Objective To investigate the causes, management, and prevention of complications in laparoscopic gynecologic surgery. Methods A retrospective analysis was made on clinical data of 4413 cases of laparoscopic gynecologic surgery from September 1995 to June 2006 in this hoapital. Results Among 4413 cases, complications occurred in 71 cases, the overall rate being 1.6% (71/4413). Out of the 71 cases, an open surgery was required in 10 cases (14.1%). Complications included 5 cases of bladder injury, 4 cases of intestinal injury, 5 cases of massive haemorrhage, 8 cases of incision hematoma and drainage bleeding, 1 case of greater omentum hernia, 9 cases of perineal emphysema, 12 cases of skin congestion, 2 cases of head hematoma, 2 cases of brachial plexus nerve injury, 1 case of infective shock, 15 cases of abnormal incision healing, 1 case of lower limb thrombosis, and 6 cases of residual cervical cyst. Conclusions Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operator.

It explores the disease range of Liuwei Dihuang Pill from formulae source,ancient clinical application,modern study and application angles,combining with modern diseases,to define its multi-system targets,main pharmaceutical function and effective components by seeking for common mechanism.

Objective To investigate the distribution and expression of trefoil factor 3(TFF3) in the eosinophilic cells and basophilic cells in the pars distalis of the rat pituitary .Methods The immunohistochemiscal staining technique was used to show the coexpression of TFF3/growth hormone (GH),TFF3/prolactin (PRL),TFF3/thyrotroph (TSH), TFF3/adrenocorticotropin (ACTH),TFF3/follicle stimulating hormone (FSH),TFF3/luteinizing hormone (LH) in two contiguous slices .Results The immunoreactive products of TFF 3 and chromophil cells were brown granules , mainly expressed in cytoplasm .ACTH positive signals were expressed in the cell membrane and mainly located in the pars distalis hypophyseos.TFF3 existed in parts of GH,PRL,TSH,ACTH,FSH and LH cells in contiguous slices, accounting for 19.4%, 22.4%, 9.2%, 6.5%, 35.7%, 8.3%, respectively , in which FSH was the most , PRL and GH were less . Conclusion TFF3 expresses in GH, PRL, TSH, ACTH, FSH, and LH cells in the pars distalis , which enriches the morphological data for the location of TFF 3 in gland cells of pars distalis hypophyseos .

Objective To investigate the effects of acupuncture on the improvement of esophageal motility disorder in patients with refractory gastroesophageal reflux disease (GERD).Methods From September 2012 to March 2014,40 patients with refractory GERD were enrolled and evenly divided into the treatment group and the control group. High resolution esophageal impedance manometry was conducted in patients.After the first examination,patients of the control group lay down for 30 minutes, and patients of the treatment group received acupuncture treatment at Neiguan,Gongsun and Zusanli points for 30 minutes.Then all the patients underwent high resolution esophageal impedance manometry again.ManoView ESO 3.0 software was used for analysis.The parameters included swallowing peristalsis defect,lower esophageal sphincter (LES)pressure,LES residual pressure,LES length,upper esophageal sphincter (UES)pressure,distal wave amplitude,peristalsis duration time,starting speed of peristalsis wave,speed of edge contraction and integration of the peristaltic waves.Chi-square test or t test was performed for data analysis.Results The percentage of normal swallows of the treatment group before and after treatment was 56.0% (112/200)and 74.0% (148/200),the percentage of delayed esophageal emptying was 31 .5 % (63/200 )and 11 .5 % (23/200 ),and the differences were statistically significant (χ2 =14.242 and 23.700,both P <0.01 ).However there was no significant difference in those of the control group (both P > 0.05 ).The LES resting pressure of the treatment group before and after treatment was (20.2 ±18.8)mmHg (1 mmHg=0.133 kPa)and (26.3±10.1)mmHg,the length of LES was (2.2 ±0.6 )cm and (3.3 ±0.8)cm,the distal esophageal peristaltic amplitude was (60.2 ± 21 .9)mmHg and (41 .1 ± 16.8 )mmHg,and the differences were statistically significant (t = 5 .519, 6.580 and 6.881 ,all P <0.01 ).There was no significant difference in LES residual pressure before and after treatment (P >0.05 ).There as no significant difference in LES resting pressure and LES residual pressure of the control group before and after lying down (both P >0.05 ).However,before and after lying down,there were significant differences in the length of LES ((2.3 ±0.6)cm vs (2.5 ±0.6)cm) and UES resting pressure ((67.4 ±21 .2 )mmHg vs (53.5 ±18.1 )mmHg)in the control group (t =2.530 and 6.652,both P <0.05 ).The distal wave amplitude of the treatment group before and after treatment was (73.7 ±28.3)mmHg and (88.5 ±29.1 )mmHg,the duration of peristalsis was (2.9 ± 0.4)s and (3.2 ± 0.4 )s,the distal contraction integral was (977.7 ± 733.2 )mmHg · cm · s and (1 225 .9±945 .1)mmHg·cm·s.All the differences were statistically significant (t=7.907,3.404 and 3.325 ,all P <0.01).There were no statistically significant difference in the beginning speed of peristaltic wave and the contractile front velocity (CFV)(all P >0.05).Before and after lying down,there was no significant difference in distal wave amplitude,duration of peristalsis,the beginning speed of the peristaltic wave and CFV of the control group (all P >0.05 ).Conclusion Acupuncture can help increase the LES resting pressure,extend the length of LES,improve the overall peristaltic pressure and completeness of esophageal somatic part,meanwhile,it increases the percentage of normal swallows of patients with refractory GERD.

