Objective To evaluate the clinical significance of harmonic dissection of the cystic artery in laparoscopic cholecystectomy (LC). Methods Clinical data of 800 cases of LC from July 1999 to December 2000, in which a harmonic scalpel was used to directly coagulate and sever the cystic artery, were retrospectively analyzed. Results The surgery was completed smoothly in all the cases, without intra-or post-operative bleeding at the stump of the cystic artery. Pathological section examinations under microscope showed that high temperatures achieved by harmonic scalpel were great enough to make the arterial walls coagulated and the arterial lumens obstructed. Conclusions Harmonic dissection of the cystic artery in LC is safe and reliable.

Objective:To explore the influence of psychological factors on temporomandibular disorders(TMD) in school students.Methods:52 school students aged 14-26 years with TMD classified as muscular dysfunction (MD,n =26),temporomandibular displacement(TD,n =14) and MD with TD(MD +TD,n =12),and 53 healthy adolescents as the controls were investigated.All the participants accepted TMD examination and their psychological status were tested by symptom checklist-90 (SCL-90).The patients were divided into acute(case history ≤6 months,n =32) and chronic(case history ＞6 months,n =20) groups.The psychological differences among the related groups were analyzed by SPSS 17.0 statistical software package.Results:The total and the factor scores of the TMD group were higher than those of control(P ＜ 0.05).There was no significant statistically difference between the MD group and the TD group(P ＞ 0.05).MD + TD group got higher SCL-90 total score and factor scores (except depression,phobic anxiety and Psychoticism score) than the other 2 groups (P ＜ 0.05).The acute and chronic group got similar SCL-90 total scores and factor scores (P ＞ 0.05),except somatization score (P ＜ 0.05).There was a positive correlation between the TMD pain level and total score of SCL-90.Conclusion:The psychological status have remarkable influence on the students with TMD.The pain degree of TMD is affected by psychological factors.Therefore,psychological therapy should be applied during the diagnosis and treatment of students with TMD.

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 investigate the efficacy of combined use of apigenin and resveratrol in the treatment of non-alcoholic fatty liver disease (NAFLD). Methods　Fifty male C57BL/6 mice were randomly divided into a normal group (n=10) and a model group (n=40). The NAFLD model was established in the model group using carbon tetrachloride (CCl4) and a high-fat diet. After successful modeling, the model group was further divided into a model group, an apigenin group, a resveratrol group, and an apigenin and resveratrol combined group (combined administration group), with 10 mice in each group. The mice were administered once daily for four consecutive weeks. At the end of the administration, the mice in each group were weighed, the eyeballs were taken for blood samples, and the necks were dissected and sacrificed. The livers were dissected and weighed, and the liver index was calculated. The automatic biochemical analyzer was used to detect the serum biochemical indicators of alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides (TG), and total cholesterol (TC) levels in mice. The ELISA method was used to detect the contents of superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) and glutathione peroxidase (GSH-Px) in mouse 10% liver tissue homogenate. HE staining was used to observe the pathological morphology of liver tissue in mice. Results Compared with the normal group, the liver index and serum biochemical ALT, AST, TG, TC levels in the model group were significantly increased (P<0.01), and the liver homogenate MDA was significantly increased (P<0.01), while the levels of SOD, CAT, GSH- Px were decreased significantly (P<0.01). There were a large number of fatty vacuoles and hepatic cord disorders in the liver tissue. Compared with the apigenin group and the resveratrol group, the liver index, and serum biochemical ALT, AST, TG and TC levels in the combined administration group decreased (P<0.05), and the liver homogenate MDA level decreased (P<0.05), and the levels of SOD, CAT and GSH-Px were increased (P<0.05). The number of fatty vacuoles in liver tissues were reduced, hepatic cord disorders were improved. Conclusions The combined administration of apigenin and resveratrol has a protective effect on NAFLD model mice, possibly through the reduction of hepatic enzymes and blood lipid levels, as well as enhanced antioxidant activity. The combination treatment shows better efficacy compared to the apigenin and resveratrol groups.

Objective:To investigate the use of psychological testing in hospital and its potential existent ethical issues.Methods:Eleven psychometricians from 6 specialized and 5 general hospitals accepted a semi-structural interview.With (10.8 ± 8.8) years of experiences on average in this field,they tested 2 to 30 patients each day.Content analysis was used to investigate the psychometricians' qualification,usage of tests,informed consent,scoring,explanation and preservation.Results:Normally,the number of psychometricians in one hospital varied from 1 to 4.Out of 11 interviewees,2 were unqualified.Three of the interviewees pointed out there were non-standard circumstances when some doctors choosing the tests.Six of them thought that the frequently used tests' norms were obsolete.Eight interviewees considered that comparatively low psychometric fee influenced their devotion of explaining the results.Conclusion:In hospital,it's necessary to strength the ethical awareness of decision-makers and executors in psychological testing.

plus stented elephant trunk implantation (Bentall+Sun′s surgery), aortic root replacement (Bentall surgery), stent implantation, thoracic and abdominal aorta replacement. The aortic operation time of the 19 patients were 5 gestational weeks to 1 month after delivery. The relation between aortic operation and the termination of pregnancy: 4 patients underwent aorta surgery after termination of pregnancy, 9 patients had cesarean section and aorta surgery at the same time, 6 patients underwent aorta surgery before cesarean section. ②5 patients did not receive arota surgery, 2 patients of type A dissection and 1 patient of type B dissection died before the surgery;2 cases of type B dissection underwent conservative treatment. The termination time of pregnancy was 6-37 gestational weeks, with the average of (26 ± 10) weeks. (3)Maternal and fetal outcomes:20 patients survived after treatment (83%,20/24) and 4 patients died (17%,4/24). 10 cases were live births, including 4 full-term infants and 6 preterm premature infants. The birth weight of the neonates was 1 080-3 800 g, with the average of (2 302±764) g. Three of them were very low birth weight infants and 1 was low birth weight infant;3 neonates had mild asphyxia. The neonates were followed up for 0.5 to 10 years, with the average time of (1.4 ± 1.7) years. So far the infants′ development was good.Conclusions Pregnancy with aortic dissection is pernicious. Early identification, prompt diagnosis and prompt interventing of the vascular surgery are necessary to the safety of mother and fetus.

