Based On current situation of experimental teaching and managementin our college,this paper raised some concrete approaches of imlxoving experimental teaching levels to strengthen lab construction and experimental teaching quality

Objective To investigate the effects of ketamine in relieving postoperative pain after laparoscopic cholecystectomy(LC).Methods Forty patients undergoing selective LC from July to August 2006 were randomly divided into ketamine group and control group,with 20 patients in each group.Incision pain and non-incision pain was assessed at 1,2,4,6,12,24 h and once each day for the first 3 days postoperatively with visual analogue pain scale(VAS)and sedation scale.Adverse effects and analgesic requirements were recorded.Results Patients in ketamine group had significantly lower scores in incision pain and non-incision pain compared with those of control group(F=22.805,P =0.000;F=18.109,P=0.000).Incidence of postoperative nausea and vomiting was not significantly different(P=1.000)between ketamine(55%)and control group(60%).No significant difference was noticed in analgesic requirements between ketamine group(3 cases)and control group(9 cases)(P=0.082).Conclusions Preoperative administration of ketamine significantly improves postoperative analgesia after laparoscopic cholecystectomy,but does not reduce the incidence of postoperative nausea and vomiting.

Objective To investigate the feasibility of thoracoscopic minimal access anterior surgery for thoracic spine. Methods Minimal access anterior thoracic surgery was conducted under thoracoscope in 14 patients in this hospital from October 2001 to October 2002.Six patients with thoracic vertebral metastasis underwent vertebral body excision, reconstruction by cement and steel plate, and anterior internal fixation with screw-rod system;4 patients with thoracic vertebral tuberculosis received focus resection,bone graft and anterior internal fixation with screw-rod system; 2 patients with of thoracic disc herniation received discectomy and fusion;2 patients with thoracic vertebral facture and dislocation received reduction, decompression, bone graft and anterior screw-rod internal fixation. Results Postoperative imageological analysis revealed that the focus had been cleaned completely and the internal fixation was excellent. Follow-up for 4～12 months in 14 patients showed that the pain on chest and back disappeared in all the patients. Of the 13 patients with spinal compression, muscle strength recovered from grade A～D preoperatively to grade C～E postoperatively. Conclusions Thoracoscopic minimal access anterior thoracic surgery is feasible. It offers satisfactory short-term effects.

O-GlcNAcylation is the addition of a single N-acetylglucosamine(GlcNAc)moiety to the hydroxyl groups of serine or threonine residues of nuclear and cytoplasmic proteins. The transcription factors, kinases of the metabolic pathways and some cytoplasmic enzymes can be O-GlcNAcylated to affect cell transcription, signal transduction, cell metabolism and other biological functions. Abnormal glucose metabolism of tumors has been a hotspot in the research field of tumor pathogenesis and therapeutic targets recently. O-GlcNAclation regulates the glucose metabolism of tumor by affecting the activity of kinases in the metabolic pathway, which is closely associated with the abnormal glucose metabolism of tumor. The abnormal O-GlcNAcylation is one of the potential reasons of cancer. In this review, in order to provide a theoretical reference for developing anti-tumor targets and drugs targeting O-GlcNAc modification, we briefly summarized how O-GlcNAcylation regulated glucose metabolism on glucose metabolism, glucose uptake, glycolysis, pentose phosphate pathway and tricarboxylic acid cycle in cancer cell.

Objective To observe the clinical effect of Zhang point in subclavian vein puncture. Methods One hundred patients underwent deep vein catheterization were selected, ASA grade of Ⅱ- Ⅲ. The patients were divided into 2 groups according to puncture method with 50 cases each, the patients in group A used traditional puncturing method, and the patients in group B used Zhang point puncture method. The total success rate, success rate of the first trial and incidence of complication were recorded. All the patients received the bedside chest X-ray examination to observe the location of central venous catheter after surgery. Results The total success rate and success rate of the first trial in group B were significantly higher than those in group A:100%(50/50) vs. 88%(44/50) and 96%(48/50) vs. 76%(38/50), the incidence of complication was significantly lower than that in group A: 4% (2/50) vs. 20%(10/50), there were statistical differences (P<0.05). Conclusions Using of Zhang point is very simple in subclavian vein puncture catheterization, with a higher success rate and a less complication rate.

