Objective To investigate the feasibility, safety and effect of gasless laparoscopic surgery in the treatment of benign ovarian tumors during pregnancy. Methods Clinical data of 45 pregnant women with benign ovary tumors undergoing gasless laparoscopic surgery from January 2006 to June 2013 were studied retrospectively.Most of the cases were given oophorocystectomy. Adnexectomy was performed for the large sized lesions, lacking of or remaining few normal ovarian tissue, or ovarian cyst torsion. Results All the 45 cases were successfully treated by gasless laparoscopic surgery.No perioperative and postoperative complications were observed.There were 42 cases receiving ovarian tumor resection while 3 cases receiving simple salpingo-oophorectomy.The mean operation time was (40.7 ±14.9) min (25-90 min), the mean blood loss was (27.3 ±16.6) ml (10 -80 ml), and the mean hospitalization time was (4.5 ±1.3) days (3-8 days).At pre-, peri-, and post-operative time, the blood pH value, blood pressure carbon dioxide (PaCO2), and blood oxygen partial pressure (PaO2) showed no statistical difference (F=0.00,P=0.999;F=2.21, P=0.114;F=0.60,P=0.555), and blood bicarbonate (HCO3-) and blood oxygen saturation (SpO2) showed statistical difference but no clinical significance (F=14.96,P=0.000;F=9.45,P=0.999), all of which were in the normal range.The fetal heart rates were all in the normal range.Pathological diagnoses were ovarian mature cystic teratoma in 25 cases (55.6%), serous cystadenoma in 6 cases (13.3%), mucinous cystadenoma in 4 cases (8.9%), mesosalpinx cyst in 3 cases (6.7%), endometrial cyst in 2 cases (4.4%), and luteal cyst in 5 cases (11.1%).No spontaneous abortion was found in post-operational follow-up.Term delivery was obtained in 43 cases, with normal fetal weight and the Apgar scores.Two cases gave up the pregnancy in the postoperative period. Conclusion Gasless laparoscopic surgery for benign ovarian tumors during pregnancy is safe and feasible.

Objective To investigate the feasibility,safety and effect of gasless laparoscopic surgery used in patients at the second trimester.MethodsFrom Aug.2006 to Aug.2008,the data of 10 cases at gestational 15 - 24 weeks complicated by ovary benign tumors ( the diameters more than 5 cm) undergoing gasless laparoscopic surgery were studied retrospectively.Operation time,bleeding loss,period of hospitalization,the status of fetus and newborn babies,and peri-operative or postoperative complications were observed.ResultsAll 10 cases were treated by gasless laparoscopic surgery,including 4 cases with mature teratoma,5 cases with epithelial tumors and 1 case with ovarian endometrioma.The mean time of surgery was (30 ± 5) minutes,the mean bleeding in the surgery was (30 ± 8) ml,the mean period of in hospitalization was ( 6 ± 2 ) days.The blood gas ( pH:7.42 ± 0.11,7.41 ± 0.18,7.42 ± 0.12 ),blood pressure [ mean arterial pressure (MAP):(90.4 ± 3.1 ),(90.6 ± 0.7 ),( 89.7 ± 0.8) mm Hg( 1 mm Hg =0.133 kPa) ] and heart rates [ ( 84.0 ± 1.6),( 84.3 ± 1.7 ),( 82.7 ± 1.1 ) bpm ] in all cases at pre,peri and postoperative time did not show statistical difference ( P all ＞ 0.05 ).The fetal hearts were all in the normal range preoperative,intraoperative and postoperative time (P ＞ 0.05 ).No perioperative and postoperative complications were observed.All the cases underwent term delivery.Fetal weight and Apgar score did not show abnormality.ConclusionGasless laparoscopic surgery at the second trimester is feasible and safe to mother and fetus.

Objective: To observe the effects of different internal fixations on the treatment of pertrochanteric hip fractures. Methods: 158 cases of pertrochanteric hip fractures treated with different internal fixations, including anatomic steel, Gamma nail and dynamic hip screw, from January 1999 to October 2004, combined with functional exercise, were summarized and the advantages and disadvantages of different fixations were evaluated. Results: All of 158 cases were followed up for 6 to 36 months with a mean of 14 months. The rate of excellent or good in all patients was 94.61% by Harris criterion and 17 cases have surgical complications (10.18%). The complication rates of the three types of treatment had no difference. Conclusion: Anatomic steel, Gamma nail and dynamic hip screw are all ideal and reliable internal fixation material for pertrochanteric hip fractures as long as they are selected properly before operation.

