Objective　To evaluate the value of CT virtual gastroscopy (CTVE) in clinical applications. Methods　52 patients (65 foci of stomach) were examined by CTVE combined with 2D CT, gastrointestinal series (GI) and fibric gastroscopy (FG). The accurate ratio in quantitative, locating, qualitative and staging diagnoses was compared. Results　CTVE demonstrated the diameter of 0.3 cm foci in stomach. The accurate ratio in quantitative, locating and qualitative diagnoses with combination of CT and CTVE was higher than that of GI (P<0.001 ) but lower that of FG (P>0.05); In staging, CTVE was better than GI and FG. Conclusion　CTVE is a complementary gastric examination, which can replace GI in the diagnosis of common physical gastrical diseases.

Objective Evaluation of application of looping vascushunt tubes in microsurgical total removal of para sinus meningiomas Methods Eighteen patients harboring para sinus meningiomas were treated in our hospital from Feb,2000 to Mar,2002,Tumors were located in the posterior two thirds superior sagittal sinus in 17 patients and in the congenitally isolated transverse sinus in one patient Looping vascushunt were applied in all cases and tumors were removed under microscope using microsurgical techniques Results Tumors and involved sinus walls were resected (Simpson grade Ⅰ) in all patients Venous sinus reconstruction were achieved in 12 patients using artificial blood vessels,sinus walls were repaired with duramater in 4 patient, venous sinus ligation was applied in two patients because of the sufficent collateral venous drainage All patients recovered and no mortality occurred Conclusions Application of vascushunt tubes is one of the important techniques in microsurgical total resection of para sinus meningiomas

Cultivation of Medical Humanism Spirit has special value in the teaching of psychiatry,but which was ignored in the teaching. This paper explored the way to integrate humanistic spirit education into the teaching process of psychiatry.

Objective The aims of this study were to assess the efficacy of video-assisted thoracoscopic extended thymectomy(VATET) as a treatment for non-thymomatous myasthenia gravis (NTMG) and to identify prognostic factors for thymectomy.Methods Retrospectively analyzed clinical datas of 112 patients received VATET for the treatment of NTMG.Clinical efficacy and variables influencing outcome were evaluated by Kaplan-Meier method and Cox proportional hazards regression analysis.Results At 3.2 years averaged (1.5-6.2 years) of follow-up,none of these patients were lost to follow up.According to the MGFA post-intervention status,54 patients(48.2％) obtained complete stable remission during follow-up,21 patients(18.8％) obtained pharmacologic remission,10 patients (8.9％) obtained minimal manifestations,7 patients (6.3％) improved,20 patients(17.8％) unchanged,and none of these patients were worse or died of MG.By multivariate analysis,the chance of complete stable remission was significantly increased when age ＜ 40 years (P ＜ 0.01,OR =3.468),symptom duration ＜ 12 months(P ＜ 0.01,OR =3.203) and the presence of thymic hyperplasia (P ＜ 0.01,OR =3.064).Conclusion Video-assisted thoracoscopic extended thymectomy achieved satisfactory long-term results in patients with nonthymomatous myasthenia gravis,while age,symptom duration,the presence of thymic hyperplasia correlated with response to operation.

