Objective:To evaluate the efficacy of laparoscopic intrafascial hysterectomy.Methods:Thirty women underwent laparoscopic intrafascial hysterectomy(GroupⅠ),29 women underwent open intrafascial hysterectomy(GroupⅡ) and 30 underwent abdominal hysterectomy(Group Ⅲ) were compared.The operating time,blood loss,postoperative pain,postoperative morbidity,time to first flatus and emiction were analyzed.Results:The blood loss was in Group I(61.00?21.95)ml,respectively,it was significantly lower than those in the GroupⅡ(121.03?53.61)ml and Group Ⅲ(101.00?21.07) ml(P0.05).Conclusion:Laparoscopic intrafascial hysterectomy is truly a minimally invasive surgery,and was associated with significantly less intraoperative bleeding,shorter hospital stay with less morbidity and shorter convalescence period.This remains the obvious advantages of laparoscopic in comparison with abdominal hysterectomy.

Objective To investigate the changes in mechanics of respiration during perioperative period in patients undergoing orthotopic liver transplantation (OLT) without venovenous bypass. Methods Thirty patients of grade Ⅱ～Ⅲ according to the American Society of Anesthesiologists (ASA) classification, undergoing orthotopic liver transplantation without venovenous bypass, were included in this study. The respiratory parameters measured perioperatively included average airway resistance, peak inspiratory pressure, peak expiratory flow rate, dynamic compliance, work of breathing and respiratory drive. The complications of respiratory system during postoperative period were observed. Results Average airway resistance was decreased after abdominal cavity opening, decreased significantly at 5 min new hepatic phase and increased postoperatively. Peak expiratory flow rate and dynamic compliance were increased gradually after induction and increased significantly at anhepatic phase and new hepatic phase but decreased significantly on the first day postoperatively. Work of breathing was decreased after induction and decreased significantly at anhepatic phase and postoperative period. There was no significant difference in peak inspiratory pressure during operation. Compared with the values preoperation, the respiratory drive was decreased significantly during anhepatic phase and new hepatic phase. Total 35 times of postoperative respiratory complications occurred, which included pleural effusion, atelectasis, pulmonary artery hypertension, pulmonary interstitial edema and pnermonia. Conclusions There are obvious changes in respiratory mechanics during perioperative period of OLT, especially in postoperative period. Mechanical respiratory support is essential for patients until respiratory function recovers.

Objective To estimate effects of AG490, a selective inhibitor of JAK2/STAT3 signaling pathway, on the biological behavior of human keloid?derived fibroblasts (HKFs), and to explore their possible mechanisms. Methods In vitro cultured human skin fibroblasts(HSFs)and HKFs were both divided into several groups to be treated with AG490 at different concentrations (12.5, 25, 50, 75, 100 μmol/L), with those receiving no treatment serving as the control group. Then, cell counting kit?8(CCK?8)assay was performed to evaluate cellular proliferative activity of HSFs and HKFs after 24?, 48?and 72?hour treatment, flow cytometry to estimate cell cycle distribution and apoptosis rate in HKFs after 24?hour treatment, reverse transcription(RT)?PCR to measure STAT3 and cyclin D1 mRNA expressions in treated HKFs as well as STAT3 mRNA expression in untreated HSFs and HKFs after 24?hour culture, and Western blot analysis to measure the protein expressions of STAT3 and p?STAT3 in HSFs and HKFs after 24?hour treatment. Results CCK?8 assay showed that the proliferation inhibition rates of both HSFs and HKFs gradually increased along with the increase in AG490 concentrations and treatment duration, and the inhibitory effects increased in both dose?and time?dependent manners(all P<0.05). Besides, when cells were treated with the same concentrations of AG490 for same durations, the proliferation of HKFs were inhibited to a greater extent than that of HSFs(all P<0.05). As flow cytometry revealed, along with the increase of AG490 concentrations, the proportion of HKFs in G1 phase and the apoptosis rate in HKFs both increased gradually(all P < 0.01), while the proportion of HKFs in G2 phase gradually decreased(all P < 0.01), and the proportion of HKFs in S phase remained insignificantly changed. RT?PCR showed that the mRNA expression of STAT3 was significantly higher in untreated HKFs than in untreated HSFs after 24?hour normal culture(P < 0.05). After 24?hour treatment with AG490, the mRNA expressions of STAT3 and cyclin D1 in HKFs gradually decreased with the increase of AG490 concentrations. Correlation analysis revealed that the mRNA expression of cyclin D1 was positively correlated with that of STAT3 in AG490?treated HKFs (r = 0.855, P < 0.01). Western blot analysis showed that the protein expressions of both STAT3 and p ? STAT3 gradually decreased in HKFs and HSFs along with the increase of AG490 concentrations(all P < 0.05), and were significantly lower in HKFs than in HSFs (both P < 0.05). Conclusion AG490 can effectively inhibit HKF proliferation by selectively blocking the JAK2/STAT3 signaling pathway.

