Objective To study the diagnostic value of radial echoendoscopy combined with ultrasonic micro-probe for differentiating mediastinal disease from esophageal submucosal lesion.Methods Data of 53 patients with esophageal eminence with unknown origin detected by gastroscopy or CT in China-Japan Union Hospital were reviewed.Ultrasonic micro-probe was performed first and followed with radial echoendoscopy.The diagnosis was compared with the results of CT.Results The diagnostic sensitivities of EUS and CT for esophageal submucosal lesion were 90.9％ (20/22) and 50.0％ (11/22),and the specificities were 93.5％ (29/31)and 83.9％ (26/31).The sensitivities for the benign mediastinal disease were 91.7％ (22/24) and 70.8％ (17/24),and the specificities for the benign disease were 93.1％ (27/29)and 62.1％ (18/29).The sensitivity and specificity for malignant mediastinal disease were both 100.0％.Conclusion Radial echoendoscopy combined with ultrasonic micro-probe shows prominent advantage in the diagnosis of the esophageal submucosal lesion and mediastinal disease over CT,especially in the specificity and sensitivity for esophageal submucosal lesion and benign mediastinal disease.

The relaxation therapy is a common method in the psychological rehabilitation in the injured and disabled patients,which can release the negative emotions,improve the quality of sleep,decrease the pain of the injured and disabled parts of the body and build up the confidence of life of the patients after the earthquake.After the long-term practice of the psychological rehabilitation in the injured and disabled patients and the experience of the psychological rehabilitation in the injured and disabled patients after the 5·12 Earthquake,the author thinks during the relaxation training psychotherapy of the injured and disabled patients after the earthquake,the choice of technique and procedure of the relaxation therapy should depend on the specific situation of the patients.The author introduces a idiographic method of the relaxation therapy and some suggestions of the implied treatment after the relaxation which is suitable for the injured and disabled patients.

The earthquake always results in a great number of the injured and disabled patients.So timely and effective psychological rehabilitation interventions are very helpful,especially for those survivors to relieve their psychological traumatic response caused by the earthquake,and renew their healthy psychological situation.The present article analyzes the chief psychological symptoms and influencing factors of the injured and disabled patients after the earthquake,and further provides some principles and strategies for the psychological rehabilitation,such as how to cope with the early stress response(anxiety,depression,self-abasement,and so on),or how to deal with the social phobia.

Objective To evaluate the effect of dexmedetomidine on the postoperative pulmonary function in patients undergoing laparoscopic operation.Methods Eighty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-70 kg,undergoing laparoscopic radical resection of rectal cancer,were divided into 2 groups (n =40 each) using a random number table:control group (group C) and dexmedetomidine group (group Dex).General anesthesia combined with epidural anesthesia was used.In group Dex,dexmedetonidine was intravenously infused as a bolus of 0.3 μg/kg over 10 min after epidural catheterization and before induction of general anesthesia,followed by an infusion of O.4 μg · kg-1 · h-1 starting from the end of tracheal intubation until 30 min before the end of operation.The equal volume of normal saline was given instead in group C.After epidural catheterization and before infusion of dexmedetomidine (T0),immediately before termination of pneumoperitoneum (T1) and at 1,6 and 24 h after operation (T2-4),blood samples were taken from the peripheral vein for determination of concentrations of serum interleukin-6 (IL-6),IL-10,tumor necrosis factor-alpha and malondialdehyde,and arterial blood gas analysis was performed simultaneously.Respiratory index and oxygenation index (OI) were calculated,and the occurrence of OI ≤ 300 mmHg was recorded.Results Compared with group C,the serum IL-6 and tumor necrosis factor-alpha concentrations and respiratory index were significantly decreased,and IL-1O concentrations and OI were increased at T1-4,and malondialdehyde concentrations were decreased at T1-3,and the incidence of OI ≤ 300 mmHg was decreased in group Dex (P＜0.05).Conclusion Dexmedetomidine can inhibit inflammatory responses and improve the postoperative pulmonary function in patients undergoing laparoscopic operation.

