Objective To explore the clinical effect and feasibility of cold cycle microwave ablation combined with laparoscopic hepatectomy for hepatic hemangioma.Methods Thirteen cases of hepatic hemangiomas were treated with cold cycle microwave ablation combined with laparoscopic hepatictomy,and their clinical data were analyzed retrospectively from March 2015 to October 2017 in the First People's Hospital of Jiangxia District of Wuhan City,including 5 males and 8 females with an average age of 52 years and age range of 45-68 years.The course of disease was 18 months to 8 years,with an average of 4.2 years.The clinical data were retrospectively analyzed and the operation time,intraoperative blood loss,postoperative hospital stay,liver function changes and complications were recorded.The data were analyzed using SPSS 17.0 statistical software,and measurement data with normal distribution were expressed as mean ± standard deviation (Mean ± SD).Results The operations of the 13 cases were successful,including 7 cases of single hepatic hemangioma (the lesions were located in segments 11,111 and Ⅳ) and 6 cases of multiple hepatic hemangioma (the lesions were located in segments Ⅱ,Ⅲ,Ⅳ,Ⅶ and Ⅷ).No hepatic portal occlusion was performed during the operation.The operation time was (135.4 ± 35.8) min,intraoperative blood loss was (95.2 ± 22.7) ml,the postoperative hospital stay was (6.4 ± 0.8) d.On the first postoperative day,alanine aminotransferase was (354.2 ± 75.4) IU/L,and aspartate aminotransferase was (382.7 ± 68.5) IU/L,during the first week after surgery,alanine aminotransferase and aspartate aminotransferase both decreased to the normal range,and no serious complications such as bile leakage or hemorrhage occurred after surgery.No recurrence was observed after 6 to 12 months of follow-up.Conclusions Under the premise of strict control of surgical indications,laparoscopic cold-circulation microwave ablation combined with hepatectomy for hepatic hemangioma is safe and feasible.It can simultaneously treat multiple lesions,and cold-cycle microwave ablation can effectively reduce intraoperative bleeding with a minimally invasive effect.

Objective To analyze the magnetic resonance imaging (MRI) of the spinal cord and clinical characteristics in patients with autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy.Methods A total of 1 040 samples of cerebrospinal fluid (CSF) and sera collected in the Second Affiliated Hospital of Guangzhou Medical University from March 2013 to June 2018 were tested with tissue-and cell-based assays,and 42 patients were found positive for GFAP-IgG.The clinical data and MRI characteristics of the spinal cord of 19 patients who were positive for GFAP-IgG in CSF with autoimmune GFAP astrocytopathy and lesions in the spinal cord were retrospectively reviewed.Results There were 12 females and seven males among the 19 patients,with onset age of (44±17) years.The main manifestations of these patients included limb weakness (14/19),abnormal vision (5/19),headache (4/19),seizure (4/19),dementia (3/19),etc.On MRI of the spinal cord,five patients showed involvement in the cervical cord alone,eight showed involvement in the thoracic cord alone and six had both cervical and thoracic segment involvement.Fifteen patients had longitudinally extensive myelitic abnormalities (≥3 vertebral segments long).Seven enhancement patterns were encountered.Lesions were displayed in the spinal cord and brain in eight patients.Central gray matter involvement in the spinal cord was found in all the 19 patients.Conclusions Autoimmune GFAP astrocytopathy more frequently presents in females than in males.MRI of the spinal cord has complex presentations and longitudinally extensive myelitic abnormalities usually.Patients often show central gray matter involvement in the spinal cord.Myelitic abnormalities present more often in thoracic segment than in cervical segment.Abnormalities in lumbar segment are less encountered.

Objective Our study aimed to delineate the clinical and radiological features of patients with anti-myelin oligodendrocyte glycoprotein antibody (MOG-Ab)positive neuromyelitis optica spectrum disorder (NMOSD). Methods Fifty-seven patients with NMOSD and 29 patients with multiple sclerosis (MS) were collected. Data on clinical and radiological features of MOG-Ab positive patients with were analyzed retrospectively. Results MOG-Abs were present in 9/57 (15.8%) NMOSD patients and 2/29 (6.9%) MS patients. Both MOG and aquaporin-4 (AQP4) antibodies were positive in one case of NMOSD. There was no significant difference between the two groups (P＞0.05). There were more females than males having MOG-Ab positive NMOSD (females: males=7:1) and the average onset age was 41.4 ± 11.5 years. There was no significant difference in gender and age between MOG-Ab negative and AQP4-Ab positive groups(P＞0.05). The durations of disease were significantly shorter in either MOG-Ab positive NMOSD patients or MOG-Ab negative NMOSD patients than in AQP4-Ab positive group (P<0.05). Recurrence was the main disease pattern of all three groups and the frequency of recurrence was not significant different among three groups (P＞0.05). The incidence of optic neuritis was 62.5% in NMOSD patients with MOG-Ab positive and 43.5% in AQP4-Ab positive NMOSD patients (P＞0.05). There was no significant difference in the morphology and location of brain lesions among the three groups (P＞0.05). MOG-Ab positive NMOSD patients had long segment spinal cord lesions. The median length of the spinal cord lesions in the MOG-Ab positive group was similar to the other two groups (P＞0.05). Conclusions MOG-Ab positive NMOSD patients have higher proportion of females with shorter recurrence course, more likely complicated with optic neuritis. And the radiological features of brain and spinal cord were not specific to patients with AQP4-Ab positive.

