Objective To study the influence of splenectomy on the surgical efficacy in the patients with gastric cancer in the up-per and middle portion and entire stomach .Methods 86 patients with gastric cancer in the upper and middle portion and entire stomach receiving the gastric cancer D 2 radical operation in the two hospitals from April 2003 to January 2008 were selected and di-vided into the observation group(47 cases) and the control group(39 cases) .The observation group accepted the modified lymph-adenectomy with spleen-preserving ,while the control group accepted the D2 total radical gastrectomy with splenectomy .The long-term effects were compared between the two groups .Results The total hospitalization time and the occurrence rate of postoperative complications were(20 .62 ± 7 .93)d and 10 .64% in the observation group ,which were less than (27 .51 ± 12 .44)d and 30 .77% in the control group ,and the differences between the two groups showed the statistical significance (t=3 .128 ,χ2 =5 .446 ,P=0 .000) . The 5-year survival rate in different TNM stages had no statistical difference between the two groups (P>0 .05) .Conclusion For the patients with gastric cancer in the upper and middle portion and entire stomach without spleen or splenogastric ligament metas-tasis ,the modified spleen-preserving lymphadenectomy could make the patients to get the same prognosis as the gastrectomy com-bined with splenectomy ,which reduces the occurrence rate of complications and is worth promoting clinically.

Objective To study comparatively reduction and prevention of surgery-induced peritoneal adhesion by methylene blue and hyaluronate sodium. Methods 46 patients with acute diffuse peritonitis or adhesion intestinal ileus were divided at random into 3 groups: methylene blue ( MB) group, hyaluronate sodium (HS) group and control ( C ) group. The alteration of postoperation recovery,serum MDA, TNF? and erythrocytes SOD in patients were investigated. Results The recuperation in group MB was better than in group C (P

Objective:To create hospital data fusion centers to solve the problems involving data incompatibility between business system and administration system and incomplete data-sharing service.Methods:The needs for hospital data fusion center were analyzed, and the protocol design for creating hospital data fusion center was put forward according to the needs.Results:The protocol design for creating hospital data fusion center facilitates the specific methods of promoting hospital data fusion.Conclusion: The protocol design for creating hospital data fusion center may promote in-and out-hospital data-sharing service and comprehensive data utilization, so as to improve hospital information utilization.

To correlate the ultrasound and MR imaging of carotid atherosclerotic plaque with its histologic compositions,20 patients(22 lesions) scheduled for carotid endarterectomy were examined by B mode ultrasound and MRI preoperatively. The specimens were also examined postoperatively and the images of carotid plaque were recorded. The transverse pathological sections of plaques were made and matched with images of ultrasound and MRI. 256 gray scale ultrasound densitometric analysis of carotid plaque compositions was performed. Ultrasonic density of calcium, fibrous tissue, hemorrage/thrombus and lipid deposits was (89?12), (53?8), (37?6) and (39?3) respectively in vivo , and was (168?11), (136?12), (85?12) and (89?10) respectively in vitro . In vivo relative signal intensities of calcium, fibrous tissue, old hemorrhage/thrombus and lipid deposits were low, equal, equal and very high respectively on T 1 W MR image, and very low, equal, high and high respectively on PDW MR image, and low, equal or slightly high, high and high respectively on T 2 W MR image. Signal intensities of plaque contents ex vivo were correlated to signal intensities in vivo. Densitometric analysis of ultrasound images of carotid plaques can quantify possible components of plaque, and MRI has the feasibility to identify the components of plaque.

To study the distribution of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries, 32 samples of endarterectomy and 10 autopsies of normal carotid specimens were fixed and embeded in paraffin, sections were stained with hematoxylin-eosin, toluidine blue,monoclonal antibodies against the two major proteases of mast cells(tryptase and chymase) and monoclonal antibodies against CD-3 of T lymphocytes and CD-68 of macrophages. The quantity,distribution and degranule of two different phenotype mast cells in atherosclerotic lesions of human carotid arteries were investigated,and the ratio of mast cells to T lymphocytes and macrophages in atherosclerotic lesions was calculated. The density(cells/mm 2 ) of mast cells in shoulder region of plaque(6 3?4 0) was much higher than that in normal intima,cap and core region(1 3?2 3,2 3?2 6,2 2?3 7) .The proportion of chymase-containing mast cells to tryptase-containing mast cells was 0 36,0 51,0 47 and 0 39 respectively in normal intima,cap,core and shoulder region of plaque.The propotion of degranulated mast cells was the highest in shoulder region of plaque(65%).The ratios of mast cells to T lymphocytes and to macrophages were 0 25 and 0 14 respectively in shoulder region of plaques.Light microscopic studies of mast cells revealed that mast cells were more commonly observed in thrombus and around calcification and blood vessels of plaque.Mast cells play a role in the formation of plaque,and participate in the destabilization of plaque.

