Objective To discuss how to improve the cultivation level of postgraduates majored in general surgery by special training.Methods We retrospectively analysed the work performance of 78 postgraduates in the first year after graduated from the general surgery of our hospital during 2005 to 2009. The employer’s evaluation of the postgraduates was compared between before and after special training.Results 22 postgraduates didn’ t receive special training,and 56 postgraduates receive special training. The clinical skills and clinical thinking ability of the postgraduates received special training were much better than the postgraduates who didn’ t receive special training, there was a significant difference between two groups ( P<0.05 ) . Conclusion The special training can significantly improve the clinical skills and clinical thinking ability of the postgraduates majored in general surgery in our hospital.

Objective To explore the effect of the combination of benazepril and beraprost sodium on urinary microalbumin (UMA), serum high sensitivity C-reactive protein (hs-CRP) and TNF-α in patients with diabetic nephropathy(DN) in early stage. Methods From Mar. 2010 to Mar. 2013, 120 patients with early-stage DN were randomly divided into Benazepril Group, Beraprost Sodium Group and Combination Group. Each group consisted of 40 patients with medical therapy in 20-week duration. The levels of 24 h-UMA, serum hs-CRP and TNF-α were detected and compared before and after therapy. Results After treatment, the levels of 24 h-UMA, serum hs-CRP and TNF-αall decreased significantly in three groups (P<0.05) and there were lower 24 h-UMA, serum hs-CRP and TNF-αin Combination Group than those in Benazepril Group and Berapros sodium Group (P <0.05). Conclusion There is coordinating protection of combination of benazepril and beraprost sodium on diabetic nephropathy in early stage, possibly being related with the inhibiting of micro-inflammation.

Objective To investigate the reversal of the multidrug resistant gene mdr1 in vivo by antisense oligodeoxynucleotide (ASODN) on the basis of study in vitro. Methods The cultured drug-resistant human hepatocellular carcinoma cells were injected under the skin of axilla to establish the tumor model of nude mice. mdr1 ASODN accompanied by Lipofectamine were injected locally and ADM was injected intraperitoneally. Control 1 and control 2 were locally injected by Lipofectamine and normal saline separately, and ADM was also injected intraperitoneally. Results As time went on the tumor size increased and from the 5th day on alterations were marked, tumor size in different time phase showed marked difference to the prior time phase with significant difference (P 0.05). The results suggested that SODN and Lipofectamine showed no marked effect on tumor growth of nude mice and ASODN had marked inhibition effect on tumor growth.Conclusion mdr1 ASODN can also reverse multidrug resistance of drug-resistant human hepatocellular carcinoma cells in vivo. After the treatment the tumor’s growth in nude mice will slow down in a range of time.

Objective To analyze the risk factors of acute kidney injury (AKI) in the patients undergoing gastrointestinal surgical procedures.Methods We retrospectively analyzed all gastrointestinal surgical patients nearly 2 years who were in the first affiliated hospital of Kunming Medical University and the first people's hospital of Yunnan province.Results The incidence of AKI was 2.1%.Univariate analysis and multivariate analysis indicated that: age>65 years, emergency operation and serious infection were significantly related with the incidence of AKI.Conclusion AKI is a common complication after gastrointestinal surgical procedures.This study showed that age>65 years, emergency operation, serious infection were risk factors most likely associated with postoperative AKI development.

Objective To analyze clinical features, diagnosis, treatment and prognosis of Hashimoto's disease ( HD) accompanying with thyroid cancer. Methods Clinical data of 10 cases of HD accompanying with thyroid cancer admitted from Jan. 1998 to Jan. 2008 were analyzed retrospectively. Results Pathology revealed 8 cases had HD accompanying with papillary cancer and 2 cases had HD with follicle cancer. Mild hoarse voice was observed in 2 cases. Varying degree of hypothyrosis was observed in 9 cases and all patients were treated with thyroxin. Conclusions It is difficult to diagnose HD accompanying with thyroid cancer preoperatively. Knowing the indications of operative exploration of HD is very important and surgical management is the best treatment. The operation should follow the principle of radical thyriodectomy. Patients should be treated with thyroxin postoperatively.

