Objective To investigate the feasibility and safety of laparoscopic myomectomy in patients with large uterine myoma and the tumor located at special sites. Methods A retrospective study of 142 patients underwent laparoscopic myomectomy was done.In the patients,all the myomas were ≥10 cm in diameter;located at the cervix,uterus posterior wall near to the isthmic uteri,or broad ligament.The procedure was completed according to the volume and location of the tumors.For large myomas,the muscle layer was resected to remove the tumor,after removing the major part of the lesion(cut into pieces before moving out),the rest small parts were cut completely.Ligation was used for large tumors with sufficient blood supply in the surface or subserous myomas.For the myomas located in the broad ligament,the ligament was opened to pull out the tumor,and then the tumor was cut into pieces and resected at the root. Results The procedure was completed by laparoscopy in all of the patients,except in one who received laparoscopy-assisted resection.The removed tumors weighed 44 to 1903 g.The operation time ranged from 30 to 175 minutes.Intraoperative blood loss was 10 to 800 ml.No serious complications occurred.Among the cases,follow-up was available in 68 patients for 2 years.During the period,ultrasonography showed recurrent myoma in 2 patients. Conclusions With the improvement of the skills of laparoscopic myomectomy,indications for the laparoscopic operation can be widened.

Aim To investigate the effects of Cariporide on expression of intercellular adhesion molecule-1(ICAM-1) and P-selectin and adhesion of monocytes and endothelial cells induced by lysophophatidylcholine(LPC).Methods The ratio of adhesion of monocytes and endothelial cells was assessed by measuring protein content.The expression of ICAM-1 and P-selectin in endothelial cells was examined by enzyme-linked immunosorbent assay(ELISA).Intracellular pH of endothelial cells was measured with 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein(BCECF).Results The results showed that LPC enhanced the adhesion of monocytes and endothelial cells in a concentration-dependant and time-related manner.The dosage of 5,10 and 20 ?mol?L-1 Cariporide reduced the adhesive ratio of endothelial cells induced by LPC(5 mg?L-1)from 36% to 23%,18% and 16%(P

Lapareseopic colectomy is commonly performed,but laparoscopic extended right hemicolectomy with D3 lymphadenectomy for cancer located at hepatic flexure of the colon is a complex procedure,even in the hands of experts.Laparoscopic dissection of the lymph nodes around the middle colonic and right gastroepiploic vessels are so complicated that precise vascular anatomy and surgical plane are essential to complete this procedure safely.We herein describe a standard technique for performing laparoscopic extended right hemicolectomy with D3 lymphadenectomy using a medial-to-lateral approach.The main surgical plane of this procedure is the right Toldt's space.The superior mesenteric vein (SMV) is the most important anatomical landmark of vascular dissection.Medial-to-lateral approach makes it easy to locate the right Toldt's space and the SMV.

Objective: To assess the tissue reactions of dogs to a new nanohydroxyapatite. Methods:Three dogs were used for root canal filling experiment, mandibular implanting and subcutaneous implanting experiment. AH-plus root canal sealer was used as control. The dogs were killed after implantation for 2,4 and 12 weeks separately. The tissue reaction was assessed by X-ray and light microscope examination. Results:①Root canal filling experiment: no inflammatory reaction was detected in specimens of n-HA group. In AH-plus group, implantation caused a middling inflammatory reaction after 2 weeks and 4 weeks. After 12 weeks the reaction of apical tissues was slight. ②Mandibular implanting experiment: no inflammatory reaction was showed by all n-HA groups and the group of AH-plus implanted for 12 weeks.Mild inflammatory reaction was observed in the groups of AH-plus implanted for 2 weeks and 4 weeks.③ Subcutaneous implanting experiment:after AH-plus was implanted for 2 weeks and 4 weeks, middling inflammatory reaction was observed. The group of n-HA implanted for 2 weeks showed the same reaction. No obvious inflammatory reaction was found in the other groups. Conclusion:n-HA shows better tissue compatibility than AH-plus.

