Lapareseopic colectomy is commonly performed,but laparoscopic extended right hemicolectomy with D3 lymphadenectomy for cancer located at hepatic flexure of the colon is a complex procedure,even in the hands of experts.Laparoscopic dissection of the lymph nodes around the middle colonic and right gastroepiploic vessels are so complicated that precise vascular anatomy and surgical plane are essential to complete this procedure safely.We herein describe a standard technique for performing laparoscopic extended right hemicolectomy with D3 lymphadenectomy using a medial-to-lateral approach.The main surgical plane of this procedure is the right Toldt's space.The superior mesenteric vein (SMV) is the most important anatomical landmark of vascular dissection.Medial-to-lateral approach makes it easy to locate the right Toldt's space and the SMV.

Aim To investigate the effects of Cariporide on expression of intercellular adhesion molecule-1(ICAM-1) and P-selectin and adhesion of monocytes and endothelial cells induced by lysophophatidylcholine(LPC).Methods The ratio of adhesion of monocytes and endothelial cells was assessed by measuring protein content.The expression of ICAM-1 and P-selectin in endothelial cells was examined by enzyme-linked immunosorbent assay(ELISA).Intracellular pH of endothelial cells was measured with 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein(BCECF).Results The results showed that LPC enhanced the adhesion of monocytes and endothelial cells in a concentration-dependant and time-related manner.The dosage of 5,10 and 20 ?mol?L-1 Cariporide reduced the adhesive ratio of endothelial cells induced by LPC(5 mg?L-1)from 36% to 23%,18% and 16%(P

Objective To investigate the feasibility and safety of laparoscopic myomectomy in patients with large uterine myoma and the tumor located at special sites. Methods A retrospective study of 142 patients underwent laparoscopic myomectomy was done.In the patients,all the myomas were ≥10 cm in diameter;located at the cervix,uterus posterior wall near to the isthmic uteri,or broad ligament.The procedure was completed according to the volume and location of the tumors.For large myomas,the muscle layer was resected to remove the tumor,after removing the major part of the lesion(cut into pieces before moving out),the rest small parts were cut completely.Ligation was used for large tumors with sufficient blood supply in the surface or subserous myomas.For the myomas located in the broad ligament,the ligament was opened to pull out the tumor,and then the tumor was cut into pieces and resected at the root. Results The procedure was completed by laparoscopy in all of the patients,except in one who received laparoscopy-assisted resection.The removed tumors weighed 44 to 1903 g.The operation time ranged from 30 to 175 minutes.Intraoperative blood loss was 10 to 800 ml.No serious complications occurred.Among the cases,follow-up was available in 68 patients for 2 years.During the period,ultrasonography showed recurrent myoma in 2 patients. Conclusions With the improvement of the skills of laparoscopic myomectomy,indications for the laparoscopic operation can be widened.

Objective: To assess the tissue reactions of dogs to a new nanohydroxyapatite. Methods:Three dogs were used for root canal filling experiment, mandibular implanting and subcutaneous implanting experiment. AH-plus root canal sealer was used as control. The dogs were killed after implantation for 2,4 and 12 weeks separately. The tissue reaction was assessed by X-ray and light microscope examination. Results:①Root canal filling experiment: no inflammatory reaction was detected in specimens of n-HA group. In AH-plus group, implantation caused a middling inflammatory reaction after 2 weeks and 4 weeks. After 12 weeks the reaction of apical tissues was slight. ②Mandibular implanting experiment: no inflammatory reaction was showed by all n-HA groups and the group of AH-plus implanted for 12 weeks.Mild inflammatory reaction was observed in the groups of AH-plus implanted for 2 weeks and 4 weeks.③ Subcutaneous implanting experiment:after AH-plus was implanted for 2 weeks and 4 weeks, middling inflammatory reaction was observed. The group of n-HA implanted for 2 weeks showed the same reaction. No obvious inflammatory reaction was found in the other groups. Conclusion:n-HA shows better tissue compatibility than AH-plus.

ObjectiveTo explore the application of evidence-based nursing in ulcer pressure prevention of patients in cardiovascular surgery department and effect evaluation. MethodsEvidence-based nursing was applied to 342 patients in our department from January 2008 to October 2010,and the nursing effect was evaluated. ResultsNon of the 342 patients suffered ulcer pressure,the course of disease was shortened and the treatment effect was increased. ConclusionsApplication of evidence- based nursing in cardiovascular surgery patients can significantly reduce the occurrence of pressure ulcers,greatly improve the patients' quality of life,and also can increase the observation,analysis and problem solving ability of nursing staff.

Objective To investigate the efficacy of pegylated interferon (Peg-IFN) plus ribavirin to treat hepatitis C virus (HCV) recurrence, and analyze possible factors associated with sustained viral responses (SVR). Methods The enrolled 39 patients, who had recurrence of hepatitis C after liver transplantation and received antiretroviral therapy, were analyzed. Treatment was discontinued in 21 patients due to side effects, and the remaining 18 patients [13 males, 5 female,median age of 54 (27-67) years, treatment duration of 25-105 weeks)] were subjected to whole standard treatment. During the treatment, HCV RNA was measured at 4, 12, 24, and 24 weeks after HCV negative change as well as drug withdrawal. SVR was defined as HCV RNA negativity within 24 weeks after the drug withdrawal. The following variables were analyzed: ages, gender,pretreatment viral load, genotype, early viral response (EVR), levels of alanine aminotransferase before treatment and their association with SVR. Results The mean treatment duration was 57weeks with an SVR achieved in 4/18 (22. 2 %). Statistical analysis revealed that the genotype of non1B (P=0.023), RNA ＜106 copy/ml (P= 0. 044) before treatment and EVR (P=0.019) were the variables associated with SVR. Conclusion Genotype of nor-1B, low level RNA before treatment and EVR were the effective predictors of interferon antiviral therapy for recurrent hepatitis C after liver transplantation.

