ObjectiveTo study the feasibility,safety and effect of laparoscopic splenectomy and selective pericardial devascularization in the treatment of portal hypertension.MethodsThis study included 7 patients diagnosed as posthepatitie cirrhosis and portal hypertension with a history of up GI bleeding receiving laparoscopic splenectomy and selective pericardial devascularization.ResultsThe operation was successful in all 7 patients without conversion to laparotomy.There were no postoperative severe complications.The average operation time was 4.2 h,mean blood loss was 430 ml.All patients recovered well,and were followed-up for 0.5 ～ 2.0 years,and there was no rebleeding in this period.ConclusionsLaparoscopic selective pericardial devascularization is feasible,safe,minimally invasive.The short to mid term result was satisfactory.

OBJECTIVE:To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS:207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tar-trate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w. Clinical efficacy,cardiac functions [left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),mi-tral early diastolic and late diastolic peak flow velocity ratio(E/A)],blood lipids [lipoprotein(a)Lp(a),triglyceride(TG),total cholesterol(TC)] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in cardiac functions and blood lipids in 2 groups(P>0.05). Af-ter treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp(a),TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSIONS:Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is su-perior to metoprolol in the treatment of CHF,with better safety.

Peritoneum is one of the common site of colorectal cancer metastasis. Traditionally, peritoneal carcinomatosis is associated with a poor prognosis without effective surgical treatment. Recently, the attitude towards the treatment strategies for colorectal peritoneal metastasis has changed significantly with advances in surgical techniques, hyperthermic intraperitoneal chemotherapy and multi-disciplinary treatment. As to the prognosis, colorectal peritoneal metastasis has an inferior outcome to non-peritoneal metastasis under the palliative systemic treatment. However, the complete peritoneal cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can achieve a long-term survival in selective patients with colorectal peritoneal metastasas. The prognostic factors include peritoneal carcinomatosis index, completeness of cytoreduction, the presence of extra-peritoneal metastasis (liver etc), peritoneal surface disease severity score and Japanese peritoneal staging. In terms of the treatment, complete peritoneal cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy and systemic treatment (including chemotherapy and targeted therapy) may be the best modality of multi-disciplinary treatment for colorectal peritoneal metastasis.

Objective To investigate the value of image analysis technology of polari-light dermoscopy (PD) in diagnosing head and face tumors. Methods We randomly collected the head and face tumors from the patients in this hospital, and then diagnosed them with naked eyes and PD, respectively. After making sure the diagnosis by histopathology, we analyzed the results retrospectively. Results We summarized the diagnostic signs of 211 head and face tumors on dermoscopy, which shown a great specificity. Its diagnosis rate reached to 92.89 %, obviously higher than that (69.67 %)with naked eyes. Due to clinical misdiagnosis and erroneous treatment, the recurrence rate of skin lesions was 19.91 %. The top 3 of head and face tumors, in turn, was seborrheic keratosis, melanocytic tumor and basal cell carcinoma. Conclusions PD is a non-invasive image analysis technology, which is especially applicable to the early diagnosis of head and face tumors. It can make sense in decreasing blind biopsy, directing surgical excision areas effectively, and selecting reasonable remedy. It also has great significance in the recovery and beauty of skin lesions.

Objective To investigate the early diagnosis of vitiligo and its differential diagnosis from other depigmentated diseases using polarized light dermoscopy(PD)imaging analysis.Methods Patients with localized depigmented macules were enrolled into this study.PD was used to observe the micromorphology,feature and color of skin lesions.Histopathology was performed to confirm the diagnosis of all cases except for those of pityriasis versicolor which were confirmed by clinical and laboratory examination.Results Of the 176 patients.97 were diagnosed as vitiligo.Residual perifollicular pigmentation Was observed in 91.94%(57/62)of patients with progressing vitiligo and 62.86%(22/35)of those with stable vitiligo,with significant difference between the two groups of patients(P<0.05).However.residual perifollicular pigmentation was absent in the 79 non-vitiligo depigrnented cases.The presence of telangiectasia,early reservoirs of pigmentation and perilesional hyperpigmentation were related to the stage of vitiligo and treatment history of patients.Conclusions PD,which efficiently eliminates the interference of reflected light on skin lesions of vililigo,is an imaging technique that allows for the visualization of minor structures and features of the skin lesions that are indiscernible to naked eyes.In a nutshell,the application of PD has offered references to the early diagnosis of vitiligo and its differential diagnosis from other depigmentation diseases.

