Objective To analyze the results of syphilis test and to understand the syphilis infection and its epidemiological characteristics .Methods 728 untreated patients with definite diagnosis of syphilis were enrolled and classified according to their age ,gender and syphilis types ,and retrospectively analysis was conducted .Results Among 728 syphilis patients ,446(61 .26% ) were diagnosed with latent syphilis ,211 (28 .98% ) with dominant syphilis ,32(4 .40% ) with neurosyphilis and 39(5 .36% ) with congenital syphilis .The average detection rate of syphilis was 1 .49% .332(45 .60% ) cases were found in female patients while 396 (54 .40% ) in male .Male syphilis patients were mainly in the 20 to 60 age group ,and female in the 20 to 50 age group .Dominant syphilis occurred mainly in the 20 to 40 age group and latent syphilis in the 20 to 60 age group .Conclusion The detection rate of syphilis increases year by year ,with the highest growing rate in latent syphilis and young adults as major incidence groups .

Objective To explore the causes and prevention methods of postoperative anastomotic leakage after colorectal cancer laparoscopic-assisted surgery.Methods 100 patients with colorectal cancer underwent laparoscopic-assisted surgery,the data was collected and retrospectively analyzed.Results All patients were successfully done,there were 5 cases with anastomotic leakage (5％).There were significant correlations of anastomotic leakage with too strong anastomotic tension,insufficiency anastomotic blood supply,tumor location,size,operation time,preoperative radiotherapy,gender,age,obesity,diabetes,hypoalbuminemia,and so on.Conclusion The laparoscopic-assisted surgery of colorectal cancer has a curative efficacy,with the continuous improvement of laparoscopic technique and operation,as long as the proper measures were taken,the occurrence of anastomotic leakage can be prevented and reduced.

Objective To explore the feasibility and clinical effect of single-incision laparoscopic surgery(SILS) in the treatment of gastrointestinal stromal tumors (GIST).Methods Clinical data of 13 GIST patients who underwent SILS resection [tumor diameter (1.3 ± 0.5) cm] were retrospectively analyzed.Surgical method was summarized and the clinical outcome was evaluated.Results All patients were successfully implemented without open conversion.The incision length was (3.8 ± 0.6) cm.Operation time was (100.0 ± 34.6) min.Intraoperative blood was (70.0 ± 45.5) ml,hospitalization time was 1 ～ 4d.There were no intraoperative or postoperative complications,such as secondary haemorrhage,anastomotic leakage or obstruction.The patients were favorably healed.Conclusion Application of SILS in treatment of GIST is safe with small trauma,fast postoperative rehabilitation,and early curative effect is satisfactory.

Objective To explore the clinical value of laparoscopic hepatectomy in liver tumor surgery.Methods The clinical data and follow-up results of 50 patients with liver tumors treated by laparoscopic hepatectomy were retrospectively analyzed.Results Laparoscopic liver resection was successful in 30 cases of primary liver cancer,10 cases of hepatic hemangioma,and 10 cases of other benign liver space occupying lesions (liver vascular smooth fatty tumor,focal nodular hyperplasia,hepatic abscess).Conclusion Laparoscopic hepatectomy as a minimally invasive treatment method is applicable to all parts of liver tumor surgery,and trauma is small,recovery is quick,and it is safe and feasible,and clinical effect is reliable.

ObjectiveElectric stimulation of the central nervous system has been served as a treatment method for variety of neurological,psychiatric and sensory disorders.Despite considerable success in some applications,current stimulation techniques offer little control over which neuronal targets are activated by stimulation.This study aimed to present a new shape self-adaptive helix electrode for selective activation of optic nerve.MethodsThe geometric model of optic nerve and new helix electrode was elaborated with COMSOL Multiphysics.The new helix electrodes consist of silicone helix frame,which acted as support and insulation,and platinum contacts embedded within the frame.The activating function (AF) was introduced to characterize the stimulation effects,and the selectivity of activating optic nerve fascicle with new helix electrode was simulated by COMSOL Multiphysics,taking into account the variations of electrode contact locations.ResultsAssuming normalized AF threshold was 0.1 V/m2,the ratio difference of AF over threshold between new helix electrode and traditional electrode was only 1.2410％.With contacts in two ends of helix electrode closer to the middle contact,the small nerve fascicle was first activated and then the large one.ConclusionThe results show that the new helix electrodes have the same stimulation effects as that of traditional cuff electrodes.The new helix electrodes can selectively activate optic nerve fascicle with variations of electrode contact locations.

