Objective To explore the optimal treatment options of Stanford type B aortic dissection. Methods A to?tal of 51 patients with Stanford type B aortic dissection who visited the General Hospital of Tianjin Medical University from May 2008 to March 2013 were analyzed retrospectively. Survival and recovery of patients were evaluated by follow ups. Pa?tients were divided to TEVAR group(40 cases)and conservative group(11 cases)according to the treatment they recieved. Results Operations were successful in all 40 patients. There were two cases of perioperative death(5%). And none of pa?tients died in TEVAR group during follow-up. One case among 11 patients who received conservative treatment dead in hos?pital(9.1%)while other 7 cases died during follow-up(63.6%). Kaplan-Meier survival curve showed that two-year survival rate of TEVAR group was significantly higher than that of conservative group. In TEVAR group, the maximum diameter of the aorta presented a decreasing trend and thrombosis was seen in artificial lumen with time going after operation. Conclu?sion For patients with Stanford type B aortic dissection, TEVAR presented a high success rate and promoted remodeling of the aortic genuine and aritificial lumen. What’s more, it can significantly improve patient’s survival rate and recovery in short or mid-term period compared with effect of traditional conservative treatment.

Objective To investigate the scientific research ability and training needs of the new posts of medical undergraduates for better training them.Methods A total of 62 new posts of medical undergraduates from a level-two general hospital in China were recruited by questionnaire survey.Resuits the scientific research ability of the new posts of medical undergraduates is poor,so it is very necessary for their in-service training,93.5~ of them have interest in scientific research and hope to get the training,especially want to take part in the practical activity.Conclusions It is not better that the scientific research ability of the new posts of medical undergraduates,so as early as possible to give the scientific research skill training to them.

BACKGROUND:Bone marrow stromal stem cels transplanted into infracted cardiac tissue can inhibit and reduce myocardial apoptosis, but whether this effect is correlated with improvement in cardiac function is stil unclear. OBJECTIVE:To study the early effect of bone marrow stromal stem cels transplanted into the ischemic myocardium on the cardiac function. METHODS: Models of acute myocardial infarction were established by ligation of the left anterior descending branch, while no ligation was done in the sham group. In the transplantation group, rat bone marrow stromal stem cels (0.1 mL, 2×106 RESULTS AND CONCLUSION:At 3 days after cel transplantation, myocardial apoptosis was more evident in the infarct and ischemic zones of the model group than the sham group; the number of apoptotic myocardial cels was significantly lower in the infarct and ischemic zones of the transplantation group than the model group. Compared with the sham group, the mean arterial blood pressure and left ventricular systolic pressure were ) were injected into five sites on the edge of infarcted myocardial tissues at 30 minutes after myocardial infarction. In the sham group and model group, the same volume of normal saline was injected into the myocardial tissues. Three days after cel transplantation, hemodynamic monitoring, echocardiography, TUNEL assay were employed to detect myocardial apoptosis. significantly reduced, the left ventricular end diastolic pressure was increased, and the left ventricular ejection fraction and shortened fraction were significantly lowered in the model and transplantation groups (P < 0.05), but there was no difference between the model and transplantation groups (P > 0.05). These findings indicate that myocardial apoptosis can be reduced but the cardiac function cannot be improved in acute myocardial infarction rats at early stage after bone marrow stromal stem cels transplantation.

[Objective]To study the clinical result of Endo-Model rotating-hinge prosthesis in the treatment of severe knee deformity. [Method]Twenty-two patients(10 males and 12 females;12 right knees,8 left knees,and 2 bilateral knees) were selected for total knee arthorplasty using Endo-Model rotating-hinge prosthesis.The average age was 56.2 years.All the patients were evaluated by HSS score system.[Result]All incisions healed at one-stage and all malformations were corrected.The functional result was good.Mile deep vein thrombosis was found in one case after operation.All the patients were followed up for 6-55 months.No infection or prosthetic loosening was developed.[Conclusion]Endo-Model rotating-hinge prosthesis is an effective and reliable prosthesis for severe knee deformity.

