Objective To analyse effect of dexamethasone combined with cefminox perioral injection on serum immunoglobulin in patients with oral and maxillofacial infection.Methods 46 patients who were diagnosed with oral and maxillofacial infection in our hospital were collected.All patients were randomly divided into experimental group and control group,23 cases in each group.Control group was treated with cefminox 3.0 g,one time per day perioral injection on the basis of control group treatment, experimental group were given dexamethasone sodium phosphate injection 10 mg, one time per day perioral injection, After the treatment, the serum levels of immunoglobulin IgA,IgG,IgM,CRP and routine blood test were detected in all patients.Results Compared with control group post-treatment, the serum levels of IgA,IgG and IgM were lower in experimental group (P<0.05);the serum level of CRP was lower in experimental group (P<0.05);the serum levels of WBC,NET% were lower in experimental group (P<0.05). Conclusion The dexamethasone combined with cefminox perioral injection can significantly reduce the serum level of immunoglobulin,CRP,WBC and NET% in patients with oral and maxillofacial infection,control the infection and inhibit the development of the disease.

Objective To investigate the effects of etomidate and propofol on circulatory system and the depth of anesthesia in laparoscopic surgery of ectopic pregnancy.Methods From January 2014 to January 2015, 40 patients with ectopic pregnancy in our hospital were selected and divided into the etomidate group and propofol group according to the principle of complete random grouping.Patients in the etomidate group received etomidate induced anesthesia, and the patients in the propofol group received propofol induced anesthesia.Hemodynamic parameters and bispectral index(BIS) of two groups were evaluated at 4 time points.The incidence of postoperative nausea and vomiting, chills and bronchospasm were recored.Results There was no significant difference in heart rate (HR),systolic blood pressure (SBP) and diastolic blood pressure(DBP) between the two groups at T0,T2and T3.But at the time of induction(T1), the heart rate of patients in propofol group was significantly lower than that in etomidate group(P<0.05).While T1, compared with etomidate group, the HR and SBP significantly decreased and DBP increased in the propofol group (P<0.05), The HR and SBP at T1of patients in the propofol group and etomidate group decreased significantly and DBP increased when compared with T0(P<0.05).and etomidate group decreased significantly compared with T0 ( P <0.05 ).There were no significant differences in BIS indexes at four time points.However, BIS indexes at T1 ,T2 and T3 were significantly lower than T0 ( P <0.05 ).There was no significant difference in three kinds of complications rates in two groups.Conclusion Etomidate, compared with propofol, can better control the cardiovascular response during induction of anesthesia.Both drugs have a consistent depth of anesthesia.There is no difference in the incidence of complications.Etomidate is more suitable for patients with ectopic pregnancy laparoscopic surgery.

BACKGROUND:The tourniquet is usualy fuly used or bilateraly used in partial time during bilateral total knee arthroplasty. However, very few people try to use it on one side and on the other side in partial time.
OBJECTIVE:To investigate the effective strategy of using a tourniquet in simultaneous bilateral total knee arthroplasty.
METHODS:80 patients (160 knees) with severe osteoarthritis who underwent simultaneous bilateral total knee arthroplasty in the Department of Orthopedics, Chinese PLA Medical School from January to December 2013 were divided into two groups according to the different tourniquet strategies. In test group (n=40), left knees did not receive tourniquet, and right knees received tourniquet in partial time. In control group (n=40), al knees received tourniquet in the whole time. The perioperative and postoperative blood loss, 3-day postoperative thigh sweling rate and pain visual analog scale, 3-week and 1-year postoperative Knee Society Score were recorded in both groups.
RESULTS AND CONCLUSION:There were no statisticaly significant differences between two groups in perioperative total blood loss (P > 0.05). However, postoperative blood loss in test group was less than that in control group (P < 0.05). The visual analog scale scores were significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). Visual analog scale scores on the left side were lower than on the right side in the test group at 3 days post surgery (P < 0.05). Bilateral thigh sweling rate was significantly lower in the test group than in the control group at 3 days after surgery (P < 0.05). The thigh sweling rate was lower on the left side than on the right side in the test group at 3 days after surgery (P < 0.05). Knee Society Score was higher in the test group than in the control group in the early stage, and no significant difference in long-term Knee Society Score was detected (P > 0.05). These findings verify that taking the strategy that the first knee without tourniquet and the second knee with part time tourniquet technique in simultaneous bilateral total knee arthroplasty wil aleviate pain and sweling after operation and promote early functional rehabilitation without increasing the perioperative total blood loss.

Objective To analysis the imaging findings of tetralogy of Fallot and related pathological basis. Methods The clinical,pathologic and right ventriculography findings of 124 tetralogy of Fallot which were confirmed by surgery were retrospectively aralyzed. Results 124 tetralogy of Fallot were separated into type Ⅰ 62, Ⅱ 31, Ⅲ 6, Ⅳ 25 by Gray's classification,and slight,midrange,severe stenosis were 71 (0.51～0.6) ,33(0.41～0.5) ,20(<0.4) by Partiole's classcification. As to ventricular septal defect(VSD) ,infra-cristal ventricular septal defect were found in 116/124 in which crista supravcntricalaris appeared as girdle-shaped filling defect in lateral position, suprac-ristal ventricular septal defect were found in 8/124 in which crista supraventricularis appeared as round filling defect in orthophoric position. Conclusions Right ventriculography can precisely display stenosis of pulmary and ventricular septal defect(VSD). It has great valne in diagnosis and surgical therapy of tetralogy of Fallot.

