The da Vinci robotic surgical system assisted colorectal radical resection has been widely applied in many countries and regions.The advantages of the da Vinci robotic surgical system include stable and distinct stereoscopic vision,short learning curve,convenient operation and feasibility of remote manipulation,while its disadvantages are expensive cost,lack of tremor and prolonged operation time.The advantage of da Vinci robotic surgical system is not distinct when compared with traditional laparoscope in radical resection of colorectal cancer.With the accumulation of clinical data and the update of the system,the prospect of da Vinci robotic surgical system assisted colorectal radical resection is promising.

Diabetic retinopathy (DR) is a common ocular complication in patients with diabetes, and diabetic macular edema (DME) is the main cause of vision loss in patients with DR, so the early diagnosis and treatment of DME is of an important clinical significance.Optical coherence tomography (OCT) can provide high-quality imaging of retina and choroid.It has been widely used in clinical practice and can be used for long-term follow-up of the diagnosis and treatment of DME.Recent studies have found various characteristic changes in retina and choroidal layer of DME on OCT, including vitreomacular interface abnormalities, disorganization of retinal inner layers, inner segment-outer segment (IS-OS) continuity destruction, external limiting membrane continuity destruction, outer retinal tubulations, hyperreflective foci, intraretinal cystic fluid, subfoveal neuroretinal detachment, low optical reflectivity, subfoveal choroidal thickness change, and choroidal vascularity index change, etc.These changes are related to the prognosis of DME, so they can be used as biomarkers of DME.This paper reviews the research progress in this field.

Objective:To study the relationship between sleep quality and mental health of pilots.Method:356 pilots in their recuperation at our sanatorium were evaluated with Pittsburgh Sleep Quality Index and Mental Health Inventory. Result:Good sleepers were significantly different to the poor ones in mental health indexes. The score of sleep quality was positively correlated with that of self-confidence, energy,character,over self-concern, anxiety, optimism, sensitivity,nervousness mental bealth and self-assertion (r=0.31-0.47,P

To improve the oral medical students' entrepreneurial ability, in accordance with the requirements of national innovation and entrepreneurship training plan for the college students,Zhaoqing Medical College launches the entrepreneurship training project-establishing and managing private dental clinics, aiming at the development trend of China medical industry and professional characteristics. The project fully mobilizes students' initiative, enables them to learn how to establish, operate and manage the community oral clinic, stimulates students' entrepreneurial spirit and improves their ability.

Objective To examine the effects of different doses of midazelam on ED50 of emulsified isoflurane and to determine the type of interaction between them for hypnosis by isobelographic analysis in rats. Methods One hundred and twenty-five adult male SD rats weighing 240-300 g were randomized into 5 groups (n=25 each): group Ⅰmidazolam (M); group Ⅱ emulsified isnflurane (Ⅰ); group Ⅲ ,Ⅳ ,Ⅴ, 1/4, 1/2 and 3/4 ED50 of midazelam for hypnosis + emulsified isoflurane (MI1 , MI2, MI3). Up-and-down sequential experiment was used to determine ED50of midazolam and emulsified isoflurane for loss of righting reflex in group Ⅰ -Ⅴ . The intial dose of midazolm was 17.3 mg/kg in group M. The initial doses of emulsified isoflurane (120 mg/ml) were 0.55 (in group Ⅰ, 0.22 (MI1), 0.19 (MI2) and 0.12 ml/kg (MI3) respectively. In group MI1-3 midazolam was injected over 15 seconds and after an interval of 2.5 min emulsified isoflurane was injected over 10 s. ED50 was calculated using Dixon-Mood method. Isebolographic and algebraic analyses were used to determine the type of interaction between midazolam and emulsified isoflurane. Results The five groups were comparable with respect to M/F sex ratio and body weight. The Edso of midazolam was 26.0 mg/kg in group M. Midazolam 6.5, 13.0 and 19.5 mg/kg were given in group MI1 , MI2 and MI3 respectively. The ED50 of emulsified isoflurane was 0.67 (ingroup Ⅰ), 0.30 (MI1), 0.22 (MI2) and 0.18 ml/kg (MI3) respectively. The isobolographic analysis indicated that with increasing doses of midazolam, the Edw of emulsified isoflurane decreased progressively in a non-linear fashion. The isobolographic and algebraic analyses demonstrated that the interaction between midazolam and emulsified isoflurane was synergistic for hypnosis. Conclusion The hypnosis is synergistic when midazolam 6.5,13 mg/kg are combined with emulsified isoflurane and additive when midazolam 19.5 mg/kg is combined with emulsified isoflurane.