Objective To explor the value of Tei index for evaluation the cardiac function of patients with chronic heart failure(CHF).Methods Tei index in 60 patients with CHF(CHF group) and 30 normal controls(control group) were evaluated and compared with the levels of NT-ProBNP and the NYHA class,and the sensitivity and specificity of Tei index for CHF diagnosis were appraised.Results (1) Tei index in CHF group was significantly higher than that in control group.When Tei index was more than and equal to 0.45,the sensitivity,specificity,positive predictive value,and negative predictive value of Tei index for diagnosing CHF were 85.6％,90.4％,89.8％ and 78.0％.(2)There was a remarkable positive correlation between Tei and Log NT-ProBNP(r =0.84,P ＜ 0.01).(3)There were significant differences in Tei index among NYHA Ⅱ,Ⅲ,Ⅳ class [(0.47 ± 0.06),(0.56 ± 0.08),(0.64 ±0.13)].Conclusion Tei index can be used to diagnose CHF and evaluate the degree of it.

Objective:To research the number and function of monocyte-macrophages in patients with chronic active hepatitis B. Methods:The 51 chronic viral hepatitis B( CHB) patients were selected randomly,which consisted of 20 cases of mild-moderate,31 cases of severe group and 13 cases of healthy controls. PBMCs were separated by percoll. Monocytes were tagged by CD14,the molecules CD80,CD86,HLA-DR and CD163 were detected by flow cytometry which expressed on the surface of PBMCs. Serum cytokine were detected for IL-10, IL-12 and IL-23 by ELISA. The distribution of CD68 was detected in the liver by immunohistochemical staining. Results:The expressions of CD80 for all chronic hepatitis B patients were lower than the controls respectively,no matter mild-moderate or even severe group. Similarly,the HBV patients expressed lower level of CD86 in the peripheral blood mononuclear cells when compared with the control group. Furthermore, there was statistically difference between the levels of CD86 in severe group compared with control group (P<0. 01). As the expression of CD80 and CD86,the levels of HLA-DR in the patents had also declined when compared with controls. While the HLA-DR levels in both the mild-moderate HBV hepatitis groups were statistically significant higher than the severe group (P<0. 01). Different from the above all,the expression of CD163 in all chronic HBV hepatitis was higher than the control group. The CD68 positive cells in chronic HBV patients were observed and infiltrated increasingly in portal area and hepatic lobules (P<0. 05). There were statistically significant differences of IL-10 levels between the mild-moderate group,severe group and the control group,respectively (P<0. 01). Conclusion:Macrophages have participated in the pathological lesions of liver in CHB patients,among peripheral blood mononuclear cells,the phenomena of imbalance between type M1/M2 and polarization to type M2 have been observed,which participated in the development of the chronicity of CHB.

