Single incision laparoscopic surgery (SILS) has many advantages than standard multiport laparoscopic cholecystectomy (MLC),such as small trauma,less postoperative pain,shorter hospital stay,good cosmetic effect,and so on.Especially the satisfying cosmetic result of no abdominal scar is more important.But the SILS is also faced with many difficulties.The operation time of SILS were significantly longer in duration than MLC.The safety and the technical feasibility were lower for the SILS whose operation complications are more than the MLC.The main reason is that the operation field don't exposureis sufficient and the formation of surgical operation triangle is not easy.In order to overcome these difficulties,scholars have used the auxiliary methods of exposing the operative field in various operation,including the penetration of abdomen wall retraction and intraperitonealretractionand abdomen wall retraction.This paper with review the advantages and disadvantages of the above methods aiming to affer more values for clinical doctors in opperating SILS who get more knonledge abont it.

We have carried out experiment design and comment,and students write the reports of experiment design in patho- physilolgy teaching from the aspects of basic process of experiment research and basic factors,principle and meaning of experi- ment design.By way of the teaching reform,the major position of students in studying is established,students' ability to study in- dependently and acquire knowledge actively are well cultivated,their comprehensive quality are enhanced and the teachers con- struction is also promoted.

0.05). Compared with primary trigeminal neuralgia group and normal control group,the LPs in each wave of BR were significantly prolonged in secondary trigeminal neuralgia group(all P

Balance function is one of injured functions needed rehabilitation after stroke. It is also the considerable signal of the restoration for motor function, which being thought highly in the field of rehabilitation. In some aspect, the restoration of balance function cannot be substituted by stance. The authors mainly discussed the mechanism and issues of balance training by which the balance function of stroke patients in chronic period improved, based on nerve compensative mechanism.

Objective To investigate the effects of mild pefioperative hypothermia on cellular immune function in patients undergoing surgery for rectal cancer.Methods Fifty ASA Ⅰ or Ⅱ patients aged 30-64 yr undergoing surgery for rectal cancer were randomly divided into 2 groups ( n =25 each):mild hypothermia group and normal body temperature group.Anesthesia was induced with midazolam,fentanyl,etomidate and vecuronium and maintained with propofol,remifentanil and vecuronium.The patients were mechanically ventilated after tracheal intubation.PET CO2 was maintained at 35-45 mm Hg.The venous blood samples were taken from peripheral vein at 1 h before anesthesia (T1 ),at the end of operation (T2),at 24 h after operation (T3),and on 7th day after operation (T4) to measure the serum Th1 and Th2 cytokines levels and Th1/Th2 cytokines balance was observed.Results Compared with the baseline value at T1,the serum Th2 cytokines level was significantly decreased and Th1/Th2 ratio was significantly increased at T4 in normal body temperature group,and the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2.3 in mild hypothermia group ( P ＜ 0.05).Compared with normal body temperature group,the serum Th1 cytokines level and Th1/Th2 ratio were significantly decreased and the serum Th2 cytokines level was significantly increased at T2-4 in mild hypothermia group ( P ＜ 0.05).Conclusion Mild perioperative hypothermia can depress cellular immune function in patients undergoing surgery for rectal cancer.

Objective To investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic carcinoma.Methods 60 cases of pleomorphic pulmonary carcinoma were collected and studied clinicopathologically between 1999 and 2011.All patients underwent pulmonary resections.Results There was no in-hospital death.1 had haemothorax that required reoperation,1 patient had a late cicatricial bronchial stenosis after sleeve lobectomy of the upper right lobe,and treated successfully by the resection of the right two lobes.The 3,5-year survival rates of all patients were 47.2％ and 25.6％ respectively.For N0 and N1-N2 patients,3-,5-year survival rates were 57.3％,32.5 ％ and 25.4％,17.1％,respectively.Overall survivals were of significant difference between radical resection and uncomplete resection.Multivariate Cox regression analyses of overall survival of all 60 patients indicated that radical resection (P =0.041) and nodal status (P =0.029) were significant independent prognostic factors.Conclusion Pleomorphic carcinoma is a rare type of lung cancer.Pleomorphic carcinoma of the lung was often found as a large mass peripherally located and was associated with poor prognosis.Radical resection and nodal status were significant independent prognostic factors.

