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.

Objective To investigate an effective algorithm for image segmentation in cervical cancer cell adhesion , which enables accurate segmentation of the contour of adherent cells .Methods The images of target cells were extracted from the background area using level set methods , normalized with minimum values of transformation algorithms ,and multi-plied by the gradient image points in the region of interest ( ROI) to inhibit the undesired gradient information before the im-ages of adherent cells were segmented using labeled watershed algorithm .Results and Conclusion Compared to conven-tional watershed segmentation methods , this algorithm is not only effective in image segmentation of adherent cervical cancer cells with uneven staining and more accurate segmentation lines established around the contours of adherent cells , but of high clinical value .

Objective The hemodynamic mechanism of Budd-Chiari syndrome ( BCS ) has become the research hotspot in recent years.The aim of this study was to discuss the hemodynamic characteristics of BCS through 3D numerical simulation for inferior vena cava stenosis based on the fluid dynamics ( CFD) method. Methods 3D model was established from a patient with Budd-Chiari syndrome based on MR image with Ansys software .The numerical simulation of this model was performed by the CFD . Results The 3D model of inferior vena cava functionally demonstrated the change procedure of hemodynamic characteristics of BCS .Vortex was found above the narrow area , and blood flow velocity achieved maximum in the center of the stenosis throughout the coronal section graph.The static pressure value gradually declined at the narrow area entrance to the narrowest place , and achieved minimum value at the exit.The maximum wall shear stress existed in the stenosis . Conclusion Specific 3D computational hemodynamic model can show the hemodynamic characteristics of BCS , and its hemodynamic parameters could be used for clinical practice .It will facilitate the study on correlation of complex hemodynamic parameters and morphology changes of inferior vena cava vascular .

To study the chemical constituents of the Entada phaseoloides (L.) Merr., seeds of Entada phaseoloides were extracted with 70% ethanol at room temperature. Isolation and purification were performed by silica gel, reversed-phase silica gel column chromatography and semi-preparative HPLC. Structures of the pure compounds were established on the basis of spectral analysis. Four sulfur-containing amide compounds were isolated from the n-BuOH-soluble fraction and identified as entadamide A-beta-D-glucopyranosyl-(1-->3)-beta-D-glucopyranoside (1), entadamide A (2), entadamide A-beta-D-glucopyranoside (3) and clinacoside C (4). Compound 1 is a new compound. Compound 4 is isolated from the genus Entada for the first time.

OBJECTIVEThis study aimed to evaluate the morphometric changes in the alveolar bone of the maxillary and mandibular anterior regions after retraction in adolescents.

METHODSThe sample size comprised 30 adolescent patients with class 1 bimaxillary protrusion (12 males and 18 females, age: 12-18 years old) and were treated by extracting four first pre-molars. Cone beam computed tomography (CBCT) was performed 1 month before and 1 month after the retraction. For each maxillary and mandibular anterior tooth, the labial and palatal alveolar plates at cervical 1/3, middle 1/3, and apical 1/3 levels for bone thickness changes during the retraction of the maxillary and mandibular anterior regions were checked. The movements of cervical 1/3, middle 1/3, and apical 1/3 levels of the maxillary central incisor were measured. Statistical analyses were performed with SPSS 16.0.

RESULTSFor the adolescents, alveolar bone thickness increased on the labial side and decreased on the palatal side. The alveolar bone thicknesses of cervical 1/3 and middle 1/3 of maxillary central incisor, cervical 1/3 and apical 1/3 of maxillary lateral incisor, middle 1/3 of mandibular central incisor, apical 1/3 of mandibular lateral incisor, and middle 1/3 and apical 1/3 of mandibular canine all increased after retraction. By contrast, the alveolar bone thickness of the apical 1/3 of maxillary canine and the cervical 1/3 of mandibular canine decreased after retraction. No statistically significant difference was observed in other region.

CONCLUSIONDuring retraction, a controlled tipping movement occur in adolescents. After retraction, the alveolar bone thickness of the labial side increase, whereas that of the palatal side decrease. Moreover, the thicknesses of major areas in the alveolar bone significantly increase.

Adolescent ; Child ; Cone-Beam Computed Tomography ; Cuspid ; Female ; Humans ; Incisor ; Male ; Maxilla ; Molar ; Palate ; Tooth Movement Techniques

OBJECTIVE To assess the pathogen features and risk factors among diabetic patients complicated by lower respiratory tract nosocomial infection.METHODS A retrospective study was carried out to survey the clinical data of diabetic patients complicated by lower respiratory tract infection during from 2002 to 2005.RESULTS The main responsible pathogens were Gram-negative bacteria,their rate was 54.5%.While the rate of Gram-positive bacteria was 35.7 %.The rate of fungi was 9.8%.The risk factors of nosocomial infection included:old age,high level of blood sugar,consciousless status,longtime usage of antibiotics,oxygen inhalation and other aggressive manipulations.CONCLUSIONS In diabetic patients with lower respiratory tract infection,the incidence and mortality were all onrelatively high level.They must be given to pay attention.The chief pathogens were Gram-negative bacteria or fungi.So we should strengthen supervision and avoid risk factors,which are the keys in saving critical diabetic patients.

A 1-year-old boy developed multiple skin-colored nodules on the forehead and extremities when he was 4 months old.Physical examination revealed that his general condition was well with no hepatomegaly,splenomegaly,lymphadenectasis,testicle abnormality or gingival hypertrophy.Pathologically,the epidermis was normal,while the dermis and subcutaneous tissue were diffusely infiltrated with medium-to large-sized deformed cells,which had a small amount of cytoplasm,oval nucleus,irregular shape and fine chromatin.Some infiltrating cells had nuclear groove and nucleoli.Immunohistochemical studies showed that the tumor cells were positive for S-100 protein,CD56,CD123,CD163,CD68,Ki-67 (40％),weakly positive for CD4 (some),but negative for myeloperoxidase,CD1,CD21.Bone marrow smears showed a 24.5％ infltration by monoblasts and promonocytes.A diagnosis of monoblastic sarcoma cutis preceding acute monoblastic leukemia was made.

Objective To observe the effect of chronic variable stress on the forced swimming test of rats,and investigate its preliminary mechanism.Methods First a mark was given to each Wistar rat by forced swimming test.12 Wistar rats which had similar scores were selected and divided into control group and model group averagely.The behavior changes of rats were induced in the forced swimming test by chronic stress and the plasma cortisol level was analyzed through radioimmunoassay(RIA) methods.The changes of hippocampus CA3 structure were observed with microscope.Results Compared with control group,chronic variable stress increased immobility time,reduced climbing time evidently and enhanced the weight of adrenal gland and the level of plasma cortisol(P