Objective To evaluate the clinical results of patients submitted to laparoscopic assisted supracervical hysterectomy for benign uterine disease.Methods Women referred for supracervical hysterectomy for benign uterine diseases were divided into laparoscopy group(n=34)or open group(n=30).The operative time,blood loss,complications,morbidity,ileus,wound infections were compared between the two groups.Results In terms of Operative time,both of total operative time and oophosalpingorectomy time,there was no significant difference between laparoscopic group and open group.Less blood loss was found in laparoscopic group than open group.No complications were found in both groups.Conclusions Laparoscopic assisted supracervical hysterectomy is a safer and easier approach to complete supracervical hysterectomy with reduced blood loss and quick convalescence.It can be successfully integrated into a large health maintenance organization/residency-training program.

ObjectiveTo evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.ResultsThere were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).CondusionThe main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.

Large-scale medical equipment is very important for comprehensive hospitals. Fault monitoring and diagnosing technologies for large-scale medical equipment have to been available to make full use of them. This paper introduces the evolution of equipment fault diagnosis. After comparing conventional technology and intelligent one, this paper lays emphasis on the latter.

Objective To evaluate the efficacy of Qingfei-Jiedu decoction in the treatment of Acne. Methods A total of 93 female patients with acne were randomly divided into 3 groups according to random number table, 31 in each group. The observation group took the oral Qingfei-Jiedu decoction, and the Chinese medicine control group took the oral tanshinone capsule, and the western medicine control group took the oral acetic acid ring propyl alcohol progesterone. All 3 groups were treated for 4 weeks. The levels of serum dihydro (DHT), IL-6 and IL-8 were measured by ELISA. The changes of the lesions before and after treatment were observed and the adverse events were recorded during the treatment. The clinical effect was evaluated. Results After treatment, the serum DHT (56.94 ± 15.74 pg/ml vs. 74.48 ± 18.53 pg/ml, t=2.089), IL-6 (22.84 ± 11.77 pg/ml vs. 30.37 ± 14.50 pg/ml, t=2.135), IL-8 (22.64 ± 7.38 pg/ml vs. 29.54 ± 9.65 pg/ml, t=2.057) in the observation group were significantly lower than those in the Chinese medicine control group (P<0.05). After treatment, the disappearance rate of skin lesions (65.4% ± 15.0% vs. 44.7% ± 12.9%, 42.7% ± 13.6%, F=6.862) and comprehensive syndrome effective rate (57.2% ± 12.6% vs. 46.3% ± 12.8%, 44.8% ± 11.7%, F=5.322) in the observation group were significantly higher than those in the other two control groups (P<0.05). The observation group and the traditional Chinese medicine control group did not have adverse events, but the western medicine control group showed one case nausea. Conclusions The Qingfei-Jiedu decoction can reduce the level of serum DHT, IL-6 and IL-8 in female patients with acne vulgaris, and improve the skin lesion disappearance rates and comprehensive syndrome rates.

In this study, a novel polyurethane membrane, modified by superfine silk-fibroin powder, was prepared for small-diameter vascular grafting. Scanning electron microscopy, transmission electron microscopy, and histological examination were applied to evaluate histocompatibility of this polyurethane membrane. The polyurethane membrane was compared with polytetrafluoroethylene material. A pseudomembrane and gap formed between polytetrafluoroethylene and the surrounding tissues, and no cells infiltrated or grew into the polytetrafluoroethylene material. On the contrary, superfine silk-fibroin powder/polyurethane blend membrane merged tightly with the surrounding tissues without gaps, and cells infiltrated and grew into the material. Moreover, the negative effects of superfine silk-fibroin powder/polyurethane blend membrane on cells were less than those of its polytetrafluoroethylene counterpart. Our findings indicated that the superfine silk-fibroin powder/polyurethane blend membrane has better histocompatibility than polytetrafluoroethylene membrane. It is concluded that the superfine silk-fibroin powder/polyurethane blend membrane is a promising biomaterial for small-diameter prosthesis.

