Objective To study reasons for conversions to open surgery in gynecological laparoscopic operations.Methods Clinical records of 53 cases of conversions to open surgery out of 1 066 cases of gynecological laparoscopic operations from January 2000 to March 2005 in this hospital were analyzed retrospectively.Results The reasons for conversions included pelvic adhesion in 23 cases,difficulty in myomectomy in 10 cases,malignant tumors in 9 cases,and intraoperative complications in 3 cases,accounting for 43.4%(23/53),18.9%(10/53),17.0%(9/53),and 5.7%(3/53) of the 53 cases,respectively.Conclusions Pelvic adhesion,which leads to difficulties in laparoscopic performance,is the primary reason for conversion to open surgery.Proper patient selection and improved capability for distinguishing benign ovarian tumors from malignant ones can decrease the incidence of conversions.

Objective To explore the rising degree of hemodiastase,lipase and the relationship with acute pancreatitis with diabetic ketoacidosis(DKA).Methods 36 diabetic ketoacidosis patients with increased trypsin were divided into non pancreatitis group(20 cases)and pancreatitis group(16 cases)based on the results of abdominal CT.And the blood amylase,urine amylase,blood fat enzyme levels of the two groups were measured and compard.Results The blood amylase of the pancreatitis group was(275.0±10.5)U/L,and that of pancreatitis group was(615.4±17.8)U/L,the difference between two groups was obvious(P＜0.01);The blood lipase of pancreatitis group was(2125.0±50.4)U/L,and that of pancreatitis group was(2021.0±19.8)U/L,there was no significant difference between the two groups(P＞0.05).The blood amylase and abdominal CT results compliance high.Conclusion Pure DKA can cause diabetes pancreatic enzyme increases,and in the diagnosis of acute pancreatitis,the specificity of blood amylase is high.

Objective To evaluate the relationship between maternal antepartum fever and early-onset neonatal bacterial sepsis.Methods A retrospective multi-centred clinical study of 404 neonates including 103 new borns with maternal antepartum fever and 311 neonates without was conducted.Results The frequency of early-onset neonatal bacterial sepsis was significantly higher in neonate with maternal antepartum fever than those without(4.9% vs 0.3%,P=0.001).Both maternal antepartum temperature ≥39℃ and maternal postpartum fever lasting several days was higher suggested the possibility of neonatal sepsis.Conclusions The neonates born with high risk factor of early-onset neonate bacterial sepsis require comprehensive lab evaluation including blood culture and uterine culture,clinical observation and aggressive treatment to decrease the mortality.

Objective To study the effect of chemotherapeutic agents of different doses on sensitivity of glioma U251 cell line to chemotherapy.Methods The rates of cell growth of the U251 cell line under the effect of different chemotherapeutic agents(DOX、VCR、VP-16 and with verapamil)of a series of doses were detected by MTT assay.Results Using DOX or VCR or VP-16 singly,the rates of cell growth were detected at a lever with positively correlates with the concentrations of these chemotherapeutic agents.Moreover the rates of cell growth changed more obviously within some range of concentrations,while the change is limited with the high or low concentrations.The combination of pates of chemotherapeutic agents and verapamil show synergistic effect.Conclusions The relationship between the doses of chemotherapeutic agents and sensitivity of chemotherapy gas a basis for choosing appropriate clinical chemotherapy doses.

[ ABSTRACT] AIM: To explore the role of chemokine receptor CXCR 4 in the pathogenesis of protein C system (PCS) in ulcerative colitis (UC).METHODS:In vivo, the mice were divided into control group and UC group .The mac-roscopic score, microscopic score and ulcer index were assessed .The mRNA levels and activity of myeloperoxidase ( MPO) , cyclooxygenase-2 ( COX-2 ) , stromal cell-derived factor-1α( SDF-1α) and monocyte chemotactic protein 1 (MCP-1) both in colonic tissue and plasma were determined .The expression and location of CXCR4,β-arrestin, p-JNK, endothelial cell protein C receptor (EPCR) and thrombomodulin (TM) were detected.The activity of protein C (PC) and protein S ( PS) was measured in each group .In vitro, mouse colonic microvascular endothelial cells were isolated , cultured and identified.Both CXCR4-overexpressing and CXCR4-silencing colonic mucosa microvascular endothelial cells were con-structed.The effects of SDF-1αon the protein levels of EPCR , TM,β-arrestin and p-JNK, and on the activity of PC , PS and activated protein C ( APC) were observed .RESULTS:Compared with control group , UC mice showed increased gross score, histopathological score and ulcer index (P<0.05).The mRNA levels and activity of MPO, COX-2, SDF-1αand MCP-1 in colon and plasma were increased (P<0.01).The protein levels of CXCR4,β-arrestin and p-JNK were up-regu-lated, EPCR expression was down-regulated in colon, and the activity of PC and PS in plasma was decreased (P<0.05 or P<0.01).CXCR4 overexpression further aggravated SDF-1α-induced PCS inhibition in colonic mucosa microvascular en-dothelial cells, and further up-regulated the protein levels of β-arrestin and p-JNK (P<0.05).CONCLUSION:PCS is inhibited in UC.CXCR4 is involved in the regulation of PCS inhibition by mediating chemokines and acting on colonic mu -cosa microvascular endothelial cells through β-arrestin-JNK pathway .

