[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 .

AIM:To establish a HPLC diagitized fingerprint for Ixeris sonchifolia Hance Injection to serve as a digitized method criteria for its overall quality control. METHODS: The chromatographic fingerprints were obtained by injecting 20 ?L of the sample solution each time on a Century SIL BDS column (250 mm?4.6 mm, 5 ?m) with the gradient elution solvent system composed of 1% acetic acid water and 1% acetic acid acetonitrile. The flow rate was 1 mL/min, the column temperature was maintained at (30?0.15)℃ and the detection wavelength was set at 265 nm. The chromatographic fingerprints were charateristically digitized and evaluated by the software of the digitized evaluation system of traditional Chinese medicine fingerprint with the super information characteristics to give the 42 parameters such as chromatographic fingerprint index (F), chromatographic fingerprint resolution index (RF), which could thoroughly disclose the hidden information in the fingerprints. Meanwhile, the apparent molecular weight, the peak position, the elution fore index and the pseudo peak area were marked in terms of the principle of QSPR when the two peaks were selected as the reference peaks. RESULTS: 21 co-possessing peaks were selected as the fingerprint peaks of Ixeris sonchifolia Hance Injection by taking caffeic acid peak as the reference peak to establish the digitized fingerprint and obtain the important digital information about its quanlity control. The stabilities among different batches of samples were evaluated by the dual qualitative and dual quantitative similarity method. CONCLUSION: This new digitized fingerprint method with good precision and reproducibility can be perfectly applied to the quality control over Ixeris sonchifolia Hance Injection. Digitized fingerprint obtained from the dual qualitative and dual quantitative similarity method maybe extend further to assess and control the quanlity of TCM.

Thoracic and cardiovascular surgery teaching is the focal and difficult point in the whole surgery teaching.This article introduces the authors'reform by using advanced multimedia and image equipment to enhance teaching effect in both theory and practice,using the modern modes such as logic guide,case study and inter-communication to inspire students'passion and by emphasizing basic skill and asepsis environment to build normative teaching in thoracic and cardiovascular surgery.

Objective To investigate the relationship between the serum concentration of neuron-specific enolase (NSE) and the brain damage severity and the prognosis of acute head injuried patients. Methods Early serum levels of NSE were measured in 70 patients with acute head injury by radioimmunoassay. The concentration of NSE was analysed by combining with GCS and GOS systems. Results NSE levels in serum of patients with major(a), minor(b) head injuries and control individuals(c) were (25 78 ? 10 80)ng/ml, (19 58 ? 8 91)ng/ml and (9 51 ? 2 79)ng/ml respectively, differences of which were significant (P a-b

Objective Thermal burns of the anterior chest disfigure the female breast, and the postburn breast deformity is a sequela of severe scar contraction of the burned chest. For deformities that affected the mammary development, museulocutaneous flaps were used. Here we introduce our experience in using the latissimus dorsi myocutaneous island flap in burned breast reconstruction. Methods During the past 7 years, 7 female patients with such deformities required reconstruction, the expanded or unex-panded latissimus dorsi musculocutaneous island flaps were used in the partial reconstruction of burned breast. In the mild deformities group (2 cases), unexpanded latissimus dorsi musculocutaneous island flaps were used. For patients with undeveloped mammary glands (5 cases), expanded latissimus dorsi musculocutaneous island flaps were used. Results The procedure was performed in 7 patients and all the flaps were alive, with significant improvement of breast appearance. The complication rate was low. There were no deformity and dysfuction in the donor site. Conclusions The technique has many advanta-ges: beautiful contour of breast, good blood supply of the flap, no donor site morbidity. It provides the plastic surgeon with an excellent, safe and consistently successful method for burned breast reconstrue-tion. This experience has led to development of surgical principles and techniques tailored to this particu-larly difficult problem.

Objective To study the clinical effect of qi supplementation combined with rehabilitation on the severity of fatigue after ischcmic stroke in patients with qi deficiency. Methods Ninety ischemic stroke patients with qi deficiency were randomly divided into 3 groups of 30. The treatment group was treated with an oral decoction of qi-supplementing Chinese medicine and also rehabilitation. The Western medicine control group was treated with a Chinese medicine placebo, Western medicine and rehabilitation. The blank control group was treated with the Chinese medicine placebo and rehabilitation. All groups were evaluated using a stroke-specific quality of life scale ( SSQOL) and a fatigue severity scale (FSS) before and 4 weeks after treatment. Results After treatment, the average SS-QOL and FSS scores had improved significantly compared with those before treatment, especially in the two treatment groups. There was a significant difference between the treatment group and the Western medicine control group,and between the treatment group and the blank control group on both scales. There was also a significant difference between the Western medicine control group and the blank control group in terms of SS-QOL scores, but not FSSscores. Conclusion All 3 treatments alleviated fatigue in ischemic stroke patients with a qi deficiency. Qi supplementation combined with rehabilitation was the most effective, followed by Western medicine combined with rehabilitation.

