Objective To investigate the feasibility and safety of laparoscopic surgery of giant hysteromyoma.Methods A total of 56 cases of giant hysteromyoma(at least 1 lesion ≥ 9 cm in diameter) underwent laparoscopic operations from January 2003 to August 2006 in this hospital.There were 30 cases of laparoscopic myomectomy(LM),10 cases of laparoscopic-assisted vaginal hysterectomy(LAVH),1 case of total laparoscopic hysterectomy(TLH),and 15 cases of laparoscopic supracervical hysterectomy(LSH).Results All of the operations were successfully performed under laparoscope.No conversion to open surgery was needed.The operation time was 40～100 min(mean,52 min),and the hemorrhage volume was 10～100 ml(mean,45 ml).Postoperatively,ureterovaginal fistula was observed in 1 case,which was cured by a re-operation of laparoscopic ureteroneocystostomy.Conclusions Laparoscopic operation for giant hysteromyoma is safe and feasible.

Objective To investigate the effects of lanthanum(La)subchronic exposure on the metabolism of calcium(Ca),magnesium(Mg)and iron(Fe)in the liver tissue and serum in rats.Methods 36 Wistar rats were treated with lanthanum chloride(LaCl3)through oral exposure at 0.1,2 and 40 mg/kg respectively.After 90 days of treatment,the rats were sacrificed and the La,Ca,Mg and Fe in the liver tissue were determined,the serum was collected for analysis of Ca,phosphorus(P),Mg,Fe,unsaturated iron-binding capacity(UIBC)and total iron binding capacity(TIBC).Results The La levels in the liver tissue in all LaCl3 exposed dose groups rats were higher obviously than those in the control group(P0.05).Conclusion The result suggests that La subchronic exposure may have some effects on the level and distribution of Ca,Mg and Fe in the liver tissue and serum,which may be a part of its biological effects.

Objective To evaluate efficacy and safety of laparoscopic surgery for ectopic pregnancy with hemorrhagic shock.Methods One hundred and thirty women with hemorrhagic shock due to ectopic pregnancy underwent laparoscopic surgery from January 2003 to August 2006,including salpingectomy in 80 cases,partial ovariotomy in 8 cases,uterus wedge resection in 15 cases,salpingotomy in 19 cases,and tubal lesion clearance in 8 cases.Results Laparoscopic surgery was successfully performed in all the cases.Intra-abdominal blood loss was 1000 to 3500 ml,with an average of 1500 ml.The operation time was 30-60 minutes(mean:40 minutes).No postoperative complication occurred.Follow-up was conducted in 106 cases,once in a week in the first month after discharge.Serial ?-hCG levels decreased gradually and reached the normal level 1-2 weeks after operation.Persistent ectopic pregnancy was not found in the studied cases.Conclusions Laparoscopic surgery is a safe and effective treatment for hemorrhagic shock due to ectopic pregnancy,given the skill of an experienced laparoscopist with the aid of optimal anesthesia and advanced cardiovascular monitoring.

Objective To establish a convenient, fast, economic and hypersensitive low-density DNA array method to detect the genotypes of human papillomavirus (HPV) and evaluate its application in clinic services.Methods HPV in cervical swab samples from 355 suspected female patients collected in gynaecology and obstetrics clinic were genotyped by hybrid capture (HC) II method and low-density DNA array simultaneously. HPV in 730 clinic samples from the area of Pearl River delta were genotyped by low-density DNA array.Results Among 355 suspected samples positive HPV-DNA were detectable in 211 (59.4%) samples by DNA array and 222 (62.5%) samples by HCII method. The concordance rate between the two assays was 94.1%. In the HPV genotypes 15 high-risk type and 5 low-risk type were detected by low-density DNA array. The most common high-risk types were HPV-16, 52, 58 and 56. The peak age of HPV infection was 26-30 years. The distribution of genotypes was different from various degree of cervical changes.Conclusion Either single type or multiple type of HPV infection can be detected by low-density DNA array. The combination of HPV detection with cytology detection will provide instruction for cervical cancer screening.

