Objective To observe changes of cardiorespiratory function and blood gas analysis in different pneumoperitoneum pressure during age-specific pediatric laparoscopic surgery and to find a compatible pneumoperitoneum pressure for different age-specific children.Methods One hundred and fifty cases undergoing laparoscopic surgery were divided into three groups:A(1～3y),B(4～6y),C(7～12y).Each group was divided into two subgroups again by different pneumoperitoneum pressure:A1,A2,B1,B2,C1,C2.Monitoring the cardiorespiratory function and blood gas analysis in different time point before and after pneumoperitoneum.Results Compared with the baseline value,PETCO2,Paw,MAP,HR,PaCO2 significantly increased after peritoneal insufflation in each group.And the increase in A2,B2,C2 were more obvious than in A1,B1,C1 (P<0.05).The eligible pneumoperitoneum pressures for A,B,C were 9,11,13mm Hg respectively.Conclusion Using a compatible pneumoperitoneum pressure for different age-specific children can meet the requirement of operation and attenuate the interference with physiological function.

Objective: To construct the recombinant eukaryotic expression plasmid pHsp70-hsv-tk(pHT)for further target gene therapy research.Methods: The oligomers of primers were synthesized based on the reported sequences of hsv-tk and with the pHSV-106 plasmid as the template.Then the hsv-tk gene fragment was amplified and inserted into the pD3SX vector.E.coli DH5? was transformed with the recombinant plasmids and the bacterial colonies containing the recombinant plasmids were identified by the PCR cloning method,and the recombinant plasmids were extracted and purified.Results: The recombinant eukaryotic expression plasmid pHT was obtained.The target gene obtained by PCR amplification had the same molecular size as predicted.The recombined pD3SX plasmid contained correct recombinant hsv-tk sequences.Conclusion: The plasmid pHT was successfully constructed,which can be used for further target gene therapy research.

Platelet count (PC) and plasma prothrombin time (PPT) of sixty- six patients with cyanotic congenital heart disease (cyanotic CHD) were determined, and linear relationship analysis was made between PC, PPT and hemoglobin (HB), Hemotocrit saturation of blood (SaO2). Blood viscosity (BV) and hemotocrit (HT) were also examined. It was discovered that there was a significant positive linear relationship between SaO2 and PC, HB and PPT, and a significant negative linear relationship between PC and HB, BV, HT, respectively. There was a significant difference of PC in cyanotic-CHD (n = 66) as compared with noncyanotic-CHD (t=13.9508, P

Natural orifice tranluminal endoscopic surgery,NOTES is a noval surgical method whose major ad vantage is the diminishing of surgieal scar,thus is benefical to a subgroup of special patients.The key issues related to the development of NOTES are the invention of instrument satisfing the clinical demand,the setting up of safe method of closing the transluminal acce88 and the training of doctors.

Objective To investigate surgical outcomes of treatment of pilon fractures of Ruedi -Allgower types Ⅱ and Ⅲ by raft screws fixation combined with bone grafting.Methods 21 patients with pilon fractures of Ruedi -Allgower types II and Ⅲ received surgery were selected.They were 15 men and 6 women,23 to 68 years of age(average 38.2 years).16 cases were closed and 5 cases open.12 cases were type II and 9 cases type III.Intervals between injury and operation ranged from 7 to 14 days,with 8.5 days on average.All of them were treated with raft screws fixation by plate type L combined with bone grafting.Results All cases were followed up for an average of 12 months(range from 8 to 30 months).Fractures healed from 16 to 24 weeks,with 18.2 weeks on average.According to the Burwell -Charnley radiological criteria,anatomical reduction was achieved in 17 cases,and fair reduction in 4.According to the Mazur clinical criteria,ankle functions were rated as excellent in 8 cases,good in 10 cases,fair in 2 cases and poor in 1 case.The rate of excellent and good was 85.7%.Conclusion Raft screws fixation combined with bone grafting are effective for the pilon fractures of Ruedi -Allgower types II and Ⅲ,preventing articular surface collapse and leading to anatomic reduction,and has stable fixation and early functional rehabilitation.

