Objective To observe the self-efficacy and body image changes of the patients with oral and maxillofacial deformity in pre-and post-operative.Methods 183 patients with oral and maxillofacial deformity and 200 relatives as control group were measured by applying General Self-Efficacy Scale (GSES) of Chinese version and Self-rating Scale of Body Image(SSBI).Postoperative satisfaction degree was scored by applying attitude measurement method of interval scale.Perioperative GSES,SSBI score,and postoperative satisfaction degree were statistically analyzed.Results GSES score (26.79 ± 5.26) was lower than that in control group in preoperative (29.69 ± 5.37),and the difference was statistically significant (P ＜ 0.05).While SSBI score (24.35 ± 8.59) was higher than that in control group(11.04 ± 6.67),and the difference was also statistically significant (P ＜ 0.05).GSES score in postoperative(29.52 ± 3.80) was significantly higher than that in preoperative (P ＜ 0.05).SSBI score in postoperative(18.88 ± 8.19) was significantly higher than that in preoperative (P ＜ 0.05).Postoperative satisfaction was comparatively lower for the patients whose GSES score was higher than 32 and 36 for SSBI in preoperative.Conclusion Oporation can enhance the self-efficacy of patients with oral and maxillofacial deformity and reduce the incidence of patients with body dysmorphic disorder tendency.

Objective To investigate the correlation between pancreatic nuclear factor-κB (NF-κB) activation, cell apoptosis and pancreatic injury. To determine effects of N-acetylcysteine (NAC) on pancreatic injury in rats with acute necrotizing pancreatitis (ANP). Methods Thirty-three Wistar rats were divided into five groups: normal group, normal saline (NS) group, ANP group, prophylactic and therapeutic groups with NAC randomly. ANP was produced by 3.5% sodium taurocholate retrograde injection. In the prophylactic group, rats received intravenous (i. v.) injection of NAC (300 mg/kg) 1 hour before taurocholate injection and in the therapeutic group, NAC i.v. injection was given 1 hour after sodium taurocholate injection. Animals were sacrificed at 12 hours after induction of pancreatitis. Activation of NF-KB in pancreatic tissues was determined by electrophoretic mobility shift assay(EMSA). Cell apoptosis was assessed by modified TUNEL method. The following parameters were also measured: plasma levels of amylase and lipase, pancreatic wet/dry weight ratio and histologic grading. Results Taurocholate pancreatitis is characteristic of necrosis, haemorrhage, and severe leukocyte infiltration in the pancreas. Plasma amylase and lipase levels, pancreatic wet/dry weight ratio increased in rats of ANP. NF-κB banding activity was higher after pancreatitis induction (6.03±0.41). When NAC was given 1 hour before induction of pancreatitis, the activation (3.28±0.42) of NF-κB was prevented with significantly decreased severity of pancreatitis as assessed by amylase, pancreatic wet/dry weight ratio. The number of apoptotic cells in pancreatic tissue sections was greater in rats treated with NAC than in rats not treated with NAC. There was a negative correlation between NF-κB banding activity and apoptosis of pancreatic cells (r=-0.96, P< 0.01) and there was a positive correlation between NF-κB activation and histopathological score (r=0.63, P<0.01). Histopathological score of pancreatic injury had negative correlation with apoptosis of pancreatic cells(r=-0.98, P<0.01). Conclusion Early blocked NF-κB activation with NAC increases cell apoptosis in pancreatic tissue and decreases edema of pancreas and severity of pancreatitis in rats with ANP.

Humanities education in military medical university must have military feature in mind.According to special military demand, this education should combine teaching with military historical tradition, historical task, construction of curricula set-up system, and the reality of military campus culture construction to make this education have pertinence.

Objective To explore detection value of vacuum sealing drainage in osteomyelitis of sternum after cardio-thoracic surgery operation.Methods 132 cases of osteomyelitis of sternum after cardio-thoracic surgery operation were randomly divided into two groups(research group and control group).The research group had 72 cases)and the control group had 60 cases.The control group was treated with conventional treatment.The research group was treated with vacuum sealing drainage.The average healing time and clinical therapeutic effect of the two groups were observed.Results The patients'age and the sternum of osteomyelitis was significantly related,with OR=1.153 and P＜0.05.After treatment,the average healing time of the research group was(3.1±0.8)months.The average healing time of the control group was(7.2±1.5)months.The average healing time of the two groups had significant difference(P＜0.05).Conclusion Vacuum sealing drainage in osteomyelitis of sternum after cardio-thoracic surgery operation has sure curative effect.It can change chronic wounds for acute tissue effectively,shorten the healing time.It has high application value in the first phase of treatment and the second phase of repair.