As the key phase for medical students to be doctors,clinical internship plays a vital role in the whole medical education process.Interns in the department of gastrointestinal surgery face series of difficulties,such as wide variety of diseases and emergence of new technology and new concepts.In addition,because of the uneven levels of teachers and low enthusiasm of interns,the result of clinical practice teaching is not satisfactory.Based on the above-mentioned problems,measures have been introduced during the process of clinical practice teaching,including selection of typical diseases and surgical procedures,construction of clinical practice teaching team,adoption of pluralistic teaching methods,reinforcement of participation of interns during the clinical practice.Finally,the quality of teaching in our department has been irmproved significandy.

Objective To evlauate the clinical feasibility and efficacy of laparoscopic right hemicolectomy in the treatment of colon carcinoma .Methods 100 patients with rightcolon carcinoma were divided into 2 groups,50 ca-ses in each group .The control group received open surgery ,and the observation group was treated by laparoscopic right hemicolectomy .The clinical effect and side effect of the two groups were compared .Results The patients of the two groups were all successfully operated .The intraoperative blood loss ,postoperative anal exhaust time ,postoperative hos-pital stay,incidence rate of postoperative complications in the observation group were (75 ±42)mL,(24.8 ±1.3)h, (7.5 ±2.0)d,4.0%,respectively,which were significantly better than those of the control group [(100 ±50)mL, (64.9 ±1.8)h,(12.1 ±3.4)d,10.0%](χ2 =5.02,9.28,11.70,9.87,all P<0.05);Conclusion The laparo-scopic right hemicolectomy in the treatment of rightcolon carcinoma is safe and feasible ,and the curative efficacy is outstanding .It can obviously improve the prognosis of patients ,which should be popularized and applied in clinical .

Objective To summarize the experience of the simple neuroendoscopic endonasal transsphenoidal surgery for the large pituitary adenoma and discuss it's application value.Methods Seventy-eight cases of the large pituitary adenoma treated by simple neuroendoscopic endonasal transsphenoidal surgery from July,2011 to May,2014 were analyzed retrospectively.Tumors were resected using 0 and 30 degree endoscope after opening the same side of the anterior wall of the sphenoidal sinus and sellar bone using the abrasive drilling during operation.Results The tumor removal was total in 62 (79.49％),subtotal in 12 (15.38％),major in 3(3.85％) and part in 1 (1.28％).Seventy-one cases were followed up for 2 months to 2 years after operation and no recurrence was founded,the symptoms of headache disappeared in 49 cases;The vision of patients was improved in 47 cases,menstruation resumed in 12 cases;The acromegaly of patients reduced in 21 cases.Hormone level review of PRL returned to normal in 32 cases,GH returned to normal in 21 cases,ACTH returned to normal in 2 cases.Conclusion The endoscopic transsphenoidal surgery for large pituitary tumors is the safely,minimally invasive surgical techniques.With the development of endoscopic equipment constantly updated and the operational flexibility and comfort is improved ceaselessly,endoscopic transsphenoidal surgery for the sellar tumor will be carried out more widely.

