Objective To study the diagnosis and treatment of typhoid intestinal perforation(TIP). Methods The clinical data of 30 cases of TIP treated in our hospital from 1978 to 1998 were retrospectively analysed. Results All 30 cases were performed emergency laparotomy exploration. Of them, 16 cases underwent suture of the perforation, 9 enterectomy and intestinal anastomosis, and 5 exteriorization of intestine. After operation, 2 cases had infection and disruption of incisional wound, 1 pulmonary infection, 1 toxic myocarditis and 4 intestinal fistula. 26 cases curred, 4 cases died including toxic shock in 1 case, intestinal fistula and concomitant asthenia universalis in 3 cases. Conclusions Early diagnosis, early operation and choosing suitable operative procedure are important to reducing the mortality of TIP.

Objective To investigate the effect of milrinone on the gastric intramucosal pH (pHi), endotoxemia and systemic inflammatory response during cardiopulmonary bypass (CPB) Methods Twenty adult patients undergoing valve replacement were randomly divided into two equal groups of ten patients each: control group (C) and milrinone group (M) In group M milrinone 30?g?kg -1 was given as an intravenous bolus after induction of anesthesia followed by 0 5?g?kg -1 ?min -1 infusion, while in group C normal saline (NS) was given instead of milrinone Patients with ejection fraction (EF)

Objective To analyze the pathologic and biology features and prognosis of HER-2,ER and PR negative breast cancer(TNBC).Methods Clinic pathologic data of 329 breast cancer patients was retrospectively analyzed. The expression of HER-2, ER, PR and P53 was determined by immunohistochemistry. The patients were divided into three groups, including TN group [ HER-2 (-), ER (-), PR (-)], HER-2 group [HER-2(+),ER(-),PR(-)] and HR group [ER(+),PR(-) or (+),HER-2(-) or (+) ].The pathology and biology features and P53 masculine expression of the three groups were compared.The 5-year overall survival and disease free survival were analyzed by Kaplan-Meier method.Results Of the 329 patients, 20.97% (69/329) was TN group, 34.04% (112/329)was HER-2 group, and 44.98% (148/329) was HR group.The percentage of with lymph node metastasis in TN group 55.07% (38/69) was higher than that in HER-2 group 42.86% (48/112) and HR group 43.24% (64/148) (χ2 = 12.57, P ＜ 0.05).The rates of P53 positive, operation recurrence and metastasis in TN group were 44.93%, 27.54% and 20.29%, which were higher than that in HER-2 group (20.54% ,16.07%,16.96%) and HR group (18.24%, 12.84%, 10.81%) (χ2=12.23, 8.36, P ＜0.05).The ratio of tumor ≥5cm, Ⅲ stages, Ⅲ grade and soakage canula cancer among three groups had statistical difference (χ2 = 7.25,8.79,9.23,8.48, P ＜ 0.05).The 5-year overall survival in three groups were 75.36%,82.14% ,85.14% and disease free survival were 68.12% ,78.57% ,82.43% (χ2 =8.52, P ＜0.05).Conclusion The pathology and biology traits of TNBC were high rate of P53 (+) and recurrence and lymph node metastasis.The most important factor for poor prognosis of TNBC was the low rate of disease free survival for 5 years.

Objective To analyze the causes of postoperative complications of Mesh plug hernia repair of inguinal hernia. Methods The 332 ingunial hernia patients from June 2002 to May 2007 who underwent Mesh plug repair were summarized retrospectivdy. the causes of postoperative complications were analyzed. Results All the patients were followed up 15～60 months.there were 3 cases of durative pain,1 case of recurring,16 cases of scrotal edema,20 cases of urinary retention. Condusion Anatomizing carefully during operation is the key to decrease the postoperative complications of Mesh plus hernia repair.