BACKGROUND:Early clinical application of non-biological materials (bone cement) for treatment of hip joint is ineffective, due to the large fixed range, long fixation time, as wel as aging and rupture of bone cement interface causing complications such as prosthetic loosening. Thus, postoperative range of motion of the hip joint can be affected to some degree.
OBJECTIVE:To investigate the methods and progress of biological and non-biological materials for total hip replacement and to assess the features and clinical application of different hip prostheses.
METHODS:A computer-based search of PubMed and CNKI was performed by the first author to retrieve articles related to biological materials and tissue-engineered hip joint using the keywords of“carpal bone, fracture ununited”in the title and abstract. The keywords were limited to Chinese and English.
RESULTS AND CONCLUSION:Biological materials for internal fixation have good wear resistance, corrosion resistance and biocompatibility. Currently, the combination of metal joint head and polyethylene acetabulum with ultrahigh molecular weight is the most commonly used in hip replacement. However, the metal joint head exhibits an elastic modulus far from the human skeleton, resulting in stress shielding effects which are easy to cause prosthetic loosening and instability. Bio-inert ceramics has high in vivo stability and good mechanical strength;and bioactive ceramics has bone conduction characteristics and performance of the living bone integration. Composite prosthesis, because of adjustable elastic modulus and sufficient mechanical strength, shows the mechanical properties close to the human bone and has been gradual y noticed. However, there is a lack of ideal prostheses with good biocompatibility and biomechanics. Therefore, hip design and manufacturing processes should be improved to elevate wear resistance and mechanical properties, to enhance the binding between prosthesis and the host bone, and to reduce stress shielding in order to improve the biocompatibility of the implant with the host, and extend the prosthetic life.

Aim To investigate the effects of masculine drug Duxil on striatum extracellular acetylcholine(ACh),glucose and lactic acid(LD) levels in energy metabolism impairment rats induced by intracerebral perfusion with sodium azide(NaN3).Methods Rats were divided into three groups:control,model and Duxil groups.Rats of Duxil group were treated with 10 mg?kg-1?d-1 Duxil for 14 d.Other two groups were treated with water for 14 d.After 2 wk microdialysis technique was adopted and the rats were perfused with NaN3 in striatum and continuously measured striatum extracellular ACh,glucose and LD levels in freely moving awake rats.Results During perfusion(90 min) and stoping perfusion(180,240,360 min)period with NaN3 striatum extracellular ACh levels in the model group were significantly lower than those in the control group(P

Objective To explore the effects of application of laparoscopic simulators in teaching of plastic surgery. Methods 10 plastic surgeons and 20 standardized training surgical residents with 2 to 4 years' experience were tested about their proficiency in moving beans, pinching, suturing and tying by timing and counting. After they were trained with laparoscopic simulators 3, 6, 9 times with each time for 90 min, tests were taken. SPSS 19.0 was used to make single factor variance analysis of the related data or conduct q test. Result There was significant difference before and after the residents' training of moving beans, pinching, suturing and tying (P<0.05). Less time to finish the operation was needed after training, but after training for 6 times or 9 times, there was no significant difference in operation time (P >0.05). Conclusion Application of laparoscopic simulator training can significantly improve the operation skills of the novices with some clinical experience in the short term, which is conducive to the endoscope assisted breast augmentation surgery, and is worthy of promotion.

OBJECTIVE To study the effect of subchronic exposure to aluminum(Al)on learning, memory,and immediate early gene expression in rats,and to explore the toxic mechanism of Al on cognitive impairment of rats. METHODS Wistar offspring rats were administered with 2.0,4.0 and 8.0 g?L-1 AlCl3 in milk and drinking water in sequence from the postnatal day 1 to 3 months. Then,learning and memory of offspring rats were measured by Morris water maze, the hippocampal Al concentration was quantitated by the atomic absorption spectrophotometer, the CA1 area of the hippocampus was collected for HE observation, and the c-fos gene and c-Fos protein expression in CA1 area of the hippo?campus in offspring rats were detected by RT-PCR and immunohistochemistry. RESULTS Learning and memory of offspring rats in AlCl3 groups were significantly lower than those in control group(P<0.01,P<0.05). The hippocampal Al concentrations of offspring rats in AlCl3 groups were higher than those in control group(P<0.01). The morphology in CA1 area of offspring rats′ hippocampus in AlCl3 groups exhibited sparse nerve fibers, depigmentation and even vacuolar degeneration in neurons and other pathological changes after Al treatment;c-fos mRNA expression in the hippocampus in 4.0 and 8.0 g?L-1 AlCl3 group rats was significantly lower than in control and 2.0 g?L-1 AlCl3 group, respectively(P<0.01). c-Fos protein expression in offspring rats′ hippocampus in AlCl3 exposed groups was significantly lower compared with control group(P<0.01). CONCLUSION Al can injure learning and memory of rats,which is related to hippocampal neuronal dysfunction in CA1 area induced by pathological changes,low levels of c-fos gene and c-Fos protein expression subsequently.