Objective:To observe the clinical efficacy of nerve-near needling for occipital neuralgia.Methods:Eighty-two subjects were randomly allocated into two groups:treatment group in which 46 cases was treated by nerve-near needling[points Tianzhu(BL 10)and Tianyou(TE 16)were selected],and control group in which 36 cases were treated by conventional acupuncture[points Tianzhu(BL 10),Fengchi(GB 20),Baihui(GV 20),Shimian Ⅱ (Extra),Wangu(GB 12)and Hegu(LI 4)were selected].One course of treatment consisted of 3.5 times,and three courses of treatment were given at most before calculating efficacy.Results:The short-term total effective rate was 93.5%in the treatment group and 69.4%in the control group,with a statistically significant difference between the two groups(P＜0.01);the long-term total effective rate Was 64.1%in the treatment group and 43.3%in the control group,with a statistically significant difierence between the two groups(P＜0.05).Conclusion:Nerve-near needling is better than conventional acupuncture in treating occipital neuralgia.

Purpose To observe the clinical efficacy of combined electro-acupuncture and moxibustion in the treatment of multiple infarctional dementia. Methods Eighty-eight patients were randomized into two groups:treatment group in which 48 cases were treated by combined electro-acupuncture and moxibustion and control group in which 40 cases were treated by oral administration of Huperzine A. Results The total effective rate was 90% in treatment group and 71% in control group,with a significant difference ( P ＜ 0.05 ); the score of Mini-mental State Examination (MMSE) increased more obviously in treatment group than in control group (P＜0.05). Conclusion Combined electro-acupuncture and moxibustion is effective in improving the clinical symptoms of multiple infarctional dementia.

Objective:To study the feasibility of digital subtraction angiography(DSA) and selective external carotid embolization(SECE) in the diagnosis and treatment of maxillofacial tumor. Methods: DSA features, embolotherapy, clinical treatment and complications were investigated retrospectively in 22 cases diagnozed by means of DSA and treated with SECE. Results: After embolization, the bleeding was completely stopped in two cases with emergent hemorrhage, the tumor was shrunk in one case with central hemangioma in maxilla three weeks later and the bleeding in operation was reduced significantly. The tumor boundary was clear for tumorectomy in all the other cases. No recurrence was observed in 3-year-follow up. Conclusion:DSA and SECE are safe, optimal and effective in the treatment of maxillofacial tumour and hemorrhage.

BACKGROUND: The grafted human hair keratin(HHK) artificial tendon,being degradable and absorbable, can induce formation of neotendon. In the present study, the main biomechanical indexes of HHK artificial tendon and its components were measured so as to determine a proper ratio for the artificial tendon composition according to different needs of the body sites and make it possess tensile stress required for functional activities.OBJECTIVE: To determine the main biomechanical indexes of HHK artificial tendon and its components.DESIGN: An observational study based on HHK artificial tendon.SETTING: Department of Biochemistry and Molecular Biology, Medical Biomechanical Key Laboratory of Chinese PLA, and Department of Histology and Embryology, a military medical university; Foshan Kangxing Medical Technology Co., Ltd.MATERIALS: The experiment was completed at the Medical Biomechanical Key Laboratory of the First Military Medical University of Chinese PLA in October 2001. The material of HHK artificial tendons was uncontaminated black hair collected from healthy young women in remote mountainous areas free from endemic diseases. There were three components of HHK artificial tendons with different in vivo absorption velocities Z, B and F. The in vivo absorption was the slowest for Z, faster for B, and the fastest for F. Different kinds of HHK artificial tendon were the mixture of Z, B and F at a proper ratio. Each group had 3 kinds, namely, Z3.0-20, B3.0-20, and F3.0-20. HHK artificial tendon consisted of 6 kinds: ZBF1. 0-20,ZBF1.5-20, ZBF3.0-20, ZBF6. 0-20, ZBF9. 0-20, and ZBF12.0-20.METHODS: Both ends of an HHK artificial tendon or each of its components were fixed on MTS 858 Moni Bionix checker to determine such biomechanical indexes as fracturing pull and tensile stress.MAIN OUTCOME MEASURES: Fracturing pull and tensile stress of HHK artificial tendon of different kinds and its components.RESULTS: Fracturing pull in Z3.0-20, B3.0-20 and F3.0-20 groups was (211.8 ± 12. 1 ), ( 178.8 ± 8.2), and ( 151.3 ± 6. 7) N, respectively; tensile stress was(71.3 ±3.9), (59.9 ±2. 7), and(50. 3 ±2.3) Mpa, respectively. Fracturing pull and tensile stress were decreased gradually in the same cross-section area of the 3 kinds of materials; Fracturing pull in ZBF1.0-20,ZBF1.5-20, ZBF3.0-20, ZBF6.0-20, ZBF9.0-20, and ZBF12.0-20 groups was(75.0 ± 3.0), (107.8±4.2), (194.1±5.3), (375.9±12.7),(508.2 ±21.3), and(670.8 ±25.4) N, respectively, while tensile stress was(75.0 ±3.0), (72.0 ±2.8), (65.1 ± 1.8), (62.9 ±2.2), (56. 3 ±2.4),and(55.8 ± 1.5) Mpa, respectively.CONCLUSION: Fracturing pull of HHK artificial tendon is increased with the increase of cross-section area, whereas tensile stress is slightly decreased with the increase of cross section area. With the increased extent of human hair treatment, its absorption in vivo is accelerated, and fracturing pull and tensile stress of HHK artificial tendon are decreased.

