Objective To explore the clinical characteristics and related factors of mental disorder caused by brain injury in the judicial identiifcation of mental illness. Methods Forensic case data of brain injury ware collected and analized. Brain injury sverity was classied into 3 groups, namely severe group(group A); moderate group (group B) and mild group(group C) according to neurosurgery GCS scores; clinical characteristics were analyzed, diagnosis were made against the Chinese Classiifcation of Mental Disorders (the 3rd ed.) (CCMD-3). Relationship between the clinical characteristics and brain damage severity was analyzed. Results Organic neurosis-like syndromes are the main manifestation of mental disorders caused by mild and moderate brain injuries. Organic intellectual deifciency is the main manifestation of mental disorders due to severe brain injury. The difference between the three groups was significant (P ≤ 0.01). Conclusion Different clinical features are related to different brain injury severities in the forensic evaluation of mental disability.

The present valuation of experimental teaching effect can not adapt to the needs of the experimental reform and develpoment due to its deficiency. After setting up the experimental curriculum,A Multivariate method has been developed to evaluate students’ experimental ability from their innovating,operating,expressing ability and scientific quality.

Objective To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic partial nephrectomy (RLPN) with individual operation plan in treatment of small renal cell carcinoma (RCC). Methods 98 patients with small RCC who was treated by RLPN from June 2012 to June 2016 were retrospectively analyzed. There were 57 males and 41 females with a mean age of 52 years old (ranging 28 ~ 75 years old). 52 cases were located on the right side while 46 cases were left. The mean tumor size was 3.1 cm in diameter (ranging 0.8 ~ 4.5 cm). 87 patients (A group) were underwent standard RLPN with clamping main renal artery. 7 patients (B group) with exophytic RCC were performed without clamping renal artery, but with separating main renal artery and prepared for possible clamping. 4 patients (C group) with endophytic RCC were performed with clamping renal artery under ultrosound monitoring. The feasibility and outcomes were evaluated by surgical and oncological outcomes. Results 84 cases among A group were underwent standard RLPN successfully, with 2 cases converted to open surgery and 1 case failed to excising tumor completely and converted to laparoscopic radical nephrectomy. The amount of bleeding during operation was 30 ~ 350 ml, average 93 ml, operation time was 70 ~ 245 min, average 127 min, warm ischemia time 20 ~ 42 min, average 26 min. 6 cases among B group were performed successfully without clamping renal artery with 1 case converted to clamp renal artery for 15 min during the operation because of obvious bleeding. The amount of bleeding was 160 ~ 380 ml, average 220 ml, operation time was 85 ~ 215 min, average143 min. 4 cases of C group were all performed successfully, The amount of bleeding was 35 ~ 250 ml, average 85 ml, operation time was 110 ~ 235 min, average 175 min, warm ischemia time 25 ~ 40 min, average 28 min. With a mean follow up of 28 months (ranging 18 ~ 42 months), there was only 1 case of A group occured local recurrence and lung metastases and accepted molecular targeted therapy with Sorafenib. Conclusion RLPN with individual operation plan in treatment of small RCC is safe and effective, the long-term effect of the procedure needs further investigation.

The aim of our study was to determine the effects of energy controllable steep pulse (ECSP) on the cytoskeleton of human ovarian cancer cells SKOV3. SKOV3 cells were divided into five groups under ECSP treatment with different parameters (frequency, pulse duration, peak value of voltage). The positive control group included SKOV3 cells treated with volchicine; the negative control group included SKOV3 cells subjected to sham-lightning stroke. Rhodamine-phalloidine was used to label microfilament directly. After using immunofluorescence to label microbules, we observed them by means of Confocal Laser Scanning Microscope. Making specimen and using electronmicroscope, we observed the ultramicrostructure of cystoskeleton. The results showed that ECSP-treated-SKOV3 cells lost their normal cystoskeleton network structure. There were obvious microfilament disaggregation, diffused skeleton protein, and disappearance of cystoskeleton network structure. Also noticeable were microbule disaggregation, reduction of pseudopod, obvious microfilament disaggregation, permutation disorder and structure disappearance. Moreover, this effect bears a direct relation with dosage.
Cell Line, Tumor ; Cytoskeleton ; ultrastructure ; Electric Conductivity ; Electromagnetic Fields ; Electroporation ; Female ; Humans ; Ovarian Neoplasms ; pathology ; Pulse