Objective To investigate the effects of different cell cycles and their regulating genes on apoptosis of mononuclear-macrophages induced by Leptospira interrogans. Methods The diversity and alteration of cell cycles of murine mononuclear-macrophage line(J774A. 1 ) and human monocyte line(THP-1 ) before and after infected with L. interrogans serogroup Icterohaemorrhagiae serovar Lai strain Lai were detected using Cell Cycle Stain Kit plus flow cytometer. The cell cycle synchronized J774A. 1 and THP-1 cells were generated and then identified by using different cell cycle blocking agents and flow cytometer. By using Annexin V/PI Detection Kit combined with flow cytometer, the rates of early-apoptosis and late-apoptosis/necrosis in the synchronized and non-synchronized J774A. 1 and THP-1 cells after infection with L. interrogans strain Lai were determined. Several real-time fluorescence quantitative RT-PCRs were performed to the changes of mRNAs levels of p21, p27, p53, c-myc and cycA genes that associated with cell cycle and apoptosis in J774A. 1 and THP-1 cells before and after infected with L. interrogans strain Lai. Results There were G1, S and G2/M phases in both the non-infected normal J774A. 1 and THP-1 cells. On the contrast,the majority of infected J774A. 1 and THP-1 cells were stagnated at G1 phase, but the amount of S phase THP-1 cells was elevated while that of S phase J774A. 1 cells was not(P ＜0.05). No remarkable early-apoptosis in both the infected G1 phase J774A. 1 and THP-1 cells was found, whereas the rates of early-apoptosis and late-apoptosis/necrosis in the infected M phase J774A. 1 and THP-1 cells were significantly increased (P ＜0.05 ). Additionally, late-apoptosis / necrosis rate in the infected G1 phase THP-1 cells (P ＜ 0.05 )that not found in the infected G1 phase J774A. 1 cells. Compared to the non-infected cells, the p21 mRNA levels in the infected J774A. 1 and THP-1 cells were significantly elevated(P ＜0.05), and the c-myc and p27 mRNA levels in the infected J774A. 1 cells and the cycA mRNA level in the infected THP-1 cells were also higher than those in both the non-infected cells ( P ＜ 0.05 ). Conclusion Different cell cycles and their regulating genes have a role to affect the apoptosis of human and murine mononuclear-macrophages caused by L. interrogans with a diversity of cell line origins.

Objective To explore the stooling patterns and sphincter function after transanal one-stage pull through operation for Hirschsprung's disease in children. Methods In this study, 73 children patients averagely aging at 24. 7 months underwent transanal one-stage pull through operation for common type Hirschsprung' s disease. Fifty-eight postoperative patients were followed up for an average of 15. 8 months. Stooling pattern was investigated with the informed questionnaire, according the result patients were divided into symptomatic and nonsymptomatic group. The rectoanal inhibitory reflex ( RIR) and vector manometry including the maximal anal pressure in resting and squeezing, the vector volume ( VV) and vector symmetric index ( VSI) were performed to explore the postoperative stooling patterns and sphincter function. Results Stooling patterns were fine in most patients, postoperative soiling was found in 9 cases, constipation in 5 and Hirschsprung-associated enterocolitis in 3, there was no incontinence. The rectoanal inhibitory reflex recovered in 5 children. The vector manometry showed the maximal anal pressure of the constipated group in resting and squeezing were both higher than those of nonsymptomatic and control group (167?36vs. 157 ?47 vs. 152 ?33,P

Objective Pneumoperitoneum is usually the result of hollow visceral perforation and requires emergent laparotomy.However,about 10％ of patients lack a pathologic cause requiring surgical intervention and can be resolved with conservative management.The aim of this study is to discuss the indications for conservative management of pneumoperitoneum in children.Methods We retrospectively reviewed the data of 5 children with pneumoperitoneum without peritonitis treated in our pediatric surgery department between January 2009 and December 2010.Results There were 5 children with an average age 5.4 years.Radiologic examinations demonstrated pneumoperitoneum and visceral perforations were suspected in the local hospitals.The abdominal examination revealed no peritoneal signs in all patients.Among them,peritoneal aspirations were implemented in 4 patients and the results were negative.One of five patients underwent laparotomy that demonstrated no visceral perforation.The remaining four were successfully managed conservatively and the pneumoperitoneum was completely resolved between 3 and 9 days.All children were without abdominal symptoms and signs throughout at least 2 years follow-up.Conclusion The presence of free intraperitoneal air does not always indicate hollow visceral perforation and the need for emergent laparotomy.It appears that therapeutic effectiveness can be readily achieved with conservative management in children with pneumoperitoneum without peritonitis.

