Objective To learn therapeutic effect of the combined treatment of multiple segmental resection and choledochoscope lithotomy on complex intrahepatic biliary calculi.To provide effective and reliable operation method for the treatment of disease.Methods 213 cases with complex intrahepatic biliary were randomly divided into observation group(117 cases)and control group(96 cases)by random number table method.The control group was treated with multiple segmental resection,the observation group was treated with multiple segmental resection com-bined choledochoscope lithotomy.The postoperative complications of the two groups were observed,and the patients of the two groups were followed up,and the effect of surgical treatment was evaluated.Results The hospitalization time of the observation group was (10.1 ±3.4)d,which was significantly shorter than (13.7 ±4.6)d of the control group (t =6.560,P <0.05).Postoperative 3 -6 weeks residual stone rate of the observation group was 7.69%(9 /117), which was lower than that of the control group,the difference was statistically significant (χ2 =4.099,P <0.05).In both two groups,the average duration of follow -up was (11.2 ±3.9)months.In the observation group,the excellent and good rate of surgery 89.74%(105 /117)was higher than the control group (χ2 =9.154,P <0.05).The postop-erative complication rate of the observation group 18.80%(22 /117)was lower than that of the control group,the difference was statistically significant (χ2 =14.467,P <0.05).Conclusion In the treatment of complex intrahepat-ic biliary calculi,the combined treatment of multiple segmental resection and choledochoscope lithotomy has better curative effect and low postoperative complication rate,with good clinical application value.

Objective:To evaluate the effect of retrograde preparation by using slow-speed handpiece or by ultrasonic tips.Methods:Forty-eight extracted premolars were inspected with Scanning Electron Microscope for the minimum dentine thickness recorded after preparation of root-end cavities by low-speed handpiece and ultrasonic instrument respectively.Results:By using slow-speed handpiece,the minimum dentine thickness recorded after the preparation of root-end cavities was 0.15 mm;whereas that was 0.82 mm and 0.76 mm by ultrasonic instrument with S12 9D and S12 9 respectively(handpiece vs ultrosonic instrument,P

ObjectiveTo investigate the clinical efficacy of acupuncture at specific points plus kidney-reinforcing Chinese herbal medicine in treating cervical spondylotic vertebral arteriopathy (liver-kidney deficiency type).MethodNinety patients with cervical spondylotic vertebral arteriopathy (liver-kidney deficiency type) were allocated, using a random number table, to a treatment group of 45 cases and a control group of 45 cases. One case dropped out in the control group. The treatment group received acupuncture at Baihui(GV20), Dazhui(GV14), Houxi(SI3), Sanyinjiao(SP6), Taixi(KI3) and Xuanzhong(GB39) plus oral administration of six ingredients with rehmanniaplus radix puerariae formula and the control group, oral administration of six ingredients with rehmannia plus radix puerariae formula alone. The clinical therapeutic effects were evaluated after eight consecutive weeks of treatment.ResultThe total efficacy rate and the cure rate were 91.1% and 62.2%, respectively, in the treatment group and 77.3% and 34.1%, respectively, in the control group; there were statistically significant differences between the two groups (P<0.05). The therapeutic effect was better in the treatment group than in the control group. After treatment, the difference values ofthe vertigo severity, frequency and duration, headache, neck and shoulder pain, and life and work scores on the scale werehigher in the treatment group than in the control group (P<0.05).ConclusionAcupuncture at specific points plus Chinese herbal medicine is more effective than Chinese herbal medicine alone in treating cervical spondylotic vertebral arteriopathy (liver-kidney deficiency type).

