Objective To study the feasibility of laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair.Methods Twenty-four adult patients received laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair in our hospital from November 2003 to April 2008.An incision was made in navel defect and entered the abdominal cavity under a direct vision.LC was performed by 3-trocar technique.Umbilical hernia was repaired by Mayo' style.Results The operation was successfully completed in all the cases.The operation time ranged from 35 to 65 minutes (mean,48 minutes),the blood loss was 5-30 ml(mean,16 ml),and hospital stay after the operation was 3 -4 days.No patient dereloped wound infection or skin necrosis.No recurreme was found during a 1-to 54-month follow-up(mean,28.6 months).Conclusions Laparoscopie cholecystectomy accompanied by simultaneous umbilical hernia repair is a safe and effective procedure.Mayo repair is simple and effective for umbilical hernia with less fascial defects.

Objective To investigate the diagnosis value of laparosco-pie examination in ascites.Methods The data of twenty-three cases with ascites of unknown origin undergoing laparescopie examination and pathologic examination were retrospectively analyzed from May 2004 to August 2008.Results Twenty-two eases were definitely diagnosed by laparoscopie exploration,the positive rate was 95.6%.One ease re-mained unknown.Among them,18 eases were tuberculous peritonitis; 3 eases were metastatic adenocarcino-ma; one ease was peritoneal mesothelioma.No obvious postoperative complications occurred.Conclusion Laparoscopie examination is a safe method with hige definite diagnostic rate,which has important values in diagnosis of ascites of unknown origin.

Objective To investigate the feasibility and safety of laparoscopic cholecystectomy(LC) in patients with chronic renal dysfunction at azotaemic stage.Methods Clinical data of 7 patients accompanying chronic renal dysfunction at azotaemic stage treated with LC between May 2004 and September 2006 were analyzed retrospectively.The operation was performed under general anesthesia and endotracheal intubation.The CO2 pressure was maintained at 9～12 mm Hg.The LC was conducted with 3-port technique in 5 patients and 4-port technique in 2.Results The LC was completed smoothly in all the 7 patients.Patients' renal dysfunction was not aggravated.There was no significant difference between pre-and post-operative time in levels of blood urea nitrogen(11.92?4.06 mmol/L vs 12.16?3.76 mmol/L;t=0.50,P=0.633) and blood creatinine(208.62?134.37 ?mol/L vs 204.20?125.53 ?mol/L;t= 0.51,P=0.626).As compared with preoperative levels,the creatinine clearance rates were not significantly changed at 2 weeks after operation in 3 patients(40.03 ml/min vs 45.61 ml/min;32.28 ml/min vs 38.93 ml/min;56.72 ml/min vs 51.60 ml/min).Follow-up checkups for 4～20 months(mean,10 months) showed no aggravation of renal dysfunction.Conclusions Laparoscopic cholecystectomy is a feasible and safe procedure for patients with chronic renal dysfunction at azotaemic stage.

Adrenal Cortex Hormones ; therapeutic use ; Antitubercular Agents ; therapeutic use ; Diagnosis, Differential ; Humans ; Sarcoidosis ; drug therapy ; epidemiology ; microbiology ; pathology ; Tuberculosis ; drug therapy ; epidemiology ; microbiology ; pathology

Adult ; Carcinoma, Small Cell ; pathology ; Female ; Humans ; Male ; Melanosis ; pathology ; Uterine Cervical Neoplasms ; pathology

Air ; Humans ; Workplace

Adolescent ; Aged ; Aspergillosis ; microbiology ; pathology ; Aspergillus ; isolation & purification ; Brain Diseases ; drug therapy ; microbiology ; pathology ; surgery ; Diabetes Complications ; microbiology ; Diagnosis, Differential ; Female ; Humans ; Male ; Mucorales ; isolation & purification ; Mucormycosis ; drug therapy ; pathology ; surgery ; Nose Diseases ; drug therapy ; microbiology ; pathology ; surgery

OBJECTIVETo explore the molecular mechanisms of main active ingredients of Siwu decoction analogous formulae for treating primary dysmenorrhea of gynecology blood stasis syndrome by network pharmacology study, and to investigate the correlations between multi-compounds, multi targets and multi pathways.

