Objective To study the incidence of complications of visceral and vascular injury in laparoscopic surgery for gynecologic diseases,and to discuss the ways to decrease the incidence. Methods The data of 2684 patients who received laparoscopic surgery from Januray 2003 to December 2005 in the Department of Obstetrics and Gynecology were reviewed retrospectively.The incidence and treatment of complications of visceral and vascular injury were observed. Results The total incidence rate of complications was 2.53%(n=68),and that of the visceral and vascular injury was 0.37%(n=10).Four cases of injury were related with trocar punctures(injury of omental blood vessel,n=2;postperitoneal vessel,n=2),three took place during the operation (severe bleeding,n=1;bladder injury,n=2),and the other three were observed in the postoperative stage(ureter injury,n=2;intestinal fistula,n=1). Conclusion The complications in laparoscopic surgery for gynecologic diseases are increased with the extension and difficulty of operation,and are closely related with the experience of the surgeons.Proper candidates for the surgery and established operative technique are the key factors in decreasing the incidence.

Purpose　To study the anti-inflammatory,anti-allergy and immunosuppressive effect of polyglycosides of tripterygium wilfordii Hook (TⅡ).　Methods　Animal model of acute and subacute inflammation,adjuvant arthritis,type Ⅳ and Ⅲ allergic reaction were used.Serum haemolysin level,lymphocyte proliferation and T-cell subsets in spleen were tested.　Results　TⅡ 60,120 mg/kg and pre(prednisone)10 mg/kg had marked inhibitory effect on carrageenine induced swelling,tampon induced granulation and on the prevention of adjuvant arthritis.The delayed type hypersensitivity reaction(type Ⅳ) and arthus reaction (type Ⅲ) was distinctly suppressed.It had a suppressive action on serum haemolysin and lymphocyte proliferation with and without concanavatin A which was dose dependent.In the T-cell subsets:TⅡ 60 mg/kg decreased TS and TⅡ 120 mg/kg inhibited both TS and TH,preacted mainly on TH and rendered the decreased ratio of TH/TS.　Conclusions　TⅡ has suppressive effect on inflammation,allergic reaction and immune function.

BACKGROUND:Typical anterior cervical decompression and fusion method has many disadvantages.Cervical fusion cage has obtained satisfactory outcomes,but many problems should be solved.OBJECTIVE:To design a type of PDLLA Cage and to investigate the immediate stability of different fusion methods in a goat cervical spine model following C_(3-4) fusion.DESIGN,TIME AND SETTING:Randomized controlled study was performed at the Laboratory of Biomechanics,Sichuan University from June 2005 to January 2006.MATERIALS:C_(3-4) segment was obtained from a total of 15 adult female 2-year goat corpses.Additional C_(3-4) from 27 adult female 2-year goats was used in biomechanics test.Samples were supplied by the Animal Experimental Center,West China Clinical Medical College,Sichuan University to use in measurement of anatomy parameter and biomechanica test.METHODS:C_(3-4) segment obtained from goat corpse was subjected to X-ray test in an anterior lateral position.In accordance with C_(3-4) mean vertebral height,the angle of C_3 vertebral inferior border and anterior border,the anterior and posterior distance of C_3 vertebral inferior border,as well as the distance of anterior and posterior borders of the middle vertebral body,a type of PDLLA Cage was designed and made,and the biomechanical behavior analysis about the materials was performed.The 27 goat samples were not destroyed following biomechanics test (normal control group),and were assigned to 3 groups,PDLLA Cage group (n=9),titanium alloy Cage group (n=9) and autologous iliac bone group (n=9).Anterior longitudinal ligament was incised at FSU intervertebral space.Following excising the nucleus pulposus,adherent muscle was removed and the whole ligament was remained,as well as the bony terminal plate and cartilage subchondral bone were reserved.PDLLA Cage and titanium alloy Cage were respectively implanted in the cavity of the Cage main body in the PDLLA Cage group and titanium alloy Cage group.The Cage was fixed in the vertebral body using two fixing plates of anterior alar plate with 3.5-mm screw.Autologous cortical iliac bone from three surfaces was implanted in the autologous iliac bone group.MAIN OUTCOME MEASURES:Biomechanics was tested in flexion,extension,axial rotation,and lateral bending using 1,2,3,4 N·m moment of force method.The mean stiffness values and the range of motion were calculated in each group. RESULTS:In every loading mode,the displacement values were statistically significant difference between cage groups (PDLLA Cage group and titanium Cage group) compared with the normal control group (P<0.05);and the displacement of cage groups were lower than that of the autologous tricortical iliac crest bone graft group except for 4 N·m bending loading mode (P<0.05).Posterior extension was significant better in the PDLLA Cage group and titanium alloy Cage group compared with the autologous iliac bone group.Compared with the normal control group,the displacement of posterior extension and lateral bending was lower in the autologous iliac bone group (P<0.05).The stiffness of PDLLA Cage and the titanium Cage group in the flexion loading had no significant difference (P>0.05).In the others loading condition,the titanium Cage group was statistically greatest in all directions (P<0.05).The stiffness of PDLLA Cage was comparable with that of the titanium Cage and was statistically higher than that of the autologous tricortical iliac crest bone graft and intact (P<0.05).CONCLUSION:This type of PDLLA Cage can provide enough primary stability for cervical intervertebral fusion.

