Objective To summarize the nursing care and cooperation with surgeons using transoral Orvil EEA stapler during total laparoscopic gastrectomy (TLG).Methods We present our initial experience of nursing care and cooperation with surgeons for 8 patients undergoing TLG using a circular end-toside anastomosis created with the transoral directed EEA circular stapler Orvil.Results The surgeries of all 8 patients were successfully completed under our good cooperation with surgeons using the technique of Orvil system.Conclusions Good preparations and knowing well the surgical procedures were the key points to achieve success using the transoral Orvil EEA stapler for patients undergoing TLG.

Aim To explore the mechanisms of Curcumin which plays a role of protecting cells through regulating the activity of GSK-3?.Methods Plasmid APPswe and BACE1-mychis were transiently co-transfected into SHSY5Y cells.The cells were treated with Curcumin and then were collected to determine the mRNA and protein levels of GSK-3?,?-catenin and CyclinD1 by RT-PCR and Western blot. Immuno-fluoresecnt staining was used to detect the location and expression of ?-catenin and GSK-3?, and ELISA was for the generation of A?.Results RT-PCR and Western blot results showed that in the cells, Curcumin inhibited the expression of GSK-3? mRNA and protein, and promoted the expression of GSK-3?-Ser9 protein (P

Objective To evaluate the effect of dexmedetomidine on baroreflex in the patients.Methods Forty-five ASA physical status Ⅰ or Ⅱ patients,aged 20-60 yr,with body mass index 18-24 kg/m2,scheduled for elective partial thyroidectomy or nasal polypectomy under general anesthesia,were randomly divided into 3 groups (n =15 each) using a random number table:control group (group C),low-dose dexmedetomidine group (group LD) and medium-dose dexmedetomidine group (group MD).Dexmedetomidine 0.5 μg/kg was injected intravenously followed by infusion at 0.2 μg· kg-1 · h-1 in group LD.Dexmedetomidine 1.0 μg/kg was injected intravenously followed by infusion at 0.5 μg· kg-1 · h-1 in group MD.After 30 min of dexmedetomidine infusion,a modified Oxford pharmacologic technique was used for evaluating baroreflex sensitivity.Results There was no significant difference in baroreflex sensitivity between the three groups.Conclusion Dexemedtomidine exerts no effect on baroreflex in the patients.

Objective To explore a technique to correct severe congenital nipple inversion,which has preferable clinical curative effect and lower recurrence rate.Methods 16 patients with bilateral severe congenital nipple inversion were included in the study.The rhomboid skin incision and triangular dermal breast compound tissue flap was designed in two directions.One compound tissue flap was pulled out through the tunnel under the nipple to the opposite side and sutured at the base of the other flap.The cross-fixation was accomplished to support the nipple tissue.The shortened lactiferous ducts and fibrous bands beneath the nipples were released.The nipple neck was tightened by suturing the shorter diagonal of rhomboid skin incision.Results No complications,such as infection,hematoma and necrosis,were found in all cases.All nipples manifested satisfactory aesthetic projection without recurrence after 6-24 months follow-up.Conclusions In the treatment of severe congenital nipple inversion,the technique of the nipple suspension using two triangular dermal breast compound tissue flaps could provide a strong suspension system with less recurrence rate.And the nipple neck could be tightened by suturing the shorter diagonal of rhomboid skin incision in the meantime.The nipple will manifest satisfactory aesthetic projection.

Objective To investigate the long-time effects of early recurrence treated by aptos thread after skin grafting of lower eyelid ectropion.Methods Eight eyelids of 6 patients with early recurrence after skin grafting of lower eyelid ectropion were reviewed.They were operated between January 2009 and January 2013.Surgeries were done under local anesthesia.Aptos thread was fixed on the deep temporal fascia above the outer canthus and implanted under the orbicularis oculi muscle.Then aptos thread was fixed with the periorbit of inner canthus.Results 8 eyes of 6 patients were followed for 6～12 months.All the patients were satisfied with the good closure function,ideal cosmetic outcome and non-recurrences of lower eyelids extropion.Conclusions The technique of deep temporal fascia and periorbit fixed by aptos thread is an effective method for early recurrence after skin grafting of lower eyelid ectropion.It would be helpful to obtain a lasting post-operative effects.

