admission test. The admission test, result of deliv-ery, amniotic fluid contamination and Apgar scores of newborns were analyzed. Results 515 cases were reactive type(78.27%), 72 cases were equivocal type(10.94%) and 71 cases were ominous type(10.79%). Total incidence of neonatal asphyxia were 6.53%,and it was 1.94% and 33.08% in reactive type subjects and ominous type subjects, respectively. The rates of anmiotic fluid contamination were 20. 97% and 67.61% in reactive type subjects and ominous type subjects (P<0.01). The incidence of reactive type and equivocal type of amniotic fluid contamination and neonatal asphyxia were significantly lower in the low risk group than those in the high-risk group (P<0.05). Conclusions Reactive type of admission test can ensure safety of fetus during the subsequent four to five hours. Admission test of fetal heart rate and artifi-cial rupture of membrane can be used to predict fetal outcome in labor.

Research-Based Teaching is to cultivate students’ competence of study and innovation,which requires teachers to change their concept and make careful design and full preparation before they put it into practice. The practice shows that adopting the teaching method of bringing students’ autonomous study into full play and intensifying the training of their scientific research is an important approach to implement it. Research-Based Teaching will play a more and more important role in cultivating students’ comprehensive competence.

Objective To investigate the effects of ZGDHu-1 on T lymphocytes activation in vitro to elucidate its immunosuppressive effects. Methods Lymphocytes isolated from healthy persons were stim-ulated with phytohanmagglutinin(PHA) and different experimental groups were set by cocultured for 24 h, 48 h with ZGDHu-1 or with ZGDHu-1 and Cyclosporin A(CSA). To assess the proliferation and apoptosis of T lymphocytes, we detected CD3~+ CD69~+ , CD3~+ CD25~+ , CD4~+ CD25~+ , CD8~+ CD25~+ and CD3~+ Fas~+, CD4~+ Fas~+ , CD8~+ Fas~+ with flow cytometry. The early apoptosis rate of lymphocytes was analyzed with flow cytometry. Culture supernatant IL-2 and TGF-β1 were detected with ELISA. Results ZGDHu-1 decreased PHA activative CD3~+ CD69~+, CD3~+ CD25~+, CD4~+ CD25~+ and CD3~+ Fas~+, CD4~+ Fas~+, Annexin V~+/ PI~- and inhibited IL-2 secretion and promoted TGF-β1 secretion respectively. ZGDHu-1 has synergistic effect with CSA to be more obvious. Conclusion ZGDHu-1 can inhibit T lymphocytes activation and de-creased apeptosis of T lymphocytes. ZGDHu-1 has synergistic effect with CSA to be obvious.

Human errors are errors found in planning or implementation, and those found in medical practice are often major causes of mishaps.To name a few, wrong-site surgery, medication error, wrong treatment, and inadvertent equipment operation.Errors of this category can be prevented by learning from experiences and achievement worldwide.Preventive measures include those taken in human aspect and system aspect, reinforced education and training, process optimization, and hardware redesign.These measures can be aided by multiple safety steps in risky technical operations, in an effort to break the accident chain.For example, pre-operative surgical site marking, multi-department co-operated patient identification, bar-coded medication delivery, read-back during verbal communication, and observation of clinical pathway.Continuous quality improvement may be achieved when both the management and staff see medical errors in the correct sense, and frontline staff are willing to report their errors.

Objective To explore the effect of Eight-Section Brocadeon improving extrapulmonary performance and lung function in elderly stable chronic obstructive pulmonary disease (COPD) patients. Methods A total of 120 elderly stable COPD patients were divided into experimental group and control group by random digits table method with 60 cases each. The experimental group received Eight-Section Brocade and the control group took a walk both based on the routine health education. The World Health Organization Quality of Life (WHOQOL)-BREF, 6 min walking test and lung function were conducted before and after intervention 12, 24 and 36 weeks. Results After intervention, the score of each field of WHOQOL-BREF were higher than those before intervention, comparison of two groups of physiological fields Ftime=57.112, Fgroup=10.510, Finteractive=13.653, all P<0.01; psychological field Ftime=240.209, Fgroup=6.201, Finteractive=6.902, all P<0.05;field of social relations Ftime=34.957, Fgroup=7.265, Finteractive=11.554, all P<0.01; environmentfield Ftime=66.431, Fgroup=8.197, Finteractive=18.413, all P<0.01, and there were significant differences in time, groups and interactive. Comparison of two groups of the result of 6 min walking test after intervention, Ftime=327.697, Fgroup=37.181, Finteractive=61.420, all P<0.01. Comparison of two groups of the result of lung function indexforced expiratory volume in one second, Fgroup=5.083, P<0.05, there was significant difference;after intervention the index of Forced expiratory volume in 1 second take up of the expected value, Fgroup=4.141, P<0.05, there was significant difference. Conclusions Eight-Section Brocade can effectively improve the elderly stable COPD patients with exercise endurance and quality of life, improve the extrapulmonary performance, delay the progressive decline of lung function.

As one of the chronic disease of respiratory system,chronic obstructive pulmonary disease contributes to a progressive decline of lung function,as well as the extra-pulmonary effects.Malnutrition,one of the extra-pulmonary effects,becoming the common problem for chronic obstructive pulmonary disease patients.It has severe harm to chronic obstructive pulmonary disease patients that need us to pay more attention to it.The choice of nutrition assessment tools has important significance for the correct results of nutrition status of the patients.