Objective:To investigate the clinical therapeutic effects on mini-phlebectomy treatment for varicosis of lower limbs.Methods:Of 46 cases(70 limbs) of varicosis of lower limbs,25(38 limbs) received flush ligation and stripping of the great saphenous vein (control group),and 21 (32 limbs) received mini-phlebectomy (mini-phlebectomy group).The data of operating time,bleeding quantity,incision number,incision length and hospital stay time was analysed retrospectively in both groups.Results:The operating time,bleeding quantity,incision number,incision length and hospital syay time of mini-phlebectomy group are much less than that of control group.The cure rate of control group and mini-phlebectomy is 71.9% and 91.3% respectively.The difference of cure rate is significant while they are compared.Conclusion:Mini-phlebectomy has the advantage of minimal invasion,less bleeding,efficacious and time saving,it will be an ideal procedure for varicosis of lower limbs

Objective To investigate the expression of TLR9 mRNA of peripheral blood mononuclear cells (PBMCs) in patients with acute pancreatitis .Methods Fifty two AP patients with the disease duration in 24 h were collected ,peripheral EDTAK2 coag‐ulation vein blood were collected on the first ,third and fifth day ,then plasma were cryop reserved to detect pancreatic elastase , proinflammatory cytokines and anti‐inflammatory cytokines .Then the peripheral EDTAK2 coagulation vein blood two to three months after treatment were collected in the same method to undertake these tests ,and act as the reference level value .Peripheral blood was collected from 36 acute pancreatitis patients .Three months later ,peripheral blood was collected again from these 36 peo‐ple as controls .PBMCs were isolated by Ficoll‐Hypaque gradient centrifugation .RT‐PCR was adopted to determine the relative con‐tent of the expression of TLR9 mRNA of the PBMCs .Results The relative content of expression of TLR9 mRNA were significant‐ly up‐regulated in the patients with acute pancreatitis ,compared with that of controls (P<0 .05) .The up‐regulated expression of TLR9 mRNA was related to expression of TNF‐a and IL‐1 .Conclusion The up‐regulated expression of TLR9 mRNA in acute pan‐creatitis patients indicates that infective factors might be mediated by TLR 9 .

Objective To evaluate the efficacy of port vein chemotherapy after simultaneous colorectal and liver resection.Methods 18 patients underwent carcinoectomy operation of colon or radical colorectal resection and irregular resection of hepatic metastases simultaneously in a single operation,and were given port vein chemotherapy in and after the operation.Result The survival rate at 1 year and 3 year were 83.3% and 55.6% respectively.Conclusion Patients underwent simultaneously colorectal and liver metastasis resection,port vein chemotherapy can improve response rate and prolong median survival to hepatic metastases of colorectal cancer.

Objective To study the anatomical relationship between the recurrent laryngeal nerve(RLN)and the inferior thyroid artery,to investigate the prophylactic measures on how to avoid iatrogenic injures while exposing the RLN during thyroid operation.Methods Retrospectively reviewed the clinical data of 1 345 patients accepted thyroid operation with RLN exposing.Results A total of RLN 1 988 were observed,874 on the left and 1 114 on the right(including 2 non-recurrent laryngeal nerve).On the left side,the nerve passed anterior to the artery in 32.8%,posterior to it in 26.7%,and between the branches of the artery in 41.6%.On the left side,the nerve was found coursing anterior to the artery in 36.2%,posterior to it in 28.2%,and between the branches in 35.3%.6 nerves were iatrogenic injured,4 cases were temporary injured and 2 were permanent.Conclusions Although the anatomical relationship between the RLN and the inferior thyroid artery are variable,iatrogenic injures of the nerve can be avoid by exposing it,and an experienced surgeon with good knowledge of RLN anatomical characteristics and skilled surgical techniques was needed.

Objective To explore the relation of recurrent laryngeal nerve damage with the mode of surgery and exposure of the nerve in thyroidectomies.Methods We retrospectively reviewed the clinical data of 2142 thyroidectomy patients.There were 540 unilateral and 1602 bilateral procedures with 3744 nerves at risk of injury.Among them,1986 nerves were explored and indentified,and 1758 nerves were not exposed.Results The overall incidence of recurrent laryngeal nerve injury was 0.93%(20/2142),and with an incidence of 0.37%(8/2142)for permanent damage.The injury incidence in the nerves exposure and non-exposure groups was 0.30% and 0.80%,respectively,the difference was significant between the two groups(P0.05).Conclusions The occurrence of recurrent laryngel nerve injury can be reduced or avoided by its careful exposure and identification during thyroid operation.