Objective To compare the effects of two positions in the infant megacolon radical operation.Methods Sixty infants undergoing abdominal perineal megacolon radical operation were randomly divided into the control group and the observation group in equal number.The former took the traditional lithotomy position and the latter modified suspended lithotomy position.Results The operative exposures in the observation group were much more sufficient than that of the control group(P<0.05).While adverse skin reactions in the observation group were more uncommon than those of the control group(P<0.05).Conclusion The suspended lithotomy position may provide a better exposure and result in fewer adverse skin reactions during the abdominal perineal megacolon radical operation.

Objective To investigate the nursing points and the effect of the conjoint liver and kindey transplantation. Methods To review the concreted nursing experience among 13 patients who have accepted the conjoint liver and kidney transplantation from 1996 to 2004 in the First Affiliated Hospital of Sun Yat-Sen University,and then summarized the nursing key points of the operation. Results All the nursing measures during the course of operation were properly,the means time of operation was 9.5 hours,the means time of liverless was 65 minutes,the blood loss volume was 7 000 ml. Conclusion The nursing key points of conjoint liver and kidney transplantation include sufficient nursing prepare,homoiothermism during the operation,proper using drugs, proper blood-transfusion and fluid infusion.

0.05).CONCLUSIONS The effects of the four sterilization methods are uniform.Plasma hydrogen peroxide is a highly effective,safe and with environmental protection method.Soak for 30 minutes with 2% alkaline glutaraldehyde is a supplementary method when using high pressure or ethylene oxide methods.

Sixty-eight cases undergoing living related renal transplantation in First Hospital of Sun Yat-sen University between April 2004 and August 2007 were selected.The informed consent was obtained from the donors and recipients.The clinical data about operation assistance were retrospectively analyzed,including the pre-operation air sterilization in operation room,preparation of apparatus,one-off utensils and medicine,donor position fixation,assistance in kidney perfusion and preparation,management and usage of medicines,and steps of assistance during operation by instrument nurse.The results show the operational apparatus and utensils were prepared well,and the nurses knew well operation process and worked in harmony with the surgeons.For the 68 donor kidneys,the warm ischemic time was 1-6 minutes,and cold ischemic time was 10-118 minutes.The operations for both donors and recipients ran smoothly and lasted for 2.5-4 hours.Blood loss was less than 200 mL.Vital signs were stable during operation,and no complications happened.Good pre-operative preparation,strict management of personnel participating in operation,and training of assistant techniques are the preconditions for operation assistance.Rigorous aseptic management and correct preservation of organs are the keys for assistance for living donor kidney transplantation.Short warm and cold ischemic time of the donor kidneys are of great importance for the success of operation and the long-term survival of transplanted patients.

Objective To approach the reasons and influence factors about sudden deafness of nurs-es in the operating room. Methods We investigated the psychologic status and etiological factors of nurs-es in operating room through questionnaires designed by ourselves about general work pressure and sudden deafness correlative reasons. Results The total score of pressure was 21.486,among which rush work and check and examination,worrying about mistakes and accidents, pricking wound were the main reasons re-suiting in sudden deafness for the operating room nurses. Conclusions Enhancement of psychological nursing, health education and working environment improvement can lessen the anxiety emotion of nurses who have sudden deafness and has considerable effect to promote recovery.

Objective To summarize the key point of application of acellular dermal matrix(ADM)in operative cooperation of pharyngeal tissue repair.Methods In order to rebuild the air-tight cavity,ADM was sewn to the anterior vertebrae fascia in 7 patients with pharyngeal malignant tumor undergoing total laryngectomy or pharyngolaryngectomy to rebuild the posterior wall of the laryngopharynx.Meanwhile the muscular flap of the pectoralis major Was used to rebuild the anterior and lateral walls of the laryngopharynx.Results There was no reject reaction or pharyngeal fistula in these 7 cases and the wound surface were all mucous membranized.All the incisions reached the primary healing.Conclusions ADM is easy to get and possesses good histocompatibility and compatible thickness.It is easy to be managed during operation and can modify the peripharyngeal defect with the combination of muscular flap of the pectoralis major or any other neck tissue.Strict nursing preparation before operation and perfect cooperation during operation are key steps to complete the surgery successfully.

Objective To explore the effect of the self-designed cotton-padded covering for a modified lithotomy position on preventing complications in the lower limbs in patients undergoing gynecological laparscopic surgery.Methods A total of 320 patients undergoing radical hysterectomy or deep invasive endometriosis were selected and randomly divided into an observation group(n=160) and a control group(n=160).The patients in the control group were placed on the routine lithotomy position,the lower extremity and popliteal space protected with oasis outline cushion in the control group,while the patients in the observation group were placed on the same pads,the lower extremity and popliteal space protected with the self-designed cotton-padded coverings.Results The average temperature of the lower limbs of patients after operation in the observation group was significantly higher than that in the control group (P<0.01).The incidences of complications in the observation group were significantly lower than those in the control group(all P<0.05). Conclusion The self-designed cotton-padded covering for modified lithotomy position can effectively prevent the complications of the lower limbs and improve the comfort of patients.

