Objective To compare the outcome of laparoscopic with open partial nephrectomy for duplication anomalies. Methods A total of 64 patients with mean age of 17 months were divided into 2 groups.Open group consisted of 36 patients,and laparoscopic group consisted of 28 patients.In open group,there were 19 boys and 17 girls,15 cases were of ectopic ureter,18 of ureterocele,2 of vesicoureteral reflux (VUR) and 1 of ureteropelvic junction obstruction.Mean age was 18 months.In laparoscopic group,there were 18 boys and 10 girls,9 were of ectopic ureter,16 of ureterocele and 3 of VUR.Mean age was 1 6 months.There were no significant differences in age and diseases.Results There were 2 conversion to open surgery in laparoscopic group and no other intra-operative and post-operative complications in 2 groups.Mean duration of operation was 2.5 h for open group,the difference of pre- and post-operation hemoglobin was 2.64 g,the volume of drainage was 91.4 ml,the time of drainage was 4.2 d and mean hospital stay was 19.3 d.In Iaparoscopic group,the figures were 2.9 h,1.45 g,55.4 ml,3.4 d and 14.3 d,respectively.The differences of the figwres were significant between the 2 groups (P＜0.05). Conclusion Laparoscopic partial nephrectomy is effective and safe for the treatment of duplicated kidney with a dysfunctional moiety.

OBJECTIVE: To analyze the long-term efficacy of nasal endoscopic opticnerve decompression for traumatic optic neuropathy(TON) and to explore its possible influencing factors. METHOD: To summarize the clinical data of 39 cases underwent transnasal decompression, which were followed-up for more than 1 year. The data, including optic canal CT scanning, flashed-elicited visual-evoked potential (FVEP), preoperational vision and visual field examination were reviewed. Nasal endoscopic optic nerve decompression was preformed. Whether or not optic nerve sheath incision decided to perform was according to preoperative CT and situations in operation. Postoperative follow-up including vision, visual field, funduscopy, nasal endoscopy were performed. RESULT: Total efficacy rate was 30. 77% (12/39), inefficacy rate was 69. 23%(27/39). The efficacy rate was 85. 71% with better than nolight perception, and the efficacy rate was 18. 75% with nolight perception, the clinical effect in the group of preoperative better than nolight perception was better than that of nolight perception, the difference was statistically significant (P<0. 05). The efficacy rate was 34. 38% with duration of less than 7 days from the traumatic point to the operation point, and the efficacy rate was 14. 29% for more than 7 days, but the difference was not statistically significant (P> 0. 05). The efficacy rate was 26. 32% with optic nerve sheathincision, while the efficacy rate was 35. 00% without optic nerve sheath incision, and there was no statistically significant difference (P>0. 05); Postoperative vision tended to stabilize until about 6 months post-operation, without complications. CONCLUSION The long-term efficacy of nasal endoscopic opticnerve decompression for TON was certain; The efficacy with preoperative residual vision was better than that of nolight perception, the factor of long or short duration from the trauma point to the operation point and the factor of optic nerve sheath incision didn't influence long curative effect. To avoid the secondary damage to the optic nerve after trauma was the key to increase long curative effect in TON.
Decompression, Surgical ; Endoscopy ; Humans ; Neurosurgical Procedures ; Nose ; surgery ; Optic Nerve ; surgery ; Optic Nerve Injuries ; surgery ; Postoperative Period ; Tomography, X-Ray Computed ; Treatment Outcome ; Visual Acuity

Objective To investigate better heating and thermal insulation methods of enteral nutrition solution by comparing different thermal insulation devices. Methods A total of 90 patients with continuous enteral nutrition support, in accordance with the random number table, were divided into 3 groups. Enteral nutrition solution was heated by three different methods. It included the heating infusion thermostat, the heating nutrition pump and the heating special insulation using medical liquid bag device, and to comparatively observe the temperature of nutrition solution of three groups in the nasal feeding tube before infusion finish, in addition, to comparatively observe adverse reaction in course of enteral nutrition support and calculate the cost of heating device. Results The percentage of nutrition solution with temperature during 35-40 ℃, the incidence rate of adverse reaction and the cost of heating device in the heating special insulation using medical liquid bag device was 100.00%( 30/30), 6.67%(2/30) and 1837.23 yuan while the heating infusion thermostat was 73.33%( 22/30), 33.33%(10/30) and 2079.46 yuan, and the heating nutrition pump was 0, 26.67% (8/30) and 2007.05 yuan. The difference among three heating devices was statistically significant (Z=48.50, P =0.000; χ2=6.69, P=0.038; F=17.87, P=0.000). Conclusions The heating special insulation using medical liquid bag device is good insulation effect, low cost and easy to handle, and is worth being popularized.

