Objective To compare the clinical efficacy and safety between the improved ligation method and the traditional ligation method in the treatment of internal hemorrhoid. Methods Double blind and randomized study were made in 86 patients with internal hemorrhoid. The traditional method was performed by ligation of internal hemorrhoidal body, and the improved method was to ligate rectal mucous membrane above internal hemorrhoidal radicles. Results The improved method has better effect than the traditional method. The clinical symptoms of internal hemorrhoid such as bleeding,pain,constipation,edema,itching and erosion in the patients treated by the improved method were significantly improved compared with the patients treated by the traditional method(P

Objective To evaluate urgent selective arterial embolization to treat massive postpartum hemorrhage. Methods Twenty seven patients with ages of 21～53 years undengoing severe postpartunm hemorrhage, were due to centrol placenta previa, uterine atony, birth canal trauma, placenta accretio, cervical pregnancy etc. All of the patients had lost a volume of blood about 1 000ml to 5 000ml while the hemorrhage could not be controlled with vaginal packing and administration of uterotonic drugs. Urgent hemostatic embolization was performed for them. After angiography, super selective catheterization was performed for bilateal anterior division of internal iliac branch of uterine arteries and embolized with Gelfoam particles. Results Catheterization success rate was 96.3%. Angiography showed ectopic uterine artery in one case. Immediate block of hemorrhage took place in 22 cases and gradual hemostasis appeared in 4 cases, the efficacy rate was 96.3%. The one with ectopic uterine artery was operated upon to ablate the uterus. 11 patients with (bleeding) shock and 8 patients with DIC were all saved. Conclusions Urgent arterial embolization is an ideal method for treating life threatening postpartum hemorrhage. The procedure saves the maternal uterus and is also effective for postpartum DIC.

The General Rules of the Civil Law of the People′s Republic of China(hereinafter the General Rules)shall officially come into effect as of July 1 of 2017.In this consideration,the paper probed into the legal attributes of the doctor-patient relationship in China in view of the relationship management in line with the General Rules.Also analyzed are the basic principles to be observed by both parties as regulated by the General Rules and patient rights protection.These efforts aim at elevating China′s medical service,protecting legitimate rights of both parties,and encourage a healthy and harmonious doctor-patient relationship.

Objective To study the effects of formaldehyde on activities of enzymes in testes of male mice. Methods Male Kunming mice were used. Experimental groups had been exposed to formaldehyde with different doses by i.p. once per day for 7 consecutive days. The formaldehyde doses were 0.2, 2.0 and 20.0 mg/kg body weight. The mice were killed after 7 days of treatment and their testes were fetched out to be made into even slurry and the activities of LDH, G-6-PD and SDH in them were tested. Results The activities of G-6-PD and SDH were decreased with the increasing of doses of formaldehyde. Compared with the control group, the activities of SDH in each exposed group had significantly decreased (P

Objective To investipate the cerebral autosomal dominat arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) through the clinical features , pathology, neuroimage, and molecular genetics as well as the family tree of a case as to exploring the diagnostic method of the disease .Methods Systematic study on the clinical manifestations, genetic site, neurologic and muscular biopsy was performed. Results The main clinical features including poor memory and history of stroke were found. Neuroimaging examination showed multiinfarct lesions and leukoencephalopathy. Biopsy indicated the arteriolar hyalinosis,GOM and osmiophilic granule. A family history was confirmed. A mutation on the fourth exon of notch 3 gene was revealed. And no risk factors of hypertension and arteriosclerosis were found. All these features are in conformity with those of CADASIL.Conclusion CADAIL is not rare and is possible to be defined in vivo by way of dermal biopsy,examination of gene and neuroimage characteristics.

Objective To evaluate the role of breast MRI in detecting the primary malignancy in patients presenting solely with axillary lymph node metastases. Methods Thirty-three patients with axillary lynph node metastases but negative findings on either physical examination or mammography underwent breast MRI to identify occult breast carcinoma. MRI of the breast was assessed according to BI-RADS criteria. The pathologic diagnosis was made according to the standard criteria by the WHO Classification of Tumor. Results Among 33 patients presenting solely with axillary metastases, 30 patients underwent modified radical mastectomy. Primary breast carcinoma was proven in 17 patients. MRI detected lesions in 16 patients, including 10 masses and 6 non-mass lesions. Size of the masses ranged from 0. 5 to 2. 6 cm (mean 1.5 cm). Six lesions were smaller than 1.5 cm in size. Non-mass lesions showed ductal enhancement in 4 cases and segmental enhancement in 2 cases. One patient with tumor detected by histopathology showed no abnormal enhancement on MRI. No tumor was found at mastectomy in the other 13 womeu, and negative MR findings were revealed in 9. Four cases with suspicious enhancement on MRI had no corresponding primary foci on pathology. Three patients didn't undergo surgical procedure. The sensitivity, specificity, and accuracy of MRI in the diagnosis of the primary malignancy were 94. 1%,69. 2%, and 83.3%, respectively. Conclusions Small size of mass and ductal or segmental enhancement of non-mass lesion were common MR features of occult malignancy. MRI showed high sensitivity and accuracy in diagnosing occult breast carcinoma. Breast MRI should be taken in search of occult malignancy in patients with axillary metastases.