Objective To investigate the modified methods and effects of the flaps with nutrient vessels of superficial vein-cutaneous nerve of lower limb which used for repair of the lower extremity soft-tissues defects.Methods Between December 2003 and September 2009, 18 patients were treated with this modified skin flap, in which 11 cases male; 7 cases were female, age from 5 to 73 years.Average age was 45.9 years.Repair parts: 4 cases of dorsal foot, 3 cases of foot, heel in 2 cases, the ankle weeks in 2 cases, calves under 1 / 3 of 7 cases, of which 8 cases of bone exposure wounds, tendons exposed in 3 cases.Surgical repair of soft tissue defect size of about 6 cm×4 cm-22 cm × 10 cm, which retained the donor sural nerve function retrograde sural nerve flap in 4 cases, with a thin layer of muscle retrograde sural nerve flap in 4 cases.Results All the flaps were survived completely without any complications.The appearance and functional results were satisfactory with following up for 3 to 36 months.18 cases of flap were survived completely, primary healing, without any complications such as vein congestion or engorgement.The 4 cases which remains the cutaneous nerve in site had an average recovery time about 13 days of the donor site.The innervated region of the cutaneous nerve had no acroesthesia or dysesthesia.Conclusion This modified operation methods of flap, enhanced the blood support of the flap, impmved the survive rates and also preserved the sensory function of the patients' donor site.This modified flap with nutrient vessels of superficial vein-cutaneous nerve is a convenient and safe method in repairing lower extremity soft-tissues defects.

Objective To investigate the relation between coagulation disorders and sepsis severity of infected patients.Methods In this retrospective study,75 patients,51 males,24 femalse,with age(55.8± 18.1),were included from January 2010 to March 2011.They were clinically diagnozed as infection,and had Thromboelastography(TEG)and routine coagulation test within 24 hours after admission to emergency department.They were divided into 3 groups based on SIRS and SOFA score within 24 hours after admission:a)infection group,patients without SIRS; b)sepsis group,patients with SIRS and SOFA score less than 5; c)severe sepsis group,patients with SOFA score greater than or equal to 5.LSD was used to compare between two groups if one-way ANOVA of three groups comparasion showed significant differences.Results In comparasion to sepsis group(n =29)and infection group(n =27),D-dimer elevated significantly in severe sepsis group(n =19)(F =3.388,P =0.004),and platelet count decreased significantly(F =3.839,P =0.026),INR and KPTT showed an increase trend without significant difference (F =2.657,P =0.077 ; F =2.782,P =0.069); TEG showed MA obviously decreased(F =5.841,P =0.004),while there were nostatistically significant differences among other data.Conclusions The extent of coagulation disorders and sepsis severity of infected patients is closely correlated to each other.

In this study ,we detected the positive rate of anti‐HBs and anti‐HBc antibody among the subject population in Fujian Medical University Union Hospital ,and to evaluate different detection methods of anti‐HBc antibody .The positive rate of anti‐HBs and anti‐HBc antibody were detected by chemiluminescent microparticle immunoassay (CMIA) and one‐step com‐petitive enzyme‐linked immunosorbent assay (ELISA) from the year 2012 to 2013 .The subject population was divided into three groups :group 1 with the age of less than 2 years old ,group 2 with the age of 2‐20 years old ,and group 3 with the age of more than 20 years old .The positive rates of anti‐HBV antibody in the different groups were analyzed .Furthermore ,anti‐HBc antibody of 92 samples selected from the immunized population was detected by CMIA and three kinds of ELISA reagents . Meanwhile ,the detection of anti‐HBc antibody by the same ELISA reagent but different operating modes were performed in these samples .The highest positive rate of anti‐HBs antibody was detected in group 1 ,and there was no significance difference of positive rate between two detection methods of anti‐HBs antibody among three groups .The positive rate of anti‐HBc anti‐body using CMIA was significantly lower than those with ELISA among group 1 and 2 .Among the 92 samples ,the positive rate of anti‐HBc antibody was 2 .2% using CMIA .With three kinds of method of ELISA reagent ,the positive rate of anti‐HBc antibody were 79 .3% ,82 .6% and 94 .6% ,respectively ,and there was no statistical significance among the results of three ELISA reagents .Anti‐HBc was not detected from 19 samples using ELISA methods with different operating modes .It's con‐cluded that the anti‐HBs antibody declined with the increase of age ,and it is necessary to discriminate the specific population to strengthen immune system .The obviously higher positive rate of anti‐HBc antibody was found by ELISA in immunized popula‐tion than that by CM IA . Concerning on the false positive of ELISA , specimen sampling with one specific test item or the CMIA method was recommended to detect the anti‐HBc antibody .

