It is related to the treatment effect of the disease and the quality of life of the patient that perioperative management of ruptured esophagogastric varices bleeding with portal hypertension.According to the individual characteristics of the patient combined with the experience of the surgeons,the key points of individualized treatment consist of accurate and comprehensive preoperative preparation,fine post-operative treatment,and the changes of pre-and post-operative hemodynamics of portal vein system to choose a reasonable procedure,meanwhile,the delicate postoperative managements can improve the surgical effect of portal hypertension.

Objective:To explore dynamic change of heart rate variability (HRV) before and after circumferential pulmonary vein ablation (CPVA ) in patients with paroxysmal atrial fibrillation (PAF) and its relationship with postoperative recur‐rence .Methods:A total of 108 PAF patients undergoing left atrial circumferential pulmonary vein electrically isolated ra‐diofrequency ablation were selected .According to 12‐lead DCG on 3d and three months after operation ,patients were di‐vided into early recurrence group (n=10) ,late recurrence group (n=21) and no recurrence group (n=77) .HRV changes were followed up and compared among all groups .Results:Compared with before ablation ,on 3d after ablation ,there were significant reductions in standard deviation of normal to normal RR intervals calculated over the 24 h period (SDNN) , standard deviation of normal to normal RR intervals in all 5 min segments of the entire recording (SDANN) ,root‐mean square of differences betweensuccessive normal to normal intervals (rMSSD) ,low frequency (LF) ,high frequency (HF) in no recurrence group ;significant rise in mean heart rate ,and significant reductions in SDNN ,LF and LF/HF in early recur‐rence group ( P< 0.05 or <0.01);compared with no recurrence group ,there were significant rise in mean heart rate [(69.3 ± 11.2) beats/min vs .(75.4 ± 14.0) beats/min] ,SDANN[(66.9 ± 25.7)ms vs .(137.5 ± 92.3)ms] ,rMSSD [(22.1 ± 10.6)ms vs .(46.2 ± 19.2)ms] ,LF [(233.1 ± 31.4)ms vs .(251.7 ± 17.3)]and HF[(228.0 ± 82.4) ms2 vs . (508.0 ± 13.5) ms2 ] ,and significant reduction in LF/HF[(1.13 ± 0.53) ms2 vs .(0.41 ± 0.13) ms2 ]in early recurrence group (P<0.05 or < 0.01);significant rise in rMSSD [(23.9 ± 11.10) ms2 vs .(52.0 ± 28.7) ms2 ]and HF[(344.4 ± 103.2) ms2 vs .(482.1 ± 100.6) ms2 ] ,and significant reduction in LF/HF[(1.16 ± 0.41) vs .(0.85 ± 0.43)]in late recur‐rence group , P<0. 05 or <0. 01. Conclusion:Vagal tone reduction may reduce recurrence after CPVA in PAF patients .

This paper reported one case with deposition of schistosome eggs in lymph nodes of rectal cancer draining area.

This paper reported one case with deposition of schistosome eggs in lymph nodes of rectal cancer draining area.

Objective The curative effect comparison of circumcision suture surgery and surgery foreskin cerclage ring.Methods Selection in our department from July 2013 to October 2016 were selected from children with phimosis or re-dundant prepuce in children with a total of 562 cases as the research object , randomly divided into control group (182 cases) and observation group (380 cases).The observation group using disposable circumcision suture treatment , the control group using prepuce ring resection in the treatment of patients , observe the operation effect , two postoperative pain and complica-tions.Results The observation group operation success rate ( 100%) was significantly higher than the control group (94.09%), observation group operation time , intraoperative bleeding volume , postoperative 24h pain scores were signifi-cantly less than the control group , the adverse reaction rate of observation group ( 6.32%) was significantly lower than the control group (11.54%),the differences between groups were significantly P<0.05.Conclusion Ircumcision surgery su-ture is better than that of ring foreskin cerclage surgery , more safe and reliable .

Oxidative stress is involved in cirrhotic portal hypertension and a close relationship exists between oxidative stress and hyperdynamic circulation.This article elaborates on the function of various reactive oxygen species (e.g.,superoxide anion and hydrogen peroxide) and corresponding anti-oxidants (e.g.,NAD(P) H oxidase inhibitor,the scavengers of superoxide anion,hydrogen peroxide,and vitamin C or E) on the occurrence and development of hyperdynamic circulation in cirrhotic portal hypertension.We observed that the level of reactive oxygen species in cirrhotic portal hypertension was elevated over normal.The potential clinical value is that inhibition or removal of these reactive oxygen species can relieve hyperdynamic circulation and reduce complications for cirrhotic portal hypertension.