Medical mode , as the concept of combination of medicine and philosophy , is an abstract summary of the nature of medicine in the process of exploring health , disease prevention and control , and is developing with the change of human conception and the deepening of cognition to health and disease .The Bio-Psycho-Social Medi-cal Mode is gradually changing people ' s cognition to the nature of medicine , and prompting people to examine the disease and health from the physiological , psychological , social and multi -angle.But this mode also needs to be further enriched and perfected , does not fully reflect the moral factors of health and the nature of medical ethics . It' s mainly manifested as that the biological basis of life science abandoned the moral health , the psychological mechanism of physical and mental trauma shielded the moral injury , and the social attributes of medicine replaced the moral essence .

Objective To discuss the short-term currative effect of horizontal osteotomy across injured vertebral forⅤdegree old frac-ture-dislocations of thoracolumbar spine.Methods The data of 4 patients who received horizontal osteotomy across injured vertebral internal fixation in our hospital from April 2010 to October 2012 were retrospectively analyzed,of which 1 case with T8-9 fracture dislocation,2 cases with T10-11 fracture dislocation,1 case with T11-12 fracture dislocation.The Franke1 classification of all patients were grade A.Results All 4 cases were achieved completely fracture reduction and followed-up for 2-14 months(an average of 7.4 months),who could get sitting posi-tion with the support of brace 1 week after operation.The postoperative follow-up indicated that all 4 cases got fusion,but there was no improve-ment for Franke1 classification.Conclusion The method of horizontal osteotomy across injured vertebral forⅤdegree old fracture-dislocations of thoracolumbar spine has good short-term clinical effect,with the advantages of shorter operation time,less bleeding and good reduction effect.

Objective To investigate the physical and mental development of small and appropriate for gestational age preterm infants in their early life. Methods This study recruited 220 preterm infants, who were discharged from our hospital and visited preterm following-up clinic at regular intervals from February 2009 to December 2012. All of those infants were divided into two groups based on whether their birth weight below 10th percentile for their gestational ages or not. Weights, lengths and head circumferences were measured up to seventh month age adjusted by gestational age. Meanwhile, mental tests were conducted by the professional staffs working on the children developmental assessment at their adjusted months of 5th, 6th or 7th. All of physical and mental scores were compared between the two groups. Results The SGA group was statistically less than the AGA group on the Z-score of weights from the ifrst to sixth month adjusted by gestational age (P<0.05). The difference disappeared on the seventh adjusted month age (P>0.05). The SGA group was statistically less than the AGA group on the Z-score of lengths from the ifrst to iffth month adjusted by gestational age (P<0.05). The difference disappeared on the sixth and seventh adjusted month age (P>0.05). The SGA group was statistically less than the AGA group on the Z-score of head circumferences from the ifrst to seventh month adjusted by gestational age (P<0.05). The SGA babies scored statistically less than the AGA babies with a mean development quotient score of 96.7 and 102.9, respectively (P<0.05). The scores of movement, cognitive, language in the SGA group were statistically less than those in the AGA group(P<0.05). Conclusions Preterm SGA could achieve satisfactory weight catch-up gain, with a decreasing difference from preterm AGA while they were getting older. But the length catch-up growth of preterm SGA seemed unsatisfactory with a big differece from preterm AGA. There was the worst catch-up on head circumference in those preterm SGA, backward in mental development, particularly in their movement, cognitive and language capacity.

Objective To compare the clinical results of the ureteral reimplantation with the traditional open approach and laparcocopic pneumovesical approach. Methods A retrospective review of 108 patients who underwent ureteral reimplantation from December 2004 to October 2010 was conducted.The patients were divided into open and pneumovesical groups according to the surgical approach.Perioperative results were compared between the two groups in terms of operative time,postoperative intravenous antibiotics duration,catheterization duration,postoperative stay,average total cost and surgical cost,respectively.And the pneumovesical group was divided into two stages by time,compared the operative time of the two stages and between the later stage and the open group. Results The postoperative hospital stay of pneumovesical group was shorter than the open group (6.8 ± 1.9 d and 8.9 ± 2.9 d,P =0.002 ).For catheterization duration,the pneumovesical group was shorter than the open group as well (5.2 ± 1.2 d and 6.2 ±2.2 d,P=0.057).For the postoperative intravenous antibiotics duration,the pneumovesical group was 5.0 ± 1.3 h,the open group was 5.4 ±1.6 h (P =0.159).For the total cost,the pneumovesical group was 16 067.9 ±4 295.8 RMB,the open group was 15 617.7 ± 5 486.5 R MB (P =0.168).For the surgical cost,the pneumovesical group was 9369.4 ± 1366.6 RMB,the open group was 7397.9 ± 1797.3 RMB ( P =0.083 ).Operative duration of the pneumovesical group and open group were 3.2 ± 1.1 h and 2.3 ± 1.1 h ( P =0.003).For pneumovesical group,the mean operative durations of the two stages were 3.6 h and 2.8 h (P =0.286).And the later stage of pneumovesical group was a little longer than the open group,but no significant difference ( P =0.234 ).No major complication was found in the 2 groups during the operative time and the postoperative hospital stay.Twenty-four patients (38 ureters) of the pneumovesical group were followed up with micturating cystourethrography ( MCU),ureterovesical reflux recurred in 3 patients.Two patients changed from grade Ⅲ to grade Ⅰ and 1 patient changed from grade Ⅴ to grade Ⅲ after the surgery.Five patients (9 ureters) of the open group were followed up,1 patient found bladder diverticulum; 1 patient found ureteral stricture 6 months after the surgery and got improved after secondary ureteral relimplantation surgery. Conclusions The pneumovesical approach is shorter than the open group in postoperative hospital stay and catheterization reserved duration.The pneumovesical approach is a safe and effective option for ureteral reimplantation.

