Objective To evaluate the feasibility and efficacy of laparoscopic repair of vesicovaginal fistula (VVF) with omentum shift.Methods Sixteen VVF patients were reviewed retrospectively from July 2007 to July 2011,aged from 34 to 72 years with a mean age of 48 years.The history of leakage of urine ranged from 1 month to 30 years,of which 15 cases due to uterine operation complication and 1 case due to IUD perforation.All cases were single fistula,with the fistula diameter ＜ 1 cm in 13 cases and ＞ 1 cm in 3 cases.Fourteen cases of fistulas were in the vaginal wall,and 2 cases were in the cervix.Surgical techniques were transabdominal laparoscopic local displacement of the great omentum and conventional layered suture repair of vesicovaginal fistula.Results All surgeries were successful.The operation time was 120 -175 min,with an average of 150 min.The blood loss was 50 -300 ml,with an average of 120 ml.The postoperative hospital stay was 6 to 10 d,with an average of 8.5 d.The catheter indwelling time was 14 to 21 d,with an average of 17 d.During the period of follow-up for 3 to 45 months with an average of 23months,14 cases cured,1 case improved and 1 case failed.No major complications such as intestinal injury occurred.Conclusions Laparoscopic repair of VVF with great omentum shift has the characteristics of less damage,less pain and positive effect.The key points of the surgery are local filling of great omentum and delicate layered suture.

Objective To explore the appropriate treatment according to the grading system of adolescent idiopathic cervical kyphosis.Methods A retrospective study was performed in 115 adolescent patients with idiopathic cervical kyphosis.The patients were divided into 4 groups according to the magnitude of kyphosis.The initial Cobb angle of 4 groups were 12.7°±1.4° 25.4°±4.8°,47.2°±4.4° and 62.6°±5.7° respectively.The patients in group I were treated with the collar support for 4-8 weeks.The patients in group Ⅱ were treated with skull traction (3-5 kg) and then fixed by cranio-cervical-thoracic plaster.According to the angles between the tangents of posterior vertebral body at each level on lateral cervical radiograph in extension,the anterior fusion levels of the group Ⅲ and angles and range of osteotomy in the group Ⅳ were decided.In group Ⅳ,the patients were treated by two steps.The anterior release and posterior osteotomy were performed firstly.Then skull traction (1/10 body weight) was maintained in order to correct the deformity for 7-10 days,fusion and anterior fusion with autologous bone graft and internal fixation was completed.Results Post-operative radiograph showed that Cobb angle were -5.5°±2.0°,-8.2°±6.1°,-4.5°±6.6° and -2.9°±7.9° in Ⅰ-Ⅳ group after treatment.The deformed appearance of the patients improved significantly.A improvement neck pain and neurologic function were found in all patients.Post-operative MRI showed that physiological curve of the cervical spine was restored,and the cerebrospinal fluid line was clear in the previous kyphosis area.Conclusion Adolescent idiopathic cervical kyphosis has specific characteristics.Surgical strategy is determined by the severity of deformity.