Based on the main schemes of the prevention and therapy for SARS issued by the state and provincial administrations of traditional Chinese medicine (TCM), the characters and regulations for the application and performance of TCM in preventing and treating SARS were studied by cluster analysis. Some problems in the rational exertions of TCM in preventing and treating SARS were also discussed. Some proposals for the rational uses of traditional Chinese drugs (TCD) in preventing and treating SARS were offered finally in this article.
Cluster Analysis ; Diagnosis, Differential ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy ; Plants, Medicinal ; chemistry ; Severe Acute Respiratory Syndrome ; drug therapy ; prevention & control

Objective To describe the reference intervals and their sources of tumor markers in clinical laboratories all over China.And make a comparison of difference between different testing systems.Methods The questionnaires about reference intervals of tumor markers testing were distributed to participants.The information was collected by external quality assessment software system based on website, which including upper and lower limits, sources, validation information and testing systems.The analytes were AFP, CEA, total-PSA, CA125, CA153, CA199, ferritin and free-PSA. The participants were classified according to the testing systems they used.The mean, median, maximum and minimum of each group were calculated using Microsoft Excel 2007.The difference of reference intervals between different testing systems were compared by Kruskal-Wallis test.Results The main source of reference intervals was instructions of testing system manufactures ( 83.1% for mean of 8 ratios ) .The next in sequence were instructions of reagent manufactures(8.4% for mean), National Guide to Clinical Laboratory Procedures (4.6%for mean), determined by their own laboratory(2.0% for mean) and the rest (1.9% for mean). There were 48.0% ( 1 906/3 967 ) of analytes whose reference intervals had been validated.Difference of reference intervals which was with P value of Kruskal-Wallis test with <0.05 was found between different testing system groups except the upper limit of free prostate specific antigen ( PSA ) .Conclusions Most clinical laboratories establish the reference intervals of tumor markers on the basis of instructions of testing system manufactures.The reference intervals among different testing systems have statistically significance.

AIM To study the central role of genistein (GST) in regulating cardiovascular function of nervous center by examining the effects of GST on the electrical activity of rat paraventricular nucleus neurons in slice preparation and to elucidate the mechanism involved. METHODS Using extracellular single-unit discharge recording technique to examine discharges of neurons in paraventricular nucleus of hypothalamic slices at the resting potential level. RESULTS ①In response to the application of GST 10, 50 and 100 μmol·L-1, respectively, in the perfusate for 2 min, the spontaneous discharge rates (SDR) of neurons in 25/26 hypothalamic slices were significantly decreased in a concentration-dependent manner. ②Pretreatment with L-glutamate 0.2 mmol·L-1 led to a marked increase in the SDR of slices in an epileptiform pattern. GST 50 μmol·L-1 significantly attenuated the increased SDR in all 7 slices. ③In 8/8 slices, the G protein-coupled inwardly rectifying K+ channels (GIRKs) antagonist, tetraethylammonium 1 mmol·L-1 completely blocked the inhibitory effect of GST 50 μmol·L-1. ④Pretreatment with nitric oxide synthase inhibitor Nω-nitro-L-arginine methyl ester 50 μmol·L-1 increased SDR in all 7 slices, but did not affect the inhibitory effect of GST 50 μmol·L-1. CONCLUSION GST can inhibit the electrical activity of paraventricular neurons, and play a protective role on the central neurons. The inhibitory effect of GST may be related to the activation of GIRKs which induce K+ outward current and then engender the cell membrane hyperpolarization, but be not due to the NO release.

