High incidence of postoperative abdominal adhesions after gynecological laparoscopy, which may induce a line of serious complications such as chronic pelvic soreness, intestinal obstruction, infertility, etc, has been clinically encountered with the major problems unsolved thus far. By further upgrading the merits of gynecological laparoscopy, including the small operative scope, mild injury and fine manipulation, coupled with the application of anti-adhesion therapies, reduced post-operative adhesions and improved clinical outcomes can be expected. Research has been actively persisted on this area in recent years to achieve new progress, especially in the development of anti-adhesion materials, as well as their clinical application and evaluation of the effects, which is overviewed in this review.

Objective To analyze the constituent and clinical features of the senile females who underwent surgery for gynecological tumors and traumatic diseases,so as to enhance the surgical safety and efficacy.Methods From Jan.2003 to Dec.2006,a total of 178 female patients,who were undergone surgery for gynecological tumors or traumatic diseases,were involved in present study,of whom the clinical data,the patients' constituent and pre-operative complications were retrospectively analyzed.The cases selected were allocated into two groups according to their age:the observation group included 116 patients with age ≥60,among them 86 cases were undergone operation for gynecological tumors and 30 cases for traumatic diseases;the control group included 62 patients with age of 40-50 and comparable parity and body weight,among them 54 cases were undergone operation for gynecological tumors and 8 cases for traumatic diseases.Results The number of the patients operated for gynecologic tumors remained the majority annually,whereas a yearly increase of traumatic diseases was noticed with 3.1 and 1.8 folds increasing in 2006 compared to that in 2003 and 2004,respectively(P

Smart classroom as the basis support of classroom teaching, should set the function of smart teaching, real-time interaction, environmental control, video monitoring and remote control, teaching reform, evaluation feedback and other functions into an organic whole, and by using new technology integration and development, to achieve the optimization of the teaching effect. In view of the characteristics of practice and complexity of medical teaching, The spatial structure of smart class-room should provide long-distance education, remote operation, live classroom group discussion, group exhibition, HD recording, classroom attendance voting and other functions, and by choosing the appro-priate teaching mode in teaching to promote the innovation and development of medical teaching.

Branchioma ; diagnosis ; Head and Neck Neoplasms ; diagnosis ; Humans ; Neck ; Rheumatoid Nodule ; diagnosis

Objective To investigate the relationship between maternal exposure to airborne inhalable particulate matters (PM10) in the first trimester of pregnancy and the risk of fetal congenital deformity.Methods Relationship between exposure to airborne PM10 during the 1st,2nd,3rd and 1-3 months of gestation and the risk of fetal anomalies in 203 pregnant women with deformed fetuses,which paralleled to normal pregnant women with discrepancy of conception date ＜30 days (control),were retrospectively analyzed by a case-control study from May 14,2007 to April 30,2012 in Fujian Medical University and Fuzhou General Hospital.Multivariate Logistic regression adjusted for potential confounders including maternal age,gravidity and parity was performed for data analysis.Results According to the inclusion and exclusion criteria,178 pregnant women with deformed fetuses and 356 controlled cases were enrolled.The average levels of PM10 exposed in pregnant women Withfetal cardiovascular anomalies during 1-3 months of gestation were significantly higher than in the controls [(73.80±11.55) μg/m3 vs (70.49±10.83) μg/m3] (t=2.066,P=0.040),but PM10 exposure in the 1st,2nd and the 3rd month of pregnancy were comparable between the observed and control groups [(74.00±17.34) μg/m3 vs (71.70±15.39) μg/m3,t=0.992,P=0.322;(75.15±16.80) μg/m3 vs (71.38±15.66) μg/m3,t=1.625,P=0.106; (70.28±15.84) μg/m3 vs (69.41± 15.84) μg/m3,t=0.383,P=0.702].There were no significant differences of PM10 exposure levels when compared between facial-cervical anomalies,neurologic anomalies and total anomalies and their corresponding controls (P＞0.05).Each increased quartile of the PM10 exposure levels was associated with an elevated risk of fetal cardiovascular anomalies by 1.218 folds (OR =2.218,95 ％ CI:1.232-3.994,P=0.008).Paired multivariate Logistic regression analysis revealed,a positive correlation between PM10 levels at 1-3 months of gestation and fetal cardiovascular anomalies (OR =1.106,95％CI:1.035-1.183,P =0.003).Conclusions Maternal exposure to PM10 in the first trimester of pregnancy possibly exerts negative effects on fetal cardiovascular anomalies.