Objective To compare the effect of silver-coated dressing and general aseptic dressing on the wound healing of abdominal operation. Methods A total of 94 patients from the general surgery department of Second Affiliated Hospital of Xi'an Jiaotong University who underwent abdominal operation were divided into two groups by double blind method, 49 cases in silver-coated dressing group, and 45 cases in general aseptic dressing group. The wound healing of the two groups were observed after wound dressing change, and the wound dressing change times, the healing time, the degree of pain, the positive rate of bacterial culture and the incidence rate of scar healing were observed in the two groups. Results The patients in silver-coated dressing and general aseptic dressing group had no significant differences in gender, age, length of incision, type of incision and poor wound healing type (all P>0.05);after two wound dressings change treatment, the wound dressing change times and incision healing timeof the silver-coated dressing group was (6.52 ± 1.52) times and (16.34 ± 5.96) days, which were less than those of the general aseptic dressing group, which were (8.74 ± 2.35) times and (23.32 ± 8.32) days; and the pain severity (NRS) scored 4.13 ± 1.01, which was lower than that of general aseptic dressing group (6.54 ± 0.95), with significant difference between two groups (t=5.482, 4.704, 11.890, P < 0.05). The bacterial culture positive rates of the silver-coated dressing group was 60.00% (21/35), which was higher than that of the general aseptic dressing group, 23.33%(7/30), the difference was statistically significant (P<0.01);at the same time, the scar healing cases was 4 in the silver-coated dressing group, which was less than 11 cases in the general aseptic dressing group. The difference was statistically significant (P < 0.05). Conclusions The silver-coated wound dressing method is better than the general aseptic wound dressing, and has obvious advantages in the treatment of abdominal poor healing incision. The silver-coated wound dressing can promote the healing of incision, reduce scar healing, shorten the hospitalization time, reduce the suffering of patients.

Objective To observe the protein expressions of PI3Kp110, pAkt, pGSK3β of phosphatidylinositol 3-kinase (PI3K) and protein kinase B (Akt) signaling pathway in the whole blood of patients with Kashin-Beck disease and analyze the status of PI3K/Akt signaling pathway. Methods Patients with Kashin-Beck disease ( KBD group ) were from six counties ( Xunyi , Linyou , Yongshou , Qianyang , Changwu and Long County) of Shannxi Province in Kashin-Beck disease areas , and the healthy controls (control group) were matched by age and sex. Venous blood was collected from patients and healthy controls. Trizol method was applied to extract the whole blood protein; protein expression levels of PI3K/Akt signaling pathway in whole blood were detected by Western blotting; the gray values were observed and recorded by the sodium dodecyl sulfate polyacrylamide gel electrophoresis(SDS-PAGE) and GDS-8000 gel imaging analysis system. Differences between the two groups were assessed by Student’s t-test. Results Compared age and sex between KBD group and control group, differences were not statistically significant(t=0.701, P>0.05;χ2=0.400, P>0.05). The protein expression levels of PI3Kp110, pAkt and p-GSK3β in KBD group were higher than that in control group(156.1 ± 92.1 vs. 79.5 ± 21.5, 113.7 ± 15.2 vs. 43.3 ± 10.7 and 105.9 ± 17.5 vs. 37.3 ± 12.0, respectively) and the differences were statistically significant (t=2.563, 6.567, 7.916; all P < 0.05 or < 0.01). Conclusion The PI3Kp110, pAkt and p-GSK3β expressions of signaling pathway proteins in the whole blood of patiens with Kashin-Beck disease are up-regulated significantly and the status of PI3K/Akt signaling pathway is activated.

Objective To summarize the operational experience and explore the best surgery strategy in cicatricial alopecia.Methods Clinical date of 80 cases of cicatricial alopecia during January 2012 to December 2016 were analyzed retrospectively.The operation methods and related adverse events were recorded.Patients were followed-up on the postoperative 1 week,1 month,3 months,6 months and 1-2 years.The outcomes were evaluated by a 4-levels questionnaire:very satisfied,satisfied,not satisfied,and no effect.Results Forty cases were operated with expanded skin flap + Follicular unit extraction (FUE) transplantation,10 cases with scar resection + FUE repair,and 30 cases only with FUE.Twenty cases were completed treatment with single-stage surgical operation,and 60 cases with two-stage surgical operation.A percentage (70％) of patients was very satisfied and 30％ were satisfied after one-stage surgical operation.A percentage (85％) of patients was very satisfied and 15％ were satisfied after two-stage surgical operation.Conclusions The cicatricial alopecia needs comprehensive surgical treatment.FUE is a best additional operation technology.The effect of combined treatment is better than single therapy method in large area cicatricial alopecia.

