Objective To evaluate the application of intraoperative endoscopy during the emergency exploratory laparotomy in the patients with acute massive small intestinal bleeding.Methods Twenty-six patients with acute massive small intestinal bleeding were examined by intraoperative endoscopy during the emergency exploratory laparotomy and the clinical data were analyzed.Results The hemorrhagic reasons were clarified in 25 patients(96.2%) through the application of intraoperative endoscopy.Of the 25 patients,the results showed that 2 cases were with duodenal leiomyoma,1 case duodenal Dieulafoy' disease,5 cases small bowel leiomyoma,2 cases small bowel leiomyosarcoma,2 cases ileum lymphoma,3 cases ileum ulcer,4 cases small bowel cavernous hemangioma,5 cases small bowel arteriovenous dysmorphosis and 1 case pancreaticojejunostomy cut bleeding.The average examination time was 15 min and no complications related to intraoperative endoscopy occurred in all patients.Conclusion The application of intraoperative endoscopy,which may increase the detection rate,is efficient and safe during the emergency exploratory laparotomy in the patients with acute massive small intestinal bleeding.

Objective To explore the value of endoscopic duodenal feeding tube placement in severe coma patients with endotracheal tube by tracheostomy. Methods 28 patients, who suffered from severe coma with endotracheal tube by tracheostomy, received endoscopic duodenal feeding tube placement. Results Endoscopic duodenal feeding tube placement in all 28 patients was successful, and complications such as tube blocking or dropping occurred only in one patient. The average time of placing duodenal feeding tube was 16 min. Conclusion Endoscopic duodenal feeding tube placement was an effective, simple,convenient and safe way to set up enteral nutrition for severe coma patients with endotracheal tube by tracheostomy.

Objective To evaluate the efficacy and safety of contact endoscopic argon plasma coagulation(APC) for treating protuberant erosive gastritis. Methods 63 patients with protuberant erosive gastritis were randomly divided into groups A and group B, which were treated with non-contact and contact APC, respectively. The efficacy and safety were compared between the two groups. Results There was no significant difference between group A and group B in the efficacy and complication frequency. The curative rates in group A and B were 96.8% and 96.9%, respectively, and only 3 patients had abdominal pain or distension 1 to 3 days after operation, and disappeared within 3 to 7 days after treatment in each group. The numbers of ineffective operation in groups A and B were 284 and 96, respectively. The duration of operation in groups A and B was 11 min and 38 sec,7 min and 22 sec, respectivley. The numbers of accidental injury in group A and B were 137 and 58 times, respectively (all P

Objective To evaluate the efficacy of oxycodone or hydromorphone combined with propofol for colonoscopy.Methods A total of 150 patients of both sexes,aged 18-64 yr,weighing 45-85 kg,of ASA physical status Ⅰ or Ⅱ,undergoing colonoscopy,were randomly divided into 3 groups (n=50) using a random number table:fentanyl combined with propofol group (group F),oxycodone combined with propofol group (group O) and hydromorphone combined with propofol (group H).In F,O and H groups,fentanyl 1 μg/kg,oxycodone 0.1 mg/kg and hydromorphone 0.02 mg/kg were injected over 60 s,respectively,and then propofol 1.5 mg/kg was injected intravenously.After eyelash reflex disappeared,a colonoscope was placed.When body movement occurred during examination,half of the initial dose of propofol was added.The time for induction of anesthesia,operation time,emergence time,recovery time,occurrence of adverse cardiovascular events,nausea and vomiting and respiratory depression,and amount of propofol consumed were recorded.Results There was no significant difference between the three groups in the time for induction of anesthesia,operation time,emergence time,recovery time,adverse cardiovascular events,respiratory depression,and amount of propofol consumed.Compared with group F,the incidence of nausea and vomiting and respiratory depression was significantly decreased,and the degree was reduced in H and O groups.No significant difference was found between group O and group H in the incidence of nausea and vomiting and respiratory depression and the degree.Conclusion Oxycodone or hydromorphone combined with propofol can be safely and effectively used for colonoscopy and the efficacy is better than that of fentanyl combined with propofol.

Objective:To explore the feasibility and preliminary effect of improving the comprehensive quality of medical students by introducing the teaching model of cleft lip and palate treatment platform in medical education.Methods:A total of 40 grade two undergraduates of Shantou University medical college were randomly divided into experimental group ( n=20) and control group ( n=20). The students in the experimental group were the volunteers of Cleft lip and palate treatment center, receiving the characteristic idea and methods in clinical teaching. The control group received conventional teaching. The evaluation indicators, including the intellectual quality (60 points), moral quality (15 points), humanistic quality (5 points), physical and mental quality (10 points), social practice (10 points), were quantified by fuzzy evaluation method and a professional evaluation team was set up to evaluate the effect of teaching. SPSS 19.0 was used to perform t test for comparison between the two groups. Results:The average scores of the above items in the experimental group were respectively (51.477±2.381), (10.613±0.169), (4.228±0.124), (8.677±0.296), and (8.565±0.421), and the average total score was (83.559±2.333); the average scores of above items in the control group were respectively (49.746±3.176), (10.268±0.266), (4.008±0.195), (8.207±0.354), and (7.575±0.321), and the average total score was (79.804±3.510). Statistical difference was found in all scores except the intellectual quality score between the two group ( P<0.05). Conclusion:Though no significant difference was found in the intellectual quality, the other qualities have played important roles in improving medical students' comprehensive quality. It is significant to improve the medical students' comprehensive quality by the method of cleft lip and palate treatment platform.