Objective To investigate the causes, management, and prevention of complications in laparoscopic gynecologic surgery. Methods A retrospective analysis was made on clinical data of 4413 cases of laparoscopic gynecologic surgery from September 1995 to June 2006 in this hoapital. Results Among 4413 cases, complications occurred in 71 cases, the overall rate being 1.6% (71/4413). Out of the 71 cases, an open surgery was required in 10 cases (14.1%). Complications included 5 cases of bladder injury, 4 cases of intestinal injury, 5 cases of massive haemorrhage, 8 cases of incision hematoma and drainage bleeding, 1 case of greater omentum hernia, 9 cases of perineal emphysema, 12 cases of skin congestion, 2 cases of head hematoma, 2 cases of brachial plexus nerve injury, 1 case of infective shock, 15 cases of abnormal incision healing, 1 case of lower limb thrombosis, and 6 cases of residual cervical cyst. Conclusions Complications of laparoscopic gynecologic surgery are correlated with the difficulty of operation and the skillfulness of operator.

Objective To describe nursing assistants' experience of caring for dementia patients with behavioral symptoms.Methods A descriptive qualitative design was used in this study.Twelve nursing assistants for dementia patients were recruited.A semi-structured interview was used to collect the data.The interview was related to nursing assistants' experience of caring for patients with behavioral symptoms.Content analysis was used to explicate the meaning of the interview data.Results Three themes were extracted:having multiple stressors; learning by practice; seeking mutual support from other nursing assistants.Conclusions Nursing assistants had multiple stressors from caring dementia patients with behavioral symptoms.Continuing supply of training on strategies of coping with behavioral symptoms as well as the emotional support are especially required.

Objective To investigate the clinical efficacy and prognosis of early protective pulmonary ventilation and intra-aortic balloon pump(IABP)combined with percutaneous coronary intervention(PCI)in treating patients with acute myocardial infarction(AMI)complicated with cardiogenic shock(CS)and hypoxemia.Methods The 49 patients diagnosed as AMI complicated with CS and hypoxemia and treated with early protective pulmonary ventilation and IABP combined with PCI in Tianjin Chest Hospital from January 2015 to December 2015 were retrospectively analyzed.Major adverse cardiovascular events(MACE)including sudden cardiac death,recurrent myocardial infarction,heart failure and development of target vessel revascularization were recorded during one year of follow-up visits.Survival rate was analyzed and Cox regression analysis was used to explore risk factors for occurrence of MACE after the treatment.Results The revascularization of target vessel was successfully operated on all of the 49 patients.The mean time from attack to hospitalization was(6.2±1.5)hours,while the mean time from emergency room to balloon dilatation was(118.55±28.28)minutes.In these patients,30(61.2%)cases were diagnosed as STEMI,among which 23(76.6%)cases as anterior wall myocardial infarction and 5(16.7%)cases as inferior wall myocardial infarction.While the other 19(38.8%)cases were diagnosed as non-STEMI.Using coronary arteriography,46(93.9%)cases had multi-vessel coronary artery disease,among which 13(26.5%)cases were complicated with severe left main coronary artery disease and 27(55.1%)cases had severe vascular calcification.44(89.8%)cases had TIMI perfusion grade 3 blood flow after PCI,while 5(10.2%)cases did not achieve TIMI grade 3 blood flow.One(2.0%)case had serious complications and 12(24.5%)patients died in hospital.31(63.3%)patients survived 1 year during follow-up visits.Total number of MACE was 32(65.3%).Among these events,18(36.7%)died,4 cases(8.2%)had recurrent myocardial infarction,13 cases(26.5%)had heart failure(HF)and 5 cases(10.2%)had target vessel revascularization(TVR).The total event-free survival rate was 34.7%.Multivariable Cox regression analysis showed that severe vascular calcification〔HR(95%CI):2.677(1.184-6.054),P=0.018〕,TIMI grade blood flow less than level 3 after PCI〔HR(95%CI):26.289(6.314-109.470),P=0.000〕and more than 120 minutes from emergency room to balloon dilatation〔HR(95%CI):2.923(1.325-6.446),P=0.008〕were risk factors for MACE.Conclusions Early protective pulmonary ventilation and IABP combined with emergency PCI are safe and effective for treatment of patients with AMI complicated with CS and hypoxemia.The pattern of treatment can significantly decrease death rate and increase 1-year survival rate.

