Network Analysis of Meaning in Life and Coping Styles among College Students / 中国医学伦理学

【Objective:】 To explore the network structure characteristics and core items of meaning in life and coping styles among college students, and provide a basis for understanding their relationships and related interventions. 【Methods:】 A survey was conducted among college students using the Simplified Coping Style Questionnaire and Meaning in Life Questionnaire . The network analysis method was used to construct a network of college students’ meaning in life and coping styles, and R software was used for statistical analysis and visualization. 【Results:】 In the network of college students’ meaning in life and coping styles, "believing that time will change the status quo, and the only thing to do is to wait" and "trying to forget the whole thing" had the closest connection. "Learning from others to handle similar difficult situations" had the highest expected impact. "Seeking the meaning in life" and "pursuing hobbies and actively participating in cultural and sports activities" had the highest bridge expected influence. The average predictability value of all nodes was 0.775. 【Conclusions:】 Interventions aimed at "learning from others to handle similar difficult situations", "changing one’s own ideas and rediscovering what is important in life" and "changing some of the original practices or problems" may maximize the coping effect of college students. "Seeking the meaning in life" can furthest influence the coping styles, and "pursuing hobbies and actively participating in cultural and sports activities" can maximize the improvement of meaning in life.

Heart sound model based on DenseNet121 architecture for diagnosis of aortic stenosis: A prospective clinical trial / 中国胸心血管外科临床杂志

@#Objective     To identify the heart sounds of aortic stenosis by deep learning model based on DenseNet121 architecture, and to explore its application potential in clinical screening aortic stenosis. Methods      We prospectively collected heart sounds and clinical data of  patients with aortic stenosis in Tianjin Chest Hospital, from June 2021 to February 2022. The collected heart sound data were used to train, verify and test a deep learning model. We evaluated the performance of the model by drawing receiver operating characteristic curve and precision-recall curve.  Results     A total of 100 patients including 11 asymptomatic patients were included. There were 50 aortic stenosis patients with 30 males and 20 females at an average age of 68.18±10.63 years in an aortic stenosis group (stenosis group). And 50 patients without aortic valve disease were in a negative group, including 26 males and 24 females at an average age of 45.98±12.51 years. The model had an excellent ability to distinguish heart sound data collected from patients with aortic stenosis in clinical settings: accuracy at 91.67%, sensitivity at 90.00%, specificity at 92.50%, and area under receiver operating characteristic curve was 0.917.   Conclusion     The model of heart sound diagnosis of aortic stenosis based on deep learning has excellent application prospects in clinical screening, which can provide a new idea for the early identification of patients with aortic stenosis.

Expression of miR-4783-3p in hepatocellular carcinoma tissue and its effect on the proliferation and migration of hepatocellular carcinoma cells / 国际外科学杂志

Objective:To study the expression of microRNA (miRNA)-4783-3p in liver cancer tissue and its effect on the proliferation and migration of liver cancer Huh-7 cells.Methods:The cBioPortal database was used to analyze the expression of miR-4783-3p in liver cancer tissues and adjacent tissues. In strict accordance with the instructions of Lipofectamine? 2000 transfection kit, miR-4783-3p overexpression mimics or overexpression control mimics were transfected into Huh-7 cells respectively, namely overexpression group and control group. The proliferation of Huh-7 cells was analyzed by CCK-8 assay, and the migration of Huh-7 cells was analyzed by cell scratch method. The targeting relationship between miR-4783-3p and insulin-like growth factor binding protein 2 ( IGFBP2) mRNA was detected by dual-luciferase reporter gene assay. RT-qPCR was used to detect the expression of IGFBP2 mRNA. Western-blotting was used to detect the expression of IGFBP2 protein and EGFR-STAT3 molecular pathway proteins. Results:The expression of miR-4783-3p in liver cancer tissues was significantly lower than that in adjacent tissues ( P<0.01). Compared with the control group, the proliferation ability of Huh-7 cells in the overexpression group was significantly decreased ( P<0.05). The scratch healing rates of Huh-7 cells in the control group and the overexpression group were (67.71±9.04)% and (29.58±10.51)%, respectively, and the scratch healing rate in the overexpression group was significantly lower ( P<0.01). miR-4783-3p targeted and bound to IGFBP2 mRNA ( P<0.01). The expression of IGFBP2 mRNA in the control and overexpression groups was 5.76±1.44 and 0.99±0.47, respectively, and miR-4783-3p negatively regulated the expression of IGFBP2 mRNA ( P<0.01). Compared with the control group, the expressions of IGFBP2 protein and EGFR-STAT3 molecular pathway protein were decreased in the overexpression group. Conclusions:miR-4783-3p is lowly expressed in liver cancer tissues. miR-4783-3p can attenuate the proliferation and invasion ability of liver cancer Huh-7 cells by inducing the low expression of IGFBP2 gene.

