Objective To investigate the clinical efficacy and safety between laparoscopic and transabdomi -nal hysterectomy ,reduce the occurrence of complications measures .Methods On 154 cases of hysterectomy indica-tions were nonrandomly divided into two groups ,one group for the observation group of 79 cases of laparoscopic opera-tion,another group was control group of 75 patients with transabdominal operation;two groups had no significant differ-ence in age and disease .The clinical effect ,postoperative complications and safety between the two groups during and after operations were observed .Results The operation time of the laparoscopic group (72.0 ±13.2) min was signifi-cantly shorter than that of the control group (98.0 ±20.7)min (t=3.396,P=0.021);The bleeding quantity of the laparoscopic group(96.0 ±75.4)mL was significantly shorter than that of the control group (159.4 ±98.0)mL(t=9.680,P=0.014);The aerofluxus time of the laparoscopic group (17.2 ±4.2) h was significantly shorter than that of the control group(28.6 ±6.1)h(t=9.760,P=0.013).The average postoperative hospital stay time was significantly shorter in laparoscopic group(5.2 ±1.9)d than those in abdominal group(9.5 ±3.2)d (t=-5.025,P=0.018). The analgesic used in the laparoscopic group (3/89)was significantly shorter than that in the control group (48/78) (t=-8.820,P=0.000).Conclusion Laparoscopic hysterectomy is safe and effective .It is worth to promote in clinical,while improving the operation skills is the key to reduce the complications .

Objective To investigate the feasibility,technique and clinical significance of preserving the great auricular nerve in parotid benign tumors surgery during the first postoperative year.Methods Fifty-two patients with parotid benign tumors were randomly divded into 2 groups.24 patients (group sacrificed) underwent classic parotidectomy with sacrifice of the great auricular nerve.The surgeons spare the nerve in the 32 patients with FOCUS ultrasonic harmonic scalpel (group preserved).Results After surgery,both groups showed lower levels of subjective sensation and sensory function test at auricle.These alterations were less pronounced in group preserved.Both groups showed improvement over time.In group preserved the sensory function reached normal level by 12 months after surgery.The recuperation in group sacrificed was partial at 12 months after operation.Conclusion The great auricular nerve preservation during parotidectomy is feasible,It can decrease sensory disturbance in the early postoperative period and avoid the permanent sequelae that occur when the nerve is sacrificed.The FOCUS ultrasonic harmonic scalpel technique can reduce the operation time.

Postoperative pancreatic fistula (POPF) is the most common complication after pancreaticoduodenectomy (PD) and remains a challenge to pancreatic surgeons.In pancreaticojejunostomy,the methods of reconstruction,experience and operational techniques of surgeons are closely related to POPF.Based on a literature review and on personal experience,the author presented the basic requirements and principle in reconstructing a safe pancreaticojejunostomy (PJ).The traditional methods of pancreaticojejunostomy and their recent developments were evaluated,with their advantages and disadvantages compared.The indications of various types of PJ and the special skills required were summarized.According to his own experience,the author described in detail his recommended method of anastomosis.

Objective To explore the ways to strengthen the mode and effect of the standard community management of the diabetes,and the management model of diabetic mellitus that adopt to current situation of China.Methods 80 diabetics patients were divided into intensive group and common group,and the period of the treatment is three consecutive months.We observed the levels of FBG,2hPG,HbA1c and the cost of drugs.Results The levels of FBG(6.82 ± 1.23),2hPG[(9.51 ± 2.18)mmol/L]and HbA1c(7.52 ± 1.31)％ in intensive group were significantly lower than common group[(8.65 ± 2.31)mmol/L、(12.22 ± 3.11)mtmol/L,(10.32 ± 3.51)％](t =3.12,3.25,3.56,3.69,all P ＜ 0.05).The cost of drugs in intensive group[(621.5 ± 204.5)yuan]was significantly lower than common group[(796.5 ± 240.6)yuan](t =3.69,P ＜ 0.05).Conclusion The ways to strengthen the mode could spend less but control disease well,and improving the existing community diabetes management should be truly effective in reducing medical costs.

Bionic cultivation of Chinese medicinal materials is an intensive Chinese herbal medicine production mode, applying engineering approach in reappearing ecological relationship between medical plants and external environment, adopting modern agricultural production technique, and absorbing the essence of traditional agriculture according to the growth habits of medicinal plants and their requirements on ecological environment. It has obvious economic benefits, ecological benefits and social benefits, adopts the bionic cultivation of authentic Chinese herbal medicine, which has great significance to protecting the ecological environment, improving the quality of cultivation of medicinal materials, meeting the demand of social medicine, and is also the most effective way to ensure the sustainable development of TCM resources.

