The da Vinci Surgical System has developed and great progress has been made recently in surgery. Despite lack of applications in tumors of head and neck, its advantages, such as minimally invasive procedure and rapid recovery, show great prospects. In this article, we reviewed the surgical method, indication, advantages and prospects of its application in tumors of head and neck.

Objective This study was to systemically evaluate the efficacy of TACE before hepatectomy on resectable primary HCC.Methods The articles focused on preoperative TACE for resectable primary HCC,published from Jan.1,1980 to Jan.1,2008,were selected by computerized search of literatures and manual search of bibliographies.The clinical controlled trials meeting inclusion criteria were reviewed systematically by meta-analysis.The reported data were processed with the statistical techniques of meta analysis.The combinability of the studies was assessed in terms of clinical and statistical criteria.Tumor-free survival rate was calculated.And pooled estimates were computed according to a fixed or random effect model by heterogeneity.Results A total of 1288 patients were included in 8 trials.There was no difference between the two groups in the 1,3-year tumor-free survival rate.Conclusion Preoperative TACE for resectable primary hepatic carcinoma can't improve survival rate.

Objective To compare the effect after endovascular repair (EVAR) or open repair (OR) of ruptured abdominal aortic aneurysm (rAAA) in Department of Vascular Surgery,Beijing Anzhen Hospital.Methods Clinical data of 46 repaired rAAAs patients was retrospectively analyzed from 2005 to 2015.The difference between the EVAR group and the OR group in perioperative mortality,operation time,ICU stay,blood transfused,length of stay (LOS),complication rate were compared by x2 test and t test.Results 18 rAAA patients were repaired by EVAR,aged from 51 to 91 with a mean of (68 ±9).28 were repaired by OR,aged from 41 to 83 with a mean of (70 ± 11).Perioperative mortality was 21.0％ for EVAR and 28.6％ for OR (P ＞0.05).LOS was (15.3 ±9.5) days for EVAR,and (23.9 ± 10.5) days for OR (P ＜0.05).Blood transfused was (3 210 ± 3 780) ml for EVAR and (4 814 ± 3 392) ml for OR (P＜0.05).ICU stay time was (7.7 ±4.2) d for EVAR and (4.2 ±2.5) d for OR (P＜0.05).Conclusion EVAR is a reliable approach for the treatment of acute rAAA.

Objective To evaluate the effectiveness of spatio-temporal image correlation with M-mode display ( STIC-M ) in monitoring fetal left ventricular systolic function in fetuses with congenital heart disease(CHD) . Methods Five hundred and thirty-six normal fetuses and 34 fetuses with CHD( 29 without hydrops and 5 with hydrops) were involved in the study . Left ventricular fractional shortening ( LVFS) was measured using STIC-M . The data of normal fetuses was used to construct reference ranges of LVFS for assessment of fetuses with CHD . Results The LVFS of the normal fetuses [ range :26 .8％ - 42 .9％ , mean :( 34 .9 ± 4 .1) ％ ] was negatively correlated with gestational age ( r = - 0 .16 , P < 0 .001) . Compared with the normal controls ,LVFS was significantly decreased in CHD fetuses with hydrops ( P < 0 .001) . However ,there was no significant difference in LVFS between normal controls and CHD fetuses without hydrops ( P > 0 .05) . Conclusions STIC-M is a new method that can be used to measure LVFS to evaluate fetal ventricular systolic function . The fetal ventricular contractile function of CHD fetuses without hydrops may not be damaged or is in compensation stage . The fetuses with cardiac hydrops generally become lower .

Objective To determine the risk factors associated with early allograft dysfunction (EAD) after liver transplantation. Methods We retrospectively analyzed the records of 138 patients who underwent liver transplantation from January 2006 to October 2016 in our department. Transplant recipients were divided into two groups:those who met the diagnostic criteria of EAD (EAD group) and those who did not (non-EAD group). We compared blood flow into the transplanted livers and other clinical features between the two groups using univariate and multivariate analysis. Results Intraoperative portal vein flow (PVF) maximum was significantly different between the two groups. Multivariate analysis revealed that intraoperative PVF maximum ＜1 600 mL/min was the only independent risk factor for the occurrence of EAD after liver transplantation in this cohort. Conclusion Intraoperative PVF maximum ＜1 600 mL/min is an independent risk factor for the occurrence of EAD after liver transplantation. Measuring intraoperative blood flow into the transplanted liver in liver transplant recipients may help identify patients at risk for developing EAD.