Paleo-polyploidization in Lycophytes / 基因组蛋白质组与生物信息学报·英文版

Lycophytes and seed plants constitute the typical vascular plants. Lycophytes have been thought to have no paleo-polyploidization although the event is known to be critical for the fast expansion of seed plants. Here, genomic analyses including the homologous gene dot plot analysis detected multiple paleo-polyploidization events, with one occurring approximately 13-15 million years ago (MYA) and another about 125-142 MYA, during the evolution of the genome of Selaginella moellendorffii, a model lycophyte. In addition, comparative analysis of reconstructed ancestral genomes of lycophytes and angiosperms suggested that lycophytes were affected by more paleo-polyploidization events than seed plants. Results from the present genomic analyses indicate that paleo-polyploidization has contributed to the successful establishment of both lineages-lycophytes and seed plants-of vascular plants.

Ultrasound-guided percutaneous ethanol injection combined with microwave ablation for treating liver cancer in special site after TACE / 中国介入影像与治疗学

Objective To explore the safety and efficacy of ultrasound-guided percutaneous ethanol injection (PEI) combined with microwave ablation for treating early- and middle-stage primary liver cancer in special site, i.e. tumors adjacent to gallbladder, dome of diaphragm, heart, gastrointestinal tract, kidney or blood vessels (with the shortest distance to the vital organ/tissue ≤0.5 cm). Methods One week after TACE, 40 patients with early- or mid-stage primary liver cancer in special sites were treated with ultrasound-guided PEI combined with microwave ablation. Absolute ethanol was injected into the tumor from the side near the vital organ/tissue. Then microwave ablation was performed with low power (40-50 W) and short time (4-5 min). After operation, the adverse reactions and complications were observed, and the efficacy was evaluated during following-up. Results There was no serious adverse reaction nor complication after treatment, only abdominal pain (17/40, 42.50%), fever (15/40, 37.50%), nausea and vomiting (12/40, 30.00%) were observed, and the patients then recovered after symptomatic treatment. A small amount of pleural effusion was found in 2 patients, and then gradually disappeared. One month after discharge, the complete ablation rate of tumor was 97.50% (39/40). Local tumor recurrence was noticed in 4 patients during 12 months' following-up. Conclusion Ultrasound-guided PEI combined with microwave ablation is safe and effective for treatment of early-and middle-stage primary liver cancer in special sites.

Effect of welding operations on the health status of workers with low working age / 中华劳动卫生职业病杂志

