In order to improve doctor patient relationship and communications, the system of doctor patient communications was implemented in an all round way. First, the contents of the system were defined. Then the ways of implementing the system were fixed: improving training and changing service concepts; bringing doctor patient communications into line with quality management; making use of special survey forms for the system, and mastering a variety of communications skills. In addition, necessary organization, personnel, and regulations were put in place to guarantee the success of the system. Consequently, implementation of the system brought about pretty tangible results.

Purpose:By ascessing the CT guided percutaneaus biopsy to improve clinical diag- nostic rate and reduce complications.Materials and methods:60 cases of biopsy with complete materials have been reviewed,and the methods of“retain anesthetic tracing needle”has been proposed-to obtain tissues for cytologic and histologic exams with different biopsy needles.Results:Successful rate of the puncfure 100%.39 cases were identified as lung cancer,8 cases as tuberculosis,7 cases as pneumonia. Successful biopsy was 90%.Conclusion:“Retain anesthetic tracing needle”could reduce the times of adjusting direction,improve the one-time successful rate and possess the characteristics of positioning safe,reliable and accurate diagnosis.

Objective: To explore the preparation methods of nanomete r powder of ZrO 2 for dental application. Methods:Zirconia gel wa s dehydrated by heterogeneous azeotropic distillation process and n-butanol was used as azeotropic solvent. The properties of ultrafine powder obtained via dec ompression (process b), atmosphere pressure (process c) and direct ethanol-wash ing (process a) were studied. Results: After drying and calcini ng the gel, the ultrafine powder obtained from process a,b and c was about 25 n m,22 nm and 17 nm respectively. 3Y-TZP ceramic prepared with the three kinds of nanometer powder had bending strength of 660 MPa,710 MPa and 640 MPa; fracture toughness of 4.34 MPa?m 1/2 ,4.77 MPa?m 1/2 and 4.24 MPa?m 1/2 , respectively. Conclusion: By the heterogeneous azeotropic dis tillation process, zirconia ultrafine powder without hard agglomeration (d BE T=17 nm) can be obtained.

Objective To evaluate clinical application of phage amplified biologically assay (PhaB) in susceptibility test of Mycobacterium tuberculosis (MTB) in sputum. Methods The drug susceptibility of MTB was detected by PhaB in 143 patients with sputum-positive pulmonary tuberculosis (PTB),and the chemotherapy regimens were adjusted according to the results of susceptibility test.Independent samples t-tests were used for comparison of means.Count numbers were compared with Chisquare test.If there were count number of 0,Fisher probabilities should be used.ResultsThe total positive rate of PhaB was 94.4％ (135/143) with no differences between three types of PTB (x2 =1.886,P ＞ 0.05 ).The duration of testing for PhaB group was (6.6 ± 1.8) days,while for control was (29.4 ±8.7) days (t =29.01,P ＜ 0.01 ).Compared with control group,the 2-month negative-conversion rate (63.2％ vs.35.1％,x2 =3.989,P ＜ 0.05 ) and cure rate ( 100％ vs.78.4％,P ＜ 0.05 ) of PhaB group in type Ⅱ patients were significantly higher.But there were no differences between PhaB and control groups in type Ⅰ and Ⅲ PTB patients.ConclusionThe results of PhaB drug susceptibility test can be helpful for choosing effective chemotherapy regimen for PTB patients rapidly.

