Objective To evaluate the effectiveness of transurethral holmium laser treatment for multiple complex bladder pathological changes.Methods Clinical data of 507 cases of transurethral holmium laser resection for multiple complex bladder pathological changes under endoscope from 2001 to 2005 were retrospectively reviewed.A total of 17 types of bladder pathological changes were encountered,and 2 or more types of pathological changes occurred simultaneously in 111 cases,including 36 cases of 3 types of coexisting changes.Results Primary operation was performed in 505 patients,and two-stage operation was performed in 2 patients.The operation time was 5~35 min(mean,20 min).No obturator nerve reflex and other complications were seen.The operation was accomplished in 3 patients with cardiac pacemaker and 3 patients with coronary stent.Follow-up examinations in all the cases for 12~24 months revealed no relapse.Conclusions Transurethral holmium laser resection for multiple complex bladder pathological changes is safe and reliable.During the procedure,the degree of resection depth in the bladder wall can be precisely controlled.It can be used as the first choice for minimally invasive treatment of multiple complex bladder pathological changes.

Objective To appraise the diagnostic capability of laparoscopic ultrasonography (LUS) for urinary system injury induced by laparoscopic surgery in goats. Methods Animal models of different types of urinary system injury at different sites were established in five goats. One goat without injury was set as a negative control. LUS was used to examine the animals following randomization and single-blind principles. Results The sensitivity of LUS was 76.9% (10/13),specificity was 100%,and the false-negative rate was 23.1% (3/13). No false-positive results were detected in this study. The sham injury was accurately detected through LUS. The scan time of LUS ranged from 19 to 25 min with a mean of 21 min. Conclusions LUS is of value in the diagnosis of urinary system injury.

Objective To promote the level of early diagnosis and strengthen the understanding of pathogenesis, pathological staging and prognosis of primary gallbladder carcinoma (PGC). Methods The data of 679 patients with PGC treated in our hospital from 1956 to 1998 were retrospectively analyzed. Results The incidence of PGC has been increasing in recent years while the surgical management for the disease was not satisfactory. Upon diagnosis, most patients were with PGC in advanced stage. PGC was usually found among the aged woman patients. The female/male ratio was 3∶1. There was a close relationship between gallstone and PGC, for the gallstone was found in 60% of the patients with PGC. The diagnostic accordance rate before and after operations was low. Most cases of PGC were found unexpectedly during operation due to gallstone or acute cholecystitis. It was even worse that many patients with PGC missed the opportunity of diagnosis and treatment because doctors noticed the gallstone only. Pathological classification revealed that most cases of PGC were of adenocarcinoma. Development in imaging medicine might help a lot in finding early-stage cases and improving prognosis. Conclusions Strengthening the understanding of pathogenesis, pathological staging and prognosis of the disease and proper use of various examinations are the basic means of obtaining early diagnosis and improving the prognosis.

ObjectiveTo evaluate the role of laparoscopic ultrasonography (LUS) in laparoscopic ureterolithotomy.MethodsLUS was utilized in laparoscopic ureterolithotomy for 7 cases of ureterolith to locate the ureter and stone.ResultsLUS demonstrated the relationship of the ureter to the adjacent structures and guided the dissection of the ureter in all the 7 patients and precisely localized the position of calculi.The stone could be touched by atraumatic clamps in 5 cases.LUS-demonstrated localizations of the ureter and calculi were verified on laparoscopic ureterotomy in the other 2.The mean operating time for LUS was 14 min (ranging from 9 to 20 min ).ConclusionsLUS is a real adjuvant means for locating the ureter and stone.

Objective To investigate the relationship between the apolipoprotein B (ApoB) gene Xba Ⅰ and EcoR Ⅰ polymorphisms and cholelithiasis in Han and Mongolian population in the Midwest Area of Inner Mongolia.Methods The clinical data of 100 patients with cholelithiasis and 115 healthy individuals at the First Affiliated Hospital of Medical College of Baotou from April to October in 2010 were collected.A case-control study which detected ApoB alleles of patients with cholelithiasis (cholelithiasis group) and healthy individuals (control group) in Han nationality and Mongolian nationality in the Midwest Area of Inner Mongolia was conducted by polymerase chain reaction-restriction fragment length polymorphism,which included Xba Ⅰ (X + X +,X + X-,X-X-,X +,X-) and EcoR Ⅰ (E + E +,E-E-,E + E-,E +,E-).The serum lipid (including triglyceride,total cholesterol,high density lipoprotein and low density lipoprotein) levels in different groups were detected.The count data and the measurement data were analyzed using the chi-square test and t test,respectively.Results Genotype X + X + was not found in the Han and Mongolian population,and Xba Ⅰ (X +) or EcoR Ⅰ (E-) alleles was not found in the Mongolian population.The levels of low density lipoprotein were (2.8 ± 0.9)mmol/L in the cholelithiasis group,which was significantly higher than (1.9 ± 0.8) mmol/L of the control group in the Han population (t =2.800,P ＜ 0.05).The levels of high density lipoprotein and low density lipoprotein were (1.7 ± 0.3) mmol/L and (3.5 ± 0.8) mmol/L of the cholelithiasis group,which were significantly higher than (1.2 ± 0.3) mmol/L and (2.8 ± 0.9) mmol/L of the control group in the Mongolian population (t =7.596,2.549,P ＜ 0.05).The levels of triglyceride,total cholesterol,high density lipoprotein and low density lipoprotein of the cholelithiasis group in the Mongolian population were (3.1 ± 1.6) mmol/L,(5.6 ± 1.0) mmol/L,(1.7 ± 0.3) mmol/L and (3.5 ± 0.8) mmol/L,which were significantly higher than (1.2 ± 0.6) mmol/L,(4.4 ± 1.2) mmol/L,(1.3 ± 0.3) mmol/L and (2.8 ± 0.9) mmol/L of the cholelithiasis group in the Han population (t =5.501,3.667,4.448,3.430,P ＜ 0.05).The levels of triglyceride,total cholesterol,low density lipoprotein were (2.6 ± 1.7) mmol/L,(5.1 ± 1.1) mmol/L and (2.8 ± 0.9) mmol/L of the control group in the Mongolian population,which were significantly higher than (1.3 ±0.7)mmol/L,(3.9 ±0.9) mmol/L and (1.9 ±0.8) mmol/L of the control group in the Han population (t =4.298,4.772,3.888,P ＜ 0.05),while the level of high density lipoprotein was significantly higher of the control group in the Han nationality than the control group in the Mongolian population (t =1.997,P ＜ 0.05).The levels of low density lipoprotein in patients with genotypes X + X-,X-X-of the cholelithiasis group in the Han population were (2.7 ± 0.1) mmol/L and (2.6 ± 1.0) mmol/L,and the levels of low density lipoprotein in patients with genoeypes E + E ±,E + E-/E-E-were (2.6 ± 1.0) mmol/L and (2.5±0.4)mmol/L,with no significant difference (t=0.225,0.124,P＞0.05).Conclusion In the Midwest area of Inner Mongolia,the Mongolian population might be more susceptible to cholelithiasis than the Han population.No relationship between the rare alleles X +,E-and the increase of blood lipids,which indicates that X + and E-of ApoB may not be a risk factor of cholelithiasis.

