Objective To investigate the effect of the modified and controllable sigmoid colostomy in ostomy operation.Methods Sixty patients were divided into two groups.The control group (30 cases) received extraperitoneal sigrnoid colostomy while the experimental group (30 cases) received modified and controllable sigmoid colostomy.Postoperative complications caused by sigmoid colostomy,artificial anal function,psychological disorder,life quality,and the level of tumor marker between two groups were compared.Results In experimental group,4 patients (13.33％,4/30) at postoperative 6 months and 1 patient (3.33％,1/30) at postoperative 12 months suffered from complications caused by sigmoid colostomy.The incidence rate of complications caused by sigmoid colostomy was higher in control group[30.00％(9/30) and 10.00％(3/30)],but there was no significant difference (P ＞ 0.05).In experimental group,the defecate controllable and times were increased,18 patients (60.00％,18/30) could freedom control defecation,14patients (46.67％,14/30) defecation times ≤3 at postoperative 12 months.But there were 11 patients (36.67％,11/30) and 8 patients (26.67％,8/30) in control group,there was significant difference (P ＜0.05).The rate of human communication disorders,self abasement,anxiety and disappointment in experimental group at postoperative 12 months were significantly lower than those in control group (P ＜ 0.05).The rate of pessimism,loneliness and fear between two groups had no significant difference (P ＞ 0.05).In the evaluation of QLQ-C30 scale,aside from recognition function and financial straits had no significant difference(P ＞ 0.05),others scores in experimental group were significantly better than those in control group (P ＜ 0.05 or ＜ 0.01).In the evaluation of QLQ-C38 scale,the scores in experimental group at postoperative 12 months were significantly better than those in control group (P ＜ 0.01 or ＜ 0.05).At postoperative 12 months,the level of carcinoembryonic antigen,cancer antigen 125 and cancer antigen 199 in experimental group were significantly lower than those in control group (P ＜ 0.05).Conclusion The modified and controllable sigrnoid colostomy has the advantages,less complications,controllable,simple,safe and it is worthy of application more widely in clinical practice.

Objective To compare nasal intermittent positive pressure ventilation （NIPPV） with nasal continuous positive airway pressure (NCPAP) treatment of primary apenea of premature (AOP) effect,and provide a scientific basis for the AOP treatment.Methods Seventy-six cases of children with AOP were randomly divided into NIPPV group (40 cases) and NCPAP group (36 cases).Comparison of two groups changes of blood gas,curative effect,after treatment for invasive mechanical ventilation ratio,ventilation time,and so on.Results Blood gas analysis of two groups before treatment had no significant difference (P ＞ 0.05),1,12 h after treatment of blood gas analysis was statistically significant (P ＜ 0.05).The cure rate,effective rate and inefficiency in NIPPV group were significantly better than those in NCPAP group [82.5％ (33/40)vs.61.1％ (22/36),92.5％ (37/40) vs.80.6％ (29/36),7.5％ (3/40) vs.19.4％ (7/36)].Assisted ventilation time was significantly shorter in NCPAP group[(39.45 ± 6.99) h vs.(69.39 ± 20.51) h].The difference was statistically significant (P ＜ 0.05).Two groups of intraventricular hemorrhage,bronchial pulmonary hypoplasia,neonatal necrotizing enterocolitis incidence rate had no significant difference (P ＞0.05).In NIPPV group the incidence rate of premature infant retina disease and cererbral white matter softening around the ventricle was significantly lower than that in NCPAP group [2.5％ (1/40) vs.13.9％(5/36),2.5％(1/40) vs.11.1％(4/36)].The difference was statistically significant (P ＜ 0.05).Conclusion NIPPV in the treatment of recurrent apnea in premature infants curative effect and prognosis is better than NCPAP.