Surgical treatment of cirrhotic portal hypertension and its accompanied abdominal diseases is one of the medical problems currently.Accurate evaluation of the hepatic function reserve,degree of portal hypertension and accompanied abdominal disease is important to decrease the postoperative morbidity and mortality as well as to raise the efficacy.The surgical procedure selection should be based on the analysis of portal vein hemodynamics of patients.There are clear indications for portosystemic shunt,devascularization and combinative surgery with shunt and devascularization.Treatment for portal hypertension should be carried out when treating the accompanied abdominal diseases.The principle of operation,operation time,operation mode,operation sequence,staging indications and the key techniques of operation were discussed in the article.Only these principles be mastered,proper selection of surgical procedures and desired treatment effect with minimal trauma can be achieved.

Objective To investigate the expressions of glial cell line-derived neurotrophic factor(GDNF)and its receptors,GFRα-1 and Ret,in cortex of rats after closed traumatic cerebral injury.Methods Male Sprague-Dawley rats were divided into normal control,sham and injury groups.The rats of injury groups were subjected to Marmarou's closed traumatic cerebral injury and then were subdivided into 1 h,2 h,4 h,8 h,12 h,24 h,48 h,72 h and 5 d groups according to the time elapsed after injury.The expression of GDNF and its receptors were determined with immunohistochemistry.Results Mild expression of GDNF and its receptors were observed in cortex of rats in control groups.The number of GDNF positive neurons reached the peak level in cortex 2 h after injury,and that of GFRα-1 and Ret positive neurons reached the peak level 4 h after injury.Conclusion The expressions of GDNF and its receptors increased significantly at the early time in cortex of rats after injury,as well as its receptors.It suggests that GDNF and its receptors play an important role after traumatic cerebral injury.

BACKGROUND:Studies have shown that human umbilical cord mesenchymal stem cel s can improve pulmonary ventilation function by reducing inflammations. OBJECTIVE:To observe the therapeutic effect of human umbilical cord mesenchymal stem cel transplantation on acute lung injury. METHODS:Thirty Sprague-Dawley rats were randomized into normal group, model group and experimental group. Rats in the latter two groups were used to establish animal models of acute lung injury by intratracheal instil ation of lipopolysaccharide. One hour after modeling, rats in the experimental group were intratracheal y administered human umbilical cord mesenchymal stem cel suspension (0.1 mL, 1×106 cel s), and those in the other two groups were given normal saline in the same dose intratracheal y. Twenty-four hours after treatment, the pathological changes of lung tissue were observed using hematoxylin-eosin staining;the wet and dry weight ratio of the lung tissue and the levels of serum interleukin-1 and interleukin-8 were detected. RESULTS AND CONCLUSION:Compared with the normal group, the wet and dry weight ratio of the lung tissue and the levels of serum interleukin-1 and interleukin-8 were significantly increased in the model group (P<0.05), while compared with the model group, these levels were significantly decreased in the experimental group (P<0.05). Hematoxylin-eosin staining results showed clear alveolar space structure with complete alveolar septum in the normal group. In the model group, the alveolar septum was markedly thickened, and there was visible pulmonary capil ary hyperemia, edema, as wel as a large amount of inflammatory cel infiltrations in the pulmonary capil aries and alveolar space. Edema fluid rich in proteins was observed in a part of the pulmonary alveoli, and an extensive transparent membrane formed in the alveolar space. In the experimental group, the alveolar structure was clear, but the alveolar septum became thickened, and red blood cel s and a smal amount of infiltrated inflammatory cel s were leaked from the pulmonary interstitial tissue. In conclusion, human umbilical cord mesenchymal stem cel transplantation for treatment of acute lung injury can reduce inflammatory factor levels and al eviate lung injury.

Objective To evaluate intrasinusal pyelolithotomy for giant staghorn calculi. Methods The data of 22 cases treated with intrasinusal pyelolithotomy were analysed. Results Lithotomy was successful in all cases with the average operation time 116 minutes.Blood transfusion during the procedure was required in 8 cases with an everage of 550 ml.Postoperative examination of 12 cases with B ultrasound revealed residual calculus in 3,the diameters being less than 0.8 cm. Conclusions The procedure for giant staghorn calculi was easy,safe,and effective with renal parenchyma intact.