With the development of imaging technology,the reports of spontaneous isolated superior mesenteric artery dissection become more frequently,but there is no consensus on the therapeutic plans which consist of conservative therapy,endovascular treatment and surgical treatment.Therefore,the related questions of the spontaneous isolated superior mesenteric artery dissection will be discussed in order to improve the diagnosis and treatment of vascular diseases of digestive tract with a review of literatures.

Objective To evaluate the analgesic effect of dexmedetomidine on the ultrasonic guidance brachial plexus block.Methods Sixty patients who underwent elective for one-side upper limb or forearm surgery were selected,they were received ultrasonic guidance brachial plexus block.The patients were divided into observation group and control group by random digits table method with 30 cases each.The observation group received 0.5％ ropivacaine 100 mg and dexmedetomidine 0.75 μg/kg,and the control group received 0.5％ ropivacaine 100 mg alone.The heart rate,mean arterial pressure (MAP),pulse oxygen saturation (SpO2) at the time of entering operating room,brachial plexus block completed,incision and the end of surgery were recorded.After brachial plexus block completed,the visual analogue score (VAS) at the time of incision,1 h during surgery and 1,2,6,12,24,48 h after surgery was recorded.Morphine was given the patients when VAS ＞ 4 scores,and the time to first prescription of morphine and total morphine consumption dose within 48 h after surgery were also detected.The adverse reaction was recorded.Results There were no statistical differences in heart rate and MAP at the time of entering operating room and brachial plexus block completed between the 2 groups (P ＞ 0.05).The heart rate and MAP at the time of incision and the end of surgery in observation group were significantly lower than those at the time of entering operating and the same time of control group,there were statistical differences (P ＜ 0.05).There was no statistical difference in SpO2 between the 2 groups (P ＞0.05).The VAS at the time of 6,12,24 and 48 h after surgery in observation group were significantly lower than those in control group [(3.0 ± 0.9) scores vs.(4.9 ± 0.5) scores,(3.0 ± 0.7) scores vs.(5.6 ± 1.2) scores,(2.2 ± 0.9) scores vs.(4.8 ± 1.8) scores,(1.7 ± 0.5) scores vs.(3.2 ± 1.0) scores],there were statistical differences (P ＜ 0.05).The time to first prescription of morphine in observation group was significantly longer than that in control group [(450 ± 37) min vs.(368 ± 42) min],the total morphine consumption dose was significantly lower than that in control group [(8.3 ± 2.8) mg vs.(15.5 ± 4.5) mg],there were statistical differences (P ＜ 0.05).There was no adverse reaction found.Conclusion Ropivacaine plus 0.75 μ g/kg dexmedetomidine for ultrasonic guidance brachial plexus block may prolong the duration of analgesia,thus reduce morphine consumption within 48 h after surgery without severe adverse reaction.

Since Reich completed the first laparoscopic hepatectomy (LH) in 1991,LH has been developed rapidly with the continuous improvement of surgeons' technique and the technological changes in devices and related processes.This article elaborates on the safety and efficacy of LH,the value of 3D visualization,3D printing technology,and 3D laparoscopic technology in guiding precise hepatectomy,control of hemorrhage during LH,and safety and efficacy of robotic hepatectomy.

Objective To investigate the effect of umbilical cord serum(UCS)during induction of dendritic cells derived from umbilical cord blood. Methods Umbilical cord blood was collected aseptically and interface cells were collected with density gradient centrifugation method,CD34 +cells were purified and collected with Mini-MACS technique. Pro-DC were obtained and were divided into 3 groups:①cultured in RPMI-1640 medium with 10%UCS and cytokine,②cultured in RPMI-1640 medium with 10%FCS and cytokine③cultured in RPMI-1640 medium with 10%FCS .Interleukin-4(IL-4),granulocyte-macrophage colony-stimulating factor(GM-CSF)and tumor necrosis factor(TNF-a)were used in the first 2 groups, but not in control group (group 3). Some cells were collected on the 8th d for phenotypes analysis. Results The expression of CD80 ,CD54 and HLA-DR on the surface of DC cultured in UCS medium had no significant difference compared with that of DC cultured in FCS medium. The expression of surface molecules in UCS-DC group and FCS-DC group were both enhanced compared with the control group. Conclusion Mature DC could be induced from pro-DC derived from umbilical cord blood when cultured with UCS instead of FCS. That provides a new approach for the clinical application of DC.

