Objective To evaluate the analgesic effect of oxycodone hydrochloride and morphine in preemptive analgesia for abdominal surgery.Methods The 200 patients who received abdominal operation were randomly divided into the oxycodone hydrochloride group (group O) and the morphine group(group M) with 100 patients in each group,and patients of the two groups were given oxycodone hydrochloride and morphine in preemptive analgesia respectively .The VAS, OAA/S and BCS 48 hours after surgery , the frequency of the use of PCIA in 24 hours,the satisfaction of patients ,and the occurrence rate of complications were compared between the two groups .Results There was no significant difference between the two groups in VAS ,BCS,OAA/S,frequency of the use of PCIA and patients satisfaction (P>0.05).The occurrence rate of nausea,vomit,and itch in group O were much lower than that in group M (P<0.05).The occurrence rate of drowsiness in group O was higher than that of group M(P<0.05).Conclusion Compared with morphine,oxycodone hydrochloride has the same analgesia efficiency and less side effect occurrence rate for patients with abdominal operation .

Objective To explore the clinical effect of the treatment for fresh achilles tendon rupture by modified double Kessler suture with S type incision .Methods Totally 21 cases of fresh achilles tendon rupture were admitted into our hospital from January 2012 to Decem-ber 2015, and they were treated by S type incision modified double Kessler suture within 7 days (averagely 4.1 days).Observed the postop-erative complications and evaluated the efficacy with Arner-Lindholm.Results All the 21 patients were followed for 6 to 24 months ( aver-agely 12 months).There was no incision infection ,necrosis, re-fracture of achilles tendon and other complications .There were 16 cases of excellent and 5 cases of good , with the excellent and good rate of 100% through the Arner-Lindholm evaluation criteria .Conclusion Modified double Kessler suture with S incision for the treatment of fresh achilles tendon rupture is conducive to early functional exercise ,and it can obtain satisfactory clinical efficacy .

Objective To compare the advantages and disadvantages of internal jugular vein and subclavian vein puncture approach by clinical and anatomical ways so as to explore the best way of establishing a central venous access to guide clinical work .Methods The 120 patients who were admitted into our hospital from January 2014 to January 2016 were randomly divided into the internal jugular vein group and the subclavian vein group with 60 cases in each group according to puncture approach , and the puncture were operated by the same group of physicians .The learning curve ,puncture success rate ,completion time ,complication rates and other indicators of the two groups were evalua-ted.Results The operating completion time of internal jugular vein puncture group was (22.00 ±5.58)minutes,the success rate was 52%, the learning curve was 12 cases;while the subclavian vein puncture group was (11.60 ±2.67)minutes,93% and 3 cases respectively,and the differences were statistically significant between the two groups (P<0.05).The total complication rate of the internal jugular vein punc-ture group was 58%while the subclavian vein group was 12%, and the difference was statistically significant (P<0.05).Conclusion Dif-ficulty,safety and complication rates of subclavian vein puncture approach were better than those of the internal jugular vein puncture ap -proach.Therefore, subclavian vein puncture approach should be the first choice when there’s a need to establish central venous access for rescuing severe patients such as shock .

Objective To summarise the clinical characteristics and surgical treatment experience of primary cardiac tumours treated by tumorectomy under extracorporeal circulation .Methods The clinical data of 352 patients with primary cardiac tumors in our hospital from January 1980 to December 2015,who received surgical treatment of tumorectomy under extracorporeal circulation were retrospectively ana -lyzed.Results Among the 352 cases in all, there were 338 cases (96%) of benign tumor, including 309 cases (87.8%) of myxoma and 14 cases (4.0%) of malignant tumor.There were 4 cases of perioperative death, and all the 4 cases were malignant tumor.Conclusion Myxoma is the most common primary cardiac tumor ,and the best solution for the cardiac benign tumor is surgery .However , the effect of sur-gical operation on malignant cardiac tumors was poor .