Objective To study the effect of Shaoyaozhitong Mixture on stageⅢ-Ⅳendometriosis, and explore its mechanism. Methods Ninty-five cases of stageⅢ-Ⅳ endometriosis were randomly divided into three groups. The traditional Chinese medicine (TCM) group (31 cases) was treated with Shaoyaozhitong Mixture, the GnRHa group (31 cases) was treated with Triptorelin Acetate for Injection, while the expectant group (33 cases) received no medications. The changes of CA125, TNF-α and VEGF levels, visual pain score and SF-36 score, total effective rate, pregnancy and recurrence were compared. Results There were significant increases in CA125, TNF-α and VEGF levels, visual analogue pain score and SF-36 score in all the three groups after treatment (P<0.05). The decline of CA125, TNF-αand VEGF levels and visual analogue pain score in TCM group and GnRHa group was significantly faster and greater than that of the expectant group (P<0.05). The total effective rates of TCM group was 83.9%(26/31), GnRHa group was 87.1%(27/31), and expectant group was 60.6%(20/33), TCM group and GnRHa group were superior to the expectant group, respectively (P<0.05). The pregnancy rate was higher and recurrence rate was lower in TCM group and GnRHa group than that of expectant group, but there was no statistical difference (P>0.05). Conclusion Shaoyaozhitong Mixture is effective in treating endometriosis by inhibiting the growth of ectopic endometrium.

Objective To investigate subacute exposure of airborne particulate matter (PM) on pregnancy and fetal development in female mice. Methods Forty female and forty male ICR adult mice group (A), small (B) , middle (C) , large (D) or overdose (E) PM challenge groups (n = 8 - 11), and were administered with 30 μl of phosphate buffered solution (A) or resuspended standard PM SRM 1649a at 0.09 (B), 0.52 (C), 1.85 (D) or 69.2 (E) μg/μl, once per trid from d 0 till d 19 of pregnancy via instillation onto the base of the tongue. Fetal mice were harvested by cesarean section at the time when spontaneous delivery occurred. Body weight of the pregnant mice, gestational days, intrauterine survival and growth, hepatic and pneumonic histopathological changes of the fetal mice were investigated. Lung/body and liver/body weight ratios were calculated. Expressions of mRNA and protein of CYP1A1 in the fetal lung and CYP1 A2 in the fetal liver were assayed. Results (1) All of the pregnant mice survived pregnancy throughout the entire experiment. Body weight of the pregnant mice was not significantly different among all the groups at gestational d 1 and 7 (P ＞ 0.05), but significantly lower in group E [(41.8 ± 5.8) and (48.9 ± 8.9) g] than in group A [(45.9 ± 1.8) and (56.2 ± 4.9) g] at gestational d 14 and 18 (P ＜0.05). The gestational days were significantly decreased in group E [(19.3 ± 1.3) d] when compared with group A [(20.5 ± 0.7) d; P ＜ 0.05] and were not significantly different among groups A, B, C and D (P ＞ 0.05). Lung/body and liver/body weight ratios of the fetal mice were significantly increased in group E [(1.21 ±0.18) and (4.68 ±0.21)%] as compared with groups A, B, C and D (P＜0.05). (2)Mortality rates of the fetuses were significantly higher in group E (23.0%) than in groups A (0.8%), B (0.9%), C (1.7%) and D (3.7%) (P ＜ 0.05), but were not significantly different among groups A,B, C and D (P ＞ 0.05) despite of an increasing tendency. (3) Pathological changes in the liver and lung of the fetuses were conspicuous in group E. The fetal liver injury was histopathologically evidenced by deranged tissue structure, degenerated parenchyma of hepatic cells, and mildly stained cytoplasm. Adipose degeneration was represented by clear-boundary intracytoplasmic vacuoles in most of the liver cells, and cell pyknosis with heavily stained cytoplasm was observed in some of the liver cells. Inflammatory cell infiltration and focal necrosis were occasionally found in the hepatic tissue. The fetal lung exhibited bronchiole with narrow lumina, vascular engorgement in the submucosal layer, interstitial and alveolar edema, thickened alveolar septum, granulocyte and lymphocyte infiltrations within the pulmonary alveoli and around the bronchioles. The above pathological changes were lesser in groups C and D, and were not or least found in groups A and B. (4) Protein expressions of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were significantly increased in group E (1.20 ± 0.40 and 2.55 ± 0.89) when compared with group A (0.77 ±0.36 and 2.08 ±0.31) (P ＜ 0.05). mRNA expressions of CYP1A1 in the fetal lung were significantly increased in groups C (0.36 ±0.12), D (0.41 ±0.08) and E (0.43 ±0.11) compared with group A (0.21 ±0.10), and significantly increased in groups D and E compared with group B (0.28 ±0.10,P＜0.05). mRNA expressions of CYP1 A2 in the fetal liver were significantly increased in groups C (0.37 ±0.13), D (0.36 ±0.14) and E (0.43 ±0.16) compared with group A (0.21 ±0.03), and significantly increased in group E compared with group B (0.24± 0.11, P ＜ 0.05). Conclusions PM elicited embryotoxigenicity and resulted in adverse pregnancy outcomes in mice by intrauterine exposure of overdose PM. The expressions of cancer-related genes CYP1A1 and CYP1A2 were up-regulated in organs after the middle- and large-dose subacute exposure of PM, which may have a potential role on the future development.