Objective To summarize experience of diagnosis and treatment of the mucin-producing bile duct tumors(MPBTs). Methods Clinicopathological features of 7 patients with MPBT undergoing surgery from Nov 2002 to May 2005,were retrospectively reviewed.The clinical radiography characteristics and the resection type were summarized respectively. Results Fluctuant iaundice was the most common manifestation of MPBTs,with different characteristics of magnetic resonance cholangiopancreatography when compared with gallbladder carcinoma,hilar cholangiocarcinoma and distal bile duct cancer.All the 7 patients with MPBT underwent successful surgical resection and were cured. Conclusion Appropriate diagnosis and treatment of MPBTs made it possible to achieve long-term survival of these patients.

Objective To investigate the technical difficulties and the avoidance of complications in delayed laparoscopic cholecystectomy (LC) for acute cholecystitis (AC).MethodsThe results of LC carried out on 133 consecutive patients with AC between February 2004 and August 2008 were retrospectively studied.The outcomes were compared between patients who received LC for AC within 72 hours (the early group) and those after 72 hours (the delayed group).There were 34 patients in the early group and 99 in the delayed group.During LC,Calot's triangle was carefully dissected,and the relationship of the cystic duct to the CBD and common hepatic duct was clearly identified.Retrograde cholecystectomy in 2 patients was used when the Calot's triangle was poorly identified.Laparoscopic subtotal cholecystectomy was carried out in 4 patients whose inflammation or fibrosis precluded dissection of the Calot's triangle.ResultsThere was no conversion to open cholecystectomy,biliary tract injury,biliary leak,or any other intraoperative or postoperative complications.There was no 30day readmission in the 2 groups.Patients who received delayed LC had a significantly longer operation time [(44.1±5.32) vs (66.4±3.05)rnin,P＜0.01].There was no significant difference in wound infection rates in the 2 groups (1/34 2.94 ％ vs 2/99 2.02 ％,P＞0.05).ConclusionsDelayed LC was as feasible and safe as early LC in the treatment of AC.Delayed LC was technically more demanding than early LC.

Objective To investigate the effects of Houpupaiqi mixture on the recovery of gastrointestinal function after open gastrointestinal surgery,and evaluate the efficacy and safety of Houpupaiqi mixture.Methods A total of 144 selected patients who underwent open gastrointestinal surgery were enrolled into the multi-center prospective randomized double-blind controlled clinical trial from October 2010 to September 2011.Of the 144 patients,66 were from People's Hospital of Peking University,72 were from Beijing Friendship Hospital of Capital University of Medical Sciences,and 6 were from People's Hospital of Guangdong Province.All the patients were randomly divided into 2 groups (test group:96 patients,control group:48 patients) at the ratio of 2∶1 according to the random number table.Five patients who did not meet the criteria were excluded from the study,and then there were 92 patients in the test group and 47 patients in the control group.The study was assessed by the ethics committees,and all the patients signed the informed consent form.Houpupaiqi mixture (50 ml) or placebo (50 ml) were administered in the test group and control group at postoperative 16 and 20 hours,respectively.Parenteral and enteral nutritional support were given after pulling out of gastric tube.A standard intravenous analgesia was applied in the 2 groups,and agents which stimulate or suppress gastrointestinal motility were prohibited.The time for the recovery of regular bowel sounds,the first exhaust and first defecation time,and the time of first solid food intake of the 2 groups were recorded.Vital signs were recored before operation and after drug administration.Blood and urinary routine test,hepatic and renal function test,electrocardiogram examination,record of adverse drug event were carried out at postoperative day 6.The time for the indexes above and relevant frequencies were calculated,and the survival curve were drawn by Kaplan-Meier method.All the time points were analyzed using the Log-rank test.The measurement data were analyzed using the t test or rank-sum test,and the enumeration data were analyzed using the chi-square test or Fisher exact probability.Results The median time for the recovery of regular bowel sounds,median time for first exhaust and defecation were 21.4 (20.0,23.7)hours,45.0 (40.0,54.0) hours and 65.5 (54.7,74.0) hours in the test group,and 47.5 (44.0,56.5) hours,91.0 (87.0,93.8)hours,98.0 (94.0,113.5)hours in the control group,there were significant differences between the 2 groups (Log-rank values =21.67,53.15,11.81,P＜0.05).The median time of first solid food intake were 72.5 (66.2,110.5) hours of the test group and 116.3 (114.8,117.3) hours of the control group,with no significant difference between the 2 groups (Log-rank value =13.70,P ＞ 0.05).There were no significant differences in the body temperature,respiration,heart rate,systolic blood pressure and diastolic blood pressure before and after medication between the 2 groups (Z =0.03,0.68,0.97,0.22,0.72,P ＞ 0.05).There were no significant differences in the number of patients with abnormal results of blood test,hepatic function,renal function and electrocardiogram between the 2 groups (P ＞ 0.05).No severe adverse event was observed in the clinical trial.Conclusion Houpupaiqi mixture significantly promotes the recovery of gastrointestinal function of the patients who underwent open gastrointestinal surgery with relatively low adverse events.

