By discussion the experience of surgery teaching for foreign students by the methods of CBL+MCAI, the successful teaching experience are the followings: making sufficient preparations before lesson according to the features and difficulties in the foreign students' surgery teaching; Emphasis on CBL teaching methods and rational application of multimedia computer assisted instruction,strengthening the teaching disciphne of foreign students and the cultivation of the spirit of students' active learning.These measures stimulated the enthusiasm of students' active learning and improved the quality of teaching.

Accordingtothe analysis ofthe characters and difficulties ofskill ofanimal surgery,we divide the teaching process into three stages:theory classes,aseptic technique and basic operating techniques,animal practice.PBL+LBL double-track teaching methods is performed,which can make up the defect of PBL in practice and should be advocated and spread in the teaching of skill of animal surgery.

Objective To investigate the diagnostic values of endoscopic ultrasonography (EUS) and computed tomographic virtual endoscopy( CTVE) in protuberant lesions of upper gastrointestinal tract. Methods EUS and CTVE were used to diagnosis the 48 patients with protuberant lesions of upper gastrointestinal tract which were diagnosised by gastroscopy. All of the results except 11 cases were compared with pathological diagnosis. Results The accuracy of electronic gastroscopy, EUS and CTVE on the diagnosis of the protuberant lesions of the upper gastrointestinal tract were 16.7% ,89. 6% ,66. 7% , respectively . There was a significantly difference among them (P

Objective To discuss the safety and efficacy of retroperitoneal laparoscopic partial nephrectomy in the treatment of unilateral multifocal renal tumors.Methods The data of 12 patients with unilateral multifocal renal tumors managed with retroperitoneal laparoscopic partial nephrectomy between 2009 and 2012 were reviewed retrospectively.The 12 patients had a mean age of 42 years (28 to 62) and body mass index of 23.5 kg/m2 (18.6 to 29.3),including 4 males and 8 females.Four cases were in the left side,7 cases were in the right side,and 1 case had bilateral renal tumors.The diameter of renal tumors ranged from 0.5 cm to 4.7 cm,and all tumors were projected on the surface of kidney.Nine cases were diagnosed as renal cell carcinoma,and 3 cases were diagnosed as angiomyolipoma before operation.All patients underwent retroperitoneal laparoscopic partial nephrectomy under general anesthesia,while 1 patient with bilateral renal tumors experienced radical nephrectomy of the contralateral renal tumor 3 months after the first operation.Results All the oprations were successful without conversion to open surgery.The mean renal artery cut off time,operative time,estimated blood loss and hospital stay were 36 min (26-60),126 min (75-184),142 ml (50-300) and 5 d (3-9),respectively.No complication occurred and 1-week postoperative serum creatinine was (78.1 ±8.1)μmol/L.Histopathological study revealed 9 cases of renal cell carcinomaand 3 cases of angiomyolipoma.During the follow-up for 33 months (13-51),1 patient with yon Hippel-Lindau syndrome was operated with ipsilateral radical nephrectomy for a local recurrence while the remains had no local recurrence or metastasis.Conclusions For localized and exogenous unilateral multifocal renal tumors,retroperitoneal laparoscopic partial nephrectomy is feasible and safe.Those who have hereditary and/or malignant renal tumors should be monitored closely.

Objective To compare the safety and efficiency of retroperitoneal laparoscopic and transperitoneal laparoscopic radical nephrectomy by meta-analysis.Methods A systematic review of the literature about laparoscopic radical nephrectomy was performed,searching Medline,Embase,Cochrane library,CBM,CNKI,VIP and Wan Fang database from January 2000 to October 2012.The key words were transperitoneal,retroperitoneal,laparoscopy,radical nephrectomy.Two researchers evaluated the quality of included studies.A meta-analysis was conducted using Review Manager 5.0 software.Results Nine controlled clinical studies were concluded,including 1 306 patients (520 in retroperitoneal group and 786 in transperitoneal group).The extracted data were comparable.Meta-analysis results showed that significant difference existed in operative time and complication rate (OR =16.23,95％ CI 1.62,30.84; OR =2.44,95％CI 1.35,4.41) (P＜0.05).It seemed that the retroperitioneal laparoscopic radical nephrectomy was prior to the transperitoneal laparoscopic radical nephrectomy in those items.There was no significant difference between transperitoneal and retroperitioneal laparoscopic radical nephrectomy in incision length,estimated blood loss,stay-in hospital,conversion rate,5-year disease-free survival and 5-year overall survival (P＞ 0.05).Conclusions Retroperitoneal laparoscopic radical nephrectomy demonstrated significant lower operative time and complication rate than those in transperitoneal laparoscopic radical nephrectomy.However,there is no significant difference in efficacy.Each center can choose a modality according to their convention.

OBJECTIVE To investigate and analyze the incidence and related factors of nosocomial infection in old inpatients with cancers during radiotherapy and chemotherapy.METHODS Retrospective surveys of nosocomial infection were carried out in 236 old inpatients with cancers from Jan 2005 to Oct 2008.?2 Test was used to evaluate the difference significance of the data.RESULTS The surveys indicated the infection rate was 44.36% and without the sex difference.The infection rate among old inpatients with lung cancer was the highest and counted for 69.39% and then with radiotherapy and chemotherapy that was 56.96%.Respiratory infection was the main infection and counted for 51.27%.The hospital stay time correlated well with the infection rate of the inpatients.With the hospital stay time increasing,the infection rate also increased.Moreover,the predisposing factors of inpatients infection included poor nutrition,advanced stage of tumors,aggressive procedures,leukopenia and application of antibiotics.CONCLUSIONS The nosocomial infection rate of old inpatients with cancers during radiotherapy and chemotherapy is much higher than that of the elders with common diseases and that of the youngers with cancers.The incidence of nosocomial infection is related to the sites of the primary cancers,therapy methods,hospital stay,etc.We must emphasize and control the predisposing factors effectively,and reduce the occurrence of nosocomial infection.

