Objective To explore the diagnosis and surgical treatment of synchronous multiple primary coloreetal carcinoma(SCC).Methods The clinical data of 36 patients with SCC were analyzed retrospectively.Results The 36 patients with SCC were resected simultaneously.Thirty-five patients were reseeted radically and one patient was reseeted palliatively.The 5-,10-year survival rate were 58.3%,41.7%,respectively.There was no significant difference in 5-year and 10-year survival rate between SCC and mono-primary colorectal carcinoma at the same time.Conclusion The preoperative or intraoperative full-course colonoseopy should be emphasized to be a routine method in the patient with colorectal carcinoma.The resection specimen should be examined routinely.Surgical radical resection is the principal in the treatment of SCC.

Objective To analyze the related risk factors of pathological changes of cardiocerebral vascular in type 2 diabetes mellitus (T2DM) patients with hypertension.Methods 100 patients with T2DM were selected as the research subjects.According to the presence of hypertension,they were divided into control group (without hyper tension) and observation group (hypertension),50 cases in each group.The incidence of pathological changes of cardiocerebral vascular in the two groups was compared,and the risk factors of pathological changes of cardiocerebral vascular were analyzed.Results In the control group,the pathological changes of cardiocerebral vascular in 16 cases,the incidence rate was 32.0％.In the observation group,the pathological changes of cardiocerebral vascular in 33 cases,the incidence rate was 66.0％.The incidence rate of the observation group was significantly higher than the control group,there was statistically significant difference (x2 =10.427,P ＜ 0.05).The age,smoking,diet,exercise,fat metabolic disorders,diabetes,glycemic control,diabetic complications between the two groups had statistically significant differences (all P ＜ 0.05).Conclusion Complicated with hypertension will increase the pathological changes incidence of cardiocerebral vascular in patients with T2DM at a certain extent.The age,smoking,diet,exercise,lipid metabolic disorders,diabetes,glycemic control,diabetic complications are related risk factors to hypertension induced the pathological changes of cardiocerebral vascular in patients with T2DM.

Objective To evaluate application effectiveness of quality control circle (QCC)in increasing the face mask wearing rate of hospitalized pulmonary tuberculosis (TB)patients.Methods Nine nurses in department of tu-berculosis formed a ‘circle’,the theme of ‘improving the face mask wearing rate of hospitalized pulmonary TB pa-tients’was established,rectification measures were formulated and implemented,face mask wearing rates of pa-tients before and after implementing QCC activities were analyzed statistically.Results The face mask wearing rate of hospitalized pulmonary TB patients after implementing QCC activities was higher than that before implementing QCC activities (87.50% [147/168]vs 65.54%[116/177],P <0.05).The abilities of every ‘circle member’have been improved in the following aspects:problem-solving skills,sense of responsibility,communication skills,self-confidence,team working,enthusiasm,quality-control techniques,and cooperation abilities,the total average score increased from 23.78 before implementing QCC to 33.78 after implementing QCC.Conclusion QCC activities can not only improve the face mask wearing rate of hospitalized pulmonary TB patients,but also enhance circle mem-bers’quality-control skills and team spirit.

Objective: To analyze the cost of laparoscopy and laparotomy in the treatment of tubal pregnancy.Methods: The selected patients of tubal pregnancy were operated on in our hospital from Jan. 2000 to Jun. 2002. Eighty received laparoscopy and 13 received laparotomy.The off work day, hospital charge, cost of no work and total cost were analyzed and compared.Results: The mean hospital stay and off work days were significantly shorter in the laparoscopy group than in the laparotomy group( P

Objective: To introduce an improved direct method for first puncture and to study the safety of first puncture in laparoscopic surgery.Methods: Four kinds of techniques were used to perform the first puncture on 4 102 patients.Group A: trocar puncture were performed after pneumoperitoneum in 2 492 cases.Group B: trocar puncture was directly through the incision of umbilical skin in 798 patients; Group C: trocar puncture was directly through the incision of umbilic skin,subcutancous fat and fascia in 387 patients.Group D: opened umbilical hole and inserted the trocar shell without puncture in 425 cases.it was a success if entered the abdominal cavity at the first time,it was unsafe if punctured twice and a failure if the needle hadn't entered the abdominal cavity for 3 times or went into the subcutaneous vessels or viscera.Results: There were no vessels and viscera injury during punctures in our study.The puncture results were related to the different methods.Compared with group A, the success rate of group C and D were significantly improved( P 0.05).Success rates of group C and D were significantly higher than that of group A.The success rate was higher in group D than in group C( P

Objective To study the advances in use of imaging in the evaluation of living donor liver.Methods The literatures in recent years on the use of imaging in evaluation of living donor liver were reviewed.Results Preoperative computed tomography(CT) and magnetic resonance imaging(MRI) in the donor allowed accurate determination of liver volume and rough determination of macrovesicular hepatic steatosis of the liver.CT angiography could assess the anatomy of hepatic artery,portal vein and hepatic veins.Intraoperative cholangiography allowed detection of the anatomy of the biliary tree.Conclusion Imaging techniques are widely used in the evaluation of liver volume,vasculature and biliary system in the living donor liver.

