[Summary] This paper reported the surgical cooperation in 72 cases of da Vinci robot operations between September 2014 and December 2014 in this hospital .All the 72 cases of total laparoscopic operation by using the da Vinci robot assistance were successfully completed, without robot faults caused by mismatch and nursing complications caused by improper nursing .We believe that nurse training with robot surgical system and qualification certification , preoperative patient visits , reasonable arrangement of operation room , careful observation with skilled coordination with the robot , proper postoperative placement of the robot , and maintenance and disinfection of the machine are crucial to a successful surgery .

BACKGROUND:Hip arthroplasty is an effective means currently in repair of femoral neck fractures. With the increased in the amount of surgery, surgery failure rate also has increased. In particular, prosthesis loosening and fracture are very common after replacement.Qiangguyin can promote the formation of osteoblasts, resist osteoporosis, inhibit osteoclast activity, and increase bone density. Drynaria invigorates the kidney, strengthens the bone and tendon and relieves pain, and has bidirectional regulatory effects on promoting bone formation and inhibiting bone resorption.
OBJECTIVE:To investigate effects ofQiangguyin on periprosthetic bone density in patients with femoral neck fracture after hip arthroplasty.
METHODS:96 patients with femoral neck fracture were equaly divided into observation group and control group based on the random number table. Both groups were given selective joint replacement. Patients were implanted with femoral head made by US Stryker Corporation, and fixed with bone cement. After replacement, patients in the control group were treated with calcium D3 tablets and capsules alfacalcidol. On this basis, the treatment group was given theQiangguyin oral drug intervention for a month. Bone density surrounding the prosthesis was observed in both groups. Alkaline phosphatase and tartrate-resistant hydrochloric acid phosphatase activities were detected. Repair effects were compared.
RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. No infection or loosening of the prosthesis occurred. Ambulation time and healing time were significantly less in the observation group than in the control group (P < 0.05). No significant difference in bone density surrounding the prosthesis was detected between the two groups before medication, and an obvious increased trend was found after medication (P < 0.05). Bone density was significantly higher in the observation group than in the control group after medication (P < 0.05). Serum alkaline phosphatase activity was significantly higher in the two groups after medication, but tartrate-resistant hydrochloric acid phosphatase activity was significantly decreased, which showed significant differences as compared with that before medication (P < 0.05). Simultaneously, significant differences in serum alkaline phosphatase activity and tartrate-resistant hydrochloric acid phosphatase activity were detected between the observation and control groups after medication (P < 0.05). At 6 months after replacement, the excelent and good rate of joint function was significantly higher in the observation group than in the control group (94%, 79%,P < 0.05). These results indicate that Qiangguyin could resist bone resorption and suppress excessive bone turnover, improve bone density around the prosthesis, and restore joint function after hip arthroplasty.

Objective To evaluate the concept of artery first and total mesopancreatic excision in radical resection of pancreatic head carcinoma through both anterior and posterior approaches.Method The anterior approach was to identify the superior mesenteric artery (SMA) and the posterior approach to confirm the possibility of negative margin at the origin of SMA,on the posterio-lateral vascular wall of superior mesenteric vein (SMV) and the supposed posterior of the mesopancreas.The resection scope were with the celiac trunk and common hepatic artery as the upper boarder,the SMA as the left boarder,the inferior mesenteric vein (IMA) level as the lower boarder,to achieve a complete mesopancreatic excision,namely the en bloc resection of all the involved nerve,the lymph tissue and vascular tissue along the right side of the axial composed by SMA and celiac trunk.Results Of the 15 patients,11 had radical Whipple procedure,among which 2 had a combining SMV resection and reconstruction.1 case suffered from delayed gastric emptying and 2 cases from bile leakage.There was no mortality.The postoperative pathology reported carcinoma in all 11 cases,with duodenum and low bile duct involved in 4 cases,with the duodenum involved in 6 cases,no surrounding tissue involvement was identified in 1 case.Nerve involvement was found in 7 (7/11),vascular involvement in 10 (10/11),and lymphnode metastasis was (2.5 ± 3.8/12.9 ± 4.9).Conclusions The radical resection of pancreatic head carcinoma using the concept of artery first and the total mesopancreatic excision is helpful for an early evaluation of the possibility of radical resection and guarantees negative margins.