Objective To discuss the clinical application value of 256-slice helical CT 3D-imaging in guiding interventional occlusion therapy for patent ductus arteriosus (PDA).Methods A total of 40 patients with sonography-proved PDA were randomly divided into group A (angiography group) and group B (CT-guided group) with 20 patients in each group.For the patients of group A,occlusion of PDA was performed based on the intraoperative angiography findings;and for the patients of group B,occlusion of PDA was carried out according to CT examination results.Intraoperative cardiac ultrasound monitoring was adopted and the curative effect was evaluated.Results The morphology of PDA demonstrated on CT 3Dimaging in group B was highly consistent with the configuration of PDA displayed on intraoperative angiography in group A.The most narrow diameters of PDA in group B and group A were (3.88±1.59) mm and (3.63±1.41) mm respectively,and the lengths of PDA in group B and group A were (6.1±1.06) mm and (6.82±0.74) mm respectively;the differences between the two groups were not statistically significant (P＞0.05).The time spent for surgery in group B and group A was (34.3±9.11) min and (17.33±5.81) min respectively,and the intraoperative X-ray radiation doses in group B and group A were (33.93±11.0) mGy and (66.48±9.77) mGy respectively;the differences between the two groups were statistically significant (P＜0.001).In group B,the preoperative X-ray radiation dose from CT examination was (119.79±29.45) mGy,when it was added to the intraoperative X-ray radiation dose the total cumulative radiation dose of group B was strikingly higher than that of group A.Conclusion Contrast-enhanced 256-slice helical CT scan and 3D-imaging technique can replace intraoperative angiography to get accurate anatomical imaging information of PDA,which are very helpful for the performance of interventional occlusion of PDA,meanwhile,it can effectively reduce the damage to the punctured artery and shorten the operation time.However,the radiation dose is a factor that should be taken into consideration.(J Intervent Radiol,2017,26:206-209)

Objective To investigate the risk factors of postoperative complications in spinal tuberculosis surgery,and try to find a way to improve the results of perioperative management and reduce or avoid the postoperative complications.Methods All of 172 cases of spinal tuberculosis who were treated by surgery from February 2005 to January 2013 in orthopedic department of Zhongshan hospital,Fudan University were retrospectively analyzed.There were 88 males and 84 females,whose average age was 50.9± 18.7y (18-84y).Among them 98 cases got cold abscess,and 56 cases had tuberculosis poisoning symptoms.The lesions located mostly in thoracic spine (112/172,65.1％) and lumbar spine (40/172,23.3％),while rarely in cervical or sacral spine.2 intervertebral spaces were involved in 116 cases (67.4％),more than 2 intervertebral spaces were involved in 32 cases (18.6％),and single intervertebral space were involved in the rest cases (14.0％).38 cases were treated through single anterior approach,54 cases were treated by anterior-posterior surgical approach,and single posterior approach was performed in 80 cases.58 cases were suffered from neurological dysfunction.All the postoperative complications and related clinical parameters during hospitalization period were collected and analyzed with SPSS software.Each clinical parameter was analyzed with univariate analysis to find the factors related to postoperative complications,and then the related factors were analyzed by multivariate regression analysis.Results All of 172 patients were included and 41.9％ (72/172) of the patients suffered from postoperative complications.System complications were the most common (33.7％,58/172).The rates of local complications were 10.5％ (18/172).Univariate analysis showed that the lesion site,value of hemoglobin,electrolyte disturbances,postoperative ASIA score and blood loss were related with postoperative complications.Posterior approach related with local complications.Multivariate regression analysis showed that preoperative hemoglobin ＜100 g/L,poor postoperative ASIA scores and long period of preoperative anti-TB treatment (＞28 days) were related with the system or local postoperative complications.Conclusion Patients with anemia (hemoglobin ＜ 100g/L),poor postoperative neurological function and long period of preoperative anti-TB treatment could take more risks of the postoperative complications.