Objective To investigate the short term efficacy of transcatheter arterial chemoembolization(TA-CE)combined with arsenic trioxide(AS203) in the treatment of primary liver cancer.Methods 91 patients with advanced primary liver cancer underwent routine hepatic arterial chemoembolization,repeated every 4 weeks for 2 to 3 cycles.In each cycle of chemoembolization,AS2O3 ,was injected intravenously once a day for 2 weeks at a dose of 10～15mg.Results All patients completed 2～3 cycles treatment and followed for more than one year.Total response rate was 61.7% and clinical benefit rate was 42 cases of partial response(PR) ,35 cases of no changes(NC) and 11 cases of progressive disease(PD).Quality of life improved in 61 cases and stabilized in 24 cases.Toxicifies was mild and tolerable.Conclusion TACE combined with arsenic trioxide in the treatment of primary liver cancer is efficient with a mild toxicities.

Secondary glaucoma is a kind of complications after vitrectomy, its etiologies are various and complex. Ineffective therapies might cause irreversible damage on optic nerves and visual field defect, even the loss in visual function. Nowadays, this project has been paid great attention by various researches both in China and abroad. Both the pathogens and therapies of secondary glaucoma after vitrectomy are analyzed as follows.

AIM:To evaluate treatment value of Xihuang Pill combined gemeitabine for advanced pancreatic cancer patients.METHODS:Thirty-two patients with advanced pancreatic cancer were randomly divided into A group and B group,treated with gemcitabine chemotherapy and traditional Chinese medicine Xihuang Pill+chemotherapy treatment,respectively.The changes of the solid tumor,serum CA19-9,physical status,clinical symptoms and toxicity were observed.RESULTS:B group(Xihuang Pill combined with gemcitabine)clinical return ratio (CR+PR+NC)was better than A group(gemcitabine).There was significant difference between two groups in the reduction of serum CA19-9 level,Karuofsky score increased,the rate of symptom improvement,Leukopenia reduction(P＜0.05).CONCLUSION:Integrating Xihuang Pill and gemcitabine in the treatment of advanced pancreatic cancer:delaying of tumor growth,reducing of CA19-9 level,improving of the clinical symptoms and life quality of patients,reducing of neutropenia in patients(chemotherapy-induced toxicity),shows good clinical benefit response.

AIM:To evaluate treatment value of Xihuang Pill combined gemcitabine for advanced pancreatic cancer patients.METHODS:Thirty-two patients with advanced pancreatic cancer were randomly divided into A group and B group,treated with gemcitabine chemotherapy and traditional Chinese medicine Xihuang Pill+chemotherapy treatment,respectively.The changes of the solid tumor,serum CA19-9,physical status,clinical symptoms and toxicity were observed.RESULTS:B group(Xihuang Pill combined with gemcitabine)clinical return ratio(CR+PR+NC)was better than A group(gemcitabine).There was significant difference between two groups in the reduction of serum CA19-9 level,Karnofsky score increased,the rate of symptom improvement,Leukopenia reduction(P

Objective To evaluate the influence of duration of laser irradiation on histomorphometric meas- urements in experimentally tenotomized and repaired rabbit Achilles tendons and to explore the best irradiation time. Methods A total of 20 male New Zealand rabbits aged 10-12 weeks were used and randomly divided into 4 groups:a control group and three experimental groups.All the animals underwent surgical excised and then repair of their Achillis tendon.The animals in the control group were then treated with sham laser irradiation,while those in the three experimental groups were treated with 10,20 and 30 minutes of He-Ne laser irradiation(632.8 nm, 18.9 mW)daily,respectively,for 14 days.On the 28th day after surgical operation,the animals were sacrificed and their Achilles tendons were sampled.HE stain and Van Geison stain were used to observe morphometric changes of tendons.The SDS-PAGE electrophoresis method and CS-930 photodensity scan instrument were employed to measure the content of typesⅠandⅢcollagen.Results it was shown that laser irradiation enhanced cell proliferation,cel- lular content,granulation tissue formation and collagen deposition in laser-treated tendons,especially in those irradia- ted for 20 minute daily,as compared to the control group.TypeⅠand typeⅢcollagen levels were significantly in- creased at the 28th day in the healing tendons and the ratio of collagenⅢtoⅠincreased in all the 3 experimental groups,and the increase of both collagen content and ratio of collagen typeⅢtoⅠwas significantly greater in those ir- radiated 20 minutes daily(P

