Objective To evaluate the efficacy of laparoscopic-assisted resection of the small bowel for stromal tumors.Methods From January 2003 to May 2007,laparoscopic abdominal exploration was carried out under general anesthesia on 10 patients with space occupying lesion and 5 patients with abdominal pain and hemafecia of unknown origin.After an intestinal lesion was found,a small incision was made at the proper site on the abdominal wall according to the location of the lesion.The diseased intestine was resected outside the abdominal cavity,and then end-to-end anastomosis was performed.Pneumoperitoneum was rebuilt after closing the abdominal cavity in order to observe the blood circulation of the small bowel and intra-abdominal hemorrhage.Results The operation was completed in all the 15 cases.The postoperative pathological examination showed stromal tumors with CD117 positive in 14 cases(93%)and CD34 positive in 9(60%).Three(20%)of the patients were at very low risk,5(33%)at low risk,4(27%)at moderate risk,and 3(20%)at high risk.The mean diameter of the tumors was(2.44?0.63)cm(ranged from 1.5 to 3.6).The operation time was 38 to 72 minutes with a mean of(57.8?10.4),and mean blood loss was(20.1?6.5)ml(10 to 30).The patients were discharged 4 to 7 days after the operation [mean,(5.3?1.1)days],and were followed up for 5 to 36 months [mean,(24.3?8.4)months].No patient had postoperative complications or recurrence in this series.Conclusion Laparoscopy is effective for resection of small bowel stromal tumors.

The features of the symptoms, laboratory tests and pathological characteristics of adrenal cortical and medullary hyperplasia were studied. In 6 cases of hypercatecholaminenia, plasma norepinephrine (NE), epinephrine (E), catecholamine (CA) and 24-h urinary vanillylmandelic acid (VMA), 17-hydroxycorticosteroid (OHCS) and 17-ketosteroid (KS) were determined. Adrenal glands were examined by CT scan and 131I-MIBG imaging. Pathological examination was performed after operation. The results showed that in 6 cases of hypercatecholaminenia (3 men and 3 women) aged from 34-50 years, the clinical features were just like "pheochromocytoma", for example, episodic headache, perspiration, palpitation, pallor, apprehension, nausea, tremor, anxiety and so on. Plasma levels of CA, NE and E were elevated in all 6 cases. 24-h urinary samples obtained at the onset revealed elevated VMA in 1 case. 24-h urinary cortisol was obviously elevated in all 6 cases. 24-h urinary 17-OHCS, 17-KS was normal. B-type ultrasound, CT, MRI and 131I-MIBG revealed 9 lateral adrenal gland diffuse or nodular enlargement in 6 cases. Pathologic examination showed adrenal cortical and medullary hyperplasia. Clinically, adrenal cortical and medullary hyperplasia resembled "pheochromocytoma". The most significant feature of this disease was both elevated plasma CA and 24-h urinary cortisol obviously. Pathologic examination showed adrenal cortex nodular hyperplasia and medullar diffuse or limit hyperplasia. Whether it is an independent disease or symptoms of the other disease has not final conclusion up till now.
Adrenal Cortex/*pathology ; Adrenal Gland Diseases/*pathology ; Adrenal Medulla/*pathology ; Adrenocortical Hyperfunction/*pathology ; Catecholamines/blood ; Hyperplasia ; Hypertension/etiology ; Retrospective Studies

Objective To compare the effects of penequinine hydrochloride and atropine on the cardiovascu-lar stability about preoperative in children by monitoring and recording the HR, MAP, SpO2, ECG changes. Methods 40 children underwent selective operation were randomly divided into two groups, 20 in each group. Penequinine hydrechloride group(group A) and atropine group(group B) were injected intramuscularly with penequinine hydro-chloride 0. 015mg/kg or atropine 0. 015mg/kg respectively, at 30 minutes before operation. Patients' HR, MAP, SpO2 and ECG changes were recorded at 10min,20min,30min and 40min after injection. Results The HR,MAP,SpO2 levels of group A and SpO2 level of group B had no significant changes. There are significant changes in HR,MAP of group B. Conclusion Penequinine hydrochloride can be used as preoperative medication and it is conducive to the maintenance of cardiovascular stability.