A high performance liquid chromatographic (HPLC) method using triethylamine (TEA), copper *" acetate and L-proline as the chiral mobile phase (CMP) and the enantiomric analysis of thyroxine (T4) are described. The influence of the mobile phase parameters including the TEA concentration, manipulation pH, concentration of Cu*", concentration of L-proline, temperature of column and flow rate of eluent on the enantiomers separation of thyroxine was studied. The HPLC-CMP is a simple method for separation and determination of D，L-T4 in drug or in human plasma. It can be used to therapeutic drug or adverse drug reactions monitor.

Objective To investigate the clinical characteristics of purulent meningitis caused by streptococcus pneumoniae.Methods We studied clinical features of 12 children with purulent meningitis caused by streptococcus pneumoniae who were hospitalized from Jan 2007 to Oct 2011 in our hospital.Results Twelve children were penicillin-resistant streptococcus pneumoniae.The ages ranged from 2 months to 10 years.Nine cases(75％) were aged less than 5 years,and 5 cases(41.6％) were aged less than 2 years.All cases were with fever,and with the nervous system symptoms involvement.All cases were with complications:9 cases(75％) with septicemia,8 cases (66.7％) with pneumonia.The white blood cells,blood C-reactive protein,peripheral blood procalcitonin,erythrocyte sedimentation rate,white cells and protein in cerebrospinal fluid were mostly significantly high,sugar in cerebrospinal fluid were low significantly.Eleven cases were eventually treatmented by vancomycin plus 3rd to 4rd generations of cephalosporins antibiotics or other antibiotics.Eight cases were cured,2 cases with serious sequela,and 2 cases died.Conclusion We should attach importance to the meningitis caused by streptococcus pneumoniae.For clinical suspects pneumonia streptococcus meningitis,to given the powerful therapy by vancomycin plus the other antibiotics,as early as possible.

Aim To study the transport of geniposide and geniposide in Zhizi Bopi Decoction in MDCK cell membrane model. Methods The safety concentration of geniposide and Zhizi Bopi Decoction in MDCK cells were determined by MTT assay. Then the MDCK cell membrane model was used to investigate the transport of drugs. Firstly, the effects of time, drug concentra-tion, P-gp inhibitor and EDTA on the absorption and transport of geniposide were studied systematically. Secondly, the differences were compared between the transport of the same concentration of geniposide as single compound and that in Zhizi Bopi Decoction in MDCK cell model. The drug concentration was deter-mined by high performance liquid chromatography ( HPLC) to calculate the apparent permeability coeffi-cient (Papp). Results Geniposide transport in MDCK cell monolayer was time and concentration dependent. P-gp inhibitors had no significant effect on its transport and the transport of geniposide was enhanced by ED-TA. The absorption Papp of different concentrations of geniposide in Zhizi Bopi Decoction were ( 8. 96 ± 0. 35 ) × 10 -7 cm · s-1 , ( 8. 95 ± 0. 38 ) × 10 -7 cm · s-1 and (9. 16 ± 0. 30) × 10 -7 cm·s-1, significantly higher than the absorption Papp of geniposide as single compound(5. 85 ± 0. 44) × 10 -7 cm·s-1, (6. 88 ± 0. 38) × 10 -7 cm·s-1 and (6. 31 ± 0. 19) × 10 -7 cm ·s-1 ( P<0. 05 ) . Conclusion The transport of ge-niposide in MDCK cell membrane model is passive transport and is not affected by P-gp. Geniposide may transport via the paracellular route. The Zhizi Bopi De-coction can increase the absorption of geniposide.