Aim To study the development of acute lung inflammation in mice induced by activation of the complement alternative pathway and the changes of the related indicators, and to provide an ideal pathological model of acute lung inflammation in mice for drug screening and intervention. Methods Cobra venom factor( CVF) was used to activate complement alterna-tive pathway of SPF Kunming mice by intravenous injection. According to different sampling time, the mice were divided into 15 min, 30 min, 1 h, 2 h, 6 h group, and the parallel PBS control groups were set at the same time. Lung coefficient, lung water content, myeloperoxidase ( MPO ) activity, BALF cell number and protein content were tested. The pathological changes of lung tissue were observed by HE staining. The concentration of IL-6 , TNF-α, P-selectin and ICAM-1 in bronchoalveolar lavage fluid ( BALF ) and serum were determined by ELISA. Results CVF caused pulmonary inflammatory cell infiltration in mice obviously. Compared with PBS groups, MPO activity of lung tissue, BALF cell and the protein concentration were significantly increased. The contents of IL-6, TNF-α, P-selectin in BALF and serum were in-creased, and the content of ICAM-1 in serum was also increased. The content of P-selectin in BALF reached the first peak at 30 min point, the content of IL-6 and TNF-α in BALF reached the first peak at 1 h point, but the indicators had no further changes at 2 h point, and all the indicators rose again at 6 h point. The lev-els of IL-6 and TNF-α in serum reached peak at 1 h point,then the content showed lower levels at the sub-sequent time points. The levels of P-selectin and ICAM-1 in serum increased along the time. Lung coef-ficient, lung water content and ICAM-1 of the BALF showed no significant alteration. Conclusion The ac-tivation of the complement alternative pathway can lead to acute lung inflammation in mice and the inflammato-ry response is the most obvious at 30 min to 1 h. The study could provide an ideal pathological model of a-cute lung inflammation in mice for drug screening and intervention.

This study is to investigate the effect of compound B2 on the damage of PC12 cells induced by serum deprivation and to explore its related mechanisms. The binding characteristics of B2 to rat striatum adenosine A2A receptor was studied by radioligand 3H-MSX-2 binding assay. Cell viability was detected by MTT assay. ROS formation was measured after DCFDA fluorescent staining. B2 has affinity to rat adenosine A2A receptor (K1 = 0.37 micromol x L(-1)). B2 remarkably increased PC12 cell survival rate in serum deprivation-induced PC12 cells. The percentage of serum deprivation-induced death of PC12 was 49.6%, and the treatment of B2 (0.1-100 micromol x L(-1)) increased the cell viability to 63.3%, 74.9%, 86.3% and 88.1%, respectively. Adenosine A2A receptor antagonist SCH 58261 could significantly block the protective effect of B2. The cell viability with 0.1 micromol x L(-1) SCH 58261 decreased by 16.1%, 24.0% and 19.8%, in the presence of B2 (0.1-10 micromol x L(-1)). Serum deprivation-induced ROS formation was 3.5 times more than that of control group, and treatment with B2 significantly and dose-dependently inhibited ROS over-formation. The protective effect of B2 may be related with adenosine A2A receptor. Decrease of serum-deprivation induced ROS formation may also be one of the mechanisms.

Objective To investigate the clinical efficacy of point Neiguan thumbtack needles in preventing and treating gastroscopy-induced nausea and vomiting.Methods Two hundred patients meeting the inclusion criteria were randomly allocated to treatment and control groups, 100 cases each. Before gastroscopy, both groups took lidocaine mucilage and the treatment group received point Neiguan thumbtack needle therapy additionally. Nausea and vomiting were observed in both groups of patients during gastroscopy.Results There were statistically significant post-treatment differences in nausea and vomiting severity and patients’ satisfaction between the two groups (P<0.05).Conclusions Point Neiguan thumbtack needle therapy can relieve gastroscopy-induced nausea and vomiting and raise patients’ satisfaction.

