Objective To investigate a expander placement technique for fast tissue expansion. Methods Port-free thin wall expanders with long tube were specially made and tested on 45 cases of patients with skin scar. All expanders were placed subcutanuously through intralesional perpendicular short incisions with injection tube laid out. A large amount of saline was injected to expanders intraoperatively. Three sorts of fast expansion were carried out. Results Under the local tumescent anaesthesia, subcutaneous pockets were all dissected successfully. The amount of bleeding was less and no patient received blood infusion. All of forty five cases completed fast expansion satisfactorily without incision infection and dehiscence. Conclusion The technique of intralesional perpendicular short incisions has the advantages of less invasion and better safety, and suitable for fast tissue expansion.

Purpose:To observe the therapeutic effect of gemcitabine combined with 5-FU for the treatment of advanced cholangiocarcinoma. Methods:21 patients were given gemcitabine and 5-FU intravenously. Results:There was no complete response .The partial response rate was 23.8% and SD,38.1%.12 patients(57.14%) had amelioration of pain and improvement in quality of life.The toxicity was low and tolerable. Conclusions:Gemcitabine combined with 5-FU was an effective and safe regimen for treating advanced cholangiocarcinoma and worthy of further evaluation.

Objective　To search for a simple and rapid skin expansion. Methods　 CCPSEPA-A kind of mutual feedback type continuous normal saline perfusion system was assembled with the use of conventional transfusi on apparatus, sphygmomanometer, three-way stopcocks, plasma bag etc.14 cases ( 17 expanders) were carried out with such a device, controlled by patients themselves. Results 　The volume of expanders was 50～300 ml and the duration of expansion was 7～14 days. All the cases proved a wonderful effect that the expansion was finished by only one or two times of water filling of storage water bag, and without any complications.Conclusion　CCPSEPA is a new skin expansion apparatus of new type and practical ,simple and low price .The general goal of safe,simple, rapid and useful was realized basically by the device,and worth popularizing.

Objective To observe and contrast the effects of dexmedetomidine and ketamine on the restlessness and analgesia during recovery period of anesthesia after tonsillectomy in children. Methods Sixty ASA Ⅰ-Ⅱ child patients underwent tonsillectomy and adenoidectomy were randomly divided into three groups, group P (appropriate amount of placebo was given in the operation), group D (dexmedetomidine) and group K (ketamine). Data of mean arterial pressure and heart rate of three groups were documented before anesthesia (T0), during extubation (T1), 5 min (T2), 10 min (T3), 15 min (T4) and 30 min (T5) after extubation were recorded. The analepsia time, adverse reactions, restlessness score and pain score were collected in three groups of patients. Results Compared with group P, values of mean arterial pressure and heart rate were more stable at T1, T2 and T3 in groups D and K (P<0.05). The restlessness score, incidence of restlessness and adverse reactions were lower in groups D and K than those in group P (P<0.05), and which were lower in group D than those of group K (P<0.05). Conclusion Both dexmedetomidine and ketamine can play an analgesic role in recovery period of anesthesia and reduce restlessness, adverse reactions and pain score in child patients. Moreover, dexmedetomidine is more effective on inhibiting restlessness and adverse reactions.

