Objective To investigate the clinical value of laparoscopic assisted transvaginal hysterectomy (LAVH) in gynecologic surgery. Methods LAVH were carried out in 68 patients with myoma of uterus, adenomyosis, and cervical carcinoma in situ,ovarian tumor and so on, which were all indications for uterus resection. Results LAVH were performed successfully in 68 cases, and the successful rate was 100% . Conclusion LAVH has notable superiority of mild trauma,minimal injury and quick recovery in gynecologic surgery.

Objective To explore the impact of ovarian function in young patients of early cervical cancer after ovarian shift surgery. Methods 6 young patients with cervical cancer were given radical surgery for ovarian transposition at the same time, before and 1 and 6 months after operation, blood FSH, LH, E2 were measured. B-ultrasound was used to monitor ovarian ovarian function. Results 4 patients after 1 month postoperative, 1 case after postoperative 6 months with normal ovarian function, 1 case of pre-operative radiotherapy after 6 months the resumption the ovarian function restoration. Conclusion Young cervical cancer patients with ovarian transposition can maintain good ovarian function.

Objective To explore the effect of nBiPAP on ET-1 of patients with overlap syndrome.Methods Levels of ET-1 in plasma of 25 cases of OS,20 cases of COPD were analysed by radioimmunoassay,and ET-1 in OS was measured before and after treatment.The relationship between ET-1 with SaO_2 during sleep was analyzed. Results (1)The ET-1 levels in plasma of OS group were significantly higher than those of COPD group before treatment(P

Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods To review the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy from September 2013 to September 2015.There were 14 males and 21 females, aged 15-70 years, with an average of 45.8 years.Preoperative CT scan was performed to determine the size, shape and location of the tumor.Tumor diameter 10-60 mm, average 31 mm.Results 35 operations were successfully accomplished via the posterior approach.The operation time was 38-138 min (mean 70.1 min) ,and the drainage tube indwelling time was 1-5 d(average 2.1 d) ,the hospital stay was 2-6d(average 3.7 d).Total hospital costs were 14 789-31 992 yuan, average of 21 239 yuan.No complications occurred during the perioperative period.Conclusions Posterior retroperitoneoscopic adrenalectomy might provide clear anatomical views.It could be a safe and effective operation for the clinical treatment of adrenal tumors.

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Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods From September 2013 to September 2015,the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy were reviewed.There were 14 males and 21 females,aged 15-70 years,with the average of 45.8 years.Preoperative CT scan showed 19 adrenal tumors in the left side,16 in the right side,and one case with the left adrenal adenoma combining with right renal cyst.Tumor diameter is between 10 ～ 60mm,with the average of 31mam.Twenty-two cases were diagnosed as primary aldosteronism,4 pheochromocytoma,and 9 non-functional adrenal tumor.The posterior retroperitoneoscopic adrenalectomy were performed in all of the cases,which are under general anesthesia with tracheal intubation and prone position with hip joints and knee joints flexion of 90.Results Thirty-five operations were successfully completed via the posterior approach demonstrating clear anatomical layers.The operation time was 38-138min(mean 70 min),the drainage tube indwelling duration was l-Sd(average 2d),and the hospital stay was 2-6d (average 4d).Total costs of hospitalization were 14 789-31 992 yuan RMB,with an average of 21 239 yuan RMB.No complications occurred during the perioperative period.The average follow-up was 11 months,and no complications such as tumor recurrence occured.Conclusions Retroperitoneoscopic adrenalectomy provided clear anatomical views.It could be a safe and effective operation for the treatment of adrenal tumors.

Objective:To study the effect of continuous blood purification on inflammatory state and immune response in patients with multiple injury and sepsis.Methods:88 patients with multiple injury and sepsis who were treated in our hospital from January 2015 to May 2016 were selected as the research object,they were divided into the control group (n=44) and observation group (n=44) according to random number table method.The control group was given conventional treatment,and the observation group was given continuous blood purification treatment.The acute physiology and chronic health conditions Ⅱ (APACHE Ⅱ)score was observed in two groups Ⅱ at 3 d after treatment.The serum content of Interleukin-2(IL-2),Interleukin-4(IL-4),Interleukin-10(IL-10) and interferon-γ (IFN-γ) were detected by ELISA method.The levels of CD3 +,CD4 +,CD8 + and NK cell were analyzed by flow cytometry.The urea nitrogen (BUN),serum creatinine (Scr),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time (APTT) were tested by automatic biochemical analyzer.Results:The APACHE Ⅱ score,BUN and Scr levels in observation group were lower than the control group (P＜0.05).The content ofIL-2,IL-4,IL-10 and IFN-γ in observation group were lower than the control group (P＜0.05).The levels of CD3+,CD4+,CD8+ and NK in observation group were higher than the control group (P＜0.05).The levels ofPT,TT and APTT in observation group were lower than the control group (P＜0.05).Conclusion:Continuous blood purification in patients with multiple injury and sepsis had better clinical curative effect,can reduce inflammation,improve immune function and the function of blood coagulation.

