Objective To study the impact of obesity on the perioperative outcomes of hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization (LSED).Methods The clinical data of patients who underwent hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization between Jan.2013 and Nov.2015 were retrospectively analyzed.The patients were classified as obese group A (BMI≥28 kg/m2) or non-obese group B (BMI ＜ 28 kg/m2).Group A was further divided into two subgroups:group A1 massive splenomegaly (diameter ＞ 20 cm) and A2 splenomegaly (diameter ≤20 cm).The conversion rates,operative complications,mortality,length of stay,operative time,and blood loss were analyzed and compared.Results One hundred and sixty patients who underwent hand-assisted LSED were included into this study.54 patients were in group A and 106 in group B.A significantly longer operative time was found in group A (291 min vs.261 min,P ＜ 0.05).The conversion rates,blood loss,length of hospital stay,overall morbidity rates,and mortality rates were similar in the two groups (P ＞0.05).The mean operative time was significantly longer in group A1 (336 min vs.270 min;P ＜0.01)although blood loss,conversion rates,and overall morbidity rates were higher in group A1.However,there were no significant differences (P ＞ 0.05).Conclusions Hand-assisted laparoscopic splenectomy combined with esophagogastric devascularization for obese patients was safe and feasible.However,for patients with massive splenomegaly,LSED should be performed with caution.

10.3969/j.issn.2095-4344.2013.26.018

Retinal degenerative disease is the leading cause of visual loss,the mechanism is not clear and has no effective treatment method.In recent years,the field of stem cell research has made great progress.Stem cells have the potential of differentiating into all the body cells.Embryonic stem cells (ESCs) can be used to differentiate a variety of retinal cells,which has brought a new promise for the treatment of retinal degeneration disease.However,the most important step of this treatment is how to differentiate ESCs into photoreceptor cells and retinal pigment epithelium (RPF) cells.In this paper,we introduced the recent progress in the differentiation methods of ESCs into retinal cells,which contains spontaneous differentiation method,co-culture method,growth factors and small molecules induced method,adherent monoculture method,three dimensional differentiation method.

Medical education for the international medical students is an important part of home medical colleges. This article focuses on the training of teacher’s ability,the understand- ing of the international medical students,the preparation for lessons and the agile use of many teaching ways during the teaching process of Nuclear Medicine for the international medical stu-dents. Up to now,we still have no textbooks of Nuclear Medicine for the international medical students. This is the problem that exists in the Nuclear Medicine teaching.

Objective To explore the characteristics and rehabilitation of Chinese dysarthria. Methods 31 patients and 63 normal controls were measured with maximum phonation time (MPT), pitch, intensity and mean airflow rate (MAR), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximum midexpiratory flow (MMF), peak expiratory flow rate (PEFR); Nasalance was tested with Nasalance Acquisition System (NasalView); Speech intelligibility was tested with mandarin words card. And alternative movement rate (AMR) were also tested. All the patients were rehabilitated with physiologic approach, 16 patients who finished the course were tested again after rehabilitation. Results MPT, MAR, aspiratory function, AMR of the patients was remarkable lower than those of the control; the nasalance scores of vowel and nonnasal sounds, words, and sentence were remarkable higher than those of the control; the speech intelligibility was also lower. After intervention, MPT, aspiratory function, AMR, and speech intelligibility improved. In the index, only MPT and AMR were correlated with the speech intelligibility. The nasalance of /i/ and nonnasal sentence related with the listener perceptions of hypernasality. Conclusion The aspiratory and phonation function of the patients with dysarthria are impaired. The patients show hypernasality which is a type of resonance abnormity. AMR is declined. Speech intelligibility is much lower. Physiologic approach can improve their phonation, aspiration, articulation and communication ability, but can't for resonance. The longer the MPT, the more /pa、ta、ka/ in specific time, the higher the speech intelligibility. Nasalance could be used for evaluating the hypernasality.

Dysarthrias are speech disorders that result from neurological impairments associated with weakness,slowness,or incoordination of the musculature used to produce speech.According to the lesion sites and the severity of the speech impairments,it is identified 6 types of dysarthria:spastic,flaccid,mixed spastic-flaccid,ataxic,hypokinetic,and hyperkinetic.And spastic is the most common.The incidence of dysarthria in cerebrovascular disease is 30%～40%.There are many researches and data on this speech disorder abroad.But because of different language,most of the data is not appropriate to Chinese.

The specificity of circulating tumor cell (CTC) such as epithelial-mesenchymal transition,fusion of bone marrow-derived cells,resistance anoikis determines the necessity of cell cultivating.The produced cell lines can provide good material basis for further research of malignant tumor metastasis,also provide individualized targeted therapy for patients with a new direction.

Adult ; Athletes ; Electroencephalography ; Female ; Humans ; Male ; Sports ; physiology

Objective To discuss the effects of curcuma on different phases of the Hela cell proliferation in order to find the effective medicine in cervix cancer treatment.Methods MTT colorimetry and flow cytometry were used to measure the inhibitory rate of Hela cell proliferation and the changes of cell cycle, and transmission electron microscope(TEM) was used to observe the changes of the Hela subcells treated with the different concentrations of curcuma(0,10,20 and(40 mg?L~(-1))).Results Curcuma(0,10,20 and 40 mg?L~(-1))had obvious inhibitory effects on the Hela cell proliferation in a dose-dependant manner,the inhibitory rates were 3.0%,21.4%,32.8% and 49.2%,respectively.Furthermore,flow cytometry showed that the number of cells in G_1 phase increased and the number of cells in S phase decreased,the number of cells in G_2/M phases relatively increased.The changes of subcell structure could be seen,such as cavernous cells,cytoplasm agglutination,increasing apoptosis.(Conclusion Curcuma) can inhabit the Hela cell proliferation, prevent the cells in G_1 phase from entering into(S phase),and promote Hela cell apoptosis.

Objectlve:To assess the influential factors of decision-to-delivery inteval (DDI) in caesarean section, and its influence on neonatal outcomes.Methods:472 caesarean sections were divided into two groups according to Lucas's classification :the emergency caesarean sections as group 1 (291) ; and the e-lective caesarean sections as group 2 (181).It was divided into DDI ≤30 min group and DDI > 30 mir group in group 1.A retrospective study was performed in DDI, influential factors of DDI, neonatal Apgar score and umbilical arterial blood gas.Results: ①The mean DDI was 35.5±11.6 min in group 1,in wgich DDI≤30 min was 210 cases (72.2%) and 49.3 ±22.8 min in group 2, in which DDI≤30 min was 86 cases (47.5%).②IN group 1,umbilical artery pH and Apgar core at 1 min after birth could be improved sigbificantly in the cases of DDI ≤ 30 min (P<0.05) , but no correlation was found between the DDI and Apgar scrore at 5 min ,as compared with DDI ＞30MIN CASES(p＞0.05).③It was mainly influenced by time taken to get the patient into operation room in DDI >30 min (56 cases, 69.1 %).Concluslons :The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as pos-sible might improve the neonatal outcome.