Objective To evaluate the effect of laparoscopic cholecystectomy(LC) combined with bile duct exploration and stone removal(BDE) and LC with endoscopic sphincterotomy(EST) in treating cholecystolithiasis with choledocholithiasis.Methods Among 256 cases of cholecystolithiasis and choledocholithlasis,132 patients were treated by LC+LCBDE,and 124 cases by EST combined with LC.The operation success rate,operation time and cost,complication rate,and length of hospital stay of the two groups were compared.Results There was no statistical difference in the operation success rate,complication rate,stone clearance rate,and average hospital stay between the two groups,but EST+LC group had significantly longer operation time and higher cost.Conclusions There are respective indications,advantages and disadvantages in the two groups.EST+LC is the better choice for patients with diameter of CBD1.0cm and with multiple choledocholithiasis,especially for middle-aged patients,the better way is LC+LCBDE.

Objective To evaluate the effect of LC+LCBDE and EST+LC in treating the cho-leeystolithiasis with choledocholithiasis. Methods The clinical data of 256 patients treated in our hos-pital were retrospectively analyzed. Of the 256 patients, 132 were treated by LC+LCBDE and 124 by EST combined with LC. The clinical data of the two groups was compared in operation success rate, operation time and cost, complication rate and operative hospital stay. Results There was no statisti-cal difference in the operation success rate, complication rate, operative hospital stay between 2 groups. However, there were significant differences in the operation time and cost between the 2 gruops. Conclusion There are respective indications, advantages and disadvantages in the two groups. EST+LC is the better choice for patients with a CBD<1.0 cm in diameter, stones impacted in the distal CBD, or old age. Otherwise, the better way is LC+LCBDE for patients with a CBD>1. 0 cm in diameter and multiple choledocholithiasis, especially in young and middle-aged people.

Objective:To explore the antipyretic effect on rabbit fever induced by endotoxin and the anti-inflammatory effect on the increase of mouse abdominal cavity capillary permeability caused by 0. 6% glacial acetic acid of Bazhong gardenia. Methods:The rab-bit fever model was made by ear margin vein injection of endotoxin in physiological saline solution, and the mouse inflammation model of abdominal cavity capillary permeability increase was established by 0. 6% glacial acetic acid solution. The animals were respectively intragastrically administrated with gardenia water-soluble effective parts and 70% alcohol-soluble effective parts. The rabbit body tem-perature and mouse celiac fluid absorbance values were detected. The effects of gardenia from different habitats were studied and com-pared. Results:The antipyretic effect of water-soluble effective parts from Bazhong gardenia extract was better than that of gardenia ex-tract from Jiangxi, Hubei and Jiangjin (P<0. 01), and that of alcohol-soluble effective parts from Bazhong gardenia extract was better than that of gardenia extract from Jiangjin and Jiangxi (P<0. 05 or 0. 01). Although compared with that of Hubei gardenia, the anti-pyretic effect of alcohol-soluble effective parts from Bazhong gardenia extract was weaker than that of gardenia extract from Hubei, the difference was not significant (P>0. 05). Bazhong gardenia could inhibit the increase of abdominal blood capillary permeability in mouse inflammation model, and the effect was better than the other gardenia, however without significant difference (P>0. 05). Con-clusion:Bazhong gardenia shows better antipyretic effect compared with that from other habitats.

Objective To evaluate the clinic effect of local resection plus axialla lympha nodes dissection on treating early stage breast cancer. Methods 112 cases of early stage breast cancer in PLA309 Hospital were divided into 2 groups: local resection plus axially dissection group (46 cases) and Halsted's operation group (66 cases). The survival rate,local recurrence rate,metastasis rate, and casmetic effect of breast were followed up for long time. Results In treatment group, the 3,5,8 years survival rates were 97.8%, 80.5%, 76.1% respectively. In control group 3,5,8 years survival rates were 97.0%, 87.9% and 71.2% respectively. The rate of local recurrence was 4.3% in treatment group and 4.6% in control group.The metastasis rate in treatment group was 19.6%, in control group was 16.7%. 93.2% of patients in treatment group kept good breast figure. Conclusions Local resection plus axially dissection, with the same effect as Halsted procedure, is an ideal method in treating early stage breast cancer.