Objective To investigate the mechanism of body weight support treadmill training (BWSTT) and electroacupuncture (EA)for spinal cord injury. Methods 56 adult SD rats were divided into control group (n=16), EA group (n=16), BWSTT-EA group (n=16) andblank group (n=8). They were treated 3 d after operation, and assessed with Basso-Beattie-Bresnahan (BBB) scale and the brain-derived neurotrophicfactor (BDNF) was measured in injured tissue with real time immunohistochemisty assay 1 d, 7 d, 14 d, 21 d after treatment. ResultsThe score of BBB was significantly higher in the BWSTT- EA group than in control group and EA group 1 d, 7 d, 14 d, 21 d after treatment(P<0.05), as well as the expression of BDNF (P<0.05). Conclusion BWSTT and EA can promote the recovery of spinal cord injury,which may associate with the expression of BDNF in injured tissue.

Objective To summarize the clinical experience of laparoscopic appendectomy(LA).MethodsA retrospective analysis was conducted on the clinical data of 683 patients with appendicitis treated by LA,including 258 cases of chronic appendicitis,425 cases of acute appendicitis(87 cases of complicated appendicitis).ResultsThe procedure was completed in all the patients without conversion to open surgery.The operation time was 30 min in average(15-150 min).The average hospital stay was 4d (2-15d).Postoperative complications included 26 cases of incision infection,3 cases of abdominal abscess,1 case of appendical mesenterium hemorrhage,1 case of small intestine fistula and 1 case of appendical stump fistula.The patients were followed up for 2 to 12 months with a mean of 6 months,during which no intestinal adhesive obstruction occurred.Conclusion LA is safe and effective for appendicitis,with advantages of minimal trauma,lighter pain,quicker recovery,shoter hospital stay,less complications and so on.For complicated appendicitis,the abundant surgical experience and proficient endoscopic technique are indispensable to reduce the occurrence of complications effectively.

Objective To investigate the dates of 477 Chinese prenatal screening centers for previous half year analyse prena-tal screening status and provide recommendations for quality control.Methods All China prenatal screening centers were sent the data via the National Quality Assessment Scheme.This covered the software used,the risk cut-offs,monthly sample throughput,monthly median MoM of AFP,hCG,β-HCG,freeβ-HCG and uE3,monthly screening positive rate for trisomy 21,trisomy 18 and Open Neural Tube Defect.Results Screening protocol were versatile,with 73.48% (133/181)used two-marker model,24.31% (44/181)used three-marker model and 2.21% used four-marker model.About the software used, 350 laboratories never updated the screening parameters,89 laboratories had updated their median or parameter by manufac-turers,24 laboratories had updated the parameters by themselves.Cut-offs differed between laboratories.59.91% (275/459) used 1/270 as their cutoffs for trisomy 21.66.22% (296/447)used 1/350 as their cutoff for trisomy 18 and 96.52% (361/374)used cutoffs between 2.0~2.5 MOM for ONTD.Results of monthly median MOM:the percentage of laboratories that all six monthly median MOM within the target of 0.90~1.10 was 46.69% (155/332)for AFP,20.0% (4/20)for hCG, 29.17% (28/96)forβ-HCG,15.66% (31/198)for freeβ-HCG and 4.82% (11/228)for uE3.The percentage of laborato-ries that all six monthly median MOM within the target of 0.95~1.05 was 14.16% (47/332)for AFP,0% (0/20)for hCG,4.17% (4/96)forβ-HCG,12.63% (25/198)for freeβ-HCG and 4.82% (11/228)for uE3.About screening positive rate,there were difference of trisomy 2 1 positive rate in the same laboratory within the six month.Conclusion There were variations types of screening protocol,different kinds of soft platform,randomness of choice or update of medians or other important parameters and great difference in awareness of quality control.It would be taken effective and practical quality control measures to help laboratories improve quality control.

