The splenic surgery has a long history of 400 years and the basic principle of selective splenectomy is finally defined.With the enhancement of the notion of preserving spleen and the modifications and improvements of the technology,the splenic surgery has made great progress both in spleen-preserving surgery and splenectomy.For the sake of preserving spleen,innocent splenectomy is avoided as much as possible.Moreover,splenic function is preserved to the largest extent through the substitution of partial splenectomy for total splenectomy or the precise resection of the lesion.On the other hand,in some circumstances,the spleen cannot be preserved.The splenectomy with a series of improvements is very safe in spite of massive splenomegaly.With the development of the technology,the splenic surgery also keeps up with times and continuously innovates.The laparoscopic technology and robotassisted technology bring new energy to the splenic surgery,clinical values of which are being explored and expanded,with a wide development space.

Laparoscopic splenectomy (LS) is considered as the standard approach for patients with normal-sized or moderately enlarged spleens because of advantages of minimal invasion.With the improvement of laparoscopic techniques,the previous concept that massive splenomegaly (MS) is a contraindication to LS is being challenged.Nevertheless,there is still a tremendous controversy over this issue.(1) Splenomegaly and MS are not clearly defined.(2) The feasibility,safety and postoperative outcomes of LS for MS are fiercely debated despite much improvement of LS for MS.(3) Whether supporting or opposing LS for MS,the core problem that the upper limit of splenic size can be in accord with a requirement of LS is controversial.Taking these issues into account,authors recommended that the splenomegaly shotdd be divided into four degrees rather than three degrees for the sake of guiding the choice of surgery.

Objective To investigate the clinical characteristics of comorbidity of migraine and epilepsy.Methods The clinical data of 67 patients with migraine were analyzed retrospectively.Results 6 cases appeared epilepsy,focal seizure 2 cases and generalized seizures 4 cases,in the 67 patients with migraine.The epileptiform waves were recorded in 57 cases by EEG,and the fulminated waves were also recorded in 6 patients with epilepsy.Treated by Sodium Valproate,migraine attacks and seizures were all controlled in the 6 cases and also EEG anastated well.Conclusions Comorbidity is existed in migraine and epilepsy.The curative effect is well by Sodium Valproate.

Objective To observe the effect and value of erythropoietin (EPO) with monosialotetrahexosylganglioside (GM 1) on hypoxic ischemic encephalopathy (HIE) of newborn.Methods Seventy cases of newborn with HIE were selected and divided into research group and control group based on different treatment methods,35 cases of each group.Research group were given EPO and GM 1:newborn were given subcutaneous injection of 300 U/(kg · w) EPO,3 times a week,with duration of two weeks;daily dose of GM1 was 20 mg,with intravenous injection for consecutive 2 weeks.Control group were given separate GM1:newborn were given GM1 intravenous injection,with daily dose of 20 mg for consecutive 2 weeks.Neonatal behavioral neurological assessment (NBNA) were performed on all newborn patients at the 14th day after born.At the 10th months after born,Gesell Scale and the Bayley Scales of Infant Development were given to all patients.Results Total effective rate of research group was 97.14％ (34/35),and 82.86％ (29/35) for control group,the difference was statistically significant (x2=3.97,P＜0.05).At the 14th day after born,the behavior ability,passive muscle tension,active tension,primitive reflexes and general assessment scores of the research group were (10.20± 1.67) points,(8.28 ± 1.60) points,(8.11 ± 1.51) points,(4.57 ± 1.97) points and (6.12 ± 1.46) points,of the control group were (9.32 ± 1.51) points,(7.33 ± 1.54) points,(7.14± 0.98) points,(3.46± 1.58) points and (5.05 ± 1.35),the differences were statistically significant (t =2.31,2.53,3.19,2.60,3.18;P＜0.05).At the 10 months after born,the DQ scores of big sports energy district,fine motor energy district,language ability district,personal and social adaptation district and social energy district of research group were (90.01 ± 7.76) points,(90.32± 6.77) points,(93.03 ± 6.28) points,(94.88 ± 5.19) points and (92.87±7.36) points,of control group were (84.91 ± 6.51) points,(86.92 ± 6.56) points,(88.13 ± 5.85)points,(88.87±6.14) points and (88.04±7.03),the differences were statistically significant (t =2.98,2.13,3.38,4.42,2.81;P ＜ 0.05).At the 10 months after born,the Mental developmental index (MDI) and Psychomotor development index(PDI) of research group were (92.87±7.05) points and (94.45±5.78) points,of control group were (89.23 ± 6.89) points and (90.26 ± 6.03) points,the differences between the two groups were statistically significant(t =2.18,2.97;P＜0.05).Conclusion EPO with GM 1 on the treatment of HIE is of high clinical efficiency.In addition,it promotes early recovery of neurological symptoms in newborn with HIE,with long-term effects on the nervous system of children.

