Objective To explore the value of Ligasure and Ultracision in total laparoscopic hysterectomy (TLH). Methods From January 2002 to December 2006,totally 225 patients received total laparoscopic hysterectomy in our hospital. Among the cases,Ligasure was used in 152 patients,and Ultracision were employed in 72. The clinical data of the patients were reviewed. Results The mean operation time in the Ligasure group was significantly shorter than that in the Ultracision group [(104.9?29.2) min vs. (152.4?46.6) min,t=-9.329,P=0.000]. And the mean blood loss of the Ligasure group was significantly less than that in the other group [(32.9?14.9) ml vs. (126.4?12.1) ml,t=-46.710,P=0.000]. In both the groups,no patient was converted to open surgery or developed complications or surgical injuries. Conclusions Both Ligasure and Ultracision are safe and effective for total laparoscopic hysterectomy. Ligasure is superior in the management of uterine vessels,while the Ultracision is more effective in opening the vesicle and separating the cardinal ligament.

Objective To investigate the efficacy and safety of laparoscopic operations of ovarian tumors in children.Methods A total of 24 children with ovarian tumors treated laparoscopically from January 2000 to March 2005 were studied.The laparoscopic operations(tumor enucleation or unilateral adnexectomy) were conducted under general anesthesia with endotracheal intubation.Electrocoagulation of the capsule was performed alongside the borderline of the lesion for tumors 5 cm in diameter.After blunt dissection of the tumor and capsule,the lesion was completely enucleated.Hemostasis of the residual cut surface was accomplished by using electrocoagulation,with no need of suture. For large ovarian cysts disturbing laparoscopic visualization,the aspiration of hydatid fluid was conducted before the enucleation.Results All the operations were successful completed under laparoscope,including 24 cases of tumor enucleation and 2 cases of unilateral adnexectomy.The operation time was 50?20 min,the amount of hemorrhage was 30?10 ml,and the postoperative hospital stay was 2~4 d.No surgical complications or wound infection occurred.Follow-up in the 24 cases for 1 year found no recurrence.Conclusions Laparoscopic operations for ovarian tumor in children is safe and effective.

Objective To investigate the effect of pelvic floor muscle exercise on perimenopausal female sexual dysfunction. Methods Forty six patients with perimenopausal female sexual dysfunction received pelvic floor muscle exercise. Sexual function and pelvic floor muscle strength were compared between pre-and post-exercises. Result The patients′pelvic floor muscle strength and sexual function after exercises were significantly better than those before the exercises (P<0.05). Conclusion Implementation of the pelvic floor muscles exercise in the patients with perimenopausal sexual dysfunction can strengthen pelvic floor muscle and thus alleviate their sexual dysfunction.

Objective To study the effect of multimedia on the home care to the patients with double lumen catheter.Methods Totally 100 patients with double lumen catheter for dialysis were divided into control group and observation group according to the registration order,50 cases in each group.In the control group,the home care was done to nurse the catheter and in the observation group,multimedia was used to guide home care to the catheter.The incidence of catheter-related complications was compared between two groups.Result The toal rate of catheter-related complications in the observed group was significantly lower than that of the control group (P＜0.05).Conclusion The multimedia for home care to the catheter for dialysis are easy for the patients to master so that the can change better their home care and avoid (or decrease) catheter-related complications.

Aim To compare the different effect of intracarotid and intravenous injection of propofol on the neuronal apoptosis of hippocampus in rats undergoing cardiopulmonary bypass.Methods Fifty rats were randomly assigned to five groups. Shame group (Group Non-CPB,n=10); group cardiopulmonary bypass(group CPB,n=10);group intravenous injection of propofol 2 mg?kg -1?h -1 (group P_ 2V,n=10);group intravenous injection of propofol 10mg.kg -1?h -1 (group P_ 10V,n=10);group intracarotid injection of propofol 2 mg?kg -1?h -1 (group P_ 2a,n=10).Mean arterial pressure(MAP)and heart rate(HR) were monitored. Changes of the neuronal apoptosis of hippocampus were observed with TUNEL staining, Bax and bcl-2 mRNA and protein expressions were measured by RT-PCR and Western blot. In addition,neuronal ultrastructures were observed. Results Neuronal apoptosis and changes of neuronal ultrastructures of hippocampus were attenuated in group P_ 2a and P_ 10V,but the apoptosis of neurons was not attenuated in group P_ 2v. Bcl-2 and Bax mRNA expression increased undergoing CPB. Bax mRNA expression decreased after CPB in group P_ 2a and P_ 10V. Bcl-2 mRNA expression increased in group P_ 2a and P_ 10V. But Bcl-2 and Bax mRNA expression in group P_ 2V was not significantly different compared with that of group CPB. Bcl-2 and Bax protein expression measured by Western blot showed the same trend with mRNA expressions. Compared with baseline values, MAP and HR in group P_ 2V and P_ 2a remained unchanged. But the MAP and HR in group P_ 10V changed compared with group CPB and baseline value.Conclusions intracarotid injection of propofol attenuated the injury of brain at a fraction of the intravenous dose and with less adverse systemic and cerebrovascular side effects.

