Objective To sum up the experience for the treatment of splenic trauma. Methods Data of 129 cases of traumatic splenic rupture from 1984 to 2004 were retrospectively analyzed. Results Conservative management was undertaken in 17 cases, splenorrhaphy in 16 cases, total splenectomy in 86 cases, partial splenectomy in 8 cases, and splenic autotransplantation in 23 cases. The results were all satisfactory. Conclusion In splenic trauma, treatment modality should be on adopted case to case basis according to the types of splenic rupture. Combined splenic salvage can be used on certain conditions.

Thirty-five patients with perioperative pulmonary embolism during January 2000 and October 2006 were analyzed retrospectively.Disease diagnosis and treatment outcomes were assessed.Of the 35 patients,2 died without any management,and 33 received conventional anti-coagulation and thrombolysis.including 3 percutaneous catheterization.Disease improvement Was seen in 29.Four deaths occurred after no response to the treatment.Thus,early diagnosis and treatment,which miight depend on further understanding of pulmonary embolism,could play an important role in reduced adverse events.Prevention is crucial to avoid perioperative occurrence of pulmonary embolism.

Objective To investigate the clinical efficacy of the laparoscopic radical resection and the conventional laparotomy for colorectal cancer. Methods The clinical data of 106 patients with colorectal cancer treated by surgery from March 2011 to January 2016 were retrospectively analyzed, including 55 patients receiving laparoscopic surgery (laparoscopic group) and 51 patients treated by traditional surgery (conventional laparotomy group). The clinical effects of both groups were compared. Results The operation time in conventional laparotomy group was shorter than that in laparoscopic group [(141.2 ±40.6) min vs. (192.0±32.5) min, t=7.136, P<0.05]. The blood loss of the laparoscopic operation group was lower than that of conventional laparotomy group [(81.2 ±16.5) ml vs. (168.0 ±36.2) ml, t= 16.077, P< 0.05]. The recovery time of gastrointestinal function and hospital stay time in laparoscopic surgery group were significantly shorter than those in the laparotomy group (t= 12.236, t= 9.524, all P< 0.05). There were no statistical differences in the number of captured lymph nodes, complications and the length of bowel resection between two groups (all P>0.05). There were no severe complications and death case in both groups. Patients were followed up for 10-60 months, and there were no significant differences on recurrence and metastasis between two groups (P> 0.05). Conclusion Compared with the conventional laparotomy, laparoscopic radical resection is an effective method for the treatment of colorectal cancer with small trauma, less bleeding and fast recovery, which is worthy of clinical application.

Objective:To investigate the expression and clinical significance of 12-lipoxygenase (12-LOX) in glioma. Methods:12-LOX expression in 40 glioma cases and 10 normal human-brain tissues was assayed by immunohistochemistry. Clinicopathological data were analyzed to reveal the association between 12-LOX expression and prognosis of glioma patients. Results:12-LOX was weak-ly expressed in the normal human brain tissues, whereas 12-LOX was strongly expressed (72.5%) in glioma tissues (P<0.05). The strong 12-LOX expression was correlated with the histopathological grading of glioma (P=0.012), whereas 12-LOX expression was not correlated with factors such as patient gender and age, tumor size, and Karnofsky Performance Score. Median survival time was longer in the group with low 12-LOX expression (25.6 months) than in the group with high 12-LOX expression (13.2 months) (P<0.05). Con-clusion:Abnormal 12-LOX expression is implicated in glioma. 12-LOX expression was correlated with the histopathological grading of glioma and was closely associated with patient prognosis.