Objective To study the effect of early trace depth hydrolyzed protein formula and infant formula milk on very low birth weight (VLBW) infants of the gastrointestinal tolerance,growth and development,and provide scientific basis for early enteral feeding VLBW.Methods 126 premature infants with birth weight lower than 1 500 g were randomly divided into observation group (63 cases) and control group (63 cases).On the basis of routine treatment,the observation group was given early trace depth hydrolyzed protein formula,the control group was given early minimal preterm formula milk.We oberserved gastrointestinal tolerance,complications and growth monitoring of two groups.Results Period to regain their birth weight,up to full enteral feeding days of age,hospitalization days,discharge rate of extrauterine growth retardation,the incidence of feeding intolerance,the incidence of neonatal necrotizing enterocolitis,feeding dyspeptic diarrhea incidence in observation group were 12.81 d,25.76 d,37.95 d,23.8％,14.3％,6.3％,3.2％.The data in control group were 16.02 d,27.75 d,45.49 d,42.9％,30.2％,19％,12.7％ respectively.There was significant difference between two groups (P ＜ 0.05).Conclusion To carry out early trace depth hydrolysis protein can reduce the risk of the incidence of complications in VLBW infant which has good promotion on the recent growth and suitable for clinical use.

Objective To analyze the trends of leprosy epidemic and evaluate the effects of its control in Yunnan Province. Methods The epidemiologic data were analyzed. Results There were 50 797 leprosy patients detected in Yunnan during 1954～ 1998 with a high prevalence in china.Among these patients,37 639 were cured,10 447 died,and 1 069 dropped out.There were 1 642 active patients at the end of 1998.It was in 1966 that the prevalence is highest(0.82/1 000) with 18 350 active patients and decreased to 0.04/1 000 in 1998.The incidence was 19.37/100 000 in 1957 and decreased to 0.32/100 000 in 1998.The most numerous patient (4 680) was detected with a rate of 24.45/100 000 in 1958,and the rate decreased to 1.63/100 000 in 1998.In 1960s and 1970s, a lot of leprosy villages were built and a mass survey of leprosy patients was taken.Doctors treated patients with DDS alone at that time. MDT was the first to use in Mengla in 1983 and spread during 1986～ 1989. Conclusion Several measures were taken for detecting and treating patients effectively, and the endemic and incidence decreased by a big margin as well.

In order to evaluate the accuracy of RayPex5 apex locator in measuring root canal working length in clinical practice and to analyze the possible factor resulting in deviation, the working length of total 211 root canals were measured by handing method and electronic method respectively. The exact working length of those root canals were determined by X-ray method. The accuracy rate of electronic method and handing method was 96.21% and 78.2% respectively, with significant difference(P<0.001). The accuracy rate of front teeth group and molar group measured by electronic method was 100% and 92.5% respectively, with significant difference(P<0.05), while the apical paradentitis group and the apical non-paradentitis group, the front teeth group and the premolar group, and the premolar group and the molar group didn' t differ from each other, respectively. The study showed that the accuracy rate of electronic method was high for determining root canal working length, and Raypex 5 apex locator could define apical seat to measure root canal working length accurately.

Objective To investigate the effect of Artesunate (Art) on experimental immune myositis (EIM) animal model. Methods Guinea pigs were immunized with rabbit muscle homogenate in Freund′s adjuvant, and a generalized myositis fundamentally similar to human polymyositis was established. These animals were divided into two groups: the control group (injected intraperitoneally with normal saline everyday) and the treatment group (injected intraperitoneally with Art everyday). Results The serum levels of CPK, AST and LDH were significantly lower in the treatment group than those in the control group. EMG demonstrated that the treatment group kept improving along with the elapse of time. Histological findings revealed that the damage of muscle in the treatment group was less severe than that of the control group. Conclusion Art is effective in therapy of EIM guinea pigs. The result of this study provides a reliable evidence that Art might be used for the treatment of PM/DM and other immune diseases.

Objective To investigate the clinical values and characteristics of whole body bone ima-ging (SPECT/CT)in detecting bone metastases in the preoperative patients with lung adenocarcinoma or squa-mous cell carcinoma for staging and determining the best treatment plan.Methods Eighty-two preoperative patients with primary pulmonary adenocarcinoma or squamous cell carcinoma performed 99 Tcm-MDP SPECT/CT whole-body bone imaging.One week before surgery,parts of positive lesions performed MRI scan.The differ-ence of the incidence of bone metastasis was analysed by χ2 test.Results In all 82 patients with lung cancer, there were 38 adenocarcinomas and 44 squamous cell carcinomas.Bone metastases were detected in 38 cases, the incidence rate was 46.3%.Of which,among lung adenocarcinoma,the incidence rate was 57.9% (22 /38),and the incidence rate was 36.4% (1 6 /44)in lung squamous cell carcinoma,and the difference was sta-tistically significant (χ2 =1 2.66,P =0.027).The most common area was bilateral ribs,followed by vertebra, pelvis,bones of the extremities and skull.Conclusion Lung adenocarcinoma compared with squamous cell carcinoma is prone to bone metastases,and bone metastases are more common in bilateral ribs.It has important value that whole body bone imaging in screening for bone metastases of pre-operative patients with lung cancer for staging and making the treatment plan.

