Objective To evaluate the operation of laparoscopic splenectomy(LS),its safety and clinical effects.Methods Literature of the advances of LS were reviewed and analyzed.Results With the development of technology and surgical technique,the indications for LS were widened,the size of spleen plays an important role in the clinical outcome of LS.Conclusion LS has all the advantages of minimally invasive surgery.The application of hand-assisted technique is safe and feasible for giant spleen.With the accumulation of surgical experiences and technique development,LS will be extensively used in clinic.

Objective To impove the cognition of allergic bronchopulmonary aspergillosis by analyzing its clinical characteristics.Methods 22 patients diagnosed as having allergic bronchopulmonary aspergillosis in our hospital were studied in their clinical characteristics,imaging findings,laboratory inspections,pathologies,therapies and follow-up results.Results (1)The patients consisted of 13males and 9 femailes.Asthma was present in 16 patients,and absent in 6 cases,some of which had no wheezing heard in lung auscultation.(2)Central bronchiectasis was present in 19 cases,with the upper lobe bronchial mainly involved.(3)Simple glucocorticoid therapy was used in 2 cases,the joint anti-fungal therapy in 19 cases(one case improved combined with itraconazole therapy after recurrence and one case improved with the joint itraconazole treatment,followed by recurrence of the symptoms after discontinued antifungal therapy and by the combination therapy again).Conclusion Clinical asthma is the most common symptom of ABPA.However,there are one-third of cases without history of asthma.Central bronchiectasis with formation of mucus suppository is a characteristic feature of ABPA which can prompt diagnosis and help in the prognosis.The combination of antifungal treatment can lead to improvement and reduce or eliminate the need of glucocorticoid therapy.

Objective To investigate whether hyperbaric oxygen(HBO)affected neuropathic pain through autophagy and verify the HBO effect. Methods A total of 60 male SD rats were selected for the study and randomly divided into 4 groups:control group(C group),sham operation group (S group),chronic constriction group(CCI group)and hyperbaric oxygen group(HBO group). LC3Ⅱand P62 were determined by Western blot method and the autophagy was detected by electron microscopy on the 7th day. Results CCI and HBO groups were significantly higher than C and S group in Western blot(P<0.05). There was no difference between group C and group S(P>0.05). The expression of LC3Ⅱin HBO group was significantly higher than that in CCI group(P<0.05). And the expression of P62 in CCI group was significantly higher than that in HBO group(P<0.05). The autophagy in CCI and HBO group were significantly increased comparing to the C and S groups(P<0.05). However,the difference be?tween group C and S was not significant(P>0.05). Conclusion Hyperbaric oxygen therapy can induce autophagy for anti?neuropathic pain.

This study aimed to study the criteria of two-way referral between tertiary-care hospital and communityhealth-care service center for patients with cerebralhemorrhage and a protocol of implementation to promote its treatment and rehabilitation.The criteria of two-way referral between tertiarycare hospital and community health-care service center for patients with cerebral hemorrhage after surgical operation were formulated on a trial basis with mutual consultation by the department of neurosurgery,Shenzhou hospital affiliated to Shenyang Medical College and Hunhewan Community Health-Care Service Center,Heping district,Shenyang. Totally,91 patients of cerebral hemorrhage admitted to the hospital during October 2007 to September 2010 were recruited for the study,46 in the intervention group with two-way referral and 45 in the control group by self-referral determined by their family members.All the patients of the two groups were followed-up for three years.During the follow-up in the intervention group,40 of 46 (95％) patients could comply with taking medication ordered by physicians,ability of daily living remarkably improved by Barthel index in 21 (50％),physical function recovered well in 33 (79％),34 (81％) could insist in self-monitoring and 32 (76％) could visit physicians for regular consultation,all these being significantly better than those in the control group (64％,31％,28％,25％ and 25％,respectively) (P ＜0.01 ).Medical and rehabilitative cost for patients with cerebral hemorrhage accounted for 575 RMB yuan per month in intervention group,as compared to 2246 RMB yuan for those in control group.Two-way referral for patients with cerebral hemorrhage can reduce their medical cost and promote their better rehabilitation.

Objective To find out the present situation of complementary feeding, breast-feeding and children nutrition, and further explore the relationship between them. Methods Random sampling was adopted and 7302pairs of mothers and their children under 36 months were investigated by means of questionnaires. Results Breastfeeding rate was 96.8% ,but exclusive breast-feeding rate was only 37.6% . Breast-feeding rate over 12 months was 34.7% ,breast-feeding rate over 24 months was only 15.8%. Timely sucking rate was 8.4％ ,19.2% of children had too early complementary feeding, 26.8% had too late,and 43. 1% had appropriate feeding . To the children over 6months, the feeding rates of meat and eggs per week were 36. 3% and 49. 3 % , respectively. The stunting-rate was 24.0％, underweight-rate 22. 1 ％ ,and wasting-rate 8. 9 ％. The incidence rate of iron deficiency anemia (IDA) was 23.3 %. Multivariable analysis showed that growth of children was associated with diet diversity,intake frequency of eggs and meat, too early complementary feeding,prolonged breast-feeding and diarrhea, etc. Conclusion In rural areas of western China ,breast-feeding has been fundamentally popularized ,however ,the unfit complementary feeding and malnutrition of children under 36 months are common and serious ,important complementary feeding recommendations and good hygiene condition are strongly needed.