Objective To apply the virtual reality training in clinical education of rehabilitation therapy. Methods 26 undergraduate students majored in rehabilitation therapy were randomly divided into 2 groups during clinical education of physiotherapy. The experimental group (n=14) received virtual reality training first, and then with routine teaching, while the control group (n=12) learnt with routine teaching only. Self-assessment and physiotherapy test were conducted after training. Results The experimental group reported more interested, initiative and positive in training than those of the control group. The experimental group achieved higher scores in practical tests than the control group (P<0.05), while no significant difference in the theoretical examination between the groups. Conclusion Application of virtual reality training may improve the teaching of physiotherapy.

Background:Irritable bowel syndrome(IBS)is a commonly seen functional intestinal disorder. Dietary factors are important factors affecting the abdominal symptoms of IBS patients. Aims:To investigate the effect of dietary factors on abdominal symptoms of IBS and the application of dietary adjustment strategy in patients lived in Xian,Shaanxi Province and the surrounding areas. Methods:Fifty-four outpatients with abdominal complaints who met the Rome Ⅲ criteria of IBS from Feb. 2015 to Jul. 2015 at the Second Affiliated Hospital of Xian Jiaotong University were enrolled. Twenty healthy volunteers were served as controls. All subjects completed a questionnaire containing issues mainly on IBS symptoms, eating habits,dietary factors causing abdominal symptoms,and the patients’coping styles. Results:Compared with healthy controls,more rice and less spicy food,fatty food,raw/ cold food,acidic beverages and alcohol drinking were observed in diet of IBS patients(P all < 0. 05). Abdominal symptoms of IBS patients could be caused or exacerbated predominantly by cold food(55. 6% ),fatty food(55. 6% ),raw food(48. 1% ),meat(48. 1% )and spicy food (40. 7% ). More than half of the IBS patients(63. 0% ) adopted an elimination diet to minimize their abdominal symptoms. Spicy food(59. 3% ),raw food(48. 1% ),cold food(44. 4% ),fatty food(44. 4% )and meat(37. 0% ) were the most frequently eliminated classes of food. Conclusions:Dietary factors can affect the abdominal symptoms of IBS in patients lived in Xian,Shaanxi Province and the surrounding areas and elimination diet based on foods they perceive as problematic is widely used. The classes of food and eating habits causing abdominal symptoms are quite different between domestic and overseas IBS patients.

Objective To evaluate the therapeutic effect of Pingyangmycin lipiodol emulsion (PLE) embolization for cavernous hemangioma of liver (CHL). Methods Seldinger technique was adopted and the catheter was super-selectively sent into the supplying artery of tumors in 18 CHL patients, 5-10 ml of Lidocaine and 5-20 ml of PLE were slowly injected. Before the embolization, 50-100 mg of pethidine was routinely injected. The embolization was conducted in several times in patients with large tumors, with multiple supplying arteries, and whose age was above 60 years. During the 3-48 months'follow-up after the operation,the change of the tumor diameter before and after the embolization was compared by using CT and ultrasound. The clinical symptomatic relief and the complications were also observed. Results The CHL of all the 18 cases were filled up by PLE. The foci were completely vanished in 9 cases, reduced by over 50% in 7 cases,and reduced by 25%-50% in 2 cases,respectively. The follow-up angiographic examination was performed in six cases, the tumor staining was completely vanished and the tumor-supplying artery was closed up. The improving rate of the clinical symtoms reached 89% . There were no serious complications. Conclusion The PLE embolization in hepatic cavernous hemangioma proves to be reliable, safe, minimally invasive, and with little side effect. This therapy, therefore, can be the first method of choice in treating the cavernous hemangioma of the liver.

PurposeThe restriction of strain ratio (SR) in the diagnosis of thyroid malignant tumor are caused mainly because of disadvantages including low sensitivity, in this research the authors used different calculation methods of strain ratio based on the size of tumors, to explore the clinical application value of them on the differentiation of benign and malignant thyroid nodules.Materials and Methods Data of 336 patients with thyroid nodule (340 nodules) who underwent elasticity imaging and ultrasound-guided fine-needle aspiration were retrospective analyzed, with the pathology combined follow up acted as golden standards, fixed surface area assay and true surface area assay of strain ratio were compared on the differential diagnosis of benign and malignant thyroid nodules with various size.Results Among 340 thyroid nodules, there were 91 small nodules and 249 big nodules. Pathological results showed that 36 of 91 small nodules and 104 of 249 big nodules were malignant, while the others were benign. The true surface area assay was significantly better for the diagnosis of smaller thyroid nodules with longitudinal diameter and transverse diameter<8 mm with higher consistency with pathology (χ2=20.89,P<0.01), and fixed surface area assay is more suitable of thyroid nodules with longitudinal diameter and transverse diameter>8mm (χ2=57.08,P<0.01). The sensitivity, specificity and consistency for the diagnosis of malignant nodules of true surface area assay were 57.10%, 83.00% and 72.30% (Kappa=0.413), which were 73.60%, 85.00% and 72.30% (Kappa=0.590) in the fixed surface area assay, and 85.00%, 85.50% and 85.30% (Kappa=0.699) in the selective usage of two methods according to the tumor size, respectively.Conclusion The sensitivity is highest when using the two methods selectively according to the nodule size, with a better consistence rate with pathological results as well.