Objective To investigate the feasibility,reliability,and complications of laparoscopic second-look exploration for ovary epithelial cancer.Methods The operation was performed under general anaesthesia.The 4-port laparoscopy was carried out.Physiological saline was used to wash the abdominal and pelvic cavity for cytological examination.Then the exploration of abdominal and pelvic cavity was performed,adhesions were dissected,and multiple punch biopsies(at more than 20 sites) were conducted in the abdominal and pelvic cavity.Results All the operations were completed successfully.The operative time was 61.3?16.7 min,and the hemorrhage volume was 98.7?32.1 ml.Positive findings were encountered in 4 cases(28.6%),3 of which(21.4%) were identified by the naked eye and 1 of which was identified by microscope,and negative findings,10 cases(71.4%).Of the 4 cases of positive findings,the tumor was located at the pelvic peritoneum or the paracolic sulci peritoneum.No abdominal organ injuries occurred,and no conversion to open surgery was needed.Delayed healing of umbilical incision happened in 1 case.Of the 10 cases of negative findings,recurrence of tumor was observed in 1 case(10.0%) at 48 months after operation.Conclusions Laparoscopic second-look exploration for ovary epithelial cancer is feasible,with advantages of minimal invasion,fast recovery,and good patient's tolerance.

Objective To investigate the feasibility of laparoscopic radical hysterectomy and abdominopelvic lymphadenectomy in the treatment of malignant uterine tumors.Methods Laparoscopic radical hysterectomy and abdominopelvic lymphadenectomy was performed in 62 cases of biopsy-confirmed early-stage malignant uterine tumors from February 2003 to August 2005.There were 26 cases of endometrial cancer and 36 cases of cervical cancer.Pelvic lymphadenectomy was conducted in all the cases;while selective lymphadenectomy of peripheral lymph nodes of the abdominal aorta was performed in 5 cases,followed by laparoscope-assisted vaginal hysterectomy(LAVH).Results The operation was completed under laparoscope in 61 cases,and a conversion to open surgery because of venous injuries was encountered in 1 case.The operation time was 165～265 min(mean,217 min);the intraoperative hemorrhage volume was 150～1200 ml(mean,260 ml);the number of excised lymph nodes was 13～23(mean,17).Bladder injury happened in 1 case and was successfully repaired under laparoscope.Postoperatively,urine retention developed in 4 cases and lymphatic cyst occurred in 5.Follow-up checkups for 1~28 months in 61 cases showed 1 case of recurrence at 3 postoperative month(stage Ⅱ_B cervical adeno-squamous carcinoma,withdrew from the treatment and died 4 months later).Conclusions Laparoscopic radical hysterectomy and abdominopelvic lymphadenectomy is safe,feasible,effective,and reliable.

Objective To investigate the clinical value of laparoscopic myomectomy.Methods A retrospective analysis was made on clinical data of 58 cases of laparoscopic myomectomy(Laparoscope Group) and 52 cases of open myomectomy(Open Group) from October 2002 to February 2004 in this hospital.Results The laparoscopic operation was all accomplished.The Laparoscope Group had significantly shorter operation time(58.0?11.2 min) than the Open Group(69.4?10.3 min)(t=(-5.535),(P=0.000)),less intraoperative blood loss(71.6?34.8 ml) than the Open Group(149.1?38.9 ml)(t=-11.029,P=0.000),lower postoperative pyrexia rate(21/58) than the Open Group(39/52)(?~2=16.642,P=0.000),shorter hospital stay(4.5?1.6 d) than the Open Group(7.6?2.1 d)(t=-8.760,P=0.000),higher total hospitalization costs (6 511.3?566.7 yuan) than the Open Group(6 286.8?387.5 yuan)(t=2.398,P=0.018),higher costs for anesthesia and operation(1 566.7?154.7 yuan) than the Open Group(946.6?156.6 yuan)(t=20.868,P=0.000),and lower costs for postoperative medication(703.5?140.2 yuan) than the Open Group(1 278.4?237.6 yuan)(t=-15.643,P=0.000).Follow-up observations in 56 cases in the Laparoscope Group and 50 cases in the Open Group for 18~34 months(mean,26 months) revealed no statistical differences in recurrence rate and pregnancy rate between the two groups.Conclusions Laparoscopic myomectomy has advantages of little hemorrhage,fast recovery,short hospital stay,and low complication rate,being one of ideal methods for the treatment of hysteromyoma.

