Objective To investigate the value of laparoscopy in the treatment of ventriculoperitoneal shunt(VPS).Methods From August 2000 to August 2008,156 patients with hydrocephalus received VPS in our hospital.During the operation,a drainage tube was placed under the right diaphragm,and then fixed to the round ligament.Results The laparoscopic surgery was successfully completed in all of the cases.A mean of 17-month follow-up(14 to 24 months) was achieved in 133 of them.During the period,no distal VPS obstruction,gastrointestinal symptoms,intra-abdominal organs injury or infection occurred.Seven patients presented with obstruction of the VPS at the ventricle side.Conclusion Laparoscopy is a minimally invasive technique for the treatment of VPS with good outcomes and few complications.

To investigate the relationship of body mass index and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus. Three hundred and eleven patients with type 2 diabetes mellitus diagnosed according WHO 1999 consensus criteria and 366 healthy subjects were enrolled in the study. Medical history was acquired and physical examination was conducted, and blood sugar, liver and kidney functions, lipid profile and abdominal ultrasonography color were examined. Sixty seven out of 366 healthy subjects were confirmed to have non-alcoholic fatty liver disease (NAFLD) ,including 51 mild case ( 13.9％ ) ,15 moderate cases(4. 1％ ) and 1 severe case(0. 3％ ) ; while in 311 diabetic patients NAFLD was detected in 144 cases, including 85 mild cases (27.3％) ,53 moderate cases( 17.3％ )and 19 severe cases( 1.9％ ). The prevalence rate of NAFLD was higher in diabetic patients than control group in BMI ＜ 23.0 kg/m2 group, 23.0 -24. 9 kg/m2 group and 25.0 -29. 9 kg/m2 group(P ＜0. 01 ) ; however, there was no difference between two groups when BMi ≥30 kg/m2 (P ＞0. 05 ). The prevalence of NAFLD increased with BMI whether in control group or in diabetic group, especially when BMI ＞ 25 kg/m2. In addition to the prevalence of NAFLD, metabolic syndrome increased with BMI in diabetic patients. These findings indicate that type 2 diabetic patients have a high prevalence of NAFLD, especially in obese patients.

Objective To explore the therapeutic effect of different postoperative chemotherapy and administration pathways in primary hepatocellular carcinoma (PHC) patients with portal vein tumor thrombus (PVTT). Methods 60 PHC patients with PVTT were divided into A, B, C and D groups. A group was treated by transcatheter arterial chemo-embolization (TACE); B group was treated by TACE and portal vein intubation(PVI) with quick intravenous injection; C group was treated by TACE and PVI with slow infusion controlled by computer; and D group was treated by hepatic arterial intubation chemo-embolization (HAI) and PVI with slow infusion controlled by computer. Results The survival rate among groups A, B and C had a significant difference (P0.05). Conclusion PHC patients with PVTT could be treated by both hepatic arterial chemotherapy and portal vein chemotherapy throug portal vein continuous infusion. TACE or HAI was suitable for postoperative chemotherapy.

Data communication and sharing of five level network of Public Health Information System, i.e. nation, province, district (city), county, and town, as far as to the countryside level were described, and how to apply the three solutions, i.e. Access VPN, Intranet VPN, and Extranet VPN of VPN technique to achieve the appropriation of the public network was also presented.
China ; Computer Communication Networks/*organization & administration ; Public Health Informatics/*methods ; User-Computer Interface

Objective To analyze the common reasons for misdiagnosis of atypical pulmonary embolism (APE) ,and to im‐prove the identification of APE .Methods The risk factors ,clinical manifestations ,laboratory examinations and radiographic data of 120 cases of APE diagnosed from January 2006 to December 2013 in the department of cardiovascular medicine and respiratory medicine of Xinqiao Hospital and the Affiliated Hospital of Luzhou Medical College were studied retrospectively .Results Among those 120 cases of APE ,39 cases were misdiagnosed on admission (32 .5% ) .8 cases were misdiagnosed as acute coronary syn‐drome ,7 cases as stable angina pectoris ,7 cases as chronic cor pulmonale ,5 cases as pneumonia ,3 cases as pleural effusion ,3 cases as tuberculosis ,3 cases as asthma ,1 case as atrial septal defect ,1 case as acute heart failure ,and 1 case as cardiogenic syncope .Con‐clusion APE is easy to be misdiagnosed for its non‐specific clinical manifestation .Pulmonary enhanced CT or CTPA should be car‐ried out in time for those highly suspected patients ,in order to reduce the misdiagnosis of APE .

