The combination of laparoscopy and gastroscopy makes up the defects of each of them when used alone, and further extends the application range of minimally invasive techniques. A 53-year-old patient with gastric stromal tumor was admitted to the Tenth People's Hospital of Tongji University on March 4, 2011. The result of gastroscopy showed that the tumor was at anterior wall of stomach with a size of 3.0 cm×3.5 cm. the result of CT scan preliminarily diagnosed the patient with gastric stromal tumor. Partial gastrectomy with laparoscopy combined with gastroscopy was applied to the patient on March 9, 2011. The operation time was 32 minutes and the blood loss was 10 ml. The duration of hospital stay was 4 days, and no postoperative complication occurred. Laparoscopy combined with gastroscopy for the treatment of gastric stromal tumor is feasible and safe with a favorable short-term outcome.

Objective To study the role of ERK1/2 signaling pathways on the process of ACA positive abortion and explore the effect of Anziheji on ERK1/2 signaling pathways from cell proliferation.Methods Levels of ERK1/2 on maternal-fetal interface of every mice in ACA positive abortion model group,blank control group,Anziheji low,mediate,high dose group,aspirin group were detected by immunohistochemical. Results The average optical density value of ERK1 in Anziheji low dose group(0.678 ±0.097)was close to normal group(0.727 ±0.047),there was no significant difference between them.Compared with blank control group,the ERK1 average optical density value in model group(0.434 ±0.066),Anziheji dose group(0.613 ±0.041),high dose group(0.487 ±0.061)and aspirin group(0.551 ±0.056)were significantly lower,and the differences were all statistically significant(P<0.01).Compared with blank control group(0.708 ±0.038),the ERK2 average optical density values in model group(0.430 ±0.058), Anziheji low dose group(0.621 ±0.041),mediate dose group(0.562 ±0.047),high dose group(0.449 ±0.062)and aspirin group(0.515 ±0.045) were significantly lower,and the differences were all statistically significant (P <0.01 ).Conclusion Anziheji can improve the activity of cell proliferation,improve the function of the placenta and change the outcome of pregnancy through ERK signal pathway.

Neurally ajd usted ventilatory assist( NAVA) uses the electrical activity of the diaphragm as a neural trigger to synchronize mechanical ventilatory breaths with the patient′s neural respiratory drive. Some studies have shown that compared with pressure-support ventilation,NAVA can improve patient-venti-lator synchrony while maintaining spontaneous breathing,unload respiratory musculaturei n term adn prte erm i nfants.Further studies are needed to determ ine whether NA VA will have significant impact on the overall outcomes of neonates.

Mesenchymal stem cells is another adult stem cells in bone marrow apart from hematopoietic stem cells.Because of their strong self-renewal capacity and the potential of multi-lineage differentiation.mesenehymal stem cells are used more and more in the treatment of malignant diseases,such as hematological malignant diseases and extensively applied in regenerative medicine and tissue engineering.However,the exact role of mesenehymal stem cells on tumor is not completely clear.This review is about the impact of mesenchymal stem cells on tumor growth and the related mechanism.

Objective To investigate the pro-apoptotic effects of an ?1-adrenergic inhibitor,doxazosin,in HeLa cells and the role of transcription factor activator protein-2? (AP-2?) in the process.Methods The HeLa cells were treated with doxazosin (0,10,40 or 60 ?mol/L) for 16 h,and cell apoptosis was detected by flow cytometric analysis.After doxazosin (60 ?mol/L) treated the HaLa cells,the cells transfected with AP-2? overexpressing constructs or an antisense oligonucleotide against AP-2? for 16 h,the apoptosis was analyzed with FCM.The expression of AP-2? and caspase-3 in above 3 groups of cells was detected by relative quantitative RT-PCR and Western blot analysis,respectively.Results Doxazosin increased the apoptotic rate and total cell death rate of the HeLa cells,and upregulated the expressions of AP-2? and caspase-3 in a dose-dependent manner.Overexpressing AP-2? improved the increased apoptotic rate and total cell death rate induced by doxazosin,and enhanced the increased expression of caspase-3.Whereas doxazosin-induced apoptosis and the total cell death in HeLa cells were decreased by antisense AP-2?,and antisense AP-2? in part abolished the increased effects of doxazosin on caspase-3 expression.Conclusion Doxazosin induces apoptosis in HeLa cells in a dose-dependent manner,and transcription factor AP-2? is functionally involved in this process.

