Objective To study the incidence, spreading path, prognosis and treatment of the umbilical metastasis Sister Mary Joseph nodule (SMJN) from malignancies Methods To analyse the clinical feature from 3 cases of SMJN and to review pertinent literatures Results Three cases SMJN were come from advanced primary peritoneal carcinoma in case 1, recurrent mucinous ovarian papillary adenocarcinoma in case 2 after primary cytoreductive surgery and systemic chemotherapy and case 3 with recurrent endometrial carcinoma All patients received umbilical resection and the umbilical metastasis was comfirmed pathologically, while case 3 was diagnosed adenocarcinoma spreading by fine needle respiration before the surgery The mean survival was 63 months following surgery or chemotherapy or radiotherapy, case 1 died of advanced malignancy, while case 2 and case 3 were still alive 58 and 44 months, respectively Conclusions Although the incidence being low, SMJN was the important sign of one of the vast metastatic malignancy and has grave prognosis Umbilical resection should be performed on some patients of SMJN with relative good condition, and chemotherapy or radiotherapy should also performed accordingly

Objective To investigate the effect of health education and behavioral intervention on the self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.Methods From March 2012 to April 2013,70 patients with gastrointestinal malignant tumor whose lifetime was estimated to be within 6 months were extracted from five general hospitals in Tangshan.70 patients were randomly divided into the intervention group and the control group with 35 cases in each group.The two groups samely received routine nursing care,while the intervention group was given health education and behavioral intervention.Both groups were evaluated by SPBS-CP before and after intervention.Results The scores of the intervention group after intervention were lower than before intervention and the control group,which were reflected in 3 dimensions such as care burden,psychological and emotional burden and treatment burden.Conclusions Health education and behavioral intervention can effectively relieve self-perceived burden of patients with gastrointestinal malignant tumor at end-stage.

Objective To investigate the distribution of the mini mental status examination in the elderly Methods Totally 3 776 residents aged 55 years or over serving as samples in the urban and rural areas of Lhasa city, from August to December in 2001 were studied A residential area and a door to door general sampling procedures were used in this study, respectively Mini mental status examination (MMSE) and a activity of daily living scale (ADL) were used as screening methods for dementia Results The distribution of lower scores in such examination in middle elderly people, in Lhasa city was 7 2%, in which, males were 9 3% and femals, 6 3% Conclusion The results of lower scores in the mini mental status examination were similar to those reporting from inland cities, but there appear some what differences in distributions of ages, educational levels and sexes from Tibetan, which may be due to their special location and living habits

To probe into the mechanism of c fos, c jun expression regulated by preconditioning, we observed protein kinase C (PKC) changes of c fos, c jun gene transcription in cultured cardiomyocytes affected by transient ischemic and medicine preconditioning mimicking ischemia reperfusion injury. Cultured rat cardiac myocytes were exposed to ischemia reperfusion mimicking solution after brief ischemic episodes or PMA, norepinephrine, adenosine preconditioning. Using Northern hybridization assay, we detected the gene transcription of c fos, c jun in cardiomyocytes. In mimicking ischemia the content of c fos, c jun mRNA increased significantly. Drug preconditioning induced cardiomyocyte c fos ,c jun expression in varing degrees. H 7 blocked this preconditioning effect. These results suggest that through activating PKC preconditioning induced c fos, c jun expression and PKC might play a central role in ischemic preconditioning.

Objective To study the prevention and treatment of bile duct injury during laparoscopic cholecystectomy(LC). Methods 22 cases of bile duct injury during LC were reviewed retrospectively. The features, diagnosis, treatment and efficacy of injury were summarized. Results All patients were successfully treated by Roux-en-Y cholangio-jejunostomy. Besides, 8 patients underwent plastic operation of bile duct of hepatic portal and 3 patients middle lobectomy of liver. 22 cases were followed up at the 1st and 3rd year after surgery, and no bile duct stricture, recurrence of jaundice and cholangitis occurred. Conclusions It's a key to prevent bile duct injury during LC. The management of bile duct injury should be chosen according to injured time, sites and types.

