Objective To explore the application value of gastrointestinal reconstruction by continuous jejunum interposition after total gastrectomy.Methods A retrospective analysis in March 2006 to March 2012 was performed in 60 patients with gastric underwent continuous jejunal interposition after total gastrectomy.Results There were no operation death and anastomotic fistula.Follow-up for 12-24 months,some patients had mild reflux esophagitis,generation of gastric capacity of more than 300 ml,emptying time of 30-100 min.The quality of life was improved after operation.Conclusions Continuous jejunal interposition pouch is safe and reliable,with satisfactory effect of digestive tract reconstruction.

Objective To observe the therapeutic effect of modified Danshen Yin on primary achalasia. Methods The 42 achalasia patients were randomized into two groups. The treatment group, 24 cases, was treated by modified Danshen Yin and the control group, 18 cases, by Nifedipine, for one week. The symptom scores of dysphagia, retrosternal pain and food regurgitation and the improvement of X-ray image were taken to evaluate the therapeutic effect. Results After treatment, both groups had improvement in the symptom scores, but the improvement of treatment group in dysphagia and food regurgitation was more significant. There was a significant difference of both groups in retrosternal pain before and after treatment (P

Objective To observe the regulation of ?-7 neuronal nicotinic acetylcholine receptors(?-7-nAChRs) by nicotine in the ventral tegmental area(VTA),the substantia nigra(SN) and the cortex of the rat. Methods Nicotine exposed animal models were established.The changes of ?-7-nAChRs proteins and mRNA were observed by immunohistochemistry and in situ hybridization in VTA,SN and cortex,and the expression of ?-7-nAChRs proteins by Western blotting in PC12 cells. Results The expression of ?-7-nAChRs proteins in cortex and mRNA in VTA and SN were upregulated by nicotine.The expressions of ?-7-nAChRs in PC12 cells were in proportion to and dependent on the time for nicotine to function and the dose.Conclusion Both ?-7-nAChRs mRNA in VTA and SN in transcriptional mechanism and ?-7-nAChRs protein in the cortex at the translation level were upregulated.

OBJECTIVE: To reduce medication errors by using bar code technology.METHODS: By searching the relevant literature about the bar code technology in preventing medication errors,this article systematically introduced the concepts of bar code technology,the FDA's bar code rules and the effect of it in reducing medication errors,as well as the current use of it by providing the relative data,examples and cases.RESULTS & CONCLUSIONS: Bar code technology can effectively reduce the incidence of medication errors.

地震造成大规模人群的复杂创伤,病情进一步发展,常导致多脏器功能障碍(MODS)。本文总结了地震伤后MODS的发病机制、预防、早期诊断以及治疗措施。

Objective To observe the safety of the compound Tiaoshi-plaster's use to skin,providing the scientific foundation for its use to the treatment for the younth's short sight.Methods Experiment 1,acute toxicity test for skin of rabbits:rabbits were randomly divided into two groups:a integrated skin group and a damaged skin group,in addition,every group further divide into high and low dosage group and vehicle control group,totally 5 groups.All above groups received the plaster or vehicle for 24 hours,then take away the drug,and after lh,24 h,48 h,72 h since the 7th day,observe each group's reaction separately everyday,to see whether there is a acute toxicity reaction or not.Experiment 2,self control group,use onerabbit's left and right sides' skin to observe stimulus toxicity via skin:divide the rabbits into a integrated skin group and a damaged skin group,in addition,every group further divide into high,low dosage group and vehicle control group,totally 6 groups.Observe the reaction after multiple doses,after 7 days' successive doses,take the drug-used tissues to do pathological examination.Experiment 3,cavy's skin irritation test:cavies were divide into vehicle group,plaster group,positive group,totally 3 groups,at the 6h,7th day,14th day,take off right side's skin of every group to do the provocative test respectively.On the 28th day,take off the left side's skin to do the provocative test.To see if the skin or the whole body is allergic to the plaster.Results In experiment 1,toxic response could not be found in any group; In experiment 2,rabbits in the integrated skin group didn't show redness or edema,rabbits in the damaged skin group all had redness and edema,but the differences were not statistically significant,compared with the corresponding time of vehicle group (P＞0.05).Such skin damage was not caused by plaster usage but inflammatory reaction of skin damage.In experiment 3,the vehicle group and the study group didn't show any abnormal anaphylactic reaction.Conclusion The compound Tiaoshiplaster is safe to skin.

Objective To investigate the value of the pre-occusion and stump pressure(SP)of the internal carotid artery in carotid endarterectomy(CEA).Methods During Januray 2007 to January 2009,12 patients with carotid arterial stenosis underwent CEA in our deparment.With cervical plexus block,we performed pre-occlusion test and measured the stump pressure(SP)by using vascular shunt selectively.The patients were monitored with clear consciousness during the whole procedure of CEA.The data of postoperative complications and results of pre-occlusion and SP as well as the follow-up were analyzed afterwards.Results During the operaion,three patients had transient increase of heart rate and blood pressure.The lowest SP was detected in two patients,who had moderate or severe stenosis of the contralateral carotid artery complicated with lesions in the vertebral basilar artery.Two patients showed positive results in pre-occusion test,and vascular shunt was used in four cases.After the operaion,one patients developed hyperperfusion syndrome.Nine patients showed improvement of symptoms of dizziness and decreased eyesight.This series were followed up for a mean of 11 months(ranged from 1 to 26 months).During the period,two of the patients showed re-stenosis of the carotid artery;none of them had cerebral infarction.Conclusions Cervical plexus block combined with pre-occusion test ensures the safty and effectiveness of minimally invasive carotid endarterectomy.We recommend selective vascular shunt according to the results of pre-occlusion test,SP,and the severity of the lesions in the contralateral carotid artery and vertebral basilar artery.