The etiology of hemophagocytic lymphohistiocytosis (HLH) is complicated and difficult to diagnose, unexplained HLH often with hematological malignancies. Invasive biopsy can help to find etiology, the results may be affected by the technique and the location of the puncture site. Multiangle puncture can improve the success rate, but the corresponding risk increases. A patient with HLH was admitted to Affiliated Hospital of Zunyi Medical College. The etiology was unknown. Active symptomatic support treatment was conducted, at the same time, finding the evidence of viral infection, autoimmune disease related detection, blood culture, bone marrow puncture smear and spleen biopsy were performed respectively to find the pathogen basis. Spleen hemorrhage was not being controlled after spleen biopsy in patients, and emergency splenectomy was adopted to stop bleeding for saving lives. Finally, the patients died of low protein, pulmonary edema and respiratory failure. The bone marrow puncture and spleen biopsy failed to provide the basis for tumor invasion, while the spleen pathological slices plus immunohistochemical indicate diffuse large B cell lymphoma (DLBCL) after splenectomy, which was identified as malignant tumor-associated hemophagocytic syndrome. Underscoring the high risk of bleeding after tumor-associated splenomegaly puncture and the importance of having emergency plans. Through analyzing the clinical characteristics, diagnosis and treatment of this patient, we hope to improve the clinicians' understanding of HLH and lymphoma.

Objective To study the effect of transcutaneous electroacupuncture(TEA)on gastric accom-modation and electrogastrogram in patients with functional dyspepsia(FD)and investigate the transcutaneous elec-troacupuncture efficacy and mechanism. Methods 106 cases of FD patients were randomLy divided into TEA group(n=53)and sham-TEA group(n=53)according to the designed random table. 10 health volunteers were recruited for participation in the study for normal control group. All patients fulfilled the Rome Ⅲ criteria of FD. Informed consent was obtained from each participant. All subjects were tested in terms of gastric accom-modation (GA),namely,maximum satiety. For the patients of TEA group,the acupoints of Zusanli(ST36)and Neiguan (PC6)were stimulated. In the sham-TEA group,the sham-acupoint for PC6 was located at about 15-20 cm away from PC6 not on any meridian and the sham-point for ST36 was located at 10-15cm down from and to the lateral side of ST36 not on any meridian.The stimulation parameters used for sham-TEA were the same as the TEA group. Four weeks after treatment with double blind crossover method,we compared the two groups in view of gastric receptivity,electrogastrogram(EGG)andclinicalsymptomscores before and after treatment respectively. Results (1)The GA was 725 ± 46 mL in the normal control group and 539 ± 36 mL in the FD patients.(2)The mean total symptom score was 24.5 ± 2.9 at baseline and significantly decreased to 11.9 ± 2.1(P < 0.001)after TEA. There were significant differences in the symptom scores between the TEA group and sham-TEA group(P<0.001).(3) The percentage of normal slow waves(N%)during fasting and postprandial state in the TEA group were respectively 70.9 ± 2.4% and 68.2 ± 3.1%. The differences were statistically significant between the TEA group,baseline and sham-TEA group(P<0.001).(4)In the TEA group,the postprandial dominant power(46.23 ± 4.03)db and the fasting dominant power(35.35 ± 1.53)db were significantly increased compared to baseline before treatment and sham-TEA group(P < 0.001). Conclusions(1)Gastric accommodation in patients with FD was decreased, showing a higher visceral sensitivity. TEA can improve the GA in FD patients,reducing visceral sensitivity.(2)TEA can increase the percentage of normal slow wave in the FD patients,increase the postprandial dominant power and regulate the abnormal gastric myoelectric activity to promote the gastric motility.

