Objective To investigate the feasibility, indications, operating technique and the clinical value of laparoscopeic surgery for ectopic pregnancy with prior history of obstetric and gynecologic operations. Methods 82 ectopic pregnancy patients with prior history of the obstetric and gynecologic operation were subjected to laparoscopic surgery. Among them, 60 patients had undergone prior obstetric and gynecologic operation only once, 21 patients had undergone twice, and the remaining one had undergone obstetric and gynecologic operation three times. The laparoscopic operation was completed in different ways as follows: puncture and injection of drug under laparoscopy, salpingectomy, resection of pregnancy in oviduct, removal of embryo through incision of oviduct under laparoscope, suction removal of embryo from oviduct, and new technique for pregnant surgery at interstitial portion. Results Of these 82 patients undergoing laparoscopic surgery, 73 cases had adhesion in different degree, and the adhesion rate was 89.0% (73/82). In the 60 patients with history of one operation, pelvic peritoneal adhesion was found in 51 patients, the adhesion rate was 85.0%. All 22 patients with two prior operations had pelvic peritoneal adhesion, and the rate was 100.0%. The laparoscopic surgery was successful in 70 cases. The rate of success was 85.4%, while in 12 patients, the operation was changed into laparectomy due to dense adhesion, and the rate was 14.6%. Of these 12 patients, in 5 of them there was endometriosis, in 6 patients chronic pelvic inflammation was found, 9 patients had a surgical history for ectopic pregnancy, 2 patients with the history of caesarean section, and one patient had a history of complicated gynecologic operation. Complications included colonic injury in one patient with ectopic pregnancy, and the operation was changed to laparotomy. Injury to the ureter happened in one patient. The operation time for laparoscopic surgery was 30-180 min. Conclusions The laparoscopic operation is an effective procedure and it has become a routine procedure for ectopic pregnancy with prior history of obstetric and gynecologic operation. Because of chronic pelvic inflammation and endometriosis, it is difficult to perform laparoscopic surgery successfully, and laparotomy should be anticipated at all time.

Objective To conduct the endoscopic sinus surgery on chronic nasosinusitis by the image guided navigation system (IGNS) and to analyze the curative effect and complication compared with traditional methods .Methods 81 cases of chronic nasosi-nusitis were randomly selected and performed endoscopic sinus surgery by using IGNS ,and compared with the other 111 cases of chronic nasosinusitis by using traditional nasal endoscopic surgery in the aspects of curative effect ,complications ,etc .Results TypeⅠ and type Ⅱ nasosinusitis had no significant difference in the effective rate between the navigation group and non-navigation group;type Ⅲ nasosinusitis had significant difference in the effective rate between navigation group and non-navigation group .The total incidence rate of complications had significant difference between the navigation group and non-navigation group(P<0 .05);the incidence rate of complications in type Ⅰ and type Ⅱ nasosinusitis had no significant difference between the navigation group and the non-navigation group(P>0 .05);the incidence rate of complications in type Ⅲ nasosinusitis had significant difference be-tween the navigation group and the non-navigation group with statistical significance (P< 0 .05);the effective rates of Haller gas room and Onodi gas rooms showed no significant difference between the navigation group and the non-navigation group (P>0 .05);the total effective raates of anatomical deformity of the frontal recess or the sinus area had significant difference between the naviga-tion group and the non-navigation group(P<0 .05);the total effective rates of agger nasi cell had significant difference between the navigation group and the non-navigation group (P<0 .05) ,the total effective rates of non-agger nasi cell had no significant differ-ence between the navigation group and the non-navigation group (P>0 .05) .Conclusion For the patients with type Ⅲ chronic na-sosinusitis ,chronic frontal sinusitis ,conduct endoscopic sinus surgery by using IGNS is a reasonable choice ,can increase the opera-tive effect and accuracy ,and reduce the occurrence of complications .