ObjectiveTo evaluate treatment of type 2 diabetes mellitus (T2DM) by laparoscopic Roux-en-Y gastric bypass (LRYGB) using different amastomoses. MethodsTwenty one T2DM patients were divided into two groups:transoral EEA (OrVil) and Endo-GIA according to ways of gastrointestinal anatomosis andunderwentLRYGB. Clinicaldataincluding outcomeof operation, complications,preoperative and postoperative oral glucose tolerance test (OGTT),Homa-IR,Homa-β,blood lipid and nutrition status were analyzed.ResultsLRYGB procedures were successfully performed in all the 21 patients with no conversion to open surgery.The difference of intraoperative blood loss,postoperative recovery time between two groups was not significant.The mean operation time in OrVil group ( 126 ± 29 )mins was shorter than that in Endo-GIA group ( 156 ± 28 ) mins ( P ＜ 0.05 ),but at the same time,the mean expenditure was higher. Evaluated on three months after operation,the T2DM cure rate was 78％,and effective rate was 100％ in OrVil goup and those were 83％,100％ respectively in Endo-GIA group.No postoperative malnutrition, anemia or severe complication occurred.ConclusionsThe efficiency of laparoscopic Roux-en-Y gastric bypass using different amastomoses was same in the treatment of type 2 diabetes mellitus.The operation time was shorter in OrVil group but the expenditure was higher.

Objective To evaluate the efficacy and safety of wuling capsule compared with deanxit in treatment of patients with depression or anxiety status. Methods A total of 139 patients with depression or anxiety status were enrolled in a multi-center double blind clinical trial. All patients were randomized into two groups, 67 patients in wuling capsule group and 73 patients in deanxit group. Efficacy and adverse effects were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD),Pittsburgh Sleep Quality Index (PSQI) and Treatment Emergent Symptoms Scale (TESS) before treatment and 1, 2, 4, 6 weeks after treatment to verify the noninferiority of wuling capsule. Results There was no significant difference in score decline of HAMA and HAMD between the two groups (HAMA: wuling vs deanxit group: 9.0 ± 5.4 vs 10.3 ± 5.4, F = 2.11, P =0.148 ; HAMD: wuling vs deanxit: 9.1±5.6 vs 10.5±5.7, F = 1.61, P=0.207). There was no significant difference in response rate and remission rate between the two groups. No significant difference was found in score decline of PSQI between the two groups (wuling vs deanxit group: 4.1±4.5 vs 5.0 ± 4.2, F = 0.72, P=0.192). The incidence of adverse events was 41% in the wuling group and 55% in the deanxit group respectively. The main adverse effects were symptoms of gastrointestinal and neurology system. Conclusion Safe and well tolerated, wuling capsule improves the anxiety, depression and insomnia symptoms of patients with depression or anxiety status.

Objective To investigate the clinical characteristics of acute inhalational metallic nickel poisoning and its treatment effect.Methods Data including epidemiology,clinical features,laboratory tests,imaging examinations,therapy protocol as well as prognosis were collected and analyzed.Results Thoracic CT scan of all patients demonstrated as bilateral diffuse infiltration.Nickel concentration in both blood and urine were high in all patients and the concentration was positively associated with poisoning severity.All 4 patients received glucocorticoid treatment,2 of whom with acute respiratory distress syndrome were admitted to ICU to initiate mechanical ventilation and were given sodium dimercaptopropanesulfonate.All patients survived to hospital discharge.Conclusions Acute inhalational metallic nickel poisoning is uncommon and early symptoms are inconclusive.The blood and urine nickel concentration is helpful to judge the severity of the disease.Pulmonary diffuse infiltration is the main clinical feature.Glucocorticoid,chelation therapy as well as symptomatic treatment are effective therapies to relief disease severity.