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Since the video compression standards, such as H.264/AVC, have been widely deployed recently, the videos transmitted over public network are efficiently compressed into a smaller data size but kept the high quality. In order to guarantee the confidentiality of patient's healthcare video, the medical video must be encrypted prior to transmitting over networks and decrypted in a way of preserving near-lossless quality. In this paper, a medical video encryption method by H.264/AVC with near-lossless compression is proposed. The experimental results show that the content of the encrypted video is visually imperceptible and the visual quality of reconstructed video is near-lossless.