Objective To systemically review andquantify the incidence of oral feeding intolerance in acute pancreatitis. Methods Randomized controlled trials that reported the oral feeding intolerance rates of acute pancreatitis were searchedfrom PubMed, EMBASE, Medline, Cochrane Library, WanFang, CNKI, CMCC and VIP dal,abase wilh the" Acute pancreatitis " " Feeding intolerance" " Incidence" " Meta- analysis "from January 2002 to May 2017. Date were analyzed by using R 3. 4. 0 software. The heterogeneity of data were analyzed using 12test. Results Eleven randomized controlled trials including 658 cases were enrolled in Meta-analysis. The incidence of oral feeding of intolerance was 12. 2% . The result of subgroup analysis showed that there were no significant difference in the incidence of oral feeding intolerance when region, sample size and published year were taken into analysis (P > 0. 05). The oral feeding intolerance rate of mild acute pancreatitis was lower than that when moderately severe acute pancreatitis and severe acute pancreatitis were, included (8. 2% and 19. 9% , respectively; P = 0. 002 7). Conclusion Oral feeding intolerance affects approximately l in 8 patients with acute pancreatitis. The incidence of oral feeding intolerance of patients with severe acute pancreatitis is higher than that of patients with mild acute pancreatitis

Objective:To explore the effect and mechanism of different processing motivation on college students' intergroup interaction willingness by technology of eye movement.Methods:Sixty college students conforming to the study conditions were selected from Northwest Normal University and randomly divided into ingroup motivation group ( n=30) and outgroup motivation group ( n=30) according to the random number table method. Subjects of the two groups first participated in the eye movement task, and then participated in the partner selection task.In the eye movement task, the percentage of time that subjects looked at faces of different groups was recorded.And in the partner selection task, the number of selections that subjects selected faces from different groups was recorded.SPSS 20.0 software was used for repeated measurement analysis of variance. Results:(1) In the eye movement task, there was a significant interaction of group and face group type ( F=13.37, P<0.001), but the main effects of group( F=3.23, P=0.077), and face group type ( F=0.09, P>0.05) were not significant. Further simple effect analysis showed that the percentage of time that the ingroup motors looked at the yellow race((16.00±0.06)%) was significantly higher than that of the outgroup motors ((12.00±0.04)%), and the percentage of time that the outgroup motors looked at the white race((17.00±0.06)%) was significantly higher than that of the ingroup motors ((9.00±0.04)%). (2) In the task of partner selection, there was a significant interaction among group, face group type and face old and new types( F=4.38, P=0.041), and the main effect of face group type was significant( F=14.87, P<0.001). The main effect of old and new types of face was significant( F=8.88, P=0.004), but the main effect of group was not significant ( P>0.05). Further simple effect analysis showed that the two groups of college students had statistically significant differences in the selection times of familiar faces from different groups( F=11.51, P=0.001). The number of times that the ingroup generator (5.51±1.14) selected the familiar yellow race as its partner was significantly greater than that of the outgroup generator (2.30±0.65). The number of times that the outgroup generator (5.40±1.00) selected the familiar white race as its partner was significantly greater than that of the ingroup generator (3.47±0.94). (3)Preferential attention to the ingroup members was a mediator between processing motivation and intergroup interaction willingness (mediating effect=0.20, 95% CI=0.02-0.31). Conclusion:Ingroup processing motivation has a threatening effect on college students' intergroup interaction willingness, outgroup processing motivation has a promoting effect on college students' intergroup interaction willingness, and processing motivation affects intergroup interaction willingness through ingroup bias.