Objective: To design and prepare siRNAs targeting ski gene and to observe its influence on the biological functions of HepG2 cells, such as proliferation, cell cycle, apoptosis, etc.. Methods: Three specific siRNAs of ski were designed and synthesized, and were transiently transfected into HepG2 via cathodolyte liposome transfection method. Real-time PCR and Western blotting were used to measure ski expression at mRNA and protein levels. The cell proliferation was assessed by MTT assay and the changes in cell cycle and apoptosis were evaluated by flow cytometry. Results: All the 3 specific ski-siRNA(A, B, C) effectively inhibited the expression of ski gene, with ski-siRNA-B having the highest inhibition rate(70%). Furthermore, the ski expression had a decreasing tendency with the transfection time. The proliferation of HepG2 cells was markedly inhibited by ski-siRNAs(P<0.05); the number of cells at S stage was obviously decreased, being 2 folds that of the negative control group. Conclusion: The siRNA of ski gene can effectively induce growth inhibition of HepG2 cells and reduce cells of S stage, which is possibly through down-regulation of ski gene.

BACKGROUND: Muscle-derived stem cells have some problems in pudflcation, amplification and directional differentiation during in vitro culture. Basic fibroblast growth factor as a membrane of bloactive factor has been paid great attention, due to its biological activity.OBJECTIVE: To explore effects of basic flbroblast growth factor on/n vitro proliferation of rat musde-derived stem cells.DESIGN, TIME AND SETTING: The cytological in vitro study was performed at the Shenyang Medical College from April to July 2008.MATERIALS: Five healthy male Wistar rats were supplied by Experimental Animal Center, Shenyang Medical College. Basic fibroblast growth factor was produced by Zhuhai Biological Product Co., Ltd.METHODS: Left anterior limb triceps brachii was sterilely obtained from rats. Muscle-derived stem cells were harvested by isolation with enzyme digestion, pudfied by density gradient centrifugation and differential attachment. At the second passage,musde-derived stem cells were treated with basic fibroblast growth factor at final concentration of 6.25, 12.50, 25.00, 50.00,100.00 pg/L. Cells received 200 uL growth medium as blank control group, and those treated with 200 μL growth medium +musde-derived stem celts as negative controls. MTT was added at 24, 48, 72 and 96 hours of culture.MAIN OUTCOME MEASURES: Immunocytochomical method was used to determine rat musde-dedved stem cells. MTT assay was utilized to detect cell proliferation.RESULTS: Musde-denved stem cells were mostly positive for Sca-1, but few was positive for Desmin. Compared with the negative control group, vanous concentrations of basic fibroblast growth factor had significant proliferation effects on musde-derived cells (P < 0.05). At 6.25-50.00 μg/L, the proliferation effect became strong with the increased concentration (P <0.01). At 50.00 μg/L, the proliferation promotion effect nearly reached a peak. Musde-derived stem cells significantly proliferated over time. Compared with the negative control group, significant proliferation promotion effect was detected in the basic fibroblast growth factor groups at 96 hours (P < 0.01).CONCLUSION: Basic fibroblast growth factor can promote proliferation of rat muscle-derived stem cells/n vitro in a dose-time dependent fashion. 50.00 μ g/L and 96 hours are separately good concentration and time for in vitro culture.

