Minimally invasive surgery has been one of the main trend of surgical practice in 21 century,while the laparoscopic technique,as one of the product of high-tech,shows the minimally invasive surgery a more lactiferous prospect.However,with the popularity of laparoscopic technique,its high complications rate is gradually being highly regarded.By analyzing various causes comprehensively,we found that the complications rate had direct correlation with the operant level of the operator.Combining the successful experience of twice laparoscopic technique training courses,which were conducted by our department,this article will give rise to a discussion about the training of the general surgery doctor.

Objective To explore the role of nuclear factor-kappa B(NF-?B)in regulating tumor necrosis factor-?(TNF-?)expression in acute pancreatitis (AP)in rats.Methods Sixty-four Wistar rats were randomly divided into two groups:the control group(n=32)and the AP group(n=32).Acute pancreatitis was induced by introperitoneal injection of caerulein,and the animals were killded at 12 hours,24 hours,36 hours,and 72 hours respectively.The activity of NF-?B and expression of TNF-? mRNA in the pancreas were determined by flow cytometry (FCM) method and semi-quantitave RT-PCR analysis,respectively,and the correlation coefficients were analyzed.Results The levels of activated NF-?B protein and TNF-?mRNA were all significantly higher in the AP group than those in the control group at any time point(P

Objective To evaluate the correlation of chemosensitivity of cancer cells and peripheral blood lymphocytes to 8 chemotherapy agents in vitro,which was helpful to guide clinical chemotherapy for patients with lung cancer. Methods The chemosensitivity of the peripheral blood lymphocytes and tumor cells to 8 clinical routine che-motherapeutic agents was tested in 40 cases of lung cancer by using MTT method. SPSS 10. 0 was used to analyze the above indicators. Results There was no significant difference in the sensitivity of 8 clinical routine chemotherapeutic agents between peripheral blood lymphocytes and tumor cells of patients with lung cancer(P > 0. 05) ,which was posi-tive correlated to chemotherapeutic drugs between peripheral blood lymphocytes and tumor cells. Conclusion The chemosensitive test of the peripheral blood lymphocytes with MTT method in vitro was valuable for reference of selec-ting anticancer drugs in clinic for patients with lung cancer.

Traumatic splenic rupture treated by splenic arterial embolization not only can reserve spleen but also prevent spleen from continually bleeding,with promising clinical effect.The paper reviews most of the traumatic splenic rupture treated by splenic arterial embolization including the basic and clinical research in recent years.

It has been widely accepted that Faecalibacterium prausnitzii (Fp) induces the differentiation of Treg cells.Lymphocyte function-associated antigen-1 (LFA-1) is also involved in the differentiation of Treg cells.Aims: To investigate the effect of Fp on Treg cells and cytokines in colitis mice with LFA-1 knockout (LFA-1-/-).Methods: Twenty wild type mice and twenty LFA-1-/-mice with same genetic background were randomly divided into wild type control group, wild type treatment group, LFA-1-/-control group and LFA-1-/-treatment group.Colitis model was induced by drinking DSS solution.Mice in the two treatment groups were intragastrically administrated with Fp.General status and histopathological score were assessed.Percentages of Treg cells in spleen and mesenteric lymph nodes were measured by flow cytometry.Serum levels of IL-10 and TGF-β1 were measured by ELISA.mRNA expressions of IL-10 and TGF-β1 in colonic tissue were detected by real time PCR.Results: Compared with corresponding control groups, histopathological score was significantly decreased in wild type treatment group (P<0.05);percentages of Treg cells in spleen and mesenteric lymph nodes were significantly increased (P<0.05), serum levels of IL-10 and TGF-β1 were significantly increased (P<0.01), expression of TGF-β1 mRNA was significantly increased in wild type treatment group and LFA-1-/-treatment group (P<0.05);expression of IL-10 mRNA was significantly decreased in LFA-1-/-treatment group (P<0.01).Compared with wild type treatment group, serum level of TGF-β1 was significantly decreased (P<0.05), and mRNA expressions of IL-10 and TGF-β1 were significantly decreased in LFA-1-/-treatment group (P<0.05).Conclusions: Fp can up-regulate the percentages of Treg cells and enhance the secretion of anti-inflammatory cytokines IL-10 and TGF-β1 in LFA-1-/-mice.The therapeutic efficacy for colitis in wild type mice is superior to that in LFA-1-/-mice, which may be related to the inhibition of function of Treg cells and secretion of cytokines due to LFA-1 knockout.

