BACKGROUND: Biliary ischemia-reperfusion injury is one of the main reasons for the injury bile duct following liver transplantation, liver resection and hepatic artery thrombosis after chemotherapy. However, nothing has been decided yet concerning liver can tolerate long intrahepatic bile ducts ischemia under normal temperature. OBJECTIVE: To use the rabbit biliary ischemia-reperfusion injury, model, analyze the rabbit intrahepatic bile ducts ischemia security time. METHODS: Rabbits were randomly divided into sham operation, hepatic artery and common bile duct joint blocking 1.5, 2, 2.5, 3 h groups. Sham operation group only free common bile duct, hepatic artery and portal vein. Hepatic artery and common bile duct joint blocking 1.5, 2, 2.5, 3 h groups, left and right hepatic duct openings superior margin was clamped using artery clamps, and hepatic artery, common bile duct and loose connective tissue were occluded. Following 1.5, 2, 2.5 and 3 hours, artery clamps were removed to recover hepatic artery or biliary tract blood flow. After a week, animal survival was calculated and liver function was tested. RESULTS AND CONCLUSION: None animals in the sham operation and hepatic artery and common bile duct joint blocking 1.5 hour groups died;survival rate was 87.5% following 2 hours of blocking. Animal survival rate was decreased gradually with prolonged blocking time of blood flow. These indicated that the maximum safety time of blocking biliary duct blood flow was 2 hours. Pathological and histological changes were mild within 2 hours of blocking, mainly presenting cell edema and inflammatory cell infiltration, and necrotic focus was punctiform or fragmentis, reversible. While ischemia above 2 hours, bile duct epithelial necrotic shape was significant. The obvious, hepatic necrosis was multifocal, flake, irreversible damage. Histological change also confirmed that 2 hours may be maximum security limitation of rabbit tolerance intrahepatic bile duct flow blocking under normal temperature.

Objective To evaluate the feasibility of using corrected body weight to set the tide volume for mechanical ventilation during general anesthesia in obese patients.Methods Ninety-six ASA physical status Ⅰ or Ⅱ obese patients,with a body mass index of 28-44 kg/m2,scheduled for elective extremity surgery under general anesthesia,were divided into 3 groups (32 cases of each group) by random digits table method:tide volume based on actual body weight group (group A),tide volume based on ideal body weight group(group B),and tide volume based on corrected body weight group(group C).The pulmonary function of all patients was normal.The patients were endotracheally intubated and mechanically ventilated after induction of anesthesia.According to the corresponding body weight,the initial tide volume was set based on 8 ml/kg in each group(respiratory rate:15 bpm).At 10 min after start of mechanical ventilation,peak airway pressure (Ppeak),airway plateau pressure (Pplat),airwayresistance (Raw) were recorded.Arterial blood samples were collected at 30 min of mechanical ventilation for blood gas analysis and arterial blood oxygen partial pressure (PaO2),arterial blood carbon dioxide partial pressure (PaCO2) and the patients requiring readjustment of tide volume were also recorded.Results The level of Ppeak,Pplat,Raw in group B and group C were significantly lower than those in group A[(15.3 ± 1.8),(18.5 ± 2.6) cmH2O (1 cmH2O =0.098 kPa) vs.(23.2 ±3.3) cmH2O; (11.5 ± 1.6),(14.3 ± 1.4) cmH2O vs.(17.6 ±2.7) cmH2O; (10.8 ± 1.7),(12.5 ± 2.6) cmH2O/ (L·s) vs.(16.8 ± 3.0) cmH2O/ (L·s)],and the level of PaCO2 in group B and group C was significantly higher than that in group A [(48.8 ± 3.1),(40.2 ± 2.3) mmHg (1 mmHg =0.133 kPa) vs.(28.6 ± 3.8) mmHg],there was significant difference(P ＜ 0.01).The level of PaO2 and oxygenation index in three groups had no significant difference (P ＞ 0.05).There were no patients requiring readjustment of tide volume in group C,however,93.8％ (30/32) patients required readjustment of tide volume in group A and 81.2 ％ (26/32) in group B,there was significant difference (P ＜ 0.01).Conclusion Corrected body weight based on 8 ml/kg can be used to set the tide volume for mechanical ventilation during general anesthesia in obese patients with normal pulmonary function.