Objective: To understand the sex related knowledge, attitude and practice of senior kindergarten children in Luzhou and its influencing factors, and to provide a scientific basis for comprehensive early childhood sexuality education. Methods: In January 2022, the stratified cluster sampling method was used to select 1 438 large class children and their parents in 24 kindergartens in Luzhou. Results: The eligible rate of sex related knowledge, attitude and practice of senior kindergarten children was 27.2% . About 91.0% of children knew that they should not let others see/touch their private parts, 88.0% of children could correctly name the source of life, 35.1% of children could correctly and completely point out the location of male/female private parts and 11.5% of children believed that girls could not play with toy pistols and 1.2% of children thought boys should not wear skirts. The results of multivariate analysis showed that public kindergarten, girls, ≥6 years old, high maternal education (college/undergraduate or above), parental sexuality education with positive attitude/good behavior were associated with high sex related knowledge, attitude and practice( OR =1.69, 1.74, 1.86, 1.37, 1.32, 1.48, P <0.05). Conclusion Sex related knowledge, attitude, and practice among senior kindergarten children is insufficient, however, knowledge regarding sexual assault prevention and life education is sufficient. It is necessary to pay attention to the role of parents attitudes and behaviors in child sexuality education, especially among boys, children from private kindergartens, as well as those with young age or low maternal education.

Objective: To investigate the attitudes and demands of parents of children in Luzhou towards family based child sexual abuse prevention education. Methods: A self administered anonymous questionnaire survey was conducted among parents of children in Luzhou City who were selected from stratified cluster sampling. Multiple linear regression model was used to analyze parents attitudes. Results: Parents attitude towards prevention of sexual assault education was positive (average score 16.70± 3.67 ). The results of multiple regression analysis showed that parents of only child ( β =0.30), parents who participated in related activities ( β =1.28), communicated with relatives and friends ( β =0.81), and lived in urban areas ( β =0.49) had more positive attitudes. In terms of parental factors, average annual family income higher than 100 000 yuan ( β =0.39), mothers of young children ( β =0.88), and parents with a high level of knowledge about sexual assault prevention education ( β =0.98), the mother being a teacher or a medical staff ( β =0.52), and educational background of the mother being high school/secondary school ( β =1.03), college/undergraduate or above ( β =1.42) were associated with more positive attitudes( P <0.01). The results of demand analysis showed that parents had high demand for child s self protection (96.86%). Conclusion Parents of young children in Luzhou City show generally positive attitude and high demand towards family based sexual abuse prevention. Knowledge training and publicity regarding child sexual abuse should be improved for children who had siblings, from rural and township areas, and whose parents with low educational background.

Objective: To investigate the awareness of sexuality education knowledge in kindergarten teachers in rural areas of Sichuan and its influencing factors, and to provide a scientific basis for sex education capacity improvement among rural teachers. Methods: With multi stage stratified cluster sampling method, 162 teachers selected from 16 rural kindergartens in rural areas of Sichuan Province to conduct questionnaires related to early childhood sex education. Results: The awereness of early childhood sex education foreskin care in rural areas in Sichuan was 73.8%. Knowledge regarding foreskin care(58.8%)", "the function of the family includes rest and entertainment functions(65.6%)", "girls need to clean the reproductive truets from the front to back (68.8%)". Multivariate non conditional Logistic regression analysis results showed that teaching experience>4 years(OR=4.16, 95%CI=1.74-9.98), notice of young children with sexual related behaviors(OR=2.97, 95%CI=1.19-7.40), the number of sources of sexual knowledge sources ≥5(OR=3.39, 95%CI=1.42-8.13) were associated with high awareness of preschool sex education knowledge. Conclusion The preschool sex education knowledge awareness among Sichuan rural kindergarten teachers needs to be improved. A variety of sex education channels should be constructed to encourage teachers, especially those who are newly employed, to acquire more relevant knowledge, pay attention to children’s sex related behaviors, and improve their ability in sex education.