Objective To design a type of poly (D, L) Lactide (PDLLA) cage, compare the characteristics of inter body fusion using PDLLA cage with those of titanium cage and autologous tricortical iliac crest graft in a goat cervical spine model in vi?vo. Methods Twenty?four goats underwent C3-4 discectomy and fusion were assigned to 3 groups, PDLLA cage group (n=8), titani?um alloy cage group (n=8) and autologous iliac bone group (n=8). Radiography was performed pre?and post?operatively and 1, 2, 4, 8, and 12 weeks after operation. At the same time points, disc space height (DSH), intervertebral angle (IVA), and lordosis angle (LA) were measured. After 12 weeks, the goats were killed and fusion sites were harvested. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending to determine the stiffness and range of motion. All cervical fusion speci?mens underwent histomorphological observation. Results The IVA of PDLLA cage 4 weeks after operation and DSH 8 and 12 weeks after operation was statistically greater than that of autologous iliac bone graft (P<0.05). The LA values were shown no signif?icant difference among PDLLA cage, Titanium cage and autologous iliac bone graft groups. The stiffness of two types of cages in ax?ial rotation and lateral bending, the ROM in every movement was statistically greater than that of autologous iliac bone graft group (P<0.05). PDLLA cage and Titanium cage had no significant difference (P>0.05). Radiographic and histomorphological observa?tion showed better fusion results in cage groups than in autologous bone group. Conclusion This type of PDLLA cage has excel?lent biocompatibility and can provide an appropriate biological environment for bone ingrowth and osteogenesis at bone?implant in?terface. Furthermore, PDLLA cage can maintain DSH and increase the stability of fusion segments to create a good biomechanical environment for the last bone fusion.

Ikaros is a regulatory factor playing an important role in control of the development of hema-topoietic cells and immune system;and as a tumor suppressor,its aberration can cause both T and B lineage development arrest and neoplastic transformation,leading to insensitive to therapy and poor prognosis in actue lymphoblastic leukemia. Recently,researches on how Ikaros affects the leukemogenesis and prognosis become the focus of attention.

Two pairs of primer targeting to the genes encoding the major outer membrane protein (MOMP) and the polymorphic membrane protein (PMP) of Chlamydophila psittaci (Cps) designed and used in the fluorescent quantitative PCR assay in the detection of this microorganism were compared in the their sensitivity and specificity.It was demonstrated that both pairs of primer could be used successfully to detect the presence of Cps of the epidemic strains isolated in China.The specificity of PMP primer used was higher than that of MOMP primer. In case of high target concentration in samples, the sensitivity of the former was also superior to that of the latter, but the amplification efficiency of the former was lower than that of the latter. The MOMP primer seemed to be more suitable to detect Cps by using the real-time quantitative assay.As demonstrated by the real-time quantitative PCR assay, great difference in the genomic copy numbers of the PMP gene existed in the epidemic strains of Cps isolated in China.

Objective To investigate the characteristics of etiology,efficacy of endoscopic management for recurrent idiopathic pancreatitis (RIP).MethodsThe clinical data of 58 cases of RIP diagnosed in our hospital from April 2005 to April 2011 were retrospectively analyzed.All the patients underwent endoscopic retrograde cholangiopancreatography (ERCP),and patients with suspected sphincter of Oddi dysfunction received manometry.According to the clinical and ERCP manifestations,the etiologies of RIP were determined and individualized endoscopic treatment was applied.The patients were followed-up postoperatively about the improvement of abdominal pain and recurrence of RIP.ResuItsFifty-eight patients (29 males,29 females) were suffered from acute pancreatitis from 3 to more than 10 times.The etiologies were as follows:29 cases of biliary microlithiasis,19 case of sphincter of Oddi dysfunction ( 16 cases of pancreatic type,3 cases of mixed type),4 cases of anomalous arrangement of the pancreaticobiliary duct,and 6 cases of normal manifestations at ERCP.Biliary sphincterotomy alone was performed in 33 patients,while both biliary and pancreatic sphincterotomy was performed in 8 patients,and pancreatic sphincterotomy alone was performed in 17 patients,after sphincterotomy,pancreatic stent insertion was performed in 24 patients.The follow-up data was obtained from 41 out of 58 patients,the follow-up period ranged from 3 ～ 67 months ( average 33 months).During this period,9(22.0％ ) patients suffered from RIP,and the treatment efficiency was 78％.ConclusionsBiliary microlithiasis and sphincter of Oddi dysfunction are the main causes of RIP.Drink could induce RIP.ERCP has definite treatment efficacy for RIP.

