Objective:To study the feasibility of surgical techniques and clinical experience of the airbag-free separation of nail and the whole extraperitoneal laparoscopic hernia repair(TEP).Methods:Ninty-three cases of inguinal hernia.Patients were treatecl in our hospital from March 2005 to January 2009,with 39 cases of regular.Free air and non-stapling of mesh TEP and 54 cases of routine open tension-free hernioplasty.Results:The operation times were as follows:TEP Group,unilateral hernia(101.3?15.6 min),bilateral hernia(138.4?17.3 min);Open Group,unilateral hernia(81.6?7.6 min),bilateral hernia 175.8?22.0 min.The couplications in TEP Goup inclucled 3 cases of retroperitoheal rupture,3 cases of intra-operative vascular injury,and 2 cases of postoperative scrotal hematoma.Nine cases of sacrotal hematoma,4 cases of infective and 6 cases of long-term pain in the groin area happened in open Group.Conclusion:TEP of free balloon separator with no stapling patch is safe,reliable,less post-operative complications and especially suitable for bilateral hernia.

Objective To discuss the clinical value of endoscopic retrograde cholangio panecreatography (ERCP) and endoscopic sphincterotomy (EST) for the treatment of extrahepatic bile duct stones. Metbods Forty-five cases were treated with ERCP and EST. Other 55 patients treated with opening proedure were selected to serve as the controls. Results The effective rate was 97.8% by ERCP and EST and 90.9% by opening procedure(P>0.05). The rate of residual stone was 2.22% by ERCP and EST and 20.00% by opening procedure(P<0.05). The rate of complications was 4.44% by ERCP and EST and 18.18% by opening procedure(P<0.05). Conclusion Therapeutic efficacy of ERCP and EST is better than the opening procedure in the treatment of extrahepatic bile duct stones. It is a safe, effective and simple method for the treatment of extrahepatic bile duct stones.

In recent years the pressure on the employment of college graduates has been increasing,therefore it is necessary to get some knowledge of employment situation.In order to know the employment situation of the medical college graduates,we made a survey on our 2008 batch medical graduates of China Three Gorges University,and also made further analysis and re-flections according to the survey results.We hope our reflections can provide some supports and assistances to the medical graduates in certain aspects.

OBJECTIVEThe purpose of the study was to investigate the prevalence of oral malodor in a group of health cohorts in Chengdu, China by using different diagnostic methods.

METHODSVolatile sulfur compounds (VSCs) level was evaluated by using Halimeter. The organoleptic score and tongue coating index were also evaluated. A questionnaire interview was conducted at the same time.

RESULTSThere were 21.61% subjects whose oral VSCs level were more than 300 ppb. No significant difference was found between male and female for the VSCs values. The subjects with malodor (score > or = 6) evaluated by organoleptic score were 28.91%, and the difference between the male and female was significant (P < 0.05). Further, a significant correlation could be detected between the VSCs level, organoleptic score and tongue coating index (P < 0.05).

CONCLUSIONThe study indicates that nearly one of fourth people suffer from oral malodor. Malodor has significant correlation with tongue coating, so cleaning of tongue dorsum is very important to reduce oral malodor.

Adult ; China ; epidemiology ; Female ; Halitosis ; epidemiology ; Humans ; Male ; Mouth ; Multivariate Analysis ; Prevalence ; Smell ; Sulfides ; analysis ; Sulfur Compounds ; analysis ; Surveys and Questionnaires

