Objective: To observe the effect of electroacupuncture (EA) combined with traction and modified oblique Ban-pulling manipulation on lumber intervertebral disc herniation (LIDH).
Methods:A total of 90 eligible cases were randomly allocated into three groups, 30 in each group. Cases in group A were treated with EA, traction and tuina of modified oblique Ban-pulling manipulation; cases in group B were treated with traction and tuina (same as group A);and cases in group C were treated with traction alone (same as the other two groups). Then the therapeutic efficacies in the three groups were evaluated using the Japanese Orthopedic Association (JOA) score rating system.
Results:The results after treatment and 1-month follow up showed that JOA scores in all three groups were improved (P<0.01); the total effective rate in Group A was 96.7%, versus 90.0% in group B and 70.0% in group C, showing a significantly better effect than the other two groups (P<0.01).
Conclusion: EA combined with traction and modified oblique Ban-pulling manipulation can obtain better effect than traction alone and traction combined with modified oblique Ban-pulling manipulation for LIDH.

Objective To investigate the effects of local injection of Botulinum toxin A (BTX-A) on hemifacial spasm guided by periph-eral nerve stimulation. Methods 57 patients with hemifacial spasm from January, 2012 to June, 2015 received local multi-point injection of BTX-A guided by peripheral nerve stimulation. The grades of facial spasm were evaluated before, 72 hours and 6 months after treatment. They were followed up for 3-9 months. Results The spasm reduced in the patients both 72 hours and 6 months after treatment (χ2=4.946, P<0.05). The incidence was 98.25% of satisfaction and 92.99% of very well 72 hours after treatment, while it was 91.23% and 78.95% 6 months after treatment. The relief of spasm was maintained for (23.1 ± 2.3) weeks. Conclusion Injection of BTX-A guided by peripheral nerve stimulation is effective on hemifacial spasm for a long time.

Pancreaticojejunostomy is a difficult procedure in laparoscopic pancreaticoduodenectomy.How to improve the method of laparoscopic pancreaticojejunostomy and decrease the incidence of pancreatic leakage is a never-ending issue for clinicians.From November 2002 to March 2012,the digestive tract of 34 patients who received laparoscopic pancreaticoduodenectomy at the First Affiliated Hospital of Guangxi Medical University was constructed by wrapping pancreatic duct-jejunum anastomosis,and satisfactory outcomes were observed except for 2 patients with slight pancreatic leakage.The results of the study showed that wrapping pancreatic duct-jejunum anastomosis is a fast,safe and effective method for pancreaticojejunostomy.

Objective To analyze the curative effect of adult urethrocutaneous fistula after hypospadias repair with X-V dartos flap technique.Methods In the experimental group,the closed fistulas were wrapped with X-V dartos flap in the 22 cases of adult hypospedias fistulas from February 2007 to October 2010.In the control group,the routine fistulas repairs were preformed in the 35 cases of adult hypospadias fistulas from January 2000 to January 2007.The operative effects were compared between the two groups.Results All cases were followed up for 3-49(5.6±12.0)months,no fistula was found in the experimental group,while 7 fistulas(20.0%,7/35)were found in the control group.The fistulas rate had statistic difference between the two groupe(P<0.05).Conclusion The use of the X-V dartos flap technique can prevent adult urethroeutaneous fistula after failed hypospadias fistulas repair and raise the success rate.

Programmed death-1(PD-1)is a major co-suppression receptor expressed on T cells.Binding with its ligands (PD-L1 and PD-L2),PD-1 can inhibit T cell proliferation,activation and cytokine secretion.In normal organs,PD-1 /PD-Ls signaling pathway plays an important role in maintaining immune tolerance,while during tumorigenesis,it can suppress T cell immune response and promote tumor immune escape.This article reviewed the research progress on PD-1 /PD-Ls signaling pathway,comprised of structure and expression of PD-1 /PD-Ls, mechanism of the signaling pathway,as well as the expression characteristics of soluble form of PD-1 /PD-L1 (sPD-1 /sPD-L1),and summarized the categories of anti-PD-1 /PD-Ls antibodies and their clinical trials in canc-er immunotherapy.

Objective To compare the clinical efficiency of endoscopic thyroidectomy by breast approach with conventional open thyroidectomy in patients with benign thyroid tumor. Methods Ninety-one patients of thyroid adenoma or adenomatous goiter underwent endoscopic thyroidectomy (group endoscopy) , Ninety-nine patients underwent conventional open thyroidectomy (group open). Operative time, blood loss, the volum of drainage, time of hospital stay and postoperative stay, postoperative complications and analgesic requirements, time taken to return to normal activity and total fee were compared. Results There were no significant differences in operative time, time of stay and postoperation stay between the two groups. Blood loss was significantly less in group endoscopy (27. 7?17. 4) ml than in group open [ (96. 8?84. 8) ml, P

Objective To evaluate the feasibility and efficacy of laparoscopic treatment of hepatic hemangioma. Methods The clinical data of 27 patients who received laparoscopic treatment of hepatic hemangioma from November 2003 to October 2009 were retrospectively analyzed. The hepatic inflow to the liver or to a hemiliver was temporarily blocked using a Pringle manoeuvre with a self-invented laparoscopic blocker at the porta hepatis or at the pedicle to the relevant hemiliver. The Electriccautery and ultracision were used for liver transaction. Results Laparoscopic treatment of hepatic hemangioma was successfully performed in 25 patients. Conversion to laparotomy was required in two (8%) patients for uncontrollable bleeding. There were no major postoperative complications and no mortality. The mean tumor diameter was (6.34±2. 17) cm. The operating time was ( 105.21 ±72.76)min. The time of hepatic inflow block was (10. 17±12. 21)min. The blood loss was (115. 5±212.14)ml. The volume of blood transfusion was (0. 87 ± 1.45)U. The volume of postoperative drainage was (112.60±201.03)ml. The time taken to return to normal activity was (2. 0±0. 8) days.The length of postoperative hospital stay was (5.5±2.4) days. The length of total hospital stay was (12. 5 ±5.3) days. The total cost was RMB10041.6±8678. 7. Conclusion In selected patients, laparoscopic treatment of hepatic hemangioma was safe and feasible.

