Objective To study the surgical techniques and clinical experience of the total laparoscopic splenectomy .Methods Retrospective analysis 31 cases were performed laparoscopic splenectomy from January 2003 to April 2015 .Among them ,there were 12 cases with liver cirrhosis and hypersplenism ,5 cases with spleen hemangiomatosis ,3 cases with splenic lymphoma ,3 cases with splenic cyst ,2 cases with obsolete rupture of spleen hematoma ,6 cases with idiopathic thrombocytopenia .During surgery ,Li‐gaSure was used to deal with stomach ligament splenic artery .Using silk or endoscopic linear cutters to process splenic pedicle indi‐vidually .Results All operations were performed successfully without conversion to open surgery .13 patients were cutting off splenic pedicle by ligating of splenic portal blood vessel and 18 patients were using endoscopic linear cutters .The operation time was 80-240 min ,mean (130 ± 35)min ,the blood loss was 60-500 mL ,mean (150 ± 80)mL ,hospital stay was 8 .3 days .There was no mortality and pancreatic leakage complications .Conclusion On the basis of open surgery ,evaluating carefully before operation ,se‐lecting appropriate cases ,using different laparoscopic instruments ,handling splenic pedicle individually ,can make the laparoscopic splenectomy be a more safe and useful operation modality .

Objective Researches have demonstrated that hyperbaric oxygen therapy (HBOT) could quickly elevate levels of nitric oxide (NO) in patients with ischemic stroke.By meta-analysis,this paper attempts to explore the efficacy of HBOT in patients with ischemic stroke.Methods Related literature was retrieved through the access of PUBMED,CNKI,EMBASE databanks from the inception to 2014-08-01,and controlled studies of patients treated with HBO and those treated with routine therapy were chosen from the retrieved literature,and then results of the meta-analysis were used to evaluate changes in the NO levels of ischemic stroke patients treated with HBO (the HBO group) and routine treatment (the sham group).Results There were 5 papers that were conformed to our selection criteria,with a total of 352 cases included.The meta-analysis showed that the odd ratio (OR) of NO levels for the patients in the HBO group and those of the sham group were respectively [4.921 (95％ CI was 1.983-12.213)].It was indicated that the NO level of the patients in the HBO group could obviously be elevated following HBO therapy,and was 4.921 times higher than that of the routine therapy group.Conclusions Present evidences indicated that HBO promised to have good clinical application in the treatment of patients with ischemic stroke,and was worth further clinical trial.

Objective Researches have demonstrated that hyperbaric oxygen therapy (HBOT) could quickly elevate levels of nitric oxide (NO) in patients with ischemic stroke.By meta-analysis,this paper attempts to explore the efficacy of HBOT in patients with ischemic stroke.Methods Related literature was retrieved through the access of PUBMED,CNKI,EMBASE databanks from the inception to 2014-08-01,and controlled studies of patients treated with HBO and those treated with routine therapy were chosen from the retrieved literature,and then results of the meta-analysis were used to evaluate changes in the NO levels of ischemic stroke patients treated with HBO (the HBO group) and routine treatment (the sham group).Results There were 5 papers that were conformed to our selection criteria,with a total of 352 cases included.The meta-analysis showed that the odd ratio (OR) of NO levels for the patients in the HBO group and those of the sham group were respectively [4.921 (95％ CI was 1.983-12.213)].It was indicated that the NO level of the patients in the HBO group could obviously be elevated following HBO therapy,and was 4.921 times higher than that of the routine therapy group.Conclusions Present evidences indicated that HBO promised to have good clinical application in the treatment of patients with ischemic stroke,and was worth further clinical trial.