Digestive tract reconstruction is the main part of gastrointestinal surgery. With the rapid development of technology and widely application in stapling device, more and more surgeons are using stapled anastomosis. Stapled anastomosis is associated with shorter operating time and hospital stay than hand-sewn anastomosis. However, it is not easy to select suitable ones from various staplers and use them correctly. Choice and reasonable application of staplers for anastomosis in gastrointestinal surgery are summarized and evaluated in this article.
Anastomosis, Surgical ; instrumentation ; Digestive System Surgical Procedures ; instrumentation ; Humans ; Surgical Staplers

Objective To observe the clinical efficacy of Lao Shi Jiu (moxibustion at a group of ten acupoints) plus Wu Zhu Xiang Sha Liu Jun decoction in treating chronic gastritis due to deficient cold in spleen-stomach. Method Ninety patients with chronic gastritis due to deficient cold in spleen-stomach were randomized into a moxibustion-medication group and a Western medication group by using the random number table, 45 cases each. The moxibustion-medication group was intervened by Lao Shi Jiu plus Wu Zhu Xiang Sha Liu Jun decoction, while the Western medication group was prescribed with conventional medications. The clinical efficacy and changes in symptoms were observed after the intervention. Result The total effective rates were respectively 88.9% and 75.6% in the moxibustion-medication group and Western medication group, and the rate in the moxibustion-medication group was significantly higher than that in the Western medication group (P<0.05); the gastroscopy-based total effective rates were respectively 91.1% and 77.8% in the moxibustion-medication group and Western medication group, indicating that the moxibustion-medication group was superior to the Western medication group (P<0.05); the improvement of stomachache in the moxibustion-medication group was more significant than that in the Western medication group (P<0.05). Conclusion The moxibustion-medication group is superior to the Western medication group in comparing the clinical efficacy and improvement of symptoms in treating chronic gastritis due to deficient cold in spleen-stomach.

With the coming of information time,multi-media technology has been used in English teaching. This paper analyzes the application and problems of multimedia technology in medical English teaching,and points out that the combination of multimedia technology and traditional teaching method can improve the medical English teaching quality.

Aggressive Periodontitis ; therapy ; Humans ; Periodontics ; methods

Objective To study the effectiveness and safety of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis therapy for acute ischemic stroke in patients with atrial fibrillation (AF).Methods A total of 94 patients treated with intravenous rt-PA thrombolysis within 4.5 hours after cerebral stroke onset were analyzed and divided into two groups:a non-AF group (n =64) and an AF group (n =30).Another 30 acute ischemic stroke patients with AF without thrombolytic therapy were selected as a control group.The prognosis of the three groups was compared.The National Institute of Health Stroke Scale (NIHSS) was used for comparison among the three groups before therapy and 7 days after therapy.The incidences of intracerebral hemorrhage (ICH) and symptomatic ICH (SICH) were recorded.The patients were followed up for 90 days and their clinical outcomes were assessed by using the modified Rankin scale (mRS).Results There were no significant differences in the NIHSS scores among three groups before treatment (P ＞ 0.05).The NIHSS scores were significantly lower in the AF and non-AF groups 7 days after thrombolysis therapy than those before thrombolysis therapy (P ＜0.05 and P ＜0.01),and no significant difference in the NIHSS scores was found in the control group before and after therapy (P ＞ 0.05).The incidence of ICH was significantly higher in the AF group than in the non-AF group (26.7％ vs.9.4％,P ＜ 0.05).No significant difference in the incidence of SICH was found between the AF and non-AF groups (13.3％ vs.6.3％,P ＞ 0.05).The favorable prognosis rate was higher in the AF and nonAFgroups than in control group (40.0％ vs.16.7％,P＜0.05; 45.3％ vs.16.7％,P＜0.01).No significant difference in very unfavorable prognosis rate was found between the AF and non-AF groups (20.0％ vs.18.8％,P ＞0.05).Conclusions It is effective and safe of rt-PA thrombolysis therapy for acute ischemic stroke patients with AF.

