Objective To evaluate the clinical results of patients submitted to laparoscopic assisted supracervical hysterectomy for benign uterine disease.Methods Women referred for supracervical hysterectomy for benign uterine diseases were divided into laparoscopy group(n=34)or open group(n=30).The operative time,blood loss,complications,morbidity,ileus,wound infections were compared between the two groups.Results In terms of Operative time,both of total operative time and oophosalpingorectomy time,there was no significant difference between laparoscopic group and open group.Less blood loss was found in laparoscopic group than open group.No complications were found in both groups.Conclusions Laparoscopic assisted supracervical hysterectomy is a safer and easier approach to complete supracervical hysterectomy with reduced blood loss and quick convalescence.It can be successfully integrated into a large health maintenance organization/residency-training program.

ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.

Large-scale medical equipment is very important for comprehensive hospitals. Fault monitoring and diagnosing technologies for large-scale medical equipment have to been available to make full use of them. This paper introduces the evolution of equipment fault diagnosis. After comparing conventional technology and intelligent one, this paper lays emphasis on the latter.

In this study, a novel polyurethane membrane, modified by superfine silk-fibroin powder, was prepared for small-diameter vascular grafting. Scanning electron microscopy, transmission electron microscopy, and histological examination were applied to evaluate histocompatibility of this polyurethane membrane. The polyurethane membrane was compared with polytetrafluoroethylene material. A pseudomembrane and gap formed between polytetrafluoroethylene and the surrounding tissues, and no cells infiltrated or grew into the polytetrafluoroethylene material. On the contrary, superfine silk-fibroin powder/polyurethane blend membrane merged tightly with the surrounding tissues without gaps, and cells infiltrated and grew into the material. Moreover, the negative effects of superfine silk-fibroin powder/polyurethane blend membrane on cells were less than those of its polytetrafluoroethylene counterpart. Our findings indicated that the superfine silk-fibroin powder/polyurethane blend membrane has better histocompatibility than polytetrafluoroethylene membrane. It is concluded that the superfine silk-fibroin powder/polyurethane blend membrane is a promising biomaterial for small-diameter prosthesis.

Objective To evaluate the efficacy of Qingfei-Jiedu decoction in the treatment of Acne. Methods A total of 93 female patients with acne were randomly divided into 3 groups according to random number table, 31 in each group. The observation group took the oral Qingfei-Jiedu decoction, and the Chinese medicine control group took the oral tanshinone capsule, and the western medicine control group took the oral acetic acid ring propyl alcohol progesterone. All 3 groups were treated for 4 weeks. The levels of serum dihydro (DHT), IL-6 and IL-8 were measured by ELISA. The changes of the lesions before and after treatment were observed and the adverse events were recorded during the treatment. The clinical effect was evaluated. Results After treatment, the serum DHT (56.94 ± 15.74 pg/ml vs. 74.48 ± 18.53 pg/ml, t=2.089), IL-6 (22.84 ± 11.77 pg/ml vs. 30.37 ± 14.50 pg/ml, t=2.135), IL-8 (22.64 ± 7.38 pg/ml vs. 29.54 ± 9.65 pg/ml, t=2.057) in the observation group were significantly lower than those in the Chinese medicine control group (P<0.05). After treatment, the disappearance rate of skin lesions (65.4% ± 15.0% vs. 44.7% ± 12.9%, 42.7% ± 13.6%, F=6.862) and comprehensive syndrome effective rate (57.2% ± 12.6% vs. 46.3% ± 12.8%, 44.8% ± 11.7%, F=5.322) in the observation group were significantly higher than those in the other two control groups (P<0.05). The observation group and the traditional Chinese medicine control group did not have adverse events, but the western medicine control group showed one case nausea. Conclusions The Qingfei-Jiedu decoction can reduce the level of serum DHT, IL-6 and IL-8 in female patients with acne vulgaris, and improve the skin lesion disappearance rates and comprehensive syndrome rates.

Objective:To evaluate dental and skeletal changes following slow maxillary expansion with quad helix using Cone-Beam computer tomography (CBCT).Methods:13 patients(5males and 8 females,mean age 14.38 ±2.22 years)requiring maxillary ex-pansion as a part of their comprehensive orthodontic treatment were included.Each patient had CBCT images taken pre-(T1 )and post-(T2)maxillary expansion with quad helix.Changes of the distances between bilateral canines,first premolars,second premo-lars,first molars,the width of basal bone and palatal suture were measured.paired t-test results were analyzed using SPSS 17.0 soft-ware.Results:The distances between the 4 bilateral teeth increased by (2.47 ±1.05)mm,(2.97 ±1.90)mm,(2.79 ±1.21) mm and (3.15 ±1.15)mm,the apical distances decreased by (1.19 ±0.40)mm,(2.12 ±0.68)mm,(2.02 ±0.65)mm and (1.34 ±0.63)mm,respectively.The inclination of the first molars were decreased by (4.45 ±2.86)°and (4.02 ±1.45)°on the left and right side respectively.The width of basal bone and palatal suture increased by (2.37 ±0.96)mm and (1.21 ±0.50)mm respectively,the differences between T1 and T2 were all statistically different(P <0.001).Conclusion:Quad helix expands maxil-lary arch by greater dental changes than by skeletal changes.