Objective To search and evaluate the quality of reports of clinical trial studies published in Chinese Pediatric Emergency Medicine according to CONSORT statement.Methods We collected all articles published in Chinese Pediatric Emergency Medicine from January 1,2011 to November 31,2015 through searching the WanFang Database,then evaluated and analyzed clinical trial studies.Results Among all 1317 articles we retrieved,62 (4.7％)of them belong to clinical trial study.According to CONSORT statement,all the articles satisfied items from 1b to 6b (including abstract,introduction,trial design,participants,interventions and outcomes),only 30(48.4％) and 4(6.5％) articles mentioned item 8a (method used to generate the random allocation sequence)and 8b(type of randomization;details of any restriction),respectively.None of the editors reported item 9(mechanism used to implement the random allocation sequence,describing any steps taken to conceal the sequence until interventions were assigned)and 10(who generated the random allocation sequence,who enrolled participants,and who assigned participants to interventions).Among 62 included studies,33(53.2％)studies concentrated on respiratory system diseases.However,studies about nervous system,circulatory system and digestive system were 5(8.1％),4(6.5％)and 4 (6.5％) respectively.Although all the results had statistical significance,only 38(61.3％),7(11.3％) and 5 (8.1％)mentioned randomization,follow-up and blinding respectively.Flow diagram was only included in one (1.6％) article.Conclusion The articles of clinical trial studies published in Chinese Pediatric Emergency Medicine did not take CONSORT statement as reference completely.

Based on the anatomical study of kidney in mammals of 27 families and 163 species, the authors discovered Anoa depressicornis type kidney, and obtained the evidence of morphological transition between Ox-type kidney and Pig-type kidney. After observing the renal papillary structure of Budorcas taxicolor, the evidence of fact and theoretical bases of the biological view was proved that the general papillae are developed from the multi-papillae kidney. The author advanced a new type of leaf-shaped multipapillae kidney. The authors suggest to classify the mammalian kidneys principally into 2 groups, i. e, simple and composite kidney, and subdivide them into 4 types, i. e, multipapillae and concentrated papillae for simple kidney and leaf-shaped multipapillae and ball-shaped mono-papillae for composite kidney. In contrast to the previous classification, the 2-group 4-type classification recommended here with its solid anatomical foundation is conformable with the viewpoint of biology, and is more practical and integrated.

ObjectiveTo explore the genetic impact of TPH1 A218C,MAOA-uVNTR on abnormal frontal lobe of depressed patients and the interactions between the two polymorphisms using the method of genetic imaging.Methods28 patients with major depression and 34 healthy controls which were equal in sex,age,years of education and had negative family history of mental illness were recruited in our study.All paticipants underwent functional Magnetic Resonance Imaging (FMRI) in negative emotion recognition and were divided into different genotypes.Then frontal lobe was extracted as region of interest by WFU software into six subregions-bilateral superior frontal lobe,middle frontal lobe and inferior frontal lobe.ResultsPatients (0.19 ± 0.01 ) and controls (0.15± 0.05 ) with TPH1 AA genotype showed increased activation in left inferior frontal lobe than patients and controls with AC or CC genot.Patients with AA genotype showed increased activation in right inferior frontal gyrus(0.28 ±0.07) than other five groups as well.Patients with MAOA-H genotype showed increased activation in right middle frontal gyrus(0.15 ±0.06),left inferior frontal gyrus(0.18±0.02) than patients and controls with L genotype.Superimposition of TPH1 A218C and MAOA-uVNTR exsited in abnormal function of left inferior frontal gyrus(F=4.98,P =0.047 ).Patients with AA and H genotype showed increased activation in this area significantly than other patient group.ConclusionDifferent genes in serotonin system can affect brain function through a common 5-HT feature.

