Objective To investigate the safety and superiority of fast track surgery (FTS)in elderly patients during the perioperative peri-od of laparoscopic cholecystectomy (LC).Methods The clinical data of 124 elderly patients who underwent LC at the Department of Gen-eral Surgery in our institution between January 2010 and March 2014 were assessed,with 62 cases assigned to FTS group and 62 cases to conventional method group.Anal exhaust time,feeding time,off-bed activity time,and length of hospital stay were compared between the two groups,and postoperative results and adverse reactions were recorded.Continuous data were analyzed using the independent-samples t test,and categorical data were compared using the chi-square test.Results Compared with the control method group,patients in the FTS group showed earlier postoperative anal exhaust,feeding,and off-bed activity,a shorter length of hospital stay,and a lower incidence of postoperative cardiovascular and cerebrovascular complications (P<0.05).Conclusion FTS is an effective approach to accelerate rehabil-itation in elderly patients after LC.

Objective To investigate the effects of Peiyuan Shengjin Tongqiao Decoction, a Chinese herbal recipe with the actions of supplementing kidney to strengthen lung and dredging orifices , on traditional Chinese medicine (TCM) symptoms and lung function of childhood asthma complicated with allergic rhinitis. Methods Fifty-five childhood asthma complicated with allergic rhinitis were randomized into treatment group(N=28) and control group (N = 27). The two groups were treated with Budesonide and Formoterol Fumarate Powder for Inhalation, and the treatment group was given oral use of Peiyuan Shengjin Tongqiao Decoction additionally. After treatment, the clinical efficacy of the two groups was evaluated, and TCM symptom scores and lung function indexes [ the percentage of forced expiratory volume in the first second to the expected value (FEV1％) and the percentage of peak expiratory flow to the expected value (PEF％) ] were also observed before and after treatment. Results (1)After treatment for 3 months, the total effective rate of the treatment group was 92.86％, being superior to that of the control group (81.48％), and the difference was significant (P<0.01). (2) After treatment, the scores of cough plus asthma, rhinitis symptom scores and overall TCM symptom scores of the two groups were decreased (P < 0.01 compared with those before treatment) , and the rhinitis symptom scores and overall TCM symptom scores of the treatment group were lower than those of the control group (P < 0.01). (3) After treatment, PEF％ and FEV1％ were both improved in the two groups (P < 0.05 compared with those before treatment) , and the improvement in the treatment group was superior to that in the control group (P <0.05). Conclusion Peiyuan Shengjin Tongqiao Decoction is effective for the control of childhood asthmacomplicated with allergic rhinitis by improving rhinitis symptom scores, overall TCM symptom scores and lung function.

Objective To investigate the etiology and prevention of venous thrombosis (VT) following laparoscopic cholecystectomy (LC). Methods A retrospective analysis on clinical records of 12 cases of VT following 258 cases of LC in this hospital from January 2002 to June 2004 was carried out. Results [WTBZ]The operation time was 17~58 min (mean, 38 min), and the intraoperative blood loss was 15~100 ml (mean, 45 ml). In 11 cases of superficial vein thrombosis, on a treatment for 6~8 days the symptoms of redness, swelling, heat, and pain vanished. Re-examinations of color Doppler ultrasonography revealed disappearance of thrombosis, and an anticoagulation therapy with Warfarin was given. Follow-ups for 6~12 months found no recurrence. In 1 case of deep femoral vein thrombosis accompanying pulmonary embolism, an anticoagulation therapy was employed for 4 months and a follow-up for 6 months showed no recurrence. Conclusions The development of VT following LC is correlated to patients' high-risk factors, carbon dioxide pneumoperitoneum, and anesthesia administration. Emphasis should be on active countermeasures during peri-operative period.