BACKGROUND:The principle of lyophilization is to sublimate the solvent of frozen materials in vacuum and retain the solute, thus making a pore structure. OBJECTIVE: To produce a chitosan tubular scaffold by lyophilization, and to test its physicochemical properties. METHODS: The chitosan tubular material was prepared by lyophilization method, folowed by gross observation and electron microscopic observation. The chitosan tubular material samples were placed into PBS solution and pure water for 50 days, respectively, and then immersed in trypsin liquid for 1 day folowed by embedded into the muscle and dorsal skin of neonatal Sprague-Dawley rats for 30 days. The degradation rate and porosity of the material were observed and calculated. The breaking strength and compressive strength of the material were determined both under drying and soaking conditions using tensile instrument and pressure meter, respectively. RESULTS AND CONCLUSION:The external form of the chitosan tubular material was normaly tubular. Under the electron microscope, it was composited by different size pores, and the pore size was 50-200μm. The degradation rates of the material were (5.33±0.12)% in PBS, (11.26±0.15) in water, 0.012% in the trypsin liquid and (35.2±3.7)in vivo. The porosity rate was (97.5±1.5)%. The breaking strength and compressive strength of the material was higher under the drying state than under the soaking state (P < 0.05). These findings indicate that the lyophilization method can produce the chitosan tubular material with good porosity rate and degradation rate as wel as good tensile ability and compressive capability.

Objective To assess the risk of sympathetic nerve injury in oblique lumbar interbody fusion (OLIF) in different lumbar spine segments based on anatomical study.Methods Twenty-four healthy adult volunteers (12 male and female) were selected and routine lumbar spine scanning was performed with MAG MAGOMOM Verio 3.0 T.The anatomical structures of left lumbar sympathetic trunk,abdominal aorta and left psoas muscle were identified on T2 images of L2,3,L3,4,L4,5 intervertebral space.And the anatomical parameters of the OLIF operation approach and the anatomical parameters of the left sympathetic trunk and adjacent structures were measured.The t-test was used to compare the parameters between the different sexes.The comparison of the data between the different segments was performed by the least significant difference (LSD) single factor analysis of variance.Results From the L2,3 to L4,5 segments,the anatomical parameters of the OLIF operation approach and the anatomical parameters of the left sympathetic trunk and the adjacent structures showed regular changes.The distances between the anterior margin of the left psoas muscle and the abdominal aorta from L2,3 to L4,5 were 13.65±4.10 mm to 9.42 ± 4.00 mm in adult healthy male individuals,and 13.89±3.18 mm to 8.38 ± 3.33 mm in female individuals,showing a significant downward trend.The distances between the left sympathetic trunk and the abdominal aorta from L2,3 to L4,5 were 10.76±3.89 mm to 6.68±3.39 mm in adult healthy male individuals,and 11.52±3.02 mm to 6.12±2.95 mm in female individuals,also showing a significant downward trend.There were significant differences in the operation area of OLIF surgery between different segments.The operation area of OLIF surgery was relatively large in L 2,3 segment,and the risk of sympathetic nerve injury was relatively small.The left lumbar sympathetic trunk in the L3,4 intervertebral space was walking front and inside,and there was a greater risk of injury in the OLIF surgery.Conclusion The left lumbar sympathetic trunk located in or close to OLIF surgery operation field in L2-L5 segments.There was a certain risk of sympathetic nerve injury in OLIF surgery,and the risk of sympathetic nerve injury was different in L2,3,L3,4,L4,5 segments.

Objective:To design the small ubiquitin modification-fibroblast growth factor receptor 4 (SUMO-FGFR4) fusion gene and construct the expression vector pET22b-SUMO-FGFR4, to optimize the expression conditions. Methods:The SUMO-FGFR4 fusion gene was obtained by Overlap PCR and was connected to pET22b;the recombinant expression vector pET22b-SUMO-FGFR4 was obtained. The influence of lactose concentration, induction time,induction temperature,induction point and adding mode of lactose in the expression levels was observed,and the best induction condition was determined; then the solubility of recombinant protein was analyzed.Results:The SUMO-FGFR4 fusion protein was highly expressed,the molecular weight of the fusion protein was about 40 000 and it could bind with FGFR4 specific antibody.When the lactose concentration was 1.0 g·L-1 ,the induction time was 3 h,the induction temperature was 37℃,the value of A (600)was 0.8,the expression level was highest;but adding mode of lactose had no remarkable effect on the protein expression.The expression level of recombinant protein induced by lactose was higher than IPTG.SUMO-FGFR4 protein existed in a form of inclusion body.Conclusion:The SUMO-FGFR4 fusion protein is expressed successfully in this study while lactose is used as inducer and the best expression conditions are confirmed.