Objective:To observe the effect of Chinese herbal fumigation combined with three-step tuina manipulation on concentration of endothelin (ET) and calcitonin gene-related peptide (CGRP) and vertigo in patients with vertebral artery cervical spondylosis (VACS).
Methods:A total of 120 eligible cases were randomly allocated into an observation group and a control group, 60 in each group. Cases in the observation group were treated with Chinese herbal fumigation combined with three-step tuina manipulation, whereas cases in the control group were treated with oral Flunarizine Hydrochloride Capsules.
Results: After treatment, vertigo in both groups was alleviated; there were intra-group significant differences in ET decrease and CGRP increase (P<0.01, P<0.05);and there were also inter-group significant differences (both P<0.05).
Conclusion: Chinese herbal fumigation combined with three-step tuina manipulation can regulate the levels of ET and CGRP and improve vertigo in patients with VACS. Its therapeutic efficacy is superior to oral Flunarizine Hydrochloride Capsules.

Objective:To evaluate the results of repairing furcation and root perforation using Mineral Trioxide Aggregate(MTA).Methods:Cases with furcation perforations were divided into two groups randomly,MTA and IRM(control group)methods were adopted in present study.Cases that had root perforations were treated with MTA.Pretreatment,immediate posttreatment,and 1year follow-up radiographs were evaluated in a double-blind manner to determine the presence or absence of any pathologic changes adjacent to the perforation site.Results:21 cases were involved.The healing rate of furcation perforation in MTA group was higher(80%)when compared with that in IRM group(75%).However,statistical analysis showed no significant difference in success rates between both groups(P=0.722).The healing rate of root perforation using MTA was 100%.Conclusion:MTA provides an effective seal of furcation /root perforations,and promises in improving the prognosis of perforated teeth.

The iatrogenic splenic injuries occurred in 49 patients who underwent abdominal surgery from January 2005 to January 2020; including grade I injury in 40 cases and grade Ⅱ injury in 9 patients. The normal saline-soaked gauze was placed on the wound surface of the injured spleen, then the high-frequency electric coagulator was employed for hemostasis. The bleeding was successfully stopped and the spleens were preserved without postoperative complications in all cases. The results show that moist electrothermal coagulation can be effectively and safely applied in treatment of grade I and grade Ⅱ injury iatrogenic splenic injuries, and no special equipment required.

A total of 521 patients underwent laparoscopic radical gastrectomy from January 2013 to January 2020 in the First People′s Hospital of Wenling. In 242 cases the splenomental fold was severed before dissecting the left half of omentum or spleen (pretreatment group), and in 279 cases the splenomental fold was not severed priorly (routine group). For pretreatment group the introoperative splenic injury occurred in 4 cases (1.65%), including 3 cases (1.24%) with class Ⅰ injury and 1 case (0.41%) with class Ⅱ injury; while for routine group splenic injury occurred in 24 cases (8.60%), including 22 cases (7.89%) with class Ⅰ injury and 2 cases (0.72%) with class Ⅱ injury, and the rupture of splenic capsule caused by tracting splenomental fold occurred in 19 cases(6.81%). There were significant differences in total number of splenic injuries, splenic injuries with class Ⅰ and rupture of splenic capsule caused by tracting splenomental fold between two groups ( P<0.05). The operation time of 28 cases with splenic injuries was (185±89) min, which was longer than that in 493 cases without splenic injuries [(172±95) min, P<0.05]. The results show that rupture of splenic capsule by tracting splenomental fold is main cause of splenic injury in laparoscopic radical gastrectomy and most of them are class Ⅰ injuries. To sever the splenomental fold priorly can reduce the incidence of iatrogenic splenic injury.

