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There are some problems such as difficulty of pressure control, inconvenience of use and carry, congested easily and dredged hardly in clinical application of vacuum extractor in common use. For solving the above problems, researchers have designed a new portable and pressure stabilized abdominal drainage system which was composed of integral double spherical aspirator and separated double cannula. The new apparatus has achieved good effects in drainage which is suitable for not only rescuing of abdominal trauma and war wound, but also abdominal surgery that manifested as sucking safe and effective, using easily and convenient, that was verified by testing.
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Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class (EC) and control class (CC), with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students (88%) were inter-ested in the new course, 91 students (91%) thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC:44 students (88%) thought that the new course could increase interests of clinical question;43 students (86%) thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students (80%) thought that the new course could strengthen the communication between doctors and patients; 42 students (84%) thought that the new course could widen the minds in diagnosis and treatment;45 students (90%) thought that the new course could enhance the ability of dialectical thinking;while in CC, the proportions of the above issues were 24(48%), 23(46%), 26(52%), 25(50%) and 26(52%) (all P<0.05). Furthermore, there were statistical difference in auerage scores bertween EC and CC [(86.26 ±5.72) vs. (77.00 ±6.16)] (P=0.000). Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.
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<p><b>OBJECTIVE</b>To investigate the influence of different pressures of CO2 pneumoperitioneum on pathomorphism and function of intestines following laparoscopic gastrectomy (LG).</p><p><b>METHODS</b>Forty-eight gastric cancer patients were prospectively enrolled in the study. Among them, 36 patients scheduled for elective LG were randomly assigned to low pressure group (LP), middle pressure (MP), and high pressure group (HP) with 12 cases in each group. The CO2 pneumoperitoneum pressure was maintained at 8-10 mmhg in LP, 11-13 mmhg in MP, and 14-16 mmhg in HP. The control group was open gastrectomy group (OG) in 12 cases. The intestinal pathomorphism and level of plasma D-lactic acid before, during and after operation, and postoperative intestinal function of four groups were examined and compared.</p><p><b>RESULTS</b>There were no statistical differences in preoperative data among the four groups(all P>0.05). LG group was associated with a lower rate of surgical complications than OG (8.3% vs. 41.7%, P<0.05). No obvious damage of intestinal mucosa was found in OG group. Damage degree of intestinal mucosa after operation in LP, MP and HP groups was 0-1, 1-2, and 2-3 respectively. There was significant change in intestinal pathomorphism after operation in both HP and MP groups. The levels of D-lactic acid before operation were not significantly different among all the four groups, but increased significantly in each group after operation (all P<0.05). HP group had the highest level of plasma D-lactic acid and presented with delayed bowel sound return (4.5 d), time to first flatus (5.4 d), and intake (6.0 d) as compared to the other 3 groups (all P<0.05).</p><p><b>CONCLUSIONS</b>Laparoscopic radical gastrectomy is safe and minimally invasive. Higher pneumoperitoneal pressure is harmful to the recovery of intestinal mucosa and function. Therefore the pneumoperitioneum pressure should be maintained as low as possible under clear visualization during operation.</p>
Subject(s)
Humans , Gastrectomy , Intestines , Physiology , Laparoscopy , Pressure , Stomach Neoplasms , General SurgeryABSTRACT
Objective To explore the application of case-based discussion combined with translational medicine teaching method in clinical teaching of gastrointestinal surgery.Methods Totally 100 undergraduates of clinical medicine in grade 2007 and 100 undergraduates in grade 2008 from the second military medical university were divided into experimental class (50 students,25 in discussion class and 25 in comprehensive class) and control class (50 students).Method of case-based discussion was applied in discussion class; method of case-based discussion combined with translational medicine was employed in comprehensive class and traditional method was used in control class.Results Scores in experimental class were superior to those in control class ; questionnaire survey showed that 90％ students thought the new model was better than the traditional model; the interests of students in exploring clinical problem in experimental class were increased (90％ vs.50％ ) ;the sense of mission and responsibility was Strengthened (86％ vs.64％ ) ;the scientific research thinking was more active (80％ vs.48％ ) ; the individual ability and quality were enhanced (76％ vs.50％ ),the depth and width of study were markedly increased (80％ vs.52％ ),the consciousness of independent study and thinking was strengthened (88％ vs.54％ ).Comprehensive class had more obvious improvements in scientific research thinking,individual ability and quality,depth and width of study,independent study and thinking.Conclusions The new teaching model which combined translational medicine with case discussion breaks through the traditional model and adapts to the requirements of modem medicine,it can enhance the teaching effect and worth promoting in educational reform.
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To evaluate the rate of early diagnosis for abdominal trauma, we design a set of visible bi-cavity abdominal puncture device to detect and diagnose abdominal organ disease. This paper simply introduces the design and the use of this device.