Objective To study the pharmacological effects of Qinggong Decoction on sedation and hypnosis. Methods Fifty mice were randomly divided into five groups: NS group, diazepam group, and low-, mid-, high-dose Qinggong Decoction group. Diazepam group was given 0.1 mL/10 g diazepam, and other four groups were given 0.2 mL/10 g corresponding drugs. Spontaneous activities before and after ig. were recorded and the sleeping time of mice with pentobarbital sodium (superthreshold dosage) and the number of the sleeping mice with pentobarbital sodium (subthreshold dosage) were measured. Convulsion model induced by nikethamide was used to observe the change of the seizure rate in mice after given Qinggong Decoction. Results Qinggong Decoction (3.0, 6.0 g/kg) could obviously inhibit spontaneous activities of mice, prolong the sleeping time of mice with pentobarbital sodium (superthreshold dosage) and increase in the number of the sleeping mice with pentobarbital sodium (subthreshold dosage), and had markedly anticonvulsant effect in mice induced by nikethamide. Conclusion Qinggong Decoction has obvious effects of sedation, hypnosis and anticonvulsion.

Objective To analyze the association of DOG1 protein with gastrointestinal stromal tumors(GIST). Methods Seventy-seven patients diagnosed with GIST between January 2005 and June 2010 were enrolled. The DOG1 expression in GIST was determined using immunohistochemistry.The result was compared with that of CD117 and CD34. Results Of 77 GIST patients, the DOG1 was expressed in 74 (96.10%) patients and CD117 in 70 (90. 9%) patients, with no significant difference between DOG1 and CD117 (P＞0.05). DOG1 expression was not related to the risk stratification of the tumor, site, age and gender (P＞0. 05). Of 7 GIST patients with negative CD117,6 patients were positive for DOG1 expression. Whereas 2 of 3 DOG1 negative patients were positive for CD117 expression. Conclusions DOG1, as a novel marker for GIST,has high sensitivity as CD117. It is a good complementarity in diagnosis of GIST when combine DOG1 with CD117, especially in diagnosis of CD117 negative patients. However, the DOG1 can not be used as an index in eveluating the risk stratification of the GIST.

BACKGROUND: It is believed that repetitive transcranial magnetic stimulation (rTMS) may produce such neurophysiological effects as regulating regional cerebral blood flow, neurotransmitters, local metabolism, and neuronal remodeling after nerve tissue injuries. The prognosis ofischemic stroke is related with the cortical function reconstruction in the ipsilateral and contralateral hemisphere of the lesion. Currently studies have not defined whether rTMS can affect the cortical function, protect ischemic neurons and promote motor functional recovery after cerebral ischemia.OBJECTIVE: To investigate the effects of rTMS on rat motor cortical excitability and neural function in acute stage of cerebral ischemia-reperfusion injury.DESIGN: Completely randomized experiment.SETTING: Electroneurophysiological Laboratory of Peking Union Medical College Hospital.MATERIALS: The experiment was completed in the Zoological Research Center of Peking Union Hospital from January to June 2004. Totally 22adult male healthy Wistar rats were randomly divided into treatment group and the control group with 11 in each.METHODS: After determination of the average motor threshold of the right hind limbs, which was 22% of the maximum output, the rats were subjected to middle cerebral artery occlusion for 1 hour followed by reperfusion for 72 hours. At each time point of immediately and at 12, 36 and 60 hours after the initiation of reperfusion, the rats in the treatment group received rTMS treatment (20 Hz, 40% maximum output, 5 seconds for each session with an between-session interval of 2 minutes for a total of 10 sessions), and the site for motor threshold evaluation was used for rTMS stimulation; the rats in the control group recevied no treatment after model establishment. Motor threshold testing was performed in both groups 4 hours after the last session of treatment to avoid immediate-early effects of rTMS on the motor threshold. At 24 and 72 hours of reperfusion, the scores of neural function were recorded according to evaluation systems. All the rats with scores between 1 and 3 were enrolled in statistical analysis were evaluated between.MAIN OUTCOME MEASURES: ① Motor threshold of the rats in both groups before and after injury; ② Neural function scores at 24 and 72 hour reperfusion; ③ Infarct volume at 72 hour of reperfusion.RESULTS: Totally 13 rats entered the final result analysis. Before injury,motor threshold in the treatment and control group was similar (P=0.71),and after the injury, the motor threshold of the control group was 1.49times that of the treatment group but such difference was not statistically significant [(41.62±24.73)% vs (28.00±9.35)%, t=-1.17, P=0.27]. At 24hours of reperfusion, the functional scores of the treatment group and control group were not significantly different (P=0.46), but at 72 hours, the scores of the treatment group were significantly lower than that of the control group (1.60±1.52 vs 7.75±3.62, t=-3.57, P=0.004). The average infarct volume of two groups was (62.00±60.88) mm3 and (20.00±12.41) mm3 at 72 hours of reperfusion, respectively, which, after logarithm transformation,was not significantly different between the two group (t=-1.31, P=0.22),but when the infarct volume was transformed into Log10 values, a significant difference occurred between them (P=0.045).CONCLUSION: rTMS may stabilize and prevent the increment of the motor threshold, time-dependently relieve the neural function disability and reduce the infarct volume after cerebral ischemia-reperfusion injury.

0.05).Conclusion these results suggest that ?_2-AR 16、27 locus genetic polymorphism is not correlated with asthma.