Hypoxic ischemic encephalopathy (HIE) is one of the leading causes of neonatal morbidity and mortality worldwide, and it has a series of clinical manifestations of encephalopathy.Survivors often have different degrees of neurodevelopmental impairment.In addition to supporting symptomatic treatment, hypothermia is the safest and most effective treatment for the neuroprotection and the improvement of the prognosis of neonatal HIE.However, hypothermia cannot provide complete neuroprotection and is limited by gestational age, time, and facilities and so on.Therefore, clinicians and researchers actively seek for supplements and/or alternative therapies for neonatal HIE.It was reported that stem cell transplantation has a good application prospect in the treatment of HIE.Erythropoietin and xenon and melatonin may also play neuroprotective roles in HIE.In order to provide a better theoretical basis for clinical practices, this paper reviewed the research progress of neonatal HIE treatment.

Objective To investigate the feasibility a nd the clinical significance of modified laparoscopic transabdomimal preperitoneal (TAPP) mesh and suture inguinal herniorrhaphy. Methods Clinic al records of 13 patients with inguinal hernia treated by laparoscopic TAPP mesh plug combined with suture fixation from June 2002 to October 2004 in this hospi tal were retrospectively reviewed. Out of the 13 patients, there were 9 patients with indirect inguinal hernia and 4 patients with direct hernia, including 1 re current patient. The hernia was right-sided in 8 patients, left-sided in 4, and bilateral in 1. Results All the operations were completed succ essfully. The unilateral operation time was 35~85 min (mean, 50 min). No convers ions to open surgery were required and no postoperative complications were noted . The mean duration of postoperative hospital stay was 2 days. Follow-up observa tions for 1~28 months (mean, 12 months) in the 13 patients found no recurrence. Conclusions Laparoscopic TAPP mesh plug combined with suture fixation, characterized by advantages of simplicity of performance, minimal inva sion, little postoperative pain, and quick recovery, is a safe, reliable and eff ective alternative of inguinal herniorrhaphy. This technique can replace the ope n surgery and is recommended for wide application.

Objective To investigate the stress reaction of the medical staff who suffered workplace violence,and provide reference for nursing interventions.Methods 13 medical staff who suffered work-place violence were interviewed through semi-constitutional formula,the data were analyzed by phenomenological method of qualitative research.Results The psychological stress of medical staff mainly included 3 themes:complex emotions,eager to help; psychological adjustment required internal and external integration; different stress reaction affected the psychological state.Conclusions The medical staff suffer seriously from the workplace violence both on the physical and mental health,individuals should learn how to deal with it correctly,and the relevant departments should pay full attention to the humane care to victims of violence,guide them to view the stress correctly,and to take effective measures to prevent and control workplace violence.

Objective To evaluate clinical application of thyroid fine-needle aspiration biopsy (FNAB) and its diagnostic value.Methods FNAB was performed for 782 cases during 2005-2009 at China-Japan Friendship Hospital,Beijing and their clinical pathological data were retrospectively analyzed.Cytopathological diagnoses by FNAB were classified as unsatisfactory,benign,atypical cellular lesions,follicular neoplasm,suspicious malignancy and definite malignancy.Results of thyroid cytological and histological examinations of 76 patients with subsequent thyroidectomies were compared to those with FNAB to evaluate its diagnostic accuracy.Results Of 782 FNAB specimens,74.4 % (582/782) were classified as benign,2.6 % (20/782) as malignant,5.6 % (44/782) as follicular neoplasm,3.2 % (25/782) as atypical cellular lesion,2.9% (23/782) as suspicious malignancy and 11.3 % (88/782) as unsatisfactory.Among 76 patients with thyroidectomies,65.8 % of them (50/76) were histologically diagnosed as benign lesion,28.9 % (22/76) as definite malignancy and only 5.3 % (4/76) as benign follicular adenoma.Agreement between FNAB cytological diagnoses and histologically confirmed diagnoses for benign lesion and malignancy was 16/16 and 16/17,respectively.Conclusion FNAB is a reliable diagnostic method for evaluation of thyroid nodules.

