Objective To investigate the advantages, indications and efficiency of video-assited thoraco-scopic sugery in spontaneous pneumothorax. Methods 31 patients with spontaneous pneumothorax underwent video-assited thoracoscopic sugery, performed with endoscopic manual suture without use of endoscopic cutters. Results All patients were cured without recurrence. Conclusions Video-assited thoracoscopic sugery is the first choice in treating spontaneous pneumothorax,with minimal trauma,less bleeding. Endoscopic manual suture can obviously re-duce the treatment cost.

Objective To observe the efficacy of electroacupuncture in improving discomforts during and after oocyte retrieval, for providing scientific and significant clinical evidence for the application of electroacupuncture to oocyte retrieval.Method A hundred and thirty-four outpatients receiving IVF-ET fertility treatment were randomized into a treatment group and a control group, 67 in each group. The two groups both received muscular injection with Sauteralgyl 50 mg. Additionally, the treatment group was also given acupuncture at Baihui (GV20), Uterus (MA-TF, right ear), Tengtong (Extra, right), Sanyangluo (TE8, right), and Zusanli (ST36). When needling qi arrived, Tengtong (Extra) and Sanyangluo (TE8) were connected to SDZ-2 electroacupuncture apparatus. The needles were removed at the end of oocyte retrieval. For patients in the control group, oocyte retrieval was conducted 30 min after injection with Sauteralgyl. The operation duration was recorded; blood pressures before injection and at the end of surgery were measured; discomforts including dizziness, nausea, vomiting, perspiration, dry mouth, palpitation, and abdominal distension during operation were observed; discomforts (dizziness, nausea, vomiting, abdominal pain, and lassitude) 0.5 h, 1.5 h, and 2 h after operation were observed.Result The difference in comparing oocyte retrieval duration was statistically significant between the two groups (P＜0.05); there were significant differences in comparing the occurrence rates of dizziness, perspiration, nausea, and palpitation during operation between the two groups (P＜0.05); there were significant differences in comparing dizziness, vomiting, nausea, abdominal pain, and lassitude between the two groups 0.5 h, 1 h, 1.5 h, and 2 h after operation (P＜0.05). The inter-group differences in dizziness, vomiting, nausea, abdominal pain, and lassitude were statistically significant after operation (P＜0.05).Conclusion Electroacupuncture is effective in relieving discomforts during and after oocyte retrieval under transvaginal ultrasound.

Objective To summarize the clinical experience of thoracic injury.Methods Analyze 778 cases of thoracic injury,including soft tissue injury,rib fracture,hemothorax and pneumothorax,pulmonary contusion,cardiovascular injury,et al.The causes of the injury including traffic accident,injury suffered from the job and dispute,et al.Results 774 cases were cured among all the 778 cases with the recovery rate of 99.35％.There were 5 cases died with the death rate of 0.65％,including 1 case of heart rupture,1 case of large vessle rupture,2 cases of brain combining injury,1 case of spleen combining injury.Conclusion Thoracic injury arise new characteristic in recent years.The main causes of the injury are traffic accident,injury suffered form the job and dispute.Most cases may be cured by rapid treatment.The main causes of death are haemorrage shock due to cardiovascular or spleen rupture and combination of severe brain injury.

AIM: To study the effect of Qingqi Liangying Injection on febrile rats induced by zymonsa and on content of PGE_2 as well as cAMP in rat hypothalamus. METHODS: The rat febrific model induced by 10% zymonsa solution was used to observe QingqiLiangying Injection's effect on the rat temperature, and the radioimmunoassay(RIA) was used to determin the content of PGE_2 and cAMP in hypothalamus of rats. RESULTS: Qingqi Liangying Injection had an obvious antipyretic effect on febrile rats; Qingqi Liangying Injection could significantly reduce the content of PGE_2 and cAMP. CONCLUSION: Qingqi Liangying Injection can obviously reduce the rat body temperature and the content of PGE_2 and cAMP in hypothalamus of rats.

