Objective To explore the value of endoscopic duodenal feeding tube placement in severe coma patients with endotracheal tube by tracheostomy. Methods 28 patients, who suffered from severe coma with endotracheal tube by tracheostomy, received endoscopic duodenal feeding tube placement. Results Endoscopic duodenal feeding tube placement in all 28 patients was successful, and complications such as tube blocking or dropping occurred only in one patient. The average time of placing duodenal feeding tube was 16 min. Conclusion Endoscopic duodenal feeding tube placement was an effective, simple,convenient and safe way to set up enteral nutrition for severe coma patients with endotracheal tube by tracheostomy.

Objective To evaluate the application of intraoperative endoscopy during the emergency exploratory laparotomy in the patients with acute massive small intestinal bleeding.Methods Twenty-six patients with acute massive small intestinal bleeding were examined by intraoperative endoscopy during the emergency exploratory laparotomy and the clinical data were analyzed.Results The hemorrhagic reasons were clarified in 25 patients(96.2%) through the application of intraoperative endoscopy.Of the 25 patients,the results showed that 2 cases were with duodenal leiomyoma,1 case duodenal Dieulafoy' disease,5 cases small bowel leiomyoma,2 cases small bowel leiomyosarcoma,2 cases ileum lymphoma,3 cases ileum ulcer,4 cases small bowel cavernous hemangioma,5 cases small bowel arteriovenous dysmorphosis and 1 case pancreaticojejunostomy cut bleeding.The average examination time was 15 min and no complications related to intraoperative endoscopy occurred in all patients.Conclusion The application of intraoperative endoscopy,which may increase the detection rate,is efficient and safe during the emergency exploratory laparotomy in the patients with acute massive small intestinal bleeding.

Objective To evaluate the efficacy and safety of contact endoscopic argon plasma coagulation(APC) for treating protuberant erosive gastritis. Methods 63 patients with protuberant erosive gastritis were randomly divided into groups A and group B, which were treated with non-contact and contact APC, respectively. The efficacy and safety were compared between the two groups. Results There was no significant difference between group A and group B in the efficacy and complication frequency. The curative rates in group A and B were 96.8% and 96.9%, respectively, and only 3 patients had abdominal pain or distension 1 to 3 days after operation, and disappeared within 3 to 7 days after treatment in each group. The numbers of ineffective operation in groups A and B were 284 and 96, respectively. The duration of operation in groups A and B was 11 min and 38 sec,7 min and 22 sec, respectivley. The numbers of accidental injury in group A and B were 137 and 58 times, respectively (all P

Objective To approach the therapeutic effects and complication of hyperfractionated radio-therapy for nasopharyngeal carcinoma. Methods From January 2000 to November 2002,283 patients with na-sopharyngeal carcinoma were treated with hyperfraetionated radiotherapy. For hyperfractionated radiotherapy,γ-ray from 60Co was performed and two fractions of 1.2 Gy were given daily,with an interval of≥6 h,5 days per week to a median dose of 72 Gy for nasopharynx and 68.4 Gy for neck. For some patients, carboplatin or cispla-tin and 5-fluorouracil were transfused. Results The incidence rate of≥3 grade acute mueositis was 12. 4%.The complete remission rate after treatment was 93.6%. The 1,2 and 5 year survival rate was 93.6% ,82. 7%and 60. 1% respectively. Conclusion patients treated with hyperfractionated radiotherapy have good tolerance and therapeutic effect. It provids a treatment means for nasopharyngeal carcinoma. But it must be validated by the large-scale clinical trials.

Objective To evaluate the efficacy of oxycodone or hydromorphone combined with propofol for colonoscopy.Methods A total of 150 patients of both sexes,aged 18-64 yr,weighing 45-85 kg,of ASA physical status Ⅰ or Ⅱ,undergoing colonoscopy,were randomly divided into 3 groups (n=50) using a random number table:fentanyl combined with propofol group (group F),oxycodone combined with propofol group (group O) and hydromorphone combined with propofol (group H).In F,O and H groups,fentanyl 1 μg/kg,oxycodone 0.1 mg/kg and hydromorphone 0.02 mg/kg were injected over 60 s,respectively,and then propofol 1.5 mg/kg was injected intravenously.After eyelash reflex disappeared,a colonoscope was placed.When body movement occurred during examination,half of the initial dose of propofol was added.The time for induction of anesthesia,operation time,emergence time,recovery time,occurrence of adverse cardiovascular events,nausea and vomiting and respiratory depression,and amount of propofol consumed were recorded.Results There was no significant difference between the three groups in the time for induction of anesthesia,operation time,emergence time,recovery time,adverse cardiovascular events,respiratory depression,and amount of propofol consumed.Compared with group F,the incidence of nausea and vomiting and respiratory depression was significantly decreased,and the degree was reduced in H and O groups.No significant difference was found between group O and group H in the incidence of nausea and vomiting and respiratory depression and the degree.Conclusion Oxycodone or hydromorphone combined with propofol can be safely and effectively used for colonoscopy and the efficacy is better than that of fentanyl combined with propofol.

