Objective To study surgical techniques and curative effects of laparoscopic vaginoplasty with transferring vascularized ileal flap.Methods Clinical data of 62 cases of laparoscopic vaginoplasty using vascularized ileal flap from March 2004 to March 2006 in this hospital were retrospectively analyzed.There were 16 cases of total laparoscopic surgery and 46 cases of laparoscope assisted surgery.Results The operation was successfully completed in all the 62 cases.The intraoperative blood loss was 30~50 ml(40.0?0.6 ml) and the operating time was 90~313 min(165.0?5.6 min).Intestinal obstruction occurred 1 month after total laparoscopic surgery in 1 case,requiring a re-operation of ileectomy with end-to-end anastomosis.Vaginal stenosis occurred in 3 cases because of incorrect use of the vaginal mold.The remaining 58 cases had satisfactory vaginal dilatation outcomes. Conclusions Laparoscopic vaginoplasty with vascularized ileal flap is micro-invasive and accordant to normal physiological conditions,being an ideal method for vaginoplasty.

Objective To investigate the risk factors of post-operative cardiovascular or pulmonary complications in patients with gastrointestinal tumor. MethodsThe data of 352 cases with gastrointestinal tumor were analyzed retrospectively. These patients were divided into the two groups based on with or without cardiovascular or pulmonary complications. Seven relative factors including the patients' age, sex, smoking, duration of surgery, pulmonary function, ECG, UCG, and relationship between these factors and the incidence of post-operative cardiovascular or pulmonary complications were analyzed.ResultsForty-two cases occourred cardiovascular or pulmonary complications in 352 patients. The mean age and surgery duration were (61.2±7.9) years and (3.0±0.9) hours in patients with cardiovascular or pulmonary complications, and (53.5±4.6) years and (2.7±0.7) hours in patients without cardiovascular or pulmonary complications respectively. There was a significant difference between the two groups ( P<0.05). The patients with abnormal FEV1%, FEV1/FVC%, MVV% and cardiac function before operation had higher risk for post-operative cardiopulmonary complications ( P<0.05).ConclusionAge, duration of surgery and cardiac and pulmonary dysfunction may be risk factors of cardiovascular or pulmonary complications after gastrointestinal surgery.

Objective To investigate the related factors of postoperative pulmonary complications with abdominal operation. Methods 193 cases after abdominal operation were reviewed. The age, smoking history, surgery duration, surgical site, pulmonary function, artery blood gas analysis, and the incidence of post-operative pulmonary complications were analyzed. Results Pulmonary complications were found in 29 cases. The age was higher and surgery duration was longer in patients with pulmonary complications than those without pulmonary complications (P<0.05). The patients with abnormal forced expiratory volume in the first second (FEV1)%, FEV1/ forced vital capacity (FVC)%, maximum ventilatory volume (MVV)% and smoking history before operation were in higher risk for post-operative pulmonary complications (P<0.05). There was significant difference in artery blood gas analysis between the 2 groups (P<0.05). Conclusion The age,smoking history, surgery duration and pulmonary dysfunction may be the risk factors of pulmonary complications after abdominal operation,while it is important to monitor the blood gas analysis.

Objective To discuss the influential factors of postoperative pulmonary complications in elder patients accepted abdominal operation. Methods The clinical data of 95 cases accepted abdominal operation were analyzed retrospectively,and all the patients aged over 60. These patients were divided into two groups based on whether they had pulmonary complications or not. Seven relative factors including the age,sex,smoking history,surgery duration ,operation place,pulmonary function,anesthesia were analyzed and the relationship between these factors and the incidence of postoperative pulmonary complications were explored,too. Results Among the 95 patients,19 cases had pulmonary complications. The surgery duration in patients with pulmonary complications ((3.4 ± 1.1)h)were significantly higher than in those without pulmonary complications ((2. 6 ± 0. 9)h)(P ＜0.05). We also found significant differences in the comparison of FEV1%(59.2 ±9.5),FEV1/FVC(61.3 ±7.7)% ,MVV%(59.3 ±8.6)% in the group with pulmonary complications,with FEV1%(79.7 ± 11.5)%、FEV1/FVC(73.2 ±8. 3)% 、MVV%(74. 2 ±6. 4)% in the group without pulmonary complications. The epigastric operation and general anesthesia before operation were risk factors for post-operative pulmonary comphcations(P ＜0. 05). Conclusions Surgery duration,operation place,pulmonary dysfunction and anesthesia may be the risk factors of pulmonary complications after abdominal operation.