Objective To evaluate the left ventricular function and the synchrony of myocardial ischemic segments in patients with coronary heart disease (CHD) after PTCA and stent implantation by quantitative tissue velocity imaging (QTVI). Methods Thirty-six patients with isolated left anterior descending stenosis (≥75%) were examined by QTVI three days before, one week and one month after successful PTCA and stent implantation to measure the following items of 5 different left ventricular segments: peak systolic velocity( Vs), early diastolic velocity (Ve), late diastolic velocity (Va), time to peak systolic velocity(Ts). Then the coefficient of variation (SD/mean) of the 5 different Ts were calculated.Results The value of Vs,Ve and Va were decreased and the Ve/Va ratio was reverses three days before PTCA + stent. Compared with that before PTCA + stent,the value of Vs and Ve were increased significantly in one week ( P ＜0. 05) and one month( P ＜0.01 ) after PTCA + stent,respectively,the value of Va was not statistically significant. Ve/Va ratio was recovered in one week after PTCA treatment. Ts and Ts-SD were shorted dramatically in one week( P ＜0. 05) and one month( P ＜0.01 ) after PTCA + stent compared with that before PTCA + stent in which Ts were prolonged more than 33 ms. Conclusions QTVI can quantitatively assess the left ventricular function and the synchrony of myocardial ischemic segments, and can be used to real-time detect the changes of function and synchrony of left ventricle after PTCA and stent implantation.

OBJECTIVE:To provide reference for the classification of the specification grade of Dioscorea opposite.METHODS:Using the Delphi method,17 experts,who were associated with the study of the distribution and clinical application of D.opposite,were selected to conduct two rounds of consultation on 18 samples of medicinal herbs.The importance of the sensory evaluation indexes of D.opposite was screened and the overall satisfaction was evaluated.The specification grade of D.oppositewas determined preliminarily.RESULTS:Totally 17 questionnaires were issued for each round of consultation,and 17 were recovered with recovery rate of 100％.According to statistical analysis,the average value of expert's authority coefficient was 0.77 +0.07,and average recurrence rate of individual review was (91.18 + 7.64)％.The average recurrence rates of group review in two rounds of consultation were (66.67 + 13.50)％ and (65.97 + 14.01)％.The influence of working life,business background and educational background on recurrence rates of group review for interviewed experts was comprehensive.The full score ratio of appearance and cross-sectional characteristics importance was more than 80％,and the average value was more than 0.8.The full score ratio and average value of iron yam were higher.CONCLUSIONS:It is accurate and scientific to evaluate the specification grade of Chinese medicinal herbs with sensory experience.The most important evaluation indicators of D.opposite were the appearance,shape and cross-sectional characteristics.And it is divided into iron yam and non-iron yam preliminarily.The iron yam grade in descending order:Henan sandy iron yam,Shandong sandy iron yam,Henan loquat iron yam.The non-iron yam grade in descending order:Henan Huaiqingfu D.opposite,Hebei Xiaobaizui D.opposite,Hebei Ma D.opposite and Shanxi Chang D.opposite.

0.8). Conclusions This DNA chip combined with multiplex PCR is a rapid diagnostic assay with high specificity and sensitivity for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis and Ureaplasma Urealyticum and their drug-resistance, and may be applied in the diagnosis of urogenital infections.

Worster-Drought syndrome (WDS) is a special and rare type of cerebral palsy, which is characte-rized by pseudobulbar palsy, selective weakness of the muscles of the lips, tongue, and soft palate, dysarthria, dysphagia, salivation, and jaw spasm.The onset of WDS is linked with a variety of prenatal, intrapartum and postnatal factors.The report of family cases of WDS suggested the genetic predisposition.Although there is no cure at present, early genetic counseling, early diagnosis and intervention can reduce the morbidity of offspring and improve the symptoms of children with WDS, which will greatly reduce the burden on the family and society in the future.In the present study, this paper aims to explore the etiology, pathogenesis, clinical manifestation, imaging examination, diagnosis, disease spectrum and current treatment of WDS, thus improving the diagnostic and therapeutic efficacy.