Objective To explore the entrapment to the deep branch of the ulnar nerve at the wrist,to assist the surgeon in diagnosis and treatment of Guyon canal syndrome.Methods Twenty fresh upper limbs were dissected on loupe(?5),to record the relationship between the ulnar nerve and the hypothenar muscles,the course of the ulnar nerve at the wrist.Results The deep branchs of the ulnar nerve go through an intermuscular space after runing out of the Guyon canal.The intermuscular space consisits of the superficial and deep head of the opponens digiti minimi and the hook of the hamate,which has one entrance and one exit.We named the intermuscular space as the hiatus of opponens digiti minimi,and named the proximal edge of the superficial head of the opponens digiti minimi as the fascial arch of the opponens digiti minimi.Conclusion We found that the fascial arch of the opponens digiti minimi can compress the deep branch of the ulnar nerve causing motor deficit of the intrinsic muscles of hands.

ObjectiveTo evaluate the marginal integrity of restoration in two types of mate- rials, or resin- modified glass ionomer cement and polyacid- modified composite resin (compomer). MethodsRestorations of four kinds of material (GC Fuji Ⅱ LC, VitremerTM, Dyract compomer and F2000 compomer) were placed in the facial Class V cavity preparations in forty noncarious human molar teeth. The teeth were randomly assigned to 4 experimental groups of 10 teeth each. After thermal cy- cling( × 20,5 ～55℃ ), the teeth were immersed in 1％ basic fuchsin dye for 24 hours at room tempera- ture. Staining along the teeth restoration interface was recorded. ResultsThe data indicated signifi- cant differences between all the restorative materials for both occlusal and gingival scores ( P=0.026, P = 0. 000)respectively. Further analysis revealed there were statistically significant differences between GC Fuji Ⅱ LC and others on occlusal margins versus Dyract compomer and others on gingival margins. Conclusion Factors such as dental conditioning, rates of water absorption and thermal coefficient were related to microleakage. Resin - modified glass ionomer cement showed less microleakage than polyacid- modified composite resin tested.

Objective To investigate the effects of median effective dose (ED50 )of ropivacaine combined with sufentanil for spinal anesthesia in elderly patients.Methods Forty-eight elderly patients (ASAⅠ-Ⅲ)scheduled for elective lower limb or perineum operation under spinal anesthesia were enrolled in this study.All patients were randomly divided into two groups:control group (group C)and sufentanil group (group S).L3-4 intervertebral puncture was selected for all patients.Anesthetic solution in group C was 0.5% ropivacaine,in group S was 0.5% ropivacaine and sufentanil,which was fixed at 5.0 μg,based on the experimental results and sequential principle.The ropivacaine dose of first patient in the control group was 9.0 mg,and in sufentanil group was 8.0 mg,followed by reducing the dose of ropivacaine,each time 1.0 mg.If the patient appeared invalid standards response,the previous one was selected as the first case. ED50 was determined by Dixon??s sequential method.Results The ED50 of sufentanil combined with ropiva-caine for spinal anesthesia in elderly patients with lower extremity or perineal surgery was 6.40 mg (95%CI:5.98-6.80 mg),ED50 of only ropivacaine was 8.42 mg (95% CI:7.79-9.03 mg).Compared with pre-dose,MAP at 3,6,15 min after treated in group C were decreased,and lower than those in group S (P <0.01).Conclusion Combined with 5.0 μg sufentanil in spinal anesthesia for lower limb or perineal surgery elderly,median effective dose of ropivacaine is reduced.

Objective Face-down positioning after vitrectomy and gas tamponade is still the standard position for patients with rhegmatogenous retinal detachment.The study was to compare the nursing effects of face-down position and flexible position after vitrecto-my for the repair of rhegmatogenous retinal detachment. Methods We investigated 120 cases of patients with rhegmatogenous retinal detachment in this study.All patients received vitrectomy with long-acting gas for tamponade, 60 patients in face-down position and 60 in the flexible position.Patients were followed up for 6 months.Observation was made on the rates of anatomical retinal reattachment and postoperative complications between the groups. Results The rates of anatomical retinal reattachment after surgery were 88.33%in the face-down position group and 100% in the flexible position group respectively.As to the satisfaction of position, the flexible position group was 100%, which was much higher than 41.67%in face-down position group(P<0.01). Conclusion Flexible position nurs-ing after vitrectomy and gas tamponade for rhegmatogenous retinal detachment repair is safe and effective.Flexible position can replace face-down position for the comfort of patients with rhegmatogenous retinal detachment after vitrectomy with gas tamponade.

Objective To establish the vascular morphology of the lymphoma of small intestine for interventional radiology and HCT diagnosis. Methods 8 cases of small intestinal autopsy specimens of normal adults, 6 cases of lymphoma specimen of bowel comfirmed by pathology were studied by angiography,pathological diagnosis and quantitative analysis with CMIAS 007 system. Results The lymphoma of bowel was poor in vascularity (P < 0.05) There were significannt difference in the blood vessels such as disorder, tortuous, interruption sign,contrast medium puddle and dyeing of mensentery compared with normal . Conclusion The study on vascular morphology of lymphoma is help for interventional radology and HCT diagnosis.