Organophosphate chemicals are widely used as agricultural pesticides and war reagents, their biodegradation is emphasized on the theoretical and practical aspects. Organophosphate hydrolases play important roles in the biodegradation of organophosphate chemicals. Great advancement was achieved recently in the determination of crystal structure and catalytic mechanisms of the hydrolase. This paper reviewed the research progresses in the enzymology, protein structure, catalytic mechanisms and application of the organophosphate hydrolase, and predicted the future research in this field.

BACKGROUND:With the development of industry and agriculture, organotin compounds have been widely used in China. Organotin compounds cause a common occupational poisoning. The toxicity of organotin was reported in animal studies; however the reports about human organotin intoxication are very rare. In this study we retrospectively analyzed the clinical manifestations of 15 organotin-poisoned patients who had been treated at our hospital from 2002 through 2007. METHODS:Fifteen patients with organotin poisoning were admitted to Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from 2002 to 2007. They were 9 males and 6 females, aged from 25 to 52 years. Clinical manifestations and Glasgow Coma Scales showed that the poisoning was mild in 4 patients, moderate in 6 and severe in 5. The severe patients were given glucocorticoid after hospitalization by intravenous guttae of 500 mg methylprednisolone for the first day, followed by 160 mg methylprednisolone per day for three days, and then 80 mg methylprednisolone per day for another three days. Potassium glutamate and sodium glutamate were intravenously dripped to reduce blood ammonia; intravenous guttae plus oral administration of potassium 9 g/day was used to correct intractable hypokalemia; sodium bicarbonate was used to correct metabolic acidosis, and sedatives were used to control spasm and twitch; mechanical ventilators were used in 4 patients with dyspnea. RESULTS:Most of the patients showed elevated level of blood ammonia, decreased level of blood potassium and metabolic acidosis, but some had demyelination changes shown by CT and MRI. Treatments included correction of metabolic acids, blood potassium and ammonia, and mechanical ventilation when necessary. For patients with injuries of the nervous system, glucocorticoids were given immediately after hospitalization. These patients showed intractable hypokalemia and metabolic acidosis during the treatment. Forteen patients recovered completely without long-term side-effect. One patient in the aphasiac stage restored the linguistic capacity during a 6-month follow-up. CONCLUSIONS:Elevated level of blood ammonia, decresed level of blood potassium, and metabolic acidosis are common in patients with organotin poisoning. Demyelination can be observed in patients with severe poisoning. The abnormalities of the patients are reversible after suitable treatments.

BACKGROUND: Adhesion molecules are closely associated with inflammation. Inflammation due to white blood cell (WBC) infiltration and free radical injury following brain ischemia are believed to be important factors contributing to the pathogenesis of multi-infarct dementia.OBJECTIVE: To determine the level of serum adhesion molecules and free radicals in patients with multi-infarct dementia to explore the relationship between their levels and multi-infarct dementia.DESIGN: A case-control trial.SETTING: Department of Neurology, Second Affiliated Hospital of Jilin University.PARTICIPANTS: Totally 82 patients with multi-infarct dementia were hospitalized in the Department of Neurology, Second Affiliated Hospital of Jilin University between January 2000 and December 2004. These patients included 32 cases of mild dementia, 21 of moderate dementia, and 29 of severer dementia. The normal controls were 23 concomitant healthy volunteers who came for routine physical examination.METHODS: Enzyme-linked immunosorbent assay (ELISA) and electron spin resonance were used to determine the level of serum soluble intercellular adhesion molecules (ICAM) and vascular cell adhesion molecules (VCAM), as well as oxygen free radical concentration in the normal controls and patients with multi-infarct dementia, and the association between the severity of the illness and the levels of adhesion molecules and oxygen free radicals was analyzed.MAIN OUTCOME MEASURES: Serum levels of ICAM-1 and VCAM-1 and oxygen free radical concentration in the two groups.RESULTS: Totally 82 patients with multi-infarct dementia and 23 healthy controls were included in this study and all enter the result analysis. In multi-infarct dementia patients, the serum levels of soluble ICAM-1 and VCAM-1 and oxygen free radical concentration [(469.00±76.33), (196.00± 45.91) and (1 103.30±98.96) μg/L, respectively] were significantly higher than those of the control group [(601.00±76.30), (4.018±1.656), and (1.295±0.718) μg/g, respectively, t=5.517-6.754, P ＜ 0.01], and the 3 indices were positively correlated with the severity of dementia (r=0.659 4,r=0.697 2, r=0.649 4, respectively, P ＜ 0.05); serum ICAM-1 and VCAM-1 levels were positively correlated with the concentration of oxygen free radicals (r=0.714 7, r=0.732 4, respectively, P ＜ 0.01).CONCLUSION: Serum ICAM-1, VCAM-1 and oxygen free radicals might be implicated in the pathophysiological development of multi-infarct dementia, and their levels increase in parallel with the severity of dementia.