ObjectiveTo explore the effect of personality and psychosocial factors on irritable bowel syndrome (IBS).MethodsPersonality and psychological status of 46 IBS patients and 32 healthy individuals were evaluated with Eysenck Personality Questionaire (EPQ), Symptom Checklist-90 (SCL-90) and Life Events Scale (LES).ResultsIn EPQ, E (extroversion-introversion) scores of IBS group were lower than those of control group; N (neuroticism) scores of IBS group were significantly higher than those of control group (P<0.01). In SCL-90, the scores of somatization, compulsion, anxiety, depression and etc. were higher than those of control group (P<0.05). The frequency of meeting negative life events, the quantity of stimulus of meeting negative life events and the total quantity of stimulus of meeting life events of IBS patients within one year until episode were significantly higher than those of control group (P<0.01).ConclusionPersonality psychological characteristics and life events before illness are associated with the morbidity of IBS.

Based on the investigation of a hospital's grants during 2004-2005 and the authorized during 2002-2005 (385 in total), we tried to find the trends and bias of clinical sciences at present. We analysed on the types of grants (clinical or basic), research objects, experimental methods, discipline involved, modes of cooperation, and background of applicants. A close connection between research and clinical trial, interdisciplinary study, patient-centered practice and international competitions are becoming more and more important. To meet the needs of clinical research, policies and devotions such as technical platforms are needed.

Objective Severe bronchial stricture due to endobronchial tuberculosis is often accompanied by complex complication,such as obstructiv pneumonia,destroyed lung and bronchiectasis.Its treatment is very diffucult.The present report is to investigate and analyze the indication and efficacy of surgical treatment of bronchial stricture due to severe endobronchial tuberculosis.Methods Reviewed the clinico-pathological records documenting the surgical outcomes in 81 bronchial stricture due to severe endobronchial tuberculosis who underwent lobectomy or pneumonectomy enrolled in our hospital between January 1990 and December 2010.There were 29 male and 52 female.Mean age was(36 ± 12) years (ranged 16-66 years).The three most common reasons of surgery were bronchial stricture accompanied by pulmonary atelectasis,destroyed lung and bronchiectasis(76 cases,93.8％).79 cases had elective operation,whereas one patients required emergency surgery.Pueumonectomy in 51,lobectomy in 16,sleeve resection in 11,segmental resection in 2,and exploratory thoracotomy in 1.If frozen pathological examination showed that endobronchial tuberculosis remained in the bronchial stump,it was covered with muscle flaps,including intercostal muscle flap in 6 cases,latissimus dorsi muscle flap in 5 cases,serratus anterior muscle flap in 5 cases.The mean operative time was 3.2 h (range between 2 h and 5.5 h) and the blood loss averaged 546 ml (range between 100ml and 4 000 ml).The post operative hospital stay averaged(12 ±8)days.Results No intraoperative or early postoperative death occurred.Nine patients developed complications,including BPF in 2,pulmonary infection in 2,empyema in 1,hemorragic shock in 1,hemothorax in 1,incision infection in 1,chylothorax in 1.All 9 cases recovered well after treatment.Pathological examination showed that tuberculosis bronchial remained in the brinchial stump in 13 cases.Neither BPF nor empyema occurred in all the 13 cases.Multivariate analysis revealed that destroyed lung was significant risk factor of postoperative complication.There were 3 late deaths.Five year survival rate was 96.2％.Conclusion Surgical treatment is still the recommeded treatment modatity for bronchial stricture caused by endobronchial tuberculosis due to its excellent results.It should be performed in time when the drug and intraluninal treatment were no effect for avoiding of being progeressed into destroyed lung.

Objective To understand colonization of pathogens in nasal vestibular of health care workers (HCWs) in intensive care unit (ICU),and provide evidence for strengthening the prevention and control of healthcare-associated infection (HAI)in ICU.Methods On may 2015,colonization status of pathogens in nasal vestibular of uninfected HCWs in ICU were actively screened,bacterial culture,isolation and identification were performed.The surveyed results were analyzed and compared with antimicrobial resistance of pathogens from patients at the same stage.Results A total of 96 HCWs were surveyed,43 pathogenic strains were isolated from different HCWs’na-sal vestibular,isolation rate and carriage rate were both 44.79%.The main pathogenic bacteria was Staphylococcus aureus(n=15,34.88%),followed by Enterobacter aerogenes (n =9,20.93%)and Klebsiella pneumoniae (K . pneumoniae ,n=7,16.28%).There was a high detection rate of pathogens from nasal vestibular of doctors,HCWs who smoked frequently and those who never exercised (all P <0.05).There were 1 strain of imipenem-resistant K . pneumoniae among 43 pathogenic strains.Resistance rate of 7 K .pneumoniae from HCWs to ampicillin/sulbactam, cefazolin,and furantoin were all >50.00%,resistance rates to cefotaxime and imipenem were 28.57% and 14.29%respectively;resistance rates of 11 strains of K .pneumoniae from patients to furantoin was 100.00% during the same stage,but were sensitive to other commonly used antimicrobial agents.Resistance rate of 4 strains of Esche-richia coli (E.coli)to ampicillin was 75.00%,to gentamicin,tobramycin,levofloxacin,ciprofloxacin,and com-pound sulfamethoxazole were all 50.00%,6 strains of E.coli isolated from patients during the same period were found to be resistant to most commonly used antimicrobial agents.Conclusion Colonization rate of pathogens is high in nasal vestibular of HCWs in ICU,active screening and monitoring on colonization of pathogens in HCWs’ nasal vestibular is significant for preventing the occurrence and cross transmission of HAI among HCWs and pa-tients.

