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.

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.

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.

Objective To evaluate the effects of early tracheotomy and delay tracheotomy on the prognosis of patients with severe craniocerebral injury.Methods Data of randomized controlled test (RCT) of early tracheotomy on the prognosis of the patients with severe craniocerebral injury were retrieved by using Conchrane Library,PubMed,Embase,OVID,CBM,CNKI,Wanfang and VIPdatahase.The retrievaled time was limited from their building to March 2016,and all the index of the obtained references was accessed.Two researchers independently screened the literature in accordance with the established criteria for inclusion or exclusion.The incidence of VAP,mechanical ventilation time and ICU length of hospital stay,mortality were considered as evaluation indexes.The methodology quality of the included references was evaluated,and the Meta-analysis was performed by using Review Manager 5.3 software.Results Finally,4 randomized controlled studies (RCT) were enrolled,including 220 patients.Meta-analysis results showed that:early tracheotomy did not have any effects on VAP incidence rate (P=0.15) and fatality rate (P=0.20) of the patients with severe craniocerebral injury,there was not any statistically difference;but there was a statistically difference between the mechanical ventilation (P =0.01) and ICU hospitalization time (P =0.05).Conclusion Early tracheostomy could not significantly reduce the incidence of VAP and fatality rate of the patients with severe craniocerebral injury,but it can reduce the mechanical ventilation time and ICU hospitalization time.

PurposeTo analyze the urinary stone chemical composition using dual source CT (DSCT) dual energy imaging.Materials and MethodsNinety-seven stone samples with known chemical composition were placed in fresh swine kidneys and examined with DSCT dual energy scan, including 55 calcium oxalate stones, 13 hydroxyapatite stones, 9 uric acid stones, 4 cystine stones, 2 struvite stones and 14 mixed stones. The mean attenuation values and dual energy index (DEI) were measured at 80 kV and 140 kV. The stone composition was analyzed to determine the sensitivity, specificity and accuracy.ResultsDual energy analysis showed 59 calcium oxalate stones, 11 hydroxyapatite stones, 9 uric acid stones, 4 cystine stones and 14 mixed stones. 2 hydroxyapatite stones were erroneously marked as calcium oxalate stones and 2 struvite stones as calcium oxalate stones. The accuracy was 95.88% (93/97). The difference CT value at 80 kV and 140 kV and DEI value were statistically significant (P<0.05). The sensitivity for detecting calcium oxalate stones, hydroxyapatite stones, uric acid stones and cysteine stones were 100.00%, 84.60%, 100.00% and 100.00%, respectively; with specificity of 85.70%, 100.00%, 100.00% and 100.00%, respectively; and the accuracy were 95.18%, 97.59%, 100.00% and 100.00%, respectively.ConclusionDSCT dual energy imaging accurately analyzes the chemical composition of urinary stone in vitro, which provides important clinical value in analyzing the urinary stonesin vivo.