Objective To explore the clinical application of analgesic and amnestic anesthesia during gastroscope.Methods 120 patients underwent gastroscopy in our hospital were randomly divided into conscious amnesia,analgesia group(experimental group)and painless gastroscopy group(observation group).Induction time recording blood pressure(BP),heart rate(HR)changes,observed gastroscopy procedure and postoperative condition.Results Two groups of patients with BP and HR in each time period,there were no significant differences between them(P＞0.05),and the recovery time of the experimental group(1.43±2.67)min was significantly lower than that of the control group(5.34±0.82)min,propofol total experimental group(34.45±11.12)mg was significantly lower than the control group(92.53±13.67)mg,the difference was significant(P＜0.05),and the experimental group the adverse reaction ratio was significantly lower than the observation group,the difference was significant(P＜0.05).Conclusion Analgesic and amnestic anesthesia during gastroscope had good controllability,fewer adverse reactions,worthy of clinical application.

In 2008,the Ministry of Health,UNAIDS and the World Health Organization held a press conference,stating that sexual transmission had become a major route of transmission in China.Epidemiological research has shown that circumcision can be efficacious for males in reducing their risk of HIV acquisition via heterosexual activity.This article analyzes male circumcision as a HIV/AIDS prevention strategy from medical,public health and ethical perspectives.

Objective To investigate the clinical application value of the laparoscopic intraoperative cholan-giography in laparoscopic cholecystectomy,and summarize the experience.Methods The clinical data of 169 cases of laparoscopic cholecystectomy intraoperative cholangiography were analyzed retrospectively.Results 169 patients were successfully completed,131 cases recovered well and no complications occurred after operation.29 patients showed hyperamylasemia,of which 3 patients had intractable hyperamylasemia,8 patients complicated with secondary acute pancreatitis,with fasting,gastrointestinal decompression,enzyme inhibition(plus somatostatin)and acid,analgesic, anti infection,rehydration treatment after remission.Conclusion Laparoscopic cholecystectomy intraoperative cholan-giography is a safe and reliable diagnostic technique,on the occurrence of biliary residual stones in prevention of post-operative prevention and timely detection of bile duct injury during operation and improves the success rate of repair of bile duct injury has important clinical value;control adaptation of intraoperative cholangiography has important clinical significance of reasonable application license.

Objective To investigate the influencing factors of the controlled virtual touch tissue quantification (VTQ) in liver of patients with type 2 diabetes mellitus (T2DM) complicated withnon-alcoholic fatty liver disease (NAFLD). Methods Two hundred and twenty-seven patients with T2DM complicated with NAFLD were enrolled in this study,and the shear wave speed of the liver was measured by VTQ. Levels of the fasting plasma glucose, glycated hemoglobin,total cholesterol three acids glyceride, low density lipoprotein, high density lipoprotein , aspertate aminotransferase , alanine aminotransferase , gamma glutamyl transpeptidase and uric acid were measured. The relationships among VTQ and the severity of NAFLD , and those quantitative indexes were analyzed. Results Univariate analysis showed that the value of shear wave speed was negatively correlated with age,duration of diabetes,INS and HDL-C,while was positively correlated with HbA1c and AST. Conclusion Age, sex and levels of serum HbA1c,INS,AST and HLD-C might affect the values of shear wave speed in patients with T2DM complicated with NAFLD.

ObjectiveTo analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. MethodsFrom October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. ResultsEleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.ConclusionUsing the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.

Objective To evaluate the reliability and validity of the Chinese version of Uncertainty Scale for Kids-22 (USK-22).Methods The Uncertainty Scale for Kids was translated and adapted according to Chinese culture.The reliability and validity of the Chinese version of USK were tested in 117children and adolescents with cancer.Results The rate of recovery was 100％.The rote of effective questionnaire was 95.7％.The patients were easily to understand and it cost them average 8 minutes to finish the questionnaires.Three factors were extracted by factor analysis and could explain 57.043％ of total variance.The correlations between each item and subscale ranged from 0.526 to 0.762.The Cronbach α of USK was 0.872 and the Cronbach α of each subscale ranged from 0.774 to 0.826.The testretest reliability was 0.835.Conclusions The Chinese version of USK is reliable and valid,and can be used to measure the level of uncertainty among Chinese children and adolescents with cancer.

Objective To evaluate the advantages of nasal septum deviation with three lines reduce tension septorhinoplasty under endoscopy.Methods Three lines reduce tension septorhinoplasty of 48 cases were compared with nasal septum submucous resection(Killian) of 43 cases.Results Followed-up for 3 months to 1 year postoperation,study group were remedied and no clinical symptoms,no complications,control group had septal perforation of 1 case,nasal synechia of 2 cases,saddle nose of 1 case.The incidence of two groups postoperative complications had statistically significant difference.Conclusion Compared with Killian,three lines reduce tension septorhinoplasty was easy to stuty and have the advantages of micro-invasion,safety and efficiency,and was favorable recovery nasal cavitysinuses physiological functions.