Fluid therapy plays a quite important role in peri-operation period,however,conventional measurements are not sensitive to hypovolemia.Goal directed fluid therapy( GDT),which is based on balance of oxygen delivery and consumption,can achieve the aim of fluid therapy more efficiently.Many RCTs have proven that GDT could reduce morbidity,shorten hospital time of high risk surgical patients,therefore,it is a beneficial work.

Objective To establish the HPLC fingerprint analysis method for the quality control of Flos Daturae. Methods Column:Zorbax C18 (4.6 mm?250 mm, 5 ?m);Mobile phase:0.07 mol/L NaPO4 (adjust pH to 6.0 with phosphatic acid, including 17.5 mmol Soldium dodecyi Sulphate)-Acetotrile (2∶1). Flow rate was 0.8 mL/min and detection wave length was 216 nm. Results The repetition and precision of the method was good. There was obvious difference between South and North Flos Daturae based on the results of cluster and similarity analysis. Conclusion The method can control the quality of Flos Daturae effectively.

To evaluate the application of wavefront aberration in diagnosis and operation of retinal detachment.Totally 17 rhegmatogenous retinal detachment patients(17 eyes),who received outer scleral cryocoagulation,silicon cushion and(or)intravitreous injection of gas,were selected from July 2004 to February 2005 at First Hospital Affiliated to Dalian Medical University.These cases were all retinal detachment in one eye.Of the 17 patients,10 were diagnosed as having myopic eye retinal detachment and 7 were non-myopic eye retinal detachment.The wavefront aberrations of these patients were checked with wavefront aberrometer produced by German Wavelight Laser Technology AG Company before operation,1 and 3 months after operation,and compared with the other eyes.The results showed that ①Root mean square(RMS)1,RMS3-RMS6 and root of mean square of higher aberration(RMSH)were significantly higher than those in the control group before operation(P 0.05).②RMS1,RMS3 and RMSH in the myopic retinal detachment eyes were lower than those in the non-myopic retinal detachment eyes before operation(P

OBJECTIVE:To understand the availability and affordability of essential medicines in Nanjing after implementing national essential medicine system,and to provide evidence for formulating and completing related policy. METHODS:With inves-tigation subjects of 6 classes of diseases with high incidence,WHO/HAI standard survey method was adopted to select 24 essential medicines and investigate and evaluate the availability and affordability of them in governmental health institutions and social retail pharmacies in Nanjing. RESULTS:Availability of essential medicines in community health service centers in Nanjing was lower than governmental hospitals and social retail pharmacies,and availability of lowest price generic drugs (LPGs) was much higher than original brand drugs (OBs);affordability was totally good,however,there were large gap in the affordability between OBs and LPGs,the affordability of OBs was relatively poor. CONCLUSIONS:The national essential medicine system has made some progress in Nanjing,but worse than expected. It is suggested to update and adjust the essential medicine list based on the clinical medication requirement,guarantee the equipment of essential medicines in medical and health institutions,popularize the knowl-edge about essential medicines,properly adjust the price of original brand drugs and ease the treatment burden.

Objective This paper analyzes the situation of confidential blood discarding in voluntary blood donation in Jiaxing in 2011-2016 years,and provides scientific evidence for ensuring the blood safety.Methods During 2011-2016 years,15 voluntary blood donors who required confidential blood donation in the blood bank were investigated for their reasons and characteristics.Results The blood discarding rate was 0.011％.15 cases were abandoned in the confidential blood discarding of voluntary blood donation in Jiaxing,in which 14 blood donors' 4 infectious disease markers were negative,1 blood donor was HIV positive,18-30 years old unmarried males are the main category of secrecy abandoned blood donors,the number of secondary donors who have high-risk behaviors or diseases are relatively small.The causes of confidentiality were mainly high risk behaviors (27％) and feculent sexual history (20％).Conclusion Blood donors' conscience to report the truth is quite important to improve the safety of blood transfusion,it is a must to prepare the training of staffs,to broaden the back way,strengthen the propaganda and education,strengthen the consultation work before the blood donation and provide a private security environment of abandoned blood for blood donors.