Objective To evaluate the clinical efficacy of four different methods of laparoscopic hysterectomy: laparoscopic supracervical hysterectomy(LSH),classic intrafascial supracervical hysterectomy(CISH),laparoscopic-assisted vaginal hysterectomy(LAVH),and total laparoscopic hysterectomy(TLH). Methods A retrospective analysis was carried out on 740 cases of laparoscopic hysterectomy in this hospital from January 1999 to December 2004 in respect of operating time,intraoperative blood loss,weight of removed uterus,postoperative recovery,time to normal sexual life,sexual satisfaction,and incidence of complications. Results The operations were accomplished under laparoscope in all the 740 cases.The operating time of LSH,CISH,TLH,and LAVH were 95.3?32.4 min,84.5?31.7 min,105.3?34.5 min,and 169.4?37.4 min,respectively.The time to normal sexual life of LSH,CISH,TLH,and LAVH were 30?5 d,50?9 d,35?7 d,and 54?11 d,respectively.The incidences of complications of LSH,CISH,TLH,and LAVH were 1.7%(2/120),1.3%(4/310),2.8%(7/250),and 1.7%(1/60),respectively. Conclusions Laparoscopic hysterectomy is safe and reliable.Of four methods of laparoscopic hysterectomy,each has its advantages and disadvantages,and method selection should be based on patient's own conditions.

Objective To better understand the MSCT characteristic of superior semicircular canal dehiscence syndrome (SSCDS). Methods A retrospective study was conducted on 8 patients who were diagnosed with SSCD syndrome in the otology and skull base surgery group of fudan university. All the patients CT features, the conventional axial and coronal images base on high-resolution MSCT and the images displayed the whole superior semicircular canal, which were reconstructed by using the technology of MPR, were reviewed. Results All the images that displayed the whole superior semicircular canal exhibited the dehiscence. Six patients' dehiscences occur in the middle of the roof over the superior semicircular (4 of 6 dehiscences also occur in the front of the roof), 2 patients dehiscences occur in the back of the roof over the superior semicircular. The range of the maximal diameter of the dehiscence was 0.8-4.2 mm, (median value: 2.4 mm). Conclusion The technology of MPR based on the high-resolution MSCT scan is very useful in diagnosis of the SSCDS.

Objective To study the CT and MRI features of primary middle ear carcinoma invading jugular foramen.Methods CT and MRI images of 7 patients with surgically and pathologically confirmed primary middle ear carcinoma invading jugular foramen were analyzed retrospectively,including high resolution CT (HRCT) scan in 6 cases,CT enhancement scan in 1 case and MR plain and enhancement scan in 7 cases.Results On HRCT,the soft tissue lesions mainly located in tympanum,tympanic sinus,the deep of external auditory canal and jugular foramen,and irregular “moth-eaten” bone destruction could be seen,including the destruction of jugular foramen in 7 cases,eustachian tube in 7 cases,facial nerve canal in 4 cases,carotid artery canal in 4 cases,external auditory canal wall in 3 cases,auditory ossicles in 2 cases,vestibular window and horizontal semicircular canal in 1 case.CT plain scan showed the density of soft tissue mass was uniform in 4 cases with CT value of 30-55 HU,and heterogeneous in 2 cases,in which small pieces high density lesions could be found.CT enhancement scan in 1 case revealed moderate and homogeneous enhancement.On MR plain scan,the soft tissue masses with hazy margins could be seen,and compared to the gray matter of brain,the lesions were isointense or slightly hypointense on T1 WI and isointense or slightly hyperintense on T2 WI.The signal was homogeneous in 5 cases and inhomogeneous in 2 cases with small pieces of hypointensity both on T1WI and T2WI.After enhancement,the lesions were enhanced moderately and homogeneously in 5 cases and inhomogeneously in 2 cases with small pieces of nonenhanced area.MRI also showed the erosion of carotid artery in 4 cases,sigmoid sinus in 1 case.Conclusion The primary middle ear carcinoma can invade the jugular foramen area extensively,which may lead to misdiagnosis.HRCT can precisely depict the bone destruction and the invasion of the important anatomic structures in the primary middle ear carcinoma,and the destruction of eustachian tube can help to reduce misdiagnosis.MRI can more clearly show the extent of tumor and the mass signal and enhancement pattern.

Objective To explore the therapeutic mechanism of Modified Lugen Formula(Phragmitis Rhizoma,Cicadae Periostracum,Batryticatus Bombyx,Lonicerae Japonicae Flos,Glycyrrhiza,Menthae Haplocalycis Herba,Notopterygii Rhizoma et Radix,Puerariae Lobatae Radix,Bupleuri Radix)in treating influenza from the virus-host interaction interface.Methods The phytocompounds were first collected from the HERB database,and then potential active compounds were screened out by Lipinski's rules of five.The targets of active compounds were further predicted through the SwissTargetPrediction platform.Differentially expressed genes(DEGs)were determined from the human H1N1 influenza dataset GSE90732 available in the Gene Expression Omnibus database(GEO).H1N1-Homo sapiens-related protein-protein interactions(PPIs)were gathered from the Pathogen-Host Interaction Search Tool(PHISTO).The above mentioned bioinformatic datasets were integrated.Then a PPI network and a Formula-virus-host interaction network were constructed using Cytoscape.Functional enrichment analyses were performed by using R software.Finally,molecular docking was carried out to evaluate the binding activities between the key compounds and targets.Results A total of 1 252 active compounds,1 415 targets,951 influenza-related DEGs,and 10 142 H1N1-Homo sapiens-related PPIs were obtained.There were 72 intersection targets between the Modified Lugen Formula and influenza.Functional enrichment analyses showed that these targets are closely related to host defense and programmed cell death.The network topological analysis showed that active compounds in the Modified Lugen Formula,such as oleanolic acid,γ-undecalactone,and longispinogenin,regulate viral proteins M2,NA,NS1,and HA and/or the host factors HSP90AA1,NRAS,and ITGB1,thus exert therapeutic effect.Molecular docking results confirmed that these compounds had a good binding ability with the targets.Conclusion Multiple active ingredients in Modified Lugen Formula directly target influenza virus proteins and/or host factors,thereby play an anti-influenza role in multiple dimensions,including inhibiting virus replication,regulating host defense and cell death.This study provides a theoretical basis for further experimental analysis of the action mechanism of the Modified Lugen Formula in treating influenza.