Objective@#To explore the impact of welding operations on the health status of workers with low working age, and provide a basis for occupational health risk assessment for workers of low working age.@*Methods@#Used the method of cluster sampling to randomly selected workers from an automobile manufacturing plant in Guangzhou as research subjects: 982 workers with welding posts of 1 year ≤working age ≤5 years were welding groups, 707 workers with simple exposure noise of 1 year ≤working age ≤5 years were assembly groups, and 717 workers in pre-job medical examinations were pre-job groups from June 2017 to September 2018. Then conducted occupational health checks on all subjects, investigated and detected the occupational hazards in welding posts and assembly posts.@*Results@#There was no statistical difference between the noise over-standard rate of welding posts' (59.3%, 16/27) and the assembly posts' (47.4%, 9/19) (P>0.05) . The over-standard rate of welding fume, manganese and its inorganic compounds in welding posts was 11.11% (3/27) . The results of occupational health examination showed that the detection rate of disease or abnormal of the welding group was 78.4% (770/982) higher than 70.2% (496/707) in the assembly group and 53.0% (380/717) in the pre-job group (the value of 2 were 14.92 and 122.37, respectively, P<0.05) . The rate of hearing loss of the assembly group and the welding group were 14.7% (104/707) and 19.3% (190/982) , respectively, which was higher than that of the pre-job group (10.5%, 75/717) , and the hearing loss rate gradually increased with the increase of working age (the value of linear-by-linear association were 12.04 and 44.67, respectively, P<0.01) . Compared with the hearing loss rate of each working age of the assembly group, the hearing loss rate of each working age of the welding group was higher, and when the working age was 3 years, the risk of hearing loss in the welding group was 2.70 times that of the assembly group (P<0.01) . The rate of pulmonary dysfunction in the welding group was 19.2% (189/982) higher than that in the pre-job group (12.6%, 90/717) , and it increased with the increase of working age (the value of linear-by-linear association was 15.97, P<0.01) .@*Conclusion@#Welding work seriously damages the health of workers with low working age, increases the hearing loss of workers and the occurrence of pulmonary dysfunction; manganese and its compounds increases noise-induced damage to the hearing system.

The feasibility study of stroke volume variability for evaluating ventilation-volume of one lung ventilation in patients with elderly coronary heart disease / 中华老年医学杂志

Objective To observe the relationship between Flo Trac/Vigileo monitor-assessed stroke volume variability(SVV) and changes in ventilation volume during one lung ventilation(OLV),and to evaluate the feasibility of SVV reflecting changes in lung ventilation volume during OLV in patients with elderly coronary heart disease.Methods A total of 40 patients with ASA grade Ⅱ or Ⅲ,aged 60-82 years,undergoing elective thoracoscopic surgery were enrolled in this study.A doublelumen endobronchial tube was inserted,and 6％ hydroxyethyl starch(HES 130/0.4)was infused intravenously for five dosage-infusion-stage of(T0)2 ml/kg,(T1)4 ml/kg,(T2)6 ml/kg,(T3)8 ml/kg,(T4)10 ml/kg.And the infusion was suspended until starting next infusion stage.After the data reached the stability,the mean arterial pressure(MAP),heart rate(HR),central venous pressure (CVP),cardiac output(CO)and SVV were recorded.The test was stopped after stage of(T4)10 ml/kg.Then,we observed and analyzed the changes of MAP,HR,CVP,CO and SVV at different time points.Results The statistically significant difference was not found in MAP(F =2.089,P =0.130),but was definitely found in SVV,HR,CO and CVP between five different time points(F =23.380,15.205,14.990,4.726,P=0.000,0.060,0.000 and 0.001,respectively).SVV(％) was 12.6 ± 1.8 at T0,10.7 ± 1.7 at T1,9.7 ± 1.3 at T2,8.6 ± 1.2 at T3,7.8 ± 1.2 at T4,with a gradually decreased trend(P =0.000,0.000,0.042,0.033,between any two adjacent time points,respectively).While CVP had no significant difference between any two adjacent time points (P =0.093,0.161,0.261 and 0.051,respectively).HR was lower in T1 vs.in T0,and in T2 vs.in T1 (P =0.015 and 0.028,respectively).There was no significant difference in HR between the other time points (P =0.149 and 0.335,respectively).The CO was higher at T4 than at T3(P =0.005),and there was no significant difference among any other time points(T0 vs.T1,T1 vs.T2,T2 vs.T3,P =0.547,0.441 and 0.400,respectively).In Spearman correlation analysis,the amount of HES infusion was positively correlated with MAP(r =0.921,P =0.021),negatively correlated with SVV and HR(r =-0.988,-0.984,P=0.001,0.002,respectively),and not correlated with CVP and CO(r =0.872 and 0.871,P =0.054 and 0.055,respectively).Conclusions SVV can effectively evaluate the volume responsiveness in elderly CHD patients with OLV.

