Objective To evaluate the therapeutic effect of mini-incision surgery for the treatment of varicose vein of lower extremities. Methods 106 limbs of 95 paitnets with varicose vein underwent saphenectomy combined with ligation of communicating veins by way of mini-incision from November 1997 to April 2001. The ascending venography and StethoDoppler examination were performed preoperatively in all of the patients. Results Venous reflux in deep vein of lower extremities were at grade 0 in 62 limbs, at grade Ⅰ in 28 limbs and at grade Ⅱ in 16 limbs demonstrated by ascending venography with Valsalva test. StethoDoppler examination showed that valve insufficiency of great saphenous vein at saphenofemoral junction was in 99 limbs, the insufficiency of small saphenous vein at saphenopopliteal in 5 limbs and incompetent perforating vein in all of the limbs. Postoperative course was uneventful, the average hospitalization days after operation were 2.8 days and no recurrent varicose veins occurred in all the patients during the follow-up period lasting 1-30 months. Conclusions With the help of preoperative StehoDoppler examination, the mini-incision surgery for the treatment of varicose vein of lower extremities is safe, simple, effective and lower costs.

ObjectiveTo discuss the effect of preoperative psychological communication on psychological state of elderly patients before destined operation.Methods136 cases of elderly patients underwent elective operation were divided into the observation group and the control group with 68 cases in each group,the control group was given routine nursing of general surgery,the observation group received targeted psychological communication based upon routine nursing for consecutive 3 days before surgery.The psychological state such as anxiety,depression and fear was compared between two groups.ResultsThe anxiety,depression and fear in the observation group was significantly improved compared with the control group.ConclusionsPreoperative appropriate and targeted psychological communication can alleviate the anxiety,depression and fear of the elderly patients with elective operation,and contribute to the smooth operation.

Objective:To study the clinical efficacy of levosimendan combined with naoxintong capsule in the treatment of acute heart failure and effects on the serum amino terminal B type natriuretic peptide precursor (NT-proBNP),Galectin-3,endothelin 1 (ET-1),Cystatin C levels.Methods:90 patients with acute heart failure from March 2015 to June 2016 in our hospital were selected and divided into observation group (n=45) and control group (n=45) by lottery method.Patients in the control group were treated by levosimendan alone.Patients in the observation group were treated by Naoxintong capsule combined with levosimendan.The clinical effect,changes of serum NT-proBNP,galectin-3,ET-1,cystatin C levels before and after treatment and the incidence of adverse reactions were compared between two groups.Results:After treatment,the total effective rate was 93.33％ in the observation group,which was higher than that in the control group (77.78％) (P＜0.05);the left ventricular fractional shortening,left ventricular ejection fraction,stroke volume of both groups were higher than those before treatment,the blood pressure,heart rate and serum NT-proBNP,galectin-3,ET-1,cystatin C levels were lower than before treatment,and LVFS,LVEF,SV levels of the patients in the observation group were significantly higer than those of the control group (P＜0.05),the blood pressure,heart rate and serum NT-proBNP,galectin-3,ET-1,cystatin C levels were lower than those of the control group (P＜0.05).Conclusion:Levosimendan combined with Naoxintong Capsule could improve the therapeutic effect of acute heart failure with higher safety and reduce the levels of serum NT-proBNP,Galectin-3,ET-1 and Cystatin C.

Medical immunology is an important frontier and bridge subject to connect basic medicine and clinical medicine, and its knowledge is abstract and difficult to understand. Micro-course is the new teaching resource with the education information. Its design, development and research have become a hot topic in network learning and mobile learning. In this article, it is elaborated that teaching design is the soul of the quality for micro-course and because micro class software is simple and easy to learn, it is a positive guarantee for the civilization and popularization of micro class, and besides, PPT is the important material in the micro-course. The article also explores the knowledge system of the fragmented micro lessons in series, and analyzes the potential value of micro teaching in the course teaching and personnel training.

Objective To compare the difference in incisional complications between transumbilical single insicion laparoscopic appendectomy(TUSILA) and conventional laparoscopic appendectomy(CLA).Methods The incisional complications in 312 cases of TUSILA and 346 cases of CLA in the general surgery department of this hospital from January 2011 to December 29014 were retrospectively analyzed.The total occurrence rate of incision complications,incision infection rate and incision hernia occurrence rate were observed in the two groups.Results The incision complications occurrence rate,incision infection rate and incision hernia occurrence rate had no statistical difference between the TUSILA group and CLA group(P＞0.05).The univariate analysis showed that the incision infection was correlated with high BMI,complicating type 2 diabetes mellitus (T2DM) and indwelling drainage tube;the Spearman correlation analysis indicated that incision hernia was closely correlated with the incision infection(r=0.82,P＜0.05).Conclusion Compared with CLA,TUSILA does not increase the incision complications occurrence rate.

Objective To explore the application and effect of SPOC platform in medical immunol-ogy teaching. Methods The teaching reform class of Grade 2015 (41students) of Changzhi Medical College was taken as the experimental group, while the parallel class of imaging (37 students), preventive specialty (40 students), Class Nine of clinical medicine (37 students) and oral specialty (39 students) were randomly selected as the control group. "SPOC learning platform + traditional teaching" method was used for teach-ing and learning in the course of the test group. The traditional teaching method was utilized in the control one. For this type of teaching activity, a questionnaire survey was carried out among the students in the reform class, and the final exam score was used as the measure standard. The data were analyzed by SPSS 17.0 software. Results The results demonstrated that the students preferred to learn on the SPOC platform for mobile phones, and the number was significantly higher than that of learning through the computers. Students in the reform class basically liked this type of learning, and their final exam scores were more significant difference than the other classes in the same grade (t'=15.21, P=0.000). The classes in the experimental group and the control group were taken as the research objects, and the rank-sum test was performed, which was statistically significant ( χ2=81.65, P=0.000). Then, the two groups were compared in different classes: the statistical difference between the teaching reform class and image 1502 (t'=11.52, P=0.000), prevention 1502 (t'=7.38, P=0.000), clinical medicine 1509 (t'=8.93, P=0.000), oral 1501 class (t'=8.93, P=0.000) were found. The questionnaire survey demonstrated that 90.24% (37 students) of the reform class liked this form of learning and at the same time, it was suggested that the learning content on the platform should be further linked to the clinical practice and combined with scientific research to expand the students' thinking. Conclusion The SPOC learning platform has turned over the teaching of medical immunology and improved students' motivation and interests in learning.