Triptolide possesses antitumor, anti-inflammatory and immuno-supression activity. 3H-triptolide given intragastrically to rats was rapidly but not totally absorbed. After ig and iv administration of 3H-triptolide to rats, the highest radioactivity level was found in the liver, followed by spleen, lung, kidney, intestine, heart and brain. The radioactivity in organs disappeared slowly. 3H-triptolide in plasma was found to be 64.7% bound to plasma protein. In 21d, the cumulative excretion of radioactivity in urine and feces after ig and iv 3H-triptolide to rats was 67.5% and 61.9% of the total dose, respectively. Among that, the radioactivity was 52.4% and 25.3% of the total dose in feces, respectively. The radioactivity excreted by bile in 24h was 6.73 ? 1.9%. The radioactivity in urine, feces and bile measured by TLC, autoradiography and liquid scintillation count indicated that 3H-triptolide excreted in urine, feces and bile was mainly in unchanged form and a few metabolites was found in urine and feces

Objective To investigate the incidence, clinical characteristics, diagnosis, treatment and prognosis of solid-pseudopapillary tumor of pancreas (SPTP) in China. Methods Data of 5 cases treated in Liaocheng Second Hospital and 649 cases reported in literature in the recent 10 years were retrospectively analyzed.Results The disease showed an increasing trend in recent 10 years. In total, 595 cases were reported in the recent 4 years. The disease was more common in young female, with a 1: 10 male female ratio. Their ages ranged from 8 to 67 years, 26.1 years on average. The chief symptoms were abdominal pain and discomfort. Diagnosis depended on postoperative pathological and immunohistochemical analysis. Tumors were mainly located in pancreas. All tumors were treated by surgical resection and prognosis was good. Conclusion SPTP is not rare. Definite diagnosis of SPTP depends on postoperative pathological and immunohistochemical study. Surgical resection is recommended due to its good prognosis.

Objective To investigate the effects of a pulsed electromagnetic field (PEMF) on cell proliferation,differentiation and the genetic expression of osteogenesis specific transcription factor-Osterix (OSX) in the calvaria-derived osteoblasts of SD rats.MethodsPrimary osteoblasts were separated from the calvarias of Sprague-Dawley rats 24 hours after birth by trypsinazation and collagenase digestion.The osteoblasts at passage 4 were randomly divided into a control group and a PEMF group,Cells in the PEMF group were placed onto PEMF therapeutic apparatus and exposed to 11 mT radiation at 12 Hz for 1 h per day for 3 days.The osteoblasts' proliferation ability was then detected via methylthiazdyl tetrazolium assay.Alkaline phosphatase (ALP) activity in the cell lysate and the supernatant fluid was assayed through disodium phenyl phosphate colorimetric determination to determine the cells'differentiation ability.OSX mRNA expression was determined using real time reverse transcription polymerase chain reaction (RT-PCR).ResultsThe proliferation of osteoblasts in the PEMF group was significantly greater than in the control group.PEMF exposure suppressed ALP activity in both the lysate and the supernatant of the osteoblasts.The OSX mRNA expression in the PEMF group was significantly down-regulated compared with the control group.ConclusionPEMF at 12 Hz and 11 mT can promote the proliferation of osteoblasts,but it inhibits cellular differentiation and down-regulates the mRNA expression of OSX.

Objective: To investigate the killing activity of cytokine-induced killer (CIK) cells after incubation with autologous tumor cell lysate-pulsed dendritic cells (Ag-DC) and to evaluate the immune functions of patients, the clinical efficacy and side effect of Ag-DC in combination with CIK on hepatocellular carcinoma. Methods: Peripheral blood mononuclear cells were isolated from 24 patients with hepatocellular carcinoma, and cultured with granulocyte-macrophage colony-stimulating factor and interleukin-4 to produce dendritic cells (DCs). The DCs were pulsed with autologous tumor cell lysate. T lymphocytes from PBMC were cultured with interferon-Y (IFN-γ), IL-2, CD3-moAb, and IL-1α to prepare CIK. The killing effect of CIK on SMMC-7721 was investigated after CIK was incubated with Ag-DC. After immunotherapy with Ag-DC and CIK, immunolog-ic and clinical responses of the 24 patients were evaluated. Results: The killing effect of CIK was remarkably improved after CIK was incubated with Ag-DC. The immunotherapy with DC and CIK alleviated symptoms and improved the immune functions of the patients. Except for transient fever and chill, no remarkable adverse events were observed. Conclusion: Ag-DC in combination with CIK shows short-term efficacy on hepatocellular carcinoma through inducing specific anti-tumor immunity and can be an effective adjuvant therapy for hepatocellular carcinoma.