We have been in charge of the teaching of the curriculum of Obstetrics & Gynecology for foreign students from Pakistan since the year of 2005,and hitherto there have been two grades of foreign students who have received this course.We have accumulated some experience through the practice of teaching,and discovered some shortcomings and problems,which are summarized as three respects:teachers and equipment,study of students,and cooperation of patients.In allusion to the shortcomings and problems,we think that we should take measures and make improvement in the respects of teachers,students,patients and so on,in order to improve the quality of the teaching for foreign students in our school.

Objective To investigate the feasibility and the short-term efficacy of laparoscopic surgery for the treatment of uterine malignant tumors. Methods Laparoscopic radical hysterectomy and pelvic lymphadenectomy was performed in 25 cases of cervical cancer and 24 cases of endometrial cancer from February 2003 to March 2005 in this hospital.Of the 49 cases,a selective paraaortic lymphadenectomy was carried out in 5 cases. Results All the operations were successfully performed under laparoscope except for 1 case of conversion to open surgery.The operating time was 190?45 min,the blood loss during operation was 172?99 ml,and the number of excised lymph nodes was 17?6.Surgical complications occurred in 8 cases(8/49,16%),including 1 case of bladder injury,1 case of internal iliac vein injury,3 cases of urinary retention,1 case of vesicovaginal fistula(VVF) at the 6 postoperative month,and 2 cases of lymphatic cyst.Follow-up observations were carried out for 1~12 months in 21 cases,12~24 months in 17 cases,and 24~27 months in 4 cases.No recurrence was seen.Conclusions Laparoscopic surgery for the treatment of uterine malignant tumors is safe and feasible and offers significant short-term effects.

Intraoperative cell salvage (IOCS) has been widely used to reduce allogeneic blood transfusion and prevent blood transfusion related complications during surgery.However, due to the risk of transfusion related reaction, contamination, and immunological reaction, its use for tumor patients has been controversial and limited.To explore the feasibility of the application of IOCS in cancer patients, we reported 2 cases of renal cell carcinoma (RCC) with tumor embolism in IVC that underwent radical nephrectomy,and inferior caval venous thrombectomy receiving IOCS combined with leukocyte depletion filter (LDF) from August 2016 to November 2016 in our hospital.The cell saver blood salvage (Haemone-tics, 5+) was used for these 2 cases.The salvaged blood was filtered through the LDF before infusion.For case 1 (male 45-year-old) the total operation time was 505 min, and the estimated blood loss was 4 500 ml.A total of 1 000 mL autologous blood, 12 u allogeneic packed red blood cells (PRBC), 1 200 mL fresh frozen plasma (FFP) were infused during the procedure.The patient was discharged from hospital after 75 days without complications.The postoperative follow-up for 3 months showed no tumor recurrence or metastasis.For case 2 (a male patient, aged 51 years), the total operation time was 490 min, and the estimated (blood loss was 7 000 mL.the patient received 2 700 mL autologous blood transfusion, 12 u allogeneic packed red blood cells (PRBC), and 2 400 mL fresh frozen plasma (FFP).The patient was discharged from hospital after 86 days without severe complications.the postoperative follow-up for 6 months showed no tumor recurrence or metastasis for this patient.Other relevant retrospective studies with this technique showed that cell salvage could be used safely in many kinds of cancer patients, for example, bladder cancer, liver cancer and kidney cancer.Furthermore,numerous researches have proved the safety and efficacy of the combination of these two techniques, the intraoperative cell salvage technique and leucocyte depletion filter in cancer patients.Here we only reported two cases using IOCS and LDF.Further work is needed to determine whether the use of intraoperative cell salvage combined with leukocyte depletion filter can be used safely for patients with HCC.