A cross-sectional study of supervision in Shanghai mental health service industry / 中国心理卫生杂志

Objective:To understand the status of supervision of mental health service industry in Shanghai, and to provide reference for further strengthening the construction of mental health service system in Shanghai. Methods: In Shanghai, 107 mental health service agencies (including psychiatric institutions, non-specialist medical institutions, non-specialist enterprise and public institutions, social institutions) were selected from Shanghai psychological service industry association. The survey was conducted with the Questionnaire on Current Situation of Mental Health Professional Service Agencies in Shanghai (agency survey), including the "relevant information of agency" and the "management of the agency in the field of mental health services"(whether the agency had supervision requirements on the mental health service personnel, whether the agency organized supervision, the source of supervisors and payment method), and the Questionnaire on Current Situation of Mental Health Service Professionals in Shanghai (professional survey), including "basic information on demography "and" psychological professional work" (the number of hours of supervision in 2015, the cost of supervision, and the form of supervision and payment method). These two parts of questionnaire were selected and analyzed. Results: Agency survey results showed that 80％ of non-specialist enterprises had no supervision requirements for mental health service personnel, supervisor in non-specialist medical institutions were mainly from psychiatric institution (52.9％). The cost of supervision in most psychiatric institutions was paid by the agency (39.1％) and the cost of supervision in most public institutions was paid by professional (37％). The professional institutions under the jurisdiction of other departments within the unit required less supervision of the professional staff than the independent institutions (P ＜ 0.001). Professional survey results showed that the number of supervision hours of mental health service professional in social institutions was more than that in the other three types of institutions (P ＜0.001), of which 47.9％ chosen to pay the cost of supervision by themselves. The proportion of their own payment in social institutions was higher than that in the other three types of institutions (P ＜0.001). Conclusion:The social institutions in Shanghai have the best supervision of social institutions, followed by the supervision of the medical institutions. The supervision of non-medical enterprises and their personnel needs to be improved.

Development of mental health service agencies in Shanghai / 中国心理卫生杂志

Objective:To investigate the development status of mental health service of Shanghai mental health agencies,and to provide reference for further strengthening the standardized management of service agencies.Methods:In Shanghai,107 mental health service agencies (including psychiatric institutions,non-specialist medical institutions,non-specialist enterprise and public institutions,social institutions) were selected from Shanghai psychological service industry association.Each person in charge of these agencies was interviewed with an adapted 5 l-item questionnaire.A total of 89 valid questionnaires were collected.In this study,25 items of the questionnaire (belonging to the parts of agency information,mental health service situation and management of mental health service) were selected and analyzed.Results:All the surveyed agencies had been registered.The average age of these agencies for setting up mental health service was 8.9 years,and the average age of psychiatric institutions was the longest (18.6 years).Besides,psychiatric institutions attracted most of the clients (83.9％) in 2015.Among the professionals,only 32.5％ were full time,74.0％ were female,41.5％ were between 31 and 40 years old and 63.8％ were undergraduates.Psychiatrists,psychotherapists,counselors and psychometric person accounted for 78.0％ of the professionals in these agencies.Only 52.3％ of the agencies had full-time management personnel for mental health service.The most used method of assessing the quality of service and staff assessment was to obtain feedback from the client/family members (81.0％) and the assessment of the services (78.8％).Conclusion:The development of mental health service in Shanghai mental health agencies has been more normalized,but there is still a lack of full-time professionals.In addition,there is a lack of unified supervision and management mechanism for professionals.

