Objective To research the clinical safety and feasibility of self-made devices in gasless laparoscopic surgery. Methods A total of 5 generations of gasless laparoscopic devices (8 models) were designed and manufactured by ourselves from April 1993 to September 2004. After animal experiments, 15 types of different gasless laparoscopic operations were carried out in 87 patients. Results Out of the 87 cases, conversions to open surgery were required in 7 cases (conversion rate, 8.0%). The other 80 cases of gasless laparoscopic operations were successfully performed, involving cholecystectomy, colorectal resection, partial cecectomy, subtotal gastrectomy, inguinal herniorrhaphy, abdominal wall contraction, radical resection for carcinoma of renal pelvis, haital herniorrhaphy with Toupet’s fundoplication and total hysterectomy. Conclusions Our self-made gasless laparoscopic devices may be applied safely and effectively in clinical cases. Gasless laparoscopic surgery has been reflecting the complementary advantages of modern laparoscopic surgery and traditional open surgery. It is of supplementary significance in patients contraindicated to pneumoperitoneum and of distinctive importance for laparoscopic gastrointestinal surgery requiring abdominal fistulization or prolonged incision, as well as hand-assisted hepatobiliary or pancreatic laparoscopic surgery.

0.05). There was significant differences between the two groups in incidence of ADRs (4.2% in Group A versus 27.6% in group B;P

Objective To explore the effects of botulinum toxin type A (BTX-A) on the F-waves of the tibial nerve and the walking ability of stroke patients.Methods Twenty stroke patients with spastic hemiplegia of a lower limb were randomly divided into experimental and control groups with 10 patients in each group.All received four weeks of conventional rehabilitation,including walking training,balance training and muscle strength training.In the experimental group,a total of 300 IU of BTX-A was injected into the gastrocnemius (200 IU) and soleus muscles (100 IU)before the start of routine rehabilitation,guided by using the electrical stimulation.Muscle tone was assessed using the modified Ashworth scale(MAS).Walking ability was assessed with the timed up and go test (TUGT) and a 10 m free walking test.F-wave parameters were recorded in the tibial nerve before,two weeks and four weeks after the injection.Results In the experimental group there was a significant difference in F-wave amplitude between those recorded before treatment and after two weeks of treatment.The control group showed no statistically significant difference.In experimental group there was also a statistically significant difference in triceps muscle tension before and after treatment which was not observed in the control group.Walking ability improved significantly in both groups.Conclusions Local injection of BTX-A into the lower limbs can reduce the F-wave amplitudes of spinal cord motor neurons.BTX-A injection combined with rehabilitation training can significantly improve the walking ability of stroke patients.

Angina Pectoris ; prevention & control ; Coronary Disease ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; History, Ancient ; Humans ; Medicine, Chinese Traditional ; methods ; Phytotherapy ; history ; methods

Humans ; Inflammation ; drug therapy ; metabolism ; MicroRNAs ; metabolism ; Stilbenes ; pharmacology ; therapeutic use

Objective To study the mechanism by which a high-intensity pulsed electromagnetic field (HIPEMF) (0.1 Hz,4 T,8 pulses) facilitates the proliferation of neural stem cells by detecting the expression of β-catenin genes and protein.Methods Neural stem cells (NSCs) were isolated from the sub-ventricular zone (SVZ) of neonatal rats and cultured in supplemented,serum-free medium for two weeks.The NSCs were then divided into an experimental group exposed to a HIPEMF for 8 pulses and a control group given sham stimulation.The gene and prorein expression of β-catenin in the NSCs were assayed by RT-PCR and Western blotting on the 1st,3rd,5th and 7th day after the stimulation.Results The NSCs' cloned spheres were round and translucent,and showed red fluorescence after staining with anti-nestin (cy3).The RT-PCR results showed β-catenin genes were highly expressed in the exposed group (significantly more than in the controls).The Western blotting showed that expression of β-catenin protein was also higher in the experimental group,especially at the 7th day after stimulation,a difference which was also statistically significant Conclusion HIPEMF at 0.1 Hz,4 T,in 8 pulse trains can promote NSC proliferation,perhaps through the Wnt/β-catenin signaling pathways.

The concentration of precursors for the production of taxol with Fusarium mairei K178 was optimized by response surface methodology.Firstly,Plackett-Burman design was undertaken to evaluate the effects of eight factors.With statistic regression analysis,the significant factors affecting taxol production were determined as follows: phenylalanine,sodium acetate and sodium benzoate.Box-Behnken design was used to optimize the three critical internal factors mentioned above,and the optimum concentration levels and the relationships among these factors was found out.By quadratic regression model equation with Design-Expert statistic methods,the optimal concentration of the variables were determined as: phenylalanine 2.8mg/L,sodium acetate 3.3g/L,sodium benzoate 31.8mg/L.Under such conditions,the taxol production was increased to 242.6?g/L,which was 15.6% higher than the maximum value in the single factor tests.The experiment values under the optimal conditions agreed with the predicted values,which indicated that the model was proper and effective.

