Objectives To sum up the experience of the gasless laparoscopic surgery using home-made abdominal-wall-take-up.Methods Using home-made abdominal-wall-take-up application on 15 patients,including 12 cholecystectmy,3 appendectomy.Every patients was used epidural block.Results All the surgery were successed and every patients had no complication.The hospitalization was 4～40 days (average 13.6 days),the time of operation was 50 to 215 minutes (average 89 minutes), fee of hospitalization was 5487 yuan.Conclusions It conclude that the gasless laparoscopic surgery using home-made abdominal-wall-take-up application is a safe,economic,useful method,which adapts to the situation of China.It reinforces the gas laparoscopic surgery.

Objective To observe the effects of target-controlled infusion ofpropofol on hemodynamics during anesthesia induction in intracranial aneurysms interventional treatment.Methods Ninety patients in intracranial aneurysms interventional treatment were divided into three groups by random digits table method with 30 cases each:control group (group C),plasma drug concentration in target controlled infusion group (group P) and effect of chamber drug concentration in target controlled infusion group (group E).The induction of anesthesia:patients in group C were single intravenous injected with propofol of 2 mg/kg; patients in group P were set target plasma concentration of propofol with 4 μ g/ml.Patients in group E were set the effect target concentration of propofol with 4 μ g/ml.Three groups were set the concentration of remifentanil 4 ng/ml with plasma controlled infusion,and cisatracurium was injected with 0.2 mg/kg.Electrocardiogram,mean arterial pressure (MAP),heart rate (HR),end-tidal pressure of carbon dioxide,bispectral index,pulse oxygen saturation were continuously monitored.Before the time of induction (T0),immediately before intubation (T1),after intubation 1 min (T2),3 min (T3),5 min (T4),10 min (T5),arterial pressure and HR were recorded and the number of using vasoactive drugs were recorded.Results The level of MAP and HR among three groups at T0 had no significant difference (P ＞ 0.05).The level ofMAP and HR in three groups at T1 was significantly lower than that at T0.(P ＜ 0.05).The level of MAP and HR in group P was lower than that in group E and group C,and there was significant difference (P ＜ 0.05).The incidence of using vasoactive agen in group P was significantly lower than that in group C [6.7％(2/30) vs.40.0％ (12/30)],and there was significant difference (P ＜0.01).Conclusion Hemodynamics is relatively stable during anesthesia induction using plasma target controlled infusion with propofol in patients undergoing interventional therapy for intracranial aneurysm.

Objective To explore the feasibility and the selection of laparoscopic cholecystectomy(LC) for the treatment of acute gallstone pancreatitis(AGP) without jaundice.Methods Laparoscopic cholecystectomy had been performed in 95 patients with AGP accompanying no jaundice from July 1996 to July 2004 in this hospital.All of the patients had a history of conservative treatment.Selective LC was performed in 79 patients after their symptoms were relieved,while emergent LC was required in 16 patients because of failure of response to conservative treatment.Results All the operations were successfully completed.The operation time was 40~328 min(mean,103 min),and the intraoperative blood loss was 0~210 ml(mean,35 ml). Intraoperative cholangiography was carried out in all the 95 patients and succeeded in 92.Thirteen patients were found having lower common bile duct stones and then were cured with endoscopic retrograde cholangiopancreatography(ERCP) and endoscopic spincterotomy(EST).No conversion to open operation was required.No postoperative biliary hemorrhage or leakage occurred.No fatal case was seen.Pathological examinations following operation revealed multiple small or sand-like stones in the gallbladder.Follow-up in 39 patients for 1 months ~ 5 years found no recurrence of pancreatitis or cholelithiasis.Conclusions Laparoscopic cholecystectomy should be performed as early as possible in the treatment of AGP without jaundice.Use of intraoperative cholangiography and postoperative EST should be emphasized in proper cases.

Purpose:To clarify the association between renal cysts and renal cell carcinoma (RCC), we analyzed the clinical characteristics of patients with renal cell carcinoma and renal cyst. Methods:From May 1996 to January 2004, a total of 198 patients were hospitalized for renal cell carcinoma in our department, and 64 patients had both renal cysts and renal cell carcinoma (RCC). The clinical characteristics of the 64 patients were evaluated, and compared to 106 renal cell carcinoma (RCC)patients without renal cysts from the 198 patients in the same period. Results:Renal cysts were identified by preoperative ultrasonography, computerized tomography and magnetic resonance imaging in 37%(22/59)、24%(15/61) and 35%(6/17) respectively. Histopathological examination revealed renal cyst in 15 patients (23%). The sizes of renal cyst were 0.5 to 12 cm. The pathological examinations showed clear cell carcinoma in 61, chromophilic cell carcinoma in 2 and a combined type of clear cell carcinoma and chromophilic cell carcinoma in 1. Compared to RCC patients with those without renal cyst,younger and male RCC patients were easier to also have with renal cyst(P

Objective To understand the current economical operation of public hospitals in Hubei province and its effect on their public welfare performance. Methods To collect data in field survey and to analyze the current economic situation of such hospitals in the province based on relevant statistics.Results Financial revenue and expenditure of these hospitals keep rising and achieving a balance in general; for the insufficient government financial subsidy, 90% of the revenue of such hospitals come from their medical services and drugs sold; the per capita revenue of these public hospitals maintains a yearly rising trend; their asset-liability ratio was relatively high. Conclusions The public welfare performance of these hospitals tends to be impeded by the reform on the macro economic system and health policy changes, on top of the attraction of economic interests. Improving the government subsidy mechanism for public hospitals and standardizing the financial management mechanism of public hospitals.

