Robotic system helps surgeons in performing surgery. Currently Da Vinci system is the most popular. Da Vinci system has been used for the stomach and bowel diseases in 27 cases(18 cases of stomach and 9 cases of colon and rectum) in the Zhongshan Hospital, Fudan University. Accurate preoperative staging is crucial, and Da Vinci system is advantageous in lymph node dissection, preservation of nerve plexus, and complete resection of mesorectum. Adoption of gastrointestinal tract reconstruction technique should depend on the operation and experience in surgery. Though Da Vinci system has limitations and the cost is high, it is believed to be the future trend.
Digestive System Surgical Procedures ; methods ; Humans ; Robotics ; methods

Objective: To observe the effects of electroacupuncture (EA) on uterine prostaglandin F2α (PGF2α), cyclooxygenase 2 (COX-2) and nuclear factor κB (NF-κB) in rats with primary dysmenorrhea (PD) and to discuss the possible mechanism in EA intervening PD. Methods: Forty Sprague-Dawley female rats were randomly divided into a blank group, a model group, an EA group and an ibuprofen group, with 10 rats in each group. The PD model was established using estradiol benzoate combined with oxytocin in the model group, EA group and ibuprofen group. At the same time of modeling, rats in the EA group were given EA at Guanyuan (CV 4) and Sanyinjiao (SP 6) once a day for 20 min each time for 10 consecutive days. Ibuprofen was intragastrically administered once a day for 10 consecutive days in the ibuprofen group. The same amount of normal saline was intragastrically administered once a day for 10 consecutive days in the blank group and model group. The number of writhing of rats in each group within 30 min was compared on the 11th day just after the interventions. The uterine homogenate supernatant was separated and the PGF2α level was detected by enzyme-linked immunosorbent assay. Western blot was applied for the detection of the expression levels of COX-2, phospho-NF-κB p65 and NF-κB p65 proteins in uterine tissues. Results: Compared with the blank group, the number of writhing in the model group increased significantly (P<0.01), and the expression levels of PGF2α, COX-2, phospho-NF-κB p65 and NF-κB p65 proteins in uterine tissues were significantly increased (all P<0.01). Compared with the model group, the number of writhing in the EA group and ibuprofen group were significantly reduced (both P<0.01), and the expression levels of PGF2α and COX-2 protein in uterine tissues were significantly reduced (both P<0.01). Compared with the model group, the phospho-NF-κB p65 level in uterine tissues in the EA group was significantly reduced (P<0.01). Compared with the ibuprofen group, the phospho-NF-κB p65 level in the EA group was significantly reduced (P<0.01). Conclusion: The mechanism of EA for PD rats may be related to inhibiting the phosphorylation of NF-κB and reducing the levels of COX-2 and PGF2α in uterine tissues.

Three primer were designed based on the consevered area of the genetic of the ATCC VR-2332 strain and LV strain. And the nest RT-PCR of testing porcine reproductive and respiratory syndrome virus were developed. The nest RT-PCR against ATCC VR-2332 strain, LV strain and B13 strain were done by this method.The DNA fragment were obtained specially from the three strains isolated from different region. The size were 430bp (430bp) , 410bp (413bp) and 410 bp (413bp) separately. But the DNA fragment were not obtained from HCV, PPV and PRV. Its sensitivity was 10-2 TCID50. It's sensitivity increased 10000 times than one step RT-PCR. It should make the method of testing porcine reproductive and respiratory syndrome virus more sensitive, fast and accurate.

Animals ; Astrocytes ; immunology ; metabolism ; Male ; Microglia ; immunology ; metabolism ; Neurons ; metabolism ; Oxidopamine ; metabolism ; Parkinson Disease ; immunology ; Rats ; Rats, Sprague-Dawley

Objective To explore the safety and effectiveness of diagnostic ultrasound associated with microbubbles to open the blood brain barrier(BBB).Methods Microbubbles were injected through caudal vein,the rat head was radiated by GE Vivid 7 diagnostic ultrasound immediately.The radiated depth was located in the basal ganglia assisted by magnetic resonance imaging(MRI)scanning.The degree of BBB opening was evaluated by enhanced MRI and Evans blue dyeing.The safety was inspected by observation of cell morphology under hematoxylin eosin(HE)staining.Results After the rat head radiated by diagnostic ultrasound with microbubbles,signal enhancement of the radiated area was observed on post contrast T1-weighted images.Red fluorescence of Evans blue was detected by fluorescence microscope in the same area.Normal cellular morphology and structural integrity were showed by HE staining.Conclusions The BBB of rat could be opened targetedly and noninvasively by diagnostic ultrasound associated with microbubbles.This may provide a new strategy for the drugs and stem cells treatment in the central nervous system diseases.

