OBJECTIVE:To study the measures to improve the patients’compliance.METHODS:An investigation was carried out in136patients in a given hospital in Wuhan in the way of questionnaire and interview.RESULTS:There was no significant difference in compliance among the patients with different sex,age,education background and income,but there we_ re significant differences among the patients with different initiatives,conceptions,habits,and knowledge of drug use.CONCL_ USION:It is suggested that IMB model should be adopted to improve patients’compliance in the respect of external informa-tion,internal motivation,and behavioral skills.

Objective To evaluate the effect of application of combined hemihepatic inflow and hepatic veins occlusion in major liver resection.Methods The clinical data of 46 cases of large hepatic carcinoma who underwent liver resection were surveyed retrospectively.The hepatic pedicle of affected side and hepatic veins were dissected and controlled initially,then hepatectomy was performed under the condition of vascular exclusion of the affected side of liver.Results All the 46 cases suffered from hepatocellular carcinoma.The average size of the tumors was 8.3 cm(6-15 cm) in diameter.One main hepatic vein was invaded by tumor in 20 cases and 2 main hepatic veins were invaded by tumor in 14 cases.Among the 46 hepatectomies,right hemihepatectomy was performed in 16,right posterior lobe hepatectomy in 14,and left hemihepatectomy in 16 cases.The mean occlusion time of the hemihepatic pedicle was 30 min(10-45 min),and occlusion time of the hepatic veins was 20 min(10-30 min).The average blood loss was 540 ml(300-1 500 mL).Postoperative complications occurred in 14 cases,and all recovered after treatment.There was no mortality in this series.Conclusions Combined hemihepatic inflow and hepatic veins occlusion in major hepatectomy is a safe,effective and practical vascular exclusion method which can effectively reduce the blood loss and the incidence of the liver function failure.

Objective To compare the clinical application of endoscope system and dimensional disc hole mirror, and its advantages of percutaneous transforaminal endoscopic discectomy TESSY technology. Methods Two hundred and eighty patients with lumbar disc herniation randomly divided into foraminal mirror group and endoscopic group(140 cases for each groups). Patients in foraminal mirror group were given TESSY removal of nucleus pulposus through lateral approach road,while in endoscopic group were given posterior approach discectomy. The operation time,bleeding volume,postoperative time,incision length,waist and leg waist pain and functional recovery were recorded. Results The operation incision length in foraminal mirror group was(0. 8 ± 0. 1)mm,significantly shorter in the endoscopic group((1. 7 ± 0. 2)mm),the amount of bleeding in foraminal mirror group was( 9. 8 ± 4. 3 )ml,significantly less than the endoscopic group(( 78. 6 ± 18. 8)ml). The above data were statistically significant difference( t =21. 753,19. 280;P ﹤0. 01 ). The getting out of bed time after operation was(0. 3 ± 0. 1)d,significantly earlier than that in the endoscopic group ((3. 5 ± 0. 8)d;t=21. 451;P﹤0. 01). VAS scores of patients in two group at postoperative were(7. 4 ± 1. 8) and(7. 3 ± 1. 6),significantly decreased than that of preoperative((2. 7 ± 1. 7)and(2. 5 ± 1. 6);t=10. 259, 11. 465;P﹤0. 01),But there were no significant differences between the two groups before and after treatment ( P﹥ 0. 05 ). After treatment,waist function recovery in the two groups were 97. 1%( 136/140 ),95. 7%(134/140),and the difference was significant(χ2 =0. 415,P﹥0. 05). Conclusion Foraminal mirror TESSY technique in the treatment of lumbar disc herniation with microendoscopy discectomy with small incision is proved a good approach with less bleeding,postoperative early rehabilitation.

Objective To evalute the diagnosis and the availability of local excision for the duodenal papilla tumor(DPT).Methods The clinical data of 12 patients with DPT treated by local excision in recent 9 years were retrospectively analysed.In this series,jaundice presented in 100% of patients and always accompanied with abdminal pain.Results There was no operation death in this seties.The preoperative diagnostic rate by biopsy was 75.0%. Ten patients(83.3%)were followed up for 1-5 years,5 patients with benign tumor were survival well.Four patients with early stage T 1 DPT were still survival for 62,31,84and 36months, respectively.Conclusions The indications of local excision for DPT include benign papillary tumor smaller

Objective To evaluate total laparoscopic splenectomy combined with pericardial devascularization. Methods In this study,40 patients with portal hypertension and hypersplenism underwent total laparoscopic splenectomy combined with pericardial devascularization,in which 26 cases had a history of up-GI bleeding. Results Procedures were successful in 36 patients.There was four conversions to open surgery.The operations were completed in a mean time of (224 ± 54) min,with a mean estimated blood loss of (296 ± 209) ml and with no serious complication. Conclusion Total laparoscopic splenectomy combined with pericardial devascularization is a safe and effective available minimally invasive procedure in patients with portal hypertension and hypersplenism.