Objective:To evaluate dental and skeletal changes following slow maxillary expansion with quad helix using Cone-Beam computer tomography (CBCT).Methods:13 patients(5males and 8 females,mean age 14.38 ±2.22 years)requiring maxillary ex-pansion as a part of their comprehensive orthodontic treatment were included.Each patient had CBCT images taken pre-(T1 )and post-(T2)maxillary expansion with quad helix.Changes of the distances between bilateral canines,first premolars,second premo-lars,first molars,the width of basal bone and palatal suture were measured.paired t-test results were analyzed using SPSS 17.0 soft-ware.Results:The distances between the 4 bilateral teeth increased by (2.47 ±1.05)mm,(2.97 ±1.90)mm,(2.79 ±1.21) mm and (3.15 ±1.15)mm,the apical distances decreased by (1.19 ±0.40)mm,(2.12 ±0.68)mm,(2.02 ±0.65)mm and (1.34 ±0.63)mm,respectively.The inclination of the first molars were decreased by (4.45 ±2.86)°and (4.02 ±1.45)°on the left and right side respectively.The width of basal bone and palatal suture increased by (2.37 ±0.96)mm and (1.21 ±0.50)mm respectively,the differences between T1 and T2 were all statistically different(P <0.001).Conclusion:Quad helix expands maxil-lary arch by greater dental changes than by skeletal changes.

Objective To assess the effect and feasibility of group reminiscence therapy on depression in the elderly.Methods We searched the Cochrane Central Register of Controlled Trials (-2013),Medline (1982-2013),Embase (1974 2013),AMED (-2013),CINAHL(-2013),CMB (1994-2013),VIP,CNKI and Wanfang to collect the randomized controlled trials (RCTs) in which the group reminiscence therapy was used to treat depression in elderly patients.The studies were selected according to the inclusion and exclusion criteria by two reviewers,and the quality of included studies was evaluated according to Cochrane Handbook and performed meta analyses by using the Cochrane Collaboration's RevMan 5.2 software.Results A total of 10 RCTs involving 944 patients were included.The results of meta-analysis showed that as compared with conventional treatment,group reminiscence therapy on the basis of conventional treatment was more effective in decreasing depression score [MD=-4.86,95 ％ C I(-5.10,-4.65)].Compared with psychological counseling,group reminiscence therapy had more effect on decreasing depression score [MD=-9.34,95％ CI (-10.77,-7.91)].There was no significant difference in the dropout rate between group reminiscence therapy and other control treatments [RR=1.22,95％ CI (0.79-1.88)].The descriptive analysis showed that group reminiscence therapy was effective in alleviating the symptoms of depression.Conclusions Group reminiscence therapy can improve the symptoms of depression in elderly patients and conforms to the principle of economic benefit.However,the results should be interpreted with caution because of the low quality of the included studies.

Objective To study the risk factors for surgical site infections (SSIs)in patients with hepatobiliary and pancreatic surgery.Methods Sixty patients who received hepatobiliary and pancreatic surgery and suffered SSIs from January 2006 to January 2010 were selected as infections group,119 patients who also received hepatobiliary and pancreatic surgery but didn’t develop infection were as control group,retrospective investigation was per-formed.Results Univariate analysis revealed the associated factors for post-operative SSIs were age,history of car-diocerebrovascular disease,history of abdominal surgery,history of smoking,preoperative anemia,abnormal pre-operative coagulation and blood sugar,pre-operative infection,use of laparoscope,incision type,duration of opera-tion,ASA score,post-operative drainage and dressing chang within 24 hours of post-operation(all P<0.05).Mult-ivariate analysis revealed that abdominal surgery history (OR95%CI:3.09 [1.21 -7.91 ]),high NISS score (OR95%CI:6.18[2.41-15.85])were risk factors of SSIs in patients with hepatobiliary and pancreatic surgery, and dressing chang within 48 hours of post-surgery were protective factor (OR95%CI:3.81 [1.56-9.34]). Conclusion History of abdominal surgery and high score of NISS are major risk factors for SSIs in patients with hepatobiliary and pancreatic surgery.To reduce the risk of SSIs,blood glucose should be actively adj usted,anemia and coagulation abnormalities should be treated;duration of operation should be shortened as far as possible,wound should be kept clean and dressing should be changed timely after surgery.