In this paper, a reflection type photoelectric pulse wave sensor was designed for short-term pulse rate variability analysis. Photoplethysmography (PPG) signals and ECG signals (obtained with the Dimetek MicroECG recorder Dicare-m1CP) were recorded synchronously from 20 healthy subjects. The analytical results show a significant correlation (correlation coefficient r > 0.99) between the PPG-derived peak-to-peak (PP) intervals and the ECG-derived RR intervals. Besides, there are no significant differences (P > 0.05) between the HRV measured by ECG and the PRV quantified by the PPG whether in time domain, frequency domain, or the Poincaré plot parameters. The experimental results suggest that the PPG-based short-term PRV analysis can be consistent with the ECG-based HRV measurement in wearable smart devices.
Electrocardiography ; Heart Rate ; Humans ; Monitoring, Physiologic ; Photoplethysmography

Objective To study the effect of transfection with antisense DNMT3b gene eukaryotic expression plasmid on the growth of human cholangiocarcinoma cell line QBC939,and to explore the role of DNMT3b in the cholangiocarcinoma tumorigenesis.Methods The constructed antisense DNMT3b gene eukaryotic expression plasmid was transfected into QBC939 cells using liposome.The expression level of DNMT3b protein was detected by Western blot after stable transfection.The growth curves of transfected cells and un-transfected cells were observed by MTT method respectively.The cell proliferation ability was also observed by the test of colony formation in soft agar.The alterations of the cell cycle and the apoptosis rate were detected by FCM.Results Following the transfection,the protein level of DNMT3b decreased significantly;transfection with antisense DNMT3b gene eukaryotic expression plasmid did not affect the cell growth curve of QBC939,and did not decrease the cell colony formation rate(P=0.717);transfection with antisense DNMT3b gene also did not result in cell cycle alterations or induce cell apoptosis(P=0.089).Conclusions Transfection with antisense DNMT3b gene eukaryotic expression plasmid can down-regulate the expression level of DNMT3b in QBC939.It can not affect the growth and proliferation of human cholangiocarcinoma cell line QBC939,nor alter the cell cycle and induce cell apoptosis.

Adolescent ; Ethmoid Sinus ; Humans ; Male ; Osteoma ; complications ; Skull Neoplasms ; complications ; Vision, Low ; etiology

ObjectiveTo identify the pathogens causing complicated skin and soft tissue infection and their susceptibility to antibiotics.MethodsThe clinical data on and aetiological examination findings in 99 cases of complicated skin and soft tissue infection were retrospectively analyzed.ResultsTotally,99 bacterial strains were isolated,including 51 Gram-positive bacteria(29 community-associated,22 hospital-acquired)and 48 Gram-negative bacteria ( 13 community-associated,35 hospital-acquired).Of the Gram-positive bacteria,staphylococci were the most common bacteria,which showed a high resistance rate to erythromycin (95.45％),penicillin G(72.73％),clindamycin,oxacillin and levofloxacin,but a high sensitivity to teicoplanin,vancomycin,linezolid,fusidic acid and moxifloxacin.Besides,the community-associated staphylococci possessed a higher sensitivity to trimethoprim + sulfamethoxazole,tetracycline and ciprofloxacin than the hospital-acquired staphylococci did(all P ＜ 0.05).Notably,11 of the 99 isolates were identified as methicillin-resistant staphylococcus aureus(MRSA).The four predominant Gram-negative bacteria were Pseudomonas aeruginosa,Klebsiella pneumonia,Escherichia coliand Acinetobacter baumannii.These Gram-negative bacteria,especially the hospital-acquired Gram-negative bacteria,exhibited high resistance to levofloxacin,trimethoprim + sulfamethox azole and gentamicin but favorable sensitivity to carbapenems,tobramycin,piperacillin and tazobactam.ConclusionsComplicated skin and soft tissue infection is caused by various species of bacteria with high resistance to common antibiotics.Therefore,the results of drug sensitive tests should serve as the basis for proper use of antibiotics in the treatment of complicated skin and soft tissue infection.

A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimiccarcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet-ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi- or multi-nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nestion, trabeculation, pseudoglandular, pseudopapillary, pseudofollicular, pseudorosetting and angiocentric patterns. Mucoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S-100 protein, NKIC3, HMB45, Melan A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, CD68, CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen.