Objective To investigate the safety and feasibility of electrocoagulation of gallbladder artery in laparoscopic cholecystectomy ( LC) . Methods A total of 376 patients with gallbladder benign diseases underwent LC in our hospital from May 2004 to September 2013.The gallbladder artery was treated by electrocoagulation . Results Because of unclear gallbladder triangle due to abdominal adhesion , conversion to laparotomy was performed in 9 patients.In the remaining 367 patients, three-port LC with electrocoagulation of the gallbladder artery was conducted successfully .Laparoscopic appendectomy was conducted simultaneously in 12 patients.An additional fenestration and drainage of the left renal cyst was performed in 1 patient.Postoperatively, a secondary bile duct exploration was conducted in 1 patient because of bile duct obstruction caused by common bile duct stones . Conclusion The electrocoagulation of gallbladder artery is safe and feasible in LC for the treatment of gallbladder benign diseases .

Objective In response to the requirements of the new nation health care reform for the first diagnosis sinking .To in‐vestigate hospital as the center ,radiation surrounding ,we build the telemedicine system .Methods We analyzed the requirement ,de‐sign the architecture of the system through the way of TOGAF .Results The telemedicine system including telemedicine ,remote diagnosis and distance education was built .Conclusion The design ,establishment and application of the telemedicine system has an important influence and meaning .

Objective To observe the clinical effect of pioglitazone combined with gliclazide sustained-release tablets in the treatment of patients with early type 2 diabetes mellitus.Methods 80 patients with early type 2 diabetes mellitus in our hospital from June 2013 to July 2016 were selected as the study object,and the patients were randomly divided into two groups, 40 cases in each group.The control group were treated with gliclazide sustained-release tablets, the observation group were treated with pioglitazone combined with gliclazide sustained-release tablets.Then the blood glucose level, glycosylated hemoglobin level, lipid metabolism indexes and islet function indexes of two groups before and after the treatment were detected and compared.Results The blood glucose level, glycosylated hemoglobin level, lipid metabolism indexes and islet function indexes of two groups before the treatment were compared, the difference was statistically significant (P<0.05), while the blood glucose level, glycosylated hemoglobin level, lipid metabolism indexes and islet function indexes of two groups after the treatment were continuously improved , and the blood glucose level and glycosylated hemoglobin level of observation group were lower than those of control group, the ipid metabolism indexes and islet function indexes were all better than those of control group, the difference was statistically significant (P <0.05).Conclusion The clinical effect of pioglitazone combined with gliclazide sustained-release tablets in the treatment of patients with early type 2 diabetes mellitus is better, and it also has active adjustion role for the blood glucose, blood lipid and islet function state.

Objective To investigate the clinical effects of Compound Biejia Ruangan Tablet (CBRT) combined with entecavir in patients with chronic hepatitis B with hepatic fibrosis.Methods Totally 92 cases of patients with hepatic fibrosis of chronic hepatitis B in Ankang people's hospital from January 2013 to May 2016 were divided into observation group (n =45) and control group (n =47),patients in observation group were treated with CBRT combined with entecavir,and patients in the control group were treated with entecavir.Treatment was for 48 weeks.The liver function,liver fibrosis,serum inflammatory factors,and adverse reactions were compared between two groups.Results After treatment,the ALT,AST,TBIL,and ALB/GLB levels of two group were significantly lower than those before treatment (P ＜ 0.05),but there was no significant difference between two groups after treatment.After treatment,the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of two group were significantly lower than those before treatment (P ＜ 0.05),and the PCⅢ,IV-C,HA,LN,IL-6,IL-4,IL-10,and TNF-α levels of observation group were significantly lower than those of control group (P ＜ 0.05);there was no statistically significant difference in the incidence of adverse reactions between two groups (P ＜ 0.05).Conclusion CBRT combined with entecavir is safe and effective to treat liver fibrosis of chronic hepatitis b,and it could significantly improve liver function,improve the degree of liver fibrosis,and reduce the level of serum inflammatory factors.

OBJECTIVE: To explore the roles of otolith organs in the occurrence and recurrence of primary benign paroxysmal positional vertigo (BPPV) by vestibular evoked myogenic potential (VEMP) test. METHOD: We enrolled 17 recurrent primary BPPV patients and 42 non-recurrent primary BPPV patients between September 2014 and November 2014. All patients underwent VEMP tests, including cervical vestibular evoked myogenic potential (cVEMP and ocular vestibular evoked myogenic potential (oVEMP) tests. The abnormal case was defined as non-elicitation or asymmetry rate between bilateral sides is larger than 29%. RESULT: Significant difference was found in abnormal rate between cVEMP and oVEMP (P < 0.05 ) in BPPV patients. The abnormal rate of oVEMP was higher than that of cVEMP. Significant difference was found in abnormal rate in oVEMP test between recurrent and non-recurrent groups (P < 0.01) but not in cVEMP( P > 0.05). No significant difference was found in sex and age between recurrent and non-recurrent groups (P > 0.05). CONCLUSION The impairment of otolith organs, especially the utricle, is related to primary BPPV. Dysfunction of utricle may play a role in recurrence of BPPV. Recurrence of BPPV is not correlated with sex and age.
Benign Paroxysmal Positional Vertigo ; physiopathology ; Humans ; Otolithic Membrane ; physiopathology ; Recurrence ; Saccule and Utricle ; physiopathology ; Vestibular Evoked Myogenic Potentials

Objective To observe the therapeutic efficacy and safety of recombinant tissue-type plasminogen activator (rt-PA) combined with edaravone on acute cerebral infarction (ACI).Methods 60 cases of ACI were divided into rt-PA group (30 cases, treated by rt-PA only) and trial group (30 cases, treated with rt-PA combined with edaravone). The nerve function deficits of patients in both groups were evaluated by European Stroke Scale (ESS) and Barthel Index (BI) before and after treatment respectively.Results The ESS scores at 21st day and 90th day after treatment in the trial group were significantly higher than those of the patients in the rt-PA group. The effective rate of patients in the trial group was significantly higher than those in the rt-PA group (P＜0.05).Conclusion The treatment of rt-PA combined with edaravone is effective and safe in patients with ACI.

