Objective To compare the surgical modes of cholecystectomy in patients with diabetes mellitus. Methods The intraoperative blood loss, operation time, duration of hospital stay and incidence of complications were respectively compared in 46 patients with diabetes receiving either laparoscopic cholecystectomy (LC, n=23) or open cholecystectomy (OC, n=23). Results In the Group LC and the Group OC, the intraoperative blood loss was (80?23) ml and (120?40) ml, respectively ( t = -4.518 , P = 0.000), the operation time was (45?20) min and (69?28) min, respectively ( t =-3.345, P =0.002), and the hospital stay was (6?2) d and (11?3) d, respectively ( t =-6.651, P =0.000). There were no statistical significances between the two groups in the incidence of complications. Conclusions LC can be performed safely in patients with diabetes mellitus. It offers the advantages over OC in less blood loss, shorter operative time and shorter hospital stay.

Objective To explore the syndrome of vital energy deficiency and blood stasis of CHF rat model. Methods The Wistar male rats were deligated the main stem of left coronary artery. The succeeded twenty rats were cut the diet half from the second week, and swam exhausted every day, compared with normal group. After four weeks, the general condition, heart function, heart construction and NE, PRA, AngⅡ,TXB2, PAI-1 were observed. Results General condition: Model group seemed tired, pelage dimed, tongue ecchymosis, meanwhile breath and heart rate raised. Heart function: There was significant difference between model group and normal group (P

Objective To study the effect of circumferential pulmonary vein isolation(CPVI) guided by Carto-Merge and Lasso catheter for the treatment of atrial fibrillation(AF).Methods Fifty-six drug refractory patients(41 male) with paroxysmal AF were enrolled into this study with a mean age of(58.5?12.7) years.Ostia of pulmonary veins(PVs) were identified by Carto-Merge.Then circumferential pulmonary vein isolation was performed.The endpoint of ablation was abolishment or dissociation of the pulmonary vein potentials(PVPs).Results Mean distance between electroanatomic mapping points and MRI surfaces was(1.79?0.33) mm as a whole in this group.Abolishment or dissociation of PVPs was accomplished in 52 patients(92.9%) during the first procedure.After a mean(18.3?5.7) months of follow up,41 patients(73.2%) maintained sinus rhythm.Ten patients received a second ablation procedure,and 8 were free of atrial tachyarrhythmias after a mean(8.2?6.9) months of the second follow up.No PV stenosis was identified after ablation procedure.Conclusion Combination of Lasso catheters with Carto-Merge to guide the CPVI procedure can confirm the isolation of PVs and lower the incidence of PVs stenosis.

In order to realize the seamless connection between superior and inferior medical institutions and simplify the process of patient referral to superior medical hospitals from the community medical institutions,Zhenjiang First People's Hospital designs a two-way referral platform for direct registration to Zhenjiang First People’s Hospital from community medical institutions.The paper introduces the design process,features and realization steps of this platform.The platform can realize the sharing of patient information between the community medical institutions and the hospital,facilitate patients' seeing a doctor and improve medical service level.

Craniocerebral Trauma ; Earthquakes ; Head ; Humans

OBJECTIVE: To analyze the characteristics of medical malpractice from different grades of hospitals and to explore forensic investigation strategies in assessing medical dispute. METHODS: A total of 206 cases of medical dispute from 2009 to 2010 investigated by the Department of Forensic Medicine in Nanjing Medical University were selected and analyzed according to fault incidence, fault-prone part, and degree of causality in the treatment. RESULTS: Among the 206 cases analyzed, tertiary hospitals, secondary hospitals and primary hospitals showed medium, high and low error rate, respectively. A majority of medical malpractice cases were distributed in the departments of surgery, medicine and gynecology. CONCLUSION The frequency and severity of medical malpractice in primary hospitals were high, which were gradually reduced in tertiary and secondary hospitals.
Dissent and Disputes ; Expert Testimony ; Forensic Medicine ; Gynecology/statistics & numerical data* ; Hospital Departments/statistics & numerical data* ; Humans ; Incidence ; Malpractice/statistics & numerical data* ; Medical Errors/statistics & numerical data* ; Retrospective Studies ; Time Factors

Objective To discuss the clinical character and the therapeutic strategy of the super-proximal bicondylartibial plateau fracture.Methods A review of 8 patients with an average age of 40.8 years old (range,28-56 years; 6 males,2 females) surgically treated from June 2007 to October 2012 was conducted.Conventional pre-operative three-dimensional CT scans were used to clarify the types of fractures and the locations of major displaced bone fragments.All patients received open reduction and internal fixation 7-14 days after injury for recovery of soft tissue.Anterolateral incision combined anteromedial incision was made on those with limited posterior column shift.Otherwise anterolateral incision combined posteromedial might be better for those with obvious displacement.Six of the patients were implanted autograft bone or allograft bone.The collateral ligaments could be repaired in one stage,but a routine repair of cruciate ligaments was not concerned,and an immobilization for six weeks with a plaster or a brace should be followed.Results All cases were followed-up for 12 to 26 months (median follow-up period,18.6 months).All the fractures in the series achieved bone union at or before the last follow-up,and the healing time ranged from 18 to 26 weeks (median healing period,21.5 weeks).The X-rays showed the smooth surface and good alignment of knee joint at the last follow-up.The median hospital for special surgery knee score (HSS) was 78.12 (range,56-90),with 3 excellent cases,3 good cases,1 fair cases and 1 poor case; the excellent and good rate was 75％ (6 of 8).The median Lysholm score was 81.37 (range,58-91),with 4 good cases,3 fair cases and 1 poor case; the excellent and good rate was 50％ (4 of 8).Conclusion Super-proximal bicondylartibial plateau fracture is a special fracture type accompanied with posterior dislocation of knee,which is predominantly presented as an anterior plateau fracture.And injuries of blood vessels and nerve are common.Conventional pre-operative three-dimensional CT scans,paying attention to the stability of the knee,restoring the alignment and joint surface and early analgesic exercises with brace might be commended in management of such plateau fracture.

Objective: Enteral nutrition was used to correct the malnutrition in the patients suffered from esophageal rupture postoperatively. Methods: The naso intestinal tube was placed during operation and the enteral nutrition was used postoperatively. The albumin, prealbumin and transferrin were measured before and day1, 5, 8 and 12 after operation. Results: All 27 patients were discharged with no death. Albumin, prealbumin and transferrin decreased on the 1st day postoperatively and reached the preoperative level on the fifth postoperativeday. Conclusion: Enteral nutrition plays an important role in the postoperative treatment for esophageal rupture.

AIM:To establish a method for evaluating the principle components of Herba Artemisiae Annuae from different habitats.METHODS:Using Fourier transform infrared spectrometry(FTIR),the characteristic peaks of fingerprints of samples from 12 habitats were recognized and compared.RESULTS:The samples from 12 habitats were obviourly different in number,frequency and intensity of peaks.CONCLUSION:FTIR is applied to analysis of principle components of Herba Artemisiae Annuae from different habitats and an operable method of quality control and discrimination for them is provided.