Objective To study if tumor retraction assessed by endiscopic uhrasonography (EUS) during radiotherapy has prognostic value in esophageal carcinoma, which may further predict the radiosensi-tivity. Methods The maximal tumor thickness was measured by EUS before radiotherapy and at 40 Gy in patients with esophaged carcinoma. Response was defined as at least 50% reduction in tumor thickness. Re-suits A total of 51 patients were included. The median follow-up time was 28.5 months. The median sur-vival time was 24.3 months. The treatment was radiotherapy alone, concurrent chemoradiotherapy and pre-operative treatment in 35, 10 and 6 patients, respectively. Tumor response was assessed by EUS in 18 pa-tients (34%). The 2-year overall survival (OS) and progression-free survival (PFS) were 69% and 59% for responders, comparing with 37% and 29% for non-responders (χ~2= 5.78, P = 0.016 and χ~2= 3.97, P =0.046, respectively). In radiotherapy alone group, the 2-year OS and PFS were significantly higher in responders (n = 11) comparing with non-responders (n =24)(60% vs 44% ,χ~2 =5.84,P =0.016 and 20% vs 10% ,χ~2 =4.20, P =0. 040). In preoperative radio (chemo) therapy group (n =6), pathological-ly complete response, partial response and minimal response were observed in 4, 1 and 1 patients, respec-tively. EUS detected tumor response in 4 of 5 (80%) patients with tumor regression, and non-response in 1 of 1 patient without tumor regression. Conclusions The prognosis is better in patients with esophageal car-cinoma responding to neoadjuvant treatment identified by EUS than that of non-responders.

Objective To explore the clinical efficacy of hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer(PLC).Methods Twenty cases of liver cancer underwent hepatic segmentectomy under segmental staining and intraoperative chemoembolization(observed group),the results were compared with 22 cases of PLC after treated by routine hepatectomy(control group).AFP,CT and MRI were regularly used after hepatectomy to evaluate the outcome.Results In observed group,the operative blood loss was(295?105)mL,blood transfusion was(280?85)mL,liver function levels were in the normal range accounted for 15%(3/20) one week postoperatively,the incidence of postoperative complications was 40%(8/20),the postoperative 3-year survival rate was 60%,and the postoperative local recurrence rate was 35%;while in the control group,these parameters were(490?140)mL,(370?105)mL,40.9%(9/22),45.5%(10/22),40.91% and 68.18% respectively.In observed group,the operative blood loss,blood transfusion,cases with liver function levels in the normal range,the incidence of postoperative complications,postoperative 3-year survival rate,and postoperative local recurrence rate were significantly lower than those in the control group(P0.05).Conclusions The hepatic segmentectomy under segmental staining and intraoperative chemoembolization for PLC may reduce postoperative complications,lower postoperative relapse rate and improve survival rate.

Objective To study the diagnosis,surgical treatment and prognosis of patients with primary duodenal carcinoma.Methods The clinical data of 56 patients with primary duodenal carcinoma treated between 2008 to 2015 were retrospectively analyzed.Results The number of patients with tumors located in the first,second,third and fourth parts of duodenum were 3,44,6,and 3 patients respectively.Tumors which were within the papillary region accounted for 71.4％ (40 patients).Twenty-two patients (22/56,39.3％) had well differentiated adenocarcinoma,16 patients (16/56,28.6％) had moderately differentiated adenocarcinoma and 6 patients (7/56,10.7％) had undifferentiated carcinoma.The clinical manifestations were not specific,which included abdominal pain,abdominal distention,jaundice,bowel obstruction or bleeding.The correct rates of diagnosis made by endoscopy,duodenography,ultrasound and CT were 84.0％,81.3％,30.4％ and 48.2％ respectively.Forty patients underwent pancreaticoduodenectomy,5 segmental duodenectomy,9 bypass operation,and 3 subtotal gastrectomy and duodenal bulb tumor resection.The 1-,3-,and 5-year survival rates of all the patients were 82.6％,56.7％ and 30.1％ respectively.The-1,3-,and 5-year survival rates of the patients who underwent pancreaticoduodenectomy and segmental duodenectomy were 100％,68.8％,42.2％ and 100％,61.8％,0 respectively.All the patients who underwent palliative resection died 6 to 24 months after surgery.Univariate analysis revealed the operation types.,depth of tumor invasion,lymphatic invasion,and tumor differentiation correlated with prognosis.Multivariate analysis showed only the operative types,depth of tumor invasion and lymphatic invasion to be independent prognostic factors.Conclusions Tumors located in the papillary region accounted for the majority of primary malignant tumors of the duodenum and they were mainly adenocarcinomas.Duodenography and endoscopy were the major methods used in the diagnosis of primary duodenal carcinoma.Pancreaticoduodeneetomy was the best therapy for primary duodenal carcinoma.