ObjectiveTo investigate the prevalence of syphilis among outpatients in sexually transmitted disease (STD) clinics in Guangxi Zhnang Autonomous Region,and to assess the socioeconomic and behavioral factors associated with the infection.MethodsThe outpatients to 14 STD clinics in 8 cities of Guangxi Zhnang Autonomous Region were investigated with questionnaires by their doctors at the first visit.Venous blood samples were obtained from these outpatients and subjected to toludine red unheated serum test (TRUST) to screen for syphilis.Treponema pollidum particle agglutination (TPPA) was performed for TRUSTpositive samples.The epidemiological data were collected by using EpiData software,statistically analyzed by using SPSS13.0 software package.ResultsA total of 10 930 STD outpatients were recruited in the study,and 1297 samples were confirmed to be both TRUST and TPPA positive.The prevalence of syphilis was 11.9％ in all of the outpatients,14.3％ in female outpatients and 10.3％ in male outpatients,13.3％ in the outpatients of Zhuang nationality,and 11.4％ in those of Han nationalily.Multivariate analysis showed that syphilis was independently related to female sex[odds ratio(OR) 2.23,95％ confidence interval(CI) 1.69 - 3.00,P＜0.01 ],low educaiion level (middle school:OR 1.70,95％ CI 1.11 - 2.62,P ＜ 0.05; primary school or illiteracy,OR 1.98,95％ CI 1.13 - 3.46,P＜0.05),annual income of more than 30000 Yuan (OR 1.91,95％ CI 1.18 -3.10,P ＜ 0.01 ),commercial sex workers or having multiple sexual partners(OR 1.54,95％ CI 1.16 - 2.06,P ＜0.01 ).ConclusionsSyphilis serology should be the routine test in STD clinical settings in Guangxi region,and the intervention should be enhanced to control the prevalence of syphilis in high-risk populations.

OBJECTIVE: To study surgical techniques and clinical applications of the intranasal endoscopic combined approach in maxillary sinus benign lesions surgery. METHOD: A retrospective clinical analysis of 27 patients "whose unilateral maxillary sinus benign lesions operated by the intranasal endoscopic middle meatus with inferior meatus tears recess approach surgical treatment was studied. RESULT: Benign lesions were confirmed by pathology in all patients before and after surgery as to rule out malignancy. All patients had been followed up for 12 to 24 months. Twenty-seven cases resulted in normal luminal epithelium and inferior turbinate shape after surgery. Only one case of papilloma relapsed 2 months after operation. So far, the papilloma has not recurred after the second surgery. There were no epiphora in all cases. CONCLUSION Endonasal endoscopic expand anterior tears recess approach have great and clear view. This approach made us accurately, mini-invade and completely remove the maxillary sinus benign lesions. It is a physiological and functional surgery and has great advantage in the nasal cavity disease treatment.
Adult ; Aged ; Endoscopy ; methods ; Female ; Humans ; Lacrimal Apparatus ; surgery ; Male ; Maxillary Sinus ; Middle Aged ; Nasal Surgical Procedures ; methods ; Nose ; surgery ; Paranasal Sinus Diseases ; surgery ; Retrospective Studies

Objective:To analyze the association between the expression of ubiquinone oxidoreductase complex assembly factor 4 (NDUFAF4) and clinical prognosis of patients with hepatocellular carcinoma (HCC), evaluate the effect of NDUFAF4 on the radiosensitivity of human HCC cell lines, and unravel the underlying mechanism.Methods:The online database and HCC tissue samples were used to investigate the expression of NDUFAF4, and the correlation between NDUFAF4 expression level and clinical prognosis. The si-NDUFAF4 plasmid which down-regulated the expression level of NDUFAF4 was transferred into HepG2 and Huh7 cells. The radiosensitivity of HCC cell lines was detected by clone formation experiment. Nude mice were prepared for tumor-bearing experiment. The β-catenin level was detected by immunofluorescent staining. The expression levels of E-cadherin and N-cadherin proteins were determined by Western blot.Results:Bioinformatics results confirmed that NDUFAF4 was significantly up-regulated in HCC tissues, and the higher the expression level, the worse the patients' clinical prognosis ( P<0.05). The expression level of NDUFAF4 in HCC tissues was significantly higher than that in the adjacent tissues. Clone formation experiment confirmed that knockdown of NDUFAF4 significantly decreased the survival rate of HCC cells ( P<0.01). In vivo experiment showed that knockdown of NDUFAF4 could prevent the proliferation of HCC cells and down-regualte the expression levels of β-catenin and Ki-67. Knockdown of NDUFAF4 significantly down-regulated the expression level of β-catenin protein in the nucleus of HCC cell lines, suggesting that NDUFAF4 could activate the WNT/β-catenin signaling pathway. Knockdown of NDUFAF4 significantly up-regulated the expression level of E-cadherin and down-regulated that of N-cadherin. Conclusions:Knockdown of NDUFAF4 can significantly enhance the radiosensitivity of HCC cell lines by inhibiting the WNT/β-catenin signaling pathway. The expression level of NDUFAF4 is intimately correlated with clinical prognosis. NDUFAF4 can be considered as a new target for lowering the radiation resistance of HCC.

