The laparoscopic technique for live donor nephrectomy is a technically difficult procedure that has not yet gained widespread acceptance in the transplantation community in our country. The procedure would be more acceptable if alterations be added to the technique to make it easier to perform and decrease operation time.In Dec.2001,we performed a hand assisted laparoscopic live donor nephrectomy (HLDN) including the use of a device allowing hand assistance.HLDN, was peformed with Hand System,Auto Sonix,Endo Clip,Hem o lok, Endo GIA, and with pheumoperitoneum the left kidney was removed through the upper midline incision.The incision was 6 0cm long.The operating time was 118min,warm ischemia time was 3 3min,and cold ischemia time 92 min. The renal artery was 2 0cm long and 0 5cm in diameter, the renal vein was 2 2cm long and 1 2cm in diameter, and the length of the ureter was 12 0cm.Both the donor and recipient recovered very well post operatively without any complication.The donor was discharged form the hospital on the day 7 after operation,and the recipient on the day 21 with normal renal functions. The advantages of the hand assisted technique include the ability to use tactile sensation to facilitate dissection,retraction and exposure.In addition,the final stages of vascular stapling and kidney removal are more as sured and rapid.The modifications in the laparoscopic technique presented here provide measurable and subjective improvements to laparoscopic live donor nephrectomy.

Objective To observe the therapeutic efficacy of different schemas in partients with contagious atypical pneumonia outbreaking in GuangZhou area.Methods Patient who were hospitalized in our ward from Feb,2003 to May,2003 were allocated to different groups according to the therapentic schema.To compare and analyse the efficacy.Results resnlts indicate that the effects of antivirus drugs of all groups have no difference.The use of glucocorticoid decreased the opportunity of mechanical ventilation and intubation.Conclusion Patients who have severe condition or present with adult respiratory dyspnea syndrome will relieve in pulmonary inflammatory bleeding at some degree if they get proper glucocorticoid and positive pressure nonivasive ventilation,the possibility of intubation and fatality will decrease

Objective To observe the different methods of hemostasis and comfort of the TR -Band com-pression hemostasis device after coronary intervention and to find the best strategy for TR -Band to stop the bleeding. Methods 150 patients with coronary artery disease were randomly divided into three groups according to the digital table method.The initial time of TR -Band compression hemostasis of group A was 3h,(once per hour,2mL per time,total compression time was 10h),while that of group B was 2h(once in every two hours,3mL per time,total com-pression time was 8h),and that of group C was 1h(once per hour,2mL per time,total compression time was 6 h). Thumb oxygen saturation,complications and comfort level in the three groups of patients were observed and compared. Results The differences between the three groups of oppression hemostasis before and after 2 h thumb oxygen saturation were normal,the three groups had no statistical significance (P >0.05).lesions,hematoma,bruising and radial artery occlusion occurred rate of group A were respectively 4,3,5,2 cases,those of group B were 3,4,6, 1 cases,and those of group C were 2,5,6,0 cases.Lesions,hematoma,bruising,radial artery occlusion of local com-plication incidence of the three groups showed no statistical significance (P >0.05).The comfort level (numbness, swelling,pain)of the three groups had statistically significant differences (Fnumbness =8.215,Fswel ing =7.657,Fpain =7.985,all P <0.01).Conclusion TR -Band compression hemostasis device can achieve effective hemostasis in the treatment of coronary artery intervention.And the reasonable adjustment of different bleeding time,compression time and the amount of bleeding can affect the comfort of patients.

Objective To investigate the performance of surgical management in facial skin malignancies.Methods From January 2000 to December 2006,65 patients with facial skin malignancies,including47 cases of basal cell carcinoma.10 cases of squamous cell carcinoma,3 cases of dermatofibrosarocoma protuberans,2 cases of malignant melanomas,and one case of malignant acanthoma,hemangioendotheliosar-coma and sebaceous carcinoma,respectively,were collected and managed with wide resection followed by reconstruction.In order to achieve a thorough resection,frozen sections were prepared and subjected to pathological examination during the operation process to ensure the margins of resection were free of malignancy.Reconstruction was carried out by direct closure,or with local random flaps,extended flaps,free skin grafts.Resuits All defects were managed by one-stage reconstruction.The survival rate of skin flaps/grafts was 100%,and a satisfactory appearance and function was achieved.During the follow-up from 6 months to 5 years,local relapse was observed in one patient with basal cell carcinoma and one with squamous eell carcinoma,lymphatic metastasis in one with squamous cell carcinoma.Distant metastasis occurred in a patient with malignant melanoma.who died consequently.Conclusions Thorough resection is the key to prevent relapse of facial skin malignancies after surgery.Appropriate reconstruction may favor the restoration of facial appearance,and local random flaps appear to be the best reconstruction strategy.

Occupational therapy is an important part of rehabilitation medicine. There is movement, feel, swallowing, speech, vision,cognitive, psychological and social relations dysfunction in stroke patients. Occupational therapy play an important part in the whole processof intervention for stroke patients, and help them improve their quality of life.