Objective To observe the apoptosis or oncosis of pancreatic acinar cells of different severity of acute pancreatitis (AP) and the release level of enzymes in vitro, and to investigate the relationship between them. Methods Two-step enzymatic digestion method was used to separate pancreatic acinar cells into 4 groups. 0. 1 μg/ml of the caerulein was added in the AP group. Caerulein and LPS (bacterial lipopolysaccharide, 10 mg/L) were added in LPS group. Caerulein and OCT (octreotide, 100 ng/ml) were added in OCT group. Medium was added in the control group. AO (acridine orange) and EB (ethidium bromide) double staining method was used to detect the incidence of apoptosis or oncosis of acinar cell. The release of intracellular enzyme was detected by measuring the concentrations of amylase and LDH in cell culture media by colorimetry method. Results The apoptosis index was 2.2 + 0.4, 6.4 ± 0.6, 4.6 + 0.4, 11.2 +1.2 in the control group, AP group, LPS group, OCT group; while the oncosis index was 3.0 +0.4, 17.2 ±1.6, 23.0 ± 2.2, 12.8 ± 1.4 in the control group, AP group, LPS group, OCT group; the release of LDH was (2180 ±240), (8060 ±930), (9460 +920), (6860 ±740) U/dl, the level of amylase was (1750 ± 190),(3820 ±460), (4420 ±480), (2260 ±260)U/L. All the values in the experiment groups were significantly higher than that in control group ( P ＜ 0.05 ). The oncosis index, LDH, amylase in LPS group was significantly higher than that in AP group ( P ＜ 0.05 ), but the apoptosis index in LPS group was significantly lower than that in AP group ( P ＜ 0.05 ). The apoptosis index in OCT group was significantly higher than that in AP group ( P ＜ 0. 05 ), but the oncosis index, LDH, amylase was significantly lower than that in AP group ( P ＜ 0. 05 ).Conclusions Induction of apoptosis and reduction of oncosis in AP pancreatic acinar cells can reduce the release of enzyme in acinar cells.

Objective To explore the reason of colon cancer with appendicitis and reduce the rate of misdiagnosis. Methods We car-ried out analysis retrospectively to analyze 1 094 hospitalized patients with colon cancer in the First Affiliated Hospital of Harbin Medical Uni-versity from January 2006 to March 2013. Results Among 1 094 colon cancer patients,31 patients who firstly diagnosed with acute appendi-citis received appendectomy,1 patient with appendiceal abscess received non-surgical treatment. Among 31 patients with acute appendicitis,6 patients were found to be with ileocecal tumors during surgeries;24 patients were diagnosed with colon cancer within one year;incision of 1 patient did not heal, with continuous drainage of brown liquid;the appendicitis of 1 patient who received non-surgical treatment was recur-rent. Conclusion As lack of typical symptoms,colon cancer is prone to misdiagnose and diagnose incorrectly when the cancer co-exists with appendicitis and symptoms of appendicitis were showed firstly. Therefore,clinicians should be vigilant for patients with appendicitis. In order to induce the rate of misdiagnosis,it is essential that requesting disease history carefully,timely and relevant inspection and appropriate ex-ploratory surgery for the patients with appendicitis.

Problem-based learning(PBL)teaching mode was applied in general surgery practice of the seven-year system externs.The externs were organized to analyze and discuss a real case,having grasped enough knowledge of relative diseases,and try to provide their advice about the diagnosis and treatment,and then their conclusions were verified by post-operational follow-up.PBL teaching mode can increase the students'study motivations and interests and the ability to resolve practical problems,master medical knowledge,train their clinical thinking and eventually pave a way to become qualified clinicians.

AIM: The bacteriostatic effects of Shenning suppository in the treatment of vaginitis were investigated in vivo and in vitro. METHODS: The minimal inhibitory concentration(MIC)against ten clinical pathogens isolates was determined by tube dilution method,minimal bactericide concentration(MBC) was measured by the agar dilution method.The model of vaginitis from Candida albicans in the rabbit was investigated. RESULTS: Shenning suppository could inhibit and/or destroy Staphylococcus aureus,Candida albicans,ect in virto.It also improved the pathological change in the model of vaginitis from Candida albicans in the rabbit. CONCLUSION: Shenning Suppository could treat bacterial and mycotic vaginitis

Objective: To observe the efficacy of skin regenerative medical technique in treating proliferative scars. Method: Select 32 patients (age16-52) with proliferative scars after burns or wound for 1-11 years,which include 25(male) and 7(female). 2 scar similar spots are chosen in each patient for self-comparison.After the experimental group uses the scar detachment, scar Pi Huizhi applies the beautiful valuable moist burn medicinal plaster gauze cover the cooperation of Chinese and Western medicine home position skin regenerative method treatment; After the control group uses the scar detachment, scar Pi Huizhi applies the petroleum jelly cover the traditional method treatment.The observation comparison curative effect, applies the Vancouver scar appraisal meter appraisal scar proliferation situation. Results: Two groups return to the scar skin which plants to survive.The experimental group regenerates the skin to be good, the cicatrization speed and the quality surpass the control group (P