Objective To explore the value of abdominal wall lifting devices in laparoscopic cholecystectomy.Methods Patients who were going to receive laparoscopic cholecystectomy were randomly divided into two groups:one group underwent pneumoperitoneum(Gas group,n=38),the other group was treated with gasless technique using a subcutaneous abdominal wall lifting devices(Gasless group,n=37).Parameters including operation time,blood loss,real-time results of arterial blood gas analysis,postoperative hospital stay,post-operative ACTH and complications were compared between the two groups.Results The operation was completed in both the groups.There existed significant difference in the mean operation time and blood loss between the two groups [Gas group vs Gasless group:(34.2?7.7) min vs(46.7?16.8) min,t=-4.160,P=0.000 and(10.4?2.0) ml vs(14.8?7.2) ml,t=-3.627,P=0.000];whereas,no significant difference was found between the two in the real-time results of arterial blood gas analysis,postoperative hospital stay [(3.7?0.7) d vs(3.9?1.2)d,t=0.884,P=0.379] and post-operative level of ACTH(5.66 pmol/L vs 5.48 pmol/L,Z=0.748,P=0.436).No severe complications occurred in both the groups.In the gasless group,20 of the 37 patients developed subcutaneous emphysema,while none of the Gas group showed the symptom.Conclusion Gasless abdominal wall lift device is safe and simple,resulting in quick recovery without leading to pneumoperitoneum-related complications.

ObjectiveTo investigate the effects of exploratory behaviors on depression-like rats treated with sleep deprivation,and the mechanism of the point of brain-derived neurotrophic factor (BDNF).Methods30 Sprague-Dawley (SD) rats were randomly divided into normal group,depression group and deprivation group,and the depression model of rats were established by chronic unpredictable stress.At the day of 6th,12th,18th,24th the deprivation group was deprived sleep for 24h by the method of multi-platform water environment,and then all groups were on the open-field test.The approach of immunohistochemistry and retrovirus polymerization chain reaction measured BDNF expression level in the hippocampal neurons.ResultsThe four open-field test scores of the day of 6th,12th,18th,24th indicated that the scores of deprivation group was a low-to high trend,and at the open-field test of the 24th day was significantly different compared with depression group(P ＜0.01 ),while no significant difference was found compared with the normal group (P ＞ 0.05 ).Compared with depression group( gray level:108.53 ± 4.45,positive area rate:0.0747 ± 0.0262 ),BDNF protein expression was significantly higher in the hippocampal neurons of deprivation group( gray level:116.00 ±5.61,positive area rate:0.2034 ± 0.0352 ) (P ＜ 0.05 ),while there was no significant difference in normal group ( gray level:117.27 ±10.66,positive area rate:0.2252 ±0.1143 ) (P＞0.05 ).Results of RT-PCR were in accord with that of immunohistochemistry.ConclusionSleep deprivation can improve the exploratory behaviors of depressive rats and the mechanism may be related to the increasing concentration of BDNF in hippocampal neurons.

OBJECTIVE To observe a time course of keratinocyte growth factor(KGF) and surfactant protein A(SPA) changes in rats with Pseudomonas aeruginosa pneumonia and to find out the significances of them.METHODS Specific pathogen-free male Sprague-Dawley rats were used to study.Standard P.aeruginosa strain ATCC 27853 was instilled into airway by the tracheal route to induce model of pneumonia.Samples of lung tissue and BALF were harvested before infection,and 6 h,9 h and 72 h after infection.Six rats per each point were sacrificed for harvesting samples.Expression of KGF protein in lungs was detected by Western blotting.Western-dot-blot was used to detect SPA expressions in BALF.RESULTS After infected with P.aeruginosa,KGF protein in lungs was markedly increased,reached the peak at 72 h postinfection.KGF protein level at 72 h postinfection was markedly higher than that of before infection(P