Objective To compare the effects of standard decompressive craniectomy (DC) vs.combined cisternostomy on severe traumatic brain injury (STBI).Methods Seventy-two patients with severe brain injury were divided into standard decompressive craniectomy group (control group,n=34) and DC combined cisternostomy group (treatment group,n=38).The clinical parameters from pre-and post-surgery were compared between the two groups.Results There was no statistical difference in clinical data including gander,age,injury causes,GSC score,Helsinki CT score and operative opportunity between two groups before surgery (P＞0.05).The treatment group was inferior in the duration of decompression (2.8±0.4 h vs.2.5±0.3 h,P＜0.05) relative to control treatment group.However,treatment group were superior to control group in the mean time of admission in neuro-intensive care unit (5.54±3.09 d vs.7.24±2.74 d,P＜0.01),the cumulative time of intracranial pressure (ICP) more than 20 nmHg within seven days after surgery(23.2±4.4 h vs.56.8±8.3 h,P＜0.01),Helsinki CT scores at postoperative day (3(2,5) vs.5(2,9),P＜ 0.01)and Glasgow Outcome Scores (GOS) at 3 month after surgery (P＜0.01).Conclusion DC combined with cisternostomy for STBI is significantly better than standard decompressive craniectomy,which is worth further study by multicenter clinical trials.

Objective To systematically evaluate the correlation between selective dipeptidyl peptidase (DPP)-4 inhibi-tor ,vildagliptin and risk of arthralgia/osteoarthritis .Methods The following databases of PubMed (1978 to February 2016) , the Cochrane Library (Issue 4 ,2015) ,EMbase (1974 to February 2016) ,CBM(1978 to February 2016) ,CNKI(1978 to Feb-ruary 2016) ,VIP(1989 to February 2016) were searched .The randomized controlled trials (RCTs) for vildagliptin related ar-thralgia/osteoarthritis were assessed using the Cochrane Collaboration system .The meta-analysis was performed with RevMan 5 .3 software .Results Ten RCTs were included .Meta-analysis showed that vildagliptin had higher risk of arthralgia/osteoar-thritis than other oral hypoglycemic agents or placebo (RR=1 .24 ,95% CI 1 .08 to 1 .44 ,P=0 .003) .Further analysis indica-ted that patients received different doses of vildagliptin had higher risk of arthralgia/osteoarthritis than the placebo group (RR=1 .35 ,95% CI 1 .02 to 1 .78 ,P=0 .04) .In particular ,the group who took vildagliptin 50mg once daily had significantly higher risk of arthralgia/osteoarthritis than the placebo group (RR=3 .04 ,95% CI 1 .44 to 6 .44 ,P=0 .004) .In comparison of other oral hypoglycemic agents ,the vildagliptin group had higher risk of arthralgia /osteoarthritis (RR=1 .19 ,95% CI 1 .01 to 1 .41 ,P=0 .04) .Conclusion Based on the Meta-analysis results ,vildagliptin increases the risk of arthralgia/osteoarthri-tis .Especially vildagliptin 50mg once daily had two times higher risk than the placebo group .However the long-term safety of vidagliptin still needs to be confirmed by RCTs with larger samples and long term follow-up .

Objective To evaluate the effects of rheumatoid arthritis treated with modified Duhuo-Jisheng decoction and western conventional treatment. Methods 120 patients with heumatoid arthritis of our hospital from January 2010 to 2013 August were recruited and randomly divided into a treatment group and a control group, 60 patients in each group. The control group was treated with oral intake of Methotrexate, Sulfasalazine and Meloxicam in acute stage and oral intake of diclofenc in stable stage, while the treatment group was further added modified Duhuo-Jisheng decoction on the basis of the control group. TCM symptom score, arthritis symptom score, symptomatic relief time, ESR, CRP, RF were observed after 3 months’ treatment. Results After 3 mouths’ treatment, the total effective rate was 90.0%(54/60) in the study group and 70.0%(42/64) in the control group. There was no significant difference(χ2=4.193,P<0.05) between the two groups. CRP,ESR, RF[The treatment group respectively(22.06±10.31)mg/L, (25.18±17.80)mm/h, (28.19±4.17)IU/L,the control group respectively (14.11±7.32)mg/L, (24.16±22.09)mm/h, (36.08±5.24)IU/L]decreased after the treatment in both groups compared with the values before the treatment[The treatment group respectively (82.16± 21.37)mg/L, (68.84±9.71)mm/h, (84.92±15.31)IU/L,the control group respectively (52.46±22.26)mg/L, (62.72±33.31)mm/h, (85.17±14.23)IU/L, P<0.01],while the decrease of CRP in the treatment group was much obvious than the control group(P<0.05),but the change of ESR had no statistical significance between the two group after the treatment(P>0.05);Number of joint tenderness, The number of swollen joints, Time of morning stiffness, Dual hands grip strength , 20 m walking time decreased obviously in both groups after the treatment[After the treatment, the treatment group respectively (3.43 ± 1.46), (2.95 ± 1.35), (19.32 ± 16.54)min,(79.35±22.14)mmHg,(19.32±4.81)s,the control group respectively (4.63±4.21), (3.55±2.47), (21.23 ± 19.37)min,(77.81 ± 16.22)mmHg,(25.15 ± 5.81)s before the treatment, the treatment group respectively(10.71±5.12), (7.95±3.97), (109.32±68.52)min, (47.12±18.22)mmHg, (36.21±6.62)s, the control group respectively (11.54±5.32), (7.64±4.01), (96.02±58.39)min, (49.67±16.48)mmHg, (36.33± 7.23)s](P<0.05). Conclusion Duhuo-Jisheng decoction could effectively improve the clinical symptoms of aged patients with osteoporosis and reduce the levels of their ESR, CRP, and RF.