BACKGROUND:Transplantation of stem cells has a beneficial effect on myocardium revascularization and improving cardiac function after myocardial infarction, and HLA-G protein contributes to the formation and maintenance of the immune tolerance.
OBJECTIVE:To investigate the transplantation effects of human umbilical cord mesenchymal stem cells at different gestational age with different HLA-G expression levels on myocardium revascularization after myocardial infarction in rabbits.
METHODS:Thirty healthy New Zealand rabbits were selected and were randomly divided into human smal gestational age umbilical cord-derived mesenchymal stem cells transplantation group, human ful-term umbilical cord-derived mesenchymal stem cells transplantation group and control group. After the rabbits models of acute myocardial infarction had been established, the former two groups were infused different umbilical cord-derived human umbilical cord mesenchymal stem cells labeled with 5-bromo-2-deoxyuridine into the edge and center of myocardial infarct region by multipoint injection. Rabbits in the control group were subjected to an equal volume of serum-free culture medium.
RESULTS AND CONCLUSION:Four weeks after celltransplantation, 5-bromo-2-deoxyuridine-positive cells were found surrounding the infarct site in both transplantation groups. Myocardial fibrosis and myocardial infarct size were significantly lower in both transplantation groups than those of the control group (P<0.05), and there was a significant difference between the two transplantation groups (P<0.01). The positive staining of factor VII indicated that capil ary density was increased significantly in the smal gestational age umbilical cord-derived mesenchymal stem cells transplantation group as compared with the ful-term umbilical cord-derived mesenchymal stem cells transplantation group (P<0.01), and a sstatistical difference was found between two transplantation groups and the control group (P<0.01). Transplantation of human umbilical cord mesenchymal stem cells with high HLA-G expression increases new capil ary vessels and improves myocardium revascularization. Al indicate that human smal gestational age umbilical cord mesenchymal stem cells have the potential to become the better source of cardiomyocytes transplantation.

Objective To investigate the clinical characteristics of primary thyroid lymphoma(PTL) and its prognostic factors.Methods Clinical and pathological data of 7 cases diagnosed as primary thyroid lymphoma were retrospectively analyzed.Results All of the 7 patients were diagnosed on thyroidectomy and presented with thyroid nodules,of whom 6 cases were middle-aged to elderly women and some had locally oppressive symptoms.Four cases were diagnosed as diffuse large B non-Hodgkin's lymphoma (DLBCL) and 3 were mucosa-associated lymphoid tissue B-cell lymphoma (MALT).Pathological subtype of mucosa-associated lymphoid tissue B-cell lymphomas and younger patients had better prognosis.Conclusion The possibility of PTL must be kept in mind in the differential diagnosis of thyroid nodules in middle-aged to elderly women.Age and pathological subtype are important prognostic factors.

Objective To investigate the diagnostic value of fine-needle aspiration(FNA) for thyroid nodules.Methods The cytological and histological results of 74 patients who had undergone FNAs for thyroid nodules,followed by thyroidectomy,were compared to evaluate the accuracy of cytological diagnosis of thyroid FNA and analyze the common causes of missed diagnosis and misdiagnosis in thyroid cytopathology.Results Benign lesions were histologically diagnosed in 48 patients(65%),malignant tumors in 22 cases(30%) and benign tumors in 4 cases(5%).Cytological diagnosis of benign and malignancy was confirmed histolopathologically in 96% and 94%,respectively.Fifteen discrepant cases came mainly from the group of FNA diagnosis of follicular neoplasm,and the discrepancies resulted mainly from cytodiagnostic errors and overlapping cytological features between adenomatoid nodule and follicular neoplasm.Conclusion Despite some limitations,thyroid fine-needle aspiration is a reliable diagnostic method of assessing thyroid nodular disease,especially in differentiation of benign lesion and malignant lesion.

Objective To analyze the diagnosis and treatment of pancreatic pseudocyst. Method This study included 46 pancreatic pseudocyst cases, 7 received conservative therapy, 12 received internal drainage, 9 received external drainage, 5 received sequential internal and external drainage and 13 received partial pancreatectomy. Result Cases receiving conservative therapy recovered well without recurrence, one case receiving internal drainage suffered from postoperative pancreatic fistula, one receiving external drainage was complicated with pancreatic fistula and recurrence developed in another 2 cases, one case undergoing partial pancreatectomy was complicated with postoperative pancreatic fistula. Conclusion Pancreatic pseudocyst should be managed individually according the course and patients' clinical condition.