Objective To investigate the relationship between abnormal bone mineral density (BMD) and subclinical thyroid dysfunction. Methods Thyroid function, biochemical indicators of bone metabolism and BMD were reviewed retrospectively in the subjects who received health checkups from July 1, 2009 to January 31, 2017 in the Health Check-up Department of Peking Union Medical College Hospital. People who had thyroid dysfunction, recognized risk factors for osteoporosis, and medication history were excluded. A cross-sectional analysis of thyroid status and biochemical indicators of bone metabolism was performed by the standard methods. BMD at the lumbar spine and femoral neck was measured using dual energy X-ray absorptiometry. Results A total of 6884 subjects (3726 women and 3158 men) were enrolled in the study, with an average age of (50.74 ± 10.41) years. They were divided into three groups:subclinical hyperthyroid, subclinical hypothyroid, and euthyroidism. The alkaline phosphatase in subclinical hyperthyroid group was higher than that in the euthyroidism group[ (67.95±20.64)U/L vs. (63.88±18.99)U/L]. Calcium and phosphorus in blood were higher in both subclinical hyperthyroid and subclinical hypothyroid groups. The rate of abnormal BMD in male euthyroidism, subclinical hyperthyroid and subclinical hypothyroid groups were 36.10％(1049/2906), 29.27％(12/41) and 27.01％(57/211), respectively. The rate of abnormal BMD showed no difference between subclinical hyperthyroid group and euthyroidism group (P>0.05). The rate of abnormal BMD was lower in subclinical hypothyroid group than in euthyroidism group (χ2=7.0901, P<0.01), especially in the males aged 40-49 years (χ2=10.4618, P<0.01). The rate of abnormal BMD in female euthyroidism, subclinical hyperthyroid and subclinical hypothyroid groups was 38.81％(1286/3314), 45.83％ (33/72) and 40.88％ (139/340), respectively. The rate of abnormal BMD showed no difference among the three groups (P>0.05). Conclusion There is no significant difference in the rate of abnormal BMD between subclinical thyroid dysfunction group and euthyroidism group, possibly because abnormal serum biochemical indicators preceded the presence of low BMD. More sensitive methods used to determine the status of bone metabolism await to be developed.

Objective To investigate the infection status of human papillomavirus (HPV) of females in Chongqing city ,in or‐der to provide scientific references for prevention of HPV infection and control of early cervical lesions .Methods The detection re‐sults of cervical cytology screening for 19 860 females in the University‐Town Hospital of Chongqing Medical University ,the First Affiliated Hospital of Chongqing Medical University and a county‐level hospital in Chongqing from January 2012 to January 2015 were collected ,and the HPV typing data were analysed .Results Among the 19 860 females ,5 681 females were infected with HPV ,the infection rate was 28 .61% .Due to the presence of multiple infection ,the actual infection frequency of HPV subtypes in 5 681 females was 8 906 .The infection frequency of high‐risk subtypes ,including multiple infections ,was 6 166 (accounted for 69 .23% ) .According to the probability of infection ,the top eight rate of subtype infection was HPV 52 ,16 ,58 ,6 ,CP8304(81) ,33 , 53 and 18 .The positive rate of single HPV infection was 19 .38% ,the positive rate of multiple infection was 8 .74% ,in which doub‐le infection was the main infection model .The infection rate of females aged 20 years old or less(43 .89% ) was the highest ,while have the infection rate of females aged 36-50 years old was the lowest(27 .26% ) .Conclusion The HPV infection rate of females in Chongqing is high ,the most of females infected by high‐risk subtype HPV .It is necessary to lay emphasis on preventing HPV 52 , 16 ,58 ,33 ,18 infection for females in Chongqing city .

Objective To investigate current status of schistosomiasis control system at the county level and make recommendations to improve the infrastructure adapting to the prevalent condition of the disease. Methods Through pertinently sampling and semi-quantitative questionnaire among the professional workers, experts and administrators in schistosomiasis control, the primary weaknesses involved in the management system and human resources were analyzed. Results 380 questionnaires were distributed, 33 out of 40 were returned from experts/administrators and 285 out of 340 were received from the professionals. In general, the participants acknowledged the effectiveness of the mechanism on anti-schistosomiasis campaign during the past 40 years. It was found that lack of funds for schistosomiasis control and the poor administrative model of anti-schistosomiasis activities were the main barriers to the control. About half of the participants agreed that the policy about merging the county level anti-schistosomiasis facilities into the Center for Disease Prevention and Control (CDPC) system. The study also showed an inbalanced distribution of the manpower for schistosomiasis control across the endemic regions. The dropout rate of human resources was high due to the poor management and welfare. Conclusion Reforms on the management model should be performed and multiform compensation system should be built in accordance with the prevalence and trends of schistosomiasis.