BACKGROUND: It is believed that repetitive transcranial magnetic stimulation (rTMS) may produce such neurophysiological effects as regulating regional cerebral blood flow, neurotransmitters, local metabolism, and neuronal remodeling after nerve tissue injuries. The prognosis ofischemic stroke is related with the cortical function reconstruction in the ipsilateral and contralateral hemisphere of the lesion. Currently studies have not defined whether rTMS can affect the cortical function, protect ischemic neurons and promote motor functional recovery after cerebral ischemia.OBJECTIVE: To investigate the effects of rTMS on rat motor cortical excitability and neural function in acute stage of cerebral ischemia-reperfusion injury.DESIGN: Completely randomized experiment.SETTING: Electroneurophysiological Laboratory of Peking Union Medical College Hospital.MATERIALS: The experiment was completed in the Zoological Research Center of Peking Union Hospital from January to June 2004. Totally 22adult male healthy Wistar rats were randomly divided into treatment group and the control group with 11 in each.METHODS: After determination of the average motor threshold of the right hind limbs, which was 22% of the maximum output, the rats were subjected to middle cerebral artery occlusion for 1 hour followed by reperfusion for 72 hours. At each time point of immediately and at 12, 36 and 60 hours after the initiation of reperfusion, the rats in the treatment group received rTMS treatment (20 Hz, 40% maximum output, 5 seconds for each session with an between-session interval of 2 minutes for a total of 10 sessions), and the site for motor threshold evaluation was used for rTMS stimulation; the rats in the control group recevied no treatment after model establishment. Motor threshold testing was performed in both groups 4 hours after the last session of treatment to avoid immediate-early effects of rTMS on the motor threshold. At 24 and 72 hours of reperfusion, the scores of neural function were recorded according to evaluation systems. All the rats with scores between 1 and 3 were enrolled in statistical analysis were evaluated between.MAIN OUTCOME MEASURES: ① Motor threshold of the rats in both groups before and after injury; ② Neural function scores at 24 and 72 hour reperfusion; ③ Infarct volume at 72 hour of reperfusion.RESULTS: Totally 13 rats entered the final result analysis. Before injury,motor threshold in the treatment and control group was similar (P=0.71),and after the injury, the motor threshold of the control group was 1.49times that of the treatment group but such difference was not statistically significant [(41.62±24.73)% vs (28.00±9.35)%, t=-1.17, P=0.27]. At 24hours of reperfusion, the functional scores of the treatment group and control group were not significantly different (P=0.46), but at 72 hours, the scores of the treatment group were significantly lower than that of the control group (1.60±1.52 vs 7.75±3.62, t=-3.57, P=0.004). The average infarct volume of two groups was (62.00±60.88) mm3 and (20.00±12.41) mm3 at 72 hours of reperfusion, respectively, which, after logarithm transformation,was not significantly different between the two group (t=-1.31, P=0.22),but when the infarct volume was transformed into Log10 values, a significant difference occurred between them (P=0.045).CONCLUSION: rTMS may stabilize and prevent the increment of the motor threshold, time-dependently relieve the neural function disability and reduce the infarct volume after cerebral ischemia-reperfusion injury.

Objective To study the pharmacological effects of Qinggong Decoction on sedation and hypnosis. Methods Fifty mice were randomly divided into five groups: NS group, diazepam group, and low-, mid-, high-dose Qinggong Decoction group. Diazepam group was given 0.1 mL/10 g diazepam, and other four groups were given 0.2 mL/10 g corresponding drugs. Spontaneous activities before and after ig. were recorded and the sleeping time of mice with pentobarbital sodium (superthreshold dosage) and the number of the sleeping mice with pentobarbital sodium (subthreshold dosage) were measured. Convulsion model induced by nikethamide was used to observe the change of the seizure rate in mice after given Qinggong Decoction. Results Qinggong Decoction (3.0, 6.0 g/kg) could obviously inhibit spontaneous activities of mice, prolong the sleeping time of mice with pentobarbital sodium (superthreshold dosage) and increase in the number of the sleeping mice with pentobarbital sodium (subthreshold dosage), and had markedly anticonvulsant effect in mice induced by nikethamide. Conclusion Qinggong Decoction has obvious effects of sedation, hypnosis and anticonvulsion.

