There was almost one hundred years since surgical stapler invention to now. Using stapler (stitching instrument) in surgery has many advantages, such as stitching fast, easy to operating, few side effects and complications. It makes tumor excision surgery can’t be cut focus in past possible and improving the curative effect of the surgery. Surgical staplers also give difficult surgery and new technology strong supports. In the last ten years, for cheap price and rapid development of the technology level, domestic staplers’ market share is increasing year by year and breaking the foreign monopoly product. In open surgery, domestic stapler has progressively more than foreign brands. In endoscopy surgery, domestic staplers also have a place. In current, surgical staplers are used more and more popular in the domestic tertiary medical institutions and becoming indispensable tools in many surgeries. Surgical staplers (stitching instrument) are broadly used in esophageal reconstruction, gastrointestinal tract reconstruction, endoscopic surgery in pulmonary bulla resection, uterus resection, pancreas resection, duodenum resection

Objective To study the method and effect of exposure the recurrent laryngeal nerve(RLN) in preventing the damage of RLN in thyroid surgery. Methods One thousand and ten sides total and(or) subtotal thyroidectomies were operated on 574 cases with RLN exposure in our hospital in recent 9 years. Results The RLN injury rate was 0.3% in this series.Of them, permanent RLN injury occurred in 2 cases and temporary injury in 1. Conclusions The exposure of RLN can greatly decrease the nerve injure in thyroid surgery, especially in total lobectomy. The dissection of RLN must followed the principle of RLN exposure . RLN should be dissected around the inferior thyroid artery first, if the RLN is difficult to be found,then dissecting around the thyroid cartilage, or finding the cervical vagus inside of carotid sheath to find RLN should be done.

Objective To analyze the effect of cervical.curvature and intervertebral height on the surgical outcome of posterior decompression in patients with multi-level cervical spondylotic myelopathy.Method A total of 50 patients with multi-segment cervical spondylotic myelopathy (≥ 3 segments),treated with posterior decompression from June 2006 to January 2009 were retrospectively analyzed.Twenty six patients underwent cervical omni-posterior decompression and lateral mass screw internal fixation (group A); 24patients underwent expansive open-door laminoplasty (group B).The effects of changing of cervical curvature and intervertebral height on JOA score and VAS score were analyzed.Results All patients were followed up for 8 months to 4 years (average,24 ±5.5 months).There were statistical differences of cervical curvature angles between preoperative and 3 days postoperatively in group A,while no statistical differences in group B.There were no statistical differences of cervical curvature angles between 3 days,6 months and 3 years postoperatively in group A,while there were differences in group B After further analysis of the loss of cervical curvature and intervertebral height,the result showed that JOA score and VAS score in the low-loss group were better than those in the high-loss group.Conclusion Lateral mass screw internal fixation after cervical omni-posterior decompression had many advantages such as reducing the change of cervical curvature,the loss of intervertebral height and incidence of cervical axial symptoms.

Objective To observe the efficacy, safety and feasibility of the four kinds of anticoagulation method in hemodialysis patients with high risk of hemorrhage. Methods 128 patients with high risk of hemorrhage who had undergone hemodialysis were randomly divided into four groups. In group A, 68patients were resorted with 30% regional sodium citrate anticoagulation(RCA). In group B, 60 patients were treated with local heparin anticoagulation. In group C, 64 patients were treated with low molecular weight heparin (LMWH). In group D, 66 patients received no heparinization hemodialysis. The changes of bleeding, clotting function, adverse effect and nursing strategies were studied. Results All patients of group A completed regular hemodialysis with satisfactory indices, 6 cases with bleeding and primary bleeding aggravated in group B, 8 cases with bleeding and primary bleeding aggravated in group C, 8 cases occurred grade three coagulation and finished dialysis in group D. 3 cases in group A and 2 cases in group B occurred adverse reaction, but no adverse reaction was seen in group C and D. Conclusions RCA is safe,effective and can be easily handled in regular hemodialysis. It is an ideal dialysate for hemodialysis in patients with high risk of hemorrhage.

Objective To investigate the efficacy and safety of long-term intermittent treatment with topical corticosteroids in localized chronic eczema.Methods A total of 129 patients with localized chronic eczema were treated with triamcinolone acetonide and econazole nitrate cream (Pevisone (R)).Those who achieved a clinical cure within 4-week treatment were recruited into the following long-term study and classifled into 2 groups to be intermittently treated with triamcinolone acetonide and econazole nitrate cream or a moisturizing cream for 8 weeks.The cream was applied topically twice a day for 2 days every week.Patients were followed up on week 4 and 8 after the beginning of treatment and on week 12 after the discontinuation of treatment.The severity of eczema in patients was rated according to SCORAD (SCORing atopic dermatitis) score.Results The SCORAD score was significantly lower in patients treated with triamcinolone acetonide and econazole nitrate cream than in those with moisturizing cream on week 8 in the treatment and week 12 after the discontinuation (t=3.076,2.367,both P<0.05).A statistical decrease was also observed in the recurrence rate of eczema in patients treated with triamcinolone acetonide and econazole nitrate cream compared with moisturizing cream.treated patients at the 3 follow-up time points (x2=4.426,7.683,8.199,all P<0.05).The incidence of adverse events was 3.1% during the treatment with triamcinolone acetonide and econazole nitrate cream.No severe adverse reactions were observed.Conclusion Long-term intermittent treatment with topical corticosteroids is effective for the prevention of exacerbation and postponement of recurrence,of eczema.

