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 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

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.

0.05),while the activities of SOD of bone tissue were lower(P

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.

OBJECTIVE:To prepare the compound tinidazole washing liquid and to establish the quality control method for this medicine.METHODS:Tinidazole and chloromycetin were taken as the chief components for the preparation of the washing liquid;the contents of the chief components were determined by the dual-wavelength spectrophotometric method.RESULTS:The linear ranges for the concentration determination of tinidazole and chloromycetin were6.4～12.8mg/L and8.0～16.0mg/L respectively;the average recoveries of tinidazole and chloromycetin were100.09%and100.00%respectively,the relative standard deviations(RSD)of which were0.17%and0.22%respectively.CONCLUSION:The preparation is simple in preparation,accurate in content determination,stable and reliable in quality.

Objective To analyze the association of DOG1 protein with gastrointestinal stromal tumors(GIST). Methods Seventy-seven patients diagnosed with GIST between January 2005 and June 2010 were enrolled. The DOG1 expression in GIST was determined using immunohistochemistry.The result was compared with that of CD117 and CD34. Results Of 77 GIST patients, the DOG1 was expressed in 74 (96.10%) patients and CD117 in 70 (90. 9%) patients, with no significant difference between DOG1 and CD117 (P＞0.05). DOG1 expression was not related to the risk stratification of the tumor, site, age and gender (P＞0. 05). Of 7 GIST patients with negative CD117,6 patients were positive for DOG1 expression. Whereas 2 of 3 DOG1 negative patients were positive for CD117 expression. Conclusions DOG1, as a novel marker for GIST,has high sensitivity as CD117. It is a good complementarity in diagnosis of GIST when combine DOG1 with CD117, especially in diagnosis of CD117 negative patients. However, the DOG1 can not be used as an index in eveluating the risk stratification of the GIST.

Objective To investigate the efficacy of pegylated interferon (Peg-IFN) plus ribavirin to treat hepatitis C virus (HCV) recurrence, and analyze possible factors associated with sustained viral responses (SVR). Methods The enrolled 39 patients, who had recurrence of hepatitis C after liver transplantation and received antiretroviral therapy, were analyzed. Treatment was discontinued in 21 patients due to side effects, and the remaining 18 patients [13 males, 5 female,median age of 54 (27-67) years, treatment duration of 25-105 weeks)] were subjected to whole standard treatment. During the treatment, HCV RNA was measured at 4, 12, 24, and 24 weeks after HCV negative change as well as drug withdrawal. SVR was defined as HCV RNA negativity within 24 weeks after the drug withdrawal. The following variables were analyzed: ages, gender,pretreatment viral load, genotype, early viral response (EVR), levels of alanine aminotransferase before treatment and their association with SVR. Results The mean treatment duration was 57weeks with an SVR achieved in 4/18 (22. 2 %). Statistical analysis revealed that the genotype of non1B (P=0.023), RNA ＜106 copy/ml (P= 0. 044) before treatment and EVR (P=0.019) were the variables associated with SVR. Conclusion Genotype of nor-1B, low level RNA before treatment and EVR were the effective predictors of interferon antiviral therapy for recurrent hepatitis C after liver transplantation.

ObjectiveTo explore the application of evidence-based nursing in ulcer pressure prevention of patients in cardiovascular surgery department and effect evaluation. MethodsEvidence-based nursing was applied to 342 patients in our department from January 2008 to October 2010,and the nursing effect was evaluated. ResultsNon of the 342 patients suffered ulcer pressure,the course of disease was shortened and the treatment effect was increased. ConclusionsApplication of evidence- based nursing in cardiovascular surgery patients can significantly reduce the occurrence of pressure ulcers,greatly improve the patients' quality of life,and also can increase the observation,analysis and problem solving ability of nursing staff.