The laparoscopic technique for live donor nephrectomy is a technically difficult procedure that has not yet gained widespread acceptance in the transplantation community in our country. The procedure would be more acceptable if alterations be added to the technique to make it easier to perform and decrease operation time.In Dec.2001,we performed a hand assisted laparoscopic live donor nephrectomy (HLDN) including the use of a device allowing hand assistance.HLDN, was peformed with Hand System,Auto Sonix,Endo Clip,Hem o lok, Endo GIA, and with pheumoperitoneum the left kidney was removed through the upper midline incision.The incision was 6 0cm long.The operating time was 118min,warm ischemia time was 3 3min,and cold ischemia time 92 min. The renal artery was 2 0cm long and 0 5cm in diameter, the renal vein was 2 2cm long and 1 2cm in diameter, and the length of the ureter was 12 0cm.Both the donor and recipient recovered very well post operatively without any complication.The donor was discharged form the hospital on the day 7 after operation,and the recipient on the day 21 with normal renal functions. The advantages of the hand assisted technique include the ability to use tactile sensation to facilitate dissection,retraction and exposure.In addition,the final stages of vascular stapling and kidney removal are more as sured and rapid.The modifications in the laparoscopic technique presented here provide measurable and subjective improvements to laparoscopic live donor nephrectomy.

Objective To explore the effects of different operations on respiratory function after colon replacement for esophageal cancer.Methods Fourty patients with esophageal cancer underwent esophagectomy from May 2004 to June 2008,were retrospectively analyzed.The site of esophageal anastomosis was at neck after sternum in 20 cages.at neck through esophageal bed in other 20 cages.Blood gas analysis and pulmonary fuction were monitored in these patients before operation and in 14 days after operation.Results VC% were (42.17±10.15)%、(49.52±9.56)%、(55.67±10.73)%、(60.27±10.52)%in patients after sternum and(37.65±9.52)%、(40.72±10.12)%、(47.02±10.65)%、(52.89±10.82)%in patients through esophageal bed in 5th、7th、10th、14th postoperative day with sigllificant statistical difference;FEV_1% were(60.55±16.71)%、(67.12±16.90)%in patients after sternum and(45.23±16.26)%、(50.52±16.72)%in patients through esophageal bed in 10th、14th postoperative day with significant statistical difference;PaO_2 were(17.56±7.32)mm Hg、(19.67±6.08)mm Hg、(17.17±4.85)mm Hg、(15.43±5.02)mm Hg、(11.32±3.79)mm Hg、(9.67±2.87)mm Hg、(6.98±3.26)mm Hg in patients after sternum and(20.17±7.04)mm Hg、(22.83±6.75)mm Hg、(20.67±4.31)mm Hg、(18.32±4.85)mm Hg、(16.02±3.71)mm Hg、(13.44±2.56)mm Hg、(9.01±3.17)mm Hg in patients through esophageal bed in 1st,2nd,3rd,5th,7th,10th,14th postoperative day with significant statistical difference. Conclusions After esophagectomy,esophageal anastomosis through esophageal bed has significant negative effect on respiratory function.

OBJECTIVE: Small diameter vascular grafts (＜ 6 mm) are used predominantly in revascularization and reconstructive procedures. The small diameter vascular grafts already used in our clinical practice include autologous veins or arteries, polyethylene terephthalate (Dacron) and expanded polytetrafluoroethylene (ePTFE) synthetic vascular grafts. Unfortunately these vascular grafts all have some disadvantages that prohibit their uses. Therefore search for ideal small diameter vascular grafts has become the focus in recent years.DATA SOURCES: A computer-based online search of Pubmed database was undertaken to identify the articles about small diameter vascular grafts published in English between January 1990 and January 2007 with the key words of "prosthetic graft, vascular bypass graft, small diameter vascular graft, tissue engineering".STUDY SELECTION: The data were selected firstly to choose the full-text of articles met the criteria. Inclusion criteria: ① Articles about biological vascular grafts; ②Articles about synthetic vascular grafts; ③Articles about small diameter tissue engineering blood vessels. Exclusion criteria: Repetitive or analogical articles or case reports.DATA EXTRACTION: Totally 113 articles on small diameter vascular grafts were collected and 41 met the inclusive criteria after eliminated the repetitive or similar studies or case reports.DATA SYNTHESIS : Although biological vascular grafts have the outstanding advantages, such as superior long-term patency, relatively resistant to infection, minimal thromboembolism, etc., they also have predominant disadvantages of limited availability, durability and aneurysm formation. Dacron and ePTFE are currently the standard synthetic vascular grafts in the vascular bypass surgery, but their immediate or long-term patency rates are relatively poor due to compliance mismatch, thrombogenicity and poor haemodynamics, especially when they are used in small diameter revascularization and reconstructive procedures. Thus, various modifications have been applied to Dacron and ePTFE grafts to improve their function. In recent two decades, the emergence of tissue-engineering technology has made the development of a novel biologically viable vascular substitute feasible, and it may prove to be the ultimate solution for better small-diameter vascular grafting.CONCLUCTION: So far there is no completely biodegradable small diameter vascular graft suitable for the arterial circulation in humans. Construction of an ideal small-diameter vascular graft will require an interdisciplinary effort requiring critical contributions from biologists, engineers, and clinicians, with strong collaborations among these 3 fields being crucial to success.