The effect of cultivation conditions on the optical purity of L(+)-lactic acid produced by Rhizopus oryzae HZS6 was investigated. The isomeric composition of lactic acid was influenced by the supplementation of L(+)-lactic acid to fermentation medium. L(+)-isomer increased with the dosage, no D(-)-lactic acid was observed when the concentration of supplemented L(+)-lactic acid in matrix was > or = 1.5 g/L. However, the L(+)-lactic acid yield, biomass and glucose conversion rate decreased with the dosage. With the same method, the supplementation of L(+)-lactic to substrate had no influence on isomeric composition of lactic acid by Lactobacillus and Escherichia coli.
Culture Media ; chemistry ; Fermentation ; Lactic Acid ; biosynthesis ; chemistry ; Rhizopus ; growth & development ; metabolism ; Stereoisomerism

Objective:To explore the feasibility and preliminary effect of improving the comprehensive quality of medical students by introducing the teaching model of cleft lip and palate treatment platform in medical education.Methods:A total of 40 grade two undergraduates of Shantou University medical college were randomly divided into experimental group ( n=20) and control group ( n=20). The students in the experimental group were the volunteers of Cleft lip and palate treatment center, receiving the characteristic idea and methods in clinical teaching. The control group received conventional teaching. The evaluation indicators, including the intellectual quality (60 points), moral quality (15 points), humanistic quality (5 points), physical and mental quality (10 points), social practice (10 points), were quantified by fuzzy evaluation method and a professional evaluation team was set up to evaluate the effect of teaching. SPSS 19.0 was used to perform t test for comparison between the two groups. Results:The average scores of the above items in the experimental group were respectively (51.477±2.381), (10.613±0.169), (4.228±0.124), (8.677±0.296), and (8.565±0.421), and the average total score was (83.559±2.333); the average scores of above items in the control group were respectively (49.746±3.176), (10.268±0.266), (4.008±0.195), (8.207±0.354), and (7.575±0.321), and the average total score was (79.804±3.510). Statistical difference was found in all scores except the intellectual quality score between the two group ( P<0.05). Conclusion:Though no significant difference was found in the intellectual quality, the other qualities have played important roles in improving medical students' comprehensive quality. It is significant to improve the medical students' comprehensive quality by the method of cleft lip and palate treatment platform.

【Objective】 To explore the effect of inspection sheet on improving the quality of apheresis platelet, the satisfaction of blood donors and the cooperation ability of phlebotomists in the process of apheresis platelet collection. 【Methods】 Apheresis platelet donors from May to August 2021 in our center were selected as control group(without inspection sheet) and those from September to December 2021 were included in the observation group (with inspection sheet). The incidence of abnormal collection and the causes during collection process were compared between the two groups.And 100 first-time blood donors in each group were randomly selected for satisfaction survey. The questionnaire was made to investigate the phlebotomists’ recognition on the implementation of inspection sheet. 【Results】 The number of blood donors in the two groups were 6 673 and 6 559, with 111 and 49 abnormal cases, respectively. The total incidence of abnormal cases during blood collection before and after the implementation of inspection sheet was 1.66% and 0.75%, respectively, with the latter significantly lower than the former(P<0.001). The most common causes of abnormal conditions were repetitive puncture, followed by adverse reaction of blood donation, red blood cells contamination in platelet and fatty blood. The satisfaction of first-time blood donors was higher than before the implementation, and the recognition of phlebotomists on the inspection sheet was more than 90%. 【Conclusion】 The implementation of inspection sheet helps to regulate the collection process, strengthen the responsibility and service consciousness of phlebotomists, improve the satisfaction of blood donors, reduce the incidence of adverse events, and improve the quality of platelet products, which is worth popularizing in blood collection and supply institutions.

Objective:To explore the clinicopathological risk factors of retroperitoneal liposarcoma recurrence-free survival after surgical resection, and establish a prediction model based on clinicopathological risk factors.Methods:We conducted a retrospective analysis for retroperitoneal liposarcoma patients undergoing surgical resection at Department of General Surgery, Shanghai Public Health Clinical Center, Zhongshan Hospital (South), Fudan University, during Jul 2014 and Jun 2020. The clinical and pathological data were collected. Univariate and multivariate analysis were used to select independent risk factors.Result:A total of 271 patients were included, and 127 (46.9%) were recurred. In the recurrence group, more patients were assessed as recurrent disease ( χ2=15.289, P<0.05), the proportion of tumors invading organs was higher ( χ2=10.123, P<0.05), and FNCLCC graded higher ( χ2=7.650, P<0.05). The median follow-up time for all patients was 25 months (1-58 months). The 1, 2, and 3-year recurrence-free survival rates were 61.4%, 40.3%, and 30.9%, respectively. Univariate analysis suggests that recurrent disease, organ invasion, poorly differentiated pathological types, and high FNCLCC grades are poor prognostic factors for postoperative recurrence (all P<0.05); Multivariate analysis showed that recurrent disease ( OR=3.135, 95% CI: 2.058-4.762, P<0.05), organ invasion ( OR=2.577, 95% CI: 1.214-5.464, P<0.05) and high FNCLCC grade ( P<0.05) is an independent prognostic factor for postoperative recurrence. Conclusion:Presentation status,FNCLCC grade and organ invasion were independent risk factors for retroperitoneal liposarcoma recurrence after surgery.