Objective: To investigate the value of NPM1 and FLT3 gene mutation combined with bone marrow imaging detection in the prognosis judgement of initial treatment cytogenetically normal acute myeloid leukemia (CN-AML). Methods: The clinical data of 100 patients (non-M₃ type) with primary and initial treatment CN-AML from January 2010 to January 2014 in the Peace Hospital Affiliated of Changzhi Medical College were retrospectively analyzed. All patients were enrolled in the bone marrow imaging examination on the end day of induction treatment or the first day after the end of induction treatment (T time point). Univariate and multivariate prognostic analyses were performed on AML patients according to FLT3 and NPM1 gene status,bone marrow juvenile cell ratio at T time point. Results: A total of 100 patients included 36 cases with FLT3 gene mutation and 44 cases with NPM1 gene mutation. The complete remission (CR) rate of CN-AML patients was 13.9% (5/36) and 71.9% (46/64), respectively (P < 0.01), 2-year recurrence-free survival (RFS) rate was 5.6% and 59.8%, respectively (P < 0.01), 2-year overall survival (OS) rate was 15.6% and 66.2%, respectively in FLT3⁺ group and FLT3^- group (P < 0.01). The median RFS and median OS time in FLT3⁺ group was 6.9 months and 9.4 months, respectively, and the median RFS and median OS time in FLT3^- group had not yet reached. There were no significant differences of all the indexes between the two groups (all P < 0.01). And there were no significant differences in CR rate, 2-year RFS rate and 2-year OS rate between NPM1⁺ group and NPM1^- group (all P > 0.05). The CR rate, 2-year RFS rate and 2-year OS rate in NPM1⁺ FLT3^- group were better than those in NPM1^- FLT3^-, NPM1^- FLT3⁺ and NPM1⁺ FLT3⁺ groups; NPM1^- FLT3⁺ and NPM1⁺ FLT3⁺ groups had the worst prognosis, and there were no statistical differences in the CR rate, RFS and OS time between the two groups (all P > 0.05). The prognosis of the patients in bone marrow juvenile cell ratio < 0.05 group at T time point was better than that in ratio ≥0.05 group (all P < 0.05). CN-AML patients were classified into the good prognosis group (NPM1^- FLT3^-), the medium prognosis group (NPM1⁺ FLT3^-), and the poor prognosis group (NPM1^- FLT3⁺ and NPM1⁺ FLT3⁺) according to the FLT3 and NPM1 genes. The good prognosis group+ the ratio of bone marrow juvenile cells at T time point < 0.05 group, the good prognosis group+ the ratio of bone marrow juvenile cells at T time point ≥0.05 group, the medium prognosis group+ the ratio of bone marrow juvenile cells at T time point < 0.05 group had no statistical differences in CR rate, 2-year RFS rate and 2-year OS rate (all P > 0.05). The medium prognosis group+ the ratio of bone marrow juvenile cells at T time point ≥0.05 group, the poor prognosis group+ the ratio of bone marrow juvenile cells at T time point < 0.05 group had the equivalent prognosis, and the average prognosis was moderate; the poor prognosis group+ the ratio of bone marrow juvenile cells at T time point ≥ 0.05 group had the worst prognosis. According to Cox multivariate regression analysis, FLT3 gene mutation and the ratio of bone marrow juvenile cells at T time point were independent influencing factors for RFS and OS in CN-AML patients (all P < 0.05). NPM1 was an independent prognosis factor affecting RFS and OS of FLT3^- patients (all P < 0.05). Conclusions After induction chemotherapy, the responsiveness and sensitivity of AML patients to chemotherapy regimen can be assessed early and objectively according to molecular genetics and the ratio of bone marrow juvenile cells at T time point, which has a certain value in the prognosis judgement.

Objective To investigate the needs and service of rehabilitation for people with psychatric disability and influential factors to support the development of rehabilitation services for them. Methods The Administration Data of 2016 Basic Service Status and Needs of People with Disabilities in Henan Province were analyzed. Results The people with psychatric disability reported rehabilitation needs in mainly the medical rehabilitation, functional training and assistive products. The highest rate of need was medical rehabilitation (58.99%) and the lowest need was functional training (10.08%). There were significant differences in the rehabilitation needs for the people with psychiatric disability in ages, genders, household registration, levels of disability, levels of education, employment, household income, poverty and registration of poverty. Rehabilitation services for the people with psychiatric disability included medical rehabilitation services, functional training services and assistive products services. The reported rate of access was medical rehabilitation services (25.82%, highest), and the assistive products services (3.06%, lowest ). There were significant differences in rate of access in their household registration, levels of disability, levels of education, employment, household income, poverty and registration of poverty. Furthermore, family in poverty, lack of knowledge, traffic inconvenience and other factors also influenced the access of rehabilitation services for the people with psychiatric disability. Conclusion The needs of rehabilitation is high for people with psychiatric disability, especially in the field of medical rehabilitation. There were factors influencing the access of rehabilitation, including genders, household registration, and levels of disability, etc. The access rate of rehabilitation is low, including the medical rehabilitation. There were other influential factors including family economic status and transportation. It is proposed to improve the reported rate of rehabilitation needs, and the coverage, quality and efficiency of rehabilitation services for people with psychiatric disability.

Objective To analyze the policies and theories, and built the theoretical framework and methods to provide policy support and service development for the development of community-based physical activity and rehabilitation for people with disabilities based on WHO Community-based Rehabilitation (CBR) Guidelines.Methods The relevant policies at home and abroad were analyzed using policy research and literature research methods, and the functions of community-based physical activity were systematically analyzed based on the framework of WHO CBR Guidelines.Results The community-based physical activity can empower people with disabilities in the fields of health, rehabilitation, education, life, and social integration.Conclusion Based on WHO CBR Guidelines, the theory and policy framework of community-based physical activity for people with disabilities has been developed. It is benefit to promote the implementation of the National "Healthy China 2030 Outline" and the "National Fitness Program" to develop community-based physical activity for PWDs, to strengthen guidance and support services for community-based physical activity and to integrate physical activity and rehabilitation at community level for people with disability. It is also to achieve inclusive community development.