OBJECTIVE To establish a simpler method for screening bacterial metallo-?-lactamase(MBL) by comparing Hodge test and double-disk synergy tests(DDSTs),and using 5 inhibitors such as sodium citrate,EDTANa2,EDTAK2,sodium dimercaptopropane sulfonate and mercaptoethanol.METHODS In Hodge test,5 inhibitors of different concentration were added to the imipenem(IMP) disks,the sizes of the inhibition zones were compared.Disk containing IMP and disk containing a metallo-?-lactamase inhibitor were used in DDSTs.The optimal inhibitors concentration and edge-to-edge distance between the two disks were selected.The performances of the Hodge test and the DDSTs were also compared.RESULTS Among the metallo-?-lactamase inhibitors used in this study,1∶15 diluted mercaptoethanol gave the most reproducible and the clearest results when a filter disk containing mercaptoethanol was placed near the IMP disk with the edge distance of 3 mm.CONCLUSIONS Mercaptoethanol-IMP DDSTs are simple,convenient and sensitive methods for screening MBL.

Objective To evaluate the efficacy of myringotomy with grommet insertion in the treatment of tympanic membrane atelectasis .Methods From July 2011 to July 2013 ,62 patient with tympanic membrane atelecta-sis were treated with myringotomy with grommet insertion in our hospital ,we evaluated 54 patients(56 ears)whose follow -up period was 1 year or more .Of the 54 patients included in this study ,28 (30 ears))were female and 26(26 ears)were male .The age of the patients ranged from 8 to 54 ,with a mean age of 25 .8 ± 6 .6 years old ,and 18 pa-tients (32% ) were under the age of 16 .The air -bone gap(ABG)was compared at pre -operation and 1 year after post-operation .Results The average ABG of pre-operation and post -operation ,including all patients ,were 27 . 07 ± 5 .03 dB and 15 .52 ± 5 .73 dB ,respectively (P<0 .05) ,and the difference was statistically significant .All the 3 groups ,the ABG of pre- and post-operation ,the difference of each group was statistically significant .Conclusion Myringotomy with grommet insertion was effective in treating tympanic membrane atelectasis .

Objective To evaluate the application value of three‐dimensional ultrasonography OmniView technology in diagnosis of fetal cleft lip/palate . Methods Three‐dimensional volume data was acquired from 100 normal singleton fetuses and 18 cleft lip/palate fetuses ,and was analysed by OmniView technology . Two‐dimensional ultrasonography and three‐dimensional OmniView technology were compared in the displaying rate of different planes of the lip and palate and the diagnosis accordance rate of cleft lip/palate.Results ①ThedisplayingrateofthelipandpalateofOmniViewtechnologywashigherthanthatof two‐dimensional ultrasonography ( the displaying rates were 64% -88% and 30% -65% ,respectively , P <0 .05) . Further more ,the curved plane tiled imaging of palate was successfully reconstructed by OmniView technology ,displaying the nonplanar panorama of the palate . ② There was no significant difference in diagnosis accordance rate of fetal cleft lip/palate between two‐dimensional ultrasonography and OmniView technology( the accordance rate was 89% -94% and 78% -100% ,respectively , P >0 .05) . Conclusions Three‐dimentional ultrasonography OmniView technology can improve the displaying rate of the hard and soft palate .The application of this technology in the fetuses who has a high risk of cleft palate may be beneficial to the diagnosis of cleft palate .

Objective To investigate the clinical characteristics of the tympanic membrane atelectasis and treatment methods ,and to provide a reference value for future clinical diagnosis and treatment .Methods A retro‐spective analysis of 86 patients(104 ears) with tympanic membrane atelectasis treated in our hospital from June 2011 to August 2013 .Disease severity was classified according to the erasmus classification of atelectasis by Sade ,and pre- and post -operative air -bone gaps (ABG) were compared .Results There was no statistical difference of mastoid gasification on CT scan between mild and sever tympanic membrane atelectasis (P>0 .05) .While the sta‐tistical difference was found in two groups of whether there were soft tissues in middle ear and mastoid cavity on CT scan(P<0 .05) .There was an improvement in the average ABG for all stages .Conclusion This study demonstrated that surgical intervention had a favorable effect on hearing level across all stages .The treatment of atelectatic ears should be taken and individualized .