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 investigate the clinical effect of precise percutaneous radiofrequency ablation of semilunar ganglion through fo -ramen ovale under the three-dimensional CT for the treatment of trigeminal neuralgia .Methods A total of 80 patients with primary trigeminal neuralgia in our hospital from August 2013 to December 2015 were selected,and they were randomly divided into two groups with 40 cases in each group .The control group was implemented blind detective radiofrequency ablation ,while the observation group was carried out under the three-dimensional CT positioning radiofrequency ablation .All the patients were followed up for 3 months after treatment .Compared the overall clinical results , and recorded the time of targeting the trigeminal nerve and the complications within 1 week after treatment between the two groups.The pain condition at different time points (before treatment,1 week and 3 months after treatment) between the two groups were com-pared.Results The positioning time of observation group was shorter than that of the control group ,the difference was significant (P<0.05). The VAS score of the observation group 1 week and 3 months after surgery was lower than the control group ,the difference was significant (P<0.05).The ratio of masticatory muscle weakness ,hypoacusis,facial swelling and congestion and corneal anesthesia of the observation group within 1 week postoperatively were lower than those of the control group ,the difference was significant (P<0.05).The effective rate of the observation group was higher than that of the control group ,the difference was significant (P<0.05).Conclusion Percutaneous radiofre-quency ablation of semilunar ganglion through foramen ovale under the three -dimensional CT for the treatment of trigeminal neuralgia has the advantages of more accurate positioning of the foramen ovale ,shorter operation time , and less complications ,which can relieve the pain of pa-tients and improve the overall clinical effect .

Objective To discuss the surgical method and efficacy of adult Dandy-Walker syndrome ( DWS) through retrospective anal-ysis and literature review .Methods There were 3 cases of adult DWS in our hospital from August 2010 to August 2011.One case of them was given posterior cranial fossa cyst peritoneal shunt , and the surgery adopted ordinary high voltage shunt .Case 2 was given left side of the lateral ventricle peritoneal shunt , and the surgery adopted ordinary high voltage shunt .Case 3 was given posterior cranial fossa cyst peritoneal shunt combined with left side of the lateral ventricle peritoneal shunt , and the surgery adopted double-end high voltage shunt .The two ends of the shunt were respectively linked with the diverter valve and abdominal cavity drainage tube through T -branch pipe .Results Among the 3 patients, there was 1 case failed to ease the headache symptoms , and it was relieved one month later .The preoperative symptoms of the oth-er 2 cases disappeared immediately after the surgery .During the 4 years of follow-up,preoperative symptoms of the 3 patients disappeared , and there was no positive signs .Conclusion For adult patients with symptomatic DWS ,shunt surgery can eliminate symptoms ,relieve the tension of the posterior fossa cyst ,achieve good curative effect , and there was no surgical complication .

Objective To investigate the efficacy and safety of non-blocking renal artery laparoscopic partial nephrectomy in the treat-ment of renal cell carcinoma of stage T 1~T2.Methods From January 2012 to May 2016,the 140 patients with renal cell carcinoma of stage T1~T2 were selected ,and their clinical data were retrospectively analyzed .All the patients were equally divided into the observation group and the control group with 70 patients in each group according to the different treatment methods .Patients of the observation group were trea-ted with non-blocking renal artery laparoscopic partial nephrectomy ,while patients of the control group were treated with blocking renal artery laparoscopic partial nephrectomy .Recorded the postoperative complications ,postoperative recovery condition and renal function changes of the two groups.Results All the patients completed the surgery sucessfully and there was no conversion to laparotomy .The perative time,amount of bleeding ,gastrointestinal recovery time and postoperative hospital stay in the observation group were less than those of the control group (P<0.05).The postoperative drainage and drainage tube indwelling time in the two groups were of no significant difference (P>0.05).One week after the operation , the incidence of secondary bleeding ,urinary leakage ,pulmonary infection ,incision infection ,renal infection and other complications in the observation group was 2.9%,which was significantly lower than 15.7%in the control group(P<0.05).The postoperative serum SCr values in the observation group and the control group were respectively (89.24 ±11.92)μmol/L and (137.24 ±11.49)μmol/L, which were significantly higher than (67.24 ±12.49)μmol/L and (68.14 ±13.11)μmol/L before the operation(P<0.05).In the mean time,the postoperative serum SCr values of the observation group was significantly lower than that of the control group (P<0.05).All the pa-tients were followed up to now , and the median survival time of the observation group and the control group were (25.32 ±3.14) months and (19.39 ±4.10) months respectively.That is to say,the median survival time of the observation group was significantly longer than that of the control group(t=4.209,P<0.05).Conclusion Non-blocking renal artery laparoscopic partial nephrectomy for treatment of renal cell car -cinoma of stage T1~T2 can avoid warm ischemia ,reduce postoperative complications ,protect renal function ,promote the patient ’ s recovery , and prolong the survival time ,which is a safe and effective method .

Objective To observe the clinical efficacy of procedure for prolapse and hemorrhoids ( PPH) for treatment of rectal mucosa prolapse.Methods The 100 patients who suffered from rectal mucosa prolapse and were planning to take surgical treatment for the first time in our hospital from June 2013 to June 2015 were randomly divided into the treatment group and the control group .Patients in the treatment group(n=50) underwent PPH while patients in the control group (n=50) underwent traditional simplified mucosal plication technique .To observe the therapeutic effect of the two groups ,the average operation time ,average length of stay in hospital ,postoperative pain within 72 hours,postoperative anal function and postoperative complications of the two groups .Results There was no significant difference in the over-all treatment effect between the two groups(P>0.05).The average operation time, average length of stay in hospital,postoperative pain with-in 72 hours and postoperative anal function of the treatment group were lower than those of the control group ,and the differences were significant (P<0.05).Bleeding and anal bearing-down occurred much less in the treatment group compared with the control group ,and the differences were statistically significant(P<0.05).But there was no significant difference in postoperative complications such as recurrence ,rectal steno-sis and anal incontinence (P>0.05).Conclusion Compare to the traditional simplified mucosal plication technique ,PPH technique has more advantages such as shorter operation time ,less anguish of patients,less complication,shorter hospitalization time,and higher security, which indicates PPH could become the preferred method for treatment of rectal mucosa prolapse .

Objective To assess the efficacy and safety of over-the-scope clip(OTSC) system in treatment of the perforation ,fistula and bleeding of the digestive tract .Methods The data of 33 patients who were treated with OTSC in our department were analyzed retrospective-ly,and the technical success rate ,clinical success rate and complications were statistically analyzed .Among the 33 patients,there were 14 pa-tients with upper gastrointestinal bleeding , 8 patients with postoperative fistula , and 11 patients with endoscopic full-thickness resection (EFTR) of gastric or duodenal bulb.Results The technical success rate and clinical success rate of 33 cases were 96.97% and 93.94%respectively,and there was no complication in all patients .Among them,the clinical success rate of the upper gastrointestinal bleeding was 92.85%,the anastomotic fistula was 75.00%,and the EFTR was 100%.Conclusion As a new type of clinical endoscopic suture system , OTSC is safe and effective in gastrointestinal bleeding ,perforation and fistula .