Virtual reality simulators and surgical demonstration were used in laparoscopic teaching combining teacher' guiding with students' practice to improve the teaching effectiveness hecause of the limitations of the traditional apprenticeship teaching methods.The new method was applied for 2 cycles and for 6 weeks.The results showed that the teaching methods of virtual reality simulators combined with surgical demonstration can significantly improve the effectiveness of laparoscopic teaching and shorten the initial learning curve,therefore it is worth promoting in laparoscopic operation training and teaching.

OBJECTIVETo investigate the effects of different ventilation modes for one lung ventilation anesthesia on arterial blood-gas, airway pressure, intrapulmonary shunt, and F(A)/F(I) changes in patients receiving sevoflurane inhalation.

METHODSThirty ASA class II-III patients with lung cancer undergoing pulmonary lobectomy were randomized into 3 equal groups. The patients in group A received volume-controlled ventilation (VCV) without positive end-expiratory pressure (PEEP) (VT=8 ml/kg, Rf=12/min), and those in group B, after a preceding VCV stabilize the airway pressure, had pressure-controlled ventilation with maintenance of an identical peak pressure (Ppeak) (Rf=12/min, PEEP=0). In group C, the patients received small tidal volume ventilation with PEEP (VT=6 ml/kg, Rf=16/min, PEEP=5 cm H(2)O). Blood gas analysis was carried out at 10 min after TLV and at 20, 45 and 70 min after one lung ventilation (OLV); the heart rate (HR), mean arterial pressure (MAP), SpO(2) and Ppeak were also recorded and blood samples collected from the artery and jugular vein at these time points. Inhalation of 1.5% sevoflurane for 20 min started at 20 min of OLV.

RESULTSCompared with those in TLV, the Ppeak increased, lung compliance decreased, arterial oxygenation (PaO(2)) decreased and intrapulmonary shunt (Qs/Qt) increased during OLV. Group B showed the fastest increase of F(A)/F(I) in the initial 8 min, followed by groups A and C, but the curves became similar with the passage of time.

CONCLUSIONSDuring OLV, the 3 ventilation modes result in similar F(A)/F(I) changes during sevoflurane inhalation but PCV can increase pulmonary compliance.

Adult ; Aged ; Anesthesia ; Arterial Pressure ; Female ; Humans ; Lung Compliance ; Lung Neoplasms ; physiopathology ; Male ; Methyl Ethers ; pharmacology ; Middle Aged ; One-Lung Ventilation ; methods ; Positive-Pressure Respiration ; Pulmonary Gas Exchange ; Young Adult

Objective To develop a simple method of determination of sorafenib in serum by reversed-phase high performance liquid chromatography (RP-HPLC) and to explore its application in sorafenib therapeutic drug monitoring (TDM).Methods Sorafenib extracted by ethyl ether-petroleum (9∶1) with internal standard of erlotinib from serum was wiped off in 60 ℃ water bath.Sorafenib was redissolved by mobile buffer and analyzed by 40 μl.Chromatographic column was Symmetry Rp18 (5 μm,4.6 mm×250 mm,waters) column in normal temperature.The mobile buffer was 28 mmol/L acetate buffer (pH 5.8)-acetonitrile (37∶63).Sorafenib and erlotinib were detected in 249 nm and 335 nm,respectively.Results The concentration range of sorafenib was 0.50-20.00 μg/ml (r =0.9999).The within-day and between-day accuracies of sorafenib were less than 4.77 ％ and 8.79 ％,respectively.The average recovery rate was 98.48 ％.Sorafenib was stable in serum or after extraction.The concentrations of sorafenib in two patients were detected.Conclusion Detection of sorafenib in serum by RP-HPLC is simple and accurate,which is available to determine sorafenib in serum.The TDM of sorafenib has clinical significance.

With the development of modern imaging technologies,three-dimensional (3D) reconstruction techniques based on the computed tomography (CT) or magnetic resonance imaging (MRI) data has been gradually applied in clinical diagnosis and treatment of hepatobiliary diseases.In order to study the characteristics of the 3 D model of portal branches and collateral circulation in various types of portal hypertension,the data of 64-slice spiral CT scan of5 patients with portal hypertension were collected and imported to the abdominal medical image three-dimensional visualization system (MI-3DVS) for sequence segmenting and 3D reconstruction,and then the results of 3D models were compared with operation findings.The 3D models were vividly,visually and clearly displayed the portal system and the collateral circulation,which is helpful in the diagnosis and treatment of the portal hypertension.