We experienced women's helpless plight of domestic violence and extramarital affairs through the data of survey and case records in Women's Federation.Women in modern society are still experiencing domestic violence from their husbands' abuse and spiritual betrayal that often can't be solved in time.All these cases fully reflected neglect of females and unfair treatment to women from social systems.According to the analysis based on realities,the above hurt women encountered in their lives goes against basic bioethical principles.Not only sufficient attention but also legal measures are required to promote the harmonious development of society.

Objective To evaluate the relationship between intraocular pressure (IOP) and anterior chamber angle in patients with different types of acute angle-closure glaucoma after phacoemulsification and intraocular lens implantation. Design Retrospective case series. Participants 173 cases of acute angle-closure glaucoma coexisting cataract (173 eyes) in Mingren Eye Hospital from January, 2005 to June, 2007. Methods All patients with acute angle-closure glaucoma underwent phacoemulsification and intraocular lens implantation, and were examined with high-frequency ultrasound biomicroscopy (UBM). Anterior chamber depth (ACD), intraocular pressure (IOP) and anterior chamber angle (ACA) were measured. Follow-up was 1-48 weeks after surgery. Main Outcome Measures Intraocular pressure, phacoemulsification complications, re-open rate of anterior chamber angle. Results At 8th week after surgery, the rate of IOP control in pupillary block group, non-pupillary blocking group, and multimechanism group was 88.9%, 52.0%, 83.4%, respectively and there was a statistically significant between these groups (?2=7.13, P=0.022). At 48th week, the rate of IOP control was 54.2%, 33.3%, 35.8%, respectively(?2=12.56, P=0.003). Fifty patients were follow up with UBM, and 66.7% in pupillary block group, 33.3% in non-pupillary blocking group and 33.3% in multimechanism group in 48 weeks postoperatively showed evidence of the widened anterior chamber angle. No specific postoperative complications were found in this study compared with those with phacoemulsification without glaucoma. Conclusions The use of phacoemulsification and intraocular lens implantation for acute angle-closure glaucoma coexsiting cataract can get best IOP-controlled rates in pupillary block group. It is related to the degree of widened anterior chamber angle.

Objective To investigate the anatomical features, operative method and efficacy of internal fixation in the treatment of iutra-articular fractures of caleaneum via the sinus tarsi approach. Methods The pathway, branches distribution and anastomosis of perforating descending branch of peroneal artery were observed on 18 adult cadaveric lower limbs. A sinus tarsi approach was designed. From July 2001 to January 2008, 71 intra-articular calcaneal fractures in 68 patients were treated with open reduction and internal fixation via sinus tarsi approach at lateral sides of calcaneus. According to the Sanders classification, there were 26 type Ⅱ fractures, 32 type Ⅲ fractures and 13 type Ⅳ fractures. Results All patients were followed up for a mean period of 39.3 months (13-85 months), and the fractures were completely healed. There was a significant difference in the length, width and height of the calcaneus, Bohler angle and Gissane angle before and after operation (P < 0.01). According to Maryland Foot Score, the operative effect was excellent in 33 feet, good in 29 feet, fair in 6 feet and poor in 3 feet. Conclusion Open reduction and internal fixation via sinus tarsi approach is an effective method for minimally invasive treatment of intraarticular fractures of the calcaneus, with the advantages of good clinical results and causing minimal damage to soft tissues.

after investigating the present situations of the AIDS prevalence and the prevention and treatment of AIDS in shanxi province,to analyze the problems of AIDS' social and ethics.Based on analyzing these problems,from the point of medical ethics & health Economic Ethics,aim at putting forward some counterplans,hope the prevention and treatment work of AIDS for shanxi province to promote a further Effectiveness.