Objective To investigate the expression of vascular endothelial growth factor-C(VEGF-C) in human non-small cell lung cancer(NSCLC) and to elucidate its roles in lymph node metastasis and prognosis evaluation. Methods The expression of VEGF-C was examined in 50 NSCLC specimens and 20 archival surgical specimens of human pulmonary inflammatory pseudotumor tissues by immunohistochemistry. Results The positive rate of VEGF-C expression in NSCLC and inflammatory pseudotumor was 44% and 5% respectively. There was significant difference in VEGF-C expression between the two groups. The expression rate of VEGF-C in NSCLC was significantly higher in the patients with lymph node metastasis (66 7%) than that in the patients without lymph node metastasis (23 1%, P

Continuing medical education is one of major parts in medical education system of minimal invasive surgeon. Based on the characteristics of net continuing medical education such as freedom of learning, no regional restriction and abundant resource, combined with visualized teaching of minimal invasive surgery education, the novel training model of e-learning based on internet was applied to establish minimal invasive surgery continuing education system.

The incidence of pancreatic cancer is gradually increasing worldwide. The overall 5-year survival rate of pancreatic cancer is about 5%, because the early diagnosis is difficult and the radical resection rate is low in pancreatic cancer. The keys of improving the poor prognosis of pancreatic cancer are early diagnosis and radical resection. Detection of serum tumor markers has an important utility in the diagnosis, prognosis and surveillance of pancreatic cancer. CA19-9 is the most widely used and best validated serum tumor marker for pancreatic cancer although it has some limits. With the development of molecular biological techniques in recent years, several potential serum tumor markers for pancreatic cancer are undergoing evaltation, including MIC- 1, M2- PK, OPN, RCAS1, and so on. This paper is to review the current status of serum tumor markers of pancreatic cancer.

Based on high requirement on trainingtarget ofcultivating8-year medical students and combined with the characteristic of general surgical teaching,we applied logical thinking to strengthen students'clinical thoughts and self-analysis ability to make them become the advanced medical talents with good clinical thoughts.

Objective To explore the relationship between diameter of liver hemangioma and operation risk.Methods The clinical data of 362 patients with liver hemangioma who were admitted to the PLA General Hospital from January 2006 to January 2014 were retrospectively analyzed.All patients were divided into the 3 groups according to diameter of gross specimen,217 with tumor diameter≥5 cm and ≤ 10 cm in the large hemangioma group,119 with tumor diameter ＞ 10 cm and ≤20 cm in the giant hemangioma group and 26 with tumor diameter≥20 cm in the extremely large hemangioma group.The operation method included open surgery and laparoscopic surgery.Hepatectomy and enucleation of liver hemangioma were major operation procedures.The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay were evaluated.Count data were analyzed using the chi-square test.Measurement data with normal distribution were presented as (x) ± s,and comparison among groups was analyzed using the ANOVA.Skewed distribution data were described as M (P25,P75),comparison among groups was analyzed by Kruskal-wallis test and pairwise comparison was done by the MannWhitney U test.Results All patients underwent operation successfully without perioperative death,including 315 receiving open surgery (175 in the large hemangioma group,114 in the giant hemangioma group and 26 in the extremely large hemangioma group) and 47 receiving laparoscopic surgery (42 in the large hemangioma group and 5 in the giant hemangioma group).The operation time,volume of intraoperative blood loss,number of patients with blood transfusion,number of patients with postoperative complications and duration of hospital stay were 160 minutes (125 minutes,205 minutes),300 mL (100 mL,500 mL),31,5 and 8 days (7 days,9 days) in the large hemangioma group,220 minutes (175 minutes,275 minutes),500 mL (300 mL,1 000mL),36,5 and 9 days (8 days,10 days) in the giant hemangioma group,330 minutes (280 minutes,420 minutes),1 975 mL (800 mL,4 000mL),20,7 and 11 days (9 days,13 days) in the extremely large hemangioma group,respectively,with significant differences (x2 =84.24,80.94,53.65,31.54,47.67,P ＜ 0.05).The operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion and duration of hospital stay were compared,showing significant differences between large hemangioma group and giant hemangioma group (Z =6.39,6.51,x2 =11.29,Z =4.73,P ＜ 0.05),with significant differences between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (Z =7.28,6.91,x2=51.22,Z =5.57,P ＜ 0.05;Z =5.33,4.86,x2=17.69,Z =3.5 1,P ＜ 0.05).Seventeen patients had postoperative complications with an incidence of 4.70％ (17/362),intra-abdominal hemorrhage were detected in 7 patients,perihepatic effusion in 4 patients,pleural effusion in 3 patients,bile leakage in 2 patients and fat liquefaction of abdominal incision in 1 patient.There was no significant difference in the number of patients with postoperative complications between large hemangioma group and giant hemangioma group (x2 =0.41,P ＞ 0.05).There were significant differences in the number of patients with postoperative complications between large hemangioma group and extremely large hemangioma group and between giant hemangioma group and extremely large hemangioma group (x2 =24.96,11.67,P ＜ 0.05).Conclusions Diameber of liver hemangioma is associated with operation time,volume of intraoperative blood loss,number of patients with intraoperative blood transfusion,number of patients with postoperative complications and duration of hospital stay,and there is a high risk in the surgical treatment of patients with liver hemangioma diameter≥20 cm.