Laparoscopic splenectomy (LS) is considered as the standard approach for patients with normal-sized or moderately enlarged spleens because of advantages of minimal invasion.With the improvement of laparoscopic techniques,the previous concept that massive splenomegaly (MS) is a contraindication to LS is being challenged.Nevertheless,there is still a tremendous controversy over this issue.(1) Splenomegaly and MS are not clearly defined.(2) The feasibility,safety and postoperative outcomes of LS for MS are fiercely debated despite much improvement of LS for MS.(3) Whether supporting or opposing LS for MS,the core problem that the upper limit of splenic size can be in accord with a requirement of LS is controversial.Taking these issues into account,authors recommended that the splenomegaly shotdd be divided into four degrees rather than three degrees for the sake of guiding the choice of surgery.

Objective To investigate the clinical characteristics of comorbidity of migraine and epilepsy.Methods The clinical data of 67 patients with migraine were analyzed retrospectively.Results 6 cases appeared epilepsy,focal seizure 2 cases and generalized seizures 4 cases,in the 67 patients with migraine.The epileptiform waves were recorded in 57 cases by EEG,and the fulminated waves were also recorded in 6 patients with epilepsy.Treated by Sodium Valproate,migraine attacks and seizures were all controlled in the 6 cases and also EEG anastated well.Conclusions Comorbidity is existed in migraine and epilepsy.The curative effect is well by Sodium Valproate.

The splenic surgery has a long history of 400 years and the basic principle of selective splenectomy is finally defined.With the enhancement of the notion of preserving spleen and the modifications and improvements of the technology,the splenic surgery has made great progress both in spleen-preserving surgery and splenectomy.For the sake of preserving spleen,innocent splenectomy is avoided as much as possible.Moreover,splenic function is preserved to the largest extent through the substitution of partial splenectomy for total splenectomy or the precise resection of the lesion.On the other hand,in some circumstances,the spleen cannot be preserved.The splenectomy with a series of improvements is very safe in spite of massive splenomegaly.With the development of the technology,the splenic surgery also keeps up with times and continuously innovates.The laparoscopic technology and robotassisted technology bring new energy to the splenic surgery,clinical values of which are being explored and expanded,with a wide development space.

Objective To observe the curative effect of whole-body mild hypothermia therapy on massive cerebral infarction(MCI).Methods 68 MCI patients were divided randomly into the mild hypothermia group(35 cases) and control group(33 cases).At the basic of routine treatment in the two guoups,the mild hypothermia group received whole-body mild hypothermia therapy,including the cooling blanket cave all the body for decrease temperature,Chlorpromazine(50 mg) plus Promethazine(50 mg),Vecuroniumbromide(200～400 mg),0.9% sodium chloride to 50 ml;and Midazolam(50 mg) plus 0.9 % sodium chloride to 50 ml intravenous infusion slowly by trace-pump and continued 6～11 d.The rectal temperature was maintained between 32～33℃.The curative effect was evaluated according to American National Institute of Health Stroke Scale(NIHSS) scores and Barthel index(BI) pre and post-treatment.The mortality and incidence of epilepsy in the two groups were statistical.Results Compared to pre-treatment,the scores of NIHSS were significantly reduced and BI were apparently increased in the both groups post-treatment(all P

Objective To investigate the feasibility with low dose contrast agent in patients undergoing peripheral magnetic resonance angiography with high spatial resolution at open-bore 3 T scanner. Methods Images of MRA were assessed separately by two radiologists. And the images of DSA were assessed by one radiologist. The degree of the two interobservers' consensus for detection of arterial stenosis was determined by calculating the Kappa coef-ficient. Spearman rank correlation coefficient was used for revealing the relationship between contrast-enhanced MR angiography and DSA,in terms of categories of stenosis. Results For the degree of vessel stenosis, Cohen' s statis-tics revealed excellent agreement between the two observers. There was a significant correlation between DSA and MRA(P<0. 05). Conclusion At this open-bore 3 T scanner, high spatial resolution peripheral magnetic reso-nance angiography is achieved with low dose contrast agent.