OBJECTIVE:To explore the clinical efficacy and safety of nalmefene combined with monosialotetrahexosylganglio-side sodium in the treatment of patients in brain tumor operation. METHODS:64 patients in brain tumor operation were randomly divided into observation group and control group,32 cases in each group. Control group received brain cell protection,reducing in-tracranial pressure,anti-infective,vasodilator and other conventional treatment;observation group additionally received 0.7μg/(kg· h) nalmefene combined with 100 mg/d monosialotetrahexosylganglioside sodium from the first day of operation,for continuous 7 d. The plasma cortisol,adrenocorticotropic hormone (ACTH) before and 3,7 d after treatment,changes of serum IL-6,TNF-αand Barthel index (BI) in 2 groups were observed,improvement of neurological function and ADR were observed;Karnofsky (KPS)score was determined after 90 d follow-up used to assess the patient’s ability to take care of themselves. RESULTS:After treatment,plasma cortisol and ACTH content,serum TNF-αand IL-6 levels in 2 groups significantly decreased than before,the dif-ference was statistically significant(P<0.05);cortisol,ACTH and TNF-α levels 3,7 d after treatment,IL-6 level 7 d after treat-ment in observation group decreased more significantly than control group,the differences were statistically significant(P<0.05). After treatment,BI score in 2 groups significantly increased,and observation group increased more significantly than control group,the differences were statistically significant (P<0.05). 7 d after treatment,improvement rate of neurological function was 50.00%,which was significantly higher than that of the control group(18.75%),the difference was statistically significant(P<0.05). There was no significant ADR occurred of 2 groups in the study. Following-up for 90 d,the KPS score in observation group with not less than 70 points accounted for 71.88%,which was significantly higher than the control group(46.87%),the difference was statistically significant (P<0.05). CONCLUSIONS:Nalmefene combined with monosialotetrahexosylganglioside sodium can promote the recovery of patients in brain tumor operation,reduce cortisol,ACTH,IL-6 and TNF-α levels and improve prognosis of patients.

Objective To detect whether and where brain functional connectivity exists in the resting state of patients with early-onset schizophrenia by using functional magnetic resonance imaging (fMRI). Methods Nineteen early-onset schizophrenic patients were diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) of American Psychiatric Association. The 19 early-onset schizophrenic patients and another 19 healthy volunteers underwent fMRI in resting state. Cingulate gyrus was selected as region of interest and the difference was analyzed in the cingulate gyrus functional connectivity pattern between the 19 patients with early-onset schizophrenia (EOS) and 19 matched controls using resting-state fMRI. A two-sample t test was performed on the individual in a voxel by voxel manner. Results Statistical map was set a combined threshold of P＜0.005 and the number of voxel>20. Functional connectivity in the resting state was abnormal in the patients,including decreased functional connectivity and increased functional connectivity. The abnormal area was distributed all over the brain. The brain area with decreased functional connectivity included bilateral posterior cerebellar lobes, superior frontal gyrus, middle frontal gyrus, gyrus rectus,hippocampus, cuneus gyrus,fusiform gyrus,middle occipital gyrus,inferior occipital gyrus, right inferior temporal gyrus,right middle temporal gyrus, and right angular gyrus. The brain area with increased functional connectivity included left middle temporal and left inferior temporal gyrus. Conclusion Abnormal cingulate gyrus functional connectivity of schizophrenia might exist in the resting state. Resting state fMRI is important for the research of schizophrenia.

Objective To compare the treatment effectiveness of AO/ASIF proximal femoral nail (PFN) and proximal femoral nail antirotation (PFNA) in treatment of intertrochanterie fractures. Methods A retrospective study was done on 233 patients with intertroehanteric fractures treated from August 2004 to December 2006. The patients were divided into PFN group (188 patients) and PFNA group (45 patients) for comparing operative procedures and postoperative functional recovery. Results There was statistical difference in aspects of incision length, blood loss and operation time between two groups. The follow-up for 22.8 months showed excellence rate of 89.9% in PFN group and 91.1% in PFNA group, with statistical difference (X2 = 0.06, P > 0.05). There occurred hip varus in one patient and antirotation nail cutting-out in two in PFN group, which was not found in PFNA group. Conclusion PFN and PFNA are both good choices for treatment of intertrochanteric fractures. Compared with PFN, PFNA has more advantages in reducing operation time and blood loss especially for the eider patients with osteoporosis.