Objective To compare the effects of repetitive transcranial magnetic stimulation (rTMS) at various low frequencies on upper limb function after cerebral infarction.Methods Fifty patients were randomly assigned to a control group (10 cases),a sham rTMS group (10 cases) or an rTMS group which had three sub-groups treated at 0.25 Hz,0.5 Hz and 0.75 Hz with 10 cases in each.All of the patients were treated with conventional medical treatment and rehabilitation training.The sham and true rTMS groups received rTMS applied over the M1 area of the unaffected hemisphere,5 days per week for 4 weeks.Motor evoked potential (MEP) cortical latency,and central motor conduction time (CMCT) were measured and the Fugl-Meyer assessment (FMA),motricity index (MI) and a Hong Kong functional test for the hemiplegic upper extremity (FTHUE-HK) were evaluated beforehand and at Post 1 after 2 weeks of treatment and Post 2 after 4 weeks of treatment.Results The average CMCT and FMA scores of the control and sham rTMS groups both had improved significantly at Post 2.There was no significant difference in any of the indices between those 2 groups at any time point.At Post 1,the average MEP cortical latencies of the 0.25 Hz and 0.5 Hz subgroups had improved to be significantly better than those of the control and sham rTMS groups.The average CMCTs of the 0.25 Hz and 0.5 Hz rTMS subgroups were significantly shorter after treatment,and significantly better than those of the control and sham rTMS groups.At Post 2,the average MEP cortical latency of all groups except the control group showed significant improvement compared with pre-treatment.The 2 indices of the 0.25 Hz and 0.5 Hz subgroups were again significantly shorter than those of the control and sham rTMS groups,and the average CMCTs were significantly better than that of 0.75 Hz subgroup.At Post 1 the average FMA and MI scores of the rTMS subgroups had all improved significantly.In the 0.25 Hz and 0.5 Hz subgroups the average MI scores were significantly higher than those of the control and sham rTMS groups.The FTHUE-HK scores of those 2 subgroups had also improved significantly.At Post 2,the average FMA and MI scores of all groups and the FTHUE-HK scores of rTMS group had improved significantly.In the 0.25 Hz and 0.5 Hz subgroups,all of the indices were significantly better than in the control and sham rTMS groups.The average FTHUE-HK score of the 0.25 Hz subgroup was significantly superior to that of the 0.75 Hz subgroup.In the 0.75 Hz subgroup the average MI score was significantly higher than in the control and sham rTMS groups.Conclusions rTMS at either 0.25 Hz or 0.5 Hz applied to the unaffected hemisphere provides effective treatment for enhancing the excitability of the motor cortex and the motor function of a paretic upper limb after stroke.Compared with others,the total number of stimulus pulse in 0.25 Hz subgroup was the least,and priority consideration should be given to the frequency of 0.25 Hz when using rTMS in clinical treatment of cerebral infarction.

Objective To evaluate the detection rates of colorectal polyps and cancer in the elderly and characterize the pathological features of the colorectal neoplasm in DongLi District in Tianjin.Method Totally,46 743 subjects aged 60-74 were recruited from the national colorectal cancer screening program,including subjects registered from November 2012 to April 2013 in DongLi District in Tianjin.Each subject completed a questionnaire and a fecal occult blood test.Colonoscopies were conducted in 434 subjects with high risk for colorectal cancer.Results Among all the subjects,2 880 were at high risk for colorectal cancer which accounts for 6.16％ (2 880/46 743) of the total subjects.Among the subjects who underwent the colonoscopy,165 (men:105,women:60) were colorectal polyps accounting for 5.73％ (165/2 880)in the total risk,with 51 subjects (1.77％) advanced neoplasms and 4 subjects (0.14％) cancer.The detection rates of colorectal polyps is 0.35％ (165/46 743),and colorectal cancer is 8.6/105(4/46 743).More polyps were found on the left colon compared with the right.More tubular adenoma was found compared with the other pathological types.Most of the polyps were smaller than 0.5 cm.Colorectal polyps and advanced neoplasms were more frequent in men than women [45.45％ (105/231) vs 29.56％ (60/203),16.02％ (37/231) vs 6.90％ (14/203),all P ＜ 0.01].Multiple polyps (P ＜ 0.05) and polyps with diameter larger than 1.0 cm (P ＜ 0.01) were more often in men than in women.Men tended to have more colorectal polyps in right colon and higher detection rate for moderate or sever atypical hyperplasia than women(all P ＜ 0.05).Conclusion There is a higher incidence of colorectal polyps in the elderly.It is important to establish the national sequential colorectal cancer screening program for the early diagnoses of colorectal polyps and cancer in the elderly.

Objective To fabricate an immunofluorescence probe system of carbon dots conjugated antibody based on antigen-antibody reaction principles.Methods A green one-step microwave assisted pyrolysis method was applied to preparing fluorescent carbon dots (CDs) using aminoglucose as carbon source and the obtained CDs were conjugated with antibody via EDC/NHS reactions to build CDs based fluorescent probe.Furthermore,the properties of CDs and CDs based probe system were evaluated by Fourier transform infrared (FTIR) spectra,transmission electron microscopy (TEM),UV-vis absorption and so on.Results The as-prepared CDs showed excellent fluorescence and hydrophilicity and CDs based immunofluorescence probe exhibited the capability of quick detection of E.coli O157:H7.Cinclusion Fluorescent CDs as one new emerging environment-friendly nanomaterial has great potential in biosensors.

