This study was to appraise safety and feasibility of laparoscopic approach and investigate the clinical effects of laparoscopic tension-free repair of esophageal hiatal hernia using mesh. From August 2006 to July 2009, 24 patients with esophageal hiatal hernia underwent laparoscopic repair. Twenty-three patients received laparoscopic tension-free repair using mesh, at the same time, Toupet or Dor partial fundoplication was performed. One patient was converted to open surgery. The average operating time was 90 min (70-210 min) and the blood loss was between 10-110 mL. There was no death. The mean postoperative hospital stay was 5 days (3-30 days). During a follow-up period of 12-20 months (mean 15 months), there was no recurrence of the hernia, and no complication with use of mesh. The present study suggested that laparoscopic approach was secure and minimally invasive operation for esophageal hiatal hernia and the use of mesh could reduce recurrence rate.

Aged ; Ameloblastoma ; Female ; Humans ; Jaw Neoplasms ; Nasal Septum ; Nose Neoplasms

Objective To better promote the health education and health promotion among patients with chronic disease, general practitioners (GPs) in the community should master the knowledge of non-communicable diseases (NCDs). This paper aimed to describe the current situation of GPs' knowledge about prevention and treatment of NCDs. Methods Self-designed questionnaires were issued to 1 077 GPs in community health service centers, and all GPs finished the questionnaire without assistance. The content of questionnaire includes the general information of GPs and six questions focusing on NCDs. Results Overall, 1 076 GPs completed the questionnaire, and the response rate was 99.9% (1 076/1 077). With regard to the six questions about NCDs, 90.4% (973/1 076) of GPs were well aware of the diagnosis of hypertension. Apart from that, the knowledge of diabetes mellitus (60.9%, 655/1 076), factors related to NCDs (70.2%, 755/1 076), the concepts of mental illness (52.0%, 560/1 076) and the clinical significance of tumor markers (87.9%, 946/1 076) among GPs were adequate, while more than half of the GPs did not know a lot about home oxygen therapy. Conclusion The mastering level of knowledge about prevention and treatment of NCDs among GPs varies that they need further improvement.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Drugs, Chinese Herbal ; therapeutic use ; Evidence-Based Medicine ; Humans ; Lung Neoplasms ; complications ; therapy ; Neoplasms ; complications ; drug therapy ; Pain, Intractable ; drug therapy ; Phytotherapy ; Stomach Neoplasms ; complications ; therapy

The teaching methods were explored to improve the quality of medical genetic teaching for foreign students according to the common problems during the teaching process. The negative effects of communication barriers in medical genetic teaching could be reduced by interactive teaching or problem-based learning in groups,in which the ability to resolve problems by themselves could be improved. In order to improve the teaching systematicness and teaching quality,the teaching contents in class should be from simple to deep,covering genetic laws,pathogenesis,diagnosis and control measure of genetic diseases. From the perspective of practical application and combining with the construction of self-de-signed teaching textbook and cases, the quality of medical genetic teaching ultimately could be further improved.

Objective To investigate the levels of blood pressure, blood lipid, blood glucose, body mass index (BMI) as well as the epidemiological characteristics of dyslipidemia, hyperglycemia, hypertension and metabolic syndrome of Hangzhou citizens. Methods A total of 28 990 citizens in Hangzhou city who underwent health checkup were recruited in this study, including 10 179 males and 18 811 females. The average age of subjects was 65.05 years. Subjects were asked to complete questionnaires regarding personal characteristics. The physical examination emphasized measurement of height, waist and blood pressure. Blood samples were collected and subjected to serum glucose, TC, HDL-C, LDL-C and TG measurements. The values of the examinations was described as xˉ± s . The ratios were compared with chi-square test. The trend analysis was conducted by linear correlation test. Results The prevalence of hypertension and metabolic syndrome was 17.1% and 11.2% respectively. And the prevalence of overweight/obesity and hyperglycemia was 36.3%,8.1%,16.4%respectively. It was indicated that the men had higher prevalence of hyperglycemia, hypertension, metabolic syndrome and overweight compared with women. However, as to the dyslipidemia, men and women were totally different. Women were more prone to suffer from hypercholesterolemia and elevation of low-density lipoprotein cholesterol. Men were apt to suffer from hypertriglyceridemia and reduction of high-density lipoprotein cholesterol. Divided the subjects by age into three groups, it was suggested that the rates of dyslipidemia, hyperglycemia, hypertension and overweight/obesity increased along with the increment of age in women. Although the rates of metabolic disorders were higher in the group of men, the trend of increase with age was not as significant as in women. It could be seen in men that dyslipidemia and overweight/obesity were reduced with the increase of age. Conclusion The metabolic disorders in Hangzhou citizens showed their own characteristics. It is suggested that multiple strategies targeting at different sexes and age-groups should be formulated to prevent and control the occurrence of metabolic diseases.

