Objective To investigate difference of clinical curative effect between laparoscope combined with choledochoscope and traditional laparotomy in treatment of cholecystolithiasis and choledocholithiasis.Methods The clinical data of 80 patients with cholecystolithiasis and choledocholithiasis were retrospectively analyzed,among whom 48 patients were given laparoscopic cholecystectomy (LC) ± laparoscopic common bile duct exploration (LCBDE) (observation group),and 32 patients were given traditional laparotomy (control group).The curative effect was compared between 2 groups.Results There were no statistical differences in operating time,calculi clearance rate and cost of hospitalization between 2 groups (P ＞ 0.05).The intraoperative bleeding,postoperative length of hospital stay,and rate of postoperative complication in observation group were significantly lower than those in control group:(28 ± 5) ml vs.(32 ± 11) ml,(6.0 ± 1.1) d vs.(7.0 ± 1.2) d,4.17％ (2/48) vs.18.75％ (6/32),and there were statistical differences (P ＜ 0.05).Conclusion Laparoscope combined with choledochoscope is an effective treatment method of cholecystolithiasis and choledocholithiasis.

Humanistic quality of medical workers directly affects the quality of medical service and patient satisfaction.In view of patient′s value demand,this paper identified main setbacks in humanistic service in China in the course of medical service.The authors found out the reasons for the lack of humanities quality,and interpreted medical humanistic spirit,medical professional spirit,medical ethics and morality,and connotation of medical law culture.On such basis,the paper unveiled the importance of medical humanities accomplishment in medical practice and medical students′training,proposing to promote the concept of humanistic spirit of medicine and the doctor-patient communication skills.

0.05). Conclusion The noise induced by otologic drill did not show the effect that could damage the inner ears and led to the deterioration of the inner ear function.

Objective To study the efficacy of pelvic reconstruction surgery in the treatment of pelvic organ prolapsey (POP).Methods 18 patients with POP underwent pelvic reconstruction surgery were selected.Clinical parameters during peri-operation were recorded.After 3 months and 6 months,pelvic organ prolapse quantitative examination(POP-Q) and anatomic improvement in these patients were analyzed.Comparisons of pelvic floor distress impact questionnaire short form 7 (PFIQ-7) and quality of sexual life of chinese women questionnaire in these patients before and after surgery were used to evaluate quality of life and quality of sexual life.Results Median operation time was (90.0 ± 13.2) minutes and median blood loss was (30.0 ± 1.2) ml,all the patients were followed.The objective cure rate was 100％.The mean score of post-operative PFIQ-7 were significantly lower than those of pre-operation (P ＜ 0.01),and those of qualify of sexual life of chinese women questionnaire was no significantly difference (P ＞0.05).The rate of mesh crosion was 0,and there was no case of de novo urinary incontinence and de novo dyspareunia.Conclusion Pelvic reconstruction surgery is a safe and efficacious management.It can improve qualify of life remarkably and have no influence on sexual quality of life.

Accidents, Traffic ; statistics & numerical data ; China ; epidemiology ; Humans ; Wounds and Injuries ; epidemiology

Humans ; Orthopedics ; methods ; trends ; Traumatology ; methods ; trends

ObjectiveTo evaluate the effect of lornoxicam used for craniotomy. Methods60 neurosugical patients, ASA physical I～II, were randomly allocated into three groups to receive normal saline in controlled group (GroupⅠ), lornoxicam 8 mg (Group Ⅱ) and lornoxicam 24 mg (Group Ⅲ) intravenously 10～15 min before anesthesia. The end-tidal concentration of isoflurane was measured. The volumes of bleeding, transfusion, fluid infusion and urine were recorded. The time of consciousness, psychomotor and cognitive recoveries from general anesthesia were observed. The VAS scores of pain were evaluated 48 h after operation.ResultsThe concentrations of end-tidal isoflurane in the controlled group were significantly higher than other groups (P<0.01). There was no difference among the three groups in the volume of bleeding, transfusion, infusion and urine. The recovery time of conscious, psychomotor and cognitive from general anesthesia were shorter in group Ⅱ and Ⅲ (P<0.01). The total dose of tramadol and VAS score after the operation were no difference among the three groups.ConclusionThe preoperative application of lornoxicam can reduce the concentrations of end-tidal isoflurane significantly, smooth the recovery from anesthesia.

Otjective To study whether there is the apoptosis of neural cells and the expressionof Bcl-2 protein in intracerebral hemorrhage (ICH) in model of rats, for the further understanding the mechanism of the delayed damage of the neural cells around the hematoma after ICH. Methods Fifty SD rats were randomly divided into 5 groups, ten in each. With the Group A as the control, the rest 40 were used to set up intracerebral hemorrhage model. The brains were taken out at 12th, 24th, 48th and 72th hours, respectively. Apoptosis cells were detected with terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL), and the expression of Bcl-2 protein was detected with immunochemical stainging methed (SP). Results In the control group, no apoptosis cells and Bcl-2protein were detected. In rest groups, the apoptosis cells and Bcl-2 protein were expressed in different degree.Apoptosis rates verified and corresponded with the time after ICH, with the peak at 48th -72th hour after hemorrhage.The peak rate of apoptosis cells was (24. 50± 2.69)% and Bcl-2 protein expression was (20. 76 ± 1.97)% . There was significant difference between the experimental groups and control (P＜0.05), and no linear relationship between the apoptosis rate and the expression of Bcl-2 protein. Conclusion Apoptosis may be an important factor in the secondary trauma of ICH. There is a time leg after hemorrhage. All this is instructive to clinical treatment in time. Bcl-2 protein keeps increasing in a certain time after hemorrhage, but not synchronize with the cell apoptosis. This indicates that bcl-2 has the effect to reduce the apoptosis of neural cells.

Novel intraductal radiofrequency ablation for malignant biliary stricture indicated good therapeutic prospect.In traditional intraductal radiofrequency ablation,the radiofrequency catheter was placed through endoscopic retrograde cholangiography or percutaneous transhepatic cholangiogram under the supervision of X-ray.In February 2014,a patient with intrahepatic adenocarcinoma of the bile duct and malignant common hepatic duct stricture was admitted to the Shenzhen People's Hospital.The patient received cholecystectomy + choledocholithotomy + T tube drainage 3 months prior to the admission.The results of histopathological examination indicated reactive hyperplasia.The patient recovered uneventfully after the operation.One week before the admission,the patient had jaundice and umber urine and received choledochoscopy + common bile duct dilatation + histopathological examination + biliary stent placement.The results of pathological examination confirmed that the patient had intrahepatic adenocarcinoma of the bile duct.The patient received intraductal radiofrequency ablation through T-tube fistula under direct vision of choledochoscopy,and recovered well after the operation.Intraductal radiofrequency ablation under direct vision of choledochoscopy not only has the advantages of accurate positioning and real-time monitoring,but also facilitate cyclical repeat treatment.

Objective To investigate the effect of transurethral holmium YAG laser in treatment of bladder calculi.Methods F5 laser fiber in the holmium YAG laser was used to treat 40 patients with bladder calculi.Then the effect was observed.Results All 40 cases were successfully done by the operation time range from 15 to 120 minutes.There were no major complications,such as TRUS,bladder rupture or major bleeding.There was no residue stone.Conclusion F5 laser fiber in the holmium YAG laser treatment could be protected by the transurethral scope.It was safe,effective and has shorter operation time in treatment of bladder calculi.