Objective To investigate the effect of hyperbaric oxygen(HBO)on p38 MAPK signal pathway in neuropathic pain,and explore its mechanism. Methods The experiment was divided into two parts with thirty SD rats in each part. Each part was then randomly divided into 3 groups:sham operation group(S group),chronic constriction group(CCI group)and hyperbaric oxygen group(HBO group),with 10 rats in each group. Part one:Pain?related behavior were detected on 3 day,7 day,14 day,28 day after operation. Phosphorylative p38 was detected by Western blot method and the P2X4 receptor was detected by immunohistochemistry method on the 28th day. Part two:All the rats were treated with SB203580. Pain?related behavior were detected on 3 day,7 day,14 day,28 day after operation. P2X4 receptor was detected by immunohistochem?istry method on the 28th day. Results CCI and HBO groups were significantly lower than S group in pain?related behaviors(P<0.05). CCI group was significantly lower than that in HBO group(P<0.05). The content of phosphorylative p38 and P2X4 receptor in CCI and HBO group were increased(P<0.05),and the expression of phosphorylative p38 and P2X4 in CCI group was significantly increased than that in HBO group (P<0.05). When p38 MAPK was inhibited,pain?related behavior in HBO and CCI group increased significantly than the pain?related behavior of HBO and CCI group in Part 1(P<0.05). But the difference between group CCI and HBO was not significant(P>0.05). Though the expression of P2X4 receptor in CCI group and HBO group was significantly higher than that in S group(P<0.05),the difference between group CCI and HBO was not significant(P>0.05). Conclusion Hyperbaric oxygen therapy can affect the expression of p38 MAPK through P2X4 receptor in rats of neuropathic pain.

Objective:To evaluate the therapeutic effects and pharmacoeconomic results of four proton-pump inhibitors in the duo-denal ulcer patients with hemorrhage. Methods:Using a retrospective analysis, 90 duodenal ulcer patients with hemorrhage were in-volved. According to the proton pump inhibitors, there was no statistic difference among those groups(P>0. 05). The mean time to stop bleading,hemostalsis rate,and the incidance of adverse drug reactions of those four groups,there were no statistic differece too( P>0. 05). The cost of pantprazole group was much lower than the other three groups by cost-minimication analysis. Results:The effective rate of the four groups was 80. 0%, 86. 7%, 90. 0% and 90. 0%, respectively;there was no statistic difference among those groups(P>0. 05). The mean time to stop bleeding, hemostasis rate, and the incidence of adverse drug reactions of those four groups, there were no statistic difference too(P>0. 05). The cost of pantoprazole group was much lower than the other three groups by cost-minimization alanysis. Conclusion:The effect and safety of the four groups were basically equivalent, while the coot of pantoprazole is lowest, it is the best treatment plan by pharmacoeceonomics.

Objective To investigate demographic factors implicated in the functional maturation of autologous arteriovenous fistula in a population of patients with end-stage renal disease. Methods The data of 335 consecutive patients with end-stage renal disease who were performed autologous arteriovenous fistula from January 2010 to December 2015 were analyzed retrospectively. The parameters affecting autologous arteriovenous fistula functional maturation were screened. Results Overall arteriovenous fistula functional maturation rate was 78.14%(218/279). The arteriovenous fistula functional maturation rate was 68.33%(82/120) in diabetes and 85.54%(136/159) in non-diabetes, and there was significant difference (χ2=11.844, P<0.01). The arteriovenous fistula functional maturation rate was 62.26%(33/53) in hypoproteinemia and 81.86%(185/226) in non-hypoproteinemia, and there was significant difference (χ2=9.648, P<0.01). Diabetes and hypoproteinemia were the risk factors to promote functional maturation (OR=6.003, 8.476). The arteriovenous fistula functional maturation rate was 87.10%(81/93) in calcium channel blockers using and 73.66%(137/186) in non-calcium channel blockers using, and there was significant difference (χ2=6.556, P<0.05). Calcium channel blockers was the protective factor for promoting functional maturation (OR=0.086). Conclusions Diabetes and hypoproteinemia are found to be associated with functional non-maturation, while calcium channel-blocker agents are associated with better functional maturation.

Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Hypolipidemic Agents ; therapeutic use ; Pharmacogenetics

Objective To explore the relationship between the variation of leptin receptor (LR) gene and type 2 diabetes mellitus (DM), obesity and plasma lipid levels. Methods The variation of LR gene exon 20 was detected by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP) and their relations to type 2 DM and obesity were analyzed. Results The variant frequency at 3 057 nucleotide of G to A transversion was 82.09% for total, 87.33% for DM group, 75.42% for control group. The frequency of AA genotype in DM cases was higher than that in controls, but that of GA genotype was lower, and that of GG in cases did not indicate. According to BMI and WHR level, there was no obvious relationship between gene variations and obesity. There were significant differences between AA genotype and GA genotype about the serum levels of TG, HDL and SBP, DBP. Conclusion At nucleotide 3 057 in LR exon 20, a G to A transversion was found, which may be the susceptibility marker of DM in Chongqing population. An allele was associated with high blood lipid and increased blood pressure.