Objective To investigate the clinical value of combined general and gynecological laparoscopy.Methods From March 2003 to December 2006,160 patients with abdominal and gynecological diseases were treated with laparoscopy,including laparoscopic cholecystectomy(LC)+ salpingostomy in 20,LC + ovarian cystectomy in 24 cases,LC + hysteromyomectomy in 12,LC + hysteromyomectomy and uterine artery blockage in 7,LC + subtotal hysterectomy in 19,LC + total hysterectomy in 11,LC + treatment of endometriosis in 6,laparoscopic appendectomy(LA)+ salpingostomy in 16,LA + ovarian cystectomy in 22,LA + subtotal hysterectomy and total hysterectomy in 18,decortication of liver cysts + ovarian cystectomy in 4,and laparoscopic hepatectomy + adnexectomy in 1.Results Laparoscopic procedures were completed in all the 160 cases without conversion to open surgery.The operation time ranged from 40 to 220 min(mean,120 min),and postoperative hospital stay ranged from 1 to 6 days(mean,3.4 days).No patient had perioperative complications.Among the 160 cases,143 were followed up for 3 to 24 months(mean,19.5),during which 1 developed vaginal stump hemorrhage 10 days after the operation and was cured by conservative therapy,1 experienced vaginal polypi at the stump 2 months postoperation and underwent polyp resection.Conclusions Combined general and gynecological laparoscopy is a promising method for patients with abdominal diseases complicated with gynecological diseases.It is important for surgeons from different departments to deeply understand the indications of laparoscopy,prepare well before operation,and cooperate closely.

Objective To investigate the effect of extracellular histones (EH) on intestinal mucosal barrier function in mice and the correlation of EH with the pathogenesis of sepsis.Methods Twenty male C57BL/6 mice were assigned into experiment group (n =10) and control group (n =10) according to the random number table.Same dose (50 mg/kg) of EH and saline were administered through the caudal vein of mice in experiment and control groups respectively.Blood and intestinal samples in each group were collected 3 h after the administration.Morphology of intestinal mucosal tissue was detected by light scope and transmission electron microscope.Expressions of tight junction related proteins (ZO-1,Occludin and Claudin-1) were detected by western blot.Plasma levels of diamine oxidase (DAO) and intestinal fatty acid binding protein (I-FABP) were determined by ELISA method.Plasma level of endotoxin (ET) was determined by limulus test.Results Under transmission electron microscope,experiment group showed disorganized microvilli of intestinal epithelial cells with partially twisted,broken and lost,unclear tight junctions,and widened cellular space.Under light scope,experiment group showed substantial inflammatory cell infiltration in the intestinal wall,disorganized intestinal villi,edema and hemorrhage of mucosa and submucosa,and edematous goblet cells.Experimental versus control group showed significant reduction in levels of Claudin-1 (0.587 7 ±0.060 6 vs.0.677 2 ±0.038 3),Occludin (0.1277±0.0857vs.0.4306±0.0869) and ZO-1 (0.393 3±0.080 8 vs.0.812 8± 0.096 3) (P ＜ 0.05).Experimental versus control group showed significantly up-regulated plasma levels of DAO [(1.61 ±0.20) U/ml vs.(0.69 ± 0.15) U/ml],I-FABP [(548.5 ± 36.8) EU/ml vs.(178.8±26.9) EU/ml] andET [(0.182±0.076) EU/mlvs.(0.091 ±0.029) EU/ml](P＜0.05).Conclusion EH can obviously impair the integrity of intestinal mucosal barrier in mice and hence induce endotoxin translocation.

