Objective To explore the effect of mon-suturing peritoneum in perforating purulent infection of incisional wound of appendicitis. Methods907 patients suffered purulent perforating and gangrenous appendicitis were divided randomly into two groups:the non-suturing group of 355 patients and the control group of 552 patients.Of the non-suturing group,peritoneum was not sutured when his/her abdominal cavity was closed.It was just on the contrary to the control group.Then examined whether eoncotic rythrogenic or tender incision occurred,or whether purulent secretion flowed outside from the operative incision.These items below were also been recorded carefully:the average number of days when the temperature was abnormal,the grades of healing of incision and the average hospital stay. ResultsIn the non-suturing group,21(5.9%)patients suffered postoperative infection,the number of days of abnormal temperature was(3.8 ± 1)d on average,and the average hospital stay was(7.5 ± 1)d;in the control group,119(21.6%)patients suffered postoperative infection,the number of days of abnormal temperature was(4.3 ± 1)d on average,and the average hospital stay was(12.9 ± 1)d.First rate healing of incision in the non-suturing group was far higher than that in the control group(P＜0.05). ConclusionNon-suturing peritoneum could help internal drainage peritoneum,which was an efficient way to guard against the postoperative infection.And non-suturing was also of great significance to reduce the average number of days of abnormal temperature and hospital stay.Meanwhile,the probability of ankylenteron and incisional hernia was not increased.

Objective: To investigate the effects of morphine,tramadol and lornoxicam on the secretion of inflammatory mediators by rats'peripheral blood mononuclear cells(PBMC) at their analgesic concentrations. Methods: Mononuclear cells were isolated from peripheral blood of male SD rats by the Ficoll-Hypaque method,and treated with Morphine(50 ng/ml),Tramadol(500 ng/ml) or Lornoxicam(300(ng/ml)) respectively with or without stimulation by Lipopolysaccharide(LPS) 2 ?g/ml.After incubation for 24 h,concentrations of TNF-?,IL-6 and IL-10 were determined in the cell culture supernatants by ELISA. Results: Levels of TNF-?,IL-6 and IL-10 were reduced significantly in morphine groups with or without LPS;Tramadol reduced levels of these inflammatory mediators significantly in the groups stimulated with LPS,while it had no effects on the cells cultured in normal conditions;Lornoxicam reduced IL-6 and increased IL-10 levels in either groups. Conclusion: Morphine nonselectively suppressed mediator secretions either under inflammatory or physiological conditions;Tramadol reduced inflammatory mediator secretion in LPS stimulating group,thus could benefit patients with potential sepsis;Lornoxicam significantly reduced proinflammatory cytokine IL-6 secretion and increased anti-inflammatory cytokine IL-10 secretion,and may be a choice for postoperative hyperinflammation.

Methods A cluster random sampling method was used to select left-behind students in Grade 3 to 6 in 5 primary schools in the southern rural area of Ningxia Hui Autonomous Region. Their general information were collected, their social anxiety and loneliness were evaluated by the Child Social Anxiety Scale ( SASC ) and Children's Loneliness Scale ( CLS ). The multivariate linear regression model was used to analyze the influencing factors for the social anxiety of left-behind children.

Abdominal Neoplasms ; diagnosis ; secondary ; Adult ; Animals ; Female ; Humans ; Liver Diseases, Parasitic ; diagnosis ; Liver Neoplasms ; diagnosis ; parasitology ; pathology ; Neoplasm Metastasis ; Paragonimiasis ; diagnosis

ObjectiveTo explore the application value and techniques of vaginal hysterectomy of non-prolapsed uterus lesion in primary hospital. Methods140 cases who suffered from uterine fibroid without adhesion,glandular fibroids,functional bleeding without uterine prolapse and malignant disease were selected and divided into observation group(80 cases with vaginal hysterectomy)and control group(60 cases with routine abdominal hysterectomy).Then the clinical treatment effect was analyzed. ResultsCompared with control group,peri-operative bleeding (150 ±23)ml vs(243 ±41)ml,operation time(65 ± 14.0)min vs(90 ± 27.0)min,body temperature recovery time (3 ±0.5)d vs(4 ±0.8)d,anus exhaust time(14 ± 1.8)h vs(26 ±2.7)h,the length of time(5 ±0.8)d vs(11 ±2.9)d in observation group were all reduced,differences were significant(all P＜0.01)and no case was transferred to opening appendectomy. ConclusionFor these disease including uterine fibroids with no adhesion,glandular fibroid uterine bleeding,the vaginal hysterectomy was safe and feasible,and had the advantage of smaller trauma,less bleeding,shorter hospitalization time,faster recovery etc.It was worthy to be popularized in primary hospital.

Objective To understand the psychological needs of old people in nursing homes,so that more humanistic services will be supplied to old people,and hopefully to facilitate the management of the nursing home facilities.Methods Field research method was used in this paper in four nursing homes in Chongqing City.Data were collected by observation and interview.Results Data were coded and translated into three themes:wishing to be listened,especially the new resident; eager to be more respected and the feeling of being at home; the most important thing was happiness.Conclusions To concern the psychological needs of old people in nursing homes and supply corresponding service have a significant meaning for improving the survival state and their life quality,as well as increase service level.