Objective To compare the effects of 6MV and 10MV-X-ray intensity modulated radiotherapy (IMRT) on non-small-cell lung cancer (NSCLC) . Methods We randomly selected 20 patients with NSCLC, 6MV and 10MV X-ray were used respectively for each NSCLC patient with IMRT plan design, the ADAC Pinnacle 8.0f treatment planning system was applied to provide the convolution/iteration algorithm, for the same target IMRT plan design with two kinds of energy. By comparing the dose volume histogram (DVH),PTV parameter (Dmean, Dmin and Dmax), conformal index (CI) and homogeneity index (HI),we analyzed the metrology parameters . Results 6MV and 10MV radiation therapy plan DVH, PTV parameters,CI,HI and isodose line was similar,no statistically significant differences. But target dose homogeneity and the degree of target coverage in high dose of 6MV plan was better than that in 10MV plan. Endanger organs (OAR) such as normal lung tissue, heart, esophagus and spinal cord had basically same dose amount. Conclusion 6MV X-ray plan may be the better choice of radiotherapy on NSCLC.

[Objective] To investigate the effect of naringin at different doses on the neuropathie pain produced by lumbar 5 spinal nerve ligafion (L5 SNL). [Methods] Using the method of behavioral test, we tested the 50% paw withdrawal threshold before and after intragastrieal application of naringin in the rats with L5 SNL. [Results] Naringin at 30, 90, 100 mg/kg but not at 10 mg/kg increased the 50% paw withdrawal threshold of 1.5 SNL rats significantly. Single application of Naringin (at 30 or 90 mg/kg) inhibited mechanical allodynia for around 6 hours, and the inhibitory effect persisted for 4 days after the cessation of the drug when naringin (30 mg/kg, daily) was consecutively applied for 7 days. [Conclusion] Intragastrical of naringin could relieve the neuropathic pain produced by peripheral nerve injury.

Objective To study the antibacterial property of silver loaded titanium dioxide (TiO2) antibacterial coated endotracheal intubation tube,and to determine the minimum effective antibacterial concentration.Methods Intubation tubes coated with different concentrations of antibacterial agents were prepared with sol gel method.Polyethylene endotracheal intubation tubes were used as substrate,and silver loaded TiO2 was used as the antibacterial agent.According to the different antibacterial concentrations of the antibacterial agent,the tubes were divided into nine groups:10.0％ group,5.0％ group,2.0％ group,1.5％ group,1.0％ group,0.8％ group,0.6％ group,0.2％ group,and conrol group.They were respectively immersed in three standard bacteria suspensions with 1.0 × l05 cfu/mL:Pseudomonas aeruginosa,Staphylococcus aureus,and Escherichia coll Together with standard bacteria liquid group,there were 10 experimental groups.They were kept overnight for 24 hours.10 μL of respective culture medium was smeared on blood agar culture medium.After being cultured overnight in 35 ℃,the number of bacteria colonies was respectively counted.Results In 1.0 × 105 cfu/mL of three standard bacteria liquids with antibacterial agent concentration≥ 1.0％,three bacterial colonies had un-obviously growth rate.Almost the same strong antibacterial effects to achieve sterilizing rates of more than 98％ was shown in each group of the antibacterial coating endotracheal intubation tubes (all P＞0.05).As the antibacterial agent concentration decreased,three bacterial colonies were increasing gradually.Intermediate antibacterial effects were shown in tubes of 0.8％ group,with significant statistic difference as compared with 1.0％ and 0.6％ groups [Pseudomonas aeruginosa:7.300 (4.050,8.350) vs.0.200 (0.050,1.200),9.700 (9.000,10.000); Staphylococcus aureus:4.100 (3.300,4.650) vs.0.000 (0.000,0.150),5.800 (5.350,7.650); Escherichia coli:1.400 (0.750,3.750) vs.0.050 (0.025,0.050),9.500 (8.500,9.800),all P＜0.01].Conclusions Silver loaded TiO2 antibacterial coated endotracheal intubation tube had definite antibacterial properties,which were related to the antibacterial concentration.Strong antibacterial effects were shown when antibacterial concentration was above 1.0％,with bacteria almost completely killed in the immersing liquid.

OBJECTIVE To evaluate the clinical effect of a new foaming skin disinfectant Angaote using in operating room.METHODS The Angaote group included 48 persons of operating room who disinfected their hands and their bacterial culture results were detected retrospectively and 544 surgical cases whose incision infection rate was detected.The control group included 56 persons of operating room using alcohol for hands disinfection.RESULTS The bacterial culture results of disinfected hands were all negative in both groups.There were 15 cases of incision infection in Angaote group,the infection rate was 2.8%,compared wih 26 cases and 3.6% in alcohol group.The infection rate between the two groups showed no statistically significant difference(?2=0.690,P=0.253).CONCLUSIONS Correct application of new foaming skin disinfectant Angaote can also obtain surgical asepsis,without increase in incision infection rate.

Objective: The antitumor mechanism of Pleurotes sapidus on 4 kinds of tumor cell lines was studied. The active components of its ethanol extracts were studied. Methods:Using techniques of cell culture in vitro, phytochemical methods, FACS and RT-PCR, expressions of p53 and fas gene of four tumor cell lines treated with Pleurotas sapidu were analysed. Results:The apoptosis rates were remarkably increased after treated by ethanol extracts (0.1g/ml) and water extracts (0.1g/ml) for 12 h and 24 h respectively. The expression of P53 protein in the groups of ethanol and water extracts were significantly increased, and the gene expressions of p53 and fas were aslo highly up-regulated. Conclusion:The antitumor effect of Pleurotas sapidus on tumor cell lines in vitro is evident, and its mechanisms are probably associated with the regulation of apoptosis by inducing the gene expressions related to apoptosis.