Objective To study the therapeutic effect and mechanism of IL-6 reduced by the early shortlime veno-venous hemodialysis (BVVH) for the treatmnent of severe acute pancreatitis (SAP).Method One hundred and seventy-eight cases with SAP,in depagtment of general surgery,the Third People Hospital,Shanghai Jiao Tong University School of Medicine,were divided inlo hemodialysis group (HF,85 cases) and non-hemodialysis group (NHF,93 cases).The local and systemic manifestations,APACHE Ⅱ scores,average hospitalizing stay,mean cost of therapy,morbidity of MODS and the mortality of patients were compared between two groups.And the concentration of serum inflammatory factor IL-6 was assayed at different observation intervals.All data were managed by SPSS software and analyzed by using SNK-q test or X2 test.Results The duration for abdominal pain and distension in patiergs of HF group was (18.8+=4.2) h vs.(89.7±28.1) h in those of NHF group,P<0.05.The APACHE Ⅱ scores at the 10th day were (5.5±3.6) vs.(13.8±3.8) (P<0.05).The average hospitalizing stay and the mean costs of medical care were (28.2+ 12.4) d vs.(42.4+11.2) d and (43800±28000) vs.(74600±22000) RMB(P<0.05) respectively.The concontrafion of serum inflammatory factor IL-6 in HF group decreased significantly(P<0.05) in comparison with those in NHF group.And the morbidity such as MODS and the mortality in HF group were significantly less than those in NHF group(P<0.05).Conclusions By BWH,the excessive release of serum inflammatory factor IL-6 could he removed at early stage of SAP.So,it could result in an improving on the severity of the disease and raise the therapeutic efficacy.

Objective To explore the status of iodine nutrition in 8～10 years children after universal salt iodization(USI)in the iodine deficiency area.Methods Probability proportion to size method(PPS)or simple random sampling methods were used to sample children aged 8～10 years in iodine deficiency area in the vear 1995,1997,1999,2002 and 2005, respectively.Goiter were detected by palpation and B-ultrasound, iodine concentration in salt was detected by direct titration method and that in urine by the method of As3+-Ce4+catalytic spectrophotometry.Results After USI has been implemented,the median of salt and urinary iodine tended to mcreaseand the goiter rate tended to decrease year by year.In 2005,the coverage rate of iodinated salt was elevated to 97.2%,qualified iodize salt rate was 97.1%and edible qualified iodinated salt rate was 94.3%in the whole iodine deficiency areas.The median of urinary iodine Was 227.7 μg/L 89.7%(323/360)of the population had a level of the urinary iodine over 100μg/L Goiter rate of 8～10 years children Wag decreased from 22.3%(282/1267)to 4.4%(53/1200) from 1995 to 2005.Conclusion After 10-year USI,the status of iodine nutrition in ShaJldong Province has been promoted obviously and it is in a suitable iodine nutritional status.

Objective To sequence and analyze the envelope (E) gene of type Ⅰ dengue virus isolated from Guangzhou in 2009 for tracing the infection source. Methods The serum samples were collected from patients diagnosed with dengue fever in Guangzhou area during 2009. Dengue virus was isolated and cultured in C6/36 cells.The whole length of E gene was amplified by reverse transcriptase-polymerase chain reaction (RT-PCR) and then sequenced. The phylogenetic tree was drawn by neighbor-joining method. The bioinformatics analysis was performed by combining the phylogenetic information and the epidemiology data. Results Four strains of type Ⅰ dengue virus were isolated from 19 samples. E gene of these strains was amplified and sequenced. The phylogenetic analysis showed that 09/GZ/9104 strain and 09/GZ/9236 strain had identical nucleotide sequence and fell within the American/African group, 09/GZ/11534 stain and 09/GZ/11562 strain had similar sequence homology and fell within the Asian group. Conclusion The typeⅠdengue viruses in Guangzhou area in 2009 are imported, which belong to two genotypes and may come from two independent origins respectively.