Objective To observe the effect of aerobic exercise of different intensities on type Ⅱ collagen,glycosaminoglycan (GAG) and chondrocyte apoptosis in rabbits modeling knee osteoarthritis (OA),so as to explore the preventive effect and its possible mechanism.Methods Twenty healthy New Zealand white rabbits were randomly divided into Groups A,B,C and D,each of 5.Group A was allowed free activity in a cage for 9 weeks.Group B was allowed free activity for 4 weeks,then an OA model was established using papain and confirmed via MRI 1 week later,Another 4 weeks of free activity were then allowed.Groups C and group D were given running training for 20 minutes a day at 0.5 km/h,3 times a week,and then 20 minutes a day at 1.5 km/h,5 days a week on a treadmill for 4 weeks.Nine weeks later,all 4 groups of rabbits were killed and the articular cartilage damage of each group was compared using Mankin scoring,and expression of type Ⅱ collagen,GAG content and chondrocyte apoptosis in the cartilage.Results After the intervention,the average Mankin score,expression of type Ⅱ collagen and GAG content of groups B,C and D were significantly lower than those of group A,and all of those values in group B were significantly lower than those of group D.After 9 weeks the chondrocyte apoptosis rate of group A was significantly lower than that of the other groups,and that of groups C and D was significantly lower than that of group B.Conclusion Aerobic exercise may prevent knee articular cartilage degeneration through inhibiting reduction in the amount of type Ⅱ collagen and GAG in the cartilage matrix.It may be related to decreasing the chondrocyte apoptosis.

Pancreatoduodenectomy (PD) is considered as a complex and difficult surgical procedure even to the experi-enced surgeons, and it is thought to be the last frontier for mini-really invasive surgeons. Laparoscopic PD, despite the initial enthusiasm towards it, discourages laparoscopic surgeons by its long operating time and procedure-related fatigue resulting from technical difficulties associated with laparoscopic instruments and unstable camera platform. Although robotic surgical system with its known advantages has successfully overcome the limita-tions of traditional laparoscopic surgery, and completed the com-plex and advanced surgical procedures required in PD, reports on robot-assisted (laparobotic) PD remain few. Furthermore, there has not yet been a single report detailing PD techniques modified to take advantage of the Da Vinci platform. In this report, laparobotic PD was successfully performed on 7 patients. Five patients underwent pyloric preserving PD and 2 had stand-ard PD. All the 7 patients have been followed up till January 2009. The overall mean operative time was 326 minutes (290-400 minutes) and the mean length of postoperative stay was 10.2 days (5-30 days). There was no mortality. Five patients had perioperative complications but went on well after manage-ment. The stepwise cando-cranial approach PD is a unique approach, which is ideal for robotic platform. Although it has been shown to be feasible, safe, efficient, and reproducible in this small series, a larger scale multi-institutional study is needed to validate its efficacy.

Objective To investigate the possibility of using the results of breast ultrasound and Cohen-classification to determine the gynecomastia patients' subtype, and to evaluate the effectiveness of different surgical methods based on the classification. Methods In the past 3 years, 40 patients with gy-necomastia were treated in this hospital. The patients" age ranged from 18 to 50 years, with an average of 21.38. All the patients had the bilateral lesions, and their pathological diagnosis was gynecomastia. The mammary gland resected from each side weighted from 30 to 180 grams. The total fat volume liposucted ranged from 200 ml to 1 200 ml. As a routine, we performed breast ultrasound examination before the op-eration on each patient. According to the different echo, we marked the extent of breast gland on the chest walls and determine the Cohen classification of the patients. For breast tissue hyperplasia, we only resected the gland under the direction of the chest wall marks. For fat tissue hyperplasia, we just per-formed liposuction. For patients with mixed fat and gland hyperplasia, we combined these two methods rationally. If necessary, the procedures was repeated. Results With the help of breast ultrasound exami-nation, the operating procedure was more accurate and simple, as a result, our treatments had less injury and no severe complications. After a following-up of 6-36 months, satisfactory results were achieved, with normal male chest appearance and small obscure scar. Conclusions Male breast surgery is totally different from the females. The Cohen classification has been determined for each gynecomastia patient, based on the results of breast ultrasound examination, which helps choose the surgical methods and procedures and decrease surgical injuries and complications, with satisfactory results.

BACKGROUND: For decades, liposome drug carrier has been used to enhance drug stability and efficacy, reduce drug toxicity and adverse effects. However, they fail to provide long-term delivery due to insufficient stability. Studies have demonstrated that silica is not toxic, with chemically inert and biological compatibility, and can be used as modified material. OBJECTIVE: To characterize the silica coated liposome and investigate the controlled release property. DESIGN, TIME AND SETTING: In vitro observation. The study was performed at the Nanomedicine and Biosensor Laboratory, Biomedical Engineering Center, Harbin Institute of Technology from May 2007 to June 2008. MATERIALS: Dipalmitoylphosphatidylcholine (DPPC) was purchased from Nanjing Kangsente Chemical Engineering Company; tetraethylorthosilicate (TEOS) was purchased from Aldrich, USA. Doxorubicin (DOX) was purchased from Beijing Huafeng United Technology Company; Sephadex G-50 was purchased from Amersham Biosciences, Sweden. All other chemical agents were of analytical purity. METHODS: Liposome was formed from DPPC following the precipitation of silica by sol-gel method. MAIN OUTCOME MEASURES: Zeta-potential and dynamic light scanning were used for zeta-potential measurement and particle size distribution; transmission electron microscopy was used to collect the image of particle morphology; Fourier transform infrared spectroscopy (FTIR) was used to display chemical characteristics of Si-O-Si structure; Spectrophotofluorimetry was used to determine DOX regression equation and was further used for calculation in drug encapsulation efficiency and in vitro release.　RESULTS: ①Silica coated liposome was successfully prepared. ②FTIR proofed the presence of Si-O-Si at 1 166, 1 080, 859 and 526 cm-1. ③The DOX encapsulated silica coated liposome had encapsulation efficiency of 72.4%. ④Drug release profiles showed that sustained release of DOX was achieved after modification of silica on liposome. CONCLUSION: With Si-O-Si as protective layer, the liposome has increased stability and prolonged drug release.