The effectiveness of modified radical mastectomy combined with radioactive particle implantation in the treatment of patients with advanced breast cancer / 中华老年医学杂志

Objective To explore the effectiveness of modified radical mastectomy combined with radioactive particle implantation in treating advanced breast cancer.Methods A total of 106 patients diagnosed with advanced breast cancer at our hospital from January 2012 to July 2014 were included in this study and were randomly divided into an intervention group (n=53),in which patients were treated with modified radical mastectomy combined with radioactive particle implantation,and a control group (n=53).in which patients received modified radical mastectomy alone.Rates of 1-and 3-year survival,over 1 year local control,disease recurrence,and post treatment complications were recorded and compared between the two groups.Results There was no difference in 1-and 3 year survival rates between the two groups (both P＞0.05).The over 1-year local control rate of cancer in the intervention group (92.5％) was higher than in the control group (77.4％) (x2=4.7111,P=0.030).The disease recurrence rate within 1 year in the intervention group (9.4％) was lower than that in the control group (24.5％) (x2 =4.2828,P =0.0385).The rate of post-treatment complications in the intervention group (11.3 ％) was significantly lower than in the control group (26.4 ％) (x2 =3.9442,P =0.0470).Conclusions Radical mastectomy combined with radioactive particle implantation not only helps to improve the local control rate of patients with advanced breast cancer,but also significantly reduces the recurrence rate of disease and the incidence of complications.

Analysis on influence factors of autologous peripheral blood stem cell mobilizationand collection in 48 patients with non-Hodgkin′s lymphoma / 重庆医学

Objective To retrospectively analyze the influence factors during autologous peripheral blood stem cell (PBSC) mobilization and collection process in the patients with non-Hodgkin′s lymphoma (NHL).Methods Forty-eight patients with NHL in our hospital from January 2014 to August 2016 underwent PBPC mobilization and collection.The factors of age,sex,disease stage,bone marrow involvement at diagnosis,chemotherapy frequency,relapse and so on were analyzed retrospectively.Results PBSC mobilization and collection was successful in 37 cases (77.10%).The success rate was affected by the time from diagnosis to mobilization (P=0.038),chemotherapy courses (P=0.016),prior chemotherapy including fludarabine (P=0.049),relapse(P=0.033),and the levels of white blood cell (P=0.014) and platelet (P<0.01) before stem cells collection.Conclusion For the patients planning to receive autologous peripheral blood stem cell transplantation,many times of prior chemotherapy are unfavorable,mobilization and collection should be taken as early as possible,chemotherapeutic agents which possibly injure stem cells should be avoided,it is needed to simultaneously pay attention to peripheral blood WBC and platelet level for determining the collection timing.

Exploration of multi-supervisors system for graduates of clinical medcine during the rotating course in hematology department / 中华医学教育探索杂志

Single-supervisor system is the widespread practice for graduates of clinical medicine at present. But in terms of education to clinical medical graduate students, students rotate in the departments of various disciplines for a long time, and there are more rotary department, resulting in some students' unbalanced learning development. Combined with the charac-teristics of the department of hematology, multi-supervisors training model was carried out to the rotating masters of other disciplines when they rotated in hematology department. With supervisor equipment and teaching implementation, we applied the principle of integrating theory with practice and trained students' innovation ability and doctor-patient communication ability. Compared with traditional single supervisor training pattern, multi-supervisors system can effec-tively improve the students' theoretical level, practical skills and comprehensive ability when the clinical medical graduate students rotate in the department of hematology.

Symptom dimensions and the different impairments of quality of life in patients with obsessive-compulsive disorder / 中华行为医学与脑科学杂志

Objective To investigate the difference of quality of life in patients with different symptom dimensions of obsessive-compulsive disorder(OCD).Methods Collected 54 cases of outpatient and the first inpatient with OCD to be the research group and 54 normal persons were the control group.The quality of life was assessed with SF-36,and compared the scores.An analysis was performed on the major categories of the YBOCS-SC to derive symptom dimension scores.Results Compared to the control group,patients with OCD showed significant impairment in seven domains of quality of life,especially in the mental health(t=12.474,P＜0.01),the roleemotional(t=9.407,P＜0.01),the social functioning(t=8.862,P＜0.01) and the vitality(t=8.057,P＜0.01).The patients with distinct symptom dimensions of ①symmetry/order,contribution rate 21.60％ ; ②contaminate/clean,contribution rate 16.37％; ③ aggression/religion,contribution rate 12.34％; ④ sex/check,contribution rate 10.90％.They showed different severity of the impairments in four domains of quality of life,the role-physical(F=5.199,P=0.004),the bodily pain (F=3.169,P=0.034),the role-emotional (F=9.350,P=0.000),the mental health(F=4.854,P=0.005).The differences mainly found between the ①②③group and the ④group by LSD multiple testing.Conclusion The mental health is severely damaged with OCD patients.There is stability with the structure of the symptom dimensions of OCD.And it maybe showed the heterogeneity of the symptoms for the significant difference of impairments of quality of life in patients with OCD.