Objective To observe the effect of psychological support therapy on anxiety resulted from pain after stroke. Methods 40 patients with anxiety after stroke were divided equally into psychological support treatment group and control group. They were assessed with Hamilton Anxiety Scale (HAMA) and Visual Analogue Scale (VAS) of pain before and after treatment. Results The scores of HAMA and VAS improved more in treatment group than in control group (P<.01). Conclusion The psychological support therapy can reduce the anxiety and pain after stroke.

Based on the software of traditional Chinese medicine inheritance support system (TCMISS), this article aims to analyze the experience and composition rules for cough from the descendant of Meng He Medical School, Xu Di-hua. The cough cases treated by Xu Di-hua were collected, and recorded into TCMISS (V2.0). Data mining methods such as Apriori algorithm and complex system entropy cluster were used to analyze the medication principles of Xu Di-hua for cough from pathogenesis and therapeutie aspects, and dig out the frequency of the herbs in prescription, core medicine and new combinations. The experience of curing cough from Professor Xu Di-hua were well found in the research. He is good at choosing prescriptions accurately, and pays attention to simultaneous use of cold and moisture drugs with combination of tonification and purgation. He is skilled in adding or reducing materia medica flexibly, as well as regulating lung to relieve cough and eliminating phlegm by clearing heat.
Algorithms ; Cough ; drug therapy ; Data Mining ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Humans ; Male ; Materia Medica ; Medicine, Chinese Traditional

ObjectiveTo assess the effects of constraint-induced movement therapy(CIMT) on sub-acute stroke patients with upper extremity motor dysfunction.Methods63 patients with hemiplegia after stroke were divided into two groups: control group(31 cases) and CIMT group(32 casese). The two groups received the regular rehabilitation training for 14 d. Then the control group went on the the regular rehabilitation training, while the CIMT group received CIMT for 14 d. All patients were assessed by the Action Research Arm Test(ARAT) and Fugl-Meyer(FMA) on the first day, the 15th day and the 30th day after the treatment.ResultsARAT score and FMA scores were higher in CIMT group than in the control group 30 d after the treatment and in CIMT group 15 days after the treatment(P<0.001).ConclusionCIMT is more effective to improve the upper limb motor function of the sub-acute stroke patients than the regular rehabilitation training.

The aryl hydrocarbon receptor (AhR) is a ligand-activated transcription factor that regulates gene expression in a range of cells, including immune and epithelial cells. AhR signaling plays important roles in the immune system in both health and disease states. Tapinarof is a first-in-class small-molecule topical therapeutic AhR modulating agent launched for the treatment of psoriasis. To improve the activity and chemical stability of Tapinarof, a series of 2-phenylchromen-4-one derivatives were designed, synthesized and evaluated as novel AhR agonists. Compounds 5a, 5c, 5e and 5f potently activated AhR with an EC₅₀ value of 7, 9, 6 and 6 nmol·L^-1, respectively, which are 10-14 fold more potent than Tapinarof. Compounds 5a and 5e exhibit comparable inhibitory effects on IFN-γ production as Tapinarof. Furthermore, compounds 5a-5f exhibited favorable photochemical stability compared to Tapinarof. The compounds may eventually serve as lead compounds for the development of new AhR agonists.

Objective To study the effect of early enteral nutrition (EEN) with ω-3 polyunsaturated fatty acid on nutritional status and body immunity of postoperative patients with colorectal cancer.Methods Forty patients with colorectal cancer were randomly divided into EEN group and parenteral nutrition (PN) group by systematic sampling method with 20 cases of each.The patients in EEN group were given complete enteral nutrition with ω-3 polyunsaturated fatty acid 1-7 d after operation,while the patients in PN group only were given nutrient by regular PN.Nutritional status,body immunity before operation and 1-7 d after operation,and intestinal function recovery time,untoward reaction were determined.Results The postoperative anus first exhaust time and defecate time of patients in EEN group were significantly shorter than those in PN group [(48.0±5.6) hvs.(51.0±6.7) h,(53.0±4.8) h vs.(72.0±3.6) h,P＜0.05].Serum albumin and prealbumin 1 d after operation in 2 groups were significantly lower than before operation (P ＜0.05),but 7 d after operation were significantly higher than 1 d after operation (P ＜0.05).Serum albumin and prealbumin 7 d after operation in EEN group were significantly higher than PN group(P ＜ 0.05).IgG,IgA,IgM,CD3,CD4,CD8,CD4/CD8 1 d after operation in 2 groups were significantly lower than before operation (P ＜ 0.05).IgG,IgA,CD4,CD4/CD8 7 d after operation in EEN group were significantly higher than PN group (P＜ 0.05).Conclusions Compared with the PN,EEN with ω-3 polyunsaturated fatty acid can remarkably improve nutritional status and body immunity in postoperative patients with colorectal cancer.It can accelerate the recovery of intestine function and worthy of recommending.