Objective To investigate the effect of sufentanil postconditioning on myocardial ischemiareperfusion (I/R) injury in patients undergoing cardiac valve replacement under cardiopulmonary bypass (CPB).Methods Sixty ASA Ⅱ or Ⅲ patients ( NYHA Ⅱ or Ⅲ ) of both sexes,aged 19-64 yr,scheduled for cardiac valve rreplacement under CPB,were randomly divided into 4 groups ( n =15 each):control group ( group C),sufentanil 0.5 μg/kg group (group S1 ),sufentanil 1.0 μg/kg group (group S2 ) and sufentanil 2.0 μg/kg group ( group S3 ).In groups S1,S2 and S3,sufentanil 0.5,1.0 and 2.0 μg/kg were infused over 2 min via aortic root 5 min before aortic unclamping respectively.In group C,the equal volume of normal saline (2 ml/kg) was infused instead of sufentanil.Blood samples were taken from the radial artery immediately before induction of anesthesia ( T2 ) and at 2,4,8,24 and 48 h after aortic unclamping ( T1-5 ) for determination of plasma concentrations of cardiac troponin-I (cTnI) and malondialdehyde (MDA) and activities of creatine kinase isoenzyme-MB (CK-MB) and superoxide dismutase (SOD).The duration of CPB,time of aortic clamping,extubation time,duration of stay in ICU,and myocardial contractility score and volume of drainage at 24 h after the operation were recorded.The restoration of spontaneous heart beat and adverse cardiovascular events were observed.Results The plasma cTnI,and MDA concentrations and CK-MB activity were significantly lower,while the SOD activity was significantly higher at T1-3 in group S1 than in group C ( P ＜ 0.05).The plasma cTnl concentration and CK-MB activity were significantly lower at T1-5,the plasma MDA concentration was significantly lower at T1-4,and SOD activity was significantly higher at T1-4,the extubation time and duration of stay in ICU were significantly shorter,and the myocardial contractility score at 24 h after the operation and incidence of adverse cardiovascular events were significantly lower in groups S2,3 than in group C ( P ＜ 0.05),The plasma cTnl concentration and CK-MB activity were significantly lower at T4,5,The plasma MDA concentration was significantly lower at T4,the SOD activity was significantly higher at T3,4,and the myocardial contractility score at 24 h after the operation was significantly lower in groups S2,3 than in group S1 ( P ＜ 0.05).Conclusion Sufentanil postconditioning can relieve myocardial I/R injury in patients undergoing cardiac valve replacement under CPB,and the mechanism is related to inhibition of lipid peroxidation.

Objective To investigate the mental health and its influential factors in wounded or disabled in patients 100 d after earthquake.Methods Sixty-one patients,sampled from inpatients who were wounded or disa bled during the earthquake and hospitalized 100 d,were assessed with SCL-90.Results Twenty-eight(45%) patients'scores of SCL-90 were>160.The mental health of wounded or disabled patients after earthquake WaS corre lated with the severity of themselves physical disability.acception of early psychological intervention and the condition of wound or death in family members;but was not correlated with age,gender and education.Conclusion Patients who were wounded or disabled during earthquake had high incidences of mental disorder 100 d after earthquake.Their psychological recovery is as important ag physical recovery.

Porcine reproductive and respiratory syndrome is caused by the PRRS virus(PRRSV), which has six structural proteins(GP2, GP3, GP4, GP5, M and N). GP5 and N protein are important targets for serological detection by enzyme-linked immunosorbent assay(ELISA)and other methods. Toward this goal, we developed an indirect ELISA with recombinant GP5 antigens and this method was validated by comparison to the LSI PRRSV-Ab ELISA kit. The results indicated that the optimal concentration of coated recombinant antigen was 0.2 μg/well for a serum dilution of 1:40. The rate of agreement with the LSI PRRSV-Ab kit was 88.7%(266/300). These results support the potential use of recombinant GP5 as an antigen for indirect ELISA to detect PRRSV antibodies in pigs.

Objective:To discuss the efficacy of emergency endoscopic hemostasis combined with somatostatin in treatment of upper gastrointestinal hemorrhage.Methods:100 patients with upper gastrointestinal hemorrhage were selected and divided into two groups randomly.The control group (48 cases) was given conventional hemostatic measures.The observation group (52 cases) was given emergency endoscopic hemostasis combined with somatostatin.The efficacy of emergency endoscopic hemostasis combined with somatostatin in treatment of upper gastrointestinal hemorrhage was evaluated by efficacy,the curative success rate and the improvement situation of clinical symptoms.Results:The effective rate was 88.5 ％ in the observation group,and the effective rate was 70.8 ％ in the control group,and the effective rate of observation group was higher than that of the control group (P＜0.05).The success rate for different lesion size was higher in the observation group compared with control group (P＜0.05).According to the success rate,with the increased size of lesion,the hemostasis rate was decreased.The hospitalization,negative fecal occult and haematemesis disappeared time of observation group was shorter than that of the control group (P＜0.05).The postoperative bleeding rate of observation group was lower than that of the control group (P＜0.05).Conclusions:The emergency endoscopic hemostasis combined with somatostatin has a good therapeutic effect on upper gastrointestinal hemorrhage.It can improve the clinical symptoms and shorten the hospitalization time,but its effect is limited on large lesion of upper gastrointestinal hemorrhage.