ObjectiveTo investigate the effect of dexmedetomidine on postoperative intracranial pressure (ICP) in patients with severe brain injury.MethodsNinety ASA Ⅱ or Ⅲ patients with severe brain injury,aged 19-64 yr,with Glasgow coma scale 3-7,undergoing emergency craniotomy,were randomly divided into 3 groups (n =30 each):control group (group C) and 2 different doses of dexmedetomidine groups (groups D1,D2 ).Anesthesia was induced with propofol 1.5-2.0 mg/kg,fentanyl 4 μg/kg and vecuronium 0.1 mg/kg and maintained with iv infusion of propofol and remifentanil and intermittent iv boluses of vecuronium.The patients were mechanically ventilated after tracheal intubation.Dexmedetomidine 0.3 and 0.7 μg· kg- 1· h- 1 were infused after tracheal intubation in groups D1 and D2 respectively and the infusion was maintained for 48 h.ICP was monitored after operation and maintained ＜ 30 mm Hg by iv injection of hexadecadrol,mannitol and glycerol fructose within 2 d after operation.Venous blood samples were obtained from peripheral vein after anesthesia induction and at 6,12 and 24 h after operation (T0-3) for determination of sertum IL-1β and TNF-α concentrations by ELISA.The clinical results were evaluated using Glasgow prognosis score at 3 months after operation.The amount of hexadecadrol,mannitol and glycerol fructose consumed during 2 d after operation was recorded.ResultsCompared with T0,serum IL-1βand TNF-α concentrations were significantly higher at T1-3 in the three groups ( P ＜ 0.05).The serum IL-1β and TNF-α concentrations at T1-3 and the amount of hexadecadrol,mannitol and glycerol fructose consumed were significantly lower,and the clinical results were significant better in groups D1 and D2 than in group C,and in group D2 than in group D1 ( P ＜ 0.05).ConclusionDexmedetomidine can reduce postoperative ICP in patients with severe brain injury in a dose-dependent manner which is helpful for improving prognosis.The decrease in IL-1β and TNF-α levels and inhibition of inflammatory response may be involved in the mechanism.

Objective:To investigate the clinical characters and treatments of maxillofacial fractures. Method: A review of 101 maxillofacial fractures was presented with respect to age, sex, cause of fractures, pattern of fractures, treatments and therapeutic effect. Result:The majority of fractures were found in 20-to-50-years-old males. Most fractures happened in summer and the leading causes were traffic accidents. Mandible was the most part of fractures and associated combined injures were found in 31 cases. Rigid internal fixation was the primary treatment. Conclusion:Maxillofacial factures mainly occurred in young adult males and traffic accidents were the main causes. Rigid internal fixation after exact replacement was the primary common treatment.

Objective To investigate the relationship among HbA1c、urine microalbuminuria (UmAlb)and blood lipids in pa-tients type 2 diabetes mellitus.Methods 120 patients with type 2 diabetes in the hospital were enrolled in the study in 2012.Ac-cording to the test results of HbA1c,the people enrolled in the study were divided into two groups,group A:HbA1c <6.5%,60 cases totally;group B:HbA1c≥6.5%,60 cases totally.UmAlb and blood lipids were measured.Results Compared with group A, UmAlb、TC、TG and LDL-C concentrations increased significantly in group B(P <0.05),while HDL-C decreased significantly(P <0.05).Conclusion In type 2 diabetic patients whose HbA1c≥6.5%,UmAlb,TC,TG and LDL-C concentrations increased obvi-ously and the risk of diabetic complications increase.

Objective To study the clinical features,diagnosis and treatment of Dieulafoy′s disease.Methods The clinical characteristics,diagnosis,methods of treatment and efficacy of treatment of 19 cases of (Dieulafoy′s) disease were analyzed retrospectively.Results All cases presented as abrupt upper gastrointestinal bleeding.12 cases(63.2%) were diagnosed at the first,and 4 cases (21.1%) at the second ecdoscopic examination,and 3 cases(15.8%) were diagnosed at exploratory operation.Hemorrhage stopped successfully after one endoscopic treatment in 14 cases and after 2 endoscopic treatments in 1 case.4 cases were cured by operation(including 1 case with re-bleeding 72 hours after endoscopic treatment).Conclusions Emergency endosopic examination is the best way to diagnose Dieulafoy′s disease and endoscopic treatment is the method of choice to treat it.If hemorrhage fails to stop after endoscopic treatments,surgical operation should be (performed) immediately.

OBJECTIVE:To prepare anti-microbicide contraceptive gel and establish its quality control method. METHODS: The gel was prepared with octoxynol and policresulen as main ingredients and HPMC as matrix. The content of octoxynol in the gel was determined by HPLC,and the content of policresulen in the gel was determined by titration method. RESULTS:Prepared gel was well-proportioned and of good viscidity and its identification and test were up to the standard. The linear rang of octoxynol was 250～1 500 mg?L-1(r=0.999 6)with an average recovery of 100.84%(RSD=0.74%,n=9). The average labeled amount of policresulen was 106.64%(n=3). CONCLUSION:This preparation is feasible and stable in quality,and the quality control method is simple and accurate.

0.05).)Conclusion The extra-pedicular technique is feasible in biomechanics.