Objective To establish a rapid,sensitive and specific assay based on real-time PCR combined with reverse transcription for detecting and identifying viable Listeria monocytogenes.Methods The hlyA gene of Listeria monocytogenes was chosen as target,and then the primers and TaqMan probe were designed.Both ends of probe were modified with two different fluorescence groups.The PCR reaction was optimized systematically.The mRNA of Listeria monocytogenes was extracted,and then reverse transcription was performed through random primer.The cDNA Was detected by real-time PCR.Then the specificity,sensitivity and reproducibility of real-time PCR were estimated.In final,real-time PCR was applied to detect 20 mocked double-blind samplea.Results Viable Listeria monocytogenes were detected by real-time PCR accurately and quickly,and meanwhile,none of other bacteria and non-viable Listeria monocytogenes could be identified.The sensitivity was 10 CFU/ml in pure culture and 103CFU/ml for mocked samples respectively.The coefficient of variation of intra-assay and inter-assay Was less than 5%.When this assay was applied directly to identify 20 mocked double-blind samples,10 of these were positive to viable Listeria monocytogenes,5 were negative to non-viable Listeria monocytogenes,and 5 were negative to other pathogens.Conclusion It is demonstrated that real-time PCR is a reliable,accurate and feasible assay for viable Listeria monocytogenes.The establishment of this assay provided complete data for analysis and diagnosis in the field of food safety and epidemiologic survey.

BACKGROUND:Tantalum rod implant technology is a new method of early osteonecrosis treatment. Current research on stress distribution before and after tantalum rod implant in different sizes of femoral head necrosis area is few. OBJECTIVE:To analyze the stress distribution before and after tantalum rod implantation in different sizes of necrotic femoral head area using three-dimensional finite element method. METHODS:Three-dimensional finite element models of normal femoral head and necrotic femoral head of 15, 20 and 30 mm diameterwere constructed. Eight measuring points were chosen on two tiers of each necrotic model to detect the stress distribution and its alteration before and after tantalum rod implantation. RESULTS AND CONCLUSION:(1) Stress concentration werefound on every necrotic femoral head, most pronounced on the one with 30 mm lesion. (2) Tantalum implant appeared to reduce the stress concentration generaly. Comparison of the peak points of these models indicated most significant benefit in 15 mm lesion, next in 30 mm lesion, last in 20 mm lesion. (3) Results indicate that larger lesion entails more concentrated stress distribution and more likely to colapse. Tantalum rod implantation can delay the development of necrosis of the femoral head, andismost effective in smal lesion.

Objective To review our clinical experience on 12 patients with retroperitoneal infection who were treated with retroperitoneal laparoscopic debridement.Method This retrospective study included 12 patients with retroperitoneal infection who were treated with retroperitoneal laparoscopic dehridement and drainage.Results All the 12 patients recovered well and were finally discharged home.Conclusions Retroperitoneal laparoscopic debridement and drainage for retroperitoneal infection is a mini-invasive procedure.It was found to be safe,produced minimal bleeding and resulted in rapid postoperative recovery.It can be used as the first choice treatment in properly selected patients.

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Objective To study the protective effect and mechanism of lactulose on the renal function in acute cholelithiasis with obstructive jaundice. Methods Fifty five cases of acute cholelithotic obstruction were randomly assigned into lactulose group (group L, n=28) and control group (group C, n=27), and 50% lactulose (group L)or 10% glucose (group C ) was administered orally for 3 days before the operation , respectively. The systemic and portal blood endotoxin (ET), blood urea nitrogen (BUN) and endogenous creatinine clearance rate (Ccr) were measured periodically. Results (1) In group L, the level of systemic vein ET and BUN were significantly lower than that in group C (P0.05); and the systemic vein ET and Ccr decreased significantly on 9d (P