Objective To discuss the surgical skills and clinical value of laparoscopic splenectomy with a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen.Methods A total of 88 patients with hypersplenism secondary to liver cirrhosis who underwent laparoscopic splenectomy in our department from September 2015 to September 2016 were selected into this study.And these patients were divided into two groups based on whether to take the safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The control group included 40 cases who underwent the traditonal laparoscopic splenectomy,while the observation group included 48 cases who took the safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The clinical data were collected retrospectively by medical clinical records review.Results There was no mortality occurred in this study.The blood loss of the observation group was (247.50±135.89)mL,which was obviously lower than (361.75±144.43)mL of the control group,and the difference was statistically significant (P<0.05).The operation time of the two groups were (194.69±47.99)min and (232.75±45.26)min respectively,and the difference was statistically significant (P<0.05).No significant difference was found in terms of rate of conversion to laparotomy,rate of intraoperative blood transfusion,postoperative hospital stay and complications (P>0.05).Conclusion It is very crucial for a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen to establish a tunnel behind the splenic hilum in laparoscopic splenectomy.It is safe and feasible to perform a safe approach to the splenic hilum through first mobilizing the lower pole of the spleen in laparoscopic splenectomy.The technique is generalized in clinics,especially for freshmen.

The researches on attention provide a promising framework for studying bipolar disorder pathophysiology and treatment.Previous findings have shown the negative attention bias maybe a risk factor for bipolar disorder.The current review discusses this issue in several aspects,including attention bias toward emotional information in bipolar disorder is state or trait,and whether shows mood-congruent bias;the character of attention bias in the different episodes of bipolar disorder.The article also puts forward an intervention of attention bias modification for treating bipolar disorder.

Urinary tract infection (UTI)is a commonly encountered disease during routine clinical care. In the mean time, it is also a commonly encountered hospital acquired infection. UTI possesses various clinical symptoms, and usually the symptoms are atypical. The detection of leukocyturia and bacteriuria is an essential index for screening and confirmatory diagnosis of UTI. This article summarized the pathogenesis of UTI, diagnostic criteria, clinical significance and application evaluation of detection of the WBC and bacteria in urine.

Bronchoscopes ; Bronchoscopy ; instrumentation ; methods ; Child ; China ; Humans

Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Extracellular Matrix Proteins ; biosynthesis ; Humans ; Liver ; metabolism ; pathology ; Liver Cirrhosis ; drug therapy ; metabolism ; pathology ; Medicine, Chinese Traditional ; Phytotherapy

Objective To understand the current status and the changes in main disability reasons in the elderly with physical disabilities during the past 20 years in China. Methods　The data of the elderly with physical disabilities aged 60 years and over that were from the national sample survey on disability in 1987 and 2006 were analyzed and compared by epidemiology methods. Results　In 2006.the main disability reasons in the elderly with physical disabilities aged 60 and over were disease factors,injury factors,other factors and congenital diseases and eccyliosis.The cause-specific disability prevalences were 5.262%,1.885%,1.000% and 0.200%respectively.Cerebrovaseular diseases showed the highest cause-specific disability prevalence of 2.552% in all the causes.Compared with the national sample survey in 1987,the cause-specific disability prevalences of disease factors and injury factors were obviously increased.The top five disability reasons in the elderly with physical disabilities aged 60 years and over in China were cerebrovascular diseases,arthropathy,miscellaneous traumas,other causes and unknown causes in the national sample survey in 2006;while vascular diseases,other traumas,other causes,unknown causes and pyogenic infection were the top five disability reasons in the national sample survey in 1987.The age-specific top five reasons were basically the same with the total top five disability reasons of the elderly with physical disabilities aged 60 years and over,and also the same relationship between sex-specific top five reasons and Iotal top five disability reasons in 1987 and 2006. Conclusions　Disease factors are the main disability reasons of the elderly with physical disabilities aged 60 years and over,and cerebrovascular diseases have the highest cause specific disability prevalence.The prevention and cure of cerebrovascular diseases,arthropathy and other traumas become the key points to prevent physical disability in the elderly.

To retrospectively analyze the clinical data of 305 cases with apoplectic sequela admitted at our general geriatric nursing ward from January 2000 to December 2011.The subjects were divided into 2 groups:hypoalbuminemia and non-hypoalbuminemia.Advanced age (OR =5.624),chronic heart failure (OR =2.298),conscious disturbance (OR =1.575),dysphagia (OR =1.565),complete bedridden (OR=2.874),pneumonia (OR =3.725) and bedsore (OR =5.336) were risk factors for hypoalbuminemia in the patients with apoplectic sequela.And hyperglycemia(OR =0.066)was a protective factor for it.

Colorectal polyps are common digestive system diseases in children. The important role of endoscopy in the di-agnosis and treatment of colorectal polyps in children has been recognized. With the continuous development of endoscopic techniques, the diagnosis and treatment of colorectal polyp has become safer, more convenient and more effective. In this re-view, the progress in endoscopy for diagnosis and treatment of colorectal polyps in children has been summarized.

Objective:To evaluate the application status and change trends of insulin and its analogs in Nanjing area during 2011 to 2013. Methods:The varieties, sales amount and DDDs of insulin and its analogs in 43 hospitals of Nanjing during 2011 to 2013 were analyzed. Results:The use of insulin and its analogs was increased year by year from 2011 to 2013 with the average annual growth rate of 16%. Glargine, pre-mixed insulin 30R, aspart 30, human insulin and aspart ranked the top five in the sum of money with the proportion above 80%. Pre-mixed insulin 30R, aspart 30, glargine, human insulin and common insulin ranked the top 5 in DDDs. Conclusion:The application of insulin and its analogs is wide in clinics, and the usage and sum of money both show rapid growth trend.

Autonomic nervous system(ANS) activity plays an important role in the pathogenesis of cardiovascular disease,including organic cardiovascular disease(such as hypertension,coronary artery disease,etc) and functional cardiovascular disease (such as vasovagal syncope,postural orthostatic tachycardia syndrome,etc).Many methods was used to evaluate ANS function.Heart rate variability is a widely accepted method to assess cardiac autonomic nerve function.Autonomic nervous affected cardiac action potential and let electrocardiogram changes.Through the sympathetic and parasympathetic neurotransmitters which acting on the corresponding receptors.Electrocardiogram changes reflects autonomic nervous function.Present researches suggest that electrocardiogram has an important significance in the evaluation of autonomic nerve function in functional cardiovascular disease.