Objective To study the relationship between extraocular muscle thickness and exophthalmos degree in patients with thyroid-associated ophthalmopathy (TAO),so as to provide a scientific basis for guiding clinical treatment.Methods Forty seven patients diagnosed with TAO from May 2005 to May 2011,in the 451 Hospital of the People's Liberation Army were chosen in this study,and divided into TAO group(23 cases) and treatment group (24 cases).Meanwhile,another 32 healthy people were selected as control.Extraocular rectus muscles (including the medial rectus muscle,lateral rectus muscle,superior rectus muscle and inferior rectus muscle) of all participants were measured with B-scan ultrasonography,and exophthalmos degree with Hertel exophthalmometer.Results The thicknesses of medial rectus in control group,TAO group and treatment group were (3.35 ± 0.25),(4.38 ± 0.85),(3.58± 0.52)mm,respectively; the thicknesses of lateral rectus muscle were (2.95 ± 0.61),(4.24 ± 0.75),(3.65 ± 0.42)mm,respectively; the thicknesses of superior rectus muscle were (3.15 ± 0.20),(4.65± 0.68),(4.01 ± 0.15)mm,respectively; the thicknesses of inferior rectus muscle were (3.17 ± 0.72),(4.75 ± 0.52),(3.71 ± 0.91)mm,respectively; the sums of binocular rectus thickness in these three groups were (21.95 ± 0.65),(28.02 ± 1.51),(22.95 ± 0.65)mm,respectively; the difference between the three groups was statistically significant(F=2.32,2.43,2.25,2.17,5.63,all P ＜ 0.05),and TAO group was significantly higher than that in the control group and in the treatment group(all P ＜ 0.05),while there was no statistically significant between the control group and the treatment group(all P ＞ 0.05).The eyes exophthalmos degree in TAO group and treatment group were (16.82 ± 2.46),(14.52 ± 1.83)mm,respectively.The sum of the rectus muscle thickness and eyes exophthalmos was positively correlated(r =0.65,0.58,all P ＜ 0.05).Conclusions Extraocular muscle thickness in patients with TAO is positively correlated with exophthalmos degree,and using B-scan ultrasonography to detect the changes is practical for clinical diagnosis and treatment.

Adult ; Female ; Hemofiltration ; Humans ; Hydrocarbons, Chlorinated ; poisoning ; Male ; Middle Aged ; Poisoning ; therapy ; Treatment Outcome

OBJECTIVETo assess the temperature variation of the root surface using Nd: YAG laser irradiation in the root canal with different power and to evaluate the safety of laser application on the periodontal region.

METHODSThirty extracted human teeth with single-roots were collected. The teeth were cross-sectioned in the cervical portion, standardizing the roots at a 12-mm length. The roots were used as specimen. The roots were radiographed in the buccal-lingual direction to measure the thickness of the proximal walls, by means of a digital radiographic system. The specimens were divided into three groups according to the laser potency (1.5, 3.0, and 4.5 W). Each group was subdivided into two subgroups according to laser frequency (15 and 30 Hz). With the Nd: YAG laser irradiation for 20 s, the temperature variation of the root surface was monitored by thermocouples located at different parts of the root external wall and recorded by digital thermometers.

RESULTSThe groups irradiated with 4.5 W presented the greatest temperature variation (above 10°C), followed by 3.0 and 1.5 W. The temperatures were statistically different (P < 0.01). The groups irradiated in the same potency, regardless of whether 15 Hz or 30 Hz was used, presented with no statistical difference (P > 0.05). The apical half of the root presented statistically higher temperature rises than the cervical half of the root (P < 0.01).

CONCLUSIONThe temperature variation of the root surface was associated with laser power, irradiation time, and the thickness of dentin. Application of Nd: YAG laser in the root at 1.5 W for 20 s can safely be used in endodontic treatment.

Aim To investigate the roles of p53-dependent signaling pathways in the process of ginsenoside Rg1 protection against 8-methoxypsoralen(8-MOP) and subsequent ultraviolet A(UVA) irradiation induced photoaging model in human dermal fibroblasts(HDFs).Methods Photoaging model was established by 8-MOP/UVA in skin HDFs.Flow cytometry, enzyme cytochemistry, immunofluorescence and Western blot were employed.Results Pretreatment with ginsenoside Rg1 could significantly reduce the amount of UVA-generated 8-oxo-dG and relieve the photoaging representation.Compared with 8-MOP/UVA treatment group, pretreatment with Ginsenoside Rg1 could decrease the expression of SA β-galatosides(SA-β-Gal), and down-regulate the level of senescence associated proteins(p16 and p21).Conclusions Ginsenoside Rg1 has prominent dose-dependent antagonism on senescence of skin HDFs induced by 8-MOP/UVA, and its mechanism may be due to its antioxidation which reduces the production of photoproducts to protect telomere against abnormal shortening.