Objective To investigate the effects of melatonin on the changes of superoxide dismutase ( SOD ) , reactive oxygen species (ROS),and malondialdehyde(MDA) in N2A cells under hypoxia conditions.Methods Randomly divided the primary cultured neuroblasto-ma cells of mouse into the control group ,hypoxia group ,and MT treatment group .The MT treatment group were given melatonin 5μg/mL for 24 h to set up the treatment model .Rsbiotech of the hypoxia group and MT treatment group were given gaseous mixture of 95%N2 and 5%CO2 ,The ischemia hypoxia model of N 2A cells was set up with cells in the oxidative stress state and cultured for 24 hours at low concentra-tions of serum .The content of SOD , ROS, and MDA was measured respectively by xanthine oxidase , fluorogenic quantitative detection and thiobarbituric acid chromatometry .Results The expression of SOD in hypoxia group and MT treatment group were significantly decreased compared with that in control group(P<0.05).The level of SOD in MT treatment group significantly recovered compared with hypoxia group with singnificant difference (P<0.05).The expression of MDA and ROS in hypoxia group and MT treatment group were significantly in-creased compared with that in control group (P<0.05).The level of MDA and ROS in MT treatment group significantly recovered compared with hypoxia group with singnificant difference (P<0.05).Conclsion Melatonin provides a protective effect on the secondary damage of nerve cells with hypoxia ischemia .The possible mechanism is melatonin could play the role of free radical scavenging and up -regulate the ex-pression level of antioxidants .

Objective To evaluate the effect of plastic surgery for scar contracture after hand burn.Methods Clinical treatment data of 56 patients with scar contracture after hand burn was collected from December 2011 to December 2016.Different surgery methods were adopted to treat the scar contracture after hand burn according to different degree,different sites and different range.Results All cases were operated successfully,and the appearance and function of the hands were almost recovered during the 6 months' follow-up,without contracture again.Conclusion Appropriate surgical programs should be used in scar contracture with different parts and degrees,and reasonable postoperative rehabilitation can improve the function and appearance of hands better,which can avoid secondum contracture.

Objective To investigate the related factors of de novo stress urinary incontinence after pelvic floor reconstruction.Methods Retrospectively analyzed the clinical data of 714 patients who acceptted pelvic reconstruction surgery in our hospital from November 30,2005 to November 30,2015.Among the 714 cases,there were 544 cases without preoperative urinary incontinence.The possible related factors of de novo SUI caused by operation were statistically analyzed.Results There were 151 cases of de novo stress urinary incontinence after pelvic floor reconstruction,the incidence was about 30.5%.With a history of diabetes,fetal delivery,pelvic surgery and POP surgery(laparoscopic vaginal apical fixation of sacrum) were the risk factors for de novo stress urinary incontinence after pelvic floor reconstruction,and the OR values were 2.575,5.286,1.671 and 1 respectively.There was no correlation between other general data and POP stage(P<0.05).Conclusion When performing pelvic floor reconstruction surgery for POP patients with high risk factors,it's better to have urinary incontinence surgery simultaneously according to individual circumstances and wishes.

Objective To explore the clinic effect of intravascular stent angioplasty for extracranial internal carotid artery dissection(ICAD).Methods From July 2015 to December 2016, 25 cases of patients with extracranial ICAD were admitted into our hospital.Among them, there were 15 cases of head and neck pain,12 cases with transient ischemic or cerebral infarction symptoms (limb hemiplegia.etc.),6 cases of Horner syndrome,1 case with pulsatile tinnitus and syncope,2 cases with no obvious clinical symptoms which were found by the neck vascular ultrasound accidentally.All patients were treated with intravascular stent angioplasty.Calculated the degree of stenosis through digital subtraction angiography(DSA),measured the blood flow velocity with transcranial doppler(TCD),and observed the clinical manifestations.Reviewed those patients after six months.Results Totally 24 patients with ICAD fulfilled the intravascular stent angioplasty with no complications such as lining damage,bleeding and embolism.And one patient with ICAD abandoned intravascular stent angioplasty for the vascular is too circuity.DSA showed the average artery stenosis decreased from (76.70±10.57)% preoperatively to (11.07±4.18)% immediately after operation,and the difference was statistically significant(P<0.01).TCD measured the peak systolic velocity (PSV) of internal carotid artery stenosis segment,and the PSV changed from (189.55±54.27)cm/s averagely before operation to (88.41±17.06)cm/s on average one week after operation.The difference was statistically significant (P<0.01).Reviewed the head and neck CT angiography (CTA) after 6 months.There were 23 cases without new stenosis and 1 case had stent restenosis compared with CTA immediately after operation.Symptoms of 19 cases obviously remitted or disappeared,4 cases partially remitted,and recurrence occured in 1 patient.There was no appearance of infarction and other serious complications.Conclusion The intravascular stent angioplasty is relatively safe and effective for extracranial ICAD, which can remit the degree of stenosis,slow down the blood flow and relieve the clinical symptoms with low recent recurrence rate and adverse reaction.But it does not apply to patients with severe vascular circuity.

