Magnetic endoscopic imaging (MEI)is a non-radiographic imaging technique that has been developed in recent years. MEI is capable of displaying real-time three dimensional images of the colonoscope shaft within the abdominal cavity. MEI system has been shown to be beneficial in increasing the cecal intubation rate,helping remove colonoscope insertion tube loops,reducing the duration of looping,assisting training of colonoscopy when compared with traditional colonoscopy. This article reviewed the progress in research on MEI.

Objective: To evaluate the rationality of the use of antibiotic prophylaxis in the perioperative period of herniorrhaphy. Methods: Seventy-five cases of herniorrhaphy discharged in March, June and September of 2009 were collected. Parameters including indications, the types of antibacterial drugs, time of administration, solvent choice, usage and dosage, combination, etc, were assessed for the rationality according to the "the guiding principles of clinical use of antibacterial drugs"and other relevant documents. Results: The antibacterial drugs application rate was 100%, while the rationali-ty of the drug selection, the drug administration route, the single dose and the number of dosing, was 70.7%, 100% , 100% and 93.3% respectively. Sixty-two patients(82.7%)were treated with antibacterial drugs at 0.5～2 hours before surgery, and the average time course of the prophylactic use of antibiotics after surgery was 2.3 days. Conclusions: Some problems existed for the use of antibiotic prophylaxis in the perioperative period of herniorrhaphy. Surgeon should ensure the correct use of the antibacterial drugs to make the safety, efficiency, rationality, and economy for the patients.

Objective To evaluate the effectiveness, the influence on cellular immune function and the side-effect of bacillus of Calmette-Guerin polysaccharide nucleic acid(BCG-PSN)combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis. Methods A total of 60 pulmonary tuberculosis patients were divided into treatment group(30 patients)and control group(30 patients)by random digits table. All patients accepted the same standard antituberculous chemotherapy, meanwhile patients in treatment group were injected with BCG-PSN. Observed and compared the clinical symptom,the size of the focas nidus,the change of toxic response and immunity. Results The symptoms were significantly relieved in both groups after treatment(P＜0.05), but it was significantly better in treatment group(P＜0.05), the effective rate and control rate in treatment group[36.7%(11/30),96.7%(29/30)]were significantly higher than those in control group[23.3%(7/30), 86.7%(26/30)](P ＜ 0.05). After treatment,the levels of CD3,CD4 and IL-2 were higher, and the level of CD8 was lower, but the treatment group improved significantly better than control group(P ＜ 0.05). The rate of leukopenia was lower in treatment group than that in control group[10.0%(3/30)vs. 33.3%(10/30),P ＜0.05]. As to the safety,no other toxicities were observed in the treatment group. Conclusions BCG-PSN combined with antituberculous chemotherapy in the treatment of pulmonary tuberculosis contributes to relieve the symptom, reduce size of the nidus, decrease leukopenia incidence and enhance the cell immunity. It is safe.

Objective To explore prognostic factors of renal cell carcinoma and investigate the association of neutrophil-to-lymphocyte ratio (NLR) with the prognosis of renal cell carcinoma (RCC) in patients who received nephrectomy treatment.Methods We retrospectively reviewed the records of 1325 patients with renal cell carcinoma who underwent nephrectomy between January,2008 and December,2012.We retrospectively analyzed the clinicopathologic characteristics of patients.The optimal cutoff value for NLR was determined using receiver operating characteristic curve (ROC) analysis.We defined them as high NLR group when NLR ≥ 2.7 and low NLR group when NLR ＜ 2.7.Overall survival (OS) and recurrence free survival (RFS) were estimated using the Kaplan-Meier method and compared using the logrank test.Multivariate models were used to analyze the association of NLR with clinicopathologic outcomes.Results By the end of the study, 1220 cases were followed up.The follow-up rate was 92.1％.Mean follow-up was 40 months (range 2 months to 87 months).The three-year and five-year overall survival rate were 91.3％ and 86.9％, respectively.Meanwhile the three-year and five-year recurrence free survival rate were 88.2％ and 85.8％ ,respectively.2.7 was selected as the optimal cutoff value to differentiate between low NLR and high NLR.A NLR ≥2.7 was significantly associated with worse 5-year overall survival and worse 5-year recurrence free survival than a NLR ＜2.7,91.4％ vs 87.3％ ,89.6％ vs 71.9％ (P ＜0.05).Age ＞65, presentation mode with symptom, higher tumor stage, higher Fuhrman grade,histologic subtype,neutrophil count ≥ 4.5, lymphocyte count ＜ 1.7, NLR ≥ 2.7 significantly correlated with poor OS on univariate analysis.Multivariate analysis revealed that higher tumor stage, preoperative NLR ≥ 2.7 at diagnosis were poor independent prognostic factors for OS of renal cell carcinoma.Conclusion High NLR was independent poor predictor of renal cell carcinoma.