Objective To investigate the value of combined use of laparoscopic cholecystectomy(LC)and duodenoscopic procedures in the treatment of gallbladder stones with common bile duct stones.Methods We retrospectively analyzed clinical data of 164 cases of gallbladder stones with common bile duct stones treated with laparoscopic cholecystectomy + endoscopic sphincterotomy(EST)from January 2003 to December 2007.Results All the cases underwent ERCP and endoscopic sphincterotomy(EST)followed by LC.In the 164 cases,196 bile duct stones were extracted from 155cases with a success rate of 94.5%.The procedures were unsuccessful in 9 cases,and among them,4 cases had stricture of bile duct more than 2 cm in length,and 5 cases had impacted stones that precluded passage of the guide wire.After EST,6 of the 155 cases had the complication of mild acute pancreatitis and LC was performed after its treatment.The success rate of LC was 96.5% and the average hospital stay was(11?4)d.Conclusions The combined use of EST and ERCP before LC is effective in treatment of gallbladder stones with common bile duct stones,and has broadened the utilization of minimally invasive treatment for bile duct diseases.

Objective To investigate the satisfaction degree of students and teachers towards PBL teaching method and to provide a basis for continuing to carry out PBL teaching.Methods Anonymous questionnaires of PBL teaching method in teaching plan and procedure was conducted among 49students (2008 grade) and teachers.SPSS 13.0 software package was used to analyze the data and P ＜ 0.05 stands for statistically significant differences.Results Both students and teachers were satisfied.Teachers' evaluation scores of 17 projects were all higher than 4 points and students' evaluation scores of 13 projects were all higher than 4 points; scores for the rest projects were all higher than 3 points.Conclusions PBL teaching method combined with stomatology is effective and measures should be taken to strengthen the management of PBL teaching in stomatology.

Objective To study the disinfection efficacy of c ompound disinfectant of peracetic acid. Methods Suspended liqu id quantitative sterilization test and metal corrosion test were carried out wit h different concentrations of disinfectant compound. Results T he killing rate of Bacillus subtilis var.niger spores e xposed to peracetic acid 500 mg*L-1 or available chlorine 300 mg*L-1 for 15 minutes was 99.94% and 97.91% respectively, while that of the spores e xpos ed to the compound disinfectant containing both of them reached 100%. The influ ence of organic substances on the bactericidal efficacy of this compound disinfe ctant was less than that on the bactericidal efficacy of the single ingredient. The corrosive effect of the compound disinfectant on the metals was milder than that of peracetic acid, but heavier than that of dichlorodimethylhydantoin. Conclusions Disinfectant efficacy of compound disinfectant increase s clearly, while metal corrosiveness decreases.

Objective Current study used quantitative research methods to reveal the regional medical information research in hotspots, and summarize the mainstream knowledge base to provide the reference for researchers in the field.Methods A systematic search was conducted to find publications in CNKI, Wanfang Database and PubMed.Bibliometrics method, social network analysis, coword analysis, principal component analysis and multidimensional scaling analysis were used in this study.Results ① total 11,482 articles published from 1984 to 2013 were screened out.The development of research publications showed an increasing trend, and the papers were distributed in 1233 types of journals.The number of authors who located in Beijing, Guangdong, Jiangsu, Shanghai,Shandong ranked top five.② The top 59 high frequency key words were identified that representing the hot contents in regional health information technology research field, and was used to build knowledge network map.Among them, HIS, electronic medical records, hospital information technology,information technology were at the core of this research area.③ We summarized research and development in the field of nine major mainstream knowledge base include: research on electronic medical records, medical personnel, information systems, information security, information networks, information sharing, information integration, information technology, and information management, resident' s health record related studies;qualitative analysis and problem-oriented research;HIS and telemedicine-related research;community related research, two-way referral related research, health care reform and cloud computing-related research, telemedicine related research and V43 related research.Conclusions The development of regional medical information research has good momentum and closely follow the international trend, but the research contents and methods are still distance from international standard..Research mostly focused on hospital information system construction, regional research and applied research are weak and need to be further improved.