Objective: To investigate the effect of leukemia inhibitory factor (LIF) on the of proliferation and differentiation of ectomesenchymal cells of mandibular process in Balb/c fetal mice . Methods: Ectomesenchymal cells from the E12.5 mice mandibular process were cultured in DMEM/F12 with 10 6u/L LIF (experimental group) or without LIF (control). The proliferation effect was detected by MTT assay, Brdu test and flow cytometry. Immunohistochemistry were used to identify the differentiation state. Results: By day 7 the A value of the experimental group was 0.38?0.03,that of the control 0.30?0.02 (P

AIM: To study the effects of different process methods on the content of total flavonoids and the aqueous extract from Rhizoma Drynariae. METHODS: The contents of total flavonoids of Rhizoma Drynariae processed in different ways were assayed by polyamide chromatography and ultraviolet spectroplotometry; the contents of the aqueous extract were assayed by extraction in water. RESULTS: The contents of total flavonoids and the aqueous extract in Rhizoma Drynariae increased after it was processed and purified. The contents of total flavonoids and the aqueous extract in Rhizoma Dyrnariae hotted in sands, at constant temperature oven and microwave process were not influenced, but easier to be extracted in water by these methods. CONCLUSION:Microwave processis better than the other methods.

Objective To provide theoretical evidences for diagnosis of bladder neoplasm by using more information of imaging features. Methods MRI images of bladder neoplasm were collected for this research. The ROI (region of interest) area was selected manually,and noise reduction and sharpening were applied to the ROI area by using LoG (Laplacian of Gaussian) filter. The texture features of bladder neoplasm and normal bladder wall (smooth muscle),such as mean grey-level intensity,entropy,uniformity were calculated. A statistical analysis was made at last. Results The values of texture features were analyzed by t-test. Entropy and uniformity show significant differences between the two groups. But Mean grey-level intensity hasn't indicated this difference. Conclusion This texture features may be applied to decide the invasive depth of bladder neoplasm,it also means that the stage of bladder neoplasm may be fixed by this system.

Medical educational internationalization has already made teaching medical courses in English more and more important.Nephrology department in Tongji hospital affiliated to Tongji medical college,Huazhong university of science and technology has assumed the responsibility of teaching in English for medical students of five-year program,six-year program,seven-year program,eight-year program,and abroad student for several years.They practiced teaching in English in theory teaching,PBL teaching and clinical teaching according to the characteristics and requisitions of students in different educational systems.They accumulated some experiences,which was conducive to improving the quality of teaching in English.

Objective This paper is to validate a speech intelligibility test in Chinese mandarin for the evaluation of speakers with cleft palate, and to determine the intelligibility deficit patterns based on minimal pairs. Methods Thirty cleft palate patients with dysarthria were included as speakers for the test. Then the speech intelligibility of each speaker was rated and the error proportions of each minimal pair were analyzed by SPSS 16.0. The stepwise multiple regression analysis was employed to determine which minimal pairs were the best predictors of reduced speech intelligibility. Results The intelligibility scores were obtained form the thirty speakers ranged from 37% to 92.4%. The error proportion of the minimal pairs was ranged from 0. 13 to 0. 80. The three most problematic pairs, from the most to least severe were dental versus retroflex pair (0.80), retroflex versus palatal pair(0.68), and aspirated versus un-aspirated affricative pair(0.66). The speech intelligibility from cleft palate patients could be predicted at 71.5% accuracy using two pairs, aspirated versus un-aspirated affricative pair, dentals versus palatal pair. Conclusion The speech intelligibility test for Chinese Mandarin speakers with cleft palate can be used as an effective evaluation method, both qualitatively and quantificationally.

Objective:To research the best processing method of ginger juice baking for Rhizoma coptis. Methods:The total con-tent of four alkaloids including berberine hydrochloride determined by HPLC was used as the evaluation index, and an L9(34)orthogo-nal design with three factors including the amount of ginger juice, baking temperature and baking time and variance analysis were ap-plied to study the ginger juice baking technology for Rhizoma coptis. Results:The best processing conditions were as follows:Rhizoma coptis was soaked with 15% ginger juice, baked at 150℃ for 40 min, and withdrawn to be cool. Conclusion:The optimal ginger juice baking technology for Rhizoma coptis is reasonable, which can be used to guide the standardized production of Rhizoma coptis with gin-ger juice baking.

Objective To discuss the methods and clinical effects of phased treatment of ankylosing spondylitis (AS) combined with severe hip flexion contracture.Methods The study enrolled 8 cases (12 hips) of AS combined with severe hip flexion contracture hospitalized from September 2011 to November 2012.Phased treatments included lateral hip arthrolysis,articular capsulectomy,stripping of the reflected head of rectus femoris,femoral neck osteotomy,traction and stage Ⅱ biotype total hip arthroplasty (THA).Preoperative and postoperative Harris score,hip range of motion,and complication of femoral nerve injury were detected.Results Period of follow-up was 6-12 months (mean 10 months).One case developed heterotopic ossification,which affected postoperative hip activity and received resection one year later.One case sustained fissure fracture of calcar femorale during implantation of the prosthetic femoral stem,but no special handling was provided.Of all cases,active flexion and extension of the hip were both 0° before operation,but increased to (96.25 ± 4.33) ° and (24.17 ± 4.69)° respectively after operation ; mean Harris score was improved from (26.67 ± 2.39) points preoperatively to (90.92 ± 5.66) points postoperatively (P ＜ 0.01).Besides,no femoral nerve injury was observed.Conclusion Phased treatment of AS combined with severe hip flexion contracture restores hip function and minimizes femoral nerve injury following THA.