OBJECTIVE:To study the correlation of inorganic elements and active ingredients in Paris polyphylla. METH-ODS:HPLC was adopted for contents determination of polyphyllinⅠ,Ⅱ,Ⅵ and Ⅶ:the column was Phenomenex C18 with mo-bile phase of acetonitrile-water(gradient elution)at a flow rate of 1.0 ml/min,detection wavelength was 203 nm,and column tem-perature was 30 ℃. ICP-MS was adopted for contents determination of Na,Mg,K,Ca,Cr,Mn,Fe,Ni,Zn,Se,Sr,Mo,Pb, Cd,Hg,Cu and As:RF power was 1.55 kW,sampling depth was 10 mm,the plasma gas flow was 15.0 ml/min,carrier gas flow rate was 0.86 L/min,spray chamber temperature was 2 ℃,helium collision mode was He,gas flow was 4.5 ml/min,measurement points/peak was 6,sampling mode was hopping peak collection(repeated 3 times). And SPSS 21.0 software was adopted for step-wise regression analysis of correlation between the two above-mentioned. RESULTS:The linear range was 0.939-4.697 μg(r=0.999 8)for polyphyllinⅠ,1.124-5.620 μg(r=0.999 6)polyphyllinⅡ,0.784-3.918 μg for polyphyllin Ⅵ,0.976-4.880 μg for poly-phyllinⅦ.RSDs of precision,stability and reproducibility tests were lower than 2%,recoveries were 96.53%-100.71%(RSD=1.69%,n=6) for polyphyllinⅠ,98.19%-99.55%(RSD=0.58%,n=6) forⅡ,95.45%-100.83%(RSD=1.87%,n=6) for poly-phyllin Ⅵ,96.11%-102.01%(RSD=2.07%,n=6)for polyphyllin Ⅶ . The linear range was 0-195.984 3 mg/kg(r≥0.999 3),de-tection limit was no higher than 65.201 ng/kg. PolyphyllinⅠshowed positive correlation with Mg and negative correlation with Pb;polyphyllin Ⅱ showed positive correlation with Cu and negative correlation with As;polyphyllin Ⅵ showed positive correlation with Sr and Hg and negative correlation with Mn;polyphyllin Ⅶ showed positive correlation with Na and Ni and negative correla-tion with As;the total contents of the 4 polyphyllins showed positive correlation with Ni and Sr and negative correlation with Fe. CONCLUSIONS:The contents of inorganic elements and P. polyphylla have certain correlation with active ingredient.

Objective To analyze the clinical key points of minimally invasive tracheostomy with percutaneous horn expansion applicated in ICU,and to discuss the problems encountered in minimally invasive surgery and the solutions.Methods The clinical data of 25 patients of minimally invasive tracheostomy with percutaneous horn expansion in ICU were analyzed retrospectively.Results Twenty-one patients with minimally invasive tracheostomy with percutaneous horn expansion were successfully performed in 25 patients of ICU (no incision sputum,subcutaneous emphysema,pneumothorax and other complications),2 patients had more postoperative bleeding,2 patients were difficult to imbedding catheter,of which 1 case abandoned the catheter and received conventional tracheotomy.Conclusion Percutaneous horn expansion minimally invasive tracheostomy has the advantages of small incision,less injury,less operative time,less blood loss and low incidence of complications.However,ICU patients are in severe condition and easy to change.Adequate preoperative preparation,controlling the key steps in the operation can find a solution to the problme.

With the change of medical model and the transfer of health to communities and rural towns,the expanding enrollment of colleges and universities makes collegiate internship progrms more and more difficult Clinical College of Guilin Medical University explores the new methodology of teaching practice,constructs and practises the new molde of internal madichine teaching,Combines the coummunity internship programs with hospital internship programs.and was improved the quality of practice teaching