Objective To construct the competency model of emergency and critical care clinical nurses and provide a reference for allocation and selection of the emergency and critical care clinical nurses. Methods Twenty emergency and critical care clinical nurses were interviewed by using behavioral event interview method. The optimal competency elements were screened by comparing the difference in their competency in different performance levels, so the competency model was constructed. Results Two distinctive competencies and nine threshold competencies were comprised in the competency model. The category agreement of the competency model was 0.790 and the coding reliability coefficient was 0.882. Conclusions The competency model of emergency and critical care clinical nurses is of high reliability. The model provides a scientific basis for allocation and selection of appropriate emergency and critical care clinical nurses and develops human resources from newly graduated nurses.

A high performance liquid chromatographic method was developed and validated for the quantitative determination of catechin in rat plasma and its pharmacokinetic study after intragastric administration of Catechu and Xiongdanjiangre Wan into SD rats. Plasma samples were prepared by protein precipitation using methanol- 5％ aqueous zinc sulfate (70:30, v/v) as precipitant. Chromatographic separation was achieved on Hypersil C18 column (250 mm × 4.6 mm, 10 μm) with acetonitrile water triethylamine (6:94:0.3, v/v/v, pH 4.0±0.1, adjusted with phosphoric acid) as mobile phase, followed by a UV detection at 207 nm. Good linearity was obtained over the range of 0.143-7.15 mg/L of catechin, with correlation coefficient of 0.9992.The method was simple, sensitive, accurate and reproducible and has been successfully applied to the pharmacokinetic study of catechin in rat plasma.

Background Peripheral refraction of retina brings about influence on myopia development,and different corrective methods will play different roles on the peripheral refraction.Objective This study was to measure the peripheral refraction with progressive addition lenses (PALs) and single-vision spectacle lenses (SVLs) corrected in adolescent myopic eyes and to investigate the difference between them.Methods This was a selfcontrolled cross-sectional study.Forty corrected myopic eyes with PALs were recruited for the study.Twenty-three male and seventeen female subjects aged 10-15 years (mean 12.54 years±1.45 years) enrolled in this study.The refractive errors of the subjects ranged form-1.50 D to-6.00 D (mean-3.74 D±1.09 D) and the astigmatism was less than-1.50 D with the corrected visual acuity at least 20/25.1％ Tropicamide eye drops was topically administered for the cycloplegia and then Grand Seiko WAM-5500 Auto-refractor was used to measure the peripheral refraction.The measured points were determined follows as:fovea (0°),peripheral temporal (T30°,T20°,T10°) and nasal (N30°,N20°,N10°) visual fields from the right eyes.The mean of the six measuring points for each position was calculated.Peripheral refraction was measured from each subject under the wearing of PALs or SVLs (randomly in succession),and the statistic analyse perimeters included M value,relative peripheral refractive error (RPRE),J45,J180.Written informed consent was obtained from each subject before examination.Results The corrected visual acuity was 4.98 ± 0.65 and 4.97 ± 0.53 under the PALs and SVLs conditions respectively,showing in significant difference between them (t =0.222,P =0.639).Hypermetropic shift in peripheral M value and RPRE value were found with the increase of visual angle field,in contrast,the peripheral J180 showed a myopic shift,and significant difference was found among the six peripheral points with all of the above three perimeters (P＜0.05).Negative J45 values in the temporal visual filed and positive J45 values in the nasal filed showed less shift.Some peripheral angles of the peripheral refractions in M value,RPRE value,J180,J45 showed significantly difference from the fovea refraction(P＜0.05).Compared with SVLs correction,PALs induced relatively myopic shifts in M value and RPRE value in all of the peripheral angle fields,showing significant differences(P＜0.05).Conclusions PALs causes relatively myopic shift at the peripheral retina in adolescent myopic eyes in comparison with SVLs,and the important parameters are M value and RPRE value.The effect of PALs on controlling the onset and progression of myopia may be interpreted by peripheral refraction.

Congresses as Topic ; Otolaryngology ; Otorhinolaryngologic Diseases ; surgery

Female ; Humans ; Infant ; Male ; Ultrasonography ; Urachus ; abnormalities ; diagnostic imaging