Objective To observe the clinical efficacy of three types of drainage in the treatment of malignant obstructive jaundice.Methods 84 patients with malignant obstructive jaundice were selected,40 cases were treated with bridge drainage,24 cases were undergone percutaneous transhepatic cholangial drainage(PTCD) and 20 cases were treated with Roux-En-Y anastomosis.The changes of total bilirubin and direct bilirubin were detected 1,3,7 and 14 days after operation.Results The total bilirubin and direct bilirubin after 1,3,7 and 14 days had significantly decreased compared with pre-treatment(P ＜0.05),the decline rates in bridge drainage group were faster than the other two groups (P ＜ 0.05).Conclusion The three types of drainage for treating malignant obstructive jaundice have exact effect,and the bridge drainage can reduce the bilirubin to lower levels more quickly than the other two methods.

Objective:To design a software to read and display CT and RT structure and draw a new contour without treatment planning system (TPS).Methods: In order to display the contour information drawn by doctors, the first step was to match CT images and RT structure then the same screen rendering of CT and RT structures could be applied. In order to add contour in RT structure obtaining the coordinates interactively, connecting coordinate points were the essential steps. Then a unique identity was given in the area of that contour to ensure its unique results. Results: The software successfully read and displayed CT and RT structures and drew a new contour without TPS.Conclusion: In this study, the software establishes a basis to improve the precision of the radiotherapy dose.

Objective To propose the cause and management of necrosis in reversed island flap or distally-pedicled flap. Methods From June 2000 to June 2009, 120 cases with skin and soft tissue defect were repaired using reversed island flap or distally-pedicled flap. In 12 cases the flaps partial necrosis, to analysis the cause of necrosis. Results One hundred and eight cases survived completely in 120 patients,flap necrosis in 12 cases. 3 cases fully necrosis, in which venous disorders cause flap necrosis in 2 cases, arterial blood disorder caused necrosis of flap in 1 case. Partial necrosis in 9 cases, in which dorsal metacarpal artery reversed island flap in 1 case, digital artery reversed island flap in 1 case, posterior tibial artery reversed island flap ankle epithelial branch in 4 cases, medial leg perforating branches of reversed island flap in 1 case, superficial peroneal nerve vascular reversed island flap island flap in 1 case, distally-pedicled based sural neurocutaneous flap in 1 case, after debridement and dressing change subeschar healed in 7 cases, by the other flaps were cut close to rerepair necrotic wounds in 2 cases. Conclusion Blood circulation barrier is the main reason to flap necrosis, improper handling of pedicle is another important reason of flap necrosis,which cannot be ignored.

An investigation was made on the rehabilitation treatment for the injuries wounded in Wenchuan Earthquake offered in 30 hospitals of 8 provinces, including Beijing, Shanghai, Jiangsu, Shandong, Hubei, Guangdong, Cbongqing, and Sichuan. On the basis of data from this investigation, the paper made analysis and summary of the challenges and problems encountered in the said rehabilitation treatment, and raises such recommendations as relessing rehabilitation assessment principles and policies for the injuries to return to their home towns in Siehuan, clarifying the responsibilities of individual government authorities in the later-stage rehabilitation treatment of the injuries, and enhanced synergy among respective disciplines and authorities of both clinical practice and rehabilitation treatment. The goal of these recommendations is further development of the rehabilitation medicine discipline in China.

Objective To compare the effects of Carvedilol.Bisoprolol therapies for patients with chronic heart failure(CHF). Methods 80 patients with CHF were divided into carvedilol group(40 cases) ,Bisoprolol group (40 cases) ;The two groups were treated respectively with Carvedilol or Bisoprolol in addition to the above conventional therapy. The indicators of heart rate( HR),blood pressure( BP) ,left ventricular end-diastolic diameter( LVEDD) , left ventricular end-systolic diameter( LVESD) ,left ventricular ejection fraction(LVEF) ,6min walking test distance (6min walk) were observed after treatment and before treatment. Results Total effective rates were 82.5% and 87.5% in Carvedilol group and the Bisoprolol group,There was no statistically significant difference between two groups(χ2 =2. 18,P>0.05) ;The indicators of HR,SBP,DBP,LVEDD,LVESD after treatment were lower than before treatment ( all P < 0.05); LVEF, and 6min walk were higher than before treatment (all P < 0.05). Conclusion Bisoprolol and Carvedilol could significantly improve cardiac function in patients with heart failure.