BACKGROUND:Many scholars have experimental y confirmed the obvious effect of mesenchymal stem cells to repair radiation injury. OBJECTIVE:To preliminarily investigate the mechanism of human umbilical cord mesenchymal stem cells promoting the healing of combined radiation-wound skin injury and whether they possess tumorigenicity in vitro. METHODS:Fifteen Sprague-Dawley rats were randomly divided into three groups, five rats in each group. The right buttock of rats (2.5 cm×2.0 cm) was irradiated with 40 Gyβ-rays produced by a linear accelerator, in which a round wound with a diameter of 1.5 cm was made. After 12 hours of modeling, human umbilical cord mesenchymal stem cells at three concentrations (5.0×106, 1.0×107 and 2.0×107 ) were injected through tail vein of rats, and luciferin (20 mg/kg) was injected intraperitoneal y. celldistribution in vivo was traced using IVIS in vivo imaging system. The ability of human umbilical cord mesenchymal stem cells to form colonies was observed using the colony formation assay with soft agar. RESULTS AND CONCLUSION:Human umbilical cord mesenchymal stem cells injected through tail vein of rats were mostly gathered in the lungs. cells were accumulated in the injured site of rats injected with 2.0×10 7 human umbilical cord mesenchymal stem cells;however, the fluorescence signal was not observed in the injured site of rats injected with 5.0×106 and 1.0×107 human umbilical cord mesenchymal stem cells. The other results indicated human umbilical cord mesenchymal stem cells of low dose, medium dose and high dose had no colony formation on soft agar, but the tumor cells had a great ability to form colony. These findings indicate that human umbilical cord mesenchymal stem cells promote healing combined radiation-wound skin injury by local migration and exhibit no tumorigenicity in vitro in a short period.

Objective Pulmonary dysfunction is common in the obese patients after laparoscopic surgery. To reduce or avoid this complication caused by improper combination of mechanical ventilatory parameters,we conducted the following trial of 3 factors with 3 levels of mechanical ventilation in order to explore the optimal combination with low airway pressure. Methods Patients were randomly allocated into 9 groups (k=3,n=27) according to the "30≤BMI<40" obesity index (ASAⅠ-Ⅱ). Anesthesia machine parameters were set as follows: respiratory frequency (f), tidal volume (VT), respiratory ratio (I:E) as the three factors of A, B, C, with 3 levels of f=15, 12, 9 (bpm), VT=8, 10, 12 (mL/kg), I:E=1:2.5, 1:2.0, 1:1.5. By using L9(3~4)K=3 repeat orthogonal experimental design and analysis table, the variable factors that affect the respiratory index such as the end tidal carbon dioxide pressure (P_(ET)CO_2), peak airway pressure (PIP), mean airway pressure (P_(mean)), and the end of endogenous airway pressure (PEEPi) were analyzed. Results In this study, 27 cases undergoing laparoscopic surgery under general anesthesia were allocated into 9 experimental groups. The hemodynamics of these patients was stable, SPO_2 was kept at 100 percent during the operation. The results of different combinations were described as follows: ①P_(ET)CO_2: f and VT with different level had great impact on P_(ET)CO_2 (P<0.01), I:E had no significant difference in three levels (P>0.05);② PIP: f had great effect on PIP (P<0.05);VT and I:E in three levels also had significant effect on PIP(P<0.01);③ P_(mean): all the ventilation parameters with different combination had significant effect on P_(mean)(P<0.01). Conclusions The best combination of respiratory parameters is A3B1C2, i.e., f=9 bpm, VT=8 mL/kg, and I:E=1:2.0, which indicates that neither small tidal volume and faster frequency, nor slow frequency large tidal volume is a good choice. In order to let obese patients under general anesthesia obtain the best lung protective effect by low airway pressure with good ventilation, it is worth noting that: ①I:E has a great effect on airway pressure (PIP, P_(mean)), which is important for lung protection;②I:E has the opposite effect on PIP and P_(mean).