Objective To review the advances in techniques of hepatic blood occlusion in hepatectomy.Methods The related literatures were reviewed and analysed.Results There were many techniques of hepatic blood occlusion.The most frequently used and studied techniques were hemihepatic vascular occlusion and intermittent hepatic inflow occlusion.Hepatic vascular exclusion was employed when hepatic veins and/or vena cava would be damaged.Total vascular exclusion and other techniques were rarely used.Conclusion To reduce blood loss in hepatectomy and make patient safe,based on the situation of the patient,the technique should be ingeniously selected.

The present study predicts the development of health manpower and level structure of paramedical and pharmacy higher education by methods of dynamic series, tendency extrapolation, grey forecasting and special istic prediction. The results show that in the future 5-10 years, it is suitable for the paramedical and pharmacy higher education lo enroll 50 000-70 000 new students every year, which will account for 35 percent of total medical students of higher medical education. In their level structure undergraduates will gradually reach 30 percent and students receiving 3-year special-i/ed training 70 percent. Some policy suggestions are put forward on the basis of prediction.

Objectives:To understand the patients' cognition and satisfaction with public welfare in public hospitals.Methods:A questionnaire survey was conducted among 600 patients in Beijing municipal public hospitals and the data was statistically analyzed by SPSS 22.0.Results:Patients' understanding of public welfare was not ideal,the satisfaction was quite well,and the satisfaction of the patients in the experimental hospitals was more satisfactory than those in non-experimental hospitals.The patients have urgent needs on rational drug use,mutual recognition of medical results,smooth channels of patient rights,reduced medical expense and shortened waiting time.Conclusions:It should strengthen the publicity and governance of the public welfare of public hospitals to enhance the patients' understanding,breakthrough the urgent needs of public welfare to improve patients' satisfaction,and intensify the policy linkage and explore diversified implement forms of public welfare to improve service level.

Objective To investigate the effects of 0.9 g/dl NaCl diluting instrument method to solve the ethylenediamine tet-raacetic acid dipotassium (EDTA)anticoagulant dependency pseudo reduce platelet syndrome (PTCP)feasibility,provides solutions to clinical laboratory PTCP more effective method.Methods From August to October of 2014 in their laboratory for PTCP cases in all 3 cases,2 ml venous blood in EDTA and citron acid sodium anticoagulation in-line blending,in the im-mediate,10,30,40 and 60 min computer detection.Collected of peripheral blood in blood thinners,respectively,0.9 g/dl NaCl solution blending,in the immediate,10,30,40 and 60 min computer detection,and compared with the manual method of ammonium oxalate.Results EDTA,citron acid sodium,blood thinners and 0.9 g/dl NaCl diluting instrument immediately detected PTCP blood PLT result compared with ammonium oxalate method,there were no statistically significant difference (t=0.943~1.537,P >0.05),10 min~60 min anticoagulant blood PLT results significantly decreased,compared with am-monium oxalate method difference had statistical significance (t = 12.413 ~ 12.413,P <0.01 ~0.001).Citron acid sodium PLT began to decline after 30 min,compared with ammonium oxalate method,the difference was statistically significant (t=4.915~4.915,P <0.05~0.01).Blood dilution method in 30~40 min PLT test results began to decline,but not obvious, there was no statistically significant difference with the method of ammonium oxalate (t=1.315~1.715,P >0.05),40~60 min PLT test results appear significantly decreased,and the method of ammonium oxalate difference was statistically signifi-cant (t=3.175~3.175,P <0.05);Within 0~60 min 0.9 g/dl NaCl method to detect the PLT differences between the re-sults with the method of ammonium oxalate had no statistical significance (t=0.694~ 1.062,P >0.05).Conclusion ED-TA,citron acid sodium,blood thinners and 0.9 g/dl saline diluting instrument immediately detected PLT PTCP patients were consistent with ammonium oxalate method.Citron acid sodium within 30 minutes and blood dilution method in patientswith PTCP PLT detection could achieve ideal effect,but there were still a small amount of PLT gathered and led to a slight drop in PLT.0.9 g/dl saline diluting instrument method with ammonium oxalate within 0~60 minutes method to detect the PLT result had no difference.