ObjectiveTo explore the effect of cluster needing of scalp point combined with rehabilitation techniques on acute cerebral infarction patient's movement disturbance.MethodsFugl-Meyer Measure, Bathel Index, Nerve function disturbance and clinical effect assessment methods were used to assess the motion function and daily living activity of cluster needling of scalp point group, rehabilitation group and cluster needling of scalp point combined with rehabilitation group.ResultsThe motion function and daily living activity of the cluster needling of scalp point combined with rehabilitation group patients were superior to cluster needling of scalp point group patients and rehabilitation group patients (P<0.01,P<0.05). The total effective rate can reach to 97.14%. Otherwise, cluster needling of scalp point combined with rehabilitation could also prevent food drop or inversion, subluxation of acromioclavicular joint, shoulder-hand syndrome, contracture of joint, mistake-use syndrome and abnormal motor mode.ConclusionThe cluster needling of scalp point combined with rehabilitation can improve the patients' living quality effectively.

Objective To investigate the effect and safety of eurycoma longifolia in the treatment of erectile dysfunction(ED) in climacteric males.Methods One hundred and thirty-four climacteric males with ED were divided into the observation group and control group,67 cases in each group.The observation group was given the therapy of eurycoma longifolia and the control group was treated with testosterone undecanoate.After 3-month treatment,the scores of EHS,SHIM,AMS,EDITS,changes of serum to-tal testosterone(TT),free testesterone(FT),luteinizing hormone(LH),follicle stimulating hormone(FSH)and sex hormone-bind-ing globulin(SHGB)and complication occurrence rate were compared between the two groups.Results After 3-month treatment, the scores of EHS,SHIM,AMS and EDITS,and serum TT and FT levels in the two groups were significantly improved(P<0.05),moreover the results in the observation group were better than those in the control group(P<0.05);serum LH and FSH in the observation group had no obvious changes compared with before treatment(P>0.05),while which in the control group were significantly decreased compared with before treatment(P<0.05);serum SHGB level in the observation group was decreased com-pared with before treatment(P<0.05),while which in the control group was increased compared with before treatment(P<0.05);the EDITS score in the observation group was higher than that in the control group(P<0.01);the complication incidence rate in the observation group was 2.29 %,which was significantly lower than 16.41% in the control group(P<0.05).Conclusion Eury-coma longifolia can significantly improve sexuality and sexual function in climacteric males.

Objective To analyze the application value of T-SPOT .TB and PPD test in the diagnosis of bone and joint tuberculo-sis .Methods A total of 94 patients with tuberculosis of the bone and joint receiving surgery or conservative treatment from January 2014 to August 2016 were collected in this study ,50 patients with osteoarthritistreated by surgical treatment of bone surgery were recruited as objects too .All the objects received T-SPOT .TB and PPD test ,and the diagnosis value were compared .Results The diagnostic sensitivity ,specificity ,positive predictive value ,negative predictive value and accuracy of PPD test were 46 .81% , 98 .00% ,97 .78% ,49 .49% ,64 .58% ,those of T-SPOT .TB were 93 .62% ,100% ,100% ,89 .29% ,95 .83% .The sensitivity ,nega-tive predictive value and the coincidence rate of PPD test were less than those of T-SPOT .TB and joint test ,the differences were statistically significant(P<0 .05) ,T-SPOT .TB ,combined with the diagnostic sensitivity ,specificity ,positive predictive value ,nega-tive predictive value ,with rate no significant difference(P>0 .05) .Six cases were misdiagnosed by T-SPOT .TB ,they were all in the early stage of spinal tuberculosis ,showed cavities ,but no spinal nerve defect .One cases were erroneous diagnosis ,while 50 cases were misdiagnosed by PPD test ,all the symptoms of misdiagnosed patients were relatively mild ,with rheumatoid arthritis and other autoimmune diseases .Conclusion T-SPOT .TB is an ideal method for diagnosis of bone and joint tuberculosis ,but present interfer-ence factors ,the operation of PPD testis simply ,but lack of sensitivity ,however it has certain value in screening .