Objective The prestin,a motor protein responsible for outer hair cell(OHC)electromotility,is expressed on the OHC surface.Previous experiments revealed that OHC electromotility and its associated nonlinear capacitance was mainly located at the OHC lateral wall and was absent at the apical cuticular plate and the basal nucleus pole.Immunofluorescent staining for prestin failed to demonstrate the prestin expression at the OHC basal ends in whole-mount preparation of the organ of Corti.The aim of this study is to investigate the distribution of prestin at OHC.Methods In this experiment,the localization of prestin protein in single dissociated OHCs from cochlea of normal mouse,rat and guinea pig,were examined by immunofluorescent staining and confocal microscopy.Results We found that prestin was uniformly expressed on the OHC basolateral surface,including its basal pole.No staining was observed on the cuticular plate and stereocilia.The OHC lateral wall had a trilaminate organization and was composed of the plasma membrane,cortical lattice,and subsurface cisternae.By with co-staining with a membrane marker di-8-ANEPPS,prestin-labeling was found locating at the outer layer of the OHC lateral wall.Further separating the plasma membrane from the underlying subsurface cisternae,using a hypotonic extracellular solution,prestin-labeling was shown locating at the plasma membrane instead of the subsurface cisternae.Conclusion The data revealed that prestin is expressed in the plasma membrane on the whole OHC basolateral surface.

Objective To evaluate the feasibility and efficacy of laparoscopic tubal anastomosis after tubal sterilization.Methods A total of 27 cases of fallopian tube anastomosis with tubal anastomosis were performed under laparoscopy.After removing the sterilized scar in the tubes the hydrotubation was carried out using Methylene Blue to detect whether the tube was patent.By using 6/0 absorbable thread,we sutured the mesosalpinx with 2 or 3 stitches to close the both ends of the fallopian tube.And then,isthmus-isthmus(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the serous layer of the 8 and 4 o'clock respectively)ampulla-ampulla(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the whole layers of the 9,7,5,and 3 o'clock respectively),or isthmus-ampulla(same method as the ampulla-ampulla anastomosis but more closed sutures)was performed.The patients received hydrotubation at the first day after the operation and then 3 to 5 days after the first menstruation.They were followed up for every 6 months till pregnancy.Results In the 27 patients(54 tubes),the rate of patency was 88.9%(48/54).The patent rate in the patients received isthmus-isthmus or ampulla-ampulla anastomosis was 86.5%(32/37)and 100%(15/15)respectively.In the 2 cases of isthmus-ampulla anastomosis,one was patent after the operation,and in the other,the Methylene Blue test showed anastomotic leakage.The hydrotubation performed at the first day after the treatment showed a rate of patent in 25 cases(2.6%,25/27),only two patient showed obstruction of the tube(7.4%,2/27).Follow-up was available in 26 of the patients up to over 6 months,19 of them had intrauterine pregnancy(73.1%,19/26)in 24 months after the procedure,among which 89.5%(17/19)occurred in 12 months;one(3.8%,1/26)patient developed ectopic pregnancy.Conclusions Laparoscopic tubal anastomosis is safe and effective for patients who desire reversal after sterilization.

Objective To investigate the expression of serum microRNA-210 (miR-210) in patients with acute cerebral infarction(ACI),and to evaluate its clinical significance. Methods A retrospective study was conducted. Eighty patients with ACI admitted to Tianjin Hospital from January 2011 to March 2014 within 48 hours of onset were enrolled,and 30 healthy volunteers served as controls. The peripheral blood was collected,and the expression of serum miR-210 was determined by reverse transcription-polymerase chain reaction(RT-PCR). The receiver operating characteristic curve(ROC)was drawn to analyze the role of miR-210 in the diagnosis of ACI. According to the pathological and physiological characteristics of patients receiving treatment,the relationship between miR-210 and clinical physiology index was analyzed. Results The expression of miR-210 in serum of patients with ACI was significantly lower than that of the healthy control group(2-ΔΔCt:1.349±0.043 vs. 1.923±0.107,t=6.567, P<0.000). ROC analysis results showed that the sensitivity of miR-210 in the diagnosis of ACI was 90.4%,the specificity was 76.2%,and the area under the ROC(AUC)was 0.804〔95%confidence interval(95%CI)=0.700-0.908〕. No difference in expression of miR-210(2-ΔΔCt)in serum was found in patients of different gender,age, and infarction area(male and female:1.33±0.13 and 1.31±0.06,t=3.562,P=0.473;≤60 years and>60 years:1.32±0.12 and 1.31±0.09,t=2.351,P=0.264;large infarction,small infarction,lacunar infarction:respectively 1.31±0.02, 1.33±0.11, 1.31±0.06, F=1.236, P=0.087), or with the severity of cerebral infarction,and there was a tendency in lowering of expression of miR-210(2-ΔΔCt,light,medium,severe:1.53±0.11, 1.33±0.11,1.08±0.04,F=5.394,P=0.014).Conclusion The serum level of miR-210 in ACI was significantly lower than that in normal healthy persons,and it may be an important new serological marker in screening and diagnosis of ACI.