With more and more international medical students studying medicine in China,international medical education becomes an important part of Chinese medical education.By integration of basic and clinical pharmacology,the teaching mode of theory,experiment,problem based learning and seminar was applied to the international medical students according to their characteristics and specificity.75％,80％ and 70％ of the total international medical students respectively passed the two consecutive final exams and one pharmacology group exam.Through the teaching of pharmacology for international medical students major in MBBS,this author aims to explore the teaching mode of pharmacology for the international medical students.

Objective To observe the effect of local pain alleviation by wet compress with room temperature and low temperature lidocaine and cold wet compress in fructose infusion in children. Meth-ods 120 children patients with pain during fructose infusion were randomly divided into the wet compress group, the room temperature lidocaine group and the low temperature lidocaine group with 40 cases in each group. The analgesic effect was observed in the three groups. Results Analgesic effect of the low temper-ature lidocaine group was significantly better than the other two groups. Conclusions The wet compress with low temperature lidocaine can relieve the local pain in fructose infusion in children.

Based on a definition of the concept and its connotation,and summary of the evolution and practice of global budget in China,this paper focused on analyzing the existing problems,namely a defective mechanism in the determination and adj ustment of the total budget,unreasonable settlement, absence of a regulatory mechanism and poor linkage of this system with other payment modes reform.Thus the authors proposed such policy recommendations as designated management of those covered by health insurance,and experiments with the global budget mode for regional groups,scientific estimation and adj ustment of the total budget,reasonable setting of settlement standards and rules,and enhanced supervision and appraisal,as well as various payment system reforms based on global budget.

Objective To investigate the features of the cerebrospinal fluid (CSF) in the modified ZeiM-Neelsen (MZN) positive tuberculous mengningitis (TBM).Methods We retrospectively reviewed the clinical data of 170 patients with tuberculous meningitis confirmed by MZN stain from December 2012 to July 2015.The purpose of the present study was to investigate the relationship of MZN staining and CSF cytology.Results Among 170 patients with TBM confirmed by MZN staining,128 cases had first detectable acid-fast bacillus (AFB) in earlier stage.The cytology included 15.5％ mixed cellular cytology,58.5％ lymphoid cytology,19.5％ neutrophilic cytology and 6.5％ normal cytology.Twenty-four cases had first detectable AFB within 1-2 months following disease onset.The cytology included 13.1％ mixed cellular cytology,56.6％ lymphoid cytology,21.7％ neutrophilic cytology and 8.7％ normal cytology.Eighteen cases had first detectable AFB 2 months after disease onset.The cytology included 26.7％ mixed cellular cytology,46.7％ lymphoid cytology,20.0％ neutrophilic cytology,6.6％ normal cytology.There was no significant difference in median time of first detectable AFB among those four types of cytology (P=0.812).There was significant difference in median time of first detectable AFB between patients with and without anti-TB therapy [21.5 (12.3,37.8) days vs.8.5 (6.0,16.3)days,P＜0.001].There was no significant difference in median time MZN stain turning negative between patients with and without anti-TB therapy [11 (5.75,19.25) days vs.6(4.25,10.75)days,P=0.230].Conclusions AFB can be detectable within a month after the onset of TBM in most of cases.(MZN) positive staining is not associated with the major type of cytology.Anti-TB therapy may delay the first detectable time of AFB.

A number of studies on hospital information system (HIS) and regional information platform have been carried out in different medical institutions since HIS was defined as one ofThe 4 Beams and 8 Pillarsin 2009 , during which good results were achieved and many problems were exposed .The application of electronic medical record (EMR), a key part of HIS, is grealy concerned.The application of electronic medical record system ( EMRS) and related problems were thus described in this paper in order to provide reference for bringing it into a better play, normalizing its management, and reducing its disadvantages.