Objective To evaluate the efficacy of laparoscopic Miles surgery at differented periods.Methods Radical excision(Miles) was performed under a laparoscope on 33 patients from January 2002 to August 2002(group 1),and then on 34 cases from July 2006 to May 2007(group 2) in our hospital.Clinicopathological and follow-up data of the two groups were collected and analyzed.Results No significant difference was found in blood loss(50-200 ml vs 40-210 ml,Z=1.477,P=0.787),number of resected lymph nodes(both 3-5,Z=-0.089,P=0.233),gas expel(in 1-3 days after the surgery vs 1-4 days,Z=-1.622,P=0.574),and postoperative hospital stay(4-9 days vs 5-9 days,Z=-1.834,P=0.346) between the two groups.However,the patients in group 1 had significantly longer operation time and higher medical cost than group 2(175-210 min vs 120-150 min,Z=4.238,P=0.026;23400-27500 yuan vs 19863-22744 yuan,Z=5.283,P=0.003).Conclusion After 4-year development,the operation time and cost of laparoscopic Miles surgery has been decreased.

Objective To investigate the effects of arsenic trioxide(As2O3) on the cell proliferation and apoptosis of C6 glioma cells in vitro.Methods The C6 glioma cells were treated by 1,3,5 μ mol/L of As2O3 with different duration and observed under the microscope and electromicroscope.The viability of C6 glioma cells was examined by methyl thiazolyl tetrazolium (MTT) assay,and cell cycle and apoptosis were examined by flow cytometry.Results After treatment of 1,3,5 μ mol/L As2O3,C6 glioma cells were inhibited obviously with a dose- and time-dependent manner (P ＜0.05) by MTT.During flow cytometry,more increasing apoptotic cells were found in different concentration As2O3.Characteristic morphological changes were observed in As2O3 intervention by transmission election microscopy including cell shrinkage,physaliphore,nuclear condensation and apoptosis and so on.Conclusion As2O3 can inhibit the cell proliferation and induce the apoptosis of C6 glioma cells.

Objective To investigate the relationship between dystrobrevin binding protein 1 (DTNBP1) gene polymorphisms and cognitive function in patients with recurrent depressive disorder.Methods 49 recurrent depressive disorder patients and 60 age-,gender-and education-matched normal controls were recruited in this case-control study.Clinical symptoms were evaluated by HAMD and Wechsler adult memory scale,Wisconsin card sorting test,trail making test(TMT),verbal fluency test (VFT),S troop colorword test were used to evaluate cognitive function.The gene polymorphisms of DTNBP1 were determined by PCR-RFLP technique.SPSS 16.0 was used for statistical analysis.Results The distributions of genotypes in the patients and controls were consistent with Hardy-Weinberg equilibrium(P＞0.05).The time in trail making A task (73.4±30.5 vs 56.2± 11.7),the digital Span (9.6±2.3 vs 8.1±3.0),visual reproduction (9.6±2.3 vs 7.4±3.1),paired association learning (9.7±2.2 vs 6.1±4.2) and Spilling forward (9.1 ±2.4 vs 7.2±2.9) in Wechsler adult memory scale,the categories completed (1.8 ± 1.6 vs 2.5 ± 1.8),total trials (47.6± 1.1 vs 47.3± 0.7) and error numbers (28.5±5.3 vs 24.1±9.3) in WCST performs,and the word meaning interference score (18.4±9.0 vs 25.3±9.5) in Stroop color-word test were monitored.Patients with the genotype of rs9476867 G/G got higher interference number than patients with DTNBP1 rs9476867 C/G and C/C,and patients with the genotype of rs16876738 A/G spent more time to finish TMT-A than patients with rs16876738 G/G and A/A.G/G single nucleotide polymorphism (SNP) of rs9476867 and A/G SNP of rs16876738 affected attention ability.Conclusion DTNBP 1 gene polymorphisms are correlated with cognitive function in recurrent depressive disorder patients.

Objective To evaluate the imaging characteristics of atypical teratoid/rhab doid tumor (AT/RT) of central nervous system(CNS), and to improve the diagnostic ability of the disease. Methods The clinical and imaging findings of 9 patients were retrospectively analyzed. There were 5 male and 4 female, ages 7 months to 5 years,median age was 1.4 years. MR enhancement studies were obtained in all the cases. One case had CT enhancement examination. Results The lesions were seen in brain in 8 cases and in lumbosacral spinal cord in one case. The tumors size varied from 4.8—7.8 cm, Necrosis was seen in nine cases, cystic change in eight cases and hemorrhage in five cases. The tumors had high signal on DWI, and low signal on ADC map. Dura matter invasion(2 cases), cerebrospinal fluid spread(2 cases)and intracerebral metastasis were seen. Conclusion There are some relatively specific imaging findings of primary CNS AT/RT that could assist their diagnosis.

Objective To observe the effects of atorvastatin calcium on serum tumor necrosis factor alpha (TNF)-α and C-reactive protein (CRP) in patients with acute cerebral infarction (ACI), so as to approach the mechanism of atorvastatin calcium inhibiting ACI inflammatory injury. Methods Eighty-four patients with ACI were randomly divided into 2 groups: group B (42 cases, treated with antiplatelet therapy and improving cerebral circulation), group A(42 cases, treated with atorvastatin calcium 20 mg/d after the onset of ACI for 28 days on the base of group B). TNF- α and CRP were detected before treatment and in the 3rd,7th day after treatment. The European stroke scale (ESS) was evaluated on the same time. A healthy control group (group C, 16 cases) was also included in the study. Results The peak of CRP and TNF-α levels were observed in the 3rd and 7th day after treatment respectively, and the levels of group A were lower than those of group B [(13.00 ± 2.45) mg/L vs (19.21 ± 3.67) mg/L,(19.79 ± 11.01) ng/L vs (30.69 ± 18.47) ng/L, P < 0.05]. In the 7th day after treatment, the scores of ESS was higher in group A than that in group B [(79.19 ± 30.59) scores vs (63.91 ± 27.87) scores, P < 0.05]. Conclusions Atorvastatin calcium can prevent the increase of serum TNF-α and CRP, and it has anti-inflammatory effect. Atorvastatin calcium may have the role of neuroprotection besides lipid-lowering.

