With the advent of continuous development of radiofrequency ablation(RFA), this technique has been increasingly used in the treatment of renal cell carcinomas during recent years, with a significant therapeutic effect clinically. RFA is characteristic with the advantages of safety, convenience, minimal invasion, less complications and suffering. The improvement of the electrode needle, the radiofrequency techniques and the combination of other treatments are the key of the development of RFA in the near future. And more reasonable criteria for evaluating the therapeutic effects including imaging techniques are also needed to be set up.

Objective To analyse and summarise of the clinical effect and operative opportunity laparoscopic cholecystectomy for acute mild unobstructed gallstone pancreatitis.Methods Fify-four gallstone pancreatitis patients were treated as observation group in the first people's hospital of yangzhou from December 2012 to September 2015,which were treated with laparoscopic cholecystectomy after two weeks,while 53 patients which were treated with laparoscopic cholecystectomy after three months were treated as control group.The treatment effect,operation time,hospitalization time and total cost.Results There were no deaths,no bile duct injury and biliary fistula,the total hospitalization time [(19.8 ±2.6)d vs (26.5 ±3.5) d],the total cost [(2.6282 ± 0.2451) vs (3.2892 ± 0.3982)],recurrent pancreatitis rate (0) were lower than the control group(9.4％),the recovery rate of liver function were higher than the control group,there was significant difference between two groups(P ＜ 0.05),however,there was no significant difference between two groups for postoperative complications and operation time (P ＞ 0.05).Conclusions For acute mild unobstructed gallstone pancreatitis patients,the safe and feasible operative opportunity was recommended two weeks after the symptoms were completely improved,Laparoscopic cholecystectomy in the treatment of acute gallstone pancreatitis can promote recovery,shorten the hospitalization time.

AIM: To study the protective effect of hepatic stimulator substance(HSS) on chemotherapeutic liver damage induced by cyclophosphamide and its possible mechanism.METHODS: The serum biochemical parameters,oxidative parameters and anti-oxidative parameters of liver tissue of male Kunming mice inoculated with S_(180) cells were measured.The pathology of the liver was observed with microscope.The weight of S_(180) sarcom was weighted.RESULTS: The elevation of MDA content of liver tissue and the less of GSH content and CAT,GSH-PX,GST,and SOD activities induced by CP were restored remarkably by HSS.The ALT and LDH activities of serum in HSS group which was compared with control group and CP group were not statistically distinctive.In the pathologic examination,spotty and focal necroses of hepatocytes in the liver of CP group were found with a great deal of inflammatory cells infiltration in the necrotic and portal areas,while the damage in the liver of HSS group was ameliorated obviously;The weight of S_(180) sarcom in CP group and HSS group was not statistically distinctive.CONCLUSION: The effect of HSS on CP-induced chemotherapeutic liver damage maybe due to anti-oxidative activity.

yin asthenia. Conclusion Characteristic of syndrome about type 2 diabetes mellitus affiliated metablic syndrome show that:extreme heat with yin asthenia, deficiency of both vital energy and yin, deficiency of vital energy and blood stasis, syndrome of blood stasis run through the whole course of disease. Incorporated syndrome show characteristic of versatility and individualization.

Objective To investigate the surgical method and clinical efficacy of hilar cholangio carcinoma in Bismuth type Ⅳ.Methods The retrospective descriptive study was adopted.The clinical data of 1 patient with hilar cholangiocarcinoma in Bismuth type Ⅳ who was admitted to the Renji Hospital affiliated to Shanghai Jiaotong University in October 2014 were collected.The patient had complaint about right upper abdominal pain for half month.Enhanced CT scan showed soft-tissue mass at hepatic hilum.After accurate assessment,the patient underwent radical resection of hilar cholangiocarcinoma + right hemihepatectomy + perihilar resection + right caudate hepatectomy + Roux-en-Y hepaticojejunostomy.The operation time,volume of intraoperative blood loss,results of pathological examination,postoperative complications,time of drainage tube removal,discharge time and follow-up were observed.The follow-up was performed to detect the life quality and tumor recurrence by outpatient examination and telephone interview up to July 2015.Results The patient received successful radical resection of hilar cholangiocarcinoma + right hemihepatectomy + perihilar resection + right caudate hepatectomy + Roux-en-Y hepaticojejunostomy.Operation time and volume of intraoperative blood loss were 480 minutes and 300 mL,respectively.The result of pathological examination showed that the size of hilar bile duct was 4 cm× 3 cm × 2 cm and poor-differentiated adenocarcinoma infiltrated through bile duct into liver tissues and right branch of portal vein.Two lymph nodes in the 8th group,1 in the 12a group and 3 in the 12p group were positive by detection,showing the metastasis of cancer cells.The resection margins of liver and bile ducts were negative,achieving a R0 resection.The patient had a removal of negative pressure drainage tube at postoperative day 7 and discharged from hospital at postoperative day 12,with a good recovery and without the complications of biliary fistula,abdominal infection and hepatic failure.During the 9-month follow-up,there was a good life quality and no tumor recurrence.Conclusion The radical resection rate of Bismuth type Ⅳ tumor can be increased by accurate preoperative evaluation,rational surgical approach,individualized surgical planning and precise intraoperative procedures.