Objective To observe reverse effect of anisodamine to the adverse effect of remifentanil during enteroscopy without pain for patients with bradycardia .Methods Sixty‐five patients with bradycardia were selected and divided randomly into group C (n=21 ,control group)、group A1 (n=22 ,anisodamine by instillation) and group A2 (n=22 ,anisodamine by continous infusion) .In‐duction :Intravenous etomidate 0 .08 mg/kg ,propofol 1 .00 mg/kg and remifentanil 0 .10μg/kg in 3 groups .Ten mg anisodamine in‐fused by instillation before induction in group A1 ,5 mg anisodamine infused by instillation before induction and continous infused by 0 .25 mg/min in group A2 .Maintenance:All group received propofol 4 mg · kg‐1 · h‐1 ,remifentanil 0 .05 μg · kg‐1 · min‐1 after un‐dergoing enteroscopy .stopping pumping propofol when colonoscopy reached ileocecal junction ,and we took off remifentanil when colonoscopy withdraw to decending colon .Then we observed and recorded HR ,SpO2 ,MAP ,dosage ,fluid infusion ,induction time , check time ,analepsia time ,degree and of enterospasm and numbers of cases and side effect at T0 (before induction) ,T1 (beginning of operation) ,T2 (into the transverse colon) ,T3 (to the ileocecal junction) ,T4 (exit) .Results There were no significant difference a‐mong 3 groups of induction time .Compared with group A1 and group A2 about check time and analepsia time ,group C was much shorter .The HR of group A1 and A2 were more stable than group C at T2 、T3 .At T1 、T2 ,the fluctuation of HR of group A2 was less than that of group A1 .There was obviously different among 3 groups of propofol′s dosage ,operation time and enterospasm ,the effect of group A1 and group A2 were better .There was statistically significant in number of cases of body movement between group A1 (1/22)and group C(4/21) ,there was also statistical significance between group A1 ,group A2 and group C(P<0 .05) .Conclusion There are no difference between 2 methods about relieving enterospasm ,refraining intestinal angina ,shortening operation time , saving anesthetic dosage .Effect of continous pumping to undulation of HR may be more stable .

Objective To evaluate the agreement between colposcopic diagnosis with 2011 colposcopic terminology of the International Federation for Cervical Pathology and Colposcopy (IFCPC) and cervical pathology in cervical lesions. Methods A retrospective cohort study was performed, which included 376 patients who underwent colposcopy with 2011 international terminology of colposcopy at Obstetrics and Gynecology Hospital of Fudan University from September 2014 to November 2014. With conization or cervical biopsy pathology as the gold standard, the agreement between colposcopic diagnosis and pathologic diagnosis was calculated and correlations between variables were analyzed. Results With 2011 international terminology of colposcopy, agreement of colposcopic diagnosis and cervical pathology was 60.9%(229/376)perfectly matched, and the strength of agreement with weighted Kappa statistic was 0.401 (P<0.01), and agreement within one grade was 97.6%(367/376), which were improved compared with traditional methods. Colposcopic diagnosis were 19.9%(75/376) overestimated and 19.1%(72/376) underestimated. There were no significant difference between agreements in various grade lesions (χ2=1.996, P=0.573). Positive predictive value of high grade colposcopy or more was 84.4%, the negative predictive value of low grade colposcopy or less was 88.8%, whereas false positives were 3.5%and false negatives were 39.3%. A linear trend among three types of transformation zone and patient ages was found (χ2=45.910, P<0.01), whereas lesion sizes were not linearly correlated with lesion degrees (χ2=0.690, P=0.406). In grade 1, grade 2 and nonspecific findings, thin acetowhite epithelium, dense acetowhite epithelium and Lugol′s non-staining were most frequent, the Youden indexes of each were 0.170, 0.373 and 0.145, 0.069 respectively. Positive predictive value of some other findings (such as fine mosaic) and two new signs (inner border sign and ridge sign) were 100.0%. There were no significant difference between agreements in examiners with different levels of experience (χ2=1.197,P=0.550). Conclusions Compared to traditional methods (such as Reid index), 2011 international terminology of colposcopy could improve the agreement between colposcopic diagnosis and pathologic diagnosis, without significant differences by the severity of lesion and the level of examiners′experience. Common findings were classified reasonably, and some signs were highly reliable, which is important for guiding biopsy. However, the reproducibility of transformation zone types and the implication of lesion size need to be further discussed.