Spontaneous complete thrombosis with parent artery occlusion of giant intracranial aneurysms is rare.We report a patient with a rare giant vertebral artery aneurysm with spontaneous complete thrombosis and parent artery occlusion,and review the related literature,discuss its incidence,clinical presentation,pathogenesis,diagnosis,and treatment.

Objective: To summarize and critically assess the evidence from randomized controlled trials (RCTs) of acupuncture in treating dry eye syndrome (DES) according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and the Cochrane Collaboration recommendations. Methods: A search of PubMed, the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov and Embase was made from their inception to August 2016, as well as Chinese, Japanese, and Korean databases. Two reviewers independently selected RCTs and assessed the methodological quality. Meta-analysis and the level of evidence were processed by RevMan 5.3 and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: After selection, 8 trials were subjected to our systematic review. The methodological quality was low generally. The 3-10 weeks follow-up showed that acupuncture improved the tear film break-up time (BUT) (MD=1.33, 95%CI=1.01-1.66, 619 participants). The mean difference of Schirmer's test was 1.73 mm (95%CI=1.28-2.18, 618 participants) between the acupuncture group and the control group. The subjective variables exhibited no significant differences. Conclusion: The low methodological quality of the trials does not suggest drawing firm conclusions on the value of acupuncture therapy for DES. Acupuncture treatment may have some effects on the tear film BUT and Schirmer's test, but not on the subjective symptoms. Well-planned large-scale high-quality RCTs are needed to make it clear whether acupuncture is effective in treating DES.

To summarize the clinical experience of Prof. Yan Jun-bai in treating rheumatic arthritis (RA) with suppurative moxibustion and aim to guide acupuncture treatment for RA. Prof. Yan believes that contributing factors of RA include external contraction of pathogenic factors, obstructed flow of qi and blood, internal phlegm-turbidity (due to deficiency of healthy qi or improper diet), and obstruction or malnourishment of meridians. As a result, the treatment strategies are to warm yang, remove pathogenic factors, and tonify the liver, spleen and kidney. Suppurative moxibustion is a reliable therapy for RA.

Objective: To observe the efficacy of acupuncture combined with sitting-position knee-adjustment manipulations in treating patellofemoral osteoarthritis. Methods: Ninety-two patients with patellofemoral osteoarthritis were randomized into an observation group and a medication group, with 46 cases in each group. The observation group received acupuncture and sitting-position knee-adjustment manipulations, and the medication group received oral celecoxib capsules. After 8-week treatment, changes in the short-form McGill pain questionnaire (SF-MPQ) and Lysholm knee scoring scale (LKSS) scores were observed, and the clinical efficacy was compared.Results: The total effective rate was 87.0％ in the observation group and 63.0％ in the control group; the between- group difference was statistically significant. Before treatment, there were no significant differences in the SF-MPQ score or LKSS score (P>0.05). After 8-week treatment, the SF-MPQ [including pain rating index (PRI), visual analog scale (VAS), and present pain intensity (PPI)] and LKSS scores showed notable changes in both groups (P<0.05); the SF-MPQ and LKSS scores in the observation group were significantly different from those in the control group (P<0.05).Conclusion: Combining acupuncture and sitting-position knee-adjustment manipulations can reduce pain and ameliorate joint function in patients with patellofemoral osteoarthritis, producing more significant efficacy than oral celecoxib capsules.

Objective:To observe the therapeutic effect of warm needling moxibustion for erectile dysfunction (ED).
Methods:A total of 46 eligible ED patients were randomized into a treatment group (n=24) and a control group (n=22). The treatment group was intervened by warm needling moxibustion while the control group by conventional acupuncture treatment, for a total of 4 courses. The therapeutic effect was evaluated by the international index of erectile function 5 (IIEF-5).
Results:After 4 courses of treatment, the overall effective rate was 91.3% in the treatment group (23 completed), versus 75.0% in the control group (20 completed), with a significant difference (P<0.05). After the treatment, the change of IIEF-5 score in the treatment group was significantly different from that in the control group (P<0.05).
Conclusion:Warm needling moxibustion can produce a more significant efficacy than conventional acupuncture in the treatment of ED.