Objective:To Investigate the postoperative sexual function outcomes in patients with bladder cancer who underwent robot-assisted radical cystectomy (RARC)or laparoscopic radical cystectomy(LRC)followed by orthotopic neobladder reconstruction.Methods:We performed a retrospective review of 84 bladder cancer patients having undergone laparoscopic radical cystectomy(LRC)and robotic-assisted radical cystectomy(RARC)with≥21 IIEF-5 in our institution from Jan 2014 to Jan 2019. All of them were diagnosed as high grade urothelial carcinoma by biopsy or TURBT. Biopsy of the posterior urethra and bladder neck reveal negative result of tumor invasion. Their PSA level was less than 4.0 ng/ml with negative result of DRE. All patients undergone laparoscopic radical cystectomy and orthotopic neobladder reconstruction by one medical team. 45 patients underwent robotic assistant radical cystectomy(RARC group), and the rest of patients 39 were treated with laparoscopic radical cystectomy(LRC group). In RARC group, the mean age were 53 years old(ranging 50-67 years old)and clinical stage of the tumor was cT 1 in 10 patients, cT 2 in 21 patients and cT 3 in 14 patients. In the LRC group, the mean age were 56 years old(ranging52-65 years old) and the clinical staging of the tumors was 6 patients in cT 1, 23 patients in the cT 2 and 12 patients in the cT 3. The RARC group paid special attention to the protective function of the following surgical details: ①To detect the abdominal organs, reveal the pelvic cavity, observe the blood vessels and ureter, open the perinatal membrane next to the cross of the ureter, along the outer venous veins and closed-hole nerves around the standard or expand the pelvic lymph node cleaning. In this study, the patients who did not have obvious suspected lymph node metastasis were removed within the standard range of the pelvic lymph nodes on both sidesin order to protect the nerves at the pelvic floor as much as possible. ② With the robot 3rd arm lifting the bladder, the peritoneum was opened at the site of seminal vesicle and ampulla of vas deferent duct, which connected to the two sides with the open peritoneum. Along the vasectomy and the sac free, the denonvillier fasica was opened and exposing the back of the prostate. With the third arm pulling down, the umbilical ligament was observe. The peritoneal was opened to the retropubic space so that the prostate region was revealed. Continue to dissect the bladder front space until the pelvic fascia and the osteopathic prostate ligament are exposed. The Hem-o-1oks were used to ligate the bilateral bladder lateral ligaments. The bladder and prostate were removed in the fascia level. The NVB bundle on both sides was kept to the apex of prostate. The urethra was exposed and remove the catheter.With Hem-o-lok clamping, the urethra was dissected in the level of prostatic apex. The distal end of urethral tissue was sent to the rapid freeze pathology examination. In the procedure of prostate removing, parallel prostate fascia excision was considered and pubo-prostatic ligament could be preserved.③ Preserving the bilateral neurovascular bundle (NVB) and try to avoid the damage of NVB. Retaining the bladder lateral ligament neurovascular bundle. Retaining the1.2-1.5 cm urethra and surrounding continent control structure. The cold knife is advocated. Blood vessel clamp can be used to stop bleeding. We compared with operative time, bleeding amount, postoperative hospitalization, IIEF-5 scores and satisfaction of sexual between those groups. Results:All operations were successfully performed without conversion and serious surgical complications. The operative time in the RARC group and LRC group were [(313.5±31.9)min and (276.5±32.3)min, P>0.05] .The intraoperative amount of blood loss and postoperative hospitalization were [(190.1±44.1) ml and (212.3±39.2) ml, P>0.05], [(14.3±2.1) d and (15.2±3.0) d, P>0.05]. There was no significantly difference between the two groups. The median follow-up period of 84 patients was 18 months. The IIEF-5 score of the RARC group was higher than LRC group at 6 months(18.5±1.6 vs.10.6±1.3)and 12 months (18.6±2.4 vs.11.2±1.4) ( P<0.05). In addition, the satisfaction of sexual in the RARC group was relative better than LRC group (both P<0.05) at 6 months[44.4%(20/45)vs.25.6%(10/39)], and 12 months[51.1%(23/45) vs.28.2%(11/39)] post-operation. Conclusion:Robot-assisted radical cystectomy(RARC) and orthotopic neobladder reconstruction revealed relative better recovering in post-operative sexual function and improvements in patient quality of life.