Objective To analyze the incidence of preterm delivery among single live neonates and the association between maternal reproductive history and preterm birth.Methods A questionnaire survey was conducted on reproductive history among women at childbearing age who were selected through multi-stage stratified random sampling method in Shaanxi,during 2010-2013.Samples would include women at childbearing age and in pregnancy or having had definite pregnancy outcomes.Results A total of 29 608 women at childbearing age with their infants,were studied.The overall incidence of premature delivery among the single live birth neonates under this study,was 2.7％ during 2010-2013.Results from the logistic regression model showed that factors as:having had history with preterm delivery (OR=7.99,95％CI:5.59-11.43),age of the mothers,older than 35 (OR=2.03,95％CI:1.59-2.59) and with history of birth defects (OR=1.54,95％CI:1.01-2.34) were at higher risks for premature delivery in neonates.Intervals on pregnancies between 3-4 years (compared with ≤2 years,OR=0.74,95％CI:0.58-0.93),between 5-6 years (compared with ≤2 years,OR=0.66,95％CI:0.52-0.82),or ＞6 years (compared with ≤2 years,OR=0.48,95％CI:0.37-0.61)together with numbers of parity as 1 (compared with primiparas,OR=0.80;95％CI:0.67-0.95),as ≥2 (compared with primiparas,OR=0.62,95％ CI:0.39-0.97) etc.were protective factors to preterm delivery.Factors as:history of preterm delivery,mothers age (older than 35 years) and intervals of pregnancy,appeared influential to the age of gestation,under the ordinal polytomous logistic regression analysis.Conclusion The incidence of preterm births among single live birth neonates in Shaanxi was lower than the average national level.Programs related to health care services prior to conception and during pregnancy,together with increasing the self-care consciousness of childbearing aged women etc,should all be strengthened in order to reduce the occurrence of preterm birth,in Shaanxi province.

From the view-point of a front-line research team in clinical laboratory medicine , the advantages of microfluidic technology and its prospect in the field of in vitro diagnosis ( IVD) were reviewed in this paper. This paper introduces the application of microfluidics in molecular diagnosis , immune detection and microbial pathogen testing , showing the value of this technology in meeting challenges posed by clinical laboratory medicine .Opportunities and challenges of microfluidic IVD technology under the new situation were also discussed.The authors believe this technology will play a great role in promoting the improvement of clinical laboratory technology .

Extracellular vesicles are spherical membrane vesicles formed by bimolecular lipid layers and are secreted and released into the extracellular environment by many kinds of cells.Extracellular vesicles include exosomes, microparticles and apoptotic bodies, which represent newly discovered ways of intercellular communication and can be used as biomarkers to distinguish a variety of diseases.However, how extracellular vesicles change with age and the underlying mechanisms for these changes are not clear.This article reviews current research on extracellular vesicles, with a focus on the relationship between extracellular vesicles and aging and its role in aging-related diseases.Furthermore, its practical application in aging is also discussed, in order to provide new ideas for the intervention of the aging process and the treatment of aging-related diseases.

OBJECTIVE：To establish HPLC fingerprint of Coptis chinensis inflorescence，and study its spectrum-effect relationship with antioxidant and antibacterial effects. METHODS ：Taking 14 batches of C. chinensis inflorescence from different producing areas as the object ，HPLC method was adopted. The determination was performed on Supersil C 18 column with mobile phase consisted of acetonitrile- 0.1％ phosphoric acid solution（gradient elution ）at the flow rate of 1.0 mL/min. The column temperature was set at 25 ℃. The detection wavelength was set at 329 nm，and sample size was 10 μL. The fingerprints of 14 batches of C. chinensis inflorescence were established by Similarity Evaluation System of TCM Fingerprint （2012 A edition ），and the similarity evaluation and common peak identification were carried out. Taking DPPH free radical scavenging rate and hydroxyl radical scavenging rate as antioxidant effects index ，relative antibacterial activity （Escherichia coli ）as antibacterial effect index ， SPSS 21.0 software was adopted to analyze the Pearson correlation between common peaks of C. chinensis inflorescence and above efficacy indexes ；their spectrum-effect relationship was established and validated. RESULTS ：A total of 7 common peaks were obtained in HPLC fingerprint of C. chinensis inflorescence，and the similarity was no less than 0.916. No. 5 peak was identified as berberine hydrochloride. Seven common peaks were positively correlated with DPPH free radical scavenging rate ；No. 1-3，4，6，7 peaks were positively correlated with hydroxyl radical scavenging rate ，while No. 5 peak was negatively correlated with hydroxyl radical scavenging rate. There was a positive correlation between No. 5 peak and antibacterial activity in vitro . After validation ， relative error between the predicted values and the measured values of DPPH free radical scavenging rate ，hydroxyl radical scavenging rate and relative antibacterial activity was 0.92％- 14.5％ . CONLUSIONS ：The established spectrum-effect relationship model can be used to evaluate antioxidant andantibacterial effects of C. chinensis inflorescence. The chemical components represented by No. 1，2，3，4，6，7 peaks are the material basis of antioxidant effect of C. chinensis inflorescence， and berberine hydrochloride is the material basis of antibacterial effect.