ObjectiveTo study on the hyperlipidemia patient plasma cause atherosclerosis index and the blood,blood serum uric acid sticks and so on thrombosis risk factors of the relationship.Methods81 patients with hyperlipidemia patient and 80 cases of normal blood fat crowd as the research object,the two groups were measured blood fat including total bravery solid alcohol ( TC ),triglycerides (TG),high-density lipoprotein cholesterol ( hdl-c ),low dense white lipoprotein LDL( solid bravery alcohol-C) levd,blood uric acid,whole blood viscosity,platelet aggregation function and serum C-reactive protein(CRP) content,and according to the TG and hdl-c than of both the logarithm of conversion values calculated the two groups of the plasma to atherosclerosis values,and by using the DuoYuan linear regression analysis with the blood acid,whole blood viscosity,platelet aggregation function and serum levels of CRP relationship.ResultsObservation group AIP(2.25 ±0.18) was significantly higher( 1.31 ±0.15 ) ( t =46.71,P ＜ 0.05 ),and AIP and LDL-C,uric acid,whole blood viscosity,platelet aggregation was positively correlated ( r =0.86,0.85,0.79,0.81,0.77,all P ＜ 0.05 ),with HDL-C was negatively correlated ( r =-0.69,P ＜ 0.05 ).ConclusionPatients with hyperlipidemia plasma cause atherosclerosis index and patients,such as blood uric acid blood viscosity thrombosis dangerous close by,by early know patients plasma to atherosclerosis index,and monitor patients early blood uric acid and blood viscosity,thrombosis risk factors level,to facilitate accurate assessment of some patients with cardiovascular disease risk,and to guide to take reasonable early intervention measures,reduce cardiovascular events.

Objective To design a new type of medical management system based on No 1 military medical project.Methods Data were extracted from the database of No 1 military medical project,and PB6.5 was used to develop the system.Results The medical management system was built which could be applied to information inquiry in such three levels information as hospital,department,doctor.Conclusion This new type of medical management system,with macroscopic and microscopic medical data involved in,provides ample information for the authorities of the hospital in their decision-making.

Social duty is an important component of university students' moral quality and a weak link of current students' comprehensive quality.University education should pay adequate attention to and reinforce this link,look for reasons from society,university,family and etc,take corresponding measures,culture and construct university students' social duty,improve their comprehensive quality to adapt to the need for the great goal of building socialistic harmonious society.

Objective To systematically assess the diagnostic value of gene detection for spontaneous bacterial peritonitis (SBP) .Methods A literature search was performed in the database of PubMed ,Web of Science ,Cochrane Library and China National Knowledge Internet (CNKI) from databases establishing to March 2015 .Relevant studies on diagnostic value of gene detection for SBP were retrieved .Quality assessment of diagnostic accuracy studies (QUADAS ) was applied for the included studies .Meta-analysis was conducted using bivariate random effects model .Summary receiver operator characteristic curves (SROC) was conducted to calculate area under curve (AUC) and was compared using Z test .Results Five studies with 423 specimen involved were included in the meta-analysis .The pooled sensitivity ,specificity ,diagnostic odds ratio (DOR) ,positive likelihood ratio and negative likelihood ratio of gene detection for the diagnosis of SBP were 0 .56 (95% CI:0 .49 -0 .62) ,0 .88 (95% CI:0 .83 -0 .92 ) ,9 .94 (95% C I:1 .76-56 .27 ) ,4 .35 (95% C I:1 .05 -18 .10 ) and 0 .47 (95% C I:0 .25 -0 .88 ) , respectively .The pooled sensitivity was significantly higher than that of bacterial culture (0 .25[95% CI:0 .19-0 .31]) .The AUC of SROC of gene detection was 0 .810 9 ,which was significantly higher than that of bacterial culture (AUC=0 .659 8 ,Z=3 .14 ,P<0 .01) .Subgroup analysis was conducted in patients with polymorphonuclear neutrophils (PMN)≥250 × 106/L in ascites .All the diagnostic indices of gene detection were inferior to those of bacterial culture for SBP ,except for the sensitivity of gene detection for SBP (0 .64[95% CI:0 .53 -0 .74] vs 0 .39[95% CI:0 .29 -0 .51]) .The diagnostic value of quantitative polymerase chain reaction (qPCR) detection for SBP was inferior to that of bacterial culture in all the aspects except for the sensitivity (0 .54 [95% CI:0 .47 -0 .61 ] vs 0 .25 [95% CI:0 .19 -0 .31 ]) . Conclusions Gene detection shows higher sensitivity than bacterial culture .The diagnostic value of gene detection is influenced by diagnostic standards .qPCR also shows high sensitivity for SBP diagnosis ,while the diagnostic value was inferior to bacterial culture .More researches with high quality are required to validate the results of this study .