To meet the requirements for the development of marine resources and military operations, divers usually dive deeper than the depth at which narcosis is present during air diving.Under this condition, heliox is required for this div-ing.Sofar, some countries have developed their own decompression tables for routine heliox diving.The best-known is tables from USA and France.In the preceding century, tables of Former Soviet Union and France used for routine heliox diving were introduced into China.On the basis of both types of tables,Chinese Navy developed their own tables for this purpose. In this paper, we summarized the characteristics of these tables from 5 countries and compared them in terms of structure, oxygen use, total decompression time, first stop and other features.This may provide a basis for future modification of ta-bles used in China and the development of new tables for routine heliox diving.

Objective To analyze the results of surgical treatment on chronic pancreatitis(CP),and investigate how to choose the appropriate surgical procedure.Methods The clinical data of 54 patients with chronic pancreatitis who underwent surgery at the First Affiliated Hospital of Harbin Medical University from January 2007 to December 2011 were retrospectively analyzed.Results All the 54 patients underwent surgery,including 8 decompression and drainage procedure (Partington procedure) ; 13 resections (7 cases of pancreaticoduodenectomy,1 case of distal pancreatectomy,4 cases of distal pancreatectomy combined with splenectomy and 1 case of pancreaticoduodenectomy combined with distal pancreatectomy,respectively); 12hybrids (7 cases of Beger procedure and 5 cases of Frey procedure,respectively) and 21 other procedures (15 cases of pancreatic pseudocyst jejunostomy,4 cases of exploratory laparotomy combined with pancreatic tissue biopsy,2 cases of gastrojejunostomy combined with choledochojejunostomy,respectively).There were 4 cases of post-operative pathologic evidence of cancer.Twelve patients had postoperative complications and were cured with non-operative management.Forty-four patients (81.5％) were followed for 2 to 67 months,36 out of 42(85.7％) patients who suffered from abdominal pain had a persistent remission,there were one case of new on-set diabetes and no steatorrhea was reported.Conclusions For CP patients with surgical indications,the choice of procedure should be individualized for the purpose of preserving the endocrine and exocrine functions of pancreas,and taking effectiveness as well as safety into consideration.

Objective To evaluate the efficacy and safety of Qingpeng ointment for the treatment of localized dermatitis and eczema in children.Methods Sixty-eight outpatient children with localized dermatitis or eczema were included in this study.All the patients were topically treated by Qingpeng ointment twice daily for a week,which was agreed by their patients.The efficacy was evaluated after the end of the treatment by lesion scores,and adverse reactions during the treatment were recorded.Results Of the 68 patients,61 completed the trial,7 withdrew from the trial because of worsened lesions,unfavorable effects and distrust of this drug.The total response rate was 81.4％ (31/51) in patients treated with Qingpeng ointment alone.Irritant reaction occured in only one case,but did not influence the treatment.Conclusion Qingpeng ointment displays a favorable efficacy and safety in the treatment of localized dermatitis and eczema in children.

Objective To assess the environmental contact allergens in patients with allergic contact dermatitis (ACD).Methods Totally,167 patients with ACD were included in this study.All the patients underwent patch test.Results Of these patients,92 (55.1％) were diagnosed as facial ACD,and 148 showed positive patch test results (88.6％).The six most common allergens in a decreasing order were nickel sulfate,fragrance mix,paraphenylenediamine,thimerosal,octanoates and amerchol L 101.Conclusion Patch test may be an efficient way to confirm the cause of ACD.

Objective It is necessary for nursing staff members to assign priorities in health education to hospitalized patients to ensure curative effect .The purose of the study was to explore the effect of process management application in health education path -way to patients with rheumatoid arthritis ( RA) . Methods A total of 70 patients with rheumatoid arthritis were randomly divided into observation group and control group , 35 patients in each group .Traditional health education was done in control group , while health education pathway was performed in observation in observation group according to process management .A study of patients′satisfaction with hospitalization , compliance of medication and knowledge of health education was undertaken . Results Observation group had priority to control group in satisfaction with hospitalization and medication compliance (77.1% vs 42.9%,P <0.05; 80.0% vs 57.1%,P<0.05).As to knowledge of health education , observation group was prior to control group in dietary restrictions , functional training methods and return visit conditions (71.4% vs 40.0%;37.1% vs 14.3%;45.7% vs 17.1%).Howerver, no significant difference was found in congintion of drugs among the two groups (P>0.05). Conclusion Compared with traditional health educa-tion, the process management application of RA health education pathway helps to improve patients ′health konwledge and medical compliance , which is an effective adjuvant treatment .