To study in vitro anti-influenza viral activities of Chinese traditional patent medicines for influenza prevention and treatment, neuraminidase (NA) activity assay was used to examine NA inhibitory activity of 33 Chinese traditional patent medicines through fluorimetric assay, and influenza virus induced cytopathic effect (CPE) inhibition assay was used to verify their anti-influenza viral activities in vitro. The assay results showed that most liquid preparations displayed relatively high NA inhibitory activities, such as Shuanghuanglian oral liquid, Qingkailing oral liquid, Qingre Jiedu oral liquid, and Reduning injection. Among liquid preparations, Shuanghuanglian oral liquid not only displayed the highest NA inhibitory effect, but also exhibited obvious in vitro anti-viral activity in CPE experiment. Among solid preparations, Shuanghuanglian powder for injection showed the highest activity on NA inhibition, and Fufang Yuxingcao tablet showed relatively strong anti-influenza viral activity in CPE cells. From the results, it can be concluded that most Chinese traditional patent medicines possessed NA inhibitory activity, but only a few of them displayed significant in vitro anti-influenza viral activities. These results will provide important information for the isolation of active constituents, and for the clinical uses of Chinese traditional patent medicines for influenza treatment and prevention.

After several thousand years of development,TCM has formed its own sets of research methods.such as observation,comparison,classification,trial and error,and deduction,etc.Based on the unique TCM theory,experiences of clinical diagnosis and treatment of TCM,the author put forward that the research of TCM should combine macrophenomenon and microphenomenon,quality and quantity,and"Zheng"and"Xie",emphasize locality feature for the purpose of promoting the science research level.

This study is to investigate the therapeutic effect and mechanism of indole-3-carbinol (I3C) on pig serum-induced liver fibrosis of rats. The liver fibrotic model of rats was induced by pig serum. After models were successfully established, rats in the treatment groups were administered with I3C through intraperitoneal injection or curcumin by intragastric administration, daily for 17 days. Hepatic hydroxyproline (Hyp) content was measured. The liver histology and immunohistochemistry with a-smooth muscle actin (alpha-SMA) were assayed. Hepatic stellate cells line, HSC-T6 was incubated with different concentrations of I3C (25, 50, and 100 micromol x L(-1)) for 24 h. The effect of I3C on cell apoptosis was identified by FITC-Annexin V/PI double labeled assay. And the mRNA expressions of Bax and Bcl-2 were measured by real time RT-PCR. The results showed that hepatic content of Hyp decreased by I3C treatment, as compared with the fibrotic model control. Histopathological changes, such as steatosis, necrosis, deposition of collagenous fiber reduced remarkably and the expression of alpha-SMA was significantly down-regulated in the I3C-treated groups (P < 0.01). Apoptosis analysis showed that I3C significantly increased HSC-T6 apoptosis rate and the expressional ratio of Bax to Bcl-2. The results indicated that I3C could effectively cure pig serum-induced liver fibrosis in vivo by inducing HSC apoptosis and promoting ECM degradation.

Objective To investigate the clinical features and pathogenesis of severe congenital neutropenia (SCN) by detecting the gene mutation of a SCN patient suspected by clinical diagnosis. Methods The intravenous anticoagulant and clin-ical data and laboratory results of this child were collected;the phagocyte and oxidation function of neutrophils were evaluated by flow cytometry;ELANE, HAX1, WAS, GFI1, CSF3R and CXCR4 genes were screened by PCR amplification and sequencing. Results The neutrophil function of this patient was normal; sequencing results revealed no mutation occurred in ELANE, HAX1, WAS, GFI1, CSF3R and CXCR4;and granulocyte colony-stimulating factor (G-CSF) can obviously enhance the level of neutrophils. Conclusion SCN is a kind of genetic heterogeneity syndrome associated with multiple gene mutations, gene diag-nosis will contribute to understanding of the pathogenesis of the disease and provide theoretical basis for treatment. Though more and more pathogenic genes were found to be connected with SCN, the cases of unknown mutation still account for a large proportion of this disease.