Objective To analyze the correlations of clinical characteristics,CT and pathology features of peripheral primitive neuroectrodermal tumors (pPNET)in abdomen-pelvis region,and to improve the understanding of the disease.Methods The clinical information,CT and pathological features of 23 confirmed pPNET patients in abdomen-pelvis region were analyzed retrospectively.Results (1)All patients had preoperative clinical and imaging data integrallty.(2)23 cases showed soft tissue masses with fuzzy boundary and the average diameter were 10.72 cm.Among all,9 cases showed with varying degrees of sac necrosis,while 2 cases showed with platelet hemorrhage and 4 cases with speckled calcifications.Most showed slight-to-moderate heterogeneous enhancement and the necrosis and cystic are-as showed more obvious.12 cases showed with different degree of recurrence,invasion or distant metastasis.5 cases combined with tumor emboli and 4 cases with tumor feeding vessels.(3)Immunohistochemical examination showed CD99 expressed in 1 9 patients, CD56 in 11,vimentin(Vim)in 12,synaptophysin(Syn)in 11,neuron specific enolase(NSE)in 4,FLI-1 in 4 and epithelial membrane antigen (EMA)in 4 patients.Conclusion pPNET is common among young patients with a high degree of malignancy.CT features include large mass with invasive growth,commonly combined heterogenous density,necrosis and cystic changes.Persistent enhancement is observed during nephrographic phase.

objective To observe whether the killing effect on HCC SMMC-7721 cell of the antihepatocellular carcinoma scFv reconstructed by pharmacy was enhanced or not.Methods Prokarycytic expression vector containing PET32a-RC-RNase was induced to express by IPTG.The inclusion body purified and Western-blotting was used.PC.CHOL and CHS was added in chloroform.Dry membrane was formed after chloroform was removed.RC-RNase protein solution was added to dissolute the membrane.Then pass the solution over a Sephadex G-50 column after ultrasound and filtrated to detect the encapsulation efficiency of the liposome.The solution reacted in EDC.SSNHS and MES for 30 minutes.Then add hdscFv to the solution in 4 ℃ over night.MTT method was used to detect the killing effect on HCC cell of immunoliposome RC-RNase,immunotoxin RC-RNase and liposome RC-RNase in vitro.Resuits The killing effect on HCC cell of immunoliposome RC-RNase is the best.but that of Iiposome RC-RNase is the worst.The respective JC50 are:3.28μg/ml,22.44μg/ml and 98.26μg/ml.Conclusion The anti-hepatocellular carcinoma scFv relomtructed by pharmacy can promote the killing effect on HCC cell and may have potential in the treatment of hepatocarcinoma.

Objective To analyze the medium and long-term results of tricuspid valve replacement (TVR)and summarize the operative experience for tricuspid valve disease.Methods Clinical data of 27 patients with severe tricuspid valve disease from September 2005 to May 2010 were retrospectively reviewed.Biological valve prosthesis was replaced in 23 patients,while mechanical valve prosthesis was replaced in 4 patients.Accompanying procedures included mitral valve replacement in 8 cases,mitral valve replacement and aortic valve replacement in 4 cases,and repair of atrial septal defect in 4 cases.Results The operative mortality was 11.1％(3/27),among these patients,2 cases died of serious low cardiac output syndrome,1case died of muhiorgan failure on the 7th day after operation,1 case who underwent reoperation for hemorrhage postoperative was improved after treatment.During follow-up,1 patient died of biological valve prosthesis dysfuncion 3 years after operation,1 patient died of cerebral embolism 19 months after operation.Six cases were in New York Heart Association(NYHA)class Ⅰ,and 14 cases in NYHA class Ⅱ during the period of follow-up.Conclusions Because operative and follow-up mortality is high,TVR is the last selection for the treatment of tricuspid valve disease.Appropriate operative technique and perioperative therapy are the key for clinical success.For those older than 50 years,follow-up inconvenience and reproductive-age female patients,biological valve prosthesis should be recommended as a preferential choice.

Objective To investigate the clinical features and the management of primary pigmented nodular adrenocortical disease PPNAD) and to evaluate its relationship with Carney complex. Methods One case of PPNAD reported. The patient was a 52 years oldmale. He was hospitalized because of hypertension for one year. The patient had a Cushing's face with elevated plasma and urine cortisone levels which could not be suppressed by both low dose and high dose dexamethasone tests. Ultrasonography howed normal bilateral adrenal glands. CT scan found a 1.6 cm × 2.0 cm mass in the left adrenal gland and normal on tralateral adrenal gland. Results The patient had accepted left laparoscopic adrenalectomy. The pathological examination onfirmed the diagnosis of PPNAD. Micro scopic study showed that there were black-gray spots in the center of the specimen. Hyperplasia was found in all the three adrenal zones. Lipofuscin was observed in the cytoplasm of reticular zone cells. The patient's blood pressure had returned to normal level after the surgery. Conclusions PPNAD is a rare type of ypercortisolism. As there is no specific feature in clinical manifestation and radiological examination of this disease, it is very easy to make a misdiagnosis in clinical practice. PPNAD itself can be the comorbidity of Carney complex, careful differentiation is needed.