It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery, Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder, and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy, a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one, male aged 54 years of hepatitis B liver cirrhosis and large, with a history of hypertension for 15 years and diabetes for 10 years. On September 25th, 2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia, hyperkalemia, liver and kidney failure clinically. Case two, male aged 47 years of hepatitis B, cirrhosis and huge hepatocellular carcinoma, chronic calculous cholecystitis, with a history of hypertension for 5 years and diabetes for 2 years. On December 26th, 2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm, sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53, drowsiness and depressed spirit appeared; at day 54, the patient was disoriented, and at day 55 hemiparesis occurred at right side, gradually coma, by brain CT scan it confirmed to be intracerebral hemorrhage, and died. Case three, male aged 59 years of hepatitis B, cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th, 2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia, gradually motor dysfunction, swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium, chloral hydrate enema and luminal sodium treatment, focal epilepsy and irritable symptoms were effectively controlled, but aphasia and left hemiparesis still occurred. After five months, the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides, brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding, maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.

[Objective]To investigate the effect of chondroitinase ABC(ChABC) after spinal cord injury(SCI) in adult rats,and to evaluate the significance of treatment. [Methods]Forty adult Wistar rats were divided into two groups: the control group(group A),the chondroitinase ABC group(group B).The thoracic T10 spinal cord injury model was made by impactor model II manual.After SCI,group B animals received ChABC treatment,while group A animals only received blank saline.The locomotor functions(BBB score) and the neuroelectrophysiological changes(SEP&MEP) of the rats were evaluated.Twelve weeks after SCI,biotinylated dextran amine(BDA) was injected into the cerebral cortex to trace the corticospinal tracts(CST).Then two weeks after the tracing,the animals were killed and the spinal cord frozen sections were made.The tissue sections were processed with Cy3 fluorescence stain,HE stain and anti NF-200 immuohistological stain.The section images were analyzed by Image Pro Plus image analyzing software.All the statistics were performed by SPSS 13.0 software.[Results]At 4 weeks after SCI,group B had obvious higher BBB scores than control group(P

It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery,Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder,and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy,a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one,male aged 54 years of hepatitis B liver cirrhosis and large,with a history of hypertension for 15 years and diabetes for 10 years. On September 25th,2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia,hyperkalemia,liver and kidney failure clinically. Case two,male aged 47 years of hepatitis B,cirrhosis and huge hepatocellular carcinoma,chronic calculous cholecystitis,with a history of hypertension for 5 years and diabetes for 2 years. On December 26th,2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm,sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53,drowsiness and depressed spirit appeared; at day 54,the patient was disoriented,and at day 55 hemiparesis occurred at right side,gradually coma,by brain CT scan it confirmed to be intracerebral hemorrhage,and died. Case three,male aged 59 years of hepatitis B,cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th,2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia,gradually motor dysfunction,swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium,chloral hydrate enema and luminal sodium treatment,focal epilepsy and irritable symptoms were effectively controlled,but aphasia and left hemiparesis still occurred. After five months,the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides,brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding,maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.

Objective To summarize the clinical and EEG characteristics of benign epilepsy of childhood with centro-temporal spikes(BECCT). Methods The clinical and EEG data of 78 children with BECCT were retrospectively analyzed. Results The onset age of this disease was 3 to 14 years, and 62 patients aged 5 to 10 years(62/78,80%). The seizures of 72 cases(72/78,92.3%)were associated with sleep. 63 cases(73/78,80.8%)were partial seizures, and 15 cases(15/78,19.2%) were generalized seizures. EEG demonstrated that there were sharp or spike waves of interior discharge in the centro-temporal area of one or two sides, 55.4% cases were positive in awake EEG, and 92% cases were positive in sleep EEG. 93.2% cases were responsive to antiepileptic drugs. Conclusion The characteristics of BECCT were as follows: partial epilepsy related to sleep, partial seizure types and sharp or spike waves of EEG in centro-temporal area. EEG sleep induction test could increase positive diagnostic rate of this disease, and the prognosis of this disease was fine. The early diagnosis is helpful for the patients' prognosis, and can alleviate psychological suffering of the patients and their families.

Objective To research the clinical rehabilitative effect of repeated transcranial magnetic stimulation (rTMS) for the non-motor symptoms of Parkinson's disease.Methods Fifty-five PD patients were randomly divided into an rTMS treatment group (n =29) and a sham stimulation group (n =26).The treatment group received a course of 0.5 Hz rTMS treatment,while the sham stimulation group had the same treatment but with no energy output.Both groups were evaluated using a non-motor symptoms questionnaire (NMSQuest),the Hamilton depression scale (HAMD),the Pediatric Daytime Sleepiness Scale (PDSS),the mini-mental state examination (MMSE) and the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT) before treatment,immediately after,and a month after treatment.Results Compared with before treatment,the average NMSQuest score of the treatment group declined significantly,though 1 month after treatment the improvement was no longer significant.After treatment and 1 month later the average NMSQuest score of the sham stimulation group increased gradually.The effect in the treatment group was therefore significantly better than in the sham stimulation group.After treatment and 1 month later the average HAMD score of the treatment group was significantly lower than before treatment while the average HAMD score of the sham stimulation group had increased gradually.The improvement in depression in the treatment group was therefore significantly better than in the sham stimulation group.After treatment,sleep disorders in the treatment group had been significantly alleviated,but one month later the improvement was no longer significant compared with before treatment.PDSS scores in the sham stimulation group declined gradually,but the improvement in sleep disorders among the treatment group was significantly better than among the sham stimulation group.Cognition improved significantly among the treatment group right after treatment,but 1 month later it had worsened while the MMSE scores of the sham stimulation group decreased gradually.The difference between the two groups was statistically significant.The average SCOPA-AUT scores of the two groups were not significantly different from each other or from the scores before treatment.Conclusion Repeated TMS can improve most non-motor symptoms of PD.The improvement in depression is the most significant.A short course of rTMS has no obvious rehabilitative effect on the autonomic function disorders of PD patients.