Objective To evaluate the outcomes achieved by using left internal mammary artery(LIMA) to radial artery (RA) total arterial composite grafts in minimally invasive direct coronary artery bypass grafting (MIDCAB) for patients with multiple vessel disease.Methods From January 2009 to September 2015, 39 patients(24 males) with multiple vessel disease underwent MIDCAB with LIMA-RA total arterial composite grafts without cardiopulmonary bypass in our hospital .MIDCAB was performed through a left anterior minithoracotomy .Results All patients successfully underwent MIDCAB with LIMA-RA total arterial composite grafts.No patient required to convert to strenotomy during the surgery.Mean operation time was(176.1 ± 14.1)min.Revascularization was performed for 2 target vessels in 11 cases, 3 target vessels in 25 cases and 4 target vessels in 3 cases.Mean postoperative ventilation time was(21.9 ±27.9) h.Mean ICU time was(2.8 ±2.1) days, and mean postoper-ative inhosptial time was(11.2 ±3.3)days.There was no early death in perioperation.At a follow-up of 6 to 86 months[aver-age(27.5 ±18.0) months], one patient died.The overall survival at 2 years postoperatively was(96.0 ±3.9)%.The paten-cy rate of LIMA was 100%.The overall patency rate of RA grafts at 2 years postoperatively was(91.8 ±4.0)%.Conclusion MIDCAB with LIMA-RA total arterial composite grafts is a safe and effective procedure with favorable early and mid-term out-comes for patients with multiple vessel disease .

Objective Objectives: To introduce the technique of performing minimally invasive concomitant Cox Maze Ⅳ ablation procedure entirely by bipolar clamp through right lateral minithoracotomy for patients with atrial fibrillation(AF) associated with mitral valve diseases.Methods Sixty nine patients with mitral valve disease and long-standing persistent AF received minimally invasive Cox Maze Ⅳ ablation procedure combined with mitral valve surgery from June 2012 to January 2015.The etiology of mitral valve disease was rheumatic(41 cases) and degenerative(28 cases).Age at operation ranged from 52 to 71 years.There were 43 males and 26 females.AF duration ranged from 1.5 years to 13 years.Diameter of the left atrium ranged from 42 to 60 mm.Diameter of the left ventricle ranged from 43 to 66 mm.Left ventricle ejection fraction (LVEF) ranged from 0.45 to 0.67.Concomitant Maze Ⅳ ablation procedure was performed through right lateral minithoracotomy entirely by bipolar radiofrequency clamp.Results All patients successfully underwent this minimally invasive concomitant Maze Ⅳ ablation procedure and mitral valve surgery.The mean cardiopulmonary bypass time was(130.3 ± 17.7) minutes.The mean aortic crossclamp time was(91.8 ± 12.7) minutes.No patient needed conversion to sternotomy during the surgery.There was no early death or pacemaker implantation in the perioperation.The average length of hospital stay was(9.8 ± 3.3) days.At discharge, 65 patients(65/69, 94.2％) maintained sinus rhythm.At a mean follow-up time of(21.0 ± 8.6) months, sinus rhythm was restored in 62 patients(62/69, 89.9％).Cumulative maintenance of normal sinus rhythm without AF recurrence at 2 years postoperatively was(85.1 ± 5.8)％.Conclusion The minimally invasive concomitant Maze Ⅳ ablation procedure performed entirely by bipolar clamp through right lateral minithoracotomy was a safe, feasible, and effective technique for patients with AF associated with mitral valve diseases.

