Objective To compare the long-term prognosis of patients with stage Ⅰ endometrial cancer (EMC) after laparoscopic surgery or open laparotomy. Methods Totally 83 patients with stage Ⅰ EMC who underwent laparoscopic surgery or open laparotomy between 1993 and 2008 were enrolled in this study. The clinical data were analyzed retrospectively to compare the survival time during long-term follow-up between the two groups. Results The total survival rate was 95.2% (79/83) in the 83 cases. The median survival time was 77,51,and 31 months respectively in stages Ⅰa,Ⅰb,and Ⅰc EMC patients. No significant difference was found in the survival rate between open and laparoscopy groups [94.2% (49/52) vs 96.8% (30/31),Z=0.028,P=0.978]. For the stage Ⅰa,stages Ⅰb and Ⅰc,and G2 and G3 patients,the median survival time was similar between the open and laparoscopy groups (80 month vs 63 months,P=0.483; 49 months vs 48 months,P=0.781; and 51 months vs 49 months,P=0.635). However,in the G1 patients,significantly difference was detected in the median survival time between the two groups (77 vs 51 months,P=0.037). Conclusion Laparoscopic surgery should be used as a routine surgical approach for patients with stage Ⅰ EMC considering its minimal invasiveness and promising prognosis.

ObjectiveTo investigate the association between the FCRL5 gene (rs6427384 and rs12036228) single nucleotide polymorphism(SNP) and patients with ankylosing spondylitis (AS). Methods SNP of FCRL5 gene (rs6427384 and rs12036228) was analyzed in 169 patients with AS and 184 healthy controls by ligase detection reaction based on high temperature(LDR)-PCR. The distribution of FCRL5 genotypes and allele frequencies were detected between the two groups. Chi-square test, one-way ANOVA were used for statistical analysis. ResultsSignificant differences were found in the distribution of allele frequencies of FCRL5 gene between AS patients and health controls(P＜0.05). The C allele frequencies of FCRL5 gene at positions of rs6427384 and rs12036228 were 17.3％, 92.3％ and 25.0％, 87.2％ respectively in the AS group and the control group. And the T allele frequencies of rs6427384 and rs12036228 were 82.7％, 7.7％ and 75.0％, 12.8％ in the AS group and the control group. The percentages of CC, CT and TT genotype(rs6427384) were 3.7％, 27.2％, and 69.1％ in the AS group, which were significantly different from those of the control group(3.9％, 42.2％ and 53.9％ ) (x2=8.7637, P=0.0125 ). Staging of sacroiliitis in X ray were significantly different during AS patients whose genotype represented as CC, CT and TT (rs6427384)(x2=34.159, P=0.0001 ). Incidences of the initial symptoms (low back pain or inflammation of periphery joint)in the AS group were obviously differed among patients with different genotypes (rs6427384) (x2=7.254, P=0.027), so did the mean duration of morning stiffness (F=4.159, P=0.018) and the average scores of BASDAI (F=4.461, P=0.014). Incidences of the initial symptoms in the AS group were also conspicuously different between the AS patients with different genotypes (rs 12036228 ) (x2=6.640, P=0.036 ). ConclusionOur study suggests that the SNP(rs6427384 and rs12036228) of FCRL5 may be a susceptibility factor for AS in Anhui Han population and the genotype may influence the clinical phenotype of AS.

Objective To investigate the role and possible mechanism of caveolin-1 (CAV1) in the forming of cholesterol gallstone in mice fed with lithogenic diet.Methods Cholesterol gallstone susceptible C57BL/6 mice were study objects.The mice of control group (n=6) and experiment group (n=6) were fed with normal diet and lithogenic diet for four weeks respectively.The condition of cholesterol gallstone forming,changes of serum lipid and bile composition were measured,and the expressions of CAV1 and scavenger receptor classB member Ⅰ (SR-BⅠ) at mRNA and protein level in the liver and gallbladder were detected by realtime-polymerase chain reaction and Western blot,respectively.The t test was performed for mean comparsion between the two groups.Results The incidence rate of gallstone in experimental group was 100％ after fed with lithogenic diet for four weeks,the lipid level significantly increased,and the proportion of cholesterol in bile raised and bile salt decreased.Compared with those of control group,the expressions of CAV1 at mRNA and protein level in the liver and gallbladder tissues siginificantly decreased (in liver tissue,mRNA 0.53 ± 0.13 vs 1.00 ± 0.32,t =3.330,protein level 0.39 ± 0.07vs 0.92±0.06,t=10.280; in gallbladder tissue,mRNA 0.40±0.22 vs 1.00±0.22,t=3.823,protein level 1.04±0.07 vs 1.34 ± 0.04,t =6.367,all P＜0.01).There was no significant difference in the relative expression of SR-BⅠ at mRNA and protein level in the liver and gallbladder tissues between the mice of experiment group and control group.Conclusion The changes of CAV 1 expression at mRNA and protein level in liver and gallbladder tissues may affect lipids metabolism and cholesterol transportation in liver and gallbladder tissues of experiment mice,which might play an important role in the formation of cholesterol gallstone.