Objective To observe effects of four extracts (water, n-butanol, acetoacetate and petro-leum benzine extracts) from Hippocampus japonicus on kidney-yang deficiency mice induced by extradiol, and reveal the modern scientific connotation about sweet-flavor, warm-nature, meridian tropism in liver and kidney. Methods Kidney-yang deficiency mice was induced by intraperitoneal injection of estradiol benzoate. Effects of four extracts from H. japonicus were observed by measuring physical signs, rectal temperature, grip strength, swimming time, autonomic mobility, creatinine (Cr) and urea (UR) level in serum, haematological indexes, testis index and seminal vesicle index. Results All the four extracts from H. japonicus could markedly improve physical signs and increase seminal vesicle index, RBC, Hb and PLT in blood, and decrease UR level in serum of kidney-yang deficiency mice, water extract and petoleum benzine extract could increase rectal temperature, grip strength, swimming time, autonomic mobility, testis index, WBC, lymphocyte (LY), monocyte (MO), and neutrophilic granulocyte (NE), n-butanol extract could increase autonomic mobility and NE, acetoacetate extract could enhance grip strength and prolong swimming time. Conclusion All above effects of extracts from H. japonicus could be as the basic of improving kidney-yang deficiency, could be an important part of the modern scientific connotation about sweet-flavor, warm-nature, meridian tropism in liver and kidney. Effects of water extract and petroleum ether extract were closer and stronger, which offer enlightenment for searching the common effective substance groups of H. japoniacs.

ObjectiveTo study the association of SNP276 in adiponectin gene with impaired glucose regulation (IGR) complicating with the different component numbers of metabolism syndrome (MS) in population of IGR in Han people of Shanxi region.MethodsThe study population consisted of 256 subjects with IGR which was composed of 123 subjects with component numbers of MS ＜2 (IGRA) and 133subjects with component numbers of MS≥2 (IGRB),and 128 subjects with normal healthy (Normal) who were Chinese Hans residents and in Shanxi province.Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was applied to test the adiponectin SNP276G/T polymorphism.ResultsThe distributions of genotypes and alleles of SNP276 both displayed significant difference among the three groups ( x2 =16.893,P =0.002 ; x2 =18.149,P =0.000).In the IGRA,the SNP276 non-TT ( GT + GG) genotype was no difference which increased risk of complicating with the different component numbers of MS( P =0.781,P =0.809).In IGRB,the SNP276 non-TT ( GT + GG) genotype was associated with increased risk of complicating with the different component numbers of MS,and after age and sex-adjusted,there was significant difference ( P =0.007,P =0.007).ConclusionsSNP276 in APM1 increased the risk of complicating with the components of MS in population with impaired glucose regulation in Han people of Shanxi region.

The efficacy and safety of uric-acid-lowering therapy (UALT) on slowing the progression of chronic kidney disease (CKD) accompanied by hyperuricemia were assessed. We searched Cochrane Library, PubMed, EMbase, CNKI, Wanfang and Vip databases up to November 15, 2012 for randomized controlled trials (RCTs) which compared the effect of UALT to control therapy in hyperuricemic patients secondary to CKD, and then performed quality evaluation and meta-analysis on the included studies. Seven RCTs involving 451 cases were included. UALT delayed the increase of serum creatinine (MD=-62.55 μmol/L, 95% CI: -98.10 to -26.99) and blood urea nitrogen (MD= -6.15 mmol/L, 95% CI: -8.17 to -4.13) as well as the decrease of glomerular filtration rate [MD=5.65 mL/(min·1.73 m2), 95% CI: 1.88 to 9.41], decreased systolic blood pressure (SBP) (MD= -6.08 mmHg, 95% CI: -11.67 to -0.49), and reduced the risk of the renal disease progression (RR=0.30, 95% CI: 0.19 to 0.46). However, there was no statistically significant difference in 24-h urinary protein quantity and diastolic blood pressure (P>0.05). We identified that UALT could delay the progression of CKD with secondary hyperuricemia. And this also indirectly proved that hyperuricemia was a risk factor for the CKD progression.