ObjectiveTo explore the effects of hemofiltration on serum enzyme (SE),endotoxin (ET) and malonaldehyde (MDA) of dogs with heat stroke caused shock.MethodsSixteen healthy male hybrid dogs were randomly divided into 2 groups,8 for each:as heat stroke group (HS group ) and hemofiltration group (HF group).Severe heat stroke model was induced with high temperature.The dogs were taken out of the heating cabin when it reached heat stroke level,and then observed under normal temperature without treatment.The dogs in HF group was immediately treated with hemofiltration.The changes of SE,ET,MDA of two groups of dogs were observed and the survival time between two groups was compared,ResultsThe time from heat exposure to shock was ( 107.00 ± 28.52 ) and ( 111.38 ± 22.24 )minutes in HS group and HF group respectively ( t =- 0.354,P =0.729 ).The SE ( CK,LDH,ALT,AST) of the dogs were all higher after heat stroke,and the dogs of two groups showed no siginificant difference (P ＞ 0.05).At three hours after heat stroke,the SE increased apparently in HS group and HF group,but the level was significantly lower in HF group. Before heat stroke,the serum ET showed no siginificant difference between two groups ( P ＞ 0.05 ).After heat stroke,the serm ET was much higher than before ( P ＜0.01 ),but there was still no siginificant difference between two groups ( P ＞0.05 ).At three hours after heat stroke,the ET increased both in HF group and HS group,but the level was lower in HF group.Before heat stroke,the serm MDA had no siginificant difference between two groups ( P ＞ 0.05 ).After heat stroke,the serm MDA was much higher than before ( P ＜ 0.0l ),but there was still no siginificant difference between two groups (P ＞ 0.05 ).After heat stroke in three hours,the MDA of HS group rose apparently while HF group slowly declined.The median survival time of HF group was 180 min while HS group was 75 min,the survival rate showed siginificant difference (P ＜ 0.01 ).Conc4usions HF can improve the prognosis of dogs with heat stroke caused shock,prolong its survival time,reduce mortality.The mechanism is probably that HF clear serum MDA,partially clear serum ET and then eventually reduce cell and tissue injury and reduce SE.

Serious femoral damages are a common human bone disease. Rebuilding the femur and studying its mechanical properties are a continuous medical research topic, but traditional femoral prosthesis often cause some problems such as prosthesis loosening. In this work, we selected a healthy male, took his femur scanning by CT, and rebuilt high-precision femur prototypes by Mimics10.0 software, then chose the material having good biocompatibility and biodegradable, utilizing low-temperature deposition manufacturing (LDM) technology for the femoral manufacturing. This approach, fabricating the femur via LDM technology, laid a foundation for the later research on the femoral implantation in the human body.
Adult ; Biocompatible Materials ; Cold Temperature ; Computer-Aided Design ; Femur ; diagnostic imaging ; injuries ; Humans ; Imaging, Three-Dimensional ; methods ; Male ; Prostheses and Implants ; Prosthesis Design ; Software ; Tomography, X-Ray Computed

Three-dimensionally controlled cell-assembly technique makes fabricating tissues and organs in vitro to be possible. However, for real tissues and organs with complex structure and various cells, fabricating tissues and organs in vitro need a technique that could assemble and locate multi cells and materials precisely in the space. Facing the needs of multi-cell assembly, we designed a mixer nozzle and the matching pulse switching circuit which based on the single-nozzle cell assembly system, and developed a multi-cell-assembly system. We also carried out some assembly experiments with this system using materials that were similar to the multi-component extracellular matrix materials. The results demonstrated that the system could assemble various cells and materials into three-dimensional inhomogeneous structures precisely.
Bioartificial Organs ; Cell Culture Techniques ; instrumentation ; Cell Physiological Phenomena ; Equipment Design ; methods ; Extracellular Matrix ; chemistry ; Humans ; Tissue Engineering ; methods