Objective: To observe the effects of music electro-acupuncture and pulsed electro-acupuncture on locomotor avtivity and hippocampal astrocytes in fast-aging (SAMP8) mice, and to compare the anti-dementia mechanism.Methods: Thirty 8-month-old male SAMP8 mice were randomly divided into model group (group M), music electroacupuncture group (group MA), pulsed electro-acupuncture group (group EA) (n=10), with homologous normal aging SAMR1 mice as control group (group C) (n=10) . Acupuncture stimulation was applied to"Baihui" (GV20) 、"Yintang" (GV29) and"Renzhong" (DU26) for 20 min per day for 15 days. The Morris water maze was used to assess learningmemorize ability. Immunohistochemical DAB staining was used to observe GFAP exptession in hippocampus. Detect GFAP protein levels by Western blot in hippocampus. Results: The Morris water maze test showed: Compared with group C, the escape latency were increased (P ＜ 0.01), swimming distance were increased in space exploration experiment in group M (P ＜ 0.01) . Compared with group M, the escape latency were reduced in group MA and EA (P ＜ 0.01, P ＜ 0.05) and the swimming distance were shortened (all P ＜ 0.05) . The immunohistochemical DAB staining showed: Compared with group C, the average optical density of GFAP in the hippocampal CA1 area of group M increased significantly (P ＜0.01); the optical density of GFAP in CA1 area of hippocampus in both groups MA and EA was significantly decreased (all P ＜ 0.01), while the optical density of GFAP in MA group was lower than that of EA group (P ＜ 0.05) . Western blot test showed: Compared with group C, the expression of GFAP protein obviously increased (P ＜ 0.01) . Compared with group M, the expression of GFAP protein obviously decreased and had a downregulation tendency in group MA and EA (all P ＜ 0.05), while the expression of GFAP protein decreased in MA group compare with EA group (P ＜ 0.05) .Conclusion: Both music electro-acupuncture and pulsed electro-acupuncture can improve the learning and memory abilities of SAMP8 mice and decrease the expression of GFAP, which may be related to its mechanism of reducing neuroinflammatory reaction, improving apoptosis and eventually protecting neurons, and music electro-acupuncture has a better tendency than pulsed electro-acupuncture.

Objective To summarize clinical outcomes of subxiphoid uniportal video-assisted thoracoscopic surgery for bilateral chest diseases simultaneously. Methods The clinical data of 60 patients with bilateral chest diseases treated by uniportal thoracoscopic surgery via subxiphoid approach in the Department of Thoracic Surgery, Affiliated Hospital of Zunyi Medical College from August 2016 to December 2017 were retrospectively analyzed. There were 35 males and 25 females, aged 25.5±8.8 years ranging from 13 to 51 years. There were 40 patients wtih palmar hyperhidrosis, and 20 patients with bilateral pulmonary bullae and onset of one-side pneumothorax. All patients adopted subxiphoid uniportal video-assisted thoracoscopic surgery. Among them 36 patients with palmar hyperhidrosis underwent resection of R3 bilateral sympathetic nerves, 1 resection of R4 bilateral sympathetic nerves, 3 resection of R3+R4 bilateral sympathetic nerves, and 20 patients with pulmonary bullae underwent bilateral bullectomy and pleurodesis. Results Fifty-five patients cured within 1 to 4 days and discharged after surgery. One patient with incision infection and pulmonary infection after bullectomy, cured and discharged after 3 weeks anti-inflammation and incision dressing change. Four patients with Grade B healing recovered after 1 to 2 weeks dressing change. During the follow-up, no pneumothorax or hand perspiration relapsed. Conclusion Subxiphoid uniportal video-assisted thoracoscopic surgery for simple bilateral chest disease simultaneously is safe and feasible, which not only avoids simultaneous trauma of bilateral punch, but also alleviates the pain of patients.