Anorectal malformations (ARM)comprise a broad spectrum of congenital disorders that account for 25 ％ of gastrointestinal malformations.Despite numerous technical advances for treatment of ARM,complications such as fecal incontinence and constipation still occur and can greatly deteriorate patients' quality of life.It is recognized that lumbosacral spinal cord anomalies in ARM has been an important factor affecting the fecal function after procedure.Researchers have found that lumbosacral myelodysplasia is the common seen complication of ARM and neural cells decreased in lumbosacral spinal cord by the study on animals and human.Due to numerous factos affecting nerve innervation on annrectus and pelvic floor muscle,this review summarizes the nervous system complications and abnormal intervention of human and rats ARMs.The developments of study on ARM complications and intervention are detailed.Then the new direction of the research about the anorectal malformation nervous system is put forward,and the new strategy of improving the prognosis of anorectal malformation surgery is explored.

Objective To investigate the nursing points of endoscopic full-covered self-expanding removable metal stents (FCSERMS) implantation for bile duct anastomotic strictures after liver transplantation. Methods The clinical data of patients who were treated by endoscopic full-covered self-expanding removable metal stents implantation for bile duct anastomotic strictures after liver transplantation from January 2013 to July 2015 were retrospectively analyzed, and the nursing process were summarized. Results The group of 9 patients were successfully placed and removed with FCSERMS. There was no postoperative complication, such as stent migration, acute pancreatitis, biliary bleeding and intestinal leakage. All the bile duct strictures were relieved after FCSERMS removement. Followed up for 10-32 months, there was no symptom and sign of bile duct anastomotic stricture recurrent. Conclusions The key in nursing points of FCSERMS implantation for bile duct anastomotic strictures after liver transplantation are introducing the function of FCSERMS and therapeutic process to improve patient compliance, mastering the endoscopic operations, the placement and removal method of FCSERMS to short operation time, strengthening postoperative nasal bile duct care, paying attention to the observation, detection and treatment of postoperative complications after the metal stent placement and removement, as well as the continuing care during the period between placement and removment of FCSERMS.

OBJECTIVE To analyze the status of concomitant or combined infection in patients presented with hepatitis B for investigation of the nosocomial infection control. METHODS We determined the serum virus marker of hepatitis A,C,D,E and G from 786 cases infected with hepatitis B virus. RESULTS Double and multiple infections accompanied by hepatitis B were found to be 16.67%(131/786) and 1.78%(14/786),respectively,especially with hepatitis C which amounted to 45.52%(66/145) of those with concomitant infections(double or multiple). CONCLUSIONS It is commonness that the patient of hepatitis B to preexist other kinds of hepatitis virus infections.We determine other hepatitis markers in patients of hepatitis B to be probative for nosocomial infection.

0.05).But the cell purity and the survival rate by mechanical procedure were significantly higher than that by combination of enzymatic digestion(P

Objective To investigate the value and nursing of persistent balloon dilatation for anastomotic stricture after choledochojejunostomy. Methods The clinical data of 14 cases of anastomotic strictures after choledochojejunostomy accepted the treatment of persistent balloon dilatation were analyzed retrospectively. The effect, adverse reactions and approriate nursing were evaluated. Results Five patients were performed with persistent balloon dilatation thorough the output loop of intestine after choledochojejunostomy and 9 patients through percutaneous transhepatic cholangiography. There was no hemobilia, bile leak or other serious complications. There were 2 cases of balloon dilatation catheter damage, 5 cases of pressure pump damage and 4 cases of balloon migration with 25.0% (7/28) instrument damage rate and 4 cases of balloon migration. After persistent balloon dilation for 6 to 8 months, no anastomotic stricture was found by choledochoscopic examination. Follow up for 6 to 18 months, 2 cases had recurrent anastomotic stricture. Conclusions Persistent balloon dilatation by percutaneous transhepatic cholangiography is a simple, safe and effective method for anastomotic stricture after choledochojejunostomy. In the course of nursing, the balloon catheter and pressure pump damage, and balloon migration should be noted.

