With the advent of continuous development of radiofrequency ablation(RFA), this technique has been increasingly used in the treatment of renal cell carcinomas during recent years, with a significant therapeutic effect clinically. RFA is characteristic with the advantages of safety, convenience, minimal invasion, less complications and suffering. The improvement of the electrode needle, the radiofrequency techniques and the combination of other treatments are the key of the development of RFA in the near future. And more reasonable criteria for evaluating the therapeutic effects including imaging techniques are also needed to be set up.

yin asthenia. Conclusion Characteristic of syndrome about type 2 diabetes mellitus affiliated metablic syndrome show that:extreme heat with yin asthenia, deficiency of both vital energy and yin, deficiency of vital energy and blood stasis, syndrome of blood stasis run through the whole course of disease. Incorporated syndrome show characteristic of versatility and individualization.

Objective To analyse and summarise of the clinical effect and operative opportunity laparoscopic cholecystectomy for acute mild unobstructed gallstone pancreatitis.Methods Fify-four gallstone pancreatitis patients were treated as observation group in the first people's hospital of yangzhou from December 2012 to September 2015,which were treated with laparoscopic cholecystectomy after two weeks,while 53 patients which were treated with laparoscopic cholecystectomy after three months were treated as control group.The treatment effect,operation time,hospitalization time and total cost.Results There were no deaths,no bile duct injury and biliary fistula,the total hospitalization time [(19.8 ±2.6)d vs (26.5 ±3.5) d],the total cost [(2.6282 ± 0.2451) vs (3.2892 ± 0.3982)],recurrent pancreatitis rate (0) were lower than the control group(9.4％),the recovery rate of liver function were higher than the control group,there was significant difference between two groups(P ＜ 0.05),however,there was no significant difference between two groups for postoperative complications and operation time (P ＞ 0.05).Conclusions For acute mild unobstructed gallstone pancreatitis patients,the safe and feasible operative opportunity was recommended two weeks after the symptoms were completely improved,Laparoscopic cholecystectomy in the treatment of acute gallstone pancreatitis can promote recovery,shorten the hospitalization time.

AIM: To study the protective effect of hepatic stimulator substance(HSS) on chemotherapeutic liver damage induced by cyclophosphamide and its possible mechanism.METHODS: The serum biochemical parameters,oxidative parameters and anti-oxidative parameters of liver tissue of male Kunming mice inoculated with S_(180) cells were measured.The pathology of the liver was observed with microscope.The weight of S_(180) sarcom was weighted.RESULTS: The elevation of MDA content of liver tissue and the less of GSH content and CAT,GSH-PX,GST,and SOD activities induced by CP were restored remarkably by HSS.The ALT and LDH activities of serum in HSS group which was compared with control group and CP group were not statistically distinctive.In the pathologic examination,spotty and focal necroses of hepatocytes in the liver of CP group were found with a great deal of inflammatory cells infiltration in the necrotic and portal areas,while the damage in the liver of HSS group was ameliorated obviously;The weight of S_(180) sarcom in CP group and HSS group was not statistically distinctive.CONCLUSION: The effect of HSS on CP-induced chemotherapeutic liver damage maybe due to anti-oxidative activity.

Objective To evaluate the influence of successful revascularization by percutaneous coronary intervention(PCI)on heart function of patients with heart dysfunction combined with chronic total occlusion(CTO).Methods The clinical data of 272 patients with heart dysfunction combined with CTO were analyzed.The patients were divided into PCI success group(246 cases)and PCI failure group(26 cases)respectively according to the results of PCI.Six months after PCI,the patients underwent cardiac ultrasound examination to compare the heart function between the two groups.Results Cardiac ultrasound examination was successfully performed in 229 patients in PCI success group and 24 patients in PCI failure group at 6 months after PCI.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume index(LVEDVI)showed no significant difference in PCI failure group at 6 months after PCI compared with that before PCI(P＞0.05).In PCI success group,LVEF and LVEDVI were significantly increased at 6 months after PCI compared with that before PCI and compared with that in PCI failure group at 6 months after PCI[(51±5)％ vs.(43±6)％ and(45±2)％,(77±13)ml/m2 vs.(86±12)ml/m2 and(86±10)ml/m2,P＜0.05].The cardiac functional grading in PCI failure group had no significant difference compared with that before PCI(P＞0.05),but in PCI success group it had significant difference compared with that before PCI and compared with that in PCI failure group at 6 months after PCI(P＜0.05).Conclusion Successful revascularization by PCI can improve heart function in patients with heart dysfunction combined with CTO.