Objective To investigate the diagnostic value of Multislice CT scanning in patients with acute thoracic trauma. Methods151 patients with chest wound admitted after Multislice CT scanning were reviewed and analyzed. ResultsThis group of 151 patients with chest wound after X-ray and CT inspection were as follows:lungs were damaged in 139 cases including 52 cases with traumatic wet lung,94 cases with lung rip,28 cases with lacerated wound and 7 cases with tracheal bronchial tube damage.Damages outside the lungs were found in 108 patients including 83 patients with trauma in pleural membrane(hemothorax 27 cases,pneumothorax 32 cases and blood pneumothorax 24 cases),mediastinum damage in 9 cases(vertical mediastinal pneumatosis 6 cases,hematocele 4 cases and traumatic disphragmatic hernia 2 cases),thoracic wall damage in 76 cases(rib bone fracture 59 cases,breast bone fracture 18 cases and costal cartilages damage 5 cases).Clavicle and scapula fracture in 31 cases. ConclusionMultislice CT scanning was principal method for the diagnosis of chest wound,it had the advantages of scanning range,quick scanning and characteristics of high sensitivity,and it would certainly play a vital role in first aid process in emergency medical treatment of wound.

Data communication and sharing of five level network of Public Health Information System, i.e. nation, province, district (city), county, and town, as far as to the countryside level were described, and how to apply the three solutions, i. e. Access VPN, Intranet VPN, and Extranet VPN of VPN technique to achieve the appropriation of the public network was also presented.

Objective Revascularization of the distal segment of the anterior cerebral artery (ACA) using extracranial donors requires long interposition grafts.A novel bypass procedure which uses the two main branches of the superficial temporal artery (STA) to reach the A3 segment of the anterior cerebral artery with a single skin incision was designed.Methods Ten cadaveric specimens were dissected through a single skin incision to harvest the frontal and parietal branches of the STA from June,2017 to September,2017.An anterior interhemispheric approach provided access to the middle internal frontal artery (MIFA).The parietal STA was used as an interposition graft between the frontal STA and MIFA.Lengths and calibers of the distal branches of STA and MIFA were measured at the anastomotic sites.All data was statistical analysis by t-test.Results The average caliber of MIFA was (1.4±0.2) mm,which matched the caliber of both frontal and parietal branches of STA.The mean distance for an end-to-side bypass from STA to MIFA was (144.5±7.4) mm and the average harvested donor-graft complex length was (203.1±27.9) mm.This bypass construct provided around 140％ donor graft length.Conclusion Using the parietal branch of the STA as an interposition graft enabled a successful tension-free STA-MIFA bypass.The advantages of this technique over existing approaches include sufficient graft length,caliber match and relative technical ease.

Objective To explore the clinicopathological features,imaging manifestation and treatment of solitary fibrous tumor in the central nervous system(cSFT),in order to improve the diagnosis and treatment.Methods Fourteen cases of cSFT that had been received microsurgery treatment from June,2010 to July,2016 were analyzed retrospectively.The clinicopathological features,treatment and prognosis were concluded and analyzed.Results In 14 patients with cSFT treated with microsurgery,and 1 case in the foramen magnum region for the first time,and enriched the understanding of this disease.Of 14 patients with cSFT,12 received total resection and 2 subtotal or part.The cSFT were pathologically diagnosed as benign tumors in 11 patients and low grade cSFT in 3.The microscopical presence of spindle-shaped tumor cells arranged in fascicles that alternate hypocellular and hypercellular areas separated from each other by collagenous fibre.Immunohistochemistry was positive for Vimentin,and CD34,Bcl-2 of 14 patients,and positive for CD99 in 12 patients.Followed-up time was from 6 to 49 months.Twelve cases had good prognosis to total resection and 2 recurrence due to subtotal or part resection.Conclusion cSFT is extremely rare,and it has some characteristics on MRI,final diagnosis should be depended on pathological and immunohistochemical examination.There are good prognoses in the patients with cSFT after the total removal of cSFT,but when the lesion could not be totally resected,radiotherapy should be considered,the curative effect of chemotherapy on cSFT is not definitive.

Objective To explore the feasibility of occipital artery(OA) to anterior inferior cerebellar artery (AICA) through the extended retrosigmoid approach,also perform a systemic microanatomical study of OA and AICA with the exposure of extended retrosigmoid approach,find the easy way to perform the procedure.Methods From September,2016 to January,2017,5 adult cadaveric heads injected with colored latex (total 10 sides) were performed the extended retrosigmoid approach,and measured the caliber of distal occipital artery (OA),the final length of the OA harvest,the reliable landmark of the OA harvest,and the distance from the flocculonodular segment of anterior inferior cerebellar artery (AICA) to the OA,the diameter of AICA flocculonodular segment branch.Whole procedure of OA to IACA bypass also be performed.Statistical analysis was performed.Results By the extended retrosigmoid approach,AICA flocculonodular segment could be easily exposure,the average diameter was 1.2 mm,the OA branch could be harvested in average was (72.3±3.3)mm in length from the occipital sulcus,and the average distance between occipital sulcus and AICA flocculonodular segment was (47.6±l.9)mm.The bypass procedure also could be performed through the proper corridor.Conclusion The Extended retrosigmoid approach is a safe and efficient way to perform the OA-AICA bypass procedure,and the procedure is easier to be performed than other surgical approaches.