BACKGROUND: Light-curing composite resins have been applied in the dental repair due to its beautiful color, excellent physical and chemical properties and easy to operation. However, its insufficient mechanical properties tend to cause composite fractures, resulting in undesired clinical efficacy.OBJECTIVE: To investigate the preparation, properties and biomechanical performances of filler-co-augmented photo-curable resin-based oral materials.METHODS: The nano-silica surface-grafted with poly(methyl methacrylate) (PMMA) was obtained by atom transfer radical polymerization. Co-electrospinning was used to prepare the acrylonitrile/PMMA core-shell nanofibers, and a two-dimensional lactic acid-glycolic acid copolymer nanofiber membrane with a lattice structure was obtained using a copper mesh as a receiving device. The multi-scale and multi-dimensional packing was prepared by sol-precipitation method with silane coupling agent as a raw ethyl ester precursor, and further modified using silane coupling agent. The mechanical properties, volumetric shrinkage, toxicity, and degradation properties of the light-curing resin grafted with SiO2-PMMA were compared with those of the light-curing resin combined with trapezoidal polysiloxane materials grafted with methyl methacrylate. RESULTS AND CONCLUSION: (1) Characterization of the composite resin under scanning electron microscope: the filler SiO2-PMMA core-shell nanofibers dispersed well in the light-curing resin matrix, in the presence of monodisperse phenomenon and less aggregation phenomenon. However, the trapezoidal polysiloxane material in the light-curing resin matrix dispersed unevenly, in the presence of reunion phenomenon. (2) The flexural strength, flexural modulus and fracture work of the light-curing resin graftedwith SiO2-PMMA core-shell nanofibers were significantly higher than those of the trapezoidal polysiloxane-based light-curing resin (P < 0.05). (3) The volume shrinkage of the light-curing resin grafted with SiO2-PMMA core-shell nanofibers was lower than that of the trapezoidal polysiloxane-based light-curing resin (P < 0.05). (4) Compared with the trapezoidal polysiloxane-based light-curing resin, the water absorption and cytotoxicity (absorbance value) of the light-curing resin grafted with SiO2-PMMA core-shell nanofibers were significantly higher than those of the trapezoidal polysiloxane-based light-curing resin (P < 0.05), while the solubility of the light-curing resin grafted with SiO2-PMMA core-shell nanofibers was lower (P < 0.05). It is concluded that the prepared light-curing resin grafted with SiO2-PMMA core-shell nanofibers has excellent properties and biomechanical properties.

Objective To analyze the epidemiological characteristics of adverse drug reaction (ADR) induced by Brucea Jananica Oil Injection,through literature review and to provide theoretical support for rational use in clinic.Methods With retrospective case study,analyzed ADR induced by Brucea Jananica Oil Injection,which were searched from revelent domestic pharmaceutical database from January 1990 to September 2016.Results Totaliy 76 cases were collected,and most were middle-aged and aged patients.Males patients were more than female patients (61.84％).ADR appeared in every period.The main ADRs of Brucea Jananica Oil Injection were allergic reactions (27.71％),digestive system damage (26.51％),and skin and accessories damage (19.28％).Conclusion Brucea Jananica Oil Injection can induced various ADRs and the occurrence of ADRs was associated with a variety of factors.Clinical monitoring should be enhanced,so as to ensure safety and efficacy of medication.

Objective The study was attempted to observe the colorectal injury due to endoscopic snare polypectomy. Methods Histopathological study was conducted on 47 snared colorectal polyps as well as on the corresponding sites in 34 patients who underwent surgery thereafter for malignancy. Results The injury to all snared specimens was confined within submucosa,while that to surgically resected specimens at the snared sites extended to muscular and serosal layers in 28 out of 34 cases, which manifested as focal necrosis in inner muscularis and hemorrhage between inner and outer muscle layers, bearing no continuity with submucosal change.The mean size of polyps snared with injury to muscularis and serosa at the site was larger than those without ( P10mm.

Objective To observe the curative effect of whole-body mild hypothermia therapy on massive cerebral infarction(MCI).Methods 68 MCI patients were divided randomly into the mild hypothermia group(35 cases) and control group(33 cases).At the basic of routine treatment in the two guoups,the mild hypothermia group received whole-body mild hypothermia therapy,including the cooling blanket cave all the body for decrease temperature,Chlorpromazine(50 mg) plus Promethazine(50 mg),Vecuroniumbromide(200～400 mg),0.9% sodium chloride to 50 ml;and Midazolam(50 mg) plus 0.9 % sodium chloride to 50 ml intravenous infusion slowly by trace-pump and continued 6～11 d.The rectal temperature was maintained between 32～33℃.The curative effect was evaluated according to American National Institute of Health Stroke Scale(NIHSS) scores and Barthel index(BI) pre and post-treatment.The mortality and incidence of epilepsy in the two groups were statistical.Results Compared to pre-treatment,the scores of NIHSS were significantly reduced and BI were apparently increased in the both groups post-treatment(all P