OBJECTIVETo explore the effect of auricular point sticking before operation for postoperative complications of external excision and internal ligation on mixed hemorrhoid.

METHODSEighty patients with mixed hemorrhoid were randomly divided into an observation group and a control group, 40 cases in each group. In the control group, paracetamol and dihydrocodeine tartrate tablets were applied with oral administration 1 h after operation, 510 mg each time, twice a day; at the same time, diosmin tablets were treated with oral administration, 0.9 g each time, twice a day. Three days' treatments were required successively. In the observation group, auricular point sticking was used before operation based on the treatment in the control group. The auricular points of Shen (Co10), Pangguang (CO9), Shenmen (TF4), Pizhixia (AT4), Jiaogan (AH6a) and Gangmen (HX5) were selected. The patients were asked to press the points 3-6 times per day, 3-5 min each time, 3 days' treatment in total. The scores of the postoperative complications in the 1st and the 2nd days were compared between the two groups such as pain, edema, hematochezia, retention of urine, etc.

RESULTSAfter operation, the scores of pain, edema, hematochezia, retention of urine in the 2nd day were all decreased obviously than those in the 1st day in the two groups (all P<0.05); and the scores of pain, edema, hematochezia, retention of urine in the 1st and the 2nd days of the observation group were lower than those in the control group (all P<0.05).

CONCLUSIONAuricular point sticking before operation combined with conventional western medicine with oral administration for preventing and treating postoperative complications of external excision and internal ligation on mixed hemorrhoid achieves positive and reliable efficacy.

Acetaminophen ; administration & dosage ; Acupuncture Points ; Acupuncture, Ear ; Adult ; Codeine ; administration & dosage ; analogs & derivatives ; Combined Modality Therapy ; Female ; Hemorrhoids ; surgery ; Humans ; Ligation ; Male ; Middle Aged ; Postoperative Complications ; drug therapy ; prevention & control ; therapy

Maximum Allowable Concentration ; Mineral Fibers ; analysis ; Occupational Exposure ; analysis

BACKGROUND:Elastic stable intramedulary nailing and titanium plate fixation are two methods for the treatment of midshaft clavicular fractures. Current research about comparison of these two methods is not too much, and most of cases were retrospectively analyzed. OBJECTIVE:To compare the efficacy of elastic stable intramedulary nailing and titanium plate fixation for midshaft clavicular fractures. METHODS:The PubMed database, CBM, EMbase database, Cochrane Library database, CNKI database and Wangfang database were searched to collect the trials on midshaft clavicular fractures. The searching time ranged from the date of building to September 2015. The quality of trails was evaluated. RESULTS AND CONCLUSION:(1) Seven trials involving 512 patients were included. (2) Meta-analysis results showed the postoperative functional recovery was better in the elastic stable intramedulary nailing group than that of the plate fixation group (P< 0.01). (3) The average bone union time, operation time, incision length,intraoperative blood loss and the hospital stay of the elastic stable intramedulary nailing group were less than those of the plate fixation group (P< 0.01). (4) There were no significant differences in incidence rate of complications between two groups.(5) It is concluded that elastic stable intramedulary nailing for treating midshaft clavicular fractures is superior to the plate fixation in the efficacy. As the first choice for treatment of midshaft clavicular fractures, above conclusions are needed to be verified by large-scale multi-center randomized controled trials.