Objective To analyze the rules for acupoint selection of warming acupuncture and moxibustion in clinical treatment of knee osteoarthritis based on data mining technology. Methods CNKI, Wanfang Data, CBM, VIP, PubMed and Cochrane Library were searched for relevant literature about warming acupuncture and moxibustion in treatment of knee osteoarthritis. Database was built according to the search results. Association rules were used to analyze the rules for acupoint selection. Results Totally 189 papers were included, involving 189 prescriptions of acupuncture and moxibustion, 46 acupoints, 1270 times of acupoint selection. There were 1119 times of neighboring acupoint selection (88.1%), 151 times of distant acupoint selection (11.9%), 654 times of acupoint selection in yang meridian (51.5%) and 283 times of acupoint selection in yin meridian (22.3%). Conclusion Warming acupuncture and moxibustion in clinical treatment of knee osteoarthritis focuses on acupoints in Stomach Meridian of Foot-Yangming, Spleen Meridian of Foot-Taiyin; the neighboring acupoint selection is the main method, combined with evidence-based distant acupoint selection; acupoint selection from yang meridian was emphasized.

Objective To evaluate the effects of nicotine or electric vagal stimulation on injury to transplanted lungs in rats.Methods Twenty-four male Wistar rats with transplanted lung,weighing 250-300 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),nicotine group (group NI) and electric vagal stimulation group (group VS).Nicotine 2 mg/kgwas injected intraperitoneally at 15 min after lung transplantation in group NI.Right cervical vagus nerve trank was stimulated for 20 min with continuous electric rectangular pulses (5 V,2 ms,1 Hz) at 10 min interval twice in total starting from 15 min after lung transplantation in group VS.Arterial blood samples were then collected for blood gas analysis at 15,30,45,75,105 and 135 min after lung transplantation.Arterial blood samples were then collected at 135 min after lung transplantation for determination of the plasma concentration of interleukin-6 (IL-6),IL-8 and tumor necrosis factor-α (TNF-α) by ELISA.The rats were sacrificed at 135 min after lung transplantation and the tissue of transplanted lung was removed for determination of lung injury score (LIS) according to the pathological changes obtained with light microscope,and of wet/dry lung weight ratio (W/D ratio).Results Compared with group C,PaO2 and pH value were significantly increased,and LIS,W/D ratio,and the concentrations of plasma IL-6,IL-8 and TNF-α were decreased in NI and VS groups.Conclusion Nicotine or electric vagal stimulation can attenuate injury to transplanted lungs in rats.

ObjectiveTo investigate the correlation between the chromosomal abnormalities and prognosis of the myelodysplastic syndrome(MDS)patients, and analyze the effects of treatment. Methods Karyotype analysis of 122 patients according to the international human cytogenetics(ISCN) criteria.Treatment of RA and RAS were mainly dependent on agents to induce differentiation of hematopoietic cells and drugs based.RAEB,RAEB-t,CMML treatment were dependent on low-dose chemotherapy and low-dose combination chemotherapy regimens.The treatments of 64 MDS patients with abnormal karyotype were analyzed and compared with control group, and 58 normal karyotype MDS patients were hospitalized in the same period.ResultsAfter treatments,17 cases gained complete remission among 64 patients with abnormal karyotype MDS patients.The CR rate was 26.6 ％.While in control group,30 gained CR in 58 MDS patients with normal karyotype. The CR rate was 51.7 ％. Comparing with the CR patients of normal karyotype, the number of patients with abnormal karyotype of CR was significantly lower (x 2 =8.1 3,P ＜ 0.05).Conclusion Karyotype analysis shows important significance in the diagnosis and prognosis of MDS.Karyotype transformation demonstrates differently in the risk of leukemia progress.