Objective: Gallbladder polyps are frequently discovered in the past decade. Ifthe polyps are oenign,without concomitant stone and the gallbladder has a good function, it is not an absolutely indication for cholecystectomy. For this reason percutaneous endoscopio polypectomy of the gallbladden polyps were developed and applied. Methods: Among those who underwent peroutaneous endosoopic polypectomy of the gallbladder, 85 patients with gallblaeder polyps were studied. Under the epidural anesthesia, cholecystoscope was introduced into the gallbladder. The polyps were coagulated by self-made miorowave ceagulator and then resected for histopathelogical evaluation. The preserved gallbladders were followed up to evaluate the effioacy of this minimally invasive therapy. Results: All precedures were eventful with mean operation time of 1h to 1. 5h. Sixty seven patients were followed-up for a mean of 5.5 yeah (2～9 years) and showed all patients to be symptom free and in 64 cases the gallbladder function was found to be well preserved without recurrence of polyps and occurrenca of gallstones on ultraSound. Conclusion: The procedure reposed is a reliable, simple,effective and minimally invasive technique to remove gallbledder polyps and to preserve gallbladder function for the patients who have the benign gallbladder polyps.

AIM: To elucidate the mechanism of fibrin in cholesterol gallstone disease. METHODS: Hemostatic indices were systemically examined in the gallbladder bile obtained from 26 patients with gallstones and 17 without gallstones. RESULTS: Significant increases were found in tissue factor (TF) concentration( P

Objective To study the value of the technique of "Push-pull traction-relax homingrepeatedly confirmed" in the prevention of bile duct injury in LC. Methods From March 2001-August 2009, we applied this technique in 4800 cases of LC. The technique of "Push-pull traction" showed the structures of in the Calot's triangle. The technique of "relax homing" was to restore the cystic duct,hepatic duct and common bile duct to their original anatomical positions. The technique of "repeatedly confirmed" repeatedly identified the positions of the cystic duct, the common hepatic duct and the common bile duct. Results There was no bile duct injury. Conversion to open surgery happened in 118patients due to difficulties in identifying the Calot's triangle structures, bile duct stones, gallbladder cancer, and gallbladder-duodenal fistula. Conclusions The "Push-pull traction-relax homing-repeatedly confirmed" technique could effectively prevent bile duct injury in LC. The method is simple, easy to master and worthy of promotion.

Pinch-3 protein is an important constituent of cell membranes, which directly affects the cell morphology and mechanical properties. We observed and compared the change of morphology and cell traction force of glomerular podocytes before and after Pinch-3 gene inhibition by gene interference technology in this experiment. We found that a number of pores appeared on the cell surface, and the cell projected area were increased at the same time, with an approximate average about an increase of 40% after Pinch-3 gene inhibition. The results showed that the cell traction force of glomerular podocytes was significantly reduced, with an approximate average decrease of 40%, the maximum value of the cell traction force was reduced and the distribution of cell traction force became dispersive. All this suggested that after Pinch-3 gene inhibition, some pores created on the cell surface influenced the physical properties of glomerular podocytes and then affected the cell projected area and influenced the formation and distribution of cell traction force of the glomerular podocytes as well.
Adaptor Proteins, Signal Transducing ; genetics ; physiology ; Biomechanical Phenomena ; Cell Movement ; Genetic Engineering ; Humans ; Kidney Glomerulus ; cytology ; LIM Domain Proteins ; genetics ; physiology ; Mechanotransduction, Cellular ; physiology ; Membrane Proteins ; genetics ; physiology ; Podocytes ; cytology ; physiology ; Stress, Mechanical

OBJECTIVETo investigate the influences of temperature, lightness, storage method, storage time, and gibberellin on seed germination of Gentiana rigescens.

METHODThe germination rates of G. rigescens in different treatments were observed.

RESULT AND CONCLUSIONThe most suitable temperature for the seed germination was 25 degrees C, at which the germination rate was 76.33%. The effect of lightness on the seeds was significantly; the germination rate of the seed was very low. Under the natural condition, the best storage method was dry storage (within 6 months), which could promote the after-ripening of the seed. 100-1 000 mg x L(-1) gibberellic acid could significantly reduce the seed germination time, and 500 mg x L(-1) gibberellic acid increased the germination rate of the seed to 95.00%.