Objective:To improve the Rapid Arterial Occlusion Evaluation (RACE) scale and to investigate its value in identifying large vessel occlusion (LVO) in patients with acute anterior circulation ischemic stroke (AIS).Methods:Consecutive patients with AIS treated in Liangxiang Hospital of Fangshan District, Beijing through stroke easy access from January 1, 2016 to December 31, 2018 were enrolled prospectively. The clinical data and multimodal CT examinations required to determine LVO were collected. The existing problems in the RACE score were modified. The patients were evaluated by the modified RACE score, RACE score, and National Institute of Health Stroke Scale (NIHSS). The receiver operator characteristic (ROC) curve was used to evaluate the predictive ability of the modified RACE score for LVO, and it was compared with the RACE score and NIHSS score. The ROC curves of LVO predicted by modified RACE score and NIHSS score in patients with left and right hemispheric lesions were compared.Results:A total of 184 patients were included, of which 66 (35.9%) had LVO. The age (64.8±11.7 vs. 60.5±10.8 years; t=2.483, P=0.014), baseline NIHSS score (13 [6.75-17] vs. 5 [2-9]; Z=-6.361, P<0.001) and the proportion of patients with gaze (37.9% vs. 17.4%; χ2=4.696, P=0.030) in the LVO group were significantly higher than those in the non-LVO group. ROC curve showed that the modified RACE score was more effective in identifying LVO than RACE score (area under the curve: 0.812 vs. 0.770; Z=4.654, P<0.001). The best cutoff value of the modified RACE score in predicting LVO was 5, and its predictive sensitivity and specificity were 75.8% and 75.4%, respectively, and the positive and negative predictive values were 63.3% and 84.8%, respectively. A comparison of patients with left hemispheric lesion and those with right hemispheric lesion showed that the ability of the modified RACE score in predicting LVO was more balanced (area under the curve: 0.826 vs. 0.796; Z=0.454, P=0.650), while there was a significant difference in NIHSS score (area under the curve: 0.856 vs. 0.703; Z=2.149, P=0.031). Conclusions:The modified RACE score is better than the original RACE score in the predictive value of LVO in patients with AIS, and its predictive power of LVO in patients with left and right hemisphere stroke is more balanced than the NIHSS score, which may help clinical discrimination and screening for patients suitable endovascular treatment.

Virtual reality (VR) medical education resources are widely used in theoretical teaching and clinical skill training, but they are still in the primary stage. VR medical education resources have higher requirements for the compatibility of resource management platforms, greater difficulties and costs in resource construction, and stronger demand for copyright protection, but there is still a lack of effective VR medical resource management platforms and operating mechanisms to mobilize the enthusiasm of all participants in resource construction and application. For the key problems in VR medical education resource management, this article proposes a cloud VR medical education resource management framework based on blockchain and cloud VR technology, specifically designs the function of each module, elaborates on its operation and management mechanisms, and analyzes the effect of such framework, so as to improve the efficiency of cloud VR medical education resource management and promote the construction and shared application of cloud VR medical education resources.

Objective To evaluate the long-term safety of sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue in breast cancer patients.Methods 198 breast cancer patients with clinical negative axillary lymph node received sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue.Patients were followed up and regional lymph node recurrence,disease free survival(DFS) and overall survival(OS) were analyzed.Results After a median follow-up of 70 months,2 patients had ipsilateral lymph node recurrence with a regional lymph node recurrence rate of 1％ (2/198).14 patient had recurrence or metastasis and 6 patients died of distant metastasis.The estimated 6 years DFS was 94.4％ and OS was 96.5％.The incidence of arm lymphoedema within patients who received axillary lymph node dissection was 4.5％ and it was 2.5％ in patients who received sentinel lymph node biopsy.Conclusions The sentinel lymph node biopsy mapped by combination of indocyanine green and methylene blue was safe and reliable method for further staging axillary lymph node stastus.