Objective To explore the diagnosis value of narrow-band imaging magnifying endoscopy (NBI-ME) in the early esophageal cancer and precancerous lesions while estimating the quality,depth and treatment strategy.Methods One hundred and eleven cases of patients with suspected early esophageal cancer and precancerous lesions,who underwent ESD treatment,were selected as the study subjects.To estimate the diagnosis value of NBI-ME in the quality,depth and treatment strategy with pathological histology as gold standard.Results While estimating quality,there was no low grade intraepithelial neoplasia(LGIN) cases with NBI-ME.A total of 33 cases were diagnosed as high grade intraepithelial neoplasia(HGIN),including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,and the other 78 cases were diagnosed as early esophageal cancer,including 5 cases of LGIN,22 cases of HGIN,and 51 cases of early esophageal cancer.Compared with the pathology results,the quality consistency of NBI-ME is general:K=0.498.While estimating depth,there was no LGIN cases with NBI-ME.A total of 33 cases were diagnosed as HGIN,including 30 cases of HGIN and 3 cases of LGIN after ESD treatment,67 cases were diagnosed as intramucosal carcinoma,including 5 cases of LGIN,22 cases of HGIN,30 cases of intramucosal carcinoma,and 10 cases of submucosal carcinoma after ESD treatment,and 11 cases were diagnosed as submucosal carcinoma.Compared with the pathology results,the depth consistency of NBI-ME is general:K=0.469.Most of the patients shoud be treated by ESD except 8 cases of LGIN.Conclusion The study shows general diagnosis value of NBI-ME in estimating quality,depth and treatment strategy of early esophageal cancer and precancerous lesions.

Objective To compare the therapeutic effects and side effects of cisplatin-S-1 (CS) program and docetaxel-cisplatin-S-1(DCS) program on patients with malignant gastric tumor who were treated by laparoscopic gastrectomy.MethodsA total of 67 patients in our hospital from January 2010 to June 2013 were included in this study,of which 33 cases accepted cisplatin-S-1 program (CS group),34 cases accepted DCS program (DCS group).The related side effects including diarrhea,nausea and acute upper respiratory infection,change of routine blood tests,blood biochemical index,and death caused by chemotherapy were analyzed.The related index of surgery including operation time,blood loss,recovery time of gastrointestinal function,pain incidence,hospital stay,lymph nodes resection success rate,postoperative infection,obstruction,intestinal emptying delays were recorded.Meanwhile,the 3-year survival rate after operation and postoperative 3-year recurrence rate between the two groups were compared.Results There was no significant difference in operation time,intraoperative blood loss,postoperative recovery time of gastrointestinal function,the lymph nodes resection success rate,the incidence of postoperative pain,as well as the length of hospital stay,postoperative infection rate,and complications such as obstruction and intestinal emptying delays between the two groups(P>0.05).And there was no significant difference in chemotherapy-related complications between the two groups(P>0.05).But the postoperative 3-year survival rate and postoperative 3-year recurrence rate of DCS group was better than those of the CS Group(P<0.05).Conclusion There is no significant difference in complications and surgery-related index between the two preoperative chemotherapy.However,the DCS programs have more advantages in therapeutic effects.