Objective To investigate the specific immune therapeutic effect of the T cell fusion peptide vaccine from group II allergens from Dermatophagoides pteronyssinus(Der p2). Methods Thirty mice were randomly divided into three groups, namely a negative control group(a PBS group),positive control group(an asthma group)and protein Der p2 T cell fusion epit?ope for specific immunotherapy(SIT)group(a Der p2 T group). The extract of house dust mites(HDM)was used to establish the asthmatic models in BALB/c mice,and the PBS group was always used with PBS buffer. Thirty minutes before spray inhala?tion from 25 to 27 days,the mice of the Der p2 T group were respectively injected subcutaneously with the therapeutic proteins for SIT,then the serum and bronchoalveolar lavage fluid(BALF)were collected. ELISA was used to assay the levels of IFN?γ, IL?4,and IL?13 in BALF,as well as serum levels of specific IgE and IgG2a. The lung tissue sections were stained with haematox?ylin and eosin(H&E)for pathological examinations. Results The ELISA detection revealed that the number of eosinophil in BALF of the asthmatic mice was(5.57 ± 0.64)× 105/ml,which was significantly higher than that in the PBS group[(0.50 ± 0.30)× 105/ml,P < 0.01],the number of eosinophil in the Der p2 T immunotherapy group decreased significantly[(3.45 ± 0.36)×105/ml,P<0.01]. The content of IFN?γin the PBS group,asthma group and Der p2 T group were(267.00 ± 21.98), (155.80 ± 20.53)pg/ml and(234.40 ± 24.46)pg/ml respectively. Compared with the asthma group,the mice with Der p2 T vac?cine specific immune treatment produced a high level of IFN?γ(P<0.01). The content of IL?4 in the PBS group,asthma group and Der p2 T group were(23.40 ± 5.96),(53.28 ± 8.26)pg/ml and(30.00 ± 5.50)pg/ml respectively. Compared with the asth?ma group,the content of IL?4 in the mice of the Der p2 T treatment group was significantly lower(P<0.01). Compared with the asthma group[(308.10 ± 28.32)pg/ml],the content of IL?13 in BALF of the mice in the Der p2 T treatment group was signifi?cantly decreased,which was[(174.50 ± 25.99)pg/ml,P<0.01]. The content of IL?13 in the PBS group was(95.99 ± 31.14) pg/ml. The lung tissue sections showed that the lung inflammation in the p2 T Der group was significantly less than that in the asthma group,and the inflammatory cell infiltration was significantly decreased,and airway epithelial construction remodeled. Conclusion The Der p2 T cell fusion epitope,which is as vaccines for specific immunotherapy with asthma models,can allevi?ate effectively allergic inflammation of airway and lung in the mice,and it may be used as a candidate vaccine for asthma.

Objective To investigate the different distribution and expression of mammalian target of rapamycin complex (mTORC) in the kidney of diabetic nephropathy (DN) mice.Methods Fourteen eight-week-old male C57BL/6 mice were assigned to 2 groups: the control group ( n=7 ) and the streptozotocin ( STZ )-induced DN group ( n=7 ) . Blood and urinary variables including glucose , albumin, creatinine and albumin/creatinine ratio were assessed 2 weeks after STZ injection.Hematoxylin-eosin staining was performed for renal pathological analyses .The distributions of mTOR , phosph-ser2448-mTOR(p-mTOR), mTORC1(Raptor), mTORC2(Rictor) and phosph-ser240/244-S6K1 (p-S6K1) were determined by immunofluorescence.The expression levels of mTOR, p-mTOR, mTORC1(Raptor), mTORC2(Rictor), S6K1 and p-S6K1 were detected by Western blotting .Results Two weeks after STZ injection , the diabetic mice developed albuminuria (P<0.01) and renal hypertrophy (P<0.05).The immunofluorescence positive staining for mTOR , Raptor, and Rictor was distributed in the epithelial cells of proximal tubules , glomerular mesangium and capillary loops as well as the medullary collecting ducts of the control mouse kidney .These positive signals increased in the DN mouse kidney ( P<0.05).However, pS6K1 was not detected in the inner medulla of control mouse and p-mTOR was not found in the glomeruli of both control and DN mice .Conclusion mTORC is widely expessed in the mouse kidney and participates in the development of DN , whereas the 2448 serine phosphorylation of mTOR may be not implicated in the hyperglycemia mediated glomerular injury .

Objective To evaluate the possibility and safety of balloon kyphoplasty for the aged osteoporotic thoracolumbar burst fractures. Methods From October 2007 to December 2012, 78 patients with aged osteoporotic thoracolumbar burst fractures were treated by balloon kyphoplasty. The inflatable balloon was inserted through pedicle of vertebal arch to make fracture reduction, then the centrum was stuffed with bone cement. The whole procedure was pinpointed and detected by C-arm x-ray machine. Results All operations were completed successfully. The lumbar and back pain of the patients relieved obviously. The quality of patients' life was significantly improved. Imaging examinations revealed that the vertebrae altitude was recovered and the kyphosis was corrected obviously. Conclusion Balloon kyphoplasty is effective to treat the aged osteoporotic thoracolumbar burst fractures. But the operation had certain risk, we must do a good job in preoperative preparation, strictly handle surgical indication and accurately operate.