Objective:To investigate the impact of preoperative urodynamic study on the diagnosis and treatment for female patients with clinical diagnosis of stress urinary incontinence by studying their diag-nosis and treatment database,and to assess its clinical significance of urodynamic study.Methods:From April 2011 to December 2015,196 female patients diagnosed clinically with stress urinary incontinence underwent preoperative urodynamics study,after excluding pelvic organ prolapse.The preoperative uro-dynamic data of these 196 cases were analyzed and the clinical significance of urodynamics on differential diagnosis and treatment for the female patients with stress urinary incontinence was evaluated.Results:In this study,23 cases (11.73%)changed or amended their diagnoses by the urodynamic study,which were inconsistent with the previous clinical diagnoses concluded by the symptoms,physical examinations, and lab tests.A total of 10 cases underwent a different surgery or conservative treatment instead of the original treatment according to urodynamic study.Of them,3 were diagnosed as detrusor overactive and undertook conservative treatment;3 were diagnosed as bladder outlet obstruction plus stress urinary in-continence and were undertaken the transurethral resection of the bladder neck (TURBN)plus tension free vaginal tape (TVT);2 were diagnosed as bladder outlet obstruction plus stress urinary incontinence and were undertaken TURBN alone;1 was diagnosed as bladder outlet obstruction plus stress urinary in-continence and was undertaken TURBN plus tension free vaginal tape obturator (TOT);1 was found no abnormal bladder function turned out to be interstitial cystitis and went for a bladder instillation of drug. The changed treatments avoided the risk of dysuria or residual urine increased after operation due to inap-propriate surgical methods.Conclusion:In order to make a correct diagnosis and suitable treatment for female patients with stress urinary incontinences,the preoperative urodynamic study is necessary besides detailed medical history,physical examination,and laboratory tests.With the help of the urodynamic study,the concomitant diseases of patients with stress urinary incontinence may be detected,the individualized treatment regimen can be developed,and more importantly,the inappropriate surgical de-cision can be avoided.

Background and purpose:Patients with colorectal cancer are often accompanied by the increase of plasma ifbrinogen concentration. This study aimed to investigate the distribution characteristics of beta-ifbrinogen gene-448G/A, -148C/T, -1420G/A and -854G/A polymorphism and plasma ifbrinogen (Fg) concentration in patients with colorectal cancer. Furthermore, we analyzed their effects on the occurrence and development of cancer.Methods:The level of plasma Fg was quantiifed by using Clauss clotting method.FGBβ gene polymorphisms were identiifed by re-al-time lfuorescence quantitative PCR (RTFQ-PCR) in 194 colorectal cancer patients and 74 healthy controls.Results:The plasma Fg levels in tumor metastasis group and non-metastasis group were signiifcantly higher than that in control group, respectively (P<0.05). Compared with control group, the frequencies of -148T allele and mutation genotype were notably higher in disease group (P<0.05). In all the groups, the plasma Fg levels of those with -148T allele were higher than those without -148T allele (P<0.05). In stageⅣ patients, there was no difference in PFS between -148T wild gen-otype group and mutation genotype group (P>0.05).Conclusion:Plasma Fg concentration in patients with colorectal cancer was signiifcantly raised, which suggests that Fg may play a role in the occurrence and development of colorectal cancer. The beta-ifbrinogen gene -148C/T polymorphism is one of the reasons that cause plasma Fg elevation, but has no correlation with prognosis of patients with stageⅣ colorectal cancer.