Nowadays,with the rapid development of science and technology of medicine,the detection rate of obstructivc azoospermia increased gradually,clinically not uncommon.Surgical treatment of obstructive azoospermia is also improved from traditional vasovasostomy and epididymovasostomy to microsurgical vasovasos-tomy and microsurgical va-soepididymostomy,and from 3-suture intussusception vasoepididymostomy to 2-suture intussusception vasoepididymostomy,then our modified reverse single needle anastomosis,and finally to the robot assisted anastomosis.Therefore,the anastomosis is more precise,the recanalization rate and the pregnancy rate have a revolutionary improvement.The robot era is coming.The article focuses on surgical treatment of obstructive azoospermia,comparison of the advantages and disadvantages of each operation,and prediction of the future direction of development.

ObjectiveTo evaluate the effects of all-trans retinoic acid(ATRA) on melanin content,activity and protein expression of tyrosinase,mRNA expression of Cu/Zn superoxide dismutase(SOD) in A375 cells irradiated with ultraviolet B(UVB).MethodsCultured A375 cells were classified into 6 groups:ATRA+UVB group treated with ATRA after UVB irradiation,hydroquinone+UVB group treated with hydroquinone after UVB irradiation,UVB group and ATRA group treated with UVB irradiation and ATRA respectively,negative control group receiving no treatment.Melanin content and tyrosinase activity were determined by NaOH solubilization assay and dopa-oxidation assay respectively at 24,48 and 72 hours after the addition of ATRA into medium.Western blot was performed to detect the protein expression of tyrosinase,and real-time quantitative PCR to measure the mRNA expressions of tyrosinase and Cu/Zn SOD in A375 cells after 24-hour culture with ATRA.ResultsThe melanin content and tyrosinase activity decreased in UVB-irradiated cells after being treated with ATRA for 24,48 and 72 hours.The protein (gray scale) and mRNA (2-△△Ct value) expression levels of tyrosinase were 0.72 ± 0.070 and 1.400 ± 0.135 respectively at 24 hours after UVB irradiation,decreased to 0.42 ± 0.056(P ＜0.01) and 0.810 ± 0.062(P ＜ 0.01 ) respectively after additional treatment with ATRA.The mRNA expression level of Cu/Zn SOD was 0.323 ± 0.066 in A375 cells at 24 hours after UVB irradiation,and increased to 0.625 ±0.103 (P ＜ 0.01 ) after additional treatment with ATRA.ConclusionATRA can suppress UVB-induced increase in melanin synthesis and elevate Cu/Zn SOD level in A375 cells,likely through tyrosinase pathway.

Objective To study the effect of dexmedetomidine (DEX) on postoperative cognitive function and preoperative inflammation in the elderly patients undergoing general anesthesia. Methods 70 elderly patients undergoing general anesthesia operation were chosen and divided into observation group and control group randomly. DEX and physiological saline were applied in observation group on the basis of routine general anesthesia. The cognitive function of patients in both groups were tested by mini-mental state examination (MMSE) and the incidence rate of cognitive dysfunction (POCD) were measured at 1 day before surgery, 1 day, 3 days, 5 days, and 7 days after surgery. The level of interleukin-6 (IL-6) and tumor necrosis factor-α(TNF-α) were tested before anesthesia, during skin incision, rightly after operation and 1h after operation. Results MMSE scores were significantly higher and the incident rates of POCD were lower in observation group than those in control group at 1 day and 3 days after surgery (P<0.05). The levels of IL-6 and TNF-αincreased obviously during skin incision and postoperative period, and they were significantly lower in observation group (P<0.05). The levels of IL-6 and TNF-αdecreased to the levels before anesthesia in observation group, and were still much higher in control group than that of preanesthesia (P < 0.05). Conclusions DEX infusion intraoperatively may effectively decrease the incidence of early POCD, whose mechanism could be reducing inflammation response.