Gastroesophageal variceal bleeding is one of the major causes of death for patients with portal hypertension.The treatment of portal hypertension has evolved from surgery being the only option to the wide range of options currently available,including endoscopic sclerotherapy of varietals ligation,interventional radiology and surgery.Given the shortage of liver transplantation donors,devascularization would be one of the major treatments for portal hypertension for a considerable time.Based on the clinical experience of the People's Hospital of Peking University,we think that peraesophagogastric devascularization without splenectomy is a better option for the treatment of portal hypertension,with less operation time,less intraoperative blood loss and fewer postoperative complications,and better short-and long-term hemostatic effect.

Liver transplantation is the only curative treatment for cirrhotic portal hypertension, especially for the patients with end-stage liver failure. In the era of liver transplantation, when drugs, endoscopy and interventional treatments fail, surgery (not including liver transplantation) is an irreplaceable treatment option for esophagogastric variceal bleeding, which should be individualized, in order not to increase the risk and difficulty of liver transplantation in the future.

Ample evidences have showed that the failure of early regeneration of the central nervous system(CNS) in adult mammals is mainly due to the growth inhibitory factor.Efforts have been made to promote neuron regeneration and neurological function recovery by damaging myelin and removing myelin-associated inhibitors.At present,the Nogo protein associated drugs and gene therapy have become a novel effective way to promote axon regeneration after CNS injury;here we reviews the recent progress on the related issues.

Physiological education should lead the student not only to understand the physiological knowledge itself,but also to comprehend the scientific methodology,scientific thought and scientific spirit.In our teaching process,we introduced some creative work of the famous scientists in the physiological history to stimulate the students' interest and ability on creative scientific thinking and practice.

Interventional techniques have been applicated extensively in the treatment of gynaecologic and obsterics diseases, such as the embolization therapy of the postpartum massive hemorrhage, uterine fibroids and adenomyosis, interventions of fallopian tube pregnancy etc. Though the advantages of interventional techniques in the treatment of gynaecologic and obsterics diseases are obviously revealed and accepted, the strict indication and regular maneuver to reduce the complications are still to be emphasized. (J Intervent Radiol, 2006, 15: 257-258)

OBJECTIVETo compare the effective differences between deep needling and shallow needling at three acupoints around ear for subjective tinnitus.

METHODSFifty patients with subjective tinnitus were randomized divided into a deep needling group and a shallow needling group, 25 cases in each group. Twenty-two patients in the deep needling group and 20 patients in the shallow needling group were brought into statistic in the end. In the two groups, the three acupoints around ear and distal acupoints were both selected. The acupoints of the affected side such as Yifeng (TE 17), Tinghui (GB 2), Ermen (TE 21), Zhigou (TE 6), Zhongzhu (TE 3) and Hegu (LI 4) were adopted. Yifeng (TE 17), Tinghui (GB 2) and Ermen (TE 21) were acupunctured 30-38 mm in the deep needling group and 15-20 mm in the shallow needling group. The other acupoints were conventionally acupunctured in the two groups. The needles were retained for 30 min,once a day and five times a week for all patients. The treatment was continuously for 4 weeks in the two groups. Tinnitus handicap inventory (THI) scores, tinnitus grades and visual analogue scale (VAS) for tinnitus sound levels were observed before and after treatment, and the effects of the two groups were compared.

RESULTSThe total effective rate in the deep needling group was 59.1% (13/22), and it was better than 20.0% (4/20) in the shallow needling group (P < 0.05). In the deep needling, group, the THI score, tinnitus grade and the VAS score were improved than those before treatment (all P < 0.05). In the shallow needling group, the three above indices before and after treatment were not different in statistical significance (all P > 0.05). After treatment, all the three indices in the deep needling group were superior to those in the shallow needling group (all P < 0.05).

