Objective To discuss the clinical value of modified laparoscopic lithotomy of common bile duct.Methods Clinical data of 78 patients over the age of 60 with gallstone and choledocholithiasis who underwent modified laparoscopic lithotomy of common bile duct in the past four years were analysed.Results All operations were successful.T-tubes were withdrawn 4 weeks after operation.Of the 78 cases,77 cases hat no complications and only one case had a small incision infection.All patients recovered without complications after with drawal of T-tube.Conclusions Modified laparoscopic lithotomy of common bile duct can allow incision and suture of common bile duct and placement of T-tube under direct vision,and achieves excellent therapeatic results in the treatment of common duct stones,especially in elderly patients who cannot tolerate a long period of pneumoperitoneum.

Nowadays it is generally believed that chronic hepatitis C patients who are treated with interferon combined with ribavirin and achieve sustained virologic response are considered cured,but in clinical practice,some patients develop hepatocellular carcinoma (HCC) after achieving sustained virologic response.This article summarizes and analyzes the studies on chronic hepatitis C patients who developed HCC after achieving sustained virologic response and identifies the risk factors for the development of HCC.It has been proved that some of the risk factors,such as male sex,age,liver cirrhosis,and diabetes,may be related to the development of HCC,but a lot of risk factors still await for further investigation.

Objective:To analyze the clinical drug consultation to summarize the characteristics of drug consulting services and improve clinical pharmacy service quality.Method:756 complete cases of clinical drug consulting materials were analyzed and summarized in our hospital emergency in the past three years.Result:The major consulters were patients, accounting for 59.92 percent.The most often consulted anti-infective drugs accounted for 35.85 percent.The primary attention was given to usage and dosage of drugs,accounting for 12.96 percent.Conclusion:The drug consultation lets us fully understand the issues most concerned about by medical personnel and patients,makes pharmacists improve their professional level and makes sure that patients are given reasonable,safe and effective medication.

OBJECTIVETo explore clinical effects of digital artery bilobed flap for the treatment of skin degloving injury of thumb.

METHODSFrom January 2007 to December 2012, 45 patients with skin degloving injury of thumb were treated with grafting of digital artery bilobed flap. There were 39 males and 6 females, ranging in age from 19 to 46 years, with an average of 32 years. The disease course ranged from 0.5 to 15 h. Eighteen patients suffered from defect of palmar skin above nail root and nail bed, 19 patients suffered from skin degloving injury of thumb phalangette, and 8 patients had whole skin degloving injury of thumb. The double lobe flaps were designed at the ulnar side of middle finger and the radial side of ring finger according to the defect of thumb skin. The arteria digitalis communis between the middle and ring fingers and its two branches of arteriae digitales propriae supplying the two fingers were used as a vessel pedicle. The flap with digitales proprii nervi was transposed and used to cover the exposed phalanx of thumb. Full thickness graft was used for the donor site. Observation of the appearance, texture, color and wear resistance of flap, appearance, color and depression of grafting area, skin feeling, and finger activities was conducted.

RESULTSAll the flaps and grafts were alive. Forty-three patients were followed up with an average duration of 25 months, and two patients lost follow-up. The color and texture of the flaps were similar to that of the contralateral thumb pulp. The average two point discrimination was 4.2 +/- 0.3 mm. The color of graft skin was slightly deeper than that of the surroundings skin.

CONCLUSIONDigital artery bilobed flap graft is an effective and ideal operation, which is of low risk and high success rates for skin degloving injury of thumb.

Adult ; Arteries ; surgery ; Female ; Finger Injuries ; surgery ; Humans ; Male ; Middle Aged ; Surgical Flaps ; Thumb ; blood supply ; injuries ; surgery ; Young Adult