Objective To investigate the diagnosis and surgical treatment of intracaval venous tumors. Methods Clinical data of 6 cases were retrospectively analyzed, including signs and symptoms diagnostic means such as type-B ultrasound, CTA, MRA, surgical procedures and prognosis. Results All six cases received type-B ultrasonic examination, final definite diagnosis was achieved by CTA exam in 2 cases and through MRA in 4 cases. Heart involvement was found in 3 cases. All patients underwent a surgery. According to the extent of the tumor,3 cases had thoraco-abdominal incision,3 cases with extracorporeal circulation and right atrium opening. All of the tumors were completely resected. Pathological exam revealed that 4 cases were of leiomyomatosis and 2 cases were of leiomyosarcoma. One case with leiomyosarcoma died of liver disfunction postoperatively.The other 5 cases recovered without major complications. An average 51 months of follow-up found no recurrence. Conclusions CT and MRI are the mainstay for the diagnosis,and MRI can provide clear anatomy image to the surgeons, help choose the surgical procedures. The one-stage operation is effective. During the operation, the main branches of the vena cava system should be detected, and the attachment of the tumor should be found and removed thoroughly to prevent the recurrence of the tumor. When the attachment point is lower than the iliac vein level, ligation of the involved iliac vein should be mandatory.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.

Objective To assess the effect and feasibility of group reminiscence therapy on depression in the elderly.Methods We searched the Cochrane Central Register of Controlled Trials (-2013),Medline (1982-2013),Embase (1974 2013),AMED (-2013),CINAHL(-2013),CMB (1994-2013),VIP,CNKI and Wanfang to collect the randomized controlled trials (RCTs) in which the group reminiscence therapy was used to treat depression in elderly patients.The studies were selected according to the inclusion and exclusion criteria by two reviewers,and the quality of included studies was evaluated according to Cochrane Handbook and performed meta analyses by using the Cochrane Collaboration's RevMan 5.2 software.Results A total of 10 RCTs involving 944 patients were included.The results of meta-analysis showed that as compared with conventional treatment,group reminiscence therapy on the basis of conventional treatment was more effective in decreasing depression score [MD=-4.86,95 ％ C I(-5.10,-4.65)].Compared with psychological counseling,group reminiscence therapy had more effect on decreasing depression score [MD=-9.34,95％ CI (-10.77,-7.91)].There was no significant difference in the dropout rate between group reminiscence therapy and other control treatments [RR=1.22,95％ CI (0.79-1.88)].The descriptive analysis showed that group reminiscence therapy was effective in alleviating the symptoms of depression.Conclusions Group reminiscence therapy can improve the symptoms of depression in elderly patients and conforms to the principle of economic benefit.However,the results should be interpreted with caution because of the low quality of the included studies.

Background and purpose:Loss or altered expression of Ras association domain family 1A gene (RASSF1A) through DNA methylation has been associated with the pathogenesis of a variety of cancers, which suggests the tumor suppressor function of this gene. This study aimed to explore the effect of DNA methyltransferase inhibitor 5-Aza-2’deoxycytidine (5-Aza-dc) on demethylation and expression of RASSF1A in cervical cancer cell lines. Methods:HPV positive cervical cancer cell lines HeLa and Caski, HPV negative cell lines HT-3 and C-33A were treated with two different concentration of 5-Aza-dc (5 μmol/L, 10 μmol/L). MSP (methylation-specific PCR) and Bisulfite genomic sequencing PCR (BGS) combined with TA clone were used to investigate methylation status of RASSF1A gene promoter and exon 1 before and after treatment of 5-Aza-dc. RASSF1A gene mRNA expression was detected by RT-PCR. Results:Two HPV positive cell lines showed hypomethylated RASSF1A promoters and expressed RASSF1A mRNA, and after treatment with 5-Aza-dc, the mRNA expression of RASSF1A did not change significantly (FHeLa=3.003, P=0.125; FCaski=0.045, P=0.956). Two HPV negative cervical cancer cell lines showed hypermethylation status of RASSF1A promoter and silenced RASSF1A. After treatment with 5-Aza-dc, demethylation occurred in the promoter region of RASSF1A gene, which subsequently induced re-expression of this gene in HT-3 and C-33A. The F test (FHT-3=18.002, P=0.03;FC-33A=17.179, P=0.03) and LSD-t test (P<0.05) demonstrated that significant difference in the expression of RASSF1A was found upon two different concentrations drug treatment.Conclusion:The methylation status of promoter and exon 1 of RASSFIA gene in HPV positive and HPV negative cervical cancer cell lines are different. The promoter hypermethylation is correlated with RASSF1A gene expression in HPV negative cervical cancer cell line HT-3 and C-33A, and plays a key role in RASSF1A silencing. 5-Aza-dc may effectively reverse the methylation status of RASSFIA gene promoter in cervical cancer HT-3 and C-33A cells and reactivate gene expression silenced by aberrant hypermethylation in a dose-dependent manner within certain extent.