OBJECTIVE To determine the distribution of allergens in patients with allergic rhinitis in Wenzhou area. METHODS Patients with AR symptoms from January 2013 to December 2014 were given skin prick test (SPT). The clinical data about SPT was retrospectively colleceted to analyze SPT results. RESULTS 1. Among 2991 individuals, the total positive rate of SPT was 82.0%, with Dermatophagoides farinae (Der. f) and Dermatophagoides pteronyssinus (Der.p) as the most common allergens; the positive rate of inhalant allergen was obviously higher than that of ingestive ones, with significantly statistical difference(χ2=2006.557,P<0.01). Most of patients were allergic to double allergens; the intensity of Der.f and Der.p mainly presented as (++++), with no significant difference(Z=-0.391, P=0.696). 2. There was significant difference of variation with seasons(χ2=34.254, P<0.01). 3. No significant difference of positive rate were observed in different AR-courses(χ2=16.102, P<0.01). 4. Significant difference of positive rate was found among different age-groups; The positive rate was increased along with growing age, got peak at group of 10-12 years old, and then got down after that. CONCLUSION Dust mite was the main allergen coursed AR in Wenzhou area. Seasons and age were two important factors effecting on positive of SPT and onset of AR. The positive rate of allergens was related to age.

Objective To screen the key genes of colon cancer and to explore the pathogenesis of colon cancer. Methods The expression data were searched from Gene Expression Omnibus (GEO) and the differentially expressed genes were selected by GEO2R. The differentially expressed genes were analyzed by gene ontology (GO) , KEGG pathway and protein-protein interaction networks. Results A total of 324 differentially expressed genes including 61 upregulated genes and 263 downregulated genes were found in more than three GEO series. An analysis of differentially expressed gene pathways revealed that bile secretion, drug metabolism, cytochrome P450, and chemical carcinogenesis were involved in the pathogenesis of colon cancer. Thus 9 key genes were identified, including BMP2, CXCL1, CXCL12, CXCL2, GCG, IL8, MMP1, PHLPP2 and PYY. Conclusion The key genes could be screened by bioinformatics effectively, which might provide the basis for further experimental study.

OBJECTIVETo analyze initial response rate of radiotherapy and chemotherapy for early nasal NK/T-cell lymphoma, and its prognostic factors.

METHODSFrom January 1996 to December 2002, 116 patients with nasal NK/T-cell lymphoma were diagnosed pathologically. Immunophenotyping was performed in 50 cases. According to Ann Arbor staging classification, 95 patients were stage I(E) and 21 II(E). Of the 116 patients, 22 received radiotherapy alone, 6 chemotherapy alone and 88 combined modality therapy (CMT), including, 41 radiotherapy followed by chemotherapy, and 47 chemotherapy followed by radiotherapy.

RESULTSThe 5-year overall survival (OS) rate and disease free survival (DFS) rate for all patients was 74.1% and 61.5%, respectively. For stage I(E) and II(E) patients, the 5-year OS rate was 75.1% and 68% (P = 0.45), and DFS rate was 64.7% and 47.8%, respectively (P = 0.07). The 5 year OS rate and DFS rate were 86.5% and 71.5% for patients who achieved complete response (CR), and 18.4% and 17.2% for those who didn't, respectively (P = 0.000). Sixty-three patients were treated with radiotherapy alone or radiotherapy followed by chemotherapy, while 53 with chemotherapy followed by radiotherapy or chemotherapy alone. The CR rate for radiotherapy was 74.6% while for chemotherapy was 20.8% (P = 0.000). The 5-year OS rate and DFS rate were 76.8% and 65.4% for radiotherapy with or without chemotherapy, and 78.8% and 61.8% for chemotherapy followed by radiotherapy (P > 0.05). Multivariate analysis by COX regression showed that CR rate was the only independent prognostic factor.

CONCLUSIONThe CR rate of radiotherapy is much higher than that of conventional chemotherapy. Addition of chemotherapy to radiotherapy do not improve the survival of patients with early stage nasal NK/T-cell lymphoma. Radiotherapy is the primary treatment for stage I and II nasal NK/T-cell lymphoma.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Combined Modality Therapy ; Drug Therapy ; methods ; statistics & numerical data ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lymphoma, Extranodal NK-T-Cell ; therapy ; Male ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; therapy ; Prognosis ; Proportional Hazards Models ; Radiotherapy ; methods ; statistics & numerical data ; Treatment Outcome ; Young Adult