Objective To compare the anesthetic effect of ultra-sound guided thoracic paravertebral nerve block and combined spinal-epidural anesthesia in percutaneous nephrolithotomy.Methods For 80 patients in our hospital scheduled for percutaneous nephrolithotomy were randomly divided into two groups with 40 cases each.The patients in group GT were given ultra-sound guided thoracic paravertebral nerve block.And the patients in group G were given combined spinal-epidural anesthesia.Observe and compare the aesthesia effects,the hemodynamic changes during body change in perioperative period,adverse reactions after surgery and complications of two groups.Results Anesthetic effects were not significantly different between two groups (P ＞ 0.05).During body change in perioperative period,the MAP and HR of G group were significantly lower than those of GT group.They had significantly difference (P ＜ 0.05).The adverse reactions after surgery and complications of two group were significantly different between two groups(P ＜0.05).The number of patients who have headache and urinary retention are apparently more group G than in group GT.Conclusion Ultra-sound guided thoracic paravertebral nerve block for percutaneous nephrolithotomy has significant anesthetic effect.Hemodynamics is stable during body change in perioperative period.And there is less complications after surgery.

Objective The registration data of local cancer registries from 2008 to 2012 were collected by National Central Cancer Registry to estimate the incidence and mortality of female breast cancer in China. Methods Data from 135 registries were qualified and selected in the final analysis, and each registry at least has submitted data from 2010 to 2012.Cancer incidence and mortality analyses were stratified by area ( urban／rural, eastern／middle／western areas ) and age group. The age composition of standard population of Chinese census in 2000 and Segi′s population were used for age?standardized incidence and mortality in China and worldwide, respectively. Results A total of 135 registries were recruited in the analysis, covering 629 333 910 person?years (382 669 450 in urban and 246 664 460 in rural). About 13, 258 cases of female breast cancer were diagnosed and 32 205 cases were dead between 2008 and 2012. Female breast cancer incidence was 42.67／100, 000 and age?standardized rate calculated by worldwide standard population was 28.87／100,000.The crude incidence of urban area was 51.85／100,000, higher than 28.29／100,000 of rural area, and the crude incidence of eastern area was 46.35／100,000, higher than 36.38／100,000 of middle area and 27.60／100,000 of western area. The age?specific incidence increased with age and reached the peak at age 55?59 ( 96.36／100, 000 ), and declined at age 60. The age?standardized incidence rate by Chinese standard population increased 30.56% from 2003 to 2012. The increase rate of rural area was 72.32%, faster than 23.48% of urban area. Female breast cancer mortality was 10.36／100,000 and the age?standardized rate calculated by worldwide standard population was 6.61／100,000. The crude mortality of urban area was 11.64／100,000, higher than 8.36／100,000 of rural area, and the crude mortality of eastern area was 10.81／100,000, higher than 7.38／100,000 of middle area and 9.90／100,000 of western area. The age?specific incidence increased with age and reached the peak at age above 85 ( 61.25／100, 000). Age?standardized incidence rate by Chinese standard population remained stable during the period of 2003?2012 (6.23%). The mortality rate mainly increased in rural area (54.94%), while decreased 2.32% in urban area over the 10 years. Conclusions Although the incidence and mortality of breast cancer in China are comparatively low worldwide, in China the incidence and mortality of female breast cancer have rose to the first and sixth place respectively among all the female cancers. The disease burden of breast cancer is very different between urban and rural area. Therefore, the targeted measure and strategy of control and prevention according to the area difference are needed.

Objective The registration data of local cancer registries from 2008 to 2012 were collected by National Central Cancer Registry to estimate the incidence and mortality of female breast cancer in China. Methods Data from 135 registries were qualified and selected in the final analysis, and each registry at least has submitted data from 2010 to 2012.Cancer incidence and mortality analyses were stratified by area ( urban／rural, eastern／middle／western areas ) and age group. The age composition of standard population of Chinese census in 2000 and Segi′s population were used for age?standardized incidence and mortality in China and worldwide, respectively. Results A total of 135 registries were recruited in the analysis, covering 629 333 910 person?years (382 669 450 in urban and 246 664 460 in rural). About 13, 258 cases of female breast cancer were diagnosed and 32 205 cases were dead between 2008 and 2012. Female breast cancer incidence was 42.67／100, 000 and age?standardized rate calculated by worldwide standard population was 28.87／100,000.The crude incidence of urban area was 51.85／100,000, higher than 28.29／100,000 of rural area, and the crude incidence of eastern area was 46.35／100,000, higher than 36.38／100,000 of middle area and 27.60／100,000 of western area. The age?specific incidence increased with age and reached the peak at age 55?59 ( 96.36／100, 000 ), and declined at age 60. The age?standardized incidence rate by Chinese standard population increased 30.56% from 2003 to 2012. The increase rate of rural area was 72.32%, faster than 23.48% of urban area. Female breast cancer mortality was 10.36／100,000 and the age?standardized rate calculated by worldwide standard population was 6.61／100,000. The crude mortality of urban area was 11.64／100,000, higher than 8.36／100,000 of rural area, and the crude mortality of eastern area was 10.81／100,000, higher than 7.38／100,000 of middle area and 9.90／100,000 of western area. The age?specific incidence increased with age and reached the peak at age above 85 ( 61.25／100, 000). Age?standardized incidence rate by Chinese standard population remained stable during the period of 2003?2012 (6.23%). The mortality rate mainly increased in rural area (54.94%), while decreased 2.32% in urban area over the 10 years. Conclusions Although the incidence and mortality of breast cancer in China are comparatively low worldwide, in China the incidence and mortality of female breast cancer have rose to the first and sixth place respectively among all the female cancers. The disease burden of breast cancer is very different between urban and rural area. Therefore, the targeted measure and strategy of control and prevention according to the area difference are needed.