Objective To investigate the clinical significance of laparoscopic operations in gynecologic emergency. Methods We retrospectively analyzed 145 cases of gynecologic emergency dealt with laparoscopic operations in May 1997～August 2001. Out of the 145 cases, tubal pregnancy accounted for 100 cases (Laparoscopy Group), which were further compared with 89 cases of tubal pregnancy in January 1994～April 1997 treated by open operations (Open Group). Results Out of the 145 operations, 139 (95.9%) were successfully carried out under laparoscope, with the conversion to open operations in 6 cases. There were 61 cases of salpingectomy, 28 cases of oviduct fenestration, 11 of fenestration converting into salpingectomy, 16 of partial ovariectomy, 8 of adnexectomy for ovarian cyst pediculotorsion, 4 of cyst resection, 3 for rupture of endometrial cyst of ovary, 6 for pelvic abscess and 2 for pelvic encapsulated fluid. Compared with the Open Group, the Laparoscopy Group had longer length of surgical intervention (t=3.9, P=0.000) and more intraoperative blood loss (t=5.8, P=0.000). Conclusions Laparoscopic operations play double actions both in diagnosis and in treatment for most gynecologic emergencies, being a safe and reliable approach. Laparoscopic salpingectomy (non-oviduct-sparing operations), however, should be chosen for urgent patients.

Objective To investigate the effect of ovarian cycle on the sedative effect of propofol in patients. Methods Forty ASA Ⅰ or Ⅱ patients, aged 20-40 yr, with body mass index 20-25 kg/m2 , scheduled for elective gynecologic laparoscopic surgery, were divided into 2 groups according to the progesterone level ( n = 20 each): follicular phase group (group F, serum progesterone concentration 0.31-1.52 ng/ml) and luteal phase group (group L, serum progesterone concentration 5.16-18.56 ng/ml). Anesthesia was induced with target-controlled infusion (TCI) of propofol and iv injection of fentanyl and cisatracurium. The initial target plasma concentration (Cp) of propofol was set at 2 μg/ml, after the Cp reached the predetermined level, the Cp increased by 0.5 μg/ml every 30 s until the patients lost consciousness and BIS value was decreased to 50. The BIS value and Cp of propofol was recorded when the patients lost consciousness. The Cp of propofol was also recorded when BIS value was decreased to 50. The patients were tracheal intubated and mechanically ventilated. Anesthesia was maintained with TCI of propofol combined with remifentanil. BIS value was maintained at 45-55 by adjusting the Cp of propofol. Results The Cps of propofol were significantly higher when the patients lost consciousness and when BIS value was decreased to 50 in group F than in group L ( P ＜ 0.05 or 0.01) . There was no significant difference in BIS value when the patients lost consciousness between the two groups (P ＞ 0.05). Conclusion Ovarian cycle can affect the sedative effect of propofol in patients, which shows that the sedative effect during the follicular phase is lower than that during the luteal phase.

BACKGROUND: Acellular vascular matrix as vascular scaffold has following advantages: acellular vascular matrix possesses complicated three-dimensional structure of natural blood vessels. Growth factor and structural domain on the surface of acellular matrix helps for cell adhesion and infiltration.OBJECTIVE: To prepare acellular vascular matrix material and to evaluate its biocompatibility in vivo and in vitro.METHODS: Trypsin and Triton X-100 were used to gradually dispose pig carotid artery and to prepare acellular vascular matrix. The biocompstibility of the material was evaluated by implantation in muscle, acute toxicity experiment and cytotoxicity test in vitro.RESULTS AND CONCLUSION: The acallular vascular matrix material possessed good chemical stability and did not release harmful factors that produced destruction and dissolution in erythrocytes, without acute hemolytic reaction or toxic effects on cell growth. The acellular vascular matrix material showed lots of inflammatory cell infiltration in eady stage of implantation, and no significant inflammatory cell infiltration in late stage of observation. Fibroblasts were visible in the acellular matrix. In addition, the acellular matrix material did not exhibit toxic effects on surrounding tissues, showing wound stage I healing. Simultaneously,histological sections demonstrated that there were good compatibility of scaffold material and surrounding tissues, without rejection. These indicated that acellular matrix material presented good biocompatibility in animals.