Objective:To describe the epidemiological characteristics of mental disorders in community resi-dents aged 18 years and over in the Chifeng City of Inner Mongolia Autonomous Region.Methods:Six thousand three hundred and seventy six individuals aged 18 years and over were sampled using stratified Probability-Propor-tional-to-Size Sampling in Chifeng City in 2010.All respondents were investigated by face-to-face interview.The Composite International Diagnostic Interview-3.0 Computer Assisted Personal Interview (CIDI-3.0-CAPI)was used to make diagnoses based on the definition and criteria of the Diagnostic and Statistical Manual of Mental Dis-orders,Fourth Edition (DMS-IV).Results:A total of 4528 subjects completed the CIDI-3.0-CAPI.Regarding anxi-ety disorder,mood disorder,substance use disorder,and impulse control disorder,the 30-day adjusted prevalence rates (95%CI)were 2.5%(2.08% -2.99%,0.9%(0.67% -1.23%),0.5%(0.34% -0.76%),and 0.6%(0.41% -0.86%)respectively,and the 12 -month prevalence rates were 4.5% (3.93% -5.15%),2.4%(2.0% -2.90%),1.1% (0.84% -1.45%),and 1.0% (0.74% -1.32%)respectively.The lifetime adjusted prevalence rates were 6.6% (5.92% -7.36%),6.5% (5.81% -7.24%),2.7% (2.26% -3.21%),and 1.4%(1.23% -1.95%)respectively.Conclusion:According to morbidity,anxiety disorders,mood disorder,substance use disorders and impulse control disorders are common in Chifeng City of Inner Mongolia Autonomous Region se-quencely,being a prominent public health problem.

Objective:To explore the mediating effect of work motivation of clinical nurses between work-family conflict and invisible absence, so as to provide a basis for reducing nurses′ invisible absence.Methods:From September to December 2022, a cross-sectional survey was conducted to investigate the mediating effect of work motivation between the work-family conflict and invisible absence by using the general information questionnaire, Work-Family Conflict Scale, Work Motivation Scale and Stanford Invisible Absence Scale among 522 nurses by convenience sampling.Results:The valid questionnaires were 511 samples. There were 15 male nurses and 496 female nurses among the 511 nurses. The work-family conflict of clinical nurses had a positive effect on invisible absence ( r=0.319, P<0.05), and work motivation had a partial mediating effect between work-family conflict and invisible absence (the effect value was 0.082), the mediating effect accounted for 35.00% of the total effect. Conclusions:Nursing managers and nurses themselves should take a variety of ways to reduce the work-family conflict, promote the work-family balance of nurses, and improve their work motivation, so as to reduce their invisible absence and promote the healthy development of clinical nurses.

Objective:To observe the application effect of skillful communication combined with pathway pain management on patients with hemorrhoids undergoing endoscopic sclerotherapy.Methods:Using the convenient sampling method, a total of 85 patients who received endoscopic sclerotherapy of internal hemorrhoids in the People's Hospital of Anyang City from September 2020 to August 2021 were selected as the research objects. They were divided into the intervention group (44 cases) and the control group (41 cases) . The control group was given routine nursing intervention, while the observation group was given skillful communication combined with pathway pain management on the basis of the control group. The pain level (VAS) before and 12, 24, 48, and 72 hours after the operation, as well as the negative emotions [anxiety (SAS) , depression (SDS) ], resilience (CD-RISC) and quality of life (WHOQOL-BREF) score of patients before and after the intervention were compared between the two groups.Results:Compared with before operation, the VAS scores of the intervention group at 12, 24, 48 and 72 h after operation were lower, and the VAS scores of the intervention group at each time point after operation were lower than those of the control group, and the differences were statistically significant ( P<0.05) . After the intervention, SAS and SDS scores of patients of the two groups were lower than those before the intervention, and SAS and SDS scores of the intervention group after the intervention were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of CD-RISC after intervention in the two groups were higher than those before intervention, and the scores of each dimension of CD-RISC in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The scores of each dimension of WHOQOL-BREF in the two groups after intervention were higher than those before intervention, and the scores of each dimension of WHOQOL-BREF in the intervention group after intervention were higher than those in the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Skillful communication combined with pathway pain management can reduce the pain level of patients undergoing endoscopic sclerotherapy of internal hemorrhoids, relieve the negative emotions of patients and improve their psychological resilience and quality of life, which is worthy of clinical promotion.