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.

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.

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.

AIM: To explore the role of intestinal lymphatic pathway in MODS pathogenesis by two-hit in rats. METHODS: Mesenteric lymph was diverted by ligating mesenteric lymph duct, and the MODS model was established by two-hit method. 45 Wistar rats were divided into three groups: mesenteric lymph duct ligation group, non-ligation group and sham group. All rats facilitated blood withdrawal for serum sample at pre-experiment and after 24 h. Then organs including kidney, liver, lung, heart and intestine were collected for preparing homogenate. The tumor necrosis factor-alpha (TNF?), nitric oxide (NO), malondialdehyde (MDA) and superoxide dismutase (SOD) were determined. RESULTS: It showed that the MODS model was established successfully. After two-hit, the TNF?, NO 2 -/NO 3 -, NOS, iNOS and MDA in serum of non-ligation group were significantly increased than that in pre-experiment and sham group, and SOD was significantly lower ( P

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

Background and purpose:In recent years,sleeve resection of bronchus and pulmonary artery has been more extensively applied in treatments of lung cancer patients with poor pulmonary functions.This kind of surgery meets the basic surgical principles of lung cancer being maximum both in resecting the carcinoma of the lungs and preserving pulmonary functions,has a good prospect.Therefore,we summarize our recent experience in treating central type lung cancer by this method and discuss its principles and methods in the application of the surgical operation.Methods:From Dec.1993 to Dec.2003,63 patients with central type lung cancer underwent sleeve lobectomy of bronchus and pulmonary artery,including sleeve resection of bronchus and pulmonary artery in 43 cases,wedge resection of bronchus and pulmonary artery in 3 cases,sleeve resection of bronchus and wedge resection of pulmonary artery in 17 cases.The surgical procedures of sleeve resection included sleeve resection of right upper lobe and pulmonary artery in 20 cases,sleeve resection of left upper lobe and pulmonary artery in 23 cases,and the length of pulmonary artery that had been respected is from 1.5cm to(4.5cm),the average length is 2.5cm.The surgical procedures of wedge resection included wedge resection of right upper lobe and pulmonary artery in 2 cases, wedge resection of left upper lobe and pulmonary artery in 1 case.The group of sleeve resection of bronchus with wedge resection of pulmonary artery included sleeve resection of right upper lobe and wedge resection of pulmonary artery in 5 cases,sleeve resection of left upper lobe and wedge resection of pulmonary artery in 12 cases.Results:No case of death and anastomotic leak occurred.Conclusions:Because sleeve resection of bronchus and pulmonary artery can not only effectively resect the tumor but also maximally preserve the pulmonary function at the same time,it enlarges the surgical indications of lung cancer,and is an effective and safe method for the treatment of lung cancer.