Objective To assess the implementation of essential public health services (EPHS), and determine the main influencing factors for EPHS in Menglian. Methods In September 2012, the questionnaire survey method was employed to collect the data of EPHS implementation in 2011 in three community medical institutes and the EPHS evaluation of health staff sampled by stratified random sampling in Menglian. Results In 2011, the report rates of infectious diseases epidemics, public health emergencies and health inspection were all 100%, the inoculation rates of most vaccines were over 90%,and the health management rates of the children aged 0 to 6 years,pregnant and lying-in woman,aged population,hypertensives, type 2 diabetes patients and serious psychotics were high (about 85%) . The establishment rate of heath archives (60%to 70%),the controlling rates of blood pressure in the hypertensive population (about 50%), the rates of glycemic control in type 2 diabetes patients (55%to 70%) and the steady rates of serious psychotics (50% to 60%), however, were low. The implementation of EPHS was unbalance among towns, suburbs and outer suburbs. The main factors that influenced the EPHS implementation were inadequate human resources, insufficient or unused health devices, ambiguous responsibilities among the health institutes, non-cooperative behaviors, and unhealthy living habits in rural residents. Conclusions The implementation of many EPHS items is good. For promoting EPHS,it is necessary to train human resources,activiate unused health devices,get support of residents and carry out health education.

OBJECTIVE To investigate the distribution and the resistance of pathogens from the children with VAP in PICU,and to analyze the reasons of antibiotics resistance of the pathogens.METHODS The sputum obtained from the children with final diagnosis of VAP in PICU was cultured and identified from Jan 2005 to Dec 2006.The resistance of the bacteria identified to antibiotics used frequently was determined by Kirby-Bauer method.RESULTS A total of 187 strains were isolated from sputum specimens,of which Gram-negative bacilli and Gram-positive cocci accounted for 76.5% and 23.5%,respectively.Acinetobacter baumannii(17.7%),Escherichia coli(16.0%),Pseudomonas aeruginosa(15.0%) and Klebsiella pneumoniae(13.9%) were the most frequently isolates of Gram-negative bacilli.Their resistant rates to ?-lactam antibiotics were high,especially the ESBLs-producing strains in E.coli and K.pneumoniae.The Staphylococcus epidermidis(5.9%),Staphylococcus aureus(4.8%) and Enterococcus faecalis(4.3%) were the most common strains of Gram-positive cocci.No vancomycin-resistanct strains were found,but resistance rates to ?-lactam antibiotics and other antibiotics were high in S.epidermidis and S.aureus.CONCLUSIONS The main strains cultured from the sputum specimens of children with VAP in PICU are Gram-negative bacilli with high resistance rates to antibiotics,especially the ESBLs producing bacilli to ?-lactam antibiotics.Staphylococcus are the main Gram-positive cocci.

Objective To analyze the application value of MSCT enhanced scanning in diagnosis of gastrointestinal mucoca associated lymphoid tissue(MALT) lymphoma.Methods 11 cases of gastrointestinal MALT lymphomas confirmed by pathology were analyzed retrospectively.The clinical data and imaging features of 11 cases were analyzed,including lesion sites, morphologic features and enhancement patterns of tumors,positions of lymph nodes,involvement of extranodal site excluding gastrointestinal tract.Results For morphologic features,8 cases (72.7%) were gastrointestinal wall thickening type, among them, 5 cases occurred in the stomach and 3 cases in the intestine;3 cases (27.3%) were localized mass/nodule type, among them, 2 cases occurred in the stomach and 1 case occurred in the intestine.The sign of aneurysmal dilatation was showed in 2 cases, which occurred in the intestinal tract.There was 1 case of localized mass/nodule MALT lymphoma in the ileocecal junction with local intestinal lumen stenosis.For the manifestations of enhanced scanning,10 cases (90.9%) of tumors were moderately or obviously enhanced, 9 cases (81.8%) showed homogeneous enhancement.For the involvement of lymph nodes and other extranodal organs, regional lymph nodes were involved in 5 cases(45.5%), regional lymph nodes and distant lymph nodes were involved in 1 case(9.1%), lymph nodes of both sides of the diaphragm were involved in 1 case (9.1%), extranodal sites excluding gastrointestinal tract were involved in 2 cases (18.2%).9 cases (81.8%) were classified as stage Ⅰ-Ⅱ, 2 cases (18.2%) were classified as stage Ⅳ.Conclusion MSCT enhanced scanning can provide a reliable basis for the diagnosis and staging of gastrointestinal MALT lymphoma.The chest and abdominopelvic cavity enhanced scanning is recommended as a routine examination.