Porcine VHL gene cloning and construction of VHL knockdown cloned embryos / 生物工程学报

Von Hippel-Lindau (VHL) disease is an autosomal dominant disorder and its clinical manifestation including haemangioblastomas of the central nervous system, renal cell carcinoma, haeochromocytomas, and pancreatic cyst. The deletion, mutation and promoter methylation of VHL gene can cause VHL disease. Swine is considered as an ideal model for human disease because of its physiological and anatomical similarity to human. We cloned pig VHL gene that is 2 725 bp in length. VHL highly expressed in adrenal gland, liver, pancreas, heart and testis. We designed 5 shRNAs and screened the most effective interference RNA fragment with a knockdown efficiency of 72%. Porcine embryonic fibroblasts stably transfected with pGenesil-shRNA vector were used as donor cells for nuclear transfer and there was no significant difference of embryo development compared with the control group. Moreover, VHL was efficiently knocked-down with efficiency of 71% in porcine cloned blastocyst, these results lay a solid foundation for constructing the VHL knock-down model of pig.

Clinical study of acute promyelocytic leukemia with expression of BCR 3 isoform of PML-RARa fusion gene / 重庆医学

Objective To assess the efficacy of combination therapy with all-trans-retinoic acid (ATRA ) and arsenic trioxide (ATO) in treating patients with acute promyelocytic leukemia (APL) .Methods A retrospective study was conducted to evaluate the efficacy of combining ATO with ATRA based induction therapy ,followed by 3 courses of consolidation chemotherapy and 2-year sequential ATO/ATRA maintenance therapy in newly diagnosed APL ,and the efficacy between high risk group and low/inter-mediate risk group ,also between different PML-RARa isoform sub-group were compared .Results In high risk group and low/in-termediate risk group ,the complete remission(CR)rates were 70 .0% and 96 .9% (P=0 .04) ,respectively ;the 3 years overall sur-vival rates(OS) and disease free survival rates (DFS) were(70 .0 ± 14 .5)% ,(96 .9 ± 3 .1)% ,P= 0 .01 and(66 .7% ± 19 .2)% , (93 .8 ± 6 .1)% ,P=0 .08 ,respectively .In BCR1 group and BCR3 group ,the CR were 78 .6% and 95 .6% (P=0 .14) ,respectively ;the rates of 3 years OS and DFS were(95 .7 ± 4 .3)% ,(78 .6 ± 11 .0)% ,P=0 .18 ,and(92 .9 ± 6 .9)% ,(87 .5 ± 11 .7)% ,P=0 .24 , respectively .Conclusion The results indicate that ATO based first-line protocol is highly effective for treatment of newly diagnosed APL ,especially for the PML-RARa BCR3 isoform APL .

X-linked inhibitor of apoptotic protein modified adipose-derived stem cells transplantation promotes the regeneration of myocardium and capillaries after myocardial infarction / 中华老年医学杂志