Gentiana ; drug effects ; growth & development ; Germination ; drug effects ; Gibberellins ; pharmacology ; Plant Growth Regulators ; pharmacology ; Seeds ; drug effects ; growth & development ; Sunlight ; Temperature

Objective To investigate the influence of postoperative groin pressure on transabdominal preperitoneal hernioplasty (TAPP).Methods From Mar 2015 to Jul 2016 113 TAPP cases were prospectively divided into two groups,with observation group not taking any measures and intervention group using salt bag of 500 g to compress inguinal region for 12 hours.Postoperative recovery was compared between the two groups.Results After 48 hours,there was no significant difference between the two groups in pain,local complications,scrotum or labia majora swelling remission rate and urinary retention (P ＞ 0.05).However,the observation group had a less foreign body sensation (P =0.038).After 1 month,the two groups had no significant difference in terms of pain,foreign body sensation,sexual life and scrotum or labia majora swelling residual rate (P ＞ 0.05).Conclusions Groin region compression after TAPP does not help alleviate the pain,or reduce the incidence of local complications,and it does increase the foreign body sensation.

Hiatal hernia,para-hiatal hernia,diaphragmatic hernia,diaphragmatic agenesis and diaphragmatic eventration are the main types of the diseases with diaphragmatic anatomic abnormalities.Benign and malignant tumors of the diaphragm are not discussed in this paper.Caused by the lack of knowledge about these diseases,improper imaging,clinical diagnosis is often confusing.Based on the literatures and our own experience,this paper proposes the concept of"diseases with diaphragmatic anatomic abnormalities".The purpose is to summarize these diseases,and briefly describe the treatment methods,and to help strengthen the understanding and treatment of such diseases.

BACKGROUNDEarly detection of pulmonary tuberculosis (PTB) is a big challenge in smear negative and sputum scarce patients in China. Simultaneous amplification and testing methods for detection of the Mycobacterium tuberculosis (MTB) complex (SAT-TB assay) is a novel molecular technique established in our hospital. This method has a high sensitivity and specificity in the lab. In this study, the clinical diagnostic performance of this method in smear-negative or sputum-scarce PTB suspects was investigated and evaluated.

METHODSTwo hundred smear negative and 80 sputum-scarce patients were recruited in this study. Samples that included sputum or bronchial washing fluid were collected and sent for both bacteria culture and SAT-TB assay. Diagnosis for these patients was based on the comprehensive evaluation of chestX- ray/CT study, histology examination, lab results, and treatment response. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for each diagnostic test were investigated and calculated using confirmed tuberculosis (TB) and non-TB cases. The time required for detection of MTB was also measured for each method.

RESULTSNinety-two patients (33%) were diagnosed as definitive TB, 112 patients (40%) were probable PTB, and 76 (27%) were non-TB. The sensitivity, specificity, PPV, and NPV of SAT-TB in smear-negative PTB suspects were 93% (95% CI, 84%-98%), 98% (95% CI, 90%-100%), 98% (95% CI, 91%-100%), and 93% (95% CI, 83%-98%). In sputum scarce PTB suspects, the sensitivity, specificity, PPV, and NPV of the SAT-TB assay on bronchial washing fluids were 90% (95% CI, 74%-98%), 100% (95% CI, 85%-100%), 100% (95% CI, 88%-100%), and 88% (95% CI, 69%-97%). The accuracy of the SAT-TB assay is consistent with the bacteria culture assay. The median time required for detecting MTB in the SAT-TB assay was 0.5 day, which was much faster than bacteria culture (28 days).

CONCLUSIONSThe SAT-TB assay is a fast and accurate method for the detection of MTB. It can be widely applied in the clinic and be an asset in early detection and management of PTB suspects, especially in those patients who are smear negative or sputum scarce.

Adult ; China ; Female ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; genetics ; pathogenicity ; Nucleic Acid Amplification Techniques ; methods ; Sputum ; microbiology ; Tuberculosis, Pulmonary ; diagnosis ; Young Adult