Objective To evaluate the complications and long-term efficacy of inside-out transobturator transvaginal tape ( TVT-O) for the treatment of stress urinary incontinence ( SUI) .Methods From January 2008 to December 2013,236 consecutive female patients (mean age 56 ±9 years,range 44-88 years)with the symptom of incontinence when abdominal pressure increasing (such as walking), underwent TVT-O operation.All these patients needed pads and were diagnosed with SUI by cough test and Marshall -bonny test before surgery , with the mean international consultation committee on incontinence questionnaire short form ( ICI-Q-SF) score of 15.6 ±3.9.Two grouping methods were used:the mid-term group including patients whose follow-up time was between 6 months and 3 years, the long-term group including patients whose follow-up time >3 years,the group of patients who underwent TVT-O only and the group of patients who underwent TVT-O plus pelvic floor repair at the same time . Their clinical and follow-up data , intraoperative and postoperative complications , subjective and objective effects were recorded and analyzed.Results Of these 236 patients,there were 1 case of bladder perforation (0.4%) and 1 case of intraoperative sling exposure to vagina ( 0.4%) .Postoperative complications included 36 ( 19.1%) groin/puncture point pain ,18 (9.5%) de novo frequency of micturition ,8 (4.2%) urinary retention /difficulty of urination.All the complications were relieved after symptomatic treatment or surgery except 2 cases of urinary retention/difficulty of urination.Their symptom kept existing after urethral dilatation and sling dissection and long-term intermittent self-catheterization was needed .One hundred and eighty-nine patients completed more than six months of follow-up, with mean follow-up time of ( 35.0 ±12.5 ) months.One hundred and sixteen (61.4%) cases was arranged to mid-term group and 73(38.6%) was arranged to long-term group.88.9%patients ( 168/189 ) were cured objectively and 9.5% patients ( 18/189 ) improved. There was also a significant subjective improvement ( ICI-Q-SF scores:15.6 ±3.9 preoperative versus 6.7 ± 2.3 postoperative,P<0.01).There was no significant difference of both objective and subjective efficacy between mid-term group and long-term group ( cured +improved rate 97.4% versus 95.9%;ICI-Q-SF scores 14.3 ±2.8 versus 16.7 ±3.4 preoperative ,5.8 ±1.2 versus 7.9 ±2.0 postoperative , P>0.05 ) . Patients who underwent TVT-O and those who underwent TVT-O +pelvic floor repair had no significant difference in efficacy (cured +improved rate 97.8%versus 100.0%,P>0.05).Conclusion TVT-O is a safe,effective and durable treatment for SUI , whether or not with concomitant procedure of pelvic floor repairment.

Triptolide possesses antitumor, anti-inflammatory and immuno-supression activity. 3H-triptolide given intragastrically to rats was rapidly but not totally absorbed. After ig and iv administration of 3H-triptolide to rats, the highest radioactivity level was found in the liver, followed by spleen, lung, kidney, intestine, heart and brain. The radioactivity in organs disappeared slowly. 3H-triptolide in plasma was found to be 64.7% bound to plasma protein. In 21d, the cumulative excretion of radioactivity in urine and feces after ig and iv 3H-triptolide to rats was 67.5% and 61.9% of the total dose, respectively. Among that, the radioactivity was 52.4% and 25.3% of the total dose in feces, respectively. The radioactivity excreted by bile in 24h was 6.73 ? 1.9%. The radioactivity in urine, feces and bile measured by TLC, autoradiography and liquid scintillation count indicated that 3H-triptolide excreted in urine, feces and bile was mainly in unchanged form and a few metabolites was found in urine and feces