Objective To observe the expressions of inducible nitric oxide synthase(iNOS) in the progress of rat subchronic fluorosis,and analyse the mechanism of nitric oxide(NO) free radical injnry in bone.Methods Male wistar rats were divided randomly by body weight into two groups.i.e.sodium fluoride group and control group.Sodium fluoride group was given drinking water with 150 mg/L sodium fluoride,and control group was given tap water only.The animals were bred for 24 weeks.Every four weeks some rats were killed.The contents of serum and bone fluoride were examined and analyzed.The levels of serum NO were determined by Griess Reagent.The expressions of iNOS mRNA and protein were analyzed by RT-PCR and immunohistochemistry.Results The serum NO contents significantly increased(t=9.36,P＜0.01) in NaF-treated rats after 8 weeks[(19.94±3.04)nmol/L],but significantly decreased(t=10.47,4.46,P＜0.01) after 20 weeks[(11.55±3.54)nmol/L]and 24 weeks[(20.83±2.49)nmol/L],compared with control group[(9.11±1.21,31.13±3.93,33.10±7.37)nmol/L].The expression of iNOS mRNA significantly increased(t=13.09,4.82,14.23,4.64,7.82,5.29,P＜0.01)in rats treated with sodium fluoride[(1.87±0.11),(1.87±0.78),(1.90±0.29),(1.93±0.67),(1.88±0.38),(1.84±0.03)],compared with control group[(0.41±0.25),(0.30±0.17),(0.18±0.06),(0.63±0.15),(0.66±0.04),(0.65±0.55)],and these proteins mainly appeared in hyperplasie zone and hypertrophic zone cells of epiphyseal plate,cartilages,articular cartilage cells,osteoblasts and ligament cells.Conclusions High dose fluoride might persistentlv induce the expressions of iNOS and catalyze synthesis of NO,then regulates osteoblast and osteoclast activitv and finally influences bone turnover.

Objective To observe the expressions of matrix metal proteinases-13(MMP-13) mRNA and tissue inhibitor of metal protease- 1 (TIMP- 1) mRNA and analyse the molecular mechanism of bone matrix degradation in the progress of rat subchronic fluorosis. Methods Male Wistar rats were randomly divided into two groups according to body weight, i.e. sodium floride group and control group. Rats in the sodium fluoride group were given drinking water containing 150 mg/L F-, and the animals in the control group were given tap water. The animals were bred for 24 weeks. Every 4 weeks some rats were killed. The change of obsteoclst was observed by transmission electron microscope. The expression levels of MMP-13 mRNA and TIMP-I mRNA were analyzed by RT-PCR. Results The number of lysesome and the synthesis of lysosoma enzyme in osteeclast were decreased. The expression of MMP-13 mRNA was significantly increased(t=2.29,2.41,3.07,2.52, 3.15,2.22, P<0.05) in rats treated with sodium fluoride (1.87±0.67,1.87±0.75,1.90±0.73,1.93±0.86,1.88±0.61,1.84±0.53), compared with control group(1.24±0.39, 1.19±0.27,1.07±0.22, I. 15 ~ 0.17, 1.17±0.18, 1.20±0.62). The expression of TIMP-1 mRNA was significantly increased (t=2.69,2.19,2.68,2.46,2.43,2.96, P<0.05) in rats treated with sodium fluoride(1.89±0.77,1.70±0.85,1.61±0.82,1.81±0.84,1.70±0.74, 2.06±0.96), compared with control group (1.07±0.39,0.87±0.49,0.71±0.48,0.99±0.43,0.95±0.46,0.89±0.57). Conclusion High dose fluoride might persistently induce the expressions of MMP-13 mRNA and TIMP-1 mRNA and may be involved in bone turnover.