Objective To explore the feasibility and therapeutic effect of total laparoscopic hepatectomy(LH) for treating hepa‐tolithiasis .Methods 75 consecutive patients with hepatolithiasis operatively treated in our hospital from November 2003 to Novem‐ber 2012 were retrospectively analyzed .Among them ,35 cases underwent laparoscopic hepatectomy(LH group) and 40 cases under‐went open hepatectomies(OH group) .The operative modes in the two groups included the left liver lateral lobe resection ,left hemi‐hepatecomy ,common bile duct incision exploration ,choledochoscopy exploration for calculi extraction ,T tube drainage and cholecys‐tectomy .The clinical indicators including the operation time ,intraoperative blood loss ,analgesic drug use situation ,ambulation time , diet recovery time ,postoperative complication rate ,postoperative hospital stay time ,stone clearance rate and recurrence rate were analyzed and compared between the two groups .Results The operation time of the LH group was longer than that of the OH group[(205 .0 ± 40 .9) min vs .(155 .0 ± 26 .6) min ,P< 0 .01] and the postoperative hospital stay time of the LH group was shorter than that of the OH group[(12 .3 ± 2 .6) d vs .(15 .6 ± 4 .3)d ,P< 0 .01] .The intraoperative blood loss of the LH group was slightly more than that of the OH group[(330 .0 ± 259 .7) mL vs .(151 .5 ± 137 .0) mL ,P< 0 .01] .However ,the blood loss of last 10 cases in the LH group was similar to that of the OH group[(81 .0 ± 19 .70)mL vs .(78 .0 ± 22 .0)mL ,P> 0 .05) .The use rate of analge‐sic drugs in the LH group was lower than that of the OH group (0 vs .62 .5% ) .The ambulation time and the diet recovery time in the LH group were shorter than those in the OH group[(1 .5 ± 0 .5)d vs .(3 .6 ± 0 .7)d ,P< 0 .01 ;(2 .4 ± 0 .5)d vs .(4 .0 ± 0 .7) d , P< 0 .01] .No differences between the two groups were found in the occurrence rate of postoperative complications (2 .9% vs . 16 .0% ) ,stone clearance rate(instant clearance rate 91 .4% vs .90% ;final clearance rate 97 .1% vs .100% ) and the opeartion ex‐cellent rate(97 .1% vs .100% ) .No case of perioperative death occurred in the two groups(P > 0 .05) .Conclusion LH combined with choledochoscopy for treating hepatolithiasis is feasible and safe in the patients conforming to the selected standard with an e‐qual therapeutic effect to that of open hepatectomy .LH has the advanteages of minimally invasive surgery such as small incision , less pain ,fast recovery ,less complications ,etc .

Objective To explore the clinical significance of N-terminal pro-brain natriuretic peptide(NT-proBNP)in the evaluation of cardiac function in patients with severe burns. Methods A total of 78 patients with severe burns in intensive care unit(ICU)in our hospital were selected. Patients were divided into a heart failure group(n = 31)and a non-heart failure group(n = 47)according to the heart failure complication condition. The changes of NT-proBNP level in different time ,heart function index ,relevant index and mortality were compared between the two groups. Results The levels of NT-proBNP ,troponin(CTnT),creatine kinase(CK),creatine kinase isoenzyme (CK-MB),stroke volume index (SVI),cardiac index (CI) and central venous pressure (CVP),and the score of acute physiologic and chronic health conditions(APACHE II)in the heart failure group were shown to be significantly increased than those of the non-heart failure group (P < 0.05). The mean arterial pressure(MAP)in the heart failure group was significantly lower than the non-heart failure group(P < 0.05). Mortality rate in the heart failure group was shown to be significantly higher than the non-heart failure group (P < 0.05). Conclusion Heart failure is a common complication in patients with severe burns. The mortality rate in the population with heart failure is relatively high ,for which NT-proBNP can effectively assess the conditions and prognosis.

Objective To study the feasibility and safety of laparoscopic anatomical liver lobectomy for liver tumor. Methods The feasibility and therapeutic effect of laparoscopic anatomical liver resection on 67 patients were analyzed in our hospital from January 2005 to February 2010. Results Laparoscopic anatomical liver lobectomy was carried out successfully on all the patients. The operative time was 50.6± 16.2 min and the blood loss was 220. 8±76.5 ml. We did not use Pringle's manoeuvre. There was no postoperative complication. The patients were able to be ambulated out of bed within 24 hours and they started to take in food 1-3 days after surgery. The mean hospital stay was 5-7 days after surgery (mean 6.6±1.1 d). The total hospital cost was 30767.4±150. 1 Yuan. Conclusions Laparoscopic anatomical liver resection is feasible and safe. It has the advantages of minimal trauma and quick recovery for tumors located superficially, in the left liver, and in the inferior part of the right liver. Clinically, it should be used more widely.