Objective To build a scientific,rational and practical evaluation index system for medical tutors.Methods Evaluation framework was initially constructed on the basis of literature analysis.Two rounds questionnaires investigation were conducted soon using Delphi method and the data were analyzed using descriptive analysis,independent samples of non-parametric test (Kreskas-Wallis test),expert reliability analysis,analytic hierarchy process and other methods.Results The results of two rounds of expert questionnaires showed that both recovery rate and acceptance rate of the questionnaires were more than 90％ and overall expert coefficient was 0.8957.The coordinate coefficient of the second-class index was 0.181,x2 =27.148,P ＜ 0.001,and that of the third-class index was 0.157,x2 =127.03,P ＜ 0.001.Experts' opinions were highly consistent.Conclusions Evaluation index system including three first-class indexes,seven second-class indexes and twenty-eight third-class indexes was established for medical tutors.The evaluation index system is of great importance in safeguarding postgraduate culturing quality and strengthening teaching staff construction.

Objective To evaluate the effect of dexmedetomidine on perioperative cellular immune function in elderly patients undergoing radical operation for gastrointestinal cancer.Methods Forty ASA physical status Ⅰ-ll patients,aged 65-82 yr,weighing 43-80 kg,undergoing elective radical operation for gastrointestinal cancer,were randomly divided into 2 groups (n =20 each) using a random number table:control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with sufentanil,propofol and rocuronium and maintained with inhalation of sevoflurane,infusion of propofol and intermittent iv boluses of sufentanil and rocuronium.A loading dose of dexmedetomidine 0.5 μg/kg was infused intravenously over 10 min starting from 30 min before induction of anesthesia,followed by infusion at 0.3 μg· kg-t· h-1 until the end of operation in group D.The equal volume of normal saline was given in C group.Venous blood samples were obtained at 30 min before induction,and 1,24 and 72 h after operation for determination of plasma concentrations of interferon (IFN)-γ,interleukin (IL)-2,IL-10 and IL-4 by ELISA.Results Compared with group C,the plasma concentrations of IFN-γand IL-2 were significantly increased,and the plasma concentration of IL-10 was decreased at each time point after operation (P ＜ 0.05),while no significant change was found in the plasma concentration of IL-4 at each time point after operation in group D (P ＞ 0.05).Conclusion Dexmedetomidine can improve the perioperative cellular immune function in elderly patients undergoing radical operation for gastrointestinal cancer.

Objective To study the application of debridement with arthroscopy in acetabular dysplasia with osteoarthritis. Methods Thirty-two cases in 48 hips acetabular dysplasia with osteoarthritis debrided under the arthroscopy. In this group, male 9 and female 23, the mean age was 38.1 years old (range, 28-52 years old), the left side for 9, right side for 7 and bilateralis for 16. In the 48 hips, X-ray showed that comparatively large acetabular draw with normal position of femoral head in 21 cases (28 hips), large acetabular draw with femoral head lateral shift slightly but did not exceed 1/3 of femoral head in 11 cases (20 hips).MRI demonstrated that intraarticular fluid in 28 hips, subcartilage anormal signal of acetabular and femoral head at weight loading region in 10 hips, signal interruption of glenoid lip of hip in 10 hips. The procdure which included to remove of osteophyma, loose body and hyperplasia synovial membrane, degenerated cartilage on the stress areas of the hip joint, wear and tear of glenoid lip. Results The perianal skin in 2 patients suffered dysesthesia because of the over traction during operation. They recovered 7 days postoperation. Dysesthesias twenty-eight patients (36 hips) were follow-up with an average of 23 months (range, 6 months-3.5 years). After debridement and lavage, the patients released from pain, restored function and the range of the motion. According to VAS evaluation system for pain, the preoperative score was 5-9, with an average of 6.8; the postoperative score was 4-6, with an average of 2. According to Harris hip joint score evaluation system, preoperative score was 58.8?6.15, postoperative score was 89.6?11.3. The excellent in 20, good in 4, fair in 3 and poor in 1. The excellent and good result was up to 85.7%. Conclusion Selectivity debridement and lavage were effective methods for osteoarthritis hip joint acetabular dysplasia. It can delay the developing of course of disease; improve clinical symptom and elevate quality of life.

[Objective]To examine the effect and safety of the combination of rifampin plus levofloxacin given orally for treating chronic orthopedic implant-related infections. [Methods]From March 2006 to December 2007,13 patients with chronic orthopedic implant-related infections were treated orally with rifampin ,600 mg/day,plus levofloxacin,600mg/day.The study group included 6 males and 7 females, with average age of 51.6 years (range, 17~75 years).During treatment,clinical follow-up was performed, including blood and differential counts ,erythrocyte sedimentation rate , and hepatic enzyme levels,C-reactive protein levels,and radiological data.Cure was defined as the absence of clinical signs and symptoms of infection (fever,local pain,redness,warmth,sinus tract infection ),ESR50 mg/l) without microbiological documentation of infection.[Results]Among 13 patients included in the study and evaluable for safety, one patient had gastrointestinal side effects and was not evaluable for treatment effectiveness. Twelve patients with chronic orthopedic implant-related infections , antibiotics were administrated orally for a total of 6 months . Two patients, on whom pseudoarthrosis presented, were treated with autologous bone graft and internal fixation subsequently. Ten of 12 patients with chronic orthopedic implant-related infections had successful outcomes . Those rates were determined after a post-treatment follow-up of 6 to 27 months (average, 24 months ).The overall success rate was 83.3% among 12 patients.Ten cases had been followed up,and no case had infection recurrence.[Conclusion]With nutrition support, the combination of rifampin plus levofloxacin given orally for treating chronic orthopedic implant-related infections are effective methods.

