Objective To observe the effects of postoperative patient controlled epidural analgesia(PCEA) on plasma neuropeptide Y(NPY) Methods Fifty eight patients scheduled for thoracic surgery, were randomly divided into PCEA group(n=28) and control group(n=30) After operation, patient controlled epidural analgesia was applied in PCEA group and in control group pethidine I M was given intermittently The plasma NPY and serum cortisol concentrations were measured at pre anesthesia,the end of operation,and 24h and 48h after operation by radioimmunossay Results Compared with the baselines, plasma NPY and serum cortisol levels increased significantly at the end of operation in both groups ,without the obvious differences between both groups The plasma NPY level restored to the baseline in PCEA group 24h after operation, and in control group was significantly higher 24h after operation than the besaline and restored to the besaline 48h after operation The serum cortisol level was kept higher level 24h after operation and restored to the baseline 48h after operation in PCEA group, and in control group increased significantly 24h and 48h after operation as compared with the baseline The plasma NPY level 24h after operation and serum cortisol level 24h and 48h after operation were lower markedly in PCEA group than those in control group Conclusions The PCEA can effectively depress the increase of plasma NPY and serum cortisol induced by postoperative pain in patients undergoing thoracic surgery

OBJECTIVE: To study the optimum supercritical- fluid extraction technique for Xiangjiang Granula essential oil. METHODS: The orthogonal test was adopted to optimize the extraction process using the content of Ligustilide and the yield rate of essential oil as indicators, and 95% ethanol as co- solvents. The content of Ligustilide was determined by HPLC, using Phenomenex Luna C18( 250nm? 4. 6nm, 5? m) as column and methanol- 0. 5% glacial acetic acid( 30∶ 70) as mobile phase, with the detection wavelength set at 280 nm. RESULTS: The optimal extraction conditions were: temperature at 50℃ , pressure at 45MPa, extraction time for 3h, and 95% ethanol as co- solvents. The Ligustilide had a good linearty relationship between 5. 1～ 25. 5? g? mL- 1( r=0. 999 8) . CONCLUSIONS: This technique is easy, convenient and workable, and can provide theoretical support for production.

Objective To assess the efficacy of postoperative adjuvant interferon (IFN) therapy on patients with hepatitis B virus (HBV) related hepatocellular carcinoma (HCC).Methods An electronic search for articles published from January 2000 to January 2013 was conducted to identify English language comparative studies evaluating IFN therapy on recurrence and survival after surgical treatment of HCC.Results A total of five trials consisting of 694 patients were included in the Meta-analysis.The estimated odds ratios (OR) for the 1-,2-,3-,and 5-year overall survival rates of HBV-related HCC were 3.37 (95％CI:1.18-6.27,P=0.000),2.36 (95％ CI:1.45-3.83,P=0.001),1.81 (95％ CI:1.21-2.72,P=0.004),and 1.93 (95％ CI:1.35-2.75,P=0.000),respectively.The OR for the 1-,2-,3-,and 5-year recurrence rates were 0.63 (95％ CI:0.44-0.91,P=0.014),0.84 (95％ CI:0.60-1.18,P=0.322),0.88 (95％ CI:0.63-1.22,P=0.431),and 0.78 (95％ CI:0.56-1.07,P=0.120),respectively.Conclusion This Meta-analysis shows that IFN therapy had a significant clinical effect in improving overall survival rates but not in decreasing recurrence rates of HBV infected HCC patients postoperatively.

The high incidence of postoperative recurrence of hepatocellular carcinoma ( HCC) is a most difficult obstacle for improving the prognosis of patients.Several adjuvant modalities have been developed to prevent recurrence in patients after surgery; nevertheless , there is no consensus regarding the standardized adjuvant therapy in terms of indications , clinical efficacy and interactions.In this article we review the currently available evidence in the medical literature on adjuvant therapy in HCC after radical resection.

ObjectiveTostudy the value of color Doppler sonography in diagnosisof rhabdomyolysis.Methods The color Doppler sonography images of twenty-one patients with diagnosed rhabdomyolysis were retrospective analyzed.The pathological changes of the muscle were observed.Results The appearance of ultrasound was cloundness and rough-cast glass change in the diseased area of rhabdomyolysis.The diseased region can be found by ultrasound,and location and scope can be displayed clearly.There were major differences in the location of rhabdomyolysis because of etiological factor.The muscle volume and tension of rhabdomyolysis were increased for trauma,the individual patients will lead to the osteofascial compartment syndrome.There was no blood flow signal or little blood flow signal in the diseased area of rhabdomyolysis.Conclusions The color Doppler sonography is an efficient method for diagnosis of rhabdomyolysis.