BACKGROUND: Stem cell regeneration can repair injured myocardium. However, bone marrow mononuclear cells (BM-MNCs) transplantation for non-ischemic heart failure remains poorly understood.OBJECTIVE: To investigate effect of transplantation of autologous BM-MNCs on cardiac function in canine model of heart failure by rapid ventricular pacing. METHODS: Implantation and model control groups were subjected to model establishment of heart failure by rapid pacing of apex of right ventricle, and respectively injected with CM-DiI-labeled BM-MNCs and normal saline into myocardium. After 4 weeks, all dogs were sacrificed, and specimens of myocardium were collected from the apex, anterior wall and interventricular septum. All specimens were labeled by FITC. Myocardial fibrosis conditions of implanted cells were observed, collagen volume fraction was determined, and hemodynamic indexes were measured. RESULTS AND CONCLUSION: BM-MNCs labeled by CM-DiI and FITC were observed in the transplantation group showing yellow fluorescence, while in the control group FITC-labeled green fluorescence was seen. HE and Masson staining showed that inflammatory cell infiltration in interstitial matrix, displaying interstitial fibrosis and myocardial fibrosis in model control group, but no obvious inflammatory cell infiltration or myocardial fibrosis was observed in the transplantation group, indicating a success model establishment of heart failure by rapid ventricular pacing. Compared with model control group, the collagen volume fraction decreased significantly (P < 0.05), ejection fracture remarkably increased (P < 0.05), but left ventricular end-diastolic and end-systolic diameter remained unchanged in the transplantation group (P > 0.05). Autologous BM-MNCs in canine model of heart failure show myocardium-like cells differentiation, and improve heart function, which possibly associate with the ability of inhibiting the myocardial fibrosis.

Objective To investigate the safety and feasibility of laparoscopic pylorus-preserving pancreaticoduodenectomy.MethodsThe data of 59 patients with laparoscopic pancreaticoduodenectomy in Shangjin hospital of West China hospital of Sichuan University from January 2014 to December 2015 were analyzed retrospectively.The general data,operative time,estimated blood loss,conversion rate,time to liquid diet,postoperative hospital stay and complications were analyzed.Results The laparoscopic pylorus-preserving pancreaticoduodenectomy were successfully performed in 56 cases,the successful rate was 94.9%,the other 3 patients were converted to laparotomy for superior mesenteric vein/portal vein involvement.The operative time was 255~510 minutes,with mean operative time (384±145) minutes,the intraoperatve blood soss was 50~800 mL,with mean estimated blood loss (148±28)mL,the time to liquid diet was 1.0~4.0 days,with average time (3.2±1.1)days,the postoperative hospital stay was 5.0~53.0 days,with average time (10.3±2.6)days.After surgery,16 cases suffered from complication,the rate was 27.1%.The most common complication was pancreatic fistula which occurred in 13 cases including 12 cases of grade A and 1 case of grade pancreatic fistula.No grade C pancreatic fistula occurred in this series.Six patients suffered from delayed gastric emptying.One patient suffered from bile leakage.Conclusion Laparoscopic pylorus-preserving pancreaticoduodenectomy was safe and feasible.Pylorus-preserving does not increase the incidence of delayed gastric emptying.

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P ＜ 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P ＜ 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

BACKGROUND: Spinal cord injury is a damage to the spinal cord with a high morbidity that can be divided into primary and secondary injury. Secondary injury does more harm to the body than primary injury, which can be regulated and improved through proper interventions. In addition to the drugs, surgical decompression and other traditional treatments, hypothermia is an important physical intervention that has been shown to regulate secondary injury following spinal cord injury, and hold neuroprotective effect.OBJECTIVE: To introduce different hypothermia treatments for spinal cord injury and the effect on the disordered environment after spinal cord injury, as well as summarize the latest progression. METHODS: A computer-based search of CNKI and PubMed databases was conducted for the articles addressing the application of hypothermia in spinal cord injury published from January 2001 to June 2016, using the keywords of therapeutic hypothermia or low temperature, spinal cord injury in Chinese and English, respectively. RESULTS AND CONCLUSION: Hypothermia is divided into systematic and local hypothermia, and the former is simple and convenient, but it may lead to complications. Local hypothermia can quickly reach the target temperature, to make deep hypothermia at injury site and stablize the core temperature in the body, but it is invasive, and the necessary time of locating and maintaining effective temperature is a challenge. In general, hypothermia can improve the disordered microenvironment after spinal cord injury, reduce inflammatory infiltration, regulate the expression of relative genes and proteins, and promote the proliferation and differentiation of endogenous nerve cells. There are basic and clinical studies on hypothermia neuroprotection against spinal cord injury from various aspects; thereafter, hypothermia is a promising treatment strategy for spinal cord injury.