Objective To report the method and effect of treating cholepathia under laparoscopy and endoscopy. Methods Laparoscopy, duodenoscopy and choledochoscopy in combination were used in treating 1 990 cases of cholepathy and the results were analyzed. Results Laparoscopy and duodenoscopy in combination were used in 1 350 cases of cholecystolilhiasis and choledocholith with cure rate ( 93. 6% ) ; laparoscopy and choledochoscopy in combination were used in 332 cases of choledocholith with cure rate (100% ) ; laparoscopy, duodenoscopy and choledochoscopy in combination were used in 258 cases of choledocholith (29 cases with pancreatitis) and 24 cases of Mirizzi syndrome with cure rate( 100% ). There was no serious complications happened. Followed up 1 051 patients from 3 months to 12 years (average 7.8 years) , 10 cases have recurrence of stones. There was no long-term complication such as stenosis of bile duct, etc occurred. Conclusion The procedure had minor trauma, mild suffering, and less operative complications compared with the traditional laparotomy.

OBJECTIVE:To explore medical course construction for community pharmaceutical service talents cultivation. METHODS:According to the requirements for community pharmaceutical service talents cultivation in vocational colleges, Yancheng Health Vocational & Technical College strengthened the medical course construction by optimizing the curriculum system structure,selecting the teaching contents,reinforcing the students’vocational ability education and infiltrating humanistic educa-tion. RESULTS:In terms of medical curriculum structure,the college integrated the basic medical and clinical disciplines respec-tively into Essentials of Basic Medicine and Essentials of Clinical Medicine. In terms of selection the teaching contents,the college tried to weaken medical discipline consciousness and to follow the logical relationship among medical disciplines,not only pursuing the integrity and systematization of the knowledge from different subjects. Besides,the college added teaching contents,strength-ened the cultivation of vocational skills,and increased the practical teaching contents as well as infiltrates the humanistic education into the practical teaching. CONCLUSIONS:Strengthening medical course construction makes it better for medical course structure and teaching contents to achieve the requirements of the pharmaceutical service talent cultivation goals of“good command of medi-cine and pharmacy”.

Haloacetic acids are the main disinfection by-products in chlorinated drinking water,which are known or suspected to carcinogenic. Many countries have promulgated haloacetic acids as the routine monitoring item for drinking water safety. In order to better control the formation of haloacetic acids in chlorinated drinking water,many techniques and analysis methods were exploited. This review summarized the development of techniques and analysis methods and the comparative analysis was conducted in technique cost,method detection limit,sensitivity,resistance to disturb and sample pretreatment. The electrospray mass spectrometry is the best choice,but the instrument and operation cost is much higher,so the standard method based on the gas chromatography will still be the popular method for drinking water quality analysis.

Objective To study the effect of exercises plus active vitamin D on the bone mass of the elderly osteoporosis patients. Methods Eighty nine cases of elderly osteoporosis were divided into 2 groups at random, with 45 cases in Group A (control group) and 44 in Group B (treatment group). Every patients in these two groups takes 600mg calcium and 0.25?g ? D 3 daily. At the same time, Group B conducts regular exercises. Results After the simple ? D 3 treatment, the lumbar BMD increased significantly and the level of osseous formation index BGP increased, but the osseous absorption index PYD/Cr did not change significantly. However, after the combined treatment with ? D 3 and exercise, the BMD at both the lumbar vertebra and the hip increased significantly, the level of osseous formation index BGP increased greatly and the osseous absorption index PYD/Cr decreased. Conclusion ? D 3 treatment is more favorable for aged osteoporosis patients in stimulating osseous formation than in inhibiting osseous absorption, and it is advantageous in increasing the bone mass of the lumbar vertebra. The ? D 3 treatment combined with aerobic exercise is helpful not only in increasing the bone mass of the lumbar vertebra and the hip in the elderly patients with osteoporosis, but also in stimulating osseous formation and inhibiting the osseous absorption.

Objective:Preparations level by hospital accreditation and discussion hospital medical equipment quality and safety management indicators. Methods:Ministry of health, three general hospital accreditation standards implementing rules (2011 edition)(thejudging criteria) on hospital quality and safety of medical equipment management requirements research. Results:Establish five indicators hospital medical equipment quality and safety management, include adverse event monitoring indicators, strong inspection of measuring instruments management indicators, the use of personnel training management indicators, emergency life support equipment management class indicators, single-use sterile medical supplies and equipment management indicators. Conclusion:Proposed hospital quality and safety of medical equipment management indicators help to ensure the quality and safety of medical equipment, to provide a reference by exploring management indicators for the quality and safety management of medical equipment.

Objective:To study the electrical safety of multi-parameter monitor and defibrillation monitor, and guarantee the safe and effective operation by through the medical equipment electrical safety performance in our hospital.Methods: To test 101 different models of multi-parameter monitor and defibrillation monitor electrical safety.Results: The one-time pass rate of 96%, and the two-time rate was 98%, also one multi-parameter monitor and defibrillation monitor hadn’t meet electrical safety performance after repairing.Conclusion: The equipments that don’t meet electrical safety performance prohibit using for clinical purposes; To ensure the safety of medical equipment and life safety of medical workers and patients by through developing the testing of the medical equipment electrical safety performance in our hospital.

The current problems of pharmacology teaching in nursing in 3-year program colleges lie in that the teaching ideas drop behind;course orientation is vague;the development of text books lags;the contents lack characteristics;and there is no clear aims in the practice teaching.So,it is essential to make the teaching evolution.First,according to the post needs,the orientation of the courses should be definite,and new ideas about the curriculum should be set up.Meanwhile,the development of text books should be speeded up and the teaching contents should be optimized.Then,practice teaching needs to be improved,and cultivation of their comprehensive competence should be enhanced.To improve the students’professional qualities,emphasis on the penetration of humanities should be paid attention to.

Toenhance the humanityeducation for our student nurses,in recent years,our col-lege has done innovation on humanity courses by increasing its proportion,enhancing the penetration of humanity education into other courses. We have strengthened the cultivation of humanity emotion bypaying attention to the development of recessive courses and constructing the fantastic humanity environment by the means of practical activities.

Objective To study the operative design, safety evaluation and feasibility of gasless laparoscopic operations. Methods The gasless laparoscopic devices (GLD) were applied to 124 cases of laparoscopic choledocholithotomy with T-tube drainage, 56 cases of laparoscopic choledocholithotomy with primary bile duct suture, 1 case of laparoscopic choledochocystectomy hepaticojejunostomy, 15 cases of modified gasless laparoscopic choledochojejunostomy, 1 case of hand-assisted laparoscopic megalosplenic resection and portozygos disconnection, and 1 case of gasless device assisted laparoscopic splenectomy. Results All the operations were successfully conducted, without any severe complications. Follow-up for 1~9 years in 129 cases of biliary duct operations found 1 case of recurrence. Follow-up for 3~12 months in 2 cases of splenic operations found no recurrence. Conclusions Gasless laparoscopic operations in this study have reached minimally invasive outcomes, proven to be safe and feasible.

A 66-year-old male patient presented with rhinocnesmus and mild epistaxis. More than 100 maggots were found in the right nasal cavity by nasal endoscopy. The affected nasal mucosa was erythematous, edematous, ulcerated, and mild bleeding on probing was present. No nasal septal perforation or destruction of nose was noted. Middle and inferior meatus, nasopharyngeal mucosa, orbit, facial skin, oral cavity, gingiva and external auditory canal were normal. The maggot was identified as larvae of Chrysomyia megacephala.
Aged ; Humans ; Male ; Myiasis ; Nasal Cavity ; parasitology