Objective To investigate the effect of taurine transporter in the process of protection of brain edema in rats with severe traumatic head injury. Methods A total of 24 Male Sprague-Dawley rats were randomly divided into 4 groups. Except the control rats (Group Sham), all other three groups were subjected to lateral fluid percussion head injury. The TBI (Traumatic brain injury) models (Group TBI) and surgical control rats (Group Sham) were injected with saline through caudal vein after surgery, while the Taurine prevention and Taurine treatment models (Group Pre Tau and Group Tau) were injected with 120 g/L taurine solution before or after surgeries respectively. Water content in each brain, mRNA and protein expres?sion of aquaporin 4 and taurine transporter in the injured rat brain hemispheres were all evaluated over the time course of the study (7 d) in each group. Results Compared with rats in Group Sham, water content in each brain increase, mRNA tran?scription and protein expression of AQP4 were both up regulated but the mRNA transcription and protein expression of TauT were both down-regulated in rats in TBI group. Compared with rats in TBI group, brain water content, mRNA transcription and protein expression of AQP4 all decrease while mRNA transcription and protein expression of TauT all increase in rats in Pre tau and Tau groups. There is no statistical difference of TauT expression between rats in pre-tau group and Tau group. Conclusion Taurine exert its neuron protection role through draining water content from brain and down regulating expres?sion of AQP4 but rising expression of TauT after TBI.

Objective To assess the value of MRI combined with CT in the diagnosis of ovarian sex cord stromal tumor (OSCST).Methods The CT and MRI features of 29 cases with OSCST confirmed by pathology were analyzed retrospectively.Results Fibrothecoma in 19 cases showed a solitary round mass with a regular border,solid in 12 cases (63.1％) and cystic-solid in 7 cases (36.9％),calcification in 2 cases,isointense on T1WI and hypointense or slight hyperintense on T2WI with slight enhancement.Granule cell tumor in 9 cases showed a solitary cystic solid mass with thick wall,without nodules on cystic wall,and slight enhancement in the solid parts.Sertoli-leydig cell tumor in 1 case showed a solid mass,slightly hyperintense on T1WI,hyperintense on T2 WI,and obvious enhancement.Conclusion CT and MRI manifestations of OSCST demonstrate some characteristics.Combination with MRI and CT can improve the accuracy of the diagnosis.

AIM:To investigate the production and activation of caspase-3 in primary rat renal proximal tubule cells in response to tumor necrosis factor-α(TNF-α) and the implication of nuclear factor-κB (NF-κB) in the process. METHODS:Isolated rat renal proximal tubule cells (PTCs) from male adult Sprague Dawley rats were treated with TNF-α according to the indicated time courses. A specific NF-κB inhibitor,Bay11-7082,was used alone or as a pretreatment for 1 h followed by exposure to TNF-α for 24 h.The protein levels of cleaved caspase-3,caspase-3,I-κBα,phosphorylated I-κBα,and GAPDH were detected by Western blotting using specific antibodies. RESULTS:The protein level of cleaved caspase-3 relative to caspase-3 was significantly increased in the presence of TNF-α for 6 h,12 h,and 24 h. Protein levels of caspase-3 were significantly decreased by 12 h and returned to baseline by 24 h in the presence of TNF-α. Treatment with Bay11-7082 for 25 h alone or pretreatment with Bay11-7082 for 1 h followed by addition of TNF-α for 24 h caused a remarkable reduction in both cleaved caspase-3 and caspase-3 as compared to control and TNF-α treated groups. An increase in phosphorylated I-κBα was observed from 15 min to 60 min after treatment with TNF-α at a dose of 10 μg/L in PTCs. CONCLUSION:NF-κB is not only associated with the activation of caspase-3 but also the production of caspase-3 in primary rat renal proximal tubule cells in response to TNF-α.

Objective To investigate the effect of a novel lymphotoxin with selectively binding to p55 tumor necrosis factor receptor (p55TNFR) on myocardial ischemia-reperfusion injury in rats in order to explore the mechanism.Methods A total of 40 SD rats were randomly (random number) assigned into four groups (n =10 in each),namely sham operation group (group A),I/R group (group B),wild type rhLTα treatment group (group C),and p55TNFR selective rhLTα (rhLTα-Q107E) treatment group (group D).After I/R model rats were established,various therapeutic agents or saline were given by continuous intravenous infusion for 24 h via a micropump.After 24 hours of treatment,serum myocardial zymogram,such as aspartate aminotransferase (AST),lactate dehydrogenase (LDH) and creatine kinase (CK),as well as superoxide dismutase (SOD),malondialdehyde (MDA) and glutathione peroxidase (GSH-Px) activities were determined.Myocardial infarction size (MIS) was measured by nitro blue tetrazolium chloride (NBT) staining.Results Compared to sham operation group,MIS,AST,LDH,CK,MDA were increased,while the activities of SOD and GSH-Px were decreased.However,all the effects were significantly reversed by treatment with rhLTα-Q107E (P ＜ 0.05) but not rhLTα (P ＞ 0.05).Conclusions The rhLTα-Q107E plays a role in the protection against myocardial ischemia-reperfusion injury in rats by the mechanism of scavenging oxygen free radicals and increasing the activity of endogenous antioxidant system.

The establishment of a scientific salary system is a key measure to improve the incentive and re-straint mechanisms, adjust and optimize the relations of the production, release the reform “bonus”, and is also an important health care reform today. In order to establish a scientific salary system of medical personnel adapting to the health industry characteristics, the paper makes an investigation on the salary level in the years of 2010—2012 in Shanghai, and analyzes the main problems of the present performance pay policy. On this basis, starting from the point of the health industry characteristics, the paper builds the salary system of medical personnel containing the comprehensive budget management, theoretical workload for approval, authorized personnel, performance appraisal and distribution, structural proportion within the industry, fund distribution management through the establishment of the salary level’s average wage and social linkage mechanism, and builds a theoretical framework on salary system of medical personnel in Shanghai.