Situs inversus is a rare condition of anatomical alteration, and the patient with gallbladder disease treated by laparospic cholecystectomy is rather scarce. In this condition, the operation needs to be adjusted. In this article, we reviewed the relevant literatures about the operation in the patients with this uncommon malformation and analyzed the modification of the operation.

Background and purpose:In all treatments of retroperitoneal tumors,surgical operation is still the only effective method which might cure the tumors.However,the patients were always in advanced stages when they were clinically diagnosed.The inferior cava of the patients always have been invaded by tumors,which is considered to be a relative surgical contraindication.This study was to explore the surgical method in treatment of retroperitoneal tumors with major blood vessels invasion,and in order to raise the resection rate and survival rate. Methods :Retrospective analysis of twelve cases which implicate major vessels and have parallel artificial vascular reconstruction during operations of retroperitoneal tumor from January 2003 to June 2007. Results :Twelve cases of retroperitoneal tumor and implicated major vessels were integrally resected,corresponding important vascular reconstructions were done,no short-term postoperative deaths. Conclusions :Retroperitoneal tumor involving abdominal important vessels is not a contraindication of radical surgical.Integrated resection of retroperitoneal tumor and implicated major vessels and corresponding important vascular reconstruction are safe,and can improve the resection rate and reduce the relapse rate,extend the survival time.

Francisella guangzhouensis was used as an example to illustrate how to utilize the bioinformatics resources to identify the novel species, how to name the novel species with Latinized letters, and how to validate a novel species in the clinical microbiology laboratories.Some related rules of International Code of Nomenclature of Bacteria was also introduced.

Antiplatelet therapy is a major strategy with a growing body of evidence in management of ischemic cerebrovascular diseases.This article introduces the mechanism of currently available antiplatelet drugs as well as their practice guidelines and evidence from clinical trials.There is currently no robust evidence to support the use of venous antiplatelet agents.Aspirin is the sole evidence-based antiplatelet drug for treatment of acute ischemic stroke.Aspirin,dipyridamole and clopidogrel are effective in secondary stroke prevention.Combination therapy using aspirin plus extended-release dipyridamole is the only combination approach to demonstrate additive benefit.

Objective To investigate the effect of sufentanil midazolam intravenous anesthesia combined with epidural block on hemodynamics and postoperative consciousness after anesthesia.Methods 40 cases undergoing acute chest and abdominal surgery from January 2015 to December 2016 in Taizhou tumor hospital as the research objects, were randomly divided into the control group and the experimental group, 20 cases in each group.The control group were received sufentanil midazolam intravenous anesthesia, and the experimental group were received sufentanil midazolam intravenous anesthesia combined with epidural block.Hemodynamics and anesthesia consciousness in the two groups were compared.Results Compared with pre-induction, the diastolic and systolic blood pressure and the heart rate were significantly decreased at pre-intubation (P<0.05).There were no significant differences between the two groups at other observation time points.The intravenous anesthesia medication in the experimental group was significantly less than that in the control group, the difference was statistically significant (P<0.05).The recovery time in the experimental group was (31.5±4.2) min, the extubation time was (4.8±1.5) min, and the basic awake time was (8.2±2.4) min.The above data were significantly better than those in the control group (P<0.05).No complications such as postoperative agitation and respiratory depression occurred in the experimental group and the control group.Conclusion Sufentanil midazolam intravenous anesthesia combined with epidural block, hemodynamic stability, it can reduce the amount of anesthesia drugs and shorten the recovery time to some extent, and is worthy of clinical application.

Objective To investigate and analyze the clinical observation of low dose sufentanil in the prevention of shivering and traction during cesarean section. Methods 100 cases of cesarean section in our hospital from January 2015 to December 2016 were selected and randomly divided into two groups, the control group and the experimental group, with 50 patients in each group. The control group received bupivacaine anesthesia, and the experimental group received sufentanil anesthesia on the basis of sufentanil. The clinical indexes of the experimental group and the control group were compared and analyzed. Results After the corresponding anesthesia, there was no moderate or severe traction pain in the experimental group and the control group, and 29 cases of mild traction pain in the control group, with a rate of 58%. There were 7 patients with mild traction pain in the experimental group, with a rate of 14%. The probability of mild traction pain in the experimental group was significantly lower than that in the control group, with statistical difference (P<0.05). The incidence of shivering in the experimental group was 16%, significantly lower than that in the control group, with a rate of 52%, which was statistically significant (P<0.05). The adverse reaction rate of the experimental group was 12%, significantly lower than that of the control group, the probability of occurrence was 42%, which was statistically significant (P<0.05). Conclusion The application of small dose of sufentanil in anesthesia in cesarean section can reduce the occurrence probability of visceral pain in a large extent, prevention of shivering, high safety, low incidence rate of adverse reaction, with further clinical promotion and application significance.