Objective To investigate the level of the clinical nurses' critical thinking disposition and the competence about nursing ethical decision making,and analyze the relationship between them.Methods A total of 359 clinical nurses were recruited by stratified random sampling method.They were investigated with general situation questionnaire,critical thinking disposition inventory-Chinese version (CTDI-CV) and judgment about nursing decisiors(JAND).Results The total score of CTDI-CV was (285.06±26.79),the total score of JAND was(267.91±16.62).The influencing factors of clinical nurses' competence about nursing ethical decision making was education background,ways of obtaining occupational knowledge,training of nursing ethical decision.The clinical nurses' competence about nursing ethical decision making was positively correlated with critical thinking disposition.Conclusions The level of clinical nurses' critical thinking disposition and competence about nursing ethical decision making are medium,in order to improve the level of competence about nursing ethical decision making,both school education and the continue education among hospital should strengthen the training of nurses' critical thinking disposition.

Objective To observe the effects of MSH2 gene re expression on estrogen-induced apoptosis of colon cancer cells LOVO,and to explore its mechanisms.Methods According to different plasmid and whether with estradiol intervention,colon cancer LOVO cells were divided into empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,estrogen receptor (ER) β with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group,and received corresponding treatment.The expression of MSH2,ERβ protein and apoptosis related caspase 3 protein were detected by Western blotting.Cell viability was measured by cell counting kit-8.Cell DNA fragments of each group were isolated with apoptosis DNA fragments isolation kit.And the DNA ladder was observed.The rate of apoptosis was detected by flow cytometer.Single factor variance analysis was performed for comparison among multiple groups,and t test was used for comparison between the two groups.Results After transfection,the expression of the MSH2 and ERβ at protein level in LOVO cells significantly increased and neither of their expression was effected by estradiol.The expression levels of caspase 3 cleavaged active fragments of ERβ with estradiol group and ERβ with MSH2 and ethanol group were higher than other groups,and there was no significant difference between these two groups.The LOVO cell viability of empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,ERβ with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group was 1.72 ±0.25,1.74 ± 0.31,1.77 ± 0.35,1.74±0.33,1.70±0.34,1.02±0.48,1.71±0.31 and 1.07±0.18,respectively,and the differences between the groups were statistically significant (F=3.791,P＜0.05).Among them,the LOVO cell viability of ERβ with estradiol group was lower than that of ERβ with ethanol group,accordingly,that of ERβ with MSH2 and estradiol group was lower than that of ERβ with MSH2 and ethanol group,that of ERβ with estradiol group was lower than that of empty plasmid with estradiol group,that of ERβ with MSH2 and estradiol group was lower than that of MSH2 with estradiol group,and the differences were statistically significant (t=3.158,3.075,3.648,3.253,all P＜0.05).DNA ladder formed from DNA fragments of apoptosis cells was seen in ERβ with estradiol group and ERβ with MSH2 and estradiol group.The apoptosis rate of empty plasmid with ethanol group,empty plasmid with estradiol group,MSH2 with ethanol group,MSH2 with estradiol group,ERβ with ethanol group,ERβ with estradiol group,ERβ with MSH2 and ethanol group and ERβ with MSH2 and estradiol group was 7.86±0.19,7.87±0.39,8.39±1.02,9.05±1.54,7.54±0.99,19.77±2.35,7.76±1.32 and 19.30±1.75,respectively,and the differences between groups were statistically significant (F=45.436,P＜0.05).Among them,the apoptosis rate of ERβ with ethanol group was lower than that of ERβ with estradiol group,that of ERβ with MSH2 and ethanol group was lower than that of ERβ with MSH2 and estradiol group,that of empty plasmid with estradiol group was lower than that of ERβ with estradiol group,that of ERβ with MSH2 and estradiol group was lower than that of MSH2 with estradiol group,and the differences were statistically significant (t =8.260,9.133,8.596,7.617,all P＜ 0.05).Conclusions Estrogen may promote colon cancer cell apoptosis through ERβ pathway.The process of apoptosis maybe related with caspase protein,MSH2 may not be involved in the regulation of this signal pathway.