Objective To observe the effect of Xiaoyukang capsule on the treatment of limb fracture healing.Methods65 patients according to randomized double-blind were divided into two groups (n=33) and control group (n=32 patients), postoperative observation group Xiaoyukang capsule treatment, control group were not special treatment.At different time points in all patients visual analog scale (VAS score), fracture healing fracture line score and grade the degree of X-ray, using Elisa method of total osteocalcin and collagen type I amino-terminal extension of a peptide levels (TPINP) was measured analysis of two sets of data differences.ResultsThe patients in the observation group 3 days, 7 days after, 10 days after VAS scores were lower than the control group[(3.49±0.31) points vs.4.69±0.46 points](P<0.05);[(2.40±0.25) points vs.(3.54±0.35)points](P<0.05);(1.33±0.14) points than (2.42±0.27) points, P<0.05).Patients observed Group 8 weeks, 12 weeks, 16 weeks after the fracture line rates were higher (1.59±0.27 points than (1.01±0.21) points(P<0.05);(2.65±0.40) points than (1.96 ± 0.36)min, P<0.05;(3.45±0.46) points than (2.65 ± 0.41) points(P<0.05).③ patients after 8 weeks of observation group and TPINP water osteocalcin were higher (65.37±8.07)μg/L ratio(39.95±7.18)μg/L(P<0.05);[(81.05±6.89)ng /mL ratio of (39.95±7.18) μg/L] (P<0.05).④ observation group 8 weeks after fracture healing X-ray grade level 69.70% than the control group 37.50%, and the difference was significant (P<0.05).Conclusionlimb fracture patients after taking the capsules Xiaoyu relieve pain, regulate the body and osteocalcin levels TPINP to promote fracture healing.

Objective:To investigate the effects of resuscitation with different fluids on hemodynamics,oxygen transport and extravascular lung water after acute hemorrhage in dogs. Method:Fifteen dogs were anesthetized and bled to a mean arterial pressure of 4.67 kPa to develop the hemorrhagic shock model.Then the animals were infused with one of three randomly selected fluid:lactated Ringer's solution, blood and polygeline.The terminal point of fluid resuscitation was at the level of PAWP of 2.0 kPa. Hemodynamics, oxygen transport and extravascular lung water values were measured. Result:colloids fluids infusion has more better efficacy and less extravascular lung water than crystalloids fluids infusion in hemorrhagic shock resuscitation,and polygeline infusion could restore hemodynamics better, meanwhile blood infusion could restore oxygen transport better.

Objective To evaluate the efficacy and clinical feasibility of the computer-assisted full plan- ning system for tibial fracture treatment with intramedullary nailing.Methods After analyzing the functional structure and operative procedures of the system,nine plastic tibia and 12 cadaver lower limbs were used for image mosaicing based on C-arm (PHILIPS BV Libra) fluoroscopic images in the operation room to assess the correctness of the mosaicing and planning algorithms.The plastic tibial model was used for analysis of the mosaicing precision.The cadaver tibial bone was used for reduction experiment with the reduction mechanism to analyze the operation feasi- bility.Results Only 7 to 10 [fluoroscopy time:(19.75?0.61)s] valid C-ann projection images were needed to produce a long bone panorama of the lower limb.The total time for image acquisition and mosaicing was within (4.17?0.86)minutes and the mosaicing precision in the plastic tibial model was (1.26?0.76)mm.The opera- tion of the reduction mechanism was very simple and could be controlled by a surgeon automatically or free of hand. An integrated reduction strategy could be produced for rough positioning in general and elaborate operations in de- tails.Conclusion The computer-assisted full planning system can be used for anatomical analysis based on the C-arm panorama,full surgical planning,virtual simulation,selection of proper intramedullary nails and fracture reduction in treatment of long bone fractures.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

This study was aimed to compare clinical effect and safety of ring mixed hemorrhoids treatment with pro-cedure for prolapsed and hemorrhoids (PPH) and Milligan-Morgan (M-M) in order to evaluate their effects of health economics. Retrospective analysis was given on clinical data of 100 cases (including 48 cases in P group, 52 cases in M group) which met the inclusion criteria from June 2008 to June 2010 in the Affiliated Hospital of Luzhou Med-ical College. Statistical analysis was made on short- and long-term effect, patient satisfaction, perioperative and postoperative complications of two groups. The cost-effectiveness was analyzed with the effect of health economics methods. The results showed that there was no obvious difference on short-term effect between two groups. However, aspects such as surgery time, hospitalization time, back to work time, duration of pain, bleeding condition, postopera-tive pain and anal swelling in P group were significantly better than M group (P< 0.05); long-term effect and cost-effectiveness in M group were obviously better than P group (P < 0.05). There was no obvious difference on inci-dence rate of adverse reaction between two groups. It was concluded that the traditional external dissection and inter-nal ligation for circumferential mixed hemorrhoids had better clinical effect of both short- and long-term with better cost-effectiveness. It is still a better surgical treatment for circular mixed hemorrhoids.