With the development of modern medical technology,accurate resection of tumor and timely repair and repair of defective tissues and organs are important concerns in the field of tumor research.The precise excision of tumor,refers to the preoperative assessment of systemic and local detection based on detailed to personalized surgical planning,the use of precise operation in operation,ensure as much as possible while minimizing surgical trauma to patients after removal of the lesions,creating the optimal conditions of recovery for trauma patients.Repair and regeneration of defective tissues and organs refers to the deletion or damage of tissues and organs,and gradually resume its anatomical structure and function process under the action of a variety of cells,extracellular mechanisms and related regulatory factors.Then from the tumor resection,tumor resection and accurate regeneration after three point repair technology to change rapidly in the tissue of tumor plastic organ regeneration in tissue of origin.

Objective To investigate the application value of two-step separation approach in laparoscopic hemihepatectomy.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 81 patients who underwent laparoscopic hemihepatectomy in the People's Hospital of Hunan Provincial between January 2015 and December 2017 were collected.Patients underwent laparoscopic hemihepatectomy using two-step separation approach after preoperative assessment.Hepatic pedicle,hepatic vein and branches were processed in the liver parenchyma,without intrathecal anatomy.Observation indicators:(1) preoperative assessment,intraand post-operative recovery;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed up to February 2018.Patients with hepatolithiasis received abdominal CT reexaminations at 5-7 days postoperatively for observing postoperative residual stones,and patients with malignant tumor were regularly followed up for 1-3 years.Measurement data with normal distribution were represented as (x)±s.Count data were described as frequency and percentage.Results (1) Preoperative assessment,intra-and post-operative recovery:81 patients underwent preoperative blood biochemistry,tumor biomarker and imaging examinations,and remaining functional liver volume and a liver model in 9 patients were respectively calculated and built using the 3D reconstruction software and 3D printing technology.Of 81 patients,68 underwent left hemihepatectomy and 13 underwent fight hemihepatectomy;77 underwent successful laparoscopic hemihepatectomy using two-step separation approach,4 were converted to open operation,with a rate of 4.9％ (4/81).Of 4 patients with conversion to open operation,1 had difficult tumor separation due to tumor invading port vein induced to close adhesion,1 had stone removal difficulties under laparoscopy due to hepatolithiasis,and 2 were converted to open operation due to severe liver cirrhosis induced to massive intraoperative bleeding.Of 81 patients,70 gained dividing line of hemiliver by intraoperatively hemihepatic blood flow occlusion,and then got effectively control of bleeding combined with Pringle blood flow occlusion,and 11 received Pringle blood flow occlusion in whole liver.Laparoscopic fluorescence imaging technology was intraoperatively used for 2 patients.Operation time,volume of intraoperative blood loss,rate of intraoperative blood transfusion and duration of hospital stay in 81 patients were respectively (206±42)minutes,(195±134)mL,11.1％(9/81) and (11.5+2.7)days.Eighty-one patients were complicated with bile leakage and were cured by conservative treatment,with a bile leakage incidence of 2.5％ (2/81),and without severe complications,such as postoperative bleeding,hepatic dysfunction and subphrenic abscess.There was no perioperative death and reoperation within 30 days postoperatively.(2) Follow-up and survival situations:55 patients with hepatolithiasis were followed up and underwent CT examinations of upper abdomen at 5-7 days postoperatively,including 52 with depletion of stones;3 with residual stones received removal of stones by choledochoscope at 3 months postoperatively,without residual stones.Seventeen patients with malignant tumor were followed up for 12-36 months,with a median time of 15 months,16 had tumor-free survival,and 1 was complicated with intrahepatic metastasis at 1 year after resection of hepatocellular carcinoma,and then underwent transcatheter arterial chemoembolization (TACE) and survived with tumor.Nine patients with benign liver diseases had good recovery during follow-up.Conclusion Two-step separation approach that is rationally used in laparoscopic hemihepatectomy is safe,effective and convenient.