Objective:To construct an evaluation the index system of entrustable professional activities for resident training doctors in psychiatric department,and to provide reference for formulating training strategies and assessment standards.Entrustable professional activities refers to the ability of trainees to perform and complete spe-cific clinical tasks independently after they have been trusted.Methods:Through documental analysis and semi-structured interviews,the item database of entrustable professional activities for psychiatric resident training physi-cians was established.Delphi consultation was conducted among 63 experts in the field of psychiatry from 7 national resident training bases and 3 medical colleges in China.Indicators were comprehensively screened and sorted out,and indicators at all levels and their weights were determined by the analytic hierarchy process.Results:A hierarchi-cal evaluation index system of entrustable professional activities for psychiatric resident training doctors was con-structed,including 4 first-level indicators,17 second-level indicators and 68 third-level indicators.The weights of the first-level,second-level and third-level indicators were determined.Conclusion:The evaluation index system of en-trustable professional activities is comprehensive and systematic,which is suitable for clinical work and convenient for practical application.It could provide quantitative standards for the assessment of psychiatric residents and pro-mote the improvement of training quality.

This study was aimed to analyze the application of non-pharmacotherapy in treating cervical radiculopathy (CR) in real-world,and to provide clinical reference for CR non-pharmacotherapy.The clinical real-world data of CR was extracted by using information sharing system of traditional Chinese medicine (TCM) and clinical research.Six hundred and twenty-eight inpatients and outpatients with CR were enrolled from December 2012 to July 2014 in the information system database of Wangjing Hospital.Basic characteristics of the non-pharmacotherapy groups were analyzed by statistical description method.The node degree and mutual information value were recorded for non-pharmacotherapy application of all patients by using liquorice software.Complex network diagrams were generated.The results showed that 47％ of CR patients received non-pharmacotherapy (294/628),including 67 males and 227 females.The average age of patients was 49 years old,and the prevalence of the disease was the highest from 45 to 65 years old.In all patients,the usage of manipulation and cervical traction was higher,and the combination of manipulation and acupuncture was the most.Within outpatients,the proportion of cervical traction was higher,and the combination of manipulation and acupuncture was the most frequently.Within inpatients,the proportion of manipulation and cervical traction was higher,and the combination of comprehensive physical therapy and exercise therapy was the most frequently.It was concluded that non-pharmacotherapy has been commonly used in clinical treatment of CR.Cervical traction and manipulation was the widest applications.The combination treatment was in wide application.Future studies should increase the sample size of CR patients from different regions,and enhance gradually the level of evidence of clinical research for non-pharmacotherapy treating CR.

Objective: Analyze the clinical application rule of Chinese patent medicine in cervical radiculopathy (CR) .Method: The clinical real-world data of CR were extracted by using information sharing system of traditional Chinese medicine and clinical research. Six hundred and twenty-eight inpatients and out patients with CR were enrolled from December 2012 to July 2014 in the information system database of Wangjing Hospital. The correlation analyses and mutual information value were recorded for Chinese patent medicine therapy application of all patients by using liquorice software. Complex network diagrams were generated. Result: Yuxuebi capsule and Jingshu granule is the highest frequency in application of Chinese patent medicine. Jingshu granule and Cobamamide for injection were the highest frequency in combined application of Chinese patent medicine and western medicine. Association frequency was 822, mutual information value was 268.07. Biqi capsule and Daiwenjiu cream were the highest frequency in combined application of Chinese patent medicine and topical drugs. Association frequency was 384, mutual information value was1754.76. Conclusion: The basic treating principle for CR was promoting blood circulation and removing blood stasis. The efficacy and safety of combined Chinese patent medicine with other medicine need further research