Purpose To explore the relation between the expression of Bmi-1 and cancer stem cells and its relation to chemotherapy re-sistance in breast cancer. Methods MTT method was applied to detect the inhibition effect on proliferation of different concentrations (0. 01, 0. 1, 1, 10 μg/ml) of 5-Fluorouracil (5-FU) to MDA-MB-468 cells with 48 and 72 hours culture, a curve of proliferation in-hibition rate was drawn, and a suitable experiment concentration of 5-FU was chosen. MDA-MB-468 cells was serially passaged under continuous interference with the suitable concentration of 5-FU, 6 generations of cells were collected, cells with 5-FU interference were designed as experiment group and a corresponding control group with no 5-FU was set. RT-PCR and Western blot were employed to ex-amine mRNA and protein expression of Bmi-1 and Sca-1, Oct-4 in the 6 generations of cells of both control group and experiment group. Results Results of the MTT test showed that 5-FU could inhibit the proliferation of human breast cancer cell line MDA-MB-468, the 5-FU concentration of 0. 1 μg/ml was chosen as the suitable experiment concentration. RT-PCR tests showed that the differ-ences between the relative mRNA expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were not sta-tistically significant in control group (all P>0. 05) and that the differences between the relative mRNA expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were of statistical significance in experiment group cells (all P<0. 05). The mRNA expression of Bmi-1, Sca-1 and Oct-4 showed the following tendency in the 6 generations of passaged cells:decrease (1st gen-eration)—increase (2nd generation)—continuous increase (3rd generation)—decrease (4th generation)—increase (5th genera-tion)—decrease (6th generation). Western blot tests indicated that the differences between the relative protein expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were not statistically significant in control group and that the differ-ences between the relative protein expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were of sta-tistical significance in experiment group cells (all P<0. 05). The expression of Bmi-1 was positively correlated with stem cell associat-ed factors Sca-1, Oct-4 (r=1, all P<0. 01). Conclusions The expression of Bmi-1 gene is positively correlated with expression of stem cell associated factors Sca-1 and Oct-4 in breast cancer cell line MDA-MB-468 cell, and Bmi-1 may be a novel marker for cancer stem cells in breast cancer. Administration of 5-FU can affect the expression level of Bmi-1 and the ration of cancer stem cells in breast cancer cell line MDA-MB-468. Bmi-1 gene may be associated with drug resistance to chemotherapy and recurrence in breast cancer.

Objective:To investigate the neuropsychological characteristics of Chinese agraphia caused by basal ganglia(BG)infarction.Methods:The writing abilities of 40 patients with BG infarction were detected by Chinese agraphia battery(CAB),and all the writing scores and agraphia quotient were calculated.The head CT/MRI images in agraphia and non-agraphia groups were standardized,the infarction were revealed and the superposition of two-dimensional arrays were performed,so that the central tendency of infarction was visually displayed.Results: Among the 40 patients,21 had left BG infraction,and 17 had agraphia;19 had right BG infraction,and 4 had agraphia.The two-dimensional superimposing neuroimages showed that BG infarctions caused agraphia was mostly in the left BG,including the left putamen,the head and body of the caudate nucleus,but there were fewer infarctions in the right putamen and the body of the candate nucleus.BG infarction caused agraphia was mostly aphasic agraphia,which was characterized by the orthographic disorders,paragraphia,and grammar mistakes.Conclusions: BG infarction may result in aphasic agraphia,which suggested that BG is involed in writing and processing,and it is the subcortical center of this advanced neurofunction in writing.

Objective To compare the therapeutic effect of rotating reduction manipulation with that of trinity orthopedic-spinal manipulation combined with injection of Shenmai Injection(SI) through intervertebral foramen for the treatment of lumbar disc herniation(LDH).Methods Ninety LDH patients were equally divided into 3 groups: group A received trinity orthopedic-spinal manipulation,group B received trinity orthopedic-spinal manipulation combined with injection of SI through intervertebral foramen,and group C received rotating reduction manipulation.Score of lower back pain,and scores of symptoms,signs and activities of daily life evaluated by the modified scale issued by Japanese Orthopaedics Association were examined for the comparison of therapeutic effect in the three groups.Results The score of lower back pain in the three groups after treatment differed from that before treatment(P