Objective To evaluate the changes of left atrial structure and function in the patients with atrial fibrillation who accepted bi -polar radio frequency current ablation .Methods All patients in our study were divided into three groups including the ones who had accept -ed bipolar radio frequency current ablation because of atrial fibrillation ,the ones who refused to accept ablation operation in despite of atrial fibrillation and the ones who maintained sinus rhythm before operation .All patients accepted TTE before and after operation .Results The rate of transverse diameter change of ablation group (24.24 ±8.67)%was larger than those of other two groups (P<0.05).Left atrial chan-nel capacity volume change rate of ablation group (17.18 ±3.26)%were larger than the values of the group who were suffering atrial fibrilla-tion but refused ablation advice (0.86 ±0.26)(P<0.05).Left atrial total ejection fractions of ablation group (202.41 ±81.59)%were lar-ger than the values of the group who were suffering atrial fibrillation but refused ablation advice (109.53 ±60.91)%( P<0.05) .And its ac-tive ejection fractions(12.18 ±3.48)%,total ejection fractions(41.31 ±8.26)%and so forth were less than the group who maintained si-nus rhythm before operation(21.33 ±5.61)%,(45.05 ±7.37)%,respectively (P<0.05).Left atrial posterior wall center and cardiac basal segment strain(14.34 ±9.47)%,(13.20 ±8.38)%,respectively,and strain rate values after operation of ablation group were less than other segments .Conclusion Left atrial structure remodeling inversion was not obviously 3~6 months after bipolar radio frequency cur-rent ablation .And at the same time ,the improvement of left atrial storage function was not obviously compared with the group who refused ab -lation advice,left atrial channel function compensation degree descended obviously left atrial co -pumping function in ablation group increased obviously,left atrial posterior wall center and cardiac basal segment systolic and distolic function were less than other segments of left .

Objective To explore the effects of different courses of antenatal dexamethasone on brain development of premature SD rats. Methods The pregnant rats were randomly assigned to 3 groups: 3-dose dexamethasone (group 1), 1-dose dexamethasone group (group 2) and control group. The treated were sacrificed on 19 days of gestation, body and whole brain weight of the offspring rats were measured. Meanwhile the expression o{ neuron specific enolase (NSE) in brains of offspring rats was detected by immunohistochemical staining. The histological structures of baby rat brain were observed under transmission electron microscope. The differences among the three groups were analyzed by ANOVA. Results (1) The body and whole brain weight, the brain and body weight ratio were (1.543±0.052) g, (88.80±7.12) mg, and (5.75±0.38)% in group 1 and (1.584±0.035) g,(98.21±3.71) mg, and (6.20±0.26)% in group 2, both were lower than the control group [(1.696±0.076) g, (111.53±6.29) mg, (6.59±0.48)%], (P<0.01 or P<0.05, respectively). (2) The expression of NSE in cortex in group 1 and 2 were lower than that in control group (0.223±0.054, 0.381±0.041 vs 0.590±0.064) (P<0.01). The expression of NSE in hippocampi in group 1 and 2 were also lower than that in the control group (0.192±0.054, 0.359 ±0.046 vs 0.529±0.068) (P<0.01). (3) Disconnection of nuclei membrane, vacuolization in mitochondria, loss of nueleolus, and disconnection of neurofilaments were observed in the ultrastructure of baby rat brain tissue in both group 1 and 2. Conclusions Antenantal administration of dexamethasone can cause impairment of brain development in premature offspring rats and this might be related to the times of dexamethasone administered.

nts were tend to suffer from AKI, with the most common cause of pre-renal injury and drugs such as antibiotics and contrast medium used in X-ray imaging. Outcomes of the patients with AKI depends on severity of their kidney injury.

Objective To observe effects of tetrandrine on β-glucan induced RAW 264 .7 cells proliferation .Methods RAW 264 .7 cells model was established .Four methyl thiazol tetrazolium(MTT) was used to detect the effects of different concentrations of tetrandrine on the proliferation of RAW264 .7 cells .The levels of interleukin(IL)-6 ,tumor necrosis factor-α(TNF-α) ,prostaglan-din E2 (PGE2 ) and IL-10 in the culture supernatant were measured by enzyme linked immunosorbent assay(ELISA) .Results MTT results showed that the growth curves of different concentrations of tetrandrine on RAW264 .7 cells had biphasic affections .ELISA results suggested that tetrandrine could inhibit the IL-6 ,TNF-α,PGE2 expressions and promote IL-10 expression .Conclusion Effects of tetrandrine onβ-glucan induced RAW264 .7 cells proliferation are relative to inhibition of IL-6 ,TNF-α,PGE2 expressions and promotion of IL-10 expression .