Objective:To investigate the effects of extraction orthodontic treatment on the upper airway dimensions in young adult patients with malocclusion,and to evaluate the relationship between changes in the craniofacial morphology,position of incisor and upper airway dimensions.Methods:26 patients with upper and lower first premolar extraction and 21 patients without extraction were recruited.Cephalometry and dental cast analysis were performed pretreatment and posttreatment.Results:No statistical difference was found in the parameters of the upper airway dimensions in both non-extraction group and extraction group after treatment.In linear correlation analysis,SPAS was positively correlated with cephalometric variables U1-Y and L1-Y.MAS and IAS was positively correlated with cephalometric variables SNB,U1-Y and L1-Y.The multiple regression analysis revealed that the change of U1-Y had a significant positive effect on SPAS and IAS,and the change of L1-Y also had a significant positive effect on SPAS and MAS.Conclusion:The upper airway dimensions can not be altered during extraction orthodontic treatment,while the changes of incisors are significant associated with the change of the upper airway dimensions.

The effects of cyanide poisoning on the contractibility of the cardiac muscle were observed after the dogs were infused intravenously with a lethal dose of NaCN (2.5 mg/kg) within 2 minutes through a cannulated femoral vein. Heart rate (HR) , left ventricular pressure (LVP) , the largest changing rate of LVP (LVP?dp/dtmax), cardiac muscle contractibility (CMC) , the largest changing rate of CMC (CMC?dc/dtmax) , and ECG changes were recorded. It was found that there was an initial excitatory response of cardiac functions in the first minute of NaCN infusion, and then a drastic cardiac failure occurred, which resulted in the rapid death of the dogs within 10 minutes after NaCN administration. The changes of myocardial contractibility were slower than those of .other cardiac parameters, which implies that cyanide can exert an excitation on the myocardium initially. Our results indicate that the effects of cyanide on myocardial contractibility may be one of the important factors to induce serious arrhythmia,which in turn results fatal cardiac failure.

Objective There is still controversy over the effect of hyperglycemia on the tolerance of heart to ischemia/reperfusion(I/R)injury in patients with diabetes mellitus. The aim of this study was to evaluate the effect of hyperglycemia on I/R-induced ventricular arrythmia in isolated diabetic rat hearts. Methods Twenty-four healthy male SD rats weighing 210-250g were randomly divided into two groups: control group(C, n=10) and diabetes mellitus group(DM, n=14). Diabetes mellitus was induced by intraperitoneal injection of streptozotocin 60 mg?kg~(-1). Blood glucose was measured 72h later and every week thereafter. Diabetes mellitus was defined as persistent hyperglycemia(blood glucose≥16.7 mmol/L after meal). The diabeticrats received no insulin. The rats were anesthetized with pentobarbital 60mg?kg~(-1). The hearts were immediately removed and perfused with oxygenated(95% O_2, 5% CO_2)Krebs-Henseleit buffer(KHB)in a Langendorff apparatus at a constant perfusion pressure of 80 mm Hg. The 14 diabetic rats were further divided randomly into 2 subgroups: (1)DM+KHB (n=7) and (2) DM+GLU(n=7) in which glucose 3.6 g was added to KHB 1000ml. After 20 min equilibration all hearts were subjected to 30 min global ischemia followed by 40 min reperfusion. Epicardial electrocardiogram was monitored. The incidence of ventricular tachycardia(VT) and ventricular fibrillation(VF) and their duration were measured. The severity of arrhythmia was quantified by arrythmia score(AS). Coronary outflow was collected for determination of creatine kinase(CK) release. Results The incidence of ischemia-induced arrythmia was significantly lowered in diabetic hearts. The incidence of VT was 14.3% and VF 28.6% in DM+KHB subgroup as compared to 60%(VT) and 100%(VF) in the control group. The CK release was significantly lower in diabetes group(DM) than in control group(C); furthermore the CK release in DM=KHB subgroup was lower than that in DM=GLU subgroup. Conclusion Diabetic rat hearts are less susceptible to I/R induced arrythmia. Hyperglycemic perfusion reduces to some extent the increased tolerance to I/R injury in diabetic rat hearts as shown by increased CK release in DM+GLU subgroup but hyperglycemic perfusion has anti-arrhythmic action as shown by 0% incidence of VT and VF in DM+GLU subgroup.