Objective To explore the clinical and imaging factors influencing the patients' prognosis after preoperative radiotherapy for local advanced rectal cancer.Methods We retrospectively analyzed 106 locally advanced rectal cancer patients from June 2004 to September 2015 in our institution.All patients underwent preoperative radiotherapy.According to the Mandard score,patients were divided into 5 groups (TRG1-5).All patients were divided into two groups according to the TRG,which including good responder (TRG1 + 2) and poor responder (TRG3 + 4 + 5) groups.All of the tumor ADC values of post-RT were measured by Diffusion-weighted MRI technology,and the relationship between tumor ADC values of post-RT and TRG was analyzed.Results In univariate analysis,age,chemotherapy,pT,pN,differentiation degree,vascular invasion and TRG were significantly associated with overall survival (x2 =3.945-8.110,P ＜ 0.05).Multivariate analysis indicated that differentiation degree and TRG were the independent prognostic factors for OS (x2 =5.221,6.563,P ＜ 0.05).No significant difference was found between long-course and short-course radiotherapy group (P ＞ 0.05) in OS.The good responder group had a favorable survival in 5-year OS compared to the poor responder group (x2 =8.110,P ＜ 0.05).Preoperative radiotherapy,preoperative chemotherapy,pathological type,differentiation degree and gross type,vascular tumor thrombus and tumor ADC values of post-RT were significantly associated with TRG (x2 =4.189-18.139,P ＜ 0.05).The best critical point of tumor ADC values of post-RT was 1.7 x 10-3 mm2/s by using ROC curve.The accuracy of tumor ADC values of post-RT in predicting TRG1 + 2 was 70％.Conclusions The TRG can predict the efficacy of preoperative radiotherapy in patients with locally advanced rectal cancer based on the Mandard score.There was no significant difference in OS between long-course radiotherapy group and short-course radiotherapy group.The tumor ADC values of post-RT might become a potential factor to predict TRG in patients with locally advanced rectal cancer after preoperative radiotherapy.

Objective: Based on the principle of evidence-based nursing, we searched, studied and summarized a nursing pathway for patients who after transverse tibial bone transportation, and explored its effect. Methods: With A set of targeted nursing intervention program, 17 patients with type 2 diabetic foot patients after transverse tibial bone transportation were nursed. After 2 months, the percentage of ulcer decreased, the visual analogue scale and the temperature of foot dorsum were used to evaluate the nursing effect. Results: The average temperature of foot dorsum was (28.49±1.12) ℃, the average visual analogue scale was (4.06±1.40) . And after 2 months, the average temperature of foot dorsum was (29.97± 1.26)℃, the average visual analogue scale was (1.94±1.92), and the area of ulcer in 15 cases (2 cases could not be counted due to toe amputations in treatment) decreased by 25%~100%, with an average of 59%, compared with that before intervention. Conclusions The implementation of evidence-based nursing can provide effective nursing intervention, relieve the pain of patients, and promote the rehabilitation of diabetic foot ulcers after transverse tibial bone transportation.

Objective To observe the treatment outcome of using reversed island flap based on cutaneous branch of dorsal metacarpal artery for middle-and-distal finger soft tissue defect.Methods From May,2015 to March,2017,21 cases of middle-and-distal finger soft tissue defect were treated with reversed island flaps based on cutaneous branch of dorsal metacarpal artery which were designed on the dorsal hand pedicled by dorsal metacarpal artery.The flap was then elevated and rotated at the point where digital common artery was anastomosed with the terminal branch of the dorsal metacarpal artery.The cutaneous nerve included in the flap was anastomosed with the terminal branch of digital nerve to restore sensation and the donor site was covered directly.Regular followed-up was performed after operation.Results Except 1 case was suffered with distal 1/3 skin flap necrosis,flaps were well developed.Postoperative follow-up period was 3 to 12 months.All these flaps recovered with satisfying appearance and quality,excellent sensation with grade S3 to S4 and 5 to 8 mm of two-point discrimination.Range of motion(ROM)of the metacarpalphangeal and interphalangeal joint of the injured fingers was good.The excellent and good rate was 95.2％.Conclusion Reversed island flap based on dorsal cutaneous branch of dorsal metacarpal artery transfer is an ideal method for repairing middle-and-distal finger soft tissue defect.The surgery is simple.Reliable blood supply and sensation can be achieved without sacrificing the primary artery and nerve.There is minor donor site damage and very few complications.