AIM: To evaluate the application and effect of questionnaire based on professional knowledge method combined with problem - based learning ( PBL ) in ophthalmology short-term teaching.
METHODS: Ninety non ophthalmic students of Beijing Hospital of Traditional Chinese Medicine from January to August 2015 were randomly divided into observation group (45 students) and control group (45 students). Observation group: using questionnaire based on professional knowledge method combined with PBL teaching method; the control group: using traditional teaching method.
RESULTS: The survey results showed that: non ophthalmic students were unfamiliar with eye diseases knowledge; there was no significant difference in the clinical operation examination between the 2 groups (P>0. 05 ). There were significant differences in the eye disease knowledge, eye disease knowledge related to their own major and the total score between the 2 groups (P< 0. 05), especially students in the observation group had higher scores of eye disease knowledge related to their own major. There was no significant difference in the rate of improvement of learning pressure between the 2 groups (P> 0. 05), the differences of improvement rate on other problems between 2 groups was statistically significant ( P < 0. 05 ), and the improvement rate was higher in the observation group.
CONCLUSION: Questionnaire based on professional knowledge combined with PBL teaching method can effectively improve the learning effect in ophthalmology teaching.

The first case of Hurthle cell tumor of the thyroid gland(HCT) was described in the literature a century ago. Since then, researches of HCT have been progressing from cellular to molecular level. We reviewed the literatures about HCT researching, with emphasis on differentiated diagnosis of benign and malignant HCT.

Objective To observe the clinical efficacy of scalp acupuncture plus acupuncture at Jiaji points (EX-B 2) in treating chronic fatigue syndrome (CFS).Method Seventy CFS patients were randomized into a treatment group and a control group, 35 cases in each group. The treatment group was intervened by scalp acupuncture plus acupuncture at Jiaji points (EX-B 2), while the control group was by ordinary acupuncture. The Fatigue Scale (FS)-14 was observed before and after treatment, and the clinical efficacies were compared.Result The FS-14 scores were significantly changed after treatment in both groups (P<0.01). After treatment, the FS-14 score of the treatment group was significantly different from that of the control group (P<0.05). The total effective rate and recovery-markedly-effective rate were respectively 91.4% and 71.4% in the treatment group, versus 82.9% and 45.7% in the control group. There was a significant difference in comparing the recovery-markedly-effective rate between the two groups (P<0.05).Conclusion Scalp acupuncture plus acupuncture at Jiaji points (EX-B 2) is an effective method in treating CFS.

Humans ; Myocardial Infarction ; physiopathology ; Myocardial Reperfusion Injury

ObjectiveTo explore the clinical value of 256-slice CT and coronary angiography in the diagnosis of coronary artery disease.Methods46 patients with coronary heart disease,who underwent coronary angiography and 256-slice spiral CT were selected.Compare two methods for the detection of coronary artery disease.Results( 1 ) All 256-slice CT and coronary angiography achieved a satisfactory image,in the diagnosis of coronary artery stenosis and occlusion,the two methods had no statistically significant difference ( P ＞ 0.05 ).(2) according to standard coronary angiography,256-slice spiral CT for the diagnosis of coronary artery stenosis sensitivity was 93.0％ (132/142),specificity was 91.6％ (142/155),positive predictive rate was 91.0％ (132/145),negative predictive rate was 93.4％ (142/152).Conclusion256-slice spiral CT has a high time resolution,spatial resolution,the display of the coronary artery disease has high sensitivity,specificity,positive predictive value and negative predictive value.

Objective To investigate the effect of Miles laparoscopic sigmoid colostomy surgery for elderly patients with colorectal cancer .Methods The clinical data of 78 elderly patients with colorectal cancer underwent surgery were chosen .According to the different operation method , they were randomly divided into the observation group and control group ,39 cases in each group .The observation group was treated with laparoscopic Miles ,and the control group underwent surgery for abdominal Miles .The safety,efficacy,early complications of the two groups were analyzed and compared .Results The incidence rate of postoperative complication , excellent rate of ostomy surgery 6 months after operation in the observation group were 5.13%, 66.67%, respectively, which were better than 38.46%,20.51%in the control group (χ2 =12.70,9.69,all P<0.05).The defecate feeling of the observation group was better than that of the control group (χ2 =29.40,P<0.05).The difference of patients'quality of life and physical function between the two groups was statistically significant (t=3.30,P<0.05).Conclusion The clinical effect of laparoscopic sigmoid colostomy surgery Miles in the treatment of elderly patients with colorectal cancer is bet -ter than traditional open surgery ,it has obvious practical significance such as reducing the short and long term compli -cations and improving the quality of life of patients .