Objective To evaluate the safety and short‐term efficacy of delta‐shaped anastomosis in the Billroth‐I reconstruc‐tion of totally laparoscopic distal gastric cancer radical operation (TLDG) .Methods The clinical data in 35 patients with TLDG Delta anastomosis(TLDG group) and 35 patients with laparoscopic assisted distal gastric cancer radical operation (LADG) extraper‐itoneal anastomosis (LADG group) in the gastroenterology department of our hospital from January to December 2014 were ana‐lyzed retrospectively .The intraoperative bleeding volume ,operative time ,gastroenterological function recovery time ,hospitalization duration ,postoperative pathological examination results and hospitalization total cost were compared between the two groups .Re‐sults Seventy cases successfully completed the operation without the cases of conversion to laparotomy and death .The TLDG group had no anastomotic leakage ,bleeding and stenosis after operation ;while the LADG group had 1 case of gastroparesis ,1 case of anastomotic bleeding and 2 cases of anastomotic leakage .The introperative bleeding volume ,tumor size ,number of lymph nodes dissection and distant and proximal incisal margin distance had no statistically significant differences between the two groups (P>0 .05);the operation time ,digestive tract reconstruction time ,first exhaustion time ,time taking liquid diet and postoperative hospital stay time in the TLDG group were significantly shorter than those in LADG group (P< 0 .05) ,but the hospitalization cost was higher than that in the LADG group ,the differences were statistically significant (P<0 .05) .Conclusion The delta‐shaped anasto‐mosis technique is safe and feasible for using in LADG ,moreover has better short‐term effect .

Objective To explore the change of signal value in the fetal frontal lobe with gestational age in normal second-third trimester fetuses.Methods MRI findings of 125 normal second-third trimester fetuses were divided into 5 groups according to gesta-tional age (unit:week)including 1 7-21,22-26,27 -31,32 -36,37 -40,respectively.The signal values were measured in inferior frontal,middle and upper,respectively.Results The signal value of fetal frontal lobe in 5 groups were 387.38 ± 1 66.75,354.46 ± 1 74.78,342.24±141.23,338.90±1 10.94,310.23±1 18.62,respectively.The signal value was 341.77 ±149.22,35 1.00±145.1 6, 342.85±140.61 in inferior frontal,middle and upper,respectively.The signal value of frontal lobe was 350.34±147.68 in the left and 340.73±144.29 in the right.There were no significant statistical differences on fetal frontal lobe signal value in each group (P>0.05).But the signal value in the frontal lobe had a gradually decreasing trend with fetal age,along with the signal value in the central frontal was higher than the other two parts of the frontal lobe and the left is slightly higher than the right.Conclusion The signal values in frontal lobe of normal second-third trimester fetuses were gradually decreased as gestational age increasing,with the signal values in central frontal lobe was higher than that of in margin of frontal lobe,and the left side was slightly higher than the right.

Objective The anterior-lateral defect of foot that lost one of the three supporting point of foot can lead to collapse of the lateral longitudinal arch, overload of the first metatarsal heads, and painful callus formation. It is meaningful to investigate the effect of reconstructing the lateral forefoot defect with pedical fibular osteoseptocutaneous flap. Methods From March 1989 to June 2008, there were 38 patients with anterior-lateral defect of foot were constructed. The supporting point with the local distal based pedical fibular osteoseptocutaneous flap was constracted. Results All the 38 flaps survived. All 38 patients had been followed up from 6 months to 10 years (mean 23.5 months) postoperatively. The constructed supporting point of the foot was functional. The patients could walk freely with no pain, and was satisfied with the operation. Assessed with the rating system for foot and ankle established by the American Orthopaedic Foot And Anke Society, 8 patients got a score above 85, 23 patients between 75 to 85, 7 patients between 60 to 75. Conclusion It is effective that transferring local distal based pedical fibular osteoseptocutaneous flap to repair the anterior-lateral defect of foot.