Objective To evaluate the safety and feasibility of step-by-step balloon dilatation combined with contineous biliary drainage in treating benign biliary-enteric anastomosis stricture.Methods The clinical data and imaging materials of 49 patients with benign biliary-enteric anastomosis stricture,who were admitted to authors' hospital during the period from January 2008 to March 2014 to receive treatment,were retrospectively analyzed.Before treatment,the diagnosis of benign biliary-enteric anastomosis stricture was confirmed in all patients by color Doppler ultrasound,MRI and/or contrast-enhanced CT scan,endoscopic or DSA-guided anastomosis biopsy.Among the 49 patients,23 patients (study group) were treated with percutaneous transhepatic step-by-step balloon dilatation (the diameter of used balloon was 8 mm initially,then 10 mm balloon was used in the second month,and 12 mm balloon was used in the third month) together with contineous biliary drainage (lasting for 6 months);26 patients (control group) were treated with single percutaneous transhepatic balloon dilatation (balloon diameter of 6 mm or 8 mm) plus biliary drainage (lasting for 6 months).The improvement of clinical symptoms,the incidence of postoperative complications,and the anastomotic patency rate were compared between the two groups.Results Technical success was obtained in all patients.No procedure-related complications,such as biliary tract hemorrhage and perforation,occurred.One week after the treatment,the difference in bilirubin level between the two groups was not statistically significant (P＞0.05).Although the difference in 3-month anastomotic patency rate between the two groups was not statistically significant,the 6-month,12-month and 24-month anastomotic patency rates of the study group were significantly higher than those of the control group (P＜0.05).Three patients in the study group developed recurrent jaundice at 11.2,14.3 and 17.6 months after treatment respectively;MRI and contrast-enhanced CT scan confirmed the diagnosis of anastomotic stricture recurrence,and balloon dilatation together with drainage tube placement had to be carried out again.In the control group,16 patients developed recurrent jaundice within 3.1-17.1 months after balloon dilatation management,among them one patient died of disseminated intravascular coagulation and the remaining 15 patients received balloon dilatation together with drainage tube placement again.Conclusion For benign biliary-enteric anastomosis strictures,step-by-step balloon dilatation combined with persistent biliary drainage is a safe and effective minimally-invasive treatment.

Objective To observe the effect of Chuanxiongqin injection combined with nimodipine on primary open angle glaucoma.Methods 112 patients with primary open angle glaucoma in ophthalmology department were grouped two groups,each with 56 cases.Two groups were treated with nimodipine and observation group was treated another with Chuanxiongqin injection to observe effect.Results After treatment,retinal light sensitivity,visual field defect,blood flow,blood flow velocity,erythrocyte migration rate,PSV,EDV and RI in central retinal artery of observation group were better than control group(P<0.05).There was no significant difference in adverse reactions between groups.Conclusion Chuanxiongqin injection can improve blood flow status of central retinal artery and optic papillary laminar, retinal light sensitivity and visual field defect for patients with primary open angle glaucoma.

Objective To compare the clinical effect of digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation for percutaneous screw fixation of acetabulum anterior column fractures.Methods A retrospectivecase-control analysis was made on 19 cases undergone percutaneous screw fixation of acetabular anterior column fractures under image-based computer navigation from January 2015 to 2016 March.There were 12 males and 7 females,aged from 21 to 66 years (mean,39.3 years).AO fracture classification was A3 type in 17 cases and B1 type in 2.Based on the application of three-dimensional digital programming,the cases were assigned to two groups:group A (n =9),virtual three-dimensional model was reconstructed and the virtual screw were inserted to uninjured side by software Mimics and group B (n =10),patients were only prepared for routine preoperative preparation.Time of anterior column screw insertion,intraoperative bleeding,intraoperative fluoroscopy frequency,fracture reduction and Majeed score were compared between the two groups.Results All cases were followed up for mean 8.4 months (range,3-12 months).There were no significant differences between groups A and group B in iutraoperative bleeding [(14.1 ± 3.0) ml,(15.1 ± 2.2) ml],good to excellent rate of reduction (89％,80％),good to excellent rate of Majeed score (89％,80％) (P ＞ 0.05).Time of anterior column screw insertion [(22.4-± 3.4) min] and intraoperative fluoroscopy frequency [(24.9 ± 3.8)times] in group A were significantly less than those[(29.4 ± 4.5)min,(30.5 ± 5.8)times] in group B (P ＜ 0.05).Conclusion Digital orthopedic three-dimensional visualization technology is associated with shortened time of anterior column screw insertion and reduced intraoperative fluoroscopy frequency,indicating an effective adjuvant technique for percutaneous screw fixation of acetabulum anterior column under navigation.