Objective To investigate the feasibility of application of minilap in transumbilical 2D/3D laparoscopic cholecystecto-my.Methods 32 cases of clinical data(21 cases of cholecystolithiasis,11 cases of gallbladder polyps)were retrospectively analyzed, which were transumbilical 2D/3D laparoscopic cholecystectomy assisted with Minilap below the right rib.Results Operation time ranged from 12 to 42 min,average operation time was 32 min.Bleeding volume during operation was 2~8 mL,average bleeding vol-ume was 4 mL.There was no placed drainage,no bile leakage,no bleeding,infection or other complications.It was not happened that abdominal pain,fever,jaundice on patients during postoperative follow-up of 3 months,and with umbilical scar hidden and no scar below the right rib.Conclusion Transumbilical 2D/3D laparoscopic cholecystectomy assisted with Minilap is safe and feasible,it could reduce the difficulty of total transumbilical laparoscopic cholecystectomy operation with good cosmetic result,be worthy to recommend its clinical use.

Objective To evaluate the efficacy of submucosal injection plus single intravesical instillation of epirubicin for primary superficial bladder cancer recurrence. Methods A total of 36 patients with superficial bladder carcinoma (10 cases of T a and 26 of T 1;11 cases of G 1,20 of G 2 and 5 of G 3) underwent partial cystectomy.Intraoperatively,submucosal multiple injections of epirubicin (total dose of 30 mg) were performed,and intravesical instillation of 120 mg epirubicin was conducted immediately after operation. All the patients were followed up for 1 to 4 years (mean 2.8 years). Results The postoperative disease free survival rates were 100.0%,91.7% (33/36) and 88.9% (32/36) at 1,2 and 3 years, respectively.The total recurrence rate was 11.1% (4/36),and adverse effect rate was 36.1% (13/36). Conclusions Intraoperative submucosal multiple injections combined with single intravesical instillation of epirubicin immediately after operation are effective for prophylaxis of primary superficial bladder cancer recurrence,with advantage of being more cost effective and fewer side effects.

Objective To evaluate the safety and effectiveness of the prostatectomy with bladder-flap-plasty for the treatment of benign prostatic hyperplasia(BPH).Methods The clinical data of sixty-three cases with BPH who underwent suprapubic prostatectomy combined with bladder flap-plasty were analyzed.Results Fifty-five cases(87.3%)were followed up for a mean of 23 months.The mean operative time was 60 min,the mean catheter indwelling time was 3 days,the mean bladder irrigation time was 2 days,irrigating fluid of 39 cases(61.9%)turned clear at the first day after operation,the mean hospital stay period was 9 days.Of the 55 cases,2 had urethra mouth stricture,1 had bladder surge and was powerless to urinate for 1 month after operation.All the above cases were medically managed,and the success rate was 100%.Five months after operation, international prostate symptom score(IPSS),quality of life(QOL)score,maximum flow rate (MFR)and postvoid residual rate(PVR)were improved significantly compared with those of pre- operation(P＜0.01).Conclusions The research demonstrates that prostatectomy in combination with hladder-flap-plasty is safe and effective,and the operative complications is little.

Physician-patient relationship is a basic relation in medical practice,in which communication is one important aspect.Setting Up a perfect physician-patient communication calls for the condition regarding patient as the centre of medical services,consciously cultivate medical professionals′ communicating ability,construct management institutional system,continuously improve humanistic communication between doctors and patients,thus to promote a harmonious physician-patient relationship.

Laser scanning confocal microscope is a kind of new analytical apparatus for molecular cell biology research.It has been used in many fields of biomedical research.Brief introduction of its function and feature is given in this article.Recent development is summarized in application of laser scanning confocal microscope for localization and quantification of tumor tissue and cell protein,observation of sub-cellular structure of tumor ceils,study on tumor related receptor,distribution of antitumor drug and mechanism of tumor multi-drug resistance.