Objective To investigate the protective effect of protocatechuic acid(PCA)on the PC12 cell model of Alzheimer’s disease(AD)and to explore its mechanism . Methods Amyloid beta peptide 1-42(Aβ1-42)fiber polymers were identified by immunofluorescence. After PC12 cells were stimulated with the Aβ1-42 fiber polymers, the cellular morphology was observed at different time points of hour 0, 3, 6, 9, 12, 24 , and the cellular viability was tested by methyl thiazolyl tetrazolium(MTT)assay to monitor the modeling condition. The effect of PCA on PC12 cells was detected after PC12 cells were pretreated with the different contentions of PCA. Autophagy-related marker Beclin1 protein level was detected by Western blotting method to investigate the protective mechanism of PCA. Results Aggregated white Aβ1-42 mass was stable at hour 12 and 24, and showed no significant difference between the two time points, the cell damage rate being 40%. Therefore, we defined culturing time being 12 and 24 hours as the modeling condition of AD model. The cell viability was increased with 200-800 μmol/L of PCA after culturing for 24 hours(P<0.01) , and the Western blotting results showed that the Beclin1 protein expression was up-regulated by PCA. Conclusion PCA prevents PC12 cells from Aβ1-42-induced toxicity, the mechanism being related with the increase of cellular autophagy.

Objective To investigate the clinical efficacy and experiences of laparoscopic hepatectomy (LH) for segment Ⅶ and Ⅷ liver tumors.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 94 patients who underwent LH for segment lⅦ or Ⅷ liver tumors in the Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from June 2010 to August 2016 were collected.The operating space for operation was built under laparoscopy.According to liver cirrhosis grading,tumor size,adjacent relationship with major blood vessels and residual liver volume,non-anatomical and anatomical hepatectomies were selected by patients.During the operation,tumors were precisely pinpointed and plane of liver resection was determined,and then proper instruments of liver partition and techniques of hepatic inflow occlusion were selected.Observation indicators:(1) surgical and postoperative recovery situations;(2) postoperative pathological examination;(3) follow-up and survival situation.Follow-up using outpatient examination and telephone interview was performed to detect the patients' survival up to July 2017.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (interquartile range).Survival rate was caculated by the Kaplan-Meier method.Results (1) Surgical and postoperative recovery situations:all 94 patients received successful operations,without perioperative death,including 73undergoing non-anatomical hepatectomy and 21 undergoing anatomical hepatectomy.Fourteen patients had conversion to open surgery and 27 received hepatic inflow occlusion.The median operation time,median volume of intraoperative blood loss and cases with intraoperative blood transfusion were respectively 187.5 minutes (75.0minutes),200 mL (200 mL) and 15.Eighteen patients had postoperative complications,including 6 with pleural effusion,6 with abdominal effusion,1 with wound infection,1 with abdominal infection,1 with venous thrombosis,1 with bleeding,1 with coagulation disorders and 1 with hepatic insufficiency.Clavien-Dindo classification of complications:11,1,5 and 1 patients were detected in grade Ⅰ,lⅡ,Ⅲ and Ⅳ,respectively.All complications were improved by symptomatic treatment.The median duration of hospital stay was 7 days (6 days).(2) Postoperative pathological examination:results of tumor pathological examination showed that 45,5,9 and 35 patients were respectively confirmed as hepatocellular carcinoma,cholangiocarcinoma,metastatic hepatic carcinoma and benign liver tumor.(3) Follow-up and survival situation:59 patients with malignant tumors were followed up for 6.0-52.0 months,with a median time of 42.6 months.Postoperative 1-and 3-year overall survival rates of 59 patients with malignant tumors were 98.3％ and 84.7％,respectively.Conclusions LH for segment Ⅶ and Ⅷ liver tumors which is conducted in experienced medical center is safe and feasible,with definite effects.Building operating space for operation under laparoscopy,determining precise positioning of the tumor and plane of liver resection,and selecting proper instruments of liver partition and techniques of hepatic inflow occlusion are the key points of successful operation.