Objective To explore the application effect of Sandwich teaching method in clinical teaching in the department of neurosurgery.Methods Totally 144 clinical medicine students were divided into 2 groups:Sandwich teaching group (n=72) and traditional teaching group (n=72).The analysis of test and the questionnaire of the students were conducted after the course.Comparison between the two groups was made using independent sample t test and measurement data were expressed as as ± s.P＜0.05 signifies statistically significant differences.Rank sum test was used to compare the distribution of the test scores.Results The test score was statistically higher in Sandwich teaching group than control group [(76.38 ± 10.84) vs.(69.67 ± 10.50)].And the main distribution of the test scores was 70～90 in Sandwich teaching group while 60～80 in control group.Questionnaire showed that the scores of Sandwich teaching group were statistically higher than those ofthe control group in five aspects such as enhancing self-learning ability,improving the ability to analyze and solve problems,and so on.Conclusions Sandwich teaching method achieves good teaching effect and it is worth recommending in clinical teachifig.

Objective: to examine the relationship between emotional states and skin conductance response during lie- detection and to provide evidence for improvement of lie- detection technique. Methods: 38 university students participat- ed in the study. They were provided with antisocial behavior materials that elicited different levels of emotional arousal. Results: Significant difference in skin conductance response was observed with the high emotionality items eliciting the highest skin conductance response. Conclusion: Under a certain level of pressure, individuals’emotional state has direct impact on skin conductance. High emotionality questions are better for detecting lies and honesty than low emotionality questions. In addition to lying, the questions themselves have direct impact on subjects’emotional responses, which in turn lead to skin conductance response. When cues for emotionality are obvious, related events tend to receive greater at- tention by subjects and thus lead to special skin conductance response.

Objective To establish the model of myocardial infarction by ligation of the left anterior descending branch in rats.Method Adult inbred strain Wistar rats were randomly divided into sham group(n=6) and model groups(n=79).Model of myocardial infarction were established by ligation of the left anterior descending branch.The electrocardiogram(ECG),HE staining tissue sections,and heart function of the rats were compared in the two groups.Results Rats in the model group had showed special changes of ST-T and Q wave in ECG,show serious necrosis of myocytes and proliferation of fibrous tissue compared with rats in the sham group.The left ventricular systolic pressure(LVSP),left ventricular develop pressure(LVDP),?dp/dt_(max),heart rate(HR) were significantly decreased in the rats of model group than those of the sham group(P

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

Objective To evaluate the influence of successful revascularization by percutaneous coronary intervention(PCI)on heart function of patients with heart dysfunction combined with chronic total occlusion(CTO).Methods The clinical data of 272 patients with heart dysfunction combined with CTO were analyzed.The patients were divided into PCI success group(246 cases)and PCI failure group(26 cases)respectively according to the results of PCI.Six months after PCI,the patients underwent cardiac ultrasound examination to compare the heart function between the two groups.Results Cardiac ultrasound examination was successfully performed in 229 patients in PCI success group and 24 patients in PCI failure group at 6 months after PCI.The left ventricular ejection fraction(LVEF)and left ventricular end-diastolic volume index(LVEDVI)showed no significant difference in PCI failure group at 6 months after PCI compared with that before PCI(P＞0.05).In PCI success group,LVEF and LVEDVI were significantly increased at 6 months after PCI compared with that before PCI and compared with that in PCI failure group at 6 months after PCI[(51±5)％ vs.(43±6)％ and(45±2)％,(77±13)ml/m2 vs.(86±12)ml/m2 and(86±10)ml/m2,P＜0.05].The cardiac functional grading in PCI failure group had no significant difference compared with that before PCI(P＞0.05),but in PCI success group it had significant difference compared with that before PCI and compared with that in PCI failure group at 6 months after PCI(P＜0.05).Conclusion Successful revascularization by PCI can improve heart function in patients with heart dysfunction combined with CTO.