Objective To investigate the correlation between bacteria and upper urinary tract calculi (UUTC). Methods 530 cases of UUTC were enrolled in the study.Mid-stream urine culture was obtained before operation.Intraoperative pelvic urine culture,cotton swab culture of stone-incarcerated mucosal surface,pre- and post-sterilized stone culture were also carried out. Results Among 530 cases of UUTC,the stone culture showed positive (infectious stone) in 120 cases (22.6%),more prevalent in females than in males. Staphylococcus epidermidis and Escherichia coli were the predominant bacteria, accounting for 60.1% and 32.5%,respectively.The infection rate with which a stone size was ≥1.0 cm with coarse surface,loose density or radiolucent was much higher than that of size

Objective T o detect diatom in the organs of drow ners by enzym e com bined w ith strong acid digestion m ethod, and evaluate its application value. Methods A total of 40 cases w hich have been identified as drow ning in local region w ere collected. Sam ples of the lung, liver, kidney, and the w ater of the scene w ere also gathered from each case. Strong acid digestion m ethod, enzym e com bined w ith strong acid digestion m ethod, and enzym ic digestion m ethod w ere respectively perform ed to detect the diatom in the sam ples. T he com parative analysis w as m ade on digestion tim e, digestive pow er and de-tection rate of diatom , etc. Results E nzym e com bined w ith strong acid digestion m ethod w as significant-ly better than enzym ic digestion m ethod on digestion tim e and digestive pow er;enzym e com bined w ith strong acid digestion m ethod w ere obviously superior to strong acid digestion m ethod on the detection rate of diatom . Conclusion E nzym e com bined w ith strong acid digestion m ethod com bines the advan-tages of strong acid digestion m ethod and enzym ic digestion m ethod. It has the characters of operation safety w ith little pollution to environm ent, w hich is w orthy of further popularization and practice.

Medical English listening is an important part of English education in medical institutes. On the basis of schema theory,this paper tries to explore the application of the theory in the teaching practice of medical listening and focuses on how to improve the teaching quality of medical English listening from the perspectives of phonetic schema,vocabulary schema and background schema.

Objective To evaluate the efficacy of D98A,a newly developed superparamagnetic oral MRI contrast agent,in the diagnosis of abdomen.Methods Plain and contrast MRI after taking 500～1000 ml D98Ain 80 patients were performed by using different field strength MR scanners,and the sequences included T 1WI,T 2WI,and fat suppressed sequences.The contrast effect,distribution,influence on demonstration of contours of abdominal organs,and side effects were studied concerning this suspension.Results It showed that this oral contrast agent had good security character,wide consideration area,low cost,good contrast effect,and high value of clinical application.The gastrointestinal tracts appeared as hypointensity on various MR sequences,and thus,made them easy to be identified.The margins of abdominal organs were easier to be located after taking the contrast,and the distinction had statistical denotation.The demonstration rate of gastrointestinal tracts was raised from 10% to 89% after using D98A.There were no side-effects in all patients. Conclusion D98A is safe and effective in facilitating the localization of the abdominal organs.It can improve the accuracy in delineating the gastrointestinal tracts and in diagnosing the lesions of abdominal organs.

Objective: To discuss the diagnostic value of the new 5-sector approach for orbital imaging division in the diagnosis of orbital space-occupying lesions. Methods: We retrospectively analyzed the clinical and imaging data of 374 patients with orbital space-occupying lesions. The distribution of the lesions was analyzed according to the new 5-sector approach for orbital imaging division (globe compartment, optic nerve compartment, intraconal compartment, extraconal compartment and extra-periosteum compartment) and the distribution rule of the lesions were discussed. Results: Hemangioma was the most common lesion among our group, with an incidence of 34.75%(130/374); 79.23% (103/130) of the hemangiomas were distributed in the intraconal compartment. There was a distributional difference between the lymphoma and inflammatory pseudotumor(χ 2 = 13. 63, P=0.001), with the former mainly located in the extraconal compartment and the latter often in the mixed compartments. We also found that there were distributional differences for those lesions which had more than 10 sufferers in our study(χ2= 788.058, P=0.001). Significant differences were also noted in the distribution of both benign and malignant lesions in the intraconal, extraconal and mixed type compartment(χintra/extra2=66.53, P<0.001;χintra/mixed2=88.17, P<0.001;χ extra/mixed2=5.078, P< 0.05). For the benign lesions, the incidence order was: the intraconal compartment (99.18%,121/122)> extraconal compartment (56.12%,78/139)> mixed type(36.96%, 17/46); for the malignant lesions, the incidence order was: mixed type(63. 04%,29/46)> extraconal compartment(43.88%,61/139)> intraconal compartment(0.82%,1/122). Conclusion: There are distributional differences in orbital space-occupying lesions under the new 5-sector approach for orbital imaging division, indicating that the new 5-sector approach is helpful in the diagnosis of orbital lesions.