Objective To investigate clinical efficacy of the NB-UVB phototherapy combined with calcipotriol ointment and halometasone cream in the treatment of psoriasis.Methods 90 patients with psoriasis were selected and randomly divided into control group and observation group with 45 cases of patients.In both two groups,calcipotriol ointment,1 time/d,were used combined with halometasone cream,1 time/d,with a total of 4 weeks.On the basis of these,patients of observation group were added NB-UVB phototherapy (Germany Waldmann7001K ultraviolet light therapy device),1 time every other day with starting dose of 0.5J/cm2,each increment of 0.1J/cm2,for treatment of 15 times.Before and after treatment in patients of two groups,PASI score and clinical efficacy were observed.Visual analogue scale (VAS) were was used to observe itching skin lesions before and after treatment.By using Dermatology Life Quality Index (DLQI),qualities of life in two groups of patients before and after treatment were evaluated.observe two patients before and after treatment expression levels of serum IL-17A,IL-22 and IL-1βwere also observed in patients of the two groups.Results The total efficiency of the observation group was 88.89％,which of the control group was 80.00％,the clinical efficacy of the observation group which was higher than that of the control group,and the difference was statistically significant (x2 =5.23,P ＜ 0.05).Before treatment,the difference of PASI,VAS score and DLQI in the two groups of patients were not statistically significant (P ＞ 0.05).After treatment,scores in the two groups of patients were significantly decreased,and the degree of decrease in the observation group was higher than the control group,the difference was significant (P ＜ 0.05).Before treatment,the differences in serum IL -17A,IL-22 and IL-1β expression levels of both two groups were not statistically significant (P ＞0.05).After treatment,these expression levels of the two groups of patients decreased significantly,and the decreased of observation group was more significantly than that of the control group (P ＜ 0.05).Conclusion NB-UVB phototherapy combined with calcipotriol ointment and halometasone cream in treatment of psoriasis vulgaris patients can significantly improve patients' skin lesions,and can improve patients' quality of life score,which is worthy of promotion.

Background and purpose:The extent of lymph node dissection for the stageⅢ lower rectal cancer is still a subject of debate. Some Japanese researchers recommend improved lateral lymph node dissection for stageⅢ lower rectal cancers while American scholars claim that total mesorectal excision is sufficient. This study aimed to explore the clinical significance of improved lateral lymph node dissection for stageⅢ lower rectal cancer in patients treated with radical resection.Methods:Sixty-six patients with stageⅢ lower rectal cancer were enrolled. Among these patients, 31 had been treated with radical resection combined with improved lateral lymph node dissection, whereas the others received radical resection without improved lateral lymph node dissection.Results:In the group of improved lateral lymph node dissection, five patients had positive lateral node including four poorly differentiated adenocarcinoma and one mucinous cell carcinoma. Compared with the group without improved lateral lymph node dissection, the group of improved lateral lymph node dissection showed significant difference in sexual disturbance, dysuresia and operation duration (P<0.05), but not in the presence of anastomotic fistula and blood loss during operation (P>0.05). Furthermore, patients had lower rate of pelvis recurrence and better 5-year rate of survival for the group of improved lateral lymph node dissection (P<0.05).Conclusion:Radical resection with improved lateral lymph node dissection may decrease the pelvis recurrence rate and increase survival rate in patients with stageⅢ lower rectal carcinoma.

As a distinct clinicopathological entity, mediastinal gray zone lymphoma cannot be classified by using differential diagnostic criteria. The cases represent a spectrum of tumors having characteristics of both primary mediastinal large B-cell lymphoma (PMBL) and classic Hodgkin lymphoma (cHL). In the 2008 WHO Classification, a novel category designated B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma (BCLu) has been created to include these neoplasms. The main features of BCLu are clearly different from those of conventional mediastinal large B-cell lymphomas. Diagnosis of BCLu requires a multiparameter approach incorporating morphological, immunophenotypic, immunohistochemical and other features. These lymphomas generally have a more aggressive clinical course and poorer outcome. There is no consensus on the optimum treatment, while the recommended therapies for aggressive B-cell lymphomas might be effective options.

Objective:To image workstations in the necessity of desktop computer and data lines are connected and fixed in the desktop computer of defects, design a set of wireless transmission of picture archiving and communication system.Methods: Notebook computer with a wireless network using a wireless router, switch and set up a set of wireless image text transmission equipment.Results:The wireless transmission of honeycomb like structure covered with 802.11n standard data rates up to 600Mbps, frequency of 5Hz, multiple security protection by the hospital image filing requirements, which makes medical information resources to achieve full sharing. Conclusion: In 802.11n Wireless LAN PACS system architecture, the basic realization of the wireless transmission and real-time image display, image data for clinicians can within the hospital patients with real time view and its important role in the future development of hospital.