Objective To explore the factors influencing pneumococcal vaccination uptake among the el-derly people in Guangzhou. Methods A survey by questionnaire was performed among 827 subjects aged 60 years or above and living in Guangzhou for five consecutive years. Chi-square test and multiple logistic regression analysis were applied to identify factors influencing pneumococcal vaccination uptake among the elderly. Results The positive factors for vaccination uptake among the elderly people included age of over 70 years (OR=1.677, 95%CI: 1.156 ~ 2.434), mental workers (OR = 1.837, 95%CI: 1.214 ~ 2.779), education background of over-three-year-course training (OR=1.769, 95%CI:1.039~3.012), and history of chronic diseases (OR=1.659, 95%CI:1.096~2.512) were positively associated with pneumococcal vaccination uptake. Monthly disposable income was not an influencing factor (OR=1.420, 95%CI: 0.895 ~ 2.251). Conclusion Strengthened publicity of pneumo-coccal vaccination among the elderly people and flexible measures tailored to the needs of different groups are rec-ommended in order to improve pneumococcal vaccination uptake among the elderly people.

Objective To investigate the levels of sICAM 1 and sE selectin in patients with chronic hepatitis(CHC) and to study their roles in judge of response to IFN ? 2b treatment. Methods sICAM 1 and sE selectin levels were measured in 32 cases of CHC before and after treatment of IFN ? 2b by enzyme linked immunosorbent assay(ELISA), levels of HCV RNA was detected by quantitative PCR and serum ALT activity was also detected. Results Levels of sICAM 1 and sE selectin in CHC patients were significantly higher than those in normal controls(P

Objective To evaluate the effect of levamlodipine intervention in diabetic nephropathy patients which accompanied with hypertension, using the technology of diffusion-weighted imaging (DWI) of functional magnetic resonance (fMRI).Methods A controlled prospective method was taken , and fifty diabetic nephropathy ( phase III) patients which accompanied with hypertension were randomized assigned to two groups of A ( n =26) and B ( n =24).Levamlodipine (2.5 mg qd) was taken by patients of group A and amlodipine (5 mg qd) was taken by patients of group B for 24 weeks, respectively.Two groups both took angiotensinⅡreceptor blockers (ARBs) as the first line antithypertensive agents , their urinary albumin excretion rate (UAER), serum creatinine (sCr), cystatin C (Cys C) , and DWI scanning were detected before and after intervention .The levels of UAER, apparent diffusion coeffi-cient (ADC) value were compared between two groups before and after intervention .During the 24th week, two groups'adverse reac-tion to the medicines and the levels of blood pressure were recorded in each follow-up visit.Results The levels of UAER, systolic blood pressure(SBP), and diastolic blood pressure(DBP) were Significantly lower in group A after 24-week intervention compared to baseline [42.5 (25.3~91.0)μg/min vs 49.2(29.7~96.8)μg/min,(112.6 ±6.4)mmHg vs (135.3 ±7.6)mmHg, (71.4 ± 10.7)mmHg vs (80.3 ±11.6)mmHg, P <0.05, respectively].DWI scanning showed that ADC value of renal parenchyma was sig-nificantly improved than that of baseline [(2.45 ±0.12)vs(2.17 ±0.09), P <0.05].In Group B, the level of SBP was also signifi-cantly lower than that of baseline [(121.5 ±11.6)mmHg vs (134.8 ±9.2)mmHg, P <0.05], and ADC value of renal parenchyma was significantly improved than that of baseline [(2.28 ±0.15) vs (2.14 ±0.09), P <0.05].No difference was found in DBP and UAER before and after intervention ( P >0.05).Group A had a better improvement of SBP (ΔSBP) and ADC (ΔADC) after inter-vention compared to group B ( P =0.02,0.01, respectively).The overall adverse reaction incidence was 15.4%(4/26) in group A and 41.7%(10/24)in group B, respectively (χ2 =4.27, P =0.0387).Conclusions For the diabetic nephropathy (phase III) pa-tients accompanied with hypertension , levamlodipine likely showed better effects on reducing comprehensive blood pressure and UAER , improving renal microcirculation , with less overall adverse reaction compared to amlodipine .