Objective To investigate the immunomodulatory effect of mesenchymal stem cells (MSCs) and their role in prolonging allograft survival in rat heart transplantation. Methods Inbred Wistar rats were used as donors, and Fisher 344 as recipients. MSC were isolated from femur and tibia bone marrow of donors and cultured in vitro. Mixed lymphocyte reaction assays were performed to assess the immunosuppressive effects of different concentrations of MSC on allogeneic T cell proliferation. Cardiac allograft model was established and according to different intervention measures recipients were divided into two groups (MSC treatment group and control group) (n=8 in each group). In MSC treatment group, recipients were infused with 2×106 MSC via the tail vein at designated intervals (one week before operation, during operation and consecutive three days postoperation), while in control group, the recipients were treated with Ringer's solution at the same interval& At day 5 posttransplantation real-time PCR was used to detect the changes in the expression of Thl and Th2 cytokine genes in transplanted hearts. Results In vitro allogeneic T cell response was greatly suppressed by MSC in a dose-dependent manner. Real-time PCR revealed that IL-1β,IFN-γ, IL-4 and IL-10 were expressed in MSC treatment group, while IL-4 and IL-10 were not expressed in control group but with significantly higher expression of IL-1β and IFN-γ. As compared with control group, survival of MSC-treated allografts was markedly prolonged as compared with control group (mean survivaldays: 12.4±5.3 vs 6.4±2.0, P＜0.05). Conclusion Intravenous adrninistmtion of MSC can prolong the survival of transplanted heart possibly by induction of allograft tolerance through changing Th1/Th2 balance.

Objective To evaluate the effects of domestic irbesartan on blood pressure and renal function in the aged with primary hypertension.Methods Renal function,plasma and urine β2 microglob ulin WBS measured and blood pressure was investigated by 24-hour ambulatory blood monitoring in 42 aged with primary hypertension who received domestic irbesartan(1 50 mg/d,followed up every 1-2 weeks.If the effect was not ideal,the dose could be added to 300 mg/d)in 8-week's treatment.Results After the treatment.24 hours recall systolic blood pressure,24-hour mean diastolic blood pressure,mean day systolic blood pressure,mean day diastolic blood pressure,mean night systolic blood pressure,mean night diastolic blood pressure were significantly reduced.At the same time,domestic irbesartan induced a remarkable reduction of plasma and urine β2 microglobulin [(5.9±3.3)μg/L vs(2.6±2.6)μg/L, (811.2±97.2) mmol/L vs(457.6±69.8)mmol/L,respectively].Conclusion The antihypertensive effects of domestic irbesartan can persist for 24-hour and Can reduce urinary protein.

Objective To establish computer assisted virtual ureteroscopy (VU) through data from computerized tomography urography (CTU) of patients with renal stones and make validation of effectiveness.Methods From June of 2015 to January of 2016,23 cases of renal stones cases was selected by 5 experts in 3 different centers.There were 21 unbilateral cases and 2 bilateral cases.The age ranged from 31 to 79(54.7 ± 12.5).Mean stone burden was (19.0 ± 6.2) mm.Stone number ranged from 1 to 5 (2.7 ± 1.2).VU generation was accomplished by specialized software (Crusher) with incorporating CTU data.After patientspecific VUs were presented to the experts,and the FURS surgeries were all finished successfully,face and content validations about VU using modified Likert questionnaire ordinal 10-point rating scales were made.20 trainee were selected to do the flexible ureteroscopy lithotripsy with assistance of VU.After observation of CTU and VU,the numbers of renal calyces and stones found by the experts and trainees were recorded.The statistical analysis were made before and after observation of VU between the experts and trainees.Result Face and content validation of VU:overall usefulness 7.6 ± 0.5,graphics 7.6 ± 0.5,intrarenal collecting system 8.4 ± 0.5,stone details 8.4 ± 0.5,usefulness in surgical planning and training 8.0 ± 0.7.Significant improvement was found when the trainees doing the surgery with the help of VU.Compared with using CTU only,VU could help the trainees had better understanding of intrarenal structure and stone information [the number of calyces (16.7 ±3.7)vs.(24.6 ± 1.8),P ＜0.001;the number of stones (4.9 ± 1.4)vs.(8.2 ± 1.3),P ＜0.001].Before observation of VU,trainees found much fewer calyces and stones compared with experts (P =0.004 and P ＜ 0.001 respectively).However,this gap disappeared after VU observation (P =0.327 and 0.292 respectively).Conclusions Establishing computer assisted VU through CTU data from renal stone patients is feasible and rapid.VU can significantly improve trainee's view of intrarenal collecting system and stone information before practicing FURS.