Objective To study the feasibility of tubal reversal after sterilization by laparoscopy.Methods From May 2002 to December 2005,31 patients with tubal ligation received laparoscopic tubal reversal by one-core or two-dot apposition and demixing suture of the serosa.Results The laparoscopic tubal reversal was successful in all the 31 cases.Thirty of the patients were followed up for 8-24 months(mean,16 months);27 of them had intrauterine gestation,3 were non-pregnant;none of them had ectopic gestation.Conclusions Laparoscopic tubal reversal after sterilization can satisfy with the desire and principle of microsurgery.It is feasible for clinical application and has good outcomes.

OBJECTIVE To investigate the hand hygiene situation of medical staff in order to carry out supervising and monitoring on their hand hygiene pertinently.METHODS The hand hygiene monitoring data from Jan 2004 to Dec 2007 were retrospectively analyzed.RESULTS The total qualified rate of medical staff hand hygiene was 91.4%;the qualified rate of hand hygiene monitoring for doctors was 89.8%,and it was 96.7% for nurses;the qualified rate of medical staff working in the type-Ⅱenvironment was 93.6%,and the qualified rate of those working in the type-Ⅲ environment was 95.2%;for medical students and refresher doctors,it was 81.0 %.CONCLUSIONS The medical staff still lack the knowledge on hands' cleanliness and disinfection.The supervisors should strengthen monitoring on hand hygiene;some new regulations should be established and practiced,and the hand washing equipments should be updated;the medical staff's compliance of hand hygiene should be improved,and their conceptions of hand hygiene should be strengthened;all-sided originalities on hand hygiene should be carried out in order to reduce the occurring of hospital infections.

AIM: To study the effect of peach seed (semen Persicae) on gene expression of mouse with sarcoma 180 by means of DNA microarray. METHODS: DNA microarrays were made by spotting PCR products of 4096 mice cDNA noto a specially treated glass slides. The probes were prepared by labeling experimental and control group tumor tissue mRNA with Cy3 dUTP and Cy5 dUTP separately through reverse transcription. The arrays were then hybridized against the cDNA probe mixture and the fluorescent signals were scanned. The data obtained were analyzed from two repeated experiments. RESULTS: 64 genes were obtained by computer processing. CONCLUSION: These genes identified through this approach are considered as potential candidates for PSPA anti tumor effect.

Objective:To investigate the value of serum matrix metalloproteinases- 9(MMP-9) level in the diagnosis of recurrence of endometriasis(EMs) after operation.Methods:Sixty-nine patients who had a previous operations for endometriosis were recruited in the study from February 2002 to March 2005. All the patient were examined by laparoscopy 6-12 months later after surgery. The serum were collected from the 69 patients and 25 health women for MMP-9 level measurement. ELISA was used to measure the level of serum MMP-9.Results:Twenty-two recurrent patients were diagnosed by Laparoscopy. The level of serum MMP-9 were 252.21?17.90 ng/ml in patients with recurrent endometriosis, 31.26?1.84 ng/ml in patients without recurrent endometriosis, 12.93?0.57 ng/ml in women without endometriosis. There was a clinical significance between the recurrent endometriosis group and non-recurrent endometriosis group and health women. The sensitivity for detection of recurrent endometriosis was 90.9% and the specificity was 85.1% using serum MMP-9 profile.Conclusion:Serum MMP-9 measurement is a sensitive, specific and non-invasive methods for the diagnosis of recurrent endometriosis.