Objective To observe the clinical effect of the treatment of intestinal rupture with peritonnitis. Methods The clinical data of 16 patients with hernia and intestinal rupture complicated with peritonitis who were treated by primary repair surgery were analyzed retrospectively.In the operation,the full debridement,cleaning,and the operation of a hernia repair,postoperative drainage irrigation.Results 16 cases were good and no recurrence after operation.Conclusion It was reliable to use prin ary repair for the treatment of intestinal rupture with peritonitis and incarcerated hernia.

Objective To observe the clinical effect of surgery combined with traditional Chinese medicine in the treatment of sacrococcygeal pilonidal sinus.Methods Retrospective analysis of clinical characteristics of 18 patients with sacrococcygeal pilonidal sinus was conducted.Results 18 cases of sacrococcygeal pilonidal sinus with recurrent infection,five cases of whom were misdiagnosed in other hospitals;18 patients were treated with surgery,pathological diagnosis showed foreign body granuloma,which were coincidence with the diagnostic criteria of pilonidal sinus.All of these were treated with Chinese herbal fumigation and washing of clearing away heat,eliminating swell,drying dampness,dntipruritic effect and promoting granulation.No recurrence was found in follow-up of 6 months to 3 years.Conclusion Pilonidal sinus is easy to misdiagnosis,and extensive excision combined with traditional Chinese medicine are the key to prevent recurrence.

Objective:To study daily maintenance and quality control of high pressure steam sterilizer in the hospital to provide effective methods and suggestions for medical equipment maintenance.Methods: 6 high-pressure steam sterilizers were selected and divided into three groups according to the brands and the departments which use them, in order to compare the data, analyze equipment failure, improve the maintenance process and control the risks.Results:The equipment failure rate reduced lower than 21% through the improvement of maintenance. And the equipment utilization rate was above 95% through improving personnel training. Conclusion: The pertinence of the medical equipment maintenance and training is of great significance to carrying out effective regular maintenance of equipment by the office personnel, and it can reduce the failure rate and ensure the equipment operate safely.

Large Hiatal Hernia(LHH)is a special type of hiatal hernia,usually defined as more than 1/3 of stomach mi-gration with or without other organs or diameter of esophageal hiatus more than 5 cm.Operation is the only therapeutic method. With the development of laparoscopic surgery, laparoscopic repair of large hiatal hernia(LRLHH)is the standard technique for repair of large hiatal hernias.However LRLHH still is a kind of complexity, difficulty, high risk and recurrence to some extent. Moreover, there is still no consensus amongst surgeons about what is the optimal technique for LRLHH .Currently, controver-sies and advancement of LRLHH mainly concentrated on completely dissection and reduction of the sac from the mediastinum , suture cruroplasty with or without mesh, deal with short esophagus and gastroesophageal reflux.Modified LRLHH achieves completely dissection hiatal hernia sac , which is more convenient and more helpful for suture cruroplasty and reduce the ten-sion.The use of mesh effectively reduces the anatomical recurrence rate and may lead to complications such as esophageal ero-sion or extensive fibrosis with troublesome dysphagia .LRLHH with mesh or without mesh should be individualized .Optimal technique for LRLHH needs continual improvement and high-quality randomized controlled trials to obtain the most effective and safe mesh in the long term.In this paper, the controversy and progress of laparoscopic huge esophageal hiatal hernia repair will be summarized.

BACKGROUND:Open fractures often present soft-tissue defects, high-risk infection, and fracture with bone defect, often lead to more postoperative complication, defect of limb function, and bring great difficulties to clinical treatment. There is some controversy in the treatment of such fracture. Relevant animal experiment and clinical study become the hotspot in recent years. OBJECTIVE:To review some controversy about open fracture treatment and latest research. METHODS:A computer-based online search of China National Knowledge Infrastructure database and PubMed was performed for articles published from January 2005 to January 2015. Key words included “Open fracture, Evaluation and prognosis of injury, Antibiotics, Debirdement, Treatment of fracture, Wound repair”. More than 100 literatures were retrieved, and 47 articles met the inclusion criteria. RESULTS AND CONCLUSION:After a large number of animal experiments and clinical application, open fracture debridement, prevention of infection, implant selection and evaluation of prognosis had been deeply studied, especialy the study of implant treatment of bone defects. Metal three-dimensional printer has changed the traditional concept of implant. Nano titanium dioxide /PEEK bioactive composite materials have become a hot research in recent years.

Objective To detect the relationship between ecNOS gene polymorphism and ischemic stroke in Dalian,China.Methods The polymorphism of intron 4 of ecNOS gene was analyzed in normal group(90 cases) and ischemic stroke group(170 cases) by a combination of polymerase chain reaction(PCR).Results In ischemic stroke group,hypertension, diabete mellitus, smoking, fibrinogen and internal carotid artery narrow were significantly different from those of control group(all P

BACKGROUND:Scholars around the world have attributed to establish the animal models of intervertebral disc degeneration (IVD) to imitate the IVD pathological manifestations by changing mechanical properties of the intervertebral disc, annulus fibrosus injury, and enzymatic method. OBJECTIVE:To establish the IVD model by nucleus aspiration and partial annulus incision, and to compare the modeling effects of the two methods.METHODS:Twenty 6-month-old New Zealand white rabbits were selected, in which the IVD models were then induced by nucleus aspiration (group A) or partial annulus resection (group B) of surgical y exposed L3-4, L4-5:group A, subjected to annulus puncture with a 16-gauge needle and 10-second negative pressure sunction;group B, about 1/2 part of the annulus (1 mm×2 mm) was cut under microscope, careful not to make a ful-thickness incision. MRI, X-ray examinations and Masson staining were performed at 1, 3, 5, 9, and 13 weeks after modeling. RESULTS AND CONCLUSION:X-ray examination:in the group B, the intervetebral space height began to decline in varying degrees at the 1st week postoperatively;in the group A, the intervetebral space height was decreased slightly at postoperative 1 and 3 weeks, and this reduction became obvious since the 5th week. The percentage of intervetebral space height in the group B was significantly higher than that in the group A at 3, 5 and 9 weeks postoperatively (P<0.05). MRI examination:the IVD could be induced by these two methods, and became severer with time, which was classified as grade 4 according to the modified Thompson grading criteria at the 9th week. The IVD degree in the group A was significantly severer than that in the group B at postoperative 1, 3 and 5 weeks (P<0.05). Masson staining showed that the IVD degree became severe with time in both two groups (P<0.05). Both two methods can induce the IVD. Besides, the IVD degree caused by the partial annulus incision is slighter than that of the nucleus aspiration within 5 weeks, and the incision site is a potential target of annulus repair.

Syncope is a common emergency condition,which can cause harmful danger to the physical and mental health,quality of living and learning of children.Even,syncope -related body traumatic injuries and anxiety and depression often occur in these children,and some have a high risk of sudden death.So,early diagnosis is of great sig-nificance.Head -up tilt table test is considered the gold standard for the diagnosis of syncope,it plays a significant role in diagnosis,differential diagnosis,treatment and evaluation of therapeutic effects.

Eighty-nine cases of lumbar intervertebral disc herniation were mainly dealt with acupuncture method, supplementing with traction and Tuina at lumbar region. After 4 courses of treatment, 65 cases were cured, 12 cases got marked effects, 7 some effects, and 3 no effect. This integrated treatment had good effects on lumbar intervertebral disc herniation, and are worthy of being applied widely in clinic.