Objective To investigate the mechanism of transplantation of autologous adiposederived stem cells (ADSCs) and X-linked inhibitor of apoptosis protein (XIAP) modified ADSCs for the treatment of myocardial infarction (MI) by the histological detection method.Methods Totally 27 male SD rats (aged 10 weeks,weighted 200-300 g) were randomly divided into the control group,ADSCs group and XIAP ADSCs group (n=9 each).ADSCs were isolated from inguinal adipose tissue in rats and were cultivated in Dulbecco' s modified Eagle' s medium.X-linked inhibitor of apoptotic protein expression plasmid was electrotransfected into ADSCs.Myocardial infarction model was conducted by ligating the left anterior descending artery.The control group was not given any operation.Rats in different groups received direct epicardial injections of normal saline,or ADSCs cell suspension or XIAP modified ADSCs cell suspensions respectively at five sites in the central and border zones of myocardial infarction.Results Compared with control group,the infarct areas were decreased in ADSCs and XIAP ADSCs groups,and some myocardial cells and blood capillaries could be found in the myocardial infarction zone.The capillary number was much more in XIAP-ADSCs group than in ADSCs and control groups [(18.65±1.12) /mm2 vs.(8.68±0.90) /mm2,(18.65±1.12) /mm2 vs.(7.64 ± 0.60)/mm2,t=-22.49,29.91,both P＜0.05].Conclusions Autologus ADSCs and XIAP-ADSCs transplantation may reduce infarction area and inhibit left ventricular remodeling by promoting the regeneration of myocardial cells and blood capillaries,which restores the cardiac function.

A long term accelerating corrosion fatigue texting of coronary stents in vitro / 生物医学工程学杂志

According to the related standards, an in vitro corrosion fatigue testing of coronary stents was designed. The stents were fixed in the latex tubes, which were full of 0.9% saline solution, and radial stress was produced for simulating natural vessel. The accelerated fatigue test was performed with 4 x 10(8) cycles at a frequency of 60 Hz, which was equal to 10 years in vivo implantation. Twelve coronary stents made from stainless steel were adopted in the experiment. The bulk structure and surface morphology before and after testing were analysed by scanning electron microscopy. The structure damage and surface change caused by corrosion fatigue were identified and the probable reasons were proposed.

Laparoscopic splenectomy by dissecting in situ secondary braches of splenic pedicle for idiopathic thrombocytopenic purpura:report of 41 patients / 第三军医大学学报

Objective To evaluate the feasibility and clinical efficacy of amputation in situ secondary braches of splenic pedicle for laparoscopic splenectomy(LS)in patients of idiopathic thrombocytopenic purpura(ITP).Methods LS was performed in 41 ITP patients hospitalized in our department from January 2007 to November 2008 by dissecting secondary braches of splenic pedicle.The serosa on the spleen pedicle was opened by using a harmonic scalpel.Then secondary structures of the splenic arteries and veins,one by one,were disconnected from downward to upward,and then double ligated with the Hem-O-lok clips.The ligated section was cut off with the harmonic scalpe1,and then the spleen was resected.Results LS was successfully completed with no conversion to open surgery in all the 41 cases.The operative time was 75 to 180 min,and the estimated intra-operative blood loss was 50 to 800 ml.There were 3 cases of vice spleen and the vice spleen removed.Two cases were converted to traditional LS with Endo-GIA.The period of hospitalization was 4 to 9 d after operation.There was no severe postoperative complication.Platelet counts began to increase significantly after operation,reached to the peak in 5 to 7 d after operation.During the follow-up of 3 to 20 months to all 41 ITP patients,the total effective rate was 85.4%(35/41,including 22 cases of complete response and 13 cases of partial response).Conclusion LS with amputation in situ secondary braches of splenic pedicle is a safe,effective,minimally invasive and low complication in treatment of ITP.It is worth be recommended because of its lower costs in comparison with common LS.

Surgical management of acute colon obstruction caused by carcinoma in elder patients:a report of 98 cases / 中国普通外科杂志

ObjectiveTo determine the principle and method of surgical management of acute colon obstruction caused by carcinoma in the elder patients. MethodsClinical data of 98 patients with acute colon obstruction caused by carcinoma were analyzed retrospectively. ResultsOf 98 patients undergoing operation,complications occurred in 8 cases,and 3 ( 3.1%)died postoperatively.The other patients were healed. ConclusionsThe management of acute colon obstruction caused by carcinoma in the elder patients depends on the patients,general condition and local condition of the carcinoma.If it is an indication, one-stage resection of the cancer and anastomosis of the colon may be safe and suitable .