Objective To investigate the clinical value of negative pressure vacuum cushion combined with thermoplastic body membrane in radiotherapy for Wilms tumor in children.Methods A total of 42 pediatric patients with Wilms tumor who received radiotherapy after surgery were enrolled in the study and were randomly divided into two groups according to the fixation positions:group A and group B.During radiotherapy, the patients in group A were fixed with negative pressure vacuum cushion, and those in group B were fixed by negative pressure vacuum cushion combined with thermoplastic body membrane.The setup errors, short-term effects, adverse reactions, and prognosis were compared between the two groups.ResultsGroup B showed significantly lower translational errors and rotational errors, as well as significantly higher rates of ≤3 mm and ≤5 mm errors, compared with the group A (P=0.04,0.04,0.04,0.03,0.00,0.04,0.04,0.00,0.04).Group B also showed significantly higher complete remission rates and response rates than group A (P=0.02,0.04).There were no significant differences in the adverse reaction rates (P=0.75) and the overall survival (OS) rates at 2 and 3 years (P=0.68,0.74) between the two groups.Group A had the MPTV values in left-right (LR) direction (x-axis), superior-inferior (SI) direction (y-axis), and anterior-posterior (AP) direction (z-axis) being 5.74 mm, 5.93 mm, and 5.94 mm, respectively, and group B had the MPTV values at LR, SI, and AP directions being 4.21 mm, 5.71 mm, and 4.61 mm, respectively.Conclusions In the radiotherapy positioning for Wilms tumor in children, fixation limbs with negative pressure vacuum cushion combined with thermoplastic body membrane effectively reduces the setup errors and improves the effect of radiotherapy, so it holds promise for clinical application.

Objective To investigate the effect of cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal therapy on biochemical indicators of postoperative intracranial infection, in order to improve the clinical diagnosis and treatment. Methods 70 cases with intracranial infection collected in Third Hospital of Beijing Armed Police Corps from February 2010 to April 2013 were as subject, and randomly divided into two groups. Control group(n=35) were given cerebrospinal lfuid replacement and ceftriaxone intravenously, observation group(n=35) were given cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal injection. The clinical effects and biochemical indicators were observed after treatment in two groups. Results In control group, the cure rate was 22.86%and total efifciency was 77.14%. In observation group, the cure rate was 37.14% and total efficiency was 91.43%. The differences between two groups were statistically significant (P<0.05). The differences of leukocytes, glucose, protein, intracranial pressure in two groups after treatment were also statistically signiifcant(P<0.05). Conclusion Cerebrospinal lfuid replacement combined with vancomycin and dexamethasone intrathecal injection therapy can increase intracranial infection.

Objective To investigate the therapeutic effects of arsenic trioxide(ATO) plus vitamin K2(VK2) on proliferation of HL-60 cells from acute promyelocytic leukemia cell line and explore the possible mechanism.Methods ①HL-60 cells were exposed to ATO(0.0,0.5,1.0,2.0,4.0 μmol/L),VK2(0.0,2.5,5.0,10.0,20.0μmol/L),or both of different concentrations (0.5 μmol/L ATO + 2.5 μmol/L VK2,1.0 μmol/L ATO + 5.0μmol/L VK2,2.0 μmol/L ATO + 10.0 μmol/L VK2,4.0 μmol/L ATO + 20.0 μmol/L VK2) for 24,48 or 72 h,respectively.The method of CCK-8 was used to assess the proliferation of HL-60 cells and the half inhibitory concentration(IC50) of ATO or VK2 was calculated,respectively.②Combination index (CI) was used to evaluate the combinative effect of the two treatments:CI ＜ 1,=1 or ＞ 1 indicated synergistic,additive,or antagonistic effect,respectively.③After HL-60 cells were treated with 1.0 μmol/L ATO or 5.0 μmol/L VK2 individually or simultaneously for 48 h,Annnexin V/PI staining was performed to identify the apoptosis rate of each group.Untreated cells were used as control group.Results ①ATO or VK2 alone inhibited the proliferation of HL-60 cells in a concentration and time dependent manner.The IC50 of ATO or VK2 at time of 24,48,72 h were (22.86 ± 2.44),(6.66 ± 0.34),(4.14 ± 0.41) and (18.40 ± 1.12),(13.48 ± 0.73),(8.95 ± 0.40) μmol/L,respectively; ②The combination of ATO and VK2 illustrated a synergistic effect with CI ＜ 1.③No statistical difference was found among control group [(4.38 ± 0.56)％],1.0 μmol/L ATO group [(5.76 ± 1.63)％] and 5.0 μmol/L VK2 group [(6.38 ± 1.42)％] in the apoptosis rate(all P ＞ 0.05).However,the apoptosis rate of combined group did rise to (44.18 ± 8.42)％,with a significant improvement to that of VK2 or ATO group alone (all P ＜ 0.01).Conclusions The combination of VK2 and ATO exhibits an enhanced synergistical inhibitive effect on proliferation of HL-60 cells,and apoptosis may be involved in this synergy in part.

Background and purpose:Radical surgery remains the main treatment for the patients with pancreatic and duodenal cancer,but resectability rate is low when clinically diagnosed,portal vein/superior mesenteric vein or inferior caval vein invaded by tumors are a few of the main reasons.How to increase resectability of pancreatic cancer and duodenal cancer still is very challenging to the clinician.This study was done to explore the feasibility of the new surgical approach for the treatment of pancreatic and duodenal cancer with portal vein/superior mesenteric vein or inferior caval vein invasion.Methods:5 patients received pancreatoduodenectomy with vascular reconstruction between February 2002 and June 2005.Three patients with pancreatic head cancer underwent pancreatoduodenectomy combined with portal vein/SMV resection and vascular reconstruction and two patients with duodenal cancer underwent pancreatoduodenectomy combined with inferior caval vein resection and vascular reconstruction.Results:There was no surgery related death.The serious complications such as artificial blood vessel infections or obstructions were not experienced.After surgery,one patient died 10 months later,one patient died 24 months later,two patients survived for over 3 years and one patient over 4 years.Conclusions:Pancreatoduodenectomy with vascular reconstruction for patients with carcinoma of the pancreatic head or duodenum invading portal vein/superior mesenteric vein or inferior caval vein has been proved to be a safe treatment,it could improve the resectability of the tumor and prolong survival.