AIM: To investigate the changes of first order kernel ( FOK ) and second order kernel ( SOK ) of multifocal electroretinogram( mf-ERG) in detecting the early retinal abnormalities in sub-clinical stage of diabetic retinopathy. ·METHODS: Totally 32 patients ( 58 eyes ) with type 2 diabetes mellitus ( DM ) without apparent diabetic retinopathy( DR) were detected by mf-ERG, from June 2014 to May 2015. Thirty cases ( 60 eyes ) of normal control group had also been taken to compare the difference of the amplitude and latency between the two groups. ·RESULTS: Compared with the control group: there was no statistical difference in the FOK b-wave latency of the diabetic group, and the FOK b-wave amplitude was significantly decreased (t=3. 099, P=0. 012). The SOK b-wave latency in diabetes group was statistically delayed (t=2. 643, P=0. 025), and the SOK b-wave amplitude statistically decreased (t=4. 833, P<0. 01). There was no statistically difference in the a-wave latency and amplitude of FOK and SOK. The b-wave amplitude of FOK and SOK was negatively correlated with the course of the disease. However, the b-wave amplitude was not statistically correlated with the duration of diabetes mellitus. ·CONCLUSION: The function of the post-polar outer and inner retina detected by FOK and SOK had been damage even before retinopathy. The anomaly is mainly reflected by the decreasing amplitude of b-wave.

Objective To explore the diagnosis and treatment for pancreatic cystic neoplasms.Methods The clinical data of 10 cases with pancrestic cystic neoplasms treated from 2004 to 2008 was reviewed and both domestic and internal pertinent literatures were summarized.Results The pancreatic cystic neoplasms mostly happened in middle-aged women.The clinical manifestations showed no specificity.Ultrasonography, CT and MRI could offer important sign for diagnosis.The rate of surgical resection was high and the prognosis was satis-factory.Conclusions The pancreatic cystic neoplasms is being muh with the development of imagings.It is dif-ficuh to distinguish the feature of the cystic neoplasms before surgery, so surgerical resection should be done for all cystic tumors found.

Objective To study elimination of the Micro CT projective image noise and improve the quality of the recon-structed image for the Micro CT system.Methods The forming factors of the Micro CT projective image noise were analyzed,and proposed the Micro CT projective image correction method to correct the random noise,dark field,light field,response nonuniformity and defect picture element and eliminate the random noise and the ring artifact respectively.Results Through the comparative study,it proposes a simple and practical correction method for the actual response nonuniformity which combines the corrections of light field,dark current and gain inconsistency and settles the three corrections with one circu-lation.The method can enhance the algorithm efficiency greatly and the validity of the correction protocol can be proved through experiments.Conclusion The Micro CT projective image noise is eliminated effectively and the good basis for the following work are established such as three-dimensional reconstruction.

OBJECTIVE To investigate the risk factors and prevent meaures of ophthalmic infection after operation. METHODS The factors associated with ophthalmic infection after operation were analyzed. The comprehensive and strict system of washing and sterilization of operative instruments were established. The usage of aseptic implantable articles was strictly managed. The management of operation environment,faculty,patients,and aseptic technique were further strengthened. The samples of the faculty were cultivated routinely and the fulfillment of institution was assured. RESULTS The procedure of peri-operation infection control was bettered. The awareness of infection prevention during ophthalmic operations was improved for the nurse faculty. A safe operation procedure was ascertained. The risk of ophthalmic operation infection was decreased. CONCLUSIONS Scientific and consummate management of ophthalmic operation and its proper fulfillment are key factors to prevent ophthalmic operation infection.

OBJECTIVE To investigate the degree of risk of viral prevalence of HBV,HCV and HIV through blood transfusion in Beijing Hospital in China,and to assess the need of a national Haemovigilance System. METHODS Retrospectively,7883 blood bank specimens (collected from 2004 to 2007) were re-examined using 8 indicators (including 5-item Hepatitis B,anti-HCV,anti-HIV and Syphilis) for the prevalence of most common viral infection. RESULTS From the blood bank specimens,the prevalence of HBsAg was 0.88% (69),the anti-HBc positive blood,only the anti-HBc was found in 2.65% of the specimens,while both the anti-HBc and the anti-HBe were found in 2.09% of the specimens. The prevalence of anti-HCV was 0.09% (7). CONCLUSIONS We need to establish the national Haemovigilance System to strengthen the monitoring of the above HbsAg,HBcAb and HCV indicators to prevent the transfusion-transmitted infection. Only in this way can the public confidence in blood safety be improved.

Objective To summarize the clinical experience of laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 93 cases of acute cholecystitis treated by LC from May 2003 to May 2005 was retrospectively reviewed, including 15 cases of preoperative endoscopic retrograde cholangiopancreatography (ERCP) combined with endoscopic sphincterotomy (EST) for common bile duct stones and 6 cases of intraoperative cholangiography. The LC was performed within 48 hours after admission. Results The LC was successfully completed in 91 cases (97.8%), whereas a conversion to open surgery was required in 2 cases (2.2%). The operation time was 35~160 min (mean, 65 min). Postoperatively, biliary leakage occurred in 3 cases (3.2%) and residual stones in the common bile duct were found in 3 cases (3.2%), which were all cured by open surgery combined with ERCP, EST, and endoscopic nasobiliary drainage (ENBD). No iatrogenic injuries happened. Conclusions With proper selection of ERCP and EST, LC for the treatment of acute cholecystitis is feasible and safe. But the incidence of conversions and complications may be high.