Objective To explore the causes,prevention and treatment of postoperative respiratory failure in patients with lung cancer.Methods The clinical data of 659 patients,admitted in Changzheng Hospital from Jan.2000 to Dec.2006,with lung cancer and suffered from postoperative respiratory failure were analyzed retrospectively.Preoperative lung function,past medical history,the etiology and preventive procedures,and the treatment methods for postoperative respiratory failure were also reviewed.Results Postoperative respiratory failure was occurred in 42 of 659 cases,the incidence was 6.4%,and all the 42 cases occurred in 1 to 5 days after operation.The major etiopathogenisis of postoperative respiratory failure included respiratory infection,bronchial asthma,operative wound,postoperative incision pain,preoperative cardiopulmonary dysfunction,etc.The respiratory failure was controlled in 37 of the 42 cases by mechanical ventilation and symptomatic treatment.Two cases died of multiple organ failure,another 2 cases died of respiratory distress syndrome and 1 case died of severe respiratory tract infection,the mortality was 11.9%.The preoperative lung function indexes of patients with postoperative respiratory failure were significantly lower than that of those patients without postoperative respiratory failure(P

Objective To report the surgical treatment results of cardiac and esophageal cancer of remnant stomach. Methods From 1980 to 2002, 30 patients with cardiac and esophageal cancer of remnant stomach were treated surgically. Results Primary cardiac and esophageal carcinoma of remnant stomach developed in male patients more than females. Of 30 patients, 21(70%) underwent subtotal gastrectomy with Billroth II reconstruction at first time. The mean interval between two operations was 13.5 years. Clinical symptoms frequently included abdominal distension, pain and hemorrhage. Thirty patients received radical resection. Conclusion Cancer in remnant stomach should be suspected in patients undergoing subtotal gastrectomy 5 years and over have clinical symptoms of upper gastrointestinal tract. Early diagnose and early curative resection should be done. For cardiac cancer of remnant stomach, total gastrectomy with “P” loops and Roux-en-Y esophagojejunostomy reconstruction were recommended. This procedure have advantage in retaining enough food storage preventing reflux esophagitis and allowing resection of esophagus long enough to avoid cancer remnant. For esophageal cancer of remnant stomach, colon reconstruction after the resection of esophageal cancer is recommended.

Objective: To understand and grasp the current situation and actual demands of China’s pharmaceutical industry, in order to provide a basis for the establishment of the chemometrics guideline in the Chinese Pharmacopoeia.
Methods: Online questionnaire was adopted to investigate the chemometrics backgrounds and demands of pharmaceutical industry practitioners.
Results: The practitioners of China’s pharmaceutical industry had certain expectations and demands for the chemometrics guideline, but the situation of talent reserves was not that optimistic.
Conclusions: It is extremely urgent to develop the chemometrics guideline, as general chapters of the Chinese Pharmacopoeia, which serve as the legal basis to guide the data quality control, the establishment of analytical methods and the verification of analytical methods in analytical practice, so as to ensure the scientific of multivariate analysis methods and reliability of analytical results, and will be conducive to promoting the improvement of China’s pharmaceutical level.

Objective To investigate the value of TI-RADS for sonographic diagnosis of papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC) and to evaluate the sonographic findings of FTC compared to PTC.Methods The clinical and sonographic data of 363 cases of pathology confirmed thyroid nodules were retrospectively analyzed.The thyroid nodules were classified by TI-RADS grading criteria,the accuracy of TI-RADS and sonographic findings between FTC and PTC was analyzed.Results In 363 thyroid nodules,114 cases were confirmed as benign lesions;249 cases were confirmed as carcinomas,including 50 FTC cases and 199 PTC cases.The sensitivity,specificity,PPV,NPV,and accuracy of PTC were 97.0％ (193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.The sensitivity,specificity,PPV,NPV,and accuracy of FTC were 97.0％(193/199),85.1％ (97/114),91.9％ (193/210),85.8％ (97/113),95.7％ (290/303) respectively.There were significant differences of nodule size,shape,margin,echogenecity,calcification,halo and flow between FTC group and PTC group (P ＜ 0.05).Conclusion TI-RADS has higher value in the sonographic diagnosis of PTC than that of FTC.FTC are greatly different from PTC in many sonographic findings making it less valuable for the diagnosis of FTC.

Objective To screened out items with large proportion of technical analysis in obstetrics and gynecology physical examination by using statistical parameters Kappa index and to evaluate effect and clinical significance of Kappa index based on objective data and students' and teachers' subjective feeling.Methods We made Kappa index screening with double-blind method and established the Kappa index table for teachers and students.Students were randomly divided into conventional teaching group (n =26) and teaching reform group (n =29).Students in conventional teaching group traditionally followed the teacher to carry on the practice while those in teaching reform group received training according to the numerical value index and had examination after training.We paid attention to each student's weak points,provided personalized guidance and communicated with students actively.Results We found that it was uneasy for beginners to quickly grasp four step obstetrics palpation in-spection according to Kappa index.There were statistical differences in operation of gynecological physical examination between two groups (P =0.016).Conclusions Application of Kappa index can help us screen out skills in the operation suitable for training for eight-year program medical students.With quantitative evaluation,we can improve quality of clinical practice teaching in department of obstetrics and gynecology and guide educational reform.