METHODMajor active compounds from Siwu decoction analogous formulae, including ligustilide, butylidene phthalide, senkyunolide, ferulic acid, gallic acid, peoniflorin, jioglutin A, catalpol, transanethole, zingiberone, commiphoric acid, eugenol, isorhamnetin-3-O-neohesperidoside, wulingzhic acid, alpha-cyperone, cyperene, costunolide, costic acid, tetrahydropalmatine, protopine, amygdalin, 24-methylene cycloartanol, oleic acid, linoleic acid, 3-p-coumaroylquinic acid, hydroxysafflor yellow A, coptisine, berberine, jatrorrhizine, baicalein, baicalin, wogonin were collected to build component-protein networks based on PharmMapper database. The targets information access was used to construct and visualize components-targets-pathways network model using the kyoto encyclopedia of genes and genomes (KEGG) pathway database and Cytoscape software.

RESULT AND CONCLUSIONSerine threonine protein kinases play an important role in the process of cells. They were potential targets in the effect of Siwu decoction analogous formulae. The effect of main active ingredients involved 51 the pathway. Besides the same ones, Shaofu Zhuyu decoction had more effect on lipid metabolism, Xiangfu Siwu decoction on amino acid metabolism pathways, Taohong Siwu decoction on carbohydrate metabolism, while, Qinlian Siwu decoction on ErbB, VEGF signal transduction pathway. Siwu decoction and its derived formulae not only had common targets and pathways, but also had their own emphasis. This reflected the formulae effect mode of multi-ingredients, multi-targets and multi-pathways. It may provide clues to deeper study of molecular mechanism of Siwu decoction analogous formulae action.

Drugs, Chinese Herbal ; chemistry ; pharmacology ; Dysmenorrhea ; drug therapy ; genetics ; metabolism ; Female ; Gynecology ; Humans ; Medicine, Chinese Traditional ; methods ; Signal Transduction ; drug effects ; genetics

Objective To find out the satisfaction changes among young medical workers and explore the influence of the healthcare reform on such people.Methods A survey was conducted by means of random sampling among 716 medical workers under 45 years old from 6 hospitals,and combined with the survey data in 2009,young medical workers′satisfaction changes and the influencing factors were analyzed.Results Young medical workers′satisfaction is generally low,with declining satisfaction of social respect as well;satisfaction of medical workers in community medical institutions and secondary medical institutions was found declining dramatically.Conclusions Healthcare reform should pay more attention to these young people in terms of their own satisfaction,especially for those working at primary healthcare institutions.

Objective To investigate the effect of parthenolide ( PTL) and PKC inhibitor on human gastrointestinal stromal tumor (GIST) cell proliferation and apoptosis and the mechanism involved .Methods Human GIST cell lines were cultured in vitro, and the cell proliferation rate of GIST , was determinate by MTT;flow cytometry was used to test the early apoptosis rate of GIST;Western blot assay was applied to detect the expression of endoplasmic reticulum stress-related proteins , GRP78 and GADD153.There were four groups: control group , PTL group, PKC inhibitor group , combine PTL and PKC inhibitor group .Results PTL and PKC inhibitor combination therapy for GIST was sig-nificantly more effective than a single-drug therapy (P<0.05);as for the early apoptosis rate , the combination ther-apy for GIST cells was significantly higher than that medication alone group (P<0.05).the expression of endoplas-mic reticulum stress-associated protein GRP 78 and GADD153 was obviously higher in PTL and PKC inhibitor combi-nation group than that in medication alone group (P<0.05).Conclusions PTL and PKC inhibitor combination therapy for GIST cells can induce apoptosis , which is possibly mediated via endoplasmic reticulum stress pathway .