Objective: To develop autoverification rules to assistant the verification of biochemical results, based on laboratory information management system. Methods: Designed six kinds of autoverification logic rules according to the guidelines of Clinical and Laboratory Standards Institute (CLSI) AUTO-10A and Accreditation Criteria for the Quality and Competence of Medical Laboratories(ISO15189: 2012), based on in-control of the Internal Quality Control. Those rules inculds: logic disorder rules, critical value rules, warning value rules, delta check rules, relevant contradictions rules, abnormal mode rules, etc. Those rules was setted up in laboratory information management system of Dian Diagnostics. From October 2016 to April 2017, The status of autoverification was checked according to the items and bar code, and compared with clinical diagnostic and manual review. Results: The passing rate of autoverification is over 65% when counted according to tests and is 45% when counted according to sample code, the coincidence rate is 92% with clinical diagnosis.In passing results of autoverification, the coincidence rate is 97.48% to 100% when campared with manual verification, and in not-passing results, the coincidence rate is 82.98% to 85.21%. Conclusion (1)Autoverification can verify half of routine biochemical test results by setting intelligent logics and rules. (2)Autoverification rules must be verified by a certain amount of test results before they can be formally applied. (3)Autoverification could improve the speed and efficiency of post-test steps.(Chin J Lab Med, 2018, 41: 547-553)

Objective To analyze the conding region of hantanvirus S gene and predict the structure of nucleoprotein for diagnostic antigen study.Methods RT-PCR was used to amplify the S gene of hantanvirus Hunan03 strain after designing specific primers.The amplification product was cloned into pGM-T vector and then the recombinant vector was transformed into E.coli TOP10,gene sequencing was carried out after blue-white selection and PCR screening for positive clones.The database of NCBI and Swiss-Prot/TrEMBL were used to predict and analyze the structure,biological characteristics and protein structures of S gene.Results The amplification product was about 1290 bp,the pGM-T/S vector was constructed and successfully sequenced,the whole length of the open reading frame (ORF) was composed of 1290 nucleotide residues,among them the GC content was 44.11％ and the AT content was 55.89％,it was composed of 429 amino acids (20 kinds),the accession number of the sequence submitted to GenBank was JN712306,its homology of nucleotides to the 76-118 strain was 83％ and the homology of amino acids was 98％,ten nonspecific variation sites were found.The grand average of hydropathicity was-0.405.There were three transmembrane domains and four non transmembrane domains in the secondary structure of nucleoprotein including 55％ of helix structure,6.1％ of sheet structure and 38.9％ of loop structure.Conclusion The bioinformatics analysis of Hunan03 strain S gene might be important for provide the substructure data to reveal the significance of S gene characteristics on hemorrhagic fever renal syndrome (HFRS) prevention and control.

Objective:To evaluate trans-artery pressure perfusion autologous transfusion for laparoscopic splenectomy and pericardial devascularization (LSPD).Methods:The clinical data of patients with laparoscopic splenectomy in Zhejiang Provincial People′s Hospital in recent 3 years were reviewed. The therapeutic effects of 30 LSPD cases with trans-artery pressure perfusion (observation group) and 30 radical LSPD cases (control group) were compared and analyzed.Results:There was no significant difference in age, sex, preoperative liver function grade and spleen volume between the two groups ( P>0.05). All 60 patients completed laparoscopic splenectomy without conversion to laparotomy or death. There was no significant difference in liver function, operation time and intraoperative bleeding between the observation group and the control group ( P>0.05), and there was also no significant difference in blood transfusion, postoperative complications and hospital stay ( P>0.05). The hemoglobin level in the observation group was significantly higher than that in the control group ( P<0.05). Conclusions:Laparoscopic splenectomy and pericardial devascularization with trans-artery pressure perfusion autologous transfusion can increase post-operative hemoglobin value effectively.

Objective To investigate the correlations of distribution and grading of deep medullary veins (DMVs) with clinical prognoses of patients with acute anterior circulation infarction by using susceptibility-weighted imaging (SWI).Methods Fifty patients with acute anterior circulation infarction,admitted to our hospital from August 2016 to December 2017,were enrolled in our study.SWI was performed to evaluate the DMVs.Univariate and multivariate Logistic regression models were used to determine the correlation between distribution of DMVs and clinical prognoses of patients.DMVs on the ipsilateral side of the lesions were further graded and analyzed;boxplot was used to describe its relation with modified Rankin scale (mRS) scores of the patients.Results DMVs were observed in 36 patients (72％),with 19 ipsilateral DMVs and 17 contralateral DMVs.The ipsilateral DMVs were independently associated with poor outcome (odds ratio=3.380,95％CI:1.006-11.393,P=0.049).The contralateral DMVs were not independent predictors for outcomes,but appeared commonly in patients with good outcome (44.8％).In patients with ipsilateral DMVs,grading 1,grading 2,and grading 3 were noted in 7,two and three patients,respectively;boxplot analysis showed that DMVs patients of grading 3 had higher mRS scores,with an average of 4.Conclusion The ipsilateral DMVs on SWI are independent predictive biomarkers for poor clinical outcome after stroke,and contralateral DMVs often indicate good prognosis.