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P ＜ 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P ＜ 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

[Objective] Discussion about feeding Liuwei dihuang pil to different ages of mental retardation intel igence-type mice, then test their intel igence level and mechanism. [Methods]The changes of ethology expressions are determined in healthy KunMing mice of five groups divided randomly:male mice (n=5), female mice(n=20). Group A:normal control group;Group B:the group with innate kidney deficiency and lead ingested. Group C:the group of lead poisoning, and the offspring mice are administered pil s. Group D:the group with innate kidney deficiency and lead ingested, and the adult mice are adminis-tered pil s. Group E:the group with innate kidney deficiency and lead ingested, and both the adult mice and offspring mice are administered pil s. According to the proportion of male and female mice, make them mate, remove the male mice. Before delivery, do threat means and give 0.1%Lead acetate trihydrate solution to Groups B,C,D,E.Groups D,E have tonifying the kidney. Give routine food to Groups A,B,C. Female mice wil labor in 19~22 days after mating, getting the offspring mice. The offspring mice in different periods of growth are carried out ethology determination and analyzed.[Results]Newborn rat kid-ney stand test shows rat offspring is not better than the success rate of kidney emancipated group, juvenile rat kidney tests show space group behavior test per-formance superior to that of kidney group, and long-term kidney group(offspring, mother on behalf of both rat kidney) or female offspring than only on be-half of kidney groups, multiple comparisons between groups(LSD-t statistical analysis) are statistical y significant, A group compared with B group, C group, D groups respectively(t=27.50,8.10,9.30,3.00,P<0.05), B group compared with C group, D group, E group(t=19.40,18.20,27.80, P al <0.05), C group and D group have difference statistical y significant(t=8.40, P<0.05), D group and E group difference is statistical y significant(t=9.60, P<0.05), young rats tightrope test, kidney group to some extent, is stil better than not Bushen group, multiple comparisons between groups find that:A group and D group, B group and C group, B group and E group, C group and D group, D group and E group have differences statistical y significant(t=22.01, 25.41,20.90,32.11,27.60, P<0.05). [Conclusion]Liuwei Dihuang Pil can improve the intel igence level of mice to a certain extent.

Objective To evaluate the diagnostic and differential diagnostic effects of ultrasound in testicular tumors and tumor-like lesions.Methods Ultrasound features of 33 cases of testicular masses were reviewed and the results were compared with pathological findings.Results For the 33 cases of testicular masses,12 cases were diagnosed as seminoma,6 cases as lymphoma,6 cases as epidermoid cyst,2 cases as mixed germ cell tumor,2 cases as teratoma,1 case as embryonal carcinoma,1 case as endodermal sinus tumor and 3 cases of the other tumor.Conclusions Ultrasound has important value in the diagnosis and differential diagnosis of testicular tumor and tumor-like lesions,and it can be considered first choice of clinical imaging examination.

OBJECTIVE For the reasonable use of antibacterial drugs, drug resisitance diversity of Pseudomonas aeruginosa was studied in our hospital. METHODS Antibacterial activity to all P. aeruginosa collected in four years from 2004 to 2007 were determined by K-B test, and data were analyzed by WHONET software. RESULTS The resistance rate to ampicllin, cefazolin and cefoteton were 100.0%, but low to ceftrazidime, cefoperazone and cefoperazone/sulbactam(3.2% in 2007). The resistance rate to levofloxacin increased year by year, while that to ciprofloxacin descreased from 15.6% to 9.6%.The resistance rate to gentamicin and amikacin descreased from 20.0% to 16.4%,and from 11.1% to 4.8%, respectively. The resistance rate to imipenem and meropenem accounted for about 10.0%, which was as same as ceftazidine. CONCLUSIONS The resistance of P. aeruginosa in our hospital is stable. Clinician should choose right antibacterial drugs on the basis of the test for antibacterial sensitivity and the pharmacological characteristis to improve curative effect and decrease the resistance of bacteria.

To explore the impact of normal range plasma calcium level changes on fibrinogen and homocysteine (Hcy) in non-diabetic elderly patients. Methods: A total of 1030 non-diabetic patients≥65 years were retrospectively studied. According to adjusted plasma calcium concentration (Cac), the patients were divided into 4 quartiles as Q1 group, Q2 group, Q3 group and Q4 group. The relationship between Cac and plasma levels of fibrinogen and Hcy were compared. Results: ① Plasma levels of fibrinogen and Hcy were increased by Cac elevation accordingly, P=0.010 and P<0.001 respectively. ② Cac was obviously related to the prevalence of high fibrinogen (OR=1.75, P=0.019) and high Hcy (OR=1.82, P=0.026). ③ Cac was positively related to fibrinogen (Standardized β=0.15, P<0.001) and Hcy (Standardized β=0.08, P=0.009). Conclusion: Normal range plasma calcium level changes were related to the elevation of plasma fibrinogen and Hcy in non-diabetic elderly patients.