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

Objective To investigate the pattern of plasma kisspeptin levels in normal female during various pubertal Tanner stages and the girls with idiopathic central precocious puberty(ICPP) or with premature thelarche(PT), and to evaluate the significance of detecting plasma kisspeptin levels as a new criterion for early differentiation between ICPP and PT.Methods Each study group of normal pubertal females with Tanner stage Ⅰ to Ⅴ comprised 16 to 19 individuals.The levels of plasma kisspeptin were also detected in girls with ICPP(n= 10)or PT(n = 12).The plasma kisspeptin levels were detected by enzyme-linked immunosorbent assay (ELISA).Results The level of kisspeptin was significantly higher in ICPP group than in that of PT group [(1.73±0.23 vs1.43±0.29) ng/ml, P＜0.05].Among the normal pubertal females, the level of kisspeptin decreased gradually from Tanner stage Ⅱ to Tanner stage Ⅴ, being highest in Tanner stage Ⅱ [(1.73±0.22) ag/ml] ,lower in stage Ⅳ and Ⅴ than in stage Ⅰ and Ⅲ (P＜0.01).Conclusions Plasma kisspeptin level was the highest during Tanner stage Ⅱ in normal female pubertal development.It is significant to detect plasma kisspeptin level for the differential diagnosis of ICPP and PT.

Objective To explore and evaluate the micro-anatomic structure of posterior-middle cra nial fossa in the retrosigmoid keyhole approach for clinical application. Methods Ten formalin-fixed adult cadaver heads of 20 sides were used to apply the retrosigmoid keyhole approach to reach and observe the structure of posterior-middle cranial fossa.Results The retrosigmoid keyhole approach can reach petroclival region from post-lateral aspect and through this approach the lateral potion of cerebellar hemisphere、petrosal bone,CN Ⅴ,Ⅶ,Ⅷ,part of CN Ⅸ-Ⅻ,lateral potion of pons、vertebral artery and anterior inferior cerebellavar artery can be exposed cleady.Resecting part of supra-tubercle of IAM can enlarge the exposure of IAM and CN V.After cutting off the edge of tentorial part of CN Ⅳ and middle cranial fossa can be exposed.Conclusion Through retrosigmoid keyhole approach we can use the small but compatible bone hole to diminish the ineffective exposure of the cerebellum.Meanwhile the wound because of the approach and complication can be cut down.It's an effective,safe and convenience approach in clinical application to resect the tumor mainly located in posterior cranial fossa.

Objective To explore the application effect of Sandwich teaching method in clinical teaching in the department of neurosurgery.Methods Totally 144 clinical medicine students were divided into 2 groups:Sandwich teaching group (n=72) and traditional teaching group (n=72).The analysis of test and the questionnaire of the students were conducted after the course.Comparison between the two groups was made using independent sample t test and measurement data were expressed as as ± s.P＜0.05 signifies statistically significant differences.Rank sum test was used to compare the distribution of the test scores.Results The test score was statistically higher in Sandwich teaching group than control group [(76.38 ± 10.84) vs.(69.67 ± 10.50)].And the main distribution of the test scores was 70～90 in Sandwich teaching group while 60～80 in control group.Questionnaire showed that the scores of Sandwich teaching group were statistically higher than those ofthe control group in five aspects such as enhancing self-learning ability,improving the ability to analyze and solve problems,and so on.Conclusions Sandwich teaching method achieves good teaching effect and it is worth recommending in clinical teachifig.

Objective: to examine the relationship between emotional states and skin conductance response during lie- detection and to provide evidence for improvement of lie- detection technique. Methods: 38 university students participat- ed in the study. They were provided with antisocial behavior materials that elicited different levels of emotional arousal. Results: Significant difference in skin conductance response was observed with the high emotionality items eliciting the highest skin conductance response. Conclusion: Under a certain level of pressure, individuals’emotional state has direct impact on skin conductance. High emotionality questions are better for detecting lies and honesty than low emotionality questions. In addition to lying, the questions themselves have direct impact on subjects’emotional responses, which in turn lead to skin conductance response. When cues for emotionality are obvious, related events tend to receive greater at- tention by subjects and thus lead to special skin conductance response.