Objective: To learn the influencing factors for self-violent thoughts and behaviors among the ninth-grade students in Jiangbei District of Ningbo, so as to provide the basis for carrying out psychological intervention. Methods: The ninth-grade students in a junior high school each of the six streets ( towns ) in Jiangbei District were recruited by multi-stage cluster sampling method from October to November 2018. A self-designed questionnaire was used to investigate the general information, life style, psychological condition, self-violent thoughts and behaviors in the latest year. Multivariate logistic regression model was used to analyze the influencing factors for self-violent thoughts and behaviors. Results: A total of 1 300 questionnaires were issued and 1 238 valid ones were recovered, with an effective rate of 95.23%. The prevalence rates of self-violent thoughts and behaviors among the ninth-grade students were 16.88% and 8.48%. TheResults of the multivariate logistic regression analysis showed that abnormal marital status of parents ( OR=2.074, 95%CI: 1.139-3.775 ) , no moderate physical activity ( OR=1.764, 95%CI: 1.101-2.826 ) , sleeping less than 8 hours ( OR=1.858, 95%CI: 1.273-2.712 ) , alcohol consumption ( OR=2.108, 95%CI: 1.448-3.070 ) , sense of despair ( OR=6.397, 95%CI: 4.195-9.757 ) , sense of anxiety ( OR=4.094, 95%CI: 2.725-6.151 ) , sense of loneliness ( OR=1.879, 95%CI: 1.241-2.854 ) , and cyber-bullying ( OR=5.155, 95%CI: 2.780-9.556 ) were risk factors for self-violent thoughts; not living with parents ( OR=2.057, 95%CI: 1.021-4.145 ) , alcohol consumption ( OR=1.756, 95%CI: 1.074-2.872 ) , sense of despair ( OR=7.197, 95%CI: 4.365-11.864 ) , sense of anxiety ( OR=5.832, 95%CI: 3.276-10.382 ) , fighting ( OR=2.272, 95%CI: 1.219-4.232 ) and physical bullying ( OR=3.462, 95%CI: 1.135-10.558 ) were risk factors for self-violent behaviors. Conclusion Drinking, family relationship, bullying, and mental health problems such as sense of despair and anxiety were associated with the self-violent thoughts and behaviors of ninth-grade students.

Alveolitis, Extrinsic Allergic ; diagnosis ; therapy ; Humans ; Occupational Diseases ; diagnosis ; therapy

Objective: To investigate the clinicopathological features, morphological characteristics, immunophenotypes of littoral cell angioma (LCA) in spleen, and to provide new evidence for making diagnosis and avoiding misdiagnosis.Methods: Clinicopathological data, histological characteristics of 13 cases of LCA were retrospectively studied and immunohistochemical staining was imposed on the paraffi-nembedded specimens, and 5 cases of cavernous hemangioma, 4 cases of normal littoral cells of spleens were used as control groups, simultaneously.Results: All the 13 LCA patients included 7 males and 6 females, aged from 39 to 70 years with an average of 54.2 years and a median age of 55 years.Among these tumor patients, 6 cases were accompanied by malignances, benign tumors or inflammation states at abdominal cavities, and 7 cases were accidentally discovered by physical examinations.Grossly, spleens contained solitary or multiple gray red nodules ,which ranged from 0.5 to 6.2 cm in diameter.Histologically, tumors were composed by anastomosing vascular spaces which were lining by plump, rounded to cuboidal littoral cells that extended into vascular lumens.Usually, papillary frameworks that were covered by these cells were also seen extending into the lumens in some areas.Other types of histiocytoid cells were identified in lumens and the sizes were larger than the littoral cells.Both types of cells absented cytologic atypia.Immunohistochemical study demonstrated that the littoral cells in all cases were positive for vascular endothelial and histiocyte markers, such as CD21, CD31, CD68, polyclone FⅧRAg and ERG, while these cells were negative for CD8, CD34, and WT-1.These findings manifested that immunophenotype of littoral cell in LCA distinctive from that in controls.Conclusion: LCA is a benign lesion, which frequently occurs in the elderly.Its etiology remains confusion, however, immune dysregulation may associate with it because of the concomitance with other tumor or inflammation in some cases.The littoral cells in LCA show a hybrid endothelial-histiocytic phenotype on immunohistochemistry, therefore these cells may have features that intermediate between those of endotheliocytes and histiocytes.Emphasizing the histological findings and immunophenotypes is significant for diagnosis and differential diagnosis.