Objective To investigate the effects of different ventilations during the induction of anesthesia on postoperative nausea and vomiting in patients undergoning laparoscopic cholecystectomy. Methods One hundred and twenty patients undergoing laparoscopic cholecystectomy were randomly divided into M group and V group according to random number table, 60 patients each group. The patients in M group performed manual ventilation and the patients in V group performed mechanical ventilation. According to different tidal volume, V group were randomly divided into three groups (20 patients each group:V1,V2 and V3 group, respectively recieved body weight × 4, 6 and 8 ml/kg. After tracheal intubation,the operations were completed by maintaining the end of CO2 partial pressure (PETCO2)from 35 to 45 mmHg, 1 mmHg = 0.133 kPa. Tidal volume, peak airway pressure (Ppeak) and PETCO2 in anesthesia induction,and intraoperative gastric insufflation and postoperative nausea and vomiting were recorded and compared. Results The incidence rate of gastric insufflation, postoperative nausea and vomiting in V group were significantly higher than those in M group:50.0%(30/60) vs. 21.7%(13/60), 45.0%(27/60) vs. 18.3%(11/60), 26.7%(16/60) vs. 10.0%(6/60), P<0.05. The level of Ppeak in M group, V2 group and V3 group were signicantly higher than that in V1 group: (13.55 ± 1.95), (12.05 ± 1.23), (18.35 ± 3.71) cmH2O vs. (13.55 ± 1.95) cmH2O, 1 cmH2O = 0.098 kPa, P<0.05. The level of PETCO2 in M group, V2 group and V3 group were signicantly lower than that in V1 group:(19.60 ± 4.31), (27.75 ± 1.94), (23.60 ± 4.45) mmHg vs. (29.90 ± 2.40) mmHg, P<0.05. Conclusions Manual ventilation during the induction of anesthesia in patients undergoning laparoscopic cholecystectomy is better than mechanical ventilation . Proper manual positive pressure ventilation and volume mechanical ventilation with low tidal (4 ml/kg) may allow for decreasing intraoperative gastric insufflation and postoperative nausea and vomiting.

Objective To evaluate the clinical characteristics and long-term results of elective coronary stenting in octogenarians with coronary artery disease. Methods From Jan 2000 to Dec 2003, 84 octogenarians with coronary artery disease documented agiographically were divided into stent group (n=45) and medicine group (n=39). The clinical characteristics, in-hospital and long-term results were analyzed between the two groups. Results There were no difference between the two groups at the respect of basic clinical characteristics but the percentage of AMI was higher in the stent group (40.0% vs 17.9%, P

Objective To evaluate the clinical features in patients with pre- or post-operation epilepsy, and to explore the relationship of secondary epilepsy and craniocerebral operations. Methods The patients involved in present study were admitted and underwent the craniocerebral operations in the General Hospital of PLA from Jun.1999 to Feb.2008. The clinical data of epilepsy occurred at pre- or post-operation were retrospectively analyzed. All the 186 patients were divided into the pre-operation epilepsy group(Group A, n=90 ) and the post-operation epilepsy group(Group B, n=96). Based on a standardized questionnaire, a database was established with Microsoft Access 2007 including the primary etiological factor, the location of epileptogenic focus, the seizure frequency, the seizure type, and the abnormal electroencephalogram (EEG). Results Intracranial tumor and cerebrovascular malformation were the main primary etiological factors in group A, and intracranial tumor, cerebral trauma, cerebrovascular malformation and acute cerebral apoplexy were the main primary etiological factors in group B. The four main primary etiological factors for seizures were discovered in significant difference between group A and group B(?2=45.857 3,P=0.000 0). Cranial computed tomography(CT) or nuclear magnetic resonance imaging(MRI) detected that the most locations of epileptogenic focus were in frontal lobe(31.8% in group A and 29.5% in group B), temporal lobe(30.7% in group A and 26.3% in group B), and parietal lobe(17.0% in group A and 24.2% in group B). The frequency of seizure was significantly decreased in group A(?2=11.313 3,P=0.010 1), and was increased in group B(?2=77.080 3,P=0.000 0). The quantity of abnormal EEG for focal epilepsy was significantly decreased in group A(?2=9.773 4,P=0.007 5), but the increasing quantity of abnormal EEG was not significant in group B(?2=4.366 0,P=0.112 7). No significant difference in seizure type was proved after the craniocerebral operations in group A(?2=0.214 3,P=0.643 4). Campared with the post-operation epilepsy group, the location of epileptogenic focus did not show significant distinction in the pre-operation epilepsy group(?2=1.772 2,P=0.777 6). Conclusions Craniocerebral operation is an effective therapy for the secondary epilepsy with certain epileptogenic focus, and it is one of the definite causes of secondary epilepsy.

