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 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 .

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.

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.

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.

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 microanatomy technique of the endoscopy-assisted extreme lateral supracerebellar infratentorial keyhole approach and clinical significance.Methods The extreme lateral supracerebellar infratentorial keyhole approach was imitated in 10 vascular perfusion adult cadaveric heads fixed in formalin,the dorsolateral mesencephalon region was dissected and observed by microscopy and neuroendoscopy from December 2012 to March 2013.Results The extreme lateral supracerebellar infratentorial keyhole approach could be fully exposed the ambient cisterns,the posteromedial tentorial incisura,the dorsolateral mesencephalon region,the trochlear nerve,the root of the trigeminal nerve,the superior cerebellar artery,the posterior cerebral artery and other important anatomical structures.The temporal lobe and parahippocampal gyrus could be exposed when the tentorial was incised.The application of neuroendoscopy could clearly reveal the trigeminal nerve and surrounding structures.Conclusion The extreme lateral supracerebellar infratentorial keyhole approach is suitable for the surgical resection in dorsolateral mesencephalon region.The application of neuroendoscopy can make up for the lack of the trigeminal nerve observed under microscopy and expand the operative field.

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.

BACKGROUND:Static compressure effect between the fracture fragments was generated by fixation itself (tension band wire and screw), but dynamic compression effects were generated during flexion. Mechanical strength and stability of patel ar fracture fixation have obvious advantages. However, there are lacks of quantitative comparative studies on static and dynamic compression effects of these fixation methods.
OBJECTIVE:To observe strength changes and clinical significance of static and dynamic compression using four fixation techniques.
METHODS:Standardized transverse patel ar fracture models were created with fresh cow patel as. The patel as were randomly divided into four groups:fixation was accomplished with modified tension band wiring (wire group);modified tension band with braided cable (cable group);interfragmentary screws (screw group);cannulated screw tension band with wire (cannulated screw group). Before fracture fixation, Fuji pressure-sensitive film was laid among fracture fragments to measure the pressure among fracture fragments after fixation, i.e., static and dynamic compression. Model of each group was measured as fol ows:(1) after fixation, the fixation was removed, and the Fuji pressure-sensitive film was taken out;(2) after fixation, material testing machine was used. Samples underwent a three-point bending test with a 5 000 N load, simulating dynamic compression during knee flexion. Subsequently, Fuji pressure-sensitive film was taken out. Each Fuji pressure-sensitive film was tested using prescale FPD-8010E software. Thus, average pressure among broken bone ends was obtained, and statistical analysis was performed. Static and dynamic compression among broken bone ends was compared in each group.
RESULTS AND CONCLUSION:Average static compression was significantly lower in the wire group than in the cable group, screw group and cannulated screw group (P<0.05). Under 5 000 N load of dynamic compression, similar compression among broken bone ends was visible among wire group and cable group, screw group and cannulated screw group (P>0.05). Dynamic compression was higher than static compression in the wire group (P<0.05). Results verified that compared with modified tension band wire fixation technique, cable or screw could evidently increase static compression among broken bone ends, but simultaneously weaken dynamic compression among broken bone ends.