Aim To construct eukaryotic expressing plasmid of hi FGF2 ( high molecular weight isoform fi-broblast growth factor-2,hi FGF2) gene and to investi-gate its effect on apoptosis after its overexpression in HEK293 cells. Methods The DNA template primer was designed and synthesized. The pDsRed1-N1 plas-mids were digested by the restriction enzymes of Nhel and Hind III. The hi FGF2 was ligated with linearized pDsRed1-N1 by T4 DNA Ligase. The recombinant plasmid was identified by endonuclease digestion and sequenced. The recombinant hi FGF2 plasmid was transient transfected into HEK293 cells by Lipofectami-neTM 2000 Reagent. The transfection efficiency was de-tected by fluorescence inversion microscope. The cell apoptosis was detected by Annexin V-FITC/PI apopto-sis detection kit with flow cytometry analysis. Results The pDsRed1-N1 eukaryotic expression vector was consistent with the design. The recombinant hi FGF2 plasmid was transfected in HEK293 cells. The trans-fection rate was more than 70%. The FITC/PI dyeing rate in hi-FGF2 over-expression HEK297 cells was a-bout ( 29. 12 ± 2. 81 )%. Conclusions pDsRed1-N1 eukaryotic expression vector is successfully constructed and transfected into HEK293 cells. Over-expression of hi FGF2 induces cell apoptosis.

Objective To investigate the effect of different concentrations of methotrexate (MTX) on IL-17 from peripheral blood mononuclear cells(PBMCs) and To clarify the active mechanisms of MTX on RA. Methods PBMCs were isolated from heparinized blood of healthy donors or patients with RA using Ficoll-Hypaque density gradient centrifugation. The cells were pretreated with various concentrations of MTX and then stimulated by anti-human CD3/anti-human CD28 at 37℃5%CO2. The IL-17 mRAN level was detected by semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR). The supernatants were harvested and the protein level of IL-17 was tested by ELISA kit. The percentage of CD4+IL-17+cells in PBMCs was detected by flow cytometry. Results For the four different concentrations of MTX groups (0.1,1.0, 5, 25μg/ml), the IL-17 mRNA/GAPDH ratio(0.58±0.09,0.48±0.11, 0.50±0.09, 0.51±0.14) were lower than those of the non-drug group(0.76±0.08). Paired-t test or independent-samplet test showed significant difference between the MTX treatment group and the non-drug group(P＜0.01). The level of IL-17 of the four MTX groups was(121±54)pg/ml and(104±45)pg/ml and(90±36)pg/ml and(115±41)pg/ml, which was lower than the non-drug group(370±187)pg/ml(P＜0.01). The average C D4+IL-17+cell ratio was reduced, but had no statistically signficant differences(P＞0.05). Conclusion MTX can decrease Th17 cells differentiation and suppress IL-17 production of PBMCs, but no association can be found between its effect on the expression of IL-17 and the concentration of MTX.

Based on the conservation of resource theory, we proposed a two-path model to examine the double-edged sword effects of career calling on occupational embeddedness via work–family conflict (WFC) and career adaptability. The proposed theoretical model and hypotheses were tested by structural equation modeling technology with a sample of nurses from five hospitals in China (total N = 368). Career calling has a double-edged sword effect on occupational embeddedness via WFC and career adaptability. Career calling has positive effects on WFC and career adaptability. WFC and career adaptability, in turn, negatively and positively influence occupational embeddedness, respectively. In addition to the well-established positive effects, career calling may also have adverse effects on occupational outcomes. Given the worldwide shortage of nursing staff, how career calling affects nurses' occupational embeddedness needs to be more understood. This study highlights the importance of career calling and occupational embeddedness. Nurse managers need to improve the level of nurses' career adaptability and reduce their level of WFC and hence increase their occupational embeddedness.

Based on the conservation of resource theory, we proposed a two-path model to examine the double-edged sword effects of career calling on occupational embeddedness via work–family conflict (WFC) and career adaptability. The proposed theoretical model and hypotheses were tested by structural equation modeling technology with a sample of nurses from five hospitals in China (total N = 368). Career calling has a double-edged sword effect on occupational embeddedness via WFC and career adaptability. Career calling has positive effects on WFC and career adaptability. WFC and career adaptability, in turn, negatively and positively influence occupational embeddedness, respectively. In addition to the well-established positive effects, career calling may also have adverse effects on occupational outcomes. Given the worldwide shortage of nursing staff, how career calling affects nurses' occupational embeddedness needs to be more understood. This study highlights the importance of career calling and occupational embeddedness. Nurse managers need to improve the level of nurses' career adaptability and reduce their level of WFC and hence increase their occupational embeddedness.