The finite element method was used for simulating the mechanical performance and fatigue safety of three different structures of Nitinol stent. According to the actual situation, after proposing reasonable assumptions and simplification, the geometry model and finite element model establishment, material mode selection and boundary condition setting are completed. The strain and fatigue life of different stent edges wide (omega) or strut angle (theta) are computed. The result can provide a valuable reference for the optimal design of stent.
Alloys ; Finite Element Analysis ; Prosthesis Design ; Stents

Objective To explore a rapid and accurate method for the diagnosis of smear negative tuberculosis meningitis (TBM). Methods Sixty-seven patients with TBM were selected from Tianjin Haihe Hospital from June 2014 to June 2016, and 118 patients with non-tuberculous meningitis (NTBM) in the same period were chosen as control group, including bacterial meningitis (BM) group (n=61) and viral meningitis (VM) group (n=57). The laboratory routine, biochemical and immune indicators were tested with the specimens of both the blood and cerebrospinal fluid of all the patients. The Logistic regression equation was established for the diagnosis of TBM, and the diagnostic efficacy of which was evaluated by the receiver operating characteristic curve (ROC). Results The predictive regression equations of the TBM with BM, VM and NTBM (BM + VM) were obtained when BM group was used as a control: PRE_BM=1/1 +e-(-5.298+0.196 × ESAT-6+ 0.119 × CFP-10-2.968 × PCT+2.206 × ADA_CSF+0.705 × GLU_CSF+0.093 × LDH_CSF), PRE_VM=1/1+e-(-6.907+0.394 × ESAT-6-0.120 × Na+2.633 × ADA_CSF-0.088 × Cl_CSF) and PRE_NTBM=1/1+e-(0.683+0.099×ESAT-6+0.063×CFP-10-2.645×PCT+1.393×ADA_CSF+1.342×TbAb_CSF)respectively. When BM group was served as a control, the sensitivity, specificity, positive and negative predictive values of the regression for the diagnosis of TBM were 97.01%(89.63%-99.64%), 98.36%(91.20%-99.96%), 98.48%(91.84%-99.96%) and 96.77%(88.83%-99.61%), respectively.When VM group was served as a control, which were 94.03%(85.41%-98.35%), 94.74%(85.38%-98.90%), 95.45%(87.29%-99.05%) and 93.10%(83.27%-98.09%), respectively. When NTBM group was served as control, which were 94.03%(85.41%~98.35%), 90.68%(83.93%-95.25%), 85.14%(74.96%-92.34%) and 96.40%(91.03%-99.01%), respectively. Conclusion The predictive regression equation could be used as early diagnostic TBM with high sensitivity and specificity, which should be popularized in clinical practice, while, according to the higher negative predictive value, the negative results of which could be used to rule out of the TBM and non-empirical medication.

Objective To explore the roles on psychosocial factors of suicide behavior in the suicide attempters.Methods132 suicide attempters and 132 matched controls treated in the emergency department were assessed using certain psychosocial questionnaires,such as Health Questionnaire of WHO,Questionnaire of Life Measure ( QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory ( BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale ( BAS),Social Surpport Rate Scale and Questionnaire of Coping Style (QCS).Results( 1 ) The results of single-factor analysis showed that the scores of Health Questionnaire of WHO and QL were lower in the suicide attempter group than those in the control group( suicide attempter group:17.07±3.07 and 9.76 ±7.11; control group:13.42 ±3.31 and 17.08 ±3.81,all P＜0.05),otherwise the scores of BDI,BAI,BIS and BAS were higher( suicide attempter group:15.22 ± 11.22,27.87 ± 7.24,87.67 ±20.08 and 73.74 ± 19.61 ; control group:6.87 ± 6.36,26.22 ± 5.44,73.34 ± 14.54 and 63.78 ± 16.44,all P ＜ 0.05 ).Among QCS,the sub-score of self-blaming was higher( 3.42 ± 2.44 VS 2.35 ± 2.04,P ＜ 0.05 ),otherwise the sub-scores of question solvation,asking for help and rationalization were lower( all P ＜ 0.05 ).( 2 ) The result of multi-factors analysis showed that gender,mean education times,the scores of QL,HQ,BDI,and BIS,sub-score of rationalization,and so on,entried the Logistic aggressive equaltion.Conclusion The status of health,quality of life,depressive and anxious mood,impulsive and aggressive personality,and certain coping style play important role.