ObjectiveTo investigate the value of serum carbohydrate antigen 19-9 (CA19-9) combined with procalcitonin (PCT) in the diagnosis of acute cholangitis secondary to common bile duct stones. Methods A retrospective analysis was performed for the clinical data of 764 patients with common bile duct stones who were admitted to The Third Affiliated Hospital of Zunyi Medical University from June 2012 to June 2018, and according to the presence or absence of acute cholangitis, they were divided into cholangitis group with 173 patients and non-cholangitis group with 591 patients. The t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. Receiver operating characteristic (ROC) curves were plotted for statistically different indices to calculate the cut-off value, sensitivity, and specificity of each index. ResultsCompared with the non-cholangitis group, the cholangitis group had significantly higher levels of C-reactive protein (CRP) (78.24±8.02 mg/L vs 30.14±4.25 mg/L, t=3.730, P=0.038), PCT (2.25±0.21 ng/ml vs 0.21±0.06 ng/ml,t= 9.297, P＜0.001), and CA19-9 (87.52±7.95 kU/L vs 2415±3.87 kU/L, t=26.35, P＜0.001). Serum PCT had an area under the ROC curve (AUC) of 0.907, a sensitivity of 82.4%, and a specificity of 86.1%, serum CA19-9 had an AUC of 0.825, a sensitivity of 85.2%, and a specificity of 80.5%, and serum CRP had an AUC of 0.643, a sensitivity of 69.2%, and a specificity of 54.3%; CRP had no diagnostic value due to an AUC of ＜0.7. Serum PCT combined with CA19-9 had a sensitivity of 97.11%, a specificity of 98.65%, a false negative rate of 2.89%, and a false positive rate of 1.35%. Conclusion Both serum CA19-9 and PCT have an important value in predicting acute cholangitis secondary to common bile duct stones, and combined measurement of serum CA19-9 and PCT has significant increases in specificity and sensitivity and can thus be used as a predictive indicator for acute cholangitis.

Postoperative thyroid scar not only causes itching, pain, and pulling, but also seriously affects the patient’s aesthetics, so it is important to study the prevention and treatment of postoperative thyroid scar. In the past 20 years, clinicians have made many innovative researches to alleviate postoperative thyroid scar growth, and the following progresses have been made: firstly, thyroid surgery methods and surgical accesses have been improved to a certain extent, resulting in more concealed and less traumatic accesses; secondly, the use of lasers and silicone and other drugs has significantly improved the scar treatment effect; thirdly, the concept of "cosmetic" is gradually gaining popularity, and related technical means are used throughout the treatment of postoperative scarring of the thyroid gland, and multiple treatment modalities are used "early" and "in combination" to "prevent" scar growth after surgery. The use of multiple treatment modalities to prevent scar growth in the early postoperative period has achieved twice the result with half the effort.

Objective : The purpose of this study was to investigate the relevant social and environmental factors affecting the occurrence of periodontal diseases during pregnancy in pregnant women and to analyze the influence of the periodontal status of women in the second trimester of pregnancy on small for gestational age (SGA) delivery. Methods: A total of 215 pregnant women were enrolled in this study in the Department of Periodontology of the West China Hospital of Stomatology of Sichuan University from May 2015 to May 2018. Periodontal parameters, such as bleeding on probing (BOP), probing depth (PD) and clinical attachment loss (CAL), were recorded at 16-24 weeks of gestational age. Subjects were divided into the periodontitis (n=32) group, gingivitis (n=171) group and periodontally healthy (n=12) group according to their periodontal conditions. With the patient′s informed consent, the patient decided whether to receive periodontal treatment. Basic and socioeconomic information was collected through questionnaires. After delivery, subjects were divided into the SGA group and non-SGA group according to their birth results. The periodontal clinical indicators, questionnaire results and delivery results were compared among the groups. Results : The mean PD (P=0.005, r=-0.192) and BOP% (P=0.003, r=-0.199) were negatively correlated with economic income. The family income in the periodontitis group was significantly lower than that in the healthy group and the gingivitis group (P < 0.05). The flossing use rate was significantly higher in the healthy group than that in the gingivitis group (P < 0.05). A total of 106 pregnant women received scaling and root planing, while 109 patients only received oral hygiene instruction. After delivery, SGA occurred in 23 cases (10.7%), and there were no significant difference in SGA incidence among the three groups (P > 0.05). PD ≥ 5 mm% and PD ≥ 4 mm% (P < 0.05) were significantly higher in the SGA group than in the non-SGA group. There was no significant difference in SGA incidence between the treated group and the untreated group (P > 0.05). Conclusion Family income and dental flossing use have an impact on the incidence of periodontal diseases during pregnancy. The severity of periodontitis in pregnant women is correlated with the incidence of SGA.

Endoscopy ; Hernia, Ventral/surgery* ; Herniorrhaphy ; Humans ; Laparoscopy ; Postoperative Complications ; Surgical Mesh