CONCLUSIONAcupuncture at the three acupoints around ear deeply could apparently improve tinnitus, and reduce tinnitus sound levels for subjective tinnitus. The effect is better than that by shallow needling at the three acupoints.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adult ; Aged ; Ear ; physiopathology ; Female ; Hearing ; Humans ; Male ; Middle Aged ; Tinnitus ; physiopathology ; therapy ; Treatment Outcome ; Young Adult

Objective To discuss the intraoperative and postoperative effects of conbercept combined with pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) patients.Methods From January 2016 to December 2016,123 PDR patients (149 eyes) aged 41-65 years old with nonclearing vitreous hemorrhage (VH) and/or tractional retinal detachment (TRD) were enrolled in this study.According to whether preoperative intravitreal injection conbercept,the patients were divided into two groups:Conbercept group (64 cases,78 eyes),Control group (59 cases,71 eyes).Conbercept group was treated with intravitreal injection of Conbercept 0.50 mg (0.05 mL) at 3 days before PPV.Then the standard 23G minimally invasive sclera three-channel vitrectomy was performed if no significant complications after the injection of conbercept.The operation time,intraoperative bleeding,iatrogenic retinal hole,use of endodiathermy and silicone oil,and postoperative complications were recorded and analyzed.The visual acuity and macuiar thickness were compared before and 1 month after the surgery.Results Two groups had no difference on age,sex,HbA1 C,duration,VH ≥ three degree(56/78,45/71),TRD.Conbercept pretreatment could significantly reduce the bleeding during PPV (43/78,49/71),the probability of iatrogeuic retinal holes (11/78,21/71),reduce intraocular electrocoagulation using (57/78,62/71) and silicone oil (43/78,51/71),and then shorten the operation time (58.63 ± 21.66)s and (72.69 ± 22.48)s,and it could significantly improve the postoperative visual acuity (0.23 ± 0.15,0.16 ± 0.11) and macular edema thickness (260.95 ± 27.44) μm and (330.81 ± 36.62)μm,while reduce the incidence of second bleeding (3/78,10/71).Conclusion Conbercept pre-treatment combined with PPV for PDR is a positive and effective treatment,which has good clinical application significance.

To study the necessity and teaching evaluation of clinical medical teaching in dual language,we investigated the students of a five-year medical undergraduate in clinical medicine with a questionnaire.The attitude of medical students on necessity and teaching effect in bilingual teaching was surveyed and analyzed to provide the data and reference to effectively improve the bilingual teaching program.

[Objective] To elucidate the effects and mechanism of Naoqingling Decoction(ND)on Gilles de la Tourette syndrome(TS).[Method] Central nervous system of mice was stimulated by amphetamine(AMP)to develop the model of experimental tourette syndrome(ETS).Then we observed the stereotypia and autonomic activities of mice,and determined the levels of monoamine neurotransmitters such as dopamine(DA),norepinephrine(NE),5-hydroxytryptamine(5-HT)and 5-hydroxyindoleacetic acid(5-HIAA)in the brains.[Result] To compare with model group,three-dose ND groups can resist the determinate activities stimulated by AMP;can obviously decrease the autonomic activities of mice and degrade the levels of DA,NE,5-HT and 5-HIAA in the corpora striates.[Conclusion] ND has therapeutical effect on ETS model and it's mechanism may be its effects on the secretion or metabolism of neurotransmitter in the brains.

[Objective]To explore the value of anterior approach in the surgical treatment of cervical fracture and dislocation.[Method]Thirty cases of lower cervical fractures and dislocations were treated with anterior decompression,reduction,autograft and plate fixation or titanic net.[Result]Patients were followed up for 6 to 24 months,the regular X-ray film to observe the stability of segmental injury and the Frankel grade to determine the recovery of the spinal cord were recorded.All cases were improved and obtained solid fusion within 3～5 months.The intervertebral heights and physiologic curves were kept well,without plate or screw complications occurring in these cases.[Conclusion]It is feasible to get complete decompression,good reduction and excellent maintenance of intervertebral heights and physiologic curves by employing anterior approach to treat lower cervical fractures and dislocations.More importantly,it can get immediate stabilization to cervical spine and prevent secondary injury to spinal cord and recover nervous function.