AIM To study the antiinflammatory and immunomodulatory effects of actarit(Acta). METHODS To abserve the change of primary and secondary inflammation,immune function on adjuvant arthritis(AA) rats treated with Acta and to detect the effect of Acta on T cell subgroup in mice in vitro. RESULTS Acta(10,30,90 mg?kg -1 ) intragastric injection(ig) did not significantly inhibit primary reaction of AA in rats. But Acta(10,30,90 mg?kg -1 ?11 d) ig signifcantly inhibited secondary reaction (secondary inflammatory swelling、 multiple arthritis) of AA rats. The lowered response of ConA induced splenolytes and the decreased IL 2 synthesis were restored to normal in AA rats treated with Acta, while the elevated IL 1 released from peritoneal macrophate (PM?) was reduced. Acta(1～100 ?mol?L -1 ) could inhibit ConA induced T h cells and enhance ConA induced T s cells culture in vitro . CONCLUSION Acta do not show obvious antiinflammatory action. But Acta has therapeutic action on AA rats, which may be related to its immunomodulatory activities,mainly through modulate cell mediated immunity.

Abstract: Objective　To explore the early diagnostic value of peripheral blood peroxisome proliferator-activated receptor γ (PPARγ) combined with γ-interferon (IFN-γ) release assay (IGRA) in the diagnosis of pulmonary tuberculosis in patients with end-stage renal disease (ESRD), and to provide reference for clinical diagnosis and treatment. Methods　From January 2019 to December 2021, 70 ESRD patients with suspicious symptoms of pulmonary tuberculosis were treated at Hebei Chest Hospital were selected as the research objects. According to the examination results, they were divided into ESRD group (40 cases) and ESRD complicated by pulmonary tuberculosis (40 cases, comorbidity group). In addition, 40 cases with pulmonary tuberculosis were used as the PTB group. All three groups of patients underwent IGRA test, and the peripheral blood PPARγ level was detected by enzyme-linked immunosorbent assay, and the diagnostic value of PPARγ combined with IGRA test for ESRD patients with pulmonary tuberculosis was explored. Results The expression level of PPARγ and IFN-γ content in the PTB group and the comorbidity group were obviously higher than those in the ESRD group (P<0.05), while the differences in PPARγ expression level and IFN-γ content between the PTB and comorbidity groups were not statistically significant (P>0.05). The ROC curve showed that the areas under the curve (AUC) of PPARγ and IGRA in the diagnosis of end-stage renal disease combined with tuberculosis were 0.823 (95%CI: 0.722-0.925) and 0.773 (95%CI: 0.662-0.883), respectively, and the AUC of combined detection was 0.928 (95%CI: 0.871-0.984), which was better than that of PPARγ and IGRA alone (Z/P=2.057/0.039, 2.843/0.005). The Kappa values of serum PPARγ and IGRA test compared with the clinical gold standard results in the diagnosis of ESRD complicated with pulmonary tuberculosis were 0.557 and 0.444 (P<0.05). The combined screening of ESRD with pulmonary tuberculosis was consistent with the clinical gold standard (Kappa=0.661, P<0.05). Among the 30 ESRD patients complicated with pulmonary tuberculosis, the sensitivity of PPARγ combined with IGRA test in diagnosis of ESRD complicated with pulmonary tuberculosis was 93.33% (28/30), which was higher than 70.00% (21/30) of PPARγ and 66.67% (20/30) of IGRA test alone (P<0.05). Conclusions Peripheral blood PPARγ and IGRA tests have certain diagnostic value for ESRD complicated with tuberculosis, and the combined detection of the two can improve the sensitivity and reduce the rate of missed diagnosis, which is worthy of clinical promotion.