Objective To explore the dose-effect,time-effect and safety of alteplase in the treatment of acute cerebral infarction.Methods One hundred and ten patients with acute cerebral infarction were selected,among whom 50 patients whose time window ≤3.0 h were divided into group A and group B by random digits table method with 25 cases each,and 60 patients whose time window 3.1-4.5 h were divided into group C and group D by random digits table method with 30 cases each.The patients in group A and group C received alteplase 0.6 mg/kg (maximum dose 60 mg) intravenous thrombolysis;the patients in group B and group D received alteplase 0.9 mg/kg (maximum dose 90 mg) intravenous thrombolysis.The national institutes of health stroke scale (NIHSS) scores before treatment and 1 h,24 h,7 d,30 d and 90 d after treatment were observed in the 4 groups.The therapeutic effect,complication incidence and fatality rate were compared.The prognosis was estimated by modified Rankin scale (mRS) score 90 d after treatment.Results The NIHSS scores 1 h,24 h,7 d,30 d and 90 d after treatment were significantly lower than those before treatment in the 4 groups,and there were statistical differences (P ＜ 0.05).The NIHSS score decreased significantly with time.There were no statistical differences in NIHSS score between group A and group B,group C and group D.There were no statistical differences in complication incidence and fatality rate 90 d aftcr treatment in group A and group D compared with group B and group C (P＞ 0.05).The rate of eusemia in group A was 76.00％ (19/25),in group B was 64.00％ (16/25),in group C was 43.33％ (13/30),and in group D was 53.33％ (16/30).And there were no statistical differences between group A and group B (x2 =0.620,P ＞0.05),and between group C and group D (x2 =0.069,P＞ 0.05).Conclusions The low dose alteplase is also effective and safe to acute cerebral infarction patients at time window ≤ 3 h.It is also effective and safe to acute cerebral infarction patients at time window 3.0-4.5 h at standard dose.

Objective To study how to store and display the data combined with pictures and texts in Management Information System(MIS) for client to manage and use the MIS easily.Methods The MIS used Access 2003 as database and Delphi 7 as development platform.With the use of RXRichEdit controller,the pictures and texts data were stored in database.Results The problem of storing the pictures and texts data in database was solved.The most functions such as input,storage and display of pictures and texts data were realized in MIS.Conclusion The use of RXRichEdit controller can simplify the storage and display the pictures and texts data in database.It not only makes convenience for user to operate the data,but also improves the performance of the system.

Objective To observe the factors affecting inadequate ST-segment resolution in patients with acute ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention (PCI). Methods The patients with acute ST-segment elevation myocardial infarction undergoing emergency PCI were enrolled for study. According to the ratio of ST-segment resolution, 186 cases were divided into inadequate ST-segment resolution group (54 cases) and relatively adequate ST-segment resolution (132 cases). Clinical data of two groups were compared. The single factor and multiple Logistic regression analysis were performed to determine the factors influencing inadequate ST-segment resolution. Results Pre-infarction angina was protective factor of inadequate ST-segment resolution after emergency PCI (OR=0.361, 95%CI 0.131-0.994, P<0.05). Anterior myocardial infarction, attack-to-balloon time, Killip classification and white blood cell counts were risk factors of inadequate ST-segment resolution (OR=2.389, 95%CI 1.194-4.781;OR=1.655, 95% CI 1.082-2.532; OR=1.319, 95% CI 1.026-1.695; OR=1.184, 95% CI 1.004-1.396, P<0.05). Conclusions Patients with pre-infarction angina could reduce the risk of inadequate ST-segment resolution after PCI. Patients with anterior myocardial infarction,long attack-to-balloon time, Killip classification≥2 and high blood cell counts could increase the risk of inadequate ST-segment resolution, and earlier and more active clinical intervention should be taken.

Objective To summarize the clinical experience in Da Vinci surgical system-assisted hepatopancreatobiliary surgery.Methods From January to December in 2009,94 patients with hepatopancreatobiliary diseases were treated at General Hospital of Second Artillery of PLA.The surgical procedure and postoperative recovery of patients were analysed.Results A total of 90 patients had successfully undergone robotic surgery,and 4 patients were converted to open surgery with the conversion rate of 4%(4/94).Sixteen patients received surgeries for hepatic diseases,and 1 patient with a giant hemangioma in the right posterior hepatic lobe was converted to open surgery,because a very close relationship between the hemangioma and inferior vena cava was observed;27 patients received surgeries for hilar diseases;19 patients underwent surgeries for pancreatic diseases,and 3 patients were converted to open surgery,including 2 with poor exposure of the giant pancreatic head carcinoma and 1 with tumors in the distal common bile duct:32 patients received other surgeries,including 6 with choledochojejunostomy and 11 with laparoscopic common bile duct exploration.Conclusions Almost all kinds of operations for hepatopanereatobiliary diseases could be performed by Da Vinci surgical system.Da Vinci surgical system expands the indications for laparoscopic surgery.