BACKGROUND:Supination maneuver is mainly used for reduction of radial head subluxation in children, but recently, pronation maneuver has also achieved good results in the treatment of radial head subluxation. OBJECTIVE:To objectively evaluate the efficacy of pronationversus supination maneuvers for the reduction of radial head subluxation by using Meta-analysis. METHODS:PubMed, Cochrane Central Register of Controled Trials (CENTRAL), EMbase, the ISI Web of Knowledge databases, VIP, CNKI, CBM and Wanfang were searched from database establishment to December 2014 for colecting the randomized controled trials (RCTs) about pronationversus supination maneuvers for the reduction of radial head subluxation, and the references of those RCTs were also searched by hand. After study selection, assessment and data extraction were conducted by two reviewers independently. Meta-analyses were performed by using the RevMan 5.2 software. RESULTS AND CONCLUSION:Five studies involving 436 patients were included. The results of Meta-analyses showed that: compared with the supination maneuvers group the pronation maneuvers group had a higher rate of successful reduction at the first attempt [RR=1.17, 95%CI (1.08, 1.28),P=0.000 3] and lower rate of failed reduction [RR=0.25, 95%CI(0.09, 0.65),P=0.005]. There was no significant difference in the rate of successful reduction at the second attempt [RR=1.39, 95%CI (0.75, 2.58),P=0.30]. Based on the results of systemic assessment, the level of evidence assessed by the GRADE system showed that the outcome indicators of the rate of successful reduction at the first attempt and rate of failed reduction were graded as intermediate level; the outcome indicator of the rate of successful reduction at the second attempt was graded as low level. For the poor quality of the original studies, a prudent choice is suggested; and more highly-quality, large-sample studies are needed.

Objective To investigate the effect of the modified surgery for spontaneous rupture of esophagus (SRE) so as to improve treatmeut level.Methods Clinical data and surgical methods of 16 SRE patients including four patients with mid-esophagus ruptures and 12 with lower esophagus ruptures treated between February 1999 and June 2011 were analyzed retrospectively.All patients had only one laceration with the gap length of 1.5-5 cm (median 2.5 cm).Eleven patients had rupture into the left breast,two had rupture into the right chest,with no rupture into the chest in three patients.Ten patients suffered from hydropneumothorax and five from subcutaneous emphysema.Thc esophageal mucosas rathcr than muscular layers of all patients were sutured disconnectedly with absorbable thread.Omentum majus were embedded and fixed to muscular layer on the edge of esophagus rupture site.Fundus ventriculi were suspended and fixed to the dome of diaphragm.In the meantime,diaphragmatic hiatus were reconstructed above the esophagus rupture site for lower esophagus ruptures.Results The time from SRE attack to operation ranged from one hour to three days.Eleven patients were repaired within 24 hours of SRE onset and five patients were repaired after 24 hours of SRE onset.All patients got through the perioperative period smoothly and survived the operation with cure rate of 100％.The median hospital stay was 18.5 days.No esophageal narrow or canceration were found during follow-up (range,1-10 years),but two patients suffered from reflux which were relieved significantly after conservative treatment.Conclusion For treatment of SRE,interrupted suture for esophageal mucosal layers,omentum majus embedding instead of esophageal muscular layer suture and simultaneous anti-reflux operations can significantly reduce incidence of complications like esophageal fistula,stenosis and reflux and improve the cure rate.