OBJECTIVE:To establish HPLC method for simultaneous determination of estazolam and diazepam in serum METHODS:The mobile phase consisted of methanol-water-triethylamine-acetic acid(55∶45∶0 5∶0 35)and the ?max was 254nm Phenytoin was adopted as the internal standard The drugs were extracted by diethyl ether under the alkaline condition RESULTS:The calibrating curves of estazolam and diazepam were linear in the ranges of 0 52～38 62?g/ml and 0 50～40 16?g/ml respectively CONCLUSION:The method was appropriate for determination of estazolam and diazepam qualitatively and quantitatively in intoxication accident

Chinese traditional culture is the soil for the survival and development of traditional Chinese medi-cine,among them,the concept of A thing is valued if it is rare portal factions and master has influenced the development,communication and popularization of traditional Chinese medicine.But the spirit and thinking of harmony unity of heaven and man comparative state benevolence and self-cultivation and self-re-straint has played an active role in the development of traditional Chinese medicine.Thus this paper put forward the suggestions and opinions of strengthening the cultivation of humanistic spirit of higher traditional Chinese medi-cine talents:establishing a comprehensive evaluation standards of higher traditional Chinese medicine talents,es-tablishing scientific development concept to treat the inheritance and innovation of traditional Chinese medicine cul-ture,perfecting the curriculum provision of relevant professions,creating the conducive environment for the trans-mission of traditional Chinese medicine culture,hoping to provide a reference for the explanation of the relationship between traditional culture and traditional Chinese medicine.

Objective To evaluate the relationship and screening value of percentage of body fat (BF%) and waist height ratio (WHtR) for hyperlipidemia in physical examination people. Methods A total of 2 668 objects taking physical examination in Henan Province People′s Hospital from September to December 2014 were included in this study. Values of height, body mass index (BMI), waist circumference, body composition and blood lipid level were detected. The receiver oper?ating characteristic curve (ROC) was used to analyze the screening rate of WHtR and BF%on hyperlipidemia with sensitivi?ty, specific and area under the curve (AUC). After stratified by age, waist circumference and BMI, multivariable logistic re?gression analysis was used to investigate the association between hyperlipidemia risk, BF% and WHtR. Results The screening accuracy rate on hyperlipidemia was higher for BF%, AUC was 0.79 in both female and male people. Among wom?en with BMI<18.5 kg/m2 and 18.5~<24 kg/m2, the risk of hyperlipidemia was higher in superfatted group than that of normal group. There was no correlation between WHtR and hyperlipidemia. Among men older than 40 y or with abnormal waist cir?cumference (≥85 cm), the risk of hyperlipidemia was higher in superfatted group than that of normal group, but not associat?ed with WHtR. Conclusion The BF%is a better screening indicator for hyperlipidemia compared with that of WHtR and BMI. Women with BMI<18.5 kg/m2 and 18.5~<24 kg/m2 and men older than 40 y or with waist circumference over 85 cm are suggested to do body composition tests to improve screening accuracy for hyperlipidemia.

Objective To investigate clinical and pathological features of gastrointestinal stromal tumors,the frequency and type of mutation of c-kit and platelet-derived growth factor receptor α (PDGFRA)genes.Methods 340 patients underwent surgical resection and diagnosed as gastrointestinal stromal tumors by postoperative pathology from Junuary 2012 to December 2014 were enrolled,and their tumor tissues were collected.The direct sequencing method was applied to detect the mutation status of c-kit gene (exon 9,11,13 and 17) and PDGFRA gene (exon12 and 18).Results There were 138 males and 192 females,and their median age was 58 years old (37-81 years old).There were 178 patients (52.4 ％) with gastric stromal tumors,21 cases (6.2 ％) with duodenal stromal tumors,82 cases (24.1％) with small intestinal stromal tumor,10 cases (2.9 ％) with colon stromal tumor,15 cases (4.4 ％) with rectal stromal tumors,30 cases (8.8 ％) with parenteral stromal tumor (from the peritoneum,mesentery,retroperitoneum or attachment),4 cases (1.2 ％) of liver tissues (gene detection tissues from the liver biopsy or surgical resection specimens).In the mutation analysis of all 340 patients with gastrointestinal stromal tumor,the total mutation rate was 89.4 ％ (304/340),including 81.2 ％ (276 cases) of c-kit,8.2 ％ (28 cases) of PDGFR and 10.6 ％ (36 cases) of wild type.Among 125 cases underwent the detection of the gene mutation sequences,there were 49 cases of exon11 deletion mutation,4 cases of exon11 insertion mutation,12 cases of exon 11 missense mutation,8 cases of exon9 insertion mutation,1 case of 3xon13 missense mutation,1 case of exon17 missense mutation,24 cases of exon12 synonymous mutation and 20 cases of exon18 synonymous mutation.Conclusions Gene detection is becoming more and more obvious in predicting the therapeutic effect of molecular targeted therapy,the mechanism of drag resistance and the clinical treatment,c-kit exon11 mutation is one of the most common gene mutation types related to the choice of targeted medicine.