Objective:To observe the effects of Xiaoqinglong Decoction and Tingli-Dazao-Xiefei Decoction in treating chronic heart failure with syndrome of cold phlegm obstructing lung. Methods:Eighty-six chronic heart failure patients from January of 2017 to December of 2018 in our hospital who met the inclusion criteria were selected and divided into 2 groups according to the random number table method with 43 patients in each group. The control group was treated with conventional therapy, and the observation group was orally treated with Xiaoqinglong Decoction and Tingli-Dazao-Xiefei Decoction. Both groups were treated for 3 months. Then scored the symptoms of cold phlegm obstructing lung from four aspects: palpitations, cough and asthma, uria and edema, and sputum. The ultrasonic cardiogram was used to detect the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF). The ELISA method was used to measure levels of vascular pseudohemophilia factor (vWF),endothelin-1 (ET-1) and serum levels of total antioxidant capacity (TAC), lipid peroxide (LPO), SOD, MDA. The efficacy was evaluated. Results:The total effective rate of the observation group was 90.7% (39/43), significantly higher than that of the control group as 69.8% (30/43), and the difference between the two groups was statistically significant ( χ2=4.692, P=0.030). After the treatment, scores of palpitation, cough and asthma, urine and sputum in the observation group were obviously lower than those of the control group ( t value were 7.621, 7.033, 6.831, 6.635, respectively, all Ps<0.01); the LVEDD (51.41 ± 5.69 mm vs. 58.49 ± 6.77 mm, t=9.809), LVESD (40.04 ± 4.48 mm vs. 43.25 ± 5.21 mm, t=6.776) of the observation group were significantly lower than that of the control group, and while LVEF (50.16% ± 5.89% vs. 45.87% ± 5.16%, t=7.761) was significantly higher than that of the control group ( P<0.01). Plasma levels of vWF (103.55% ± 11.98% vs. 138.11% ±15.71%, t=41.453) and ET-1 (67.05 ± 7.18 pg/ml vs. 81.72 ± 10.03 pg/ml, t=18.990) in the observation group were significantly lower than that of the control group ( P<0.01). The serum levels of TAC and SOD levels in the observation group were significantly higher ( t value were 4.662, 13.331, respectively, all Ps<0.01), while LPO and MDA levels were significantly lower than the control group ( t value were 4.982, 4.031, all Ps<0.01). Conclusions:The Xiaoqinglong Decoction and Tingli-Dazao-Xiefei Decoction in treating chronic heart failure can improve the heart function and symptoms with syndrome of cold phlegm obstructing lung, and increaseclinical efficacy.

Objective:To explore the clinical technique and method of reconstruction large soft tissue defect of plantar by skin soft tissue dilatation combined with thigh cross leg flap to improve the weight-bearing function of plantar standing.Methods:From February 2015 to June 2019, 8 cases with plantar soft tissue defects were repaired with cross leg flap expanded from the healthy side of the thigh. Right foot in 4 cases, left foot in 3 cases and bilateral in 1 case. There were 5 males and 3 females. Ages ranged from 16 to 56, with an average age of 31. Clinical features: scar ulcer in 4 cases, bone-sticking scar in 4 cases, bone exposure in 1 case. After debridement, the area of skin and soft tissue defect was 9 cm×16 cm-12 cm×29 cm, the area of harvest expanded flap was 11 cm×18 cm-14 cm×30 cm. All flaps were fixed by cross-leg with pedicle. The pedicle division were performed one month after the skin flap transmission.Results:Of the 9 flaps transferred, 8 survived, 1 died in the distal part of the flap and was repaired by secondary expanded flap, and the donor site healed in linear scar stage. After 6-24 months follow-up, the plantar flap was in good shape and could walk with weight-bearing, without ulceration, and the protective tactile sensation was gradually restored in 12 months.Conclusions:The large-area soft tissue defect of plantar was repaired with the expanded cross leg flap in the healthy thigh, which also provide sufficient thickness of soft tissue to increase the ability of bearing weight and wearing resistance of the sole. It is a good alternative method to repair large area soft tissue defect of plantar under the condition of limited transfer of perforator flap and free flap.