Objective:To evaluate the clinical outcome of transplantation of metatarsophalangeal and proximal interphalangeal joint of the second toe with toe preservation for repair of traumatic digital arthritis.Methods:From February, 2016 to June, 2018, nine cases with traumatic digital arthritis were treated, including 7 males and 2 females aged from 19 to 46 (average 26.7) years. Three cases had index finger and 6 middle fingers injuried. Four cases had arthritis in metacarpophalangeal joint (MP) and 5 in proximal interphalangeal joint (PIP). All cases with digital arthritis were secondary to trauma. The involved digital joints were reconstructed by transplanting the MP or PIP of the second toes. At the same time, the affected joints (7 cases) or autologous iliac bone grafts (2 cases) were used to repair the bone defects to retain the length of toes. The donor site were closed directly. The appearance and healing of fractures of the fingers and toes, range of motion (ROM) of the transplanted digital joint, healing of the donor site, foot function and complications were observed.Results:All 9 grafted joints survived. In 1 case, the bone defect in the donor site was fixed with iliac bone graft and mini-plate. The wound did not heal at 1 week after operation, which was considered as a rejection of internal fixator. The wound healed smoothly after having the plate removed and replaced it with a cross-fixation by Kirschner pins. Duration of postoperative followed-up was 6-30 (mean 16.3) months. Primary postoperative healing was achieved in all cases. The bone healing time in the hand was 7 to 10 (mean 8.3) weeks. The appearance and function was satisfactory. The postoperative range of motion (ROM) in the transferred MP was 50°-75°(mean 65.3°), and ROM of PIP was 10°-80°(mean 61.5°). According to the evaluation standard of upper limb function set up by the Society of Hand Surgery of Chinese Medical Association, excellent in 5 cases, good in 3 cases and fair in 1 case, with an overall satisfaction of 88.9%. The bone healing time in the foot was 9 to 12 (mean 10.2) weeks. All cases presented with good appearance of the toe without obvious affect to walking and running. For the ilium, there was only an inconspicuous linear scar without any discomfort in the donor iliac area of 2 cases.Conclusion:Transfering of MP and PIP of the second toe with toe preservation can restore the anatomy structure and function of the digital joint. Meantime, the use of autogenous iliac bone graft to replace the donor site defect may retain the length of the toe and minimizes the injury to the donor site.

Objective: To investigate the effect of O-Z flap for the reconstruction of round-or elliptical-shaped defects following the scalp tumor removal. Methods: The resection of the scalp tumor resulted in a round or elliptical-shaped defect. Intraoperative frozen section identified pathological diagnosis, while also ensured margin being tumor-free. Based on the size and location of the defect, the mobility of the surrounding scalp and hair distribution, two local flaps were designed in opposite directions on each side of the defect. The two flaps were rotated to close the defect in an O-Z fashion. Results: From April 2016 to November 2017, 6 patients underwent defect reconstruction using the scalp O-Z flap. The etiologies included basal cell carcinoma (n=2), squamous cell carcinoma (n=2), and trichilemoma and epidermoid cyst (n=2). The defect size ranged from 3.0cm×3.5cm to 5.0cm×6.0cm. Necrosis on the distal of the flap had occurred in 1 patient. It was taken approximately 6% of the flap size, and healed after conservative management. Other flaps survived without any complications. After 3 to 12 months follow-up, the appearance of the sclap was satisfactory and tumor recurrence was not noticed. Conclusions The O-Z flap technique can be considered as an alternative for the medium-sized defect reconstruction of the scalp. The postoperative outcome of scalp was satisfactory, without disrupted hair orientation.

Sarcopenia etiology is diverse and the pathogenesis is complex.It is closely related to limited activity, malnutrition and a variety of clinical diseases, which seriously affects the quality of life in the elderly and has become a global common health problem.This review focuses on the literature of non-drug interventions for sarcopenia in the past five years, focusing on the relationship of multimodal exercise, intestinal flora, parenteral nutrition and comprehensive intervention with sarcopenia, in order to provide a new basis for formulating scientific and effective non-drug intervention for sarcopenia.