Objective:To analyze the performance characteristics of the energy output of defibrillation device at different lifecycle stages of the equipment,and to improve the level of management,so as to ensure the safety and effectiveness of using the device.Methods:A total of 90 defibrillation devices of using 10 types included 861290 and CardioServ(included scrapped devices)during the period of 2015-2022 were retrospectively analyzed.The detected data of energy output of defibrillation device were analyzed as statistical method,and the error of releasing energy was calculated.A total of 36 defibrillation devices that were in the early stages of use(at the first three years of device use)were divided into the first year,the second year and the third year,and the data of energy outputs of devices among three years were compared.The data of the type A and type B defibrillation devices,which were the largest number of devices in the normal stage of use(the middle stage of use),were calibrated according to the energy release in the three years between 2018 and 2000.The difference of releasing energy at the preseted value of 100J between the two types of devices was analyzed.Finally,the errors of energy releases of 8 devices,which energy outputs exceeded the deadline,in the scrap period between 2015 and 2022 were summarized.Results:In the data of three groups of devices in the early stages of use,the differences at the first and second year of device use among 100J,150J and 200J of the energy releases of the preseted values were significant(t=-0.17,-0.17,-0.58,P>0.05).The difference of the measured values between the first and third years of device use was not significant(Z=-0.70,-0.38,-0.86,P>0.05).The results of variance analysis of repeated measurement of the energy releases of the devices in normal stage indicated that the difference of the energy release at 100J preseted point among different types of 41 devices was significant(F=4.40,P<0.05).The energy release of type X defibrillator appeared constantly high,and the relative error increased with the increasing of preseted values.The repeatability of the device was better,and the relationship between preseted energy(x)and release energy(y)conformed to linear relationship(R2=0.9985).In these defibrillation devices that were using,the qualified rate of energy output of>100J preseted point was 97.68%.Conclusion:There is slight difference in the mean value of energy release between different type of defibrillation devices within the qualified range,and the energy release still is a performance indicator that should be highly focused for defibrillation devices.We should combine with the maintenance and repair data of device to conduct in-depth analysis,so as to grasp the operating status of the device,and optimize the strategy of quality control,and ensure the safety of defibrillator in clinical use.

Objective:To analyze the survival time, prognostic factors and the value of postoperative thoracic radiotherapy in resected small cell lung cancer (SCLC) patients.Methods:Clinic opathological data of SCLC patients who received surgical treatment in Cancer Hospital & General Hospital of Ningxia Medical University from April 2014 to September 2021 were enrolled in this retrospective study. All patients were subject to follow-up. The survival time of SCLC patients was evaluated by Kaplan-Meier method. Univariate and multivariate analyses of prognostic factors were performed by Cox proportional hazard model.Results:A total of 64 patients with SCLC were enrolled in the study. The 5-year overall survival (OS) rate was 43.5%. Univariate analysis showed that TNM staging ( P=0.027), postoperative neutrophil-lymphocyte ratio (NLR) ( P=0.039) and adjuvant thoracic radiotherapy ( P=0.041) were the prognostic factors. Multivariate analysis showed that TNM staging ( P=0.038) and adjuvant thoracic radiotherapy ( P=0.022) were the prognostic factors in patients with SCLC. The 5-year OS rates of patients with and without adjuvant thoracic radiotherapy were 71.6% and 35.4% ( P=0.028), respectively. There was a statistically significant difference in the 5-year OS rates between pathological stage N 2 SCLC patients with or without adjuvant thoracic radiotherapy (75.0% vs. 0%, P=0.030). Conclusions:TNM staging and postoperative adjuvant thoracic radiotherapy are prognostic factors in patients with SCLC undergoing surgical treatment. Pathological stage N 2 SCLC patients can benefit from adjuvant thoracic radiotherapy.