Since there is a clinical need for the tissue-engineered vascular graft (TEVG), fabricating the vascular scaffold individually appears to be necessary. In this work, we have developed the traditional tubular scaffold and branch vascular scaffold utilizing low-temperature deposition manufacturing (LDM) technology. Then different tubular scaffolds were fabricated by changing the processing parameters, and the morphological properties of the scaffolds were assessed. The scaffolds reproduced the structure of 3D vascular model accurately. Wall thickness of the scaffold increased with the increase of velocity ratio (V(L)/V(s)) and nozzle temperature, and both the micropore size and wall roughness were positively correlated with the nozzle temperature. However, the porosity was barely affected by the nozzle temperature. This approach, fabricating vascular scaffold with special structure and appearance features via LDM technology, is potential for the individual fabrication of vascular scaffold.
Biocompatible Materials ; chemistry ; Blood Vessel Prosthesis ; Cold Temperature ; Computer-Aided Design ; Humans ; Lactic Acid ; chemistry ; Polyesters ; Polymers ; chemistry ; Tissue Engineering ; methods ; Tissue Scaffolds

Objective To explore the inflammatory mechanisms of pulmonary embolism ( PTE ) and/or deep venous thrombosis ( DVT ) in elders secondary to chronic obstructive pulmonary disease ( COPD) exacerbation.Methods A total of 26 elders with acute exacerbation of high-risk COPD secondary PTE and/or DVT and 26 patients with low-risk COPD during stable phase diagnosed during the period of January 2008 to December 2012 were enrolled.The relevant parameters of routine blood examination , blood viscosity, D-dimer, fibrinogen ( FIB), arterial blood gas, blood cytokine, erythrocyte sedimentation rate ( ESR ) and C-reactive protein ( CRP ) were retrospectively analyzed.Results The major nonspecific symptoms were cough, sputum and dyspnea.The mean of neutrophile percentage (N%), D-dimer, FIB, interleukin-6 (IL-6), tumor necrosis factor (TNF), C-reactive protein (CRP), low and high shear blood viscosity in blood samples of patients with acute exacerbation of high-risk COPD secondary PTE and ( or ) DVT were higher than those of the control group ( t =3.339, 2.700, 2.207, 2.431, 2.257, 2.143, 2.223, 2.797, all P<0.05).However arterial partial pressure of oxygen ( PaO2 ) was lower than that of lower-risk COPD patients (t=4.312, P<0.05).IL-6 in blood of patients with acute exacerbation of high-risk COPD secondary PTE and ( or) DVT was positively correlated with low-shear blood viscosity , D-dimer and FIB (r=0.437, 0.624, 0.429, all P<0.05).TNF in blood of patients with acute exacerbation of high-risk COPD secondary PTE and ( or ) DVT was positively correlated to FIB , low and high cut blood viscosity ( r =0.624, 0.519, 0.513, all P <0.05 ).Plasma CRP in blood of patients with acute exacerbation of high-risk COPD secondary PTE and/or DVT was positively correlated with D-dimer, FIB, IL-6 and TNF ( r=0.478, 0.541, 0.533, 0.491, all P<0.05).Conclusions Inflammation may exist in elders with acute exacerbation of high-risk COPD secondary thrombotic disease.IL-6 and TNF may promote thrombosis secondary to acute exacerbation of COPD disease.Early screening and/or prophylactic anticoagulation are necessary for prevention.

To sum up the reform of internal performance appraisal system and income allocation system of Shanghai municipal hospitals.The internal performance appraisal index system,evaluation methods and corresponding income allocation system,featuring two breaks,one change and eight elements.The reforms highlight public welfare nature of public hospitals,which is expected to create profound impacts on hospital operation and medical staff behavior.

Objective To explore methods for performance appraisal of directors of municipal hospitals in Shanghai.Methods To assess the management performance of directors of 24 tertiary hospitals each year,measured by five dimensions of social satisfaction,management efficiency,capital operation,development sustainability and staff satisfaction,and 23 indexes.Results Implementation of the performance appraisal has witnessed constant improvement of patient satisfaction and quality of medical care,as well as rational control of medical expenses and cost.In 2014 for example,the cost of emergency/outpatients per visit at such hospitals were 312 yuan and 1 5 600 yuan per hospitalization respectively,with 7.6 days of stay in average.Also improved were service efficiency,clinical research output and hospital business performance in general.Conclusion Performance appraisal of directors of public hospitals proves an important means for guiding the hospitals to adhere to public welfare, consistent with the government medical institution operation target, and to strengthen internal management of such hospitals.