ObjectiveTo compare the clinical and social-psychological characteristics of patients with and without mental disorder.MethodsBase the diagnosis of mental disorder,232 suicide attempters were divided into two groups:suicide attempter with mental disorder ( 105 cases) and suicide attempter without mental disorder (127 cases).The Structured Clinical Interview for DSM-Ⅳ,the Strength of Suicide Ideation,Health Questionnaire of WHO,Questionnaire of Life Measure (QLM),Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI),Barratt Impulsiveness Scale (BIS) and Buss Aggressiveness Scale (BAS),Social Support Rate Scale and Questionnaire of Coping Style (QCS) were conducted.ResultsThe 105 suicide attempters with a mental disorder were older than the 127 suicide attempter without a mental disorder ( 37.9 ± 14.5 vs 32.9 ± 13.3,t =2.710,P =0.007 ),and the percentage of female was lower in the former than in the later(65.7％ vs 81.1％,x2 =7.099,P =0.008 ).In the total of 232 cases,female was more than male with the gender ratio of 2.87 ( female vs male).The strength level of suicide ideation was higher ( 7.1 ± 2.8 vs 4.8 ± 2.3,t =6.498,P =0.000).The scores of health questionnaire of WHO,BDI and BAI were higher in the suicide attempters with a mental disorder than those without a mental disorder,otherwise the scores of QLM,BIS and its three sub-scales were higher.Among QCS,the sub-score of Self-blaming was higher,and the sub-scores of Question solvation and Asking for help were lower.ConclusionThere are distinguished differences on the sociodemographic and psychological characteristics among the suicide attempters with and without a mental disorder.Mental diseases play an important role in the development of suicide attempter with a mental disorder.

ObjectiveTo understand the behavioral characteristics,strength on suicide ideation and mental disorder diagnosis among suicide attempers,so as to provide consultation for crisis intervention of suicide.Methods232 suicide attempters from emergency of 5 general hospital in south-west of Shandong province were enrolled.They were assessed using questionnaires on attempted suicide behaviors and scale on the strength of suicide ideation,and were diagnosed using the Structured Clinical Interview for DSM-Ⅳ Disorders axis Ⅰ for patient (SCID/I-P).Results( 1 ) In the total of 232 cases,female was more than male with the gender ratio of 2.87 (female vs male).The highest proportion rate (56.9％) existed between 16 years old to 35 years old.Oral application pesticide was the most commom suicide pattern (83.2％),91.4％ of the suicide attempt occurred in the their homes.The top three reasons leading to suicide were family contrary (61.2％),depressive mood (15.1％)and fail in love (9.5％).(2) In all cases,83.6％ did not think if they were found,84.1％ did not adopted any precaution measures,over 60.0％ did not tell anyone their attempted plans,and 90％ had no dying structions and /or dying testaments before their attempted behaviors.At the moment of attemp behaviors,62.9％ did not contact with someone.The 60.0％ of all the cases had wanted strongly to die,otherwise 7.3％ had wanted to manipulate others.(3) The diagnosis rate of mental disorder on DSM-Ⅳ was 45.3％,in which the mood disorder was most.ConclusionThere are no changes on the behavioral characteristics among the suicide attempters in the south-west rural area of Shandong province.Their strength of suicide ideation are moderate,and a certain proportion of suicide attempters may be impulsive suicide attempters.There is more relationship between mental disorder and suicide attempt.