Objective To evaluate the tissue motion tracking of mitral annular displaeement(TMAD) method in the assessment of short-term effect of cardiac resynchronization therapy (CRT). Methods Twenty six chronic heart failure (CHF) patients with CRT were detected by TMAD. The maximal displacement of the six points of mitral annulus(DS), the standard deviation of the time to regional peak systolie displacement of the six points (Td-sd) and the maximal temporal difference of any two points(Tds-diff) were compared before and one month after CRT. And the correlation between mean displacement and left ventricular ejection fraetion(LVEF),left ventricular end systolic volume(LVESV), fraction area change (FAC) was analyzed. Results Compared with the pre-operatively, the displacement and the mean displaeement of the six points of mitral annulus were significantly increased(P<0.01),Tds diff and Td-sd were decreased(P<0.05) one month after CRT. TMAD correlated with LVEF,LVESV and FAC (r =0.419, r = 0.529, r = 0.567, P <0.05) one month after CRT. Conclusions TMAD is a new technology to evaluate the short-term effect of CRT.

Objective: To observe the role of rmh-TNF in enhancing the anti-angiogenesis effect of cisplatin on Lewis lung carcinoma in the mice.Methods: Lewis lung carcinoma model was established in C57BL/6 mice.Sixty model mice were randomly divided into 4 groups: control group,rmh-TNF group(1500000 U/kg),cisplatin group(6.15 mg/kg), and rmh-TNF plus cisplatin group.Twelve days after implantation of cancer cells,different drugs were injected intra- tumorallv for 3d.The expression of hypoxia inducible factor-1?(HIF-1?)gene in the tumor was identified by RT-PCR. Immunohistochemistry(IHC)image analysis was performed to determine the vascular endothelial growth factor(VEGF) and kinase domain region receptor(KDR)expression and the microvessel density(MVD).Expression of matrix metallo- proteinase-2(MMP-2)was detected by flow cytometry.Results: The MVD values in the control group,the rmh-TNF group,the DDP group and the combination group were(24.76?1.28),(18.95?1.22),(19.53?1.15),(10.43?1.05),respectively,with those of the rmh-TNF and DDP groups significantly lower than that of the control group and higher than that of the combination group(all P

Objective To detect and analyze thyroid tumor by two-dimensional sonogram and Doppler parameter, and evaluate the value of high-frequency ultrasound in diagnosing thyroid benign and malignant tumors. Methods The ultrasonic images of 104 thyroid tumor from 80 patients with typical features were collected. Thyroid tumor was classified into benign and malignant nodules, based on the shape, border, or the rear wall echo, echo attenuation loss, internal echo, and microcalcifications in two-dimensional sonogram and systolic blood peak velocity (Vmax) and resistant index (RI) in Doppler examination. The expected results of high frequency ultrasound were compared with pathological results on consistency and error rate. Results Prediction of benign tumor by high frequency ultrasound was 66, and pathology 61, consistency rate of the two was 92.4%. Prediction of malignant lesions was 38, and pathological examination 32, consistency rate of the two was 84.2%. The total coincidence rate was 89.4%(93/104) and the error rate was 11.6%( 11/104). Conclusions The typical features of thyroid tumor on high-frequency ultrasound are helpful in diagnosis of benign or malignant nodules, which is valuable in guiding clinical treatment.

Objective Meta-analysis the efficacy and safety of Exenatide and insulin therapy oral hypoglycemic drugs effect of obesity with type 2 diabetes .Methods According to the research purpose to set up the screening of related literature and exclusion criteria; formulatethe searching strategy, through PubMed、the Chinese Biological Medicine Datebase(CBM)、 CNKI、Wanfang Data Knowledge Service Platform, VIP to retrieve all theliterature selection of efficacy and safety by Exenatide oral hypoglycemic drugs and insulin therapy of obese type 2 diabetes mellitus.Choose met inclusion exclusion criteria, the complete data information randomized controlled trial (RCT) as the research object; Apply to the international commonly used Jadad score method to evaluate quality included in the test; To process the relevant data in the test ; Apply the ReviewManager 5.1 software to analysis the extracted research data.Analysis the results and put forward conclusions.Results Participants included 11 RCT , meta analysis results showed that compared with the Exenatide, in terms of reducing fasting glucose ,insulin effect more apparent [MD = 0.35, 95％CI: (0.11, 0.59), P = 0.004)]. In control effect of glycosylated hemoglobin, there was no statistically significant difference[MD=-0.04 ,95％CI:(-0.20,0.11), P=0.58],between Exenatide and insulin. Compared with the insulin, Exenatide reduce BMI more apparent[MD=-2.77,(95％CI: -3.34,-2.20),P<0.00001]; Compared with the insulin, Exenatide reduce insulin resistance index, the effect is more obvious[MD=-1.67,95％CI:(-1.93,-1.41), P<0.00001]; Adverse reaction in the process of treatment, the insulin is more likely to lead to hypoglycemia, [OR = 0.32, 95％ CI: 0.19, 0.54), P<0.0001]; While Exenatide are more likely to lead to gastrointestinal adverse reaction [OR = 4.04, 95％ CI: 2.35, 6.93), P<0.00001).Conclusion According to the Meta-analysis: Exenatide can be used in the treatment of oral hypoglycemic drugs of adult obesity with type 2 diabetes, and obvious effects of treatment of insulin resistance, long-term results still needs a large number of samples of high quality RCT to verify.