Objective To improve the animal model of hypertrophic scars for studying their pathology. Methods Twenty nude mice were divided randomly into two groups of 10. In group one every mouse received a full thickness piece of human skin grafted into the subcutaneous tissue of their hack. After the graft had survived 14d after transplantation, a burn was caused on the graft with a heated copper cylinder. The mice in the second group received the transplant but no burn. The status of the grafts and scars was observed, and histological examinations of the grafts were performed. Results Nine mice in group one survived, of which eight developed obvious and persistent hyper-trophic scars after the burns. These were hard and rose above the surrounding skin. Eight nude mice survived in group two, of which only six developed hypertrophic sear analogues after transplantation. Histological examinations showed abundant collagen deposition and inflammatory infiltration in all sears. Conclusion The similarity, repeat-ability, certainty, and survival rate of this improved hypertrophic scar model are superior to those reported previously. This improved animal model can induce obvious and persistent scarring that can be used to observe the whole proce-dure of hypertrophic scarring, so it is a useful tool for studying hypertrophic scars.

OBJECTIVE To discuss the feasibility of the establishment of the ventilator management center.METHODS Through the investigation on the circumstances of the use of ventilator in 2005 to find out the risk factors of ventilator associated pneumonia(VAP).RESULTS In whole hospital-acquired infections cases,VAP occupied 54.3% in lower respiratory tract infections.CONCLUSIONS Ventilator management is an important and complex work and the establishment of a ventilator management center is a favorable measure to prevent nosocomial infections.It is not only grant the use of ventilator in emergency,but also reduces the incidence of nosocomial infections.It can raise the intact rate of ventilator use,reduce energy and human resources consumption greatly and create a good economic and social benefits.

Objective To study the surgical techniques and effects of laparoscopy-assisted sigmoid colon vaginoplasty.MethodsClinical data of 27 patients,who underwent laparoscopy-assisted sigmoid colon vaginoplasty at Beijing Anzhen Hospital between June 2006 and June 2007,were retrospectively analyzed.A 15-cm segment of pedicled sigmoid colon was isolated using an ultrasound knife.The distal end of the segment was pulled into the vaginal space in the cul-de-sac of Douglas under a laparoscopic vision as the neovagina.The continuity of the intestinal tract(end-to-end bowel anastomosis) was restored using a circular mechanical suture through the rectum.ResultsThe surgery was successfully completed in all the cases,no intra-operative complication occurred.The mean blood loss and operation time was 82 ml(50-180 ml) and 168 min(120-246 ml) respectively.One patient developed incomplete intestinal obstruction 16 days after the operation,and was cured by conservative treatment.Follow-up was available in 21 patients for 14-20 months.Five patients had no sexual partner during the follow-up,while the other 16 patients were satisfied with their sexual lives after the surgeries.ConclusionLaparoscopic vaginal reconstruction using a sigmoid colon segment is satisfying for cosmetic,functional,and anatomic results.

Objective To study the effect of CEREC CAD/CAM ceramic inlay on repair of wedge-shaped defects of teeth and test its anti-fracture properties. Methods Extracted teeth were divided into control group ( n = 16) and experimental group ( n = 16) ,and prepared into imitating teeth with wedge-shaped defects. Teeth in experimental and control groups were repaired with CEREC CAD/CAM ceramic inlay and light-cured composite resin,respectively. Anti-fracture strength of teeth with wedge-shaped defects repaired with CEREC CAD/CAM was assayed on a universal testing device with its maximal loading recorded. The anti-fracture strength was compared between the 2 groups. Results The anti-fracture strength of teeth with wedge-shaped defects repaired with CEREC CAD/CAM ceramic inlay was significantly higher in experimental group than in control group ( 3. 56 ? 0. 27 vs 2. 43 ? 0. 15,P

[Summary] The mechanisms of gastroesophageal reflux disease ( GERD) include abnormal antireflux function and esophageal mucosa attacked by regurgitation .Gastroesophageal flap valve ( GEFV) located in the gastroesophageal junction is one mechanism of the antireflux barrier .An increased GEFV grade is associated with an increased incidence of erosive esophagitis and Barrett ’ s epithelium.With abnormal esophageal acid exposure and prevalence of a mechanically defective sphincter , patients usually have severe symptoms and lower efficiency of medication .Therefore , GEFV is valued in the diagnosis and treatment of GERD .This review summarized the relationship between GEFV and GERD .

Objective To test the fracture loading of extracted cracked teeth with CEREC CAD/CAM ceramic inlays/onlays. Methods All the extracted teeth were divided into two groups (A: control group; B: test group; n=15 teeth in each group). All the teeth were prepared into those imitating cracked teeth. Those teeth in group B were strengthened with CEREC CAD/CAM ceramic inlays/onlays. All teeth were thermocycled and mounted for testing and then were loaded until fracture. Results The force of anti-fracture of extracted teeth imitating cracked teeth with CEREC CAD/CAM ceramic inlays/onlays (group B) was obviously higher than that of the teeth without CEREC CAD/CAM ceramic inlays/onlays (group A). Conclusion CEREC CAD/CAM ceramic inlays/onlays can effectively prevent the crack of teeth in clinical practice.