Objective To investigate and confirm the value of minimal invasion of separation between specific subcutancous layers of rats.Methods Thirty-two male SD rats were randomized into four groups,group 1:normal incision plus separation beneath superficial fascia; group 2:normal incision plus subdermal separation; group 3:normal incision plus extended separation beneath superficial fascia ; group 4:extended incision plus separation beneath superficial fascia.Blood sampling was taken preopeatively,2 h,12 h,24 h and 48 h postoperatively.The increase of serum IL-6 and neutrophil elastase levels were compared between different groups.Results Compared with each other,the increase of serum IL-6 and NE levels in group 1 vs 3 and group 2 vs 4 was not different significantly (P value was 0.074,0.096 and 0.747,0.897,respectively).However,the increase of serum levels in group 1 vs 2,1 vs 4,3 vs 2 and 3 vs 4 was different significantly (P ＜ 0.01).Conclusion Operation of separating beneath superficial fascia plus small skin incision in rats conduces to relatively minimal invasion.

The J-curve phenomenon in the antihypertensive treatment of cardiovascular disease has had more theoretical and experimental evidence and has been recognized by most researchers.However,there are a few related studies and reports about whether antihypertensive treatment has the J-curve phenomenon in ischemic stroke.It has not yet reached a consensus.This article reviews this phenomenon and expecting it to contribute to the blood pressure mangement of ischemic stroke.

Objective To compare the effects of fundus-first laparoscopic cholecystectomy and laparoscopic subtotal cholecystectomy in complicated cholecystolithiasis cases. Methods The effects of fundus-first laparoscopic cholecystectomy (n = 21) and laparoscopic subtotal cholecystectomy (a = 18) in the 39 cases of complicated chole-cystolithiasis from our hospital within 2 years were analyzed retrospectively. Results The operation time in subtotal laparoscopic cholecystectomy group was shorter than in fundus-first laparoscopic cholecystectomy group (88.89±18.11) min vs. (109.52±21.79) min, P < 0.05). Less blood lose (82.78±44.96) ml and fluid replacement (847.22±169.32)ml during the operation were observed in the former group than those in the later group (116.67±53.23) ml and (964.29±147.60) ml, respectively, P < 0.05). However, the patients' postoperative recovery time and the duration of postoperative hospital staying were similar in the two groups(5.56±1.20) days vs. (5.29±1.38) days, P > 0.05). Conclusions Proper use of subtotal laparoscopic cholecystectomy in complicated cholecystolithiasis cases can simplify the operation and obligate the operation time, which will increase the safety of the operation with the outcome similar to fundus-first laparoscopic cholecystectomy.

ObjectiveTo evaluate the advantages and disadvantages of endoscopic thyroidectomy by the breast approach. MethodsFrom August 2002 to April 2003, sixty single thyroid nodule patients were divided into 2 groups randomly. Group 1 (30 patients) received endoscopic thyroidectomy(ET) by the breast approach. The other 30 patients underwent conventional thyroidectomy(CT). Preoperative diagnosis,operative time,operative cost,postoperative pain,complications,and cosmetic result between the 2 groups were compared. ResultsOperative time was 118.0?34.3 minutes for ET group and 80.0?23.5 minutes for CT group( P

Using Eu3+as a tracer,a sandwich?type assay was established. HE4 in serum specimens from 225 patients were detected by TRFIA. Serum levels of HE4 in pelvic tumors were quantitatively analyzed. From receiver operating characteristic (ROC) curves,the reference values was calculated for endometrial cancer,cervical cancer and ovarian cancer,respectively. Results The working range of serum HE4 for TRFIA was 10~10000 pmol/L with a sensitivity of 7.5 pmol/L. The method offered less interaction with CA125 and CA199,and also provided a better correlation with ECLA,while the CV of intra?assay was below 10%. HE4 levels were significantly higher in endometrial cancer,cervical cancer and ovarian cancer groups than in healthy volunteer group,while did not differ significantly between uterine fibroid group and healthy women group. As aging,the risk for developing pelvic tumors increased. The area of ROC for malignant tumors was all above 0.5 and the accurate interpretation of HE4 was 60 pmol/L. Conclusion A stable,precise HE4 TRFIA is well established,which is helpful in diagnosis of gynecologic cancers.