In view of the actual situation of our university,we carried out an experimental physiology teaching reform.By ways of preparing experiment guidance,setting conventional and potential experiment material,increasing choice of content and the opportunity for students to design experiments and optimizing experiment teaching processes in purpose of strengthening students' skills and promoting the training of application ability and innovation ability,we achieved high efficiency and low consumption of experimental physiology and improve the teaching quality.

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.

Objective: To analyze the risk factors of adverse neurodevelopmental prognostic in very /extremely low birth weight infants (VLBWI/ELBWI). Methods: The 24 hours VLBWI/ELBWI admitted to the neonatal intensive care unit between January 2016 and October 2016 were enrolled.These infants were followed up and neurodevelopmental evaluation was performed at a corrected age of 12 months by using the Bayley Scales of Infant Development Ⅱ (BSID-Ⅱ). According to the neurodevelopmental outcomes, they were divided into normal and abnormal neurodeve-lopment groups.The data of prenatal, intrapartum and postpartum periods in the two groups were compared.Potential risk factors of neurodevelopmental impairment were analyzed with Logistic stepwise regression. Results: A total of 167 VLBWI/ELBWI were enrolled, among which 14 cases died during hospitalization or after giving up treatment.At the corrected age of 12 months, 140(91.5%) infants completed follow-up and 13(8.5%) were lost to follow-up.Among 140 infants who completed neurodevelopmental evaluation at the corrected age of 12 months, there were 86 males, 54 females, and in which 28 cases had extremely low birth weight, 112 cases with very low birth weight, with gestational age of (30.4±2.2) weeks (25.3-36.0 weeks). There were one hundred and twenty-five cases with normal neurodevelopmental outcomes and 15 cases with abnormal neurodevelopmental outcomes.The results of univariate analysis showed that birth weight<1 000 g, exposure to antenatal steroids, N -terminal brain natriuretic peptide (NT-proBNP) ≥35 000 ng/L and bronchopulmonary dysplasia (BPD) in the two groups were statistically significant(P<0.05). Logistic stepwise regression showed that NT-proBNP level≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI (OR=22.774, 95%CI: 3.079-168.425, P=0.002). Exposure to antenatal steroids may be a protective factor for neurodevelopmental impairment (OR=0.125, 95%CI: 0.020-0.782, P=0.026). Conclusions Plasma NT-proBNP level ≥35 000 ng/L may independently predict neurodevelopmental impairment among VLBWI/ELBWI.Antenatal corticosteroids may be the protective factor of poor neurodevelopmental outcomes.

Objective To investigate the normal development of anterior and posterior acetabulum in children through measuring anterior and posterior acetabular indexes with the baseline from the thinnest point of acetabulum to the center of femoral head.Methods MRI data in 165 normal children aged 0-12 years were collected.The baselines were drawn from the center of the femoral head to the thinnest point of acetabulum (method 1) and from the one midpoint of Y cartilage to the contralateral (method 2),then the anterior or posterior bony acetabular index (A/PBAI) and anterior or posterior cartilaginous acetabular indexes (A/PCAI) were measured.The consistency of above parameters measured using two methods and between two observers was observed,and the correlation with parameters-gestational ages was analyzed.Results The consistency of ABAI (ICC=0.832) measured with two methods was good,and the consistency of ACAI (ICC=0.535),PBAI (ICC=0.565) and PCAI (ICC=0.472) was fair.The consistency between two observers was good (all ICC＞0.75).ABAI,ACAI and PBAI were negatively correlated with age (r=-0.762,-0.475,-0.368,all P＜0.001),and PCAI had no correlation with age (r=-0.190,P＜0.005).Before 4 years old,ABAI gradually decreased with age and gradually stabilized after 4 years of age.ACAI and PBAI decreased slightly with aging.PCAI did not change obviously with aging.Conclusion The measuring method of anterior and posterior acetabular indexes with the baseline from the thinnest point of acetabulum to the center of femoral head can accurately evaluate the normal development of anterior and posterior acetabulum in children.

Objective To investigate application effect of strengthened night nursing to the prevent of vascular crisis in patients after finger replantation. Methods A total of 155 patients with finger replantation in Hand surgery from February 2014 to February 2016 were selected as research object, 90 cases from March 2015 to February 2016 with strengthened night nursing were as the observation group,65 cases from February 2014 to February 2015 with routine nursing were as the control group. The two groups were compared of limb replantation success rate, vascular crisis rate and nursing satisfaction. Results The replantation success rate in the observation group was 90.00%(81/90)higher than 76.92%(50/65)in the control group,the occurrence of vascular crisis rate was 11.11%(10/90)lower than 27.69%(18/65)in the control group,the success rate was 7/10 higher than 10/18 in the control group, and the difference was statistically significant (χ2=4.932, 7.013, 4.216, all P<0.05). The nursing satisfaction in the observation group was (94.32 ± 3.57) points, 93.33%(84/90) higher than (91.22 ± 4.48) points, 83.08%(54/65) in the control group, and the difference was statistically significant (t=4.789, χ2=4.071, P<0.05). Conclusions Strengthened night nursing can effectively prevent vascular crisis in patients after finger replantation,improve nursing satisfaction of patients.