Objective To analyze the characteristics of erectile dysfunction(ED)in aged men.Methods Erectile dysfunction(ED)was diagnosed according to the International Index of Erectile Function(IIEF).78 aged men(average 65.9 yrs)as the study group,and 82 young patients(average 36.0 yrs)as the control group,all with ED,Were compared in complicating diseases,self-rating SDS scores,penile-brachial indexes(PBI),the time of achieving erection,and ejaculatory latency time.Results The main complicating diseases in study group were cardiovascular diseases(42 cases,53.9%),lower urinary tract symptoms(LUTS)(31 cases,39.7%)and diabetes(26 cases,33.3%).In the control group,the main complicating diseases were chronic prostatitis(52 cages,63.4%),premature ejaculation(PE)(32 cases,39.0%)and depression(12 csses,14.6%).SDS scores of study group and control group were(29.13±5.63)and(39.59±13.31),PBI were(0.78±0.12)and(0.91±0.06),the time of achieving erection were(13.85±5.75)min and(3.61±4.29)min,ejaculatory latency time were(7.03±5.35)min and(3.81±5.53)min.All with significant difference(P＜0.01).Conclusion Most of the ED old men were complicated with organic diseases,such as the time of achieving erection,PBI low scores and longer ejaculatory latency time.

sis were given.

Chitinases genes from Metarhizium anisopliae which is an important entomopathogenic fungus were considered one of the key factors to invade their hosts. One Metarhizium anisopliae HN1 strain was isolated and screened. A chitinase gene was amplified by RT-PCR from Metarhizium anisopliae HN1, The whole length of this gene was 1275bp,and the nucleotide sequence of the gene was 96% similarity to that of the M. anisopliae E6 accessed in GenBank ( AF02749). The gene has been registered in GenBank and its accession number is DQ011865. The gene was subcloned into prokaryon expression vector pET-22b( + ), transformed this recombinant expression plasmid into E. coli strain BL 21 and effective expressed. The SDS-PAGE analysis indicated that the recombinant protein was 42kDa which is same to the reported article. The expression level of recombinant protein was about 63. 3% of whole expressed proteins , And when recombinant E. coli were crushed by freeze and supersonic wave , the activity assay indicates that the chitinase expressed in bacteria possesses biological activity.

Objective To investigate the effect of glucose-based peritoneal dialysis fluids and icodextrin-based peritoneal dial-ysis fluids on the expression of TLR2 and TLR4 on huamn peritoneal mesothelial cells .Methods Human peritoneal mesothelial cell line 5 - 10 generations(HMrSV5) was cultured in DMEM /F12 medium supplemented with 10% (v/v) fetal calf serum (FCS) .Cell viability and cell proliferation were assessed using M TT method .The experiment were divided into 5 different groups :group A (control group) ,1 .5% dextrose group ,2 .5% dextrose group ,4 .25% dextrose group and 7 .5% Lcodextrin group .Icodextrin group (aikau dextrin) ,TLR2 and TLR4 expression were detected by Western blot .Results Treatment with different concentrations of glucose-based peritoneal dialysis fluids for 24 h did not affect the expression of TLR2 and TLR4 protein .In addition ,after stimula-tion for 48 h ,1 .5% dextrose ,2 .5% dextrose ,4 .25% dextrose decreased TLR2 expression by (5 .5 ± 2 .8)% ,(31 .4 ± 7 .5)% , (54 .9 ± 1 .9)% respectively ,TLR4 expression by (32 .9 ± 17 .6)% ,(47 .7 ± 13 .5)% ,(66 .4 ± 13 .5)% respectively .Stimulation for 72 h ,decreased TLR2 expression by (29 .4 ± 14 .7)% ,(38 .9 ± 9 .9)% ,(63 .5 ± 16 .5)% respectively ,TLR4 expression by(59 .5 ± 16 .8)% ,(63 .1 ± 9 .5)% ,(79 .2 ± 14 .0)% respectively .There was no significant change in TLR2 and TLR4 protein expression on 7 .5% icodextrin group .Conclusion Glucose-based peritoneal dialysis fluids ,but not icodextrin-based peritoneal dialysis fluids downregulates expression of TLR2 and TLR4 by HM rSV5 .