Objective To observe the effect of early goal directed therapy (EGDT) on tissue perfusion,microcirculation and tissue oxygenation in patients with septic shock.Methods A prospective observational study was carried out in 20 patients with early septic shock admitted to ICU within 24 hours after onset.Patients with one of following conditions,including stroke,brain injury,other types of shock,severe heart failure,acute myocardium infarction,ages below 18,pregnancy,terminal stage of disease,cardiac arrest,extensive bums,mouth bleeding,oromandiblular dyetonia (difficult to open the mouth),and the time elapsed over 24 hours after onset of septic shock,were excluded.The eligible patients were treated with the standard procedure of EGDT.The partial pressure of transcutaneous oxygen and carbon dioxide (PtcO2,PtcCO2) was monitored and hemodynamic data were recorded.Sidestream dark field imaging device was applied to detect the sublingual microcirculation.Hemodynamics,tissue oxygen,and sublingual microcirculation were compared before treatment and after EGDT.When the variables met the normal distribution,t test was applied.Otherwise,Wilcoxon test was used.Correlation between variables was analyzed with Pearson Correlation Analysis.Results Of 20 patients,19 met all 4 elements in criteria of EGDT after treatment and were eligible for study.PtcO2 and PtcCO2 were monitored in 19 patients.Sublingual microcirculation was obtained in four of them.(1) After the criteria of EGDT were entirely met,PtcO2 increased from (62.7 ± 24.0) mm Hg to (78.0 ± 30.9) mm Hg (P ＜ 0.05) ; tissue oxygenation index (PtcO2/FiO2) was (110.7 ± 60.4) mm Hg before treatment and (141.6 ± 78.2) mm Hg after EGDT (P ＜ 0.05).PtcCO2 and PaCO2 gap (difference between PtcCO2 and PaCO2) decreased significantly after EGDT (P ＜ 0.05).(2) Both proportion of small vessels with perfusion (PVP) and microcirculatory flow index of small vessels (MFI) showed a trend of increase after EGDT,but there were no significant differences between pre-and post-EGDT (P was 0.051 and 0.074 respectively).(3) PtcO2,PtcO2/FiO2,and PtcCO2 were not linearly related to central venous saturation,lactate,oxygen delivery,and oxygen consumption (All P ＞ 0.05).Conclusions Peripheral perfusion improved after EGDT in patients with septic shock but those hemodynamic variables might not exactly reflect the authenticity of global perfusion.

BACKGROUND:The rabbit adipose-derived stem cells are mostly isolated by type I col agenase digestion, but rarely by explants culture method.
OBJECTIVE:To isolate rabbit adipose-derived stem cells for adipogenic and osteogenic differentiation.
METHODS:The rabbit adipose-derived stem cells were isolated from rabbit adipose by explants culture method, and cultured in vitro fol owed by morphological observation. The grow curve and cellsurface markers CD29, CD44, CD45 of passage 3 cells were analyzed respectively by 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide and flow cytometry;cells from the third passages were induced for adipogenic and osteogenic differentiation by different revulsants, and cells were examined by oil red O staining and alizarin red staining .
RESULTS AND CONCLUSION:The rabbit adipose-derived stem cells cultured in vitro exhibited a spindle-shaped appearance and could rapidly expand. Flow cytometry analysis revealed that the third passage of rabbit adipose-derived stem cells was positive for CD29, CD44, but negative for CD45. Rabbit adipose-derived stem cells were positive for oil red O staining at 14 days of adipogenic induction, and positive for alizarin red staining at 14 days of osteogenic induction. In conclusion, we could successful y isolate rabbit adipose-derived stem cells using explants culture method.