This study was aimed at the transport across blood-brain barrier (BBB) of polysorbate-80 modified neurotoxin loaded polybutylcyanoacrylate nanoparticle (P-80-NT-NP) and its cytotoxicity. An in vitro model of BBB using rat brain microvascular endothelial cells (rBMECs) was established. The cytotoxicity of P-80-NT-NP was measured by the MTT assays, where neurotoxin (NT), nanoparticle (NP), neurotoxin nanoparticle (NT-NP) as control, and the permeability of P-80-NT-NP was determined by using of Millicell insert coculture with rBMECs and fluorescence spectrophotometry. MTT results showed that NT, NP, NT-NP and P-80-NT-NP were avirulent to rBMECs when the concentration of NT was lower than 200 ng x mL(-1). But the cytotoxicity of NP, NT-NP and P-80-NT-NP would be augmented accordingly as concentration increased (P < 0.01), causing obvious reductions of cell survival rate, with no significant difference between them (P > 0.05). When the concentration of NT was 150 ng x mL(-1), the permeability on rBMECs of P-80-NT-NP and NT-NP were both significantly higher than that of NT (P < 0.01), and the permeability of P-80-NT-NP was greater than that of NT-NP (P < 0.05). In conclusion, polysorbate-80 modified neurotoxin nanoparticles can transport across the BBB, while concentration of NT is greater than 200 ng x mL(-1), P-80-NT-NP has a little cytotoxicity against rBMECs.

The culture of umbilical cord-derived mesenchymal stem cells is extremely important for studies on umbilical cord mesenchymal stem cells. Optimization of cellculture technology is crucial for clinical application of mesenchymal stem cells and even celltherapy. Meanwhile, the labeling and tracer technique of umbilical cord-derived mesenchymal stem cells is a hotspot in stem celltransplantation. OBJECTIVE:To review the research and development of the cellmarkers and tracer methods of umbilical cord-derived mesenchymal stem cells. METHODS:A computer-based search of VIP, CNKI, Medline, Highwire and Foreign Journals Integration System databases was performed for articles concerning culture and labeling of umbilical cord-derived mesenchymal stem cells published from January 2001 to October 2013. The keywords were“stem cells, mesenchymal stem cells, umbilical cord-derived mesenchymalstem cells, cellculture, labeling methods”in Chinese and English, respectively. Final y, 35 articles were included in result analysis. RESULTS AND CONCLUSION:Umbilical cord-derived mesenchymal stem cells have not yet been widely used, mainly because of the immature isolation, culture and staining techniques of umbilical cord-derived mesenchymal stem cells. These techniques are worthy of further optimization studies. Although in recent years, cellmarkers and tracer technology of umbilical cord-derived mesenchymal stem cell s have made great progress, there are stil many problems need to be solved.

Purpose To investigate the research trends and focus in low-dose CT study at home and abroad in recent ten years according to literature distribution and growth law. Materials and Methods The papers on low-dose CT research published at home and abroad from 2003 to 2012 which were abstracted in Web of Science database were taken as study objects. Data filtering was performed by using the Thomson Data Analyzer (TDA) Version 2.1 analysis software for the trend of cooperation, institutional cooperation trends, national distribution of the papers trend, high-citations, subject distribution, hot topics and other aspects to do bibliometric analysis. Results A total number of 6725 papers on low-dose CT from 2003-2012 were abstracted by Web of Science. The average number of authors in single papers was 6.05 (cooperation rate, 95.7%), and the average number of institutions in single papers was 2.56 (cooperation rate, 73.9%), which both showed an increasing trend year by year. 318 Chinese papers were published, and the published literatures in 2012 were ranked third in the world. Papers on low-dose CT, which were published in Medical Physics, European Journal of Radiology and the American Journal of Roentgenology, had rapid growth. The research focus of low-dose CT study involved in lung cancer screening, coronary angiography, pulmonary embolism examination, CT radiation dose and so on. Conclusion CT low-dose studies involve in collaboration between multi-author, multi-institutional and multi-disciplinary. The trends and focus of low-dose CT study in China keep pace with the world, and the quality and quantity of paper need to be further improved.

Objective To establish a new methA of detecting vWF function. Methas The capability of vWF to bind collagen was evaluated with ELISA. Results The assay′s sensitivity was 0.001 U/ml. Coefficient of variation for inner-batch and inter-batch were 3.34 and 6.70 respectively.The vWF:CBA value of plasma was(90.24?22.87)% in 20 normal subjects. The vWF:CBA value was (31.94?27.36)% in 54 vWD, (35.22?20.02)% in 10 type 1 vWD, (8.74?6.38)% in 10 type 2A vWD and (0.70?0.58)% in 6 type 3 vWD,the values of all four vWD groups were lower than that of normal group( P

Objective To study the relationship between lymph node micrometasis and clinicopathological parameters.Methods Immunohistochemical method was adopted to detect cytokeratin pan(CK)、Epithelial Membrane Antigen(EMA) and Carcinoembryonic Antigen(CEA) in 389 lymph nodes from 36 cases of breast cancer, in which conventional pathological diagnosis showed no lymph node metastasis.Results Micrometastasis was found in 38 lymph nodes (9.2) of 12 cases (33.3) .The incidence of micrometasis was correlated with tumor size. Pathological diagonosis and metastasis lymph nodes. Conclusion Micrometastasis detection in negative lymph nodes of breast cancer is recommended to precisely determine the tumor stage, in order to direct cancer therapy and predict prognosis.