Objective To analyze the change of disease constitution of complications in preterm infants in our hospital and to provide a scientific basis for the clinical prevention and treatment in the future. Methods Two hundred and sixty-eight preterm infants were admitted in NICU of our hospital from Jan. 2004 to Dec. 2009. The constitutions of complications in preterm infants were retrospectively analysed by year. Results One hundred and ninety-seven cases had complications and the incidence of complications was 73.51% ( 197/268 ). The most common complications of preterm infants in our hospital included neonatal hyperbilirubinemia (41. 62% ,82/197), neonatal hypoxic-ischemic encephalopathy (39. 59% , 78/197) and neonatal aspiration syndrome (34. 01%, 67/ 197). The change of disease constitution of the complications were as follows: the disease constitution of neonatal hyperbilirubinemia always located within the first 3 diseases ( ranged from 28. 57% to 75.76% , χ2 =13. 582, P < 0. 001) ;the occurrence of neonatal hypoxic-ischemic encephalopathy showed upward trend( increased from 10. 71% to 56. 25% ,χ2 =7. 577,P<0. 001) ,but decreased in 2008,2009;the neonatal aspiration syndrome presented with a high but fluctuant incidence among the 6 years (ranged from 15. 15% to 56. 25% ,x2=12.002,P < 0.001) ; the neonatal hypoglycemia increased in the nearly 3 years;the incidence of neonatal asphyxia was stationary;the disease constitution of neonatal respiratory distress syndrome fluctuated up and down( ranged from 3. 57% to 20.41% ,χ2 = 4. 125,P<0. 05) ;the anemia in premature infant showed upward trend,increasing from 3.03% to 18. 37% (χ2 = 4. 332,P< 0.05 ) ; the occurrence of neonatal scleredema decreased with no statistical significance; the preterm infants suffered from infectious diseases with lower rate. Conclusions The disease constitution of the hospitalized preterm infants in our hospital in the last 6 years is mainly non-infectious diseases. The neonatal asphyxia recovery technology should be further improved. The serum bilirubin concentration should be monitored early after birth of preterm infants and intervened timely. Cranial imaging studies should be performed timely for early detection of brain injury.

Objective To investigate the pharmacodynamics of cis-atracurium after a single bolus injection in adults and children undergoing live donor liver transplantation during preanhepatic,anhepatic and neohepatic phase.Methods Twenty-six ASA Ⅲ or Ⅳ patients aged 7 months-64 yr,werghing 6-80 kg of beth sexes undergoing live donor liver transplantation were assigned to one of 2 groups:group A adults (n=16) and group B children(n=10).Anesthesia was induced with midazolam 0.05 mg/kg and fentanyl 3-5 μg/kg in both groups and propofol TCI (Cp 3μg/ml) in adults.As soon as the patients lost consciousness,tracheal intubation was facilitated with 2×ES95 of cis-atracurium (0.1 mg/kg).The intubation condition wag recorded.The response of the adductor pollicis to TOF stimulation of the ulnar nerve was recorded (TOF-Guard).An increment of cis-atracurium 0.03 mg/kg was given when T1 returned to 25% of baseline value or the four twitches appeared.Cis-atracurium administration and sevoflurane inhalation were stopped before the three phases and resumed when T1 reached 75% of baseline value.The onset time,mterval between the 2 cis-atracurium administrations,duration of clinical action and recovery of neuromuscular block were recorded.The intubation condition was evaluated.Results The onset time was significantly shorter in adults than in children.There was no significant difference in intubation condition between the 2 groups.The interval between the 2 cis-atracurium administrations and duration of clinical action were similar during the 3 phases in adults and significantly shorter during neohepatic phase than during anhepatic phase in children.The recovery was faster in children than in adults.Conclusion Cis-atracurium 2×ED95 (0.1 mg/kg)can be used for both adults and children undergoing live donor liver transplantation.The onset time is longer and recovery is faster in children than in adults.Cis-atracurium is suitable for patients of different ages and liver function.

Objective To investigate the influence of class lecture on health care of sex and production to the sexual attitudes of college students. Methods 930 college students were assessed by The Sexual Attitudes Questionnaire(SAQ) before and after taking part in the lesson of health care of sex and production. Results The score of SAQ of all subjects was lower after class lecture (9.44 ± 2.67 ) than before ( 10.78 ± 2.65 ), there was significant difference(P＜ 0.05 ). Compared to before class lecture , the scores of male and female college students were decreased after education(P＜0. 05 ). There was apparent difference between clinical and nonclinical students before and after class lecture ( clinical (99.70 ± 2.50) vs ( 8.30 ± 1.70), P ＜ 0.05; nonclinical (11.71 ± 2.67)vs (10.81 ± 2.23), P＜0.05). Conclusion Sexual knowledge was increased, and the sexual attitudes was tended to maturity of the students. It' s nessary to promote opening lecture of Health Care of Sex and Production in college students.