Objective:To evaluate the clinical efficacy of SKy bone expander system in percutaneous kyphoplasty for treat- ment of osteoporotie verterbral compression fracture.Methods:Twenty-two patients(aged 62-90 years,32 vertebrae)under- went percutaneous kyphoplasty using SKy bone expander system.The bone cement was injected into the collapsed vertebrae. The vasual analogue scale(VAS)and complications were recorded during follow up.Results:The operations were successful in all patients via unilateral or bilateral approach.The operation time ranged from 30 to 120 min.The mean volume of cement in- jected into each vertebra body was(4.8?1.1)ml,ranged from 3.1 to 6.8 ml.Extravertebral leakage of bone cement was ob- served in two vertebrae with no symptoms.All patients had their pain relieved;the VAS was 7.6?0.8 before operation,3.5?0.5 one day after operation,2.8?0.6 one week after operation,and 2.4?0.6 one month after operation,with significant difference found between preoperation and postoperation(P

Objective To understand the specimen sources,clinical characteristics,and antimicrobial resistance of Burkholderia cepacia (B .cepacia )isolated from infected patients in intensive care unit(ICU),so as to provide reference for guiding rational use of antimicrobial agents.Methods Clinical data of patients with B .cepacia infec-tion in an ICU between 2011 and 2014 were analyzed retrospectively,antimicrobial resistance of strains was ana-lyzed.Results A total of 267 B .cepacia strains were isolated,the major specimen sources were sputum (80.15%, n=214),blood(14.23%,n =38),and urine(3.37%,n =9).Antimicrobial susceptibility testing results revealed that B .cepacia had multiple resistance,and was naturally resistant to multiple clinically used antimicrobial agents, such as ampicillin,cefazolin,ampicillin/sulbactam,nitrofurantoin,and cefuroxime,resistant rates were all 100%;resistant rates to ceftazidime and levofloxacin were 4.12% and 3.00% respectively;resistant rate to compound sulfa-methoxazole had increased tendency(χ2 =5.885,P =0.015).Conclusion Isolation of B .cepacia in ICU increased year by year,antimicrobial resistance is serious,management and targeted monitoring of prevention and control of healthcare-associated infection should be strengthened,antimicrobial agents should be chosen according to antimi-crobial susceptibility testing results.

Objective To sunomanize the experience of consecutive 353 patients and mean 2-years follow-up following Mei mini maze procedure for atrial fibrillation.Methods Between June 2010 and May 2015,353 patients(240 males, 113 females) of atrial fibrillation received this therapy.The age of these patients were(59.7 ± 8.5) years.Among them, 186 were with paroxysmal and 167 were with non-paroxysmal.The procedure, through three ports on left chest wall, included pulmonary vein isolation and ablations of the roof and posterior wall of left atrium which were achieved by bipolar radiofrequency ablation.Ganglionic plexus ablation was made by the ablation pen.Left atrial appendage was excluded.Results Durations of their procedures were(92.3 ± 19.1) mins.No conversion to sternotomy or pacemaker implantation occurred and none of the patients died.The hospital stay was(8.5 ± 2.1) days.The mean follow-up duration was (25.0 ± 15.1) months.308 (90.1％) patients were in sinus rhythm.34 patients could not maintain sinus rhythm.Stroke, thrombus in the left atrium and stenosis of pulmonary vein were not found after their procedures.Conclusion Mei mini maze procedure is a safe, effective, and appropiiate treatment for AF, which restores sinus rhythm and may be associated with the prevention of AF-related stroke.It deserved to be promoted in future.

Objective To evaluate negative lymph node count (NLNC) in prediction of prognosis of T3 gastric cancer after radical resection.Method 214 T3 patients of radical gastrectomy with complete clinical and follow-up data between Jan 2003 to Dec 2007 were enrolled.Survival was determined by the Kaplan-Metier method and univariate analysis was done by Log-rank test,Multivariate analysis was performed using the COX proportional hazard regression model.-2loglikelihood value and the hazard ratio (HR) value were used to compared the value of number of lymph node-negative (NLNC) staging and pN staging and lymph node metastasis rate (MLR) in gastric cancer prognosis evaluation.Results Univariate analysis showed that,pN stage (x2 =31.664),MLR stage (x2 =34.123),tumor size (x2 =5.025),type of differentiation (x2 =5.993),Borrmann classification (x2 =5.401),NLNC stage (x2 =37.256) were related to survival (P ＜ 0.05).COX multivariate analysis showed that-2loglikelihood of pN staging is 1 336.761,HR value is 1.464,-2loglikelihood value of MRL staging is 1 335.821,HR value is 1.441.-2loglikelihood value of NLNC staging is 1 326.902,HR value is 1.725.The N0 and N1 staging prognosis in different NLNC staging was significant (P =0.008,P =0.014).Conclusions Sufficient number of negative lymph node prolongs survival and reduces the risk of early recurrence in advanced gastric cancer.