Objective To investigate the risk factors and the characteristic patterns of development changes of macrosomia.Methods 208 cases of macrosoroia were collected.Then the risk factors related to macrosomia by use of Logistic regression analysis were researched.208 infants of normal birth weight were selected as control group.The weight and length in 8 growth development monitoring time according to their health care manual were recorded.Mental development index(MDI)and physical development index(PDI)were tested and calculated by CDCC method when macrosomia and normal birth weight infants were 30 months.The characteristic patterns of development changes of macrosomia wre analyzed statistically.Results The risk factors of macrosomia contain age and height of the pregnant women,weight before pregnancy,weight increasing during pregnancy,nutriture,physical activity,family history of obesity and father's weight.Macrosomia was weighter than normal birth weight infants in the 8 growth development monitoring time and was longer than normal birth weight infants from 3 to 30 months(P ＜0.05).However,the length of macrosomia was not significantly different with that of control group when they were 36 months(P ＞ 0.05).MDI and PDI in macrosomia group were(107.33 ± 7.29)and(104.71 ± 6.93)respectively.MDI and PDI of normal birth weight infants group were(112.58 ± 7.61)and(109.09 ± 7.14)respectively.The differences were statistically significant(t =4.28,5.33;both P ＜ 0.01).Conclusion There were several risk factors for macrosomia such as environment and heredity.At the period of infants and young children,macrosomia were weighter than normal birth weight infants.The mental development and psycho-moter development of macrosomia were behind normal birth weight infants.

Objective To evaluate and compare the clinical effects of forward and reverse anterior cruciate ligament (ACL) reconstruction through the arthroscopy. Methods From April 2008 to August 2009,97 cases with simple ACL injures were treated with eight strands of hamstring tendons in way of two-bundle and four-tunnel reconstruction. The patients were randomly divided into two groups according to the number of hospital admissions: odd numbers (A group, 47 cases) were treated with forward double-bundle reconstruction and even (B group,50 cases) were treated with reverse. The grafts were fixed with a suspension technique by mini-plates and mini-buttons. Mean follow-up exceeded one year. The function of knee joint were assessed by the IKDC, Lysholm and Tegner rating scale. Results Mean follow-up was 13.71 months.At the last follow-up, 2 patients in A group had a 10°extension deformity and 5 had a less than 15° flexion limitation. All patients in B group showed normal knee extension, and 4 had a 5° flexion limitation. According to Lachman test, there were one case with one plus positive and one with two plus positive in A group,and one with two plus in B. KT-1000 examination (30° flexion and 30 N) showed the side to side mean difference of anterior knee laxity was (1.04±1.11) mm in A group and (0.86±1.12)mm in B. According to objective IKDC evaluation, the results were graded as normal or nearly normal in 46 patients in A group and 48in B. There were no statistical differences in the IKDC, Lysholm, and Teguer scores between two groups.Conclusion Forward or reverse ACL double-bundle reconstruction with eight strands of hamstring tendons can both restore knee stability, and there is no significant deviation between the two techniques.

Objective The purpose of this study is to evaluate the relevance of the recovery of proprioception function and the reservation of residual torn ligamentous fiber in the anterior cruciate ligament (ACL)reconstruction.Methods A retrospective study was carried out in 65 cases of ACL injury,who were treated with double-bundle ACL reconstruction and tibial remnant preservation and tensioning.All the patients were divided into four groups according to the degree of tibial residual fiber observed in the operation,no residual fiber was found(Group A),the length of the residual fiber was less than one third of the normal ACL(Group B),the length of the residual fiber was more than one third less than two thirds of the normal (Group C),the length of the residual fiber was more than two thirds of the normal(Group D).After one year follow-up,the passive angle reproduction test was performed with magnetic angle instrument in 3 flexion ranges(flexion of 90°-60°,60°-30°,and 30°-0°).All the results were contrasted among the four groups by statistical methods.Results In the passive angle reproduction test of the 3 flexion ranges,Group A and B showed a significant difference between the test side and control side(P＜0.05),and Group C showed a significant difference between the test side and control side at the flexion of 30°-0°(P＜0.05),but Group D showed no significant difference at the 3 flexion ranges(P＞0.05).Conclusion During double-bundle ACL reconstruction,with the reservation of tibial residual tom ligamentous and tensioning may have a good effect on the recovery of proprioception function of the knees,which ensure a better functional outcome in the reconstructed knee.

With the development of minimally invasive management,laparoscopic operation has become more and more prevalent.As a surgical procedure,a serial of events,such as psychological damage,fasting,bleeding,hypothermia,pain,introduce of cathartic,gastric tube,urinary catheter and aggressive resuscitation of crystal fluid,can produce stress and delay the rehabilitation. Evidence-based medicine has demonstrated that during the laparoscopic surgery,alleviating these events is associated with milder stress reaction and fast recovery.The focus of minimally invasive surgery should be shifted from the local injury to the stress of the whole body,from the wound size to the psychological,physiological and pathological changes of the whole body,from the technique of operation to the comprehensive management during perioperative period.In summary,the minimally invasive surgery focuses more and more on minimizing the stress influence on the whole body rather than merely on the minimal incision.It is reasonable to conclude that this kind of research will bring significant innovation in minimally invasive surgery in the future.