Objective To explore the application value of detection of Mycoplasma,Chlamydia and anti-sperm antibodies for male infertility.Methods Culture method,immune chromatography,and enzyme linked immunosorbent assay were adopted for the detection of Mycoplasma,Chlamydia,and anti-sperm antibodies respectively in 102 cases of infertile males and 42 cases fertile males.And the routine semen analysis was proceed as well.All the subjects were divided into 4 groups according to the detection re-sults:simple Mycoplasma or/and Chlamydia positive group(71 cases),simple anti-sperm antibodies positive group(21 cases),My-coplasma and Chlamydia or/and anti-sperm antibodies positive group(8 cases),Mycoplasma,Chlamydia and anti-sperm antibodies negative group(44 cases).The main indexes of semen routine were compared among 4 groups.Results The positive rates of Myco-plasma,Chlamydia and anti-sperm antibodies in infertile males were significantly higher than those of fertile males (P <0.05).The sperm densities,activity rates,activity of simple Mycoplasma or/and Chlamydia positive group,simple anti-sperm antibodies posi-tive group,and Mycoplasma and Chlamydia or /and anti-sperm antibodies positive group were significantly lower than the nega-tive group,while the sperm malformation rates,liquefaction times,white blood cell counts of the three groups were significantly higher than the negative group(P <0.05 ).Conclusion Mycoplasma,Chlamydia infection and anti-sperm antibodies production have significant effect on the indexes of semen,which cause decline in semen quality and the occurrence of male infertility.

Objective To analyze the clinical distribution and drug resistance of Staphylococcus aureus isolated from the speci‐mens of inpatient and outpatient in 2013 .Methods All of the isolated Staphylococcus aureus were identified and tested drug sensi‐tivity in 2013 ,and the results were analyzed .Results 286 strains of Staphylococcus aureus were isolated with the detection rate of MRSA accounting for 46 .9% .The respiratory specimens had the highest detection rates of Staphylococcus aureus and MRSA .The isolated strains of Staphylococcus aureus were mainly distributed in ICU ,Department of Neurosurgery ,Department of Orthopedic trauma ,and Department of Respiratory Medicine .The isolated Staphylococcus aureus had high drug resistant rates to penicillin and ampicillin .The drug resistant rates of most of the drugs were different between MSSA and MRSA .Conclusion Monitoring the drug resistance of Staphylococcus aureus is very important to rational choice of antimicrobial agents .

Background and purpose:Colorectal serrated adenoma (SA) was ofifcially named in 2000 by the WHO as a separate disease, with unique properties compared with traditional adenoma (TA), and its relationship with colorectal cancer (CRC) is very concerned. This study was to analyze and compare the telomerase, p53 and Ki-67 immunohistochemical expression on the tissues of SA, TA and CRC. Methods:Immunohistochemistry was adopted to analyze the expression of telomerase, p53, and Ki-67 in 37 cases of SA, 36 cases of TA and 34 cases of CRC. Results:The p53-positive percentage of SA was signiifcantly lower than that of TA (P<0.01), and the p53-positive percentage of TA was signiifcantly lower than that of CRC (P<0.01). No signiifcant difference of Ki-67 expression was found between SA and TA, and the Ki-67-positive percentage of SA and TA was lower than that of CRC (P<0.01). The telomerase-positive percentage of TA was signiifcantly lower than that of SA (P<0.01), and the telomerase-positive percentage of SA was signiifcantly lower than that of CRC (P<0.05). Conclusion:Telomerase, P53, and Ki-67 immunohisto chemical analysis indicated that SA is a kind of proliferative adenoma, and telomerase activation may play a role in the cancer process.

Proceeding from the requirements of teaching target for postgraduate students,the course of progress in pathophysiology was constructed and administrated.The course objective was defined which combined teaching knowledge with fostering students' ability together,especially the ability to think new ideas and to do scientific research.Aiming at this teaching target,the teaching contents which combined with the direction of scientific research of the department was growing together with scientific development,especially in new knowledge and new technique.Multiple teaching means and several mode of examine were adopted during the process of teaching practice.