Objective To study the effects of community nursing interventions on stroke patients with attention disorders.Methods A total of 60 stroke patients fulfilling eligibility were divided randomly into two groups.Their data were collected between December 2010 and February 2012.The intervention group was treated by community nurses while the control group trained by family members.Attention was assessed by simple reaction time (SRT) and number cancellation test (NCT).Modified Barthel index was used to assess the activities of daily living (ADL).Both groups were evaluated before and after a 2-month intervention.Results Before treatment,the control group had(0.71 ± 0.25),(662.8 ± 152.7) and(31 ±8)scores at SRT,NCT and MBI respectively.And the intervention group yielded(0.69 ± 0.19),(652.7 ±131.0) and (30 ± 8)scores at SRT,NCT and MBI respectively.There were no significant differences in average value of SRT,NCT and MBI between training and control groups at pre-treatment (P ＞ 0.05).After 2 months,the control group had (0.68 ± 0.20),(637.4 ± 151.7) and (33 ± 8) scores at SRT,NCT and MBI respectively.And the intervention group yielded (0.56 ± 0.16),(540.3 ± 125.9) and(37 ± 8) scores at SRT,NCT and MBI respectively.Very significant difference existed in attention scale scores at Month 2 (P ＜ 0.01) and the difference in ADL scale scores was also significant (P ＜ 0.05).Conclusion For stroke patients with attention disorders,strengthening community nursing interventions may help to improve attention and boost activity of daily living.

A total of 60 brain injury patients with cognitive impairment were randomly divided into electro-acupuncture,computer and combination groups (n =20 each).The electro-acupuncture group received electroacupuncture,computer group cognitive rehabilitation training with specialized equipment and combination group both regimens.The treatment lasted for 2 months.Before training,Loewenstein occupational therapy cognitive assessment (LOTCA) test was not statistically significant among all groups (P 8 0.05).After 1 month,the combination group scored higher than pre-training (P ＜ 0.05).After 2 months,the scores of all groups were higher than pre-training(P ＜ 0.05).After 1 and 2-month training,the combination group scored higher than the other two groups in aspects of consciousness,optomotor tissue,attention,thinking and aggregate score (P ＜ 0.05).However,the orientation scores of all groups changed insignificantly after 1-month training (P 8 0.05),the combination group scored higher than the other two groups in improved orientation after 2 months (P ＜ 0.05).

Objective:To evaluate the short-term effect of robotic pancreaticoduodenectomy (RPD) and laparoscopic pancreaticoduodenectomy (LPD) in the treatment of ampullary and periampullary tumor systematically.Methods:A systematic search of the PubMed, Embase and Cochrane library database using the key words "pancreaticoduodenectomy, duodenopanreatectpmy, whipple, laparoscopic, robotic, Da Vinci" . A systematic search of the Sinomed, Wangfang, VIP and CNKI databases including the key words "胰十二指肠切除" , "腹腔镜" , "机器人" , "达芬奇" . To investigate the differences of the conversion rate of laparotomy, incidence of postoperative complications, and the postoperative hospital stay between the RPD group and the LPD group. The software RevMan5.3 was used in this meta-analysis.Results:A total of 4 retrospective cohort studies and 1 001 patients were included in this meta-analysis, including 451 patients in the RPD group and 550 patients in the LPD group. The results of the meta-analysis showed that there were significant differences between RPD group and LPD group for the conversion rate laparotomy ( OR=0.35, 95% CI: 0.24-0.50, P<0.05). There were no significant differences between RPD group and LPD group for the incidence rate of overall complication( OR=1.23, 95% CI: 0.95-1.58, P>0.05), hemorrhage ( OR=0.71, 95% CI: 0.50-1.00, P>0.05), pancreatic fistula ( OR=1.09, 95% CI: 0.80-1.49, P>0.05), delayed gastric empty ( OR=0.81, 95%CI: 0.57-1.14, P>0.05) and hospital stay after surgery ( WMD=-2.87, 95% CI: -1.44-1.70, P>0.05). Conclusions:RPD is as safe as LPD, with the same complication rate. Therefor it is worthy for further application in medical institutions with relevant conditions.

Objective To investigate the clinical application of Glissonean pedicle transection method in hepatocellular carcinoma. Methods We analyzed the clinical data of 232 cases of hepatocellular carcinoma underwent hepatic resection in our department from April 2009 to April 2013. Eighty-nine cases underwent hepatic resection by Glissonean pedicle transection method, and 143 cases underwent Pringle maneuver. Results There was no significant differences in the operation time and blood loss between the two groups (P > 0.05). However, the postoperative hospital stay time and the postoperative complications in group A were better than those in group B(P<0.05). Levels of ALT and AST in group A increased significantly slowly than those in group B. The 1, 3-year disease-free survival rates in the two groups were 87.4%, 71.1% and 85.1%, 60.0%, respectively. The 1, 3-year survival rates were 93.3%, 73.5% and 93.4%, 65.0%, respectively, with no significant differences (P>0.05). Conclusion Glissonean pedicle transection method has many advantages including effectively preventing the intraoperative bleeding, maximally reserving the remaining of liver function, decreasing the rate of tumor spread and metastasis. Meanwhile, it is a safe and effective technique for hepatectomy without dissection of the hepatic artery, portal vein and bile duct in the hepatoduodenal ligament.

Objective To study the clinical value of color Doppler ultrasonography in the persistent sciatic artery.Methods The ultrasonographic images of eleven patients with persistent sciatic artery diagnosed by CT angiography or digital subtraction angiography were retrospective analyzed,the ultrasonographic features were summarized.Results The sciatic artery showed the enlarged internal iliac artery,which continued into the thigh in a posterior location,the sciatic artery described a tortuous course toward the knee,slowly filling normal-appearing popliteal artery in 8 cases,there were no connection with popliteal artery in 1 cases.The common femoral artery and superficial femoral artery was dysplasia in 7 patients,which was thinner than the popliteal artery.Conclusions The ultrasonography is the effective imaging method for diagnosis of the persistent sciatic artery.