Objective To study the cytoprotective effect of prostaglandin E1(PGE1)in the imme- diate period after orthotopic liver transplantation (OLT).Methods Ten patients undergoing OLT were divided into 2 groups: group P (n=6) was administered with PGE1 and group C (n=4) served as control group. Serum ALT, AST, TBIL, DBIL, bile output and the period of intensive care unit (ICU) in both groups were observed in the first 3 weeks after OLT. Results Postoperative increases in serum ALT, AST, TBIL and DBIL levels were significantly suppressed by PGE1. In addition, PGE1 contributed distinctly to an increase of bile output (P

The purpose of the National Competition in Basic Medicine Innovation Forum & Ex-perimental Design in colleges is to boost Excellent-doctor Education Training Plan, cultivating students' scientific research ability and other comprehensive capacity. In practice, the originality and the scientific nature of the selected topic were emphasized through the provision of scientific research funding. The teachers changed their traditional instructional concept and teaching models. They guided the students to select the scientific subjects and took various measures to change students ' learning mode, resulting in gradually pro-moting the students' scientific research level and comprehensive ability. The results showed that these novel strategies are feasible and effective, which may provide a new way for improvement of the excellent doctor program.

Aiming to solve the problems in traditional classroom mode PBL teaching during clinical practice of oral and maxillofacial surgery,this paper investigated multi-pattern PBL teaching basing on Weblog,daily ward round and classroom discussion in the clinical practice,and focused on the practice methods,advantages and feature of this multi-pattern PBL teaching.

Objective To investigate the clinical efficacy of treatment for chronic pancreatitis and mass in the head of the pancreas.Methods The clinical data of 19 patients with chronic pancreatitis with mass in the head of the pancreas who were admitted to the China-Japan Union Hospital of Jilin University from May 2008 to May 2013 were retrospectively analyzed,including 2 patients with gallstone.Methods of treatment were selected by in traoperative pathological results.All the patients were followed up by outpatient examination and telephone interview till January 2014.Results The operations of the 19 patients were successfully done,including 11 with pancreaticoduodenectomy,5 with exploratory laparotomy and 3 with the laparoscopic cholecystectomy and choledochojejunostomy.The operation time and intraoperative blood loss were (249± 140)minutes (50-390 minutes) and (320 ± 260)mL (50-900 mL).The postoperative mean time of recovery of gastrointestinal function and duration of postoperative hospital stay were 3.0 days (2.0-6.0 days) and 22.6 days (8.0-30.0 days) after the operation.The mean casein-IgG4 of 12 patients was higher (2.64 g/L) after operation.Five patients with operation-related complication were cured after symptomatic treatment,among 2 patients with leakage of the pancreatic fluid,2 with operative incision fat necrosis and liquefaction and 1 with bile leakage.No patients died perioperatively.Nineteen patients were followed up for 11.0 months to 36.0 months with the median time of 28.2 months.The pancreatic head mass of 8 patients with non-pancreaticoduodenectomy were reduced or disappeared by a computed tomography (CT) or magnetic resonance imaging (MRI) rescan,who were treated by the oral prednisone.No complications were detected in the other 11 patients with pancreaticoduodenectomy.Conclusion Method of surgery or medicine treatment for atypical mass in the head of the pancreas is selected according to the pathology results by effective communication with patients and family members,exploratory laparotomy and interpretative aspiration biopsy.

Objective To study the influence of qiqishen granules on the cellular and humoral immune functions in model mice. Methods Six-week-old mice were divided into control group and qiqishen granule (high, medium and low dose) groups. The suspension of chicken red blood cells was injected into the mouse abdominal cavity. The influence of qiq-ishen granules on the phagocytic function of the macrophages in mouse abdominal cavity was observed. The sheep red blood cells (SRBC) were prepared. The blood corpuscle coagulation was observed, and the serum hemolysin was detected. The ac-tivity of the mouse natural killer (NK) cells were detected by the interaction between the target cell (YAC-1) and spleen cell (the response cell). The influence of qiqishen granules on the cellular immunity was detected by the lymphocyte transforming assay. The influence of qiqishen granules on organ/body weight ratio was measured by calculating the thymus/body and spleen/body ratio. Results Compared with the control,qiqishen granules significantly improved phagocytic function of the macrophages in mouse abdominal cavity. The humoral immune function was also improved in mice. The activity of NK cell was enhanced by qiqishen granules, which also enhanced the lymphocyte transforming induced by the concanavalin (Con) A. There was no significant influence in the organ/body weight ratio. Conclusion The qiqishen granules could increase the im-munomodulating effect, indicating it would have a good using prospect.

OBJECTIVE To observe the effect of vacuum-assisted closure in clinical persistent infection patients.METHODS Thirty two sufferers infected in soft tissue,bones and joints were treated by general methods but without durable concrescence.It lasted averagely 138 days.In our department it treated by vacuum-assisted closure in 23 days.Thereby a comparison of self-control came into being.RESULTS Thirty two cases were cured after following at least one year except for one case with recrudescence.CONCLUSIONS Vaccum-assisted closure is the most effective surgery therapy measurement and is a kind of unidirectional drainage.If we can use it felicitously then we can treat infection in orthopedics′ effectively.