Objective To explore the clinical efficacy and the influence of one-port,three-port and four-port laparoscopic cholecystectomy on quality of life in patients with laparoscopic cholecystectomy.Methods The clinical data of 60 patients with laparoscopic cholecystectomy were reviewed,and to compare the general condition,the influence of postoperative recovery and complications,disease of digestive system and the quality of life index in patients treated by one-port laparoscopic cholecystectomy(one-port group),three-port laparoscopic cholecystectomy(three-port group) and four-port laparoscopic cholecystectomy(four-port group).Results Although the time of operation in oneport group was longer than the other two groups (t =3.82,P ＜ 0.05 ; t =4.04,P ＜ 0.05),there were significant differ ences in the volume of the inoperative blood loss,hospital stay time,hospital costs in one-port group compared with the other two groups (P ＜ 0.05).There was no difference among the three groups in the incidence of postoperative complications (P ＞ 0.05).And when leaving hospital,the score of all dimensionalitis in the scale of Gastrointestinal quality of life index (CIQLI),containing the state of physiological function,state of daily life and social activities,psychological emotional state and quality of life of the total score were all higher than those in the other two groups (t =2.22,1.87,2.31,2.43,all P ＜ 0.05),and there was no difference between three-port group and four-port group(P ＞ 0.05).Conclusion Compared with the three-port laparoscopic cholecystectomy and four-port laparoscopic cholecystectomy,one-port laparoscopic cholecystectomy can reduce the inoperative blood loss,shorten hospitalization time and reduce their fee in hospital,and it also can effectively improve patients'quality of life,restore the patients'normal work and life in the shortest possible time.

Objective To study the postoperative cognitive dysfunction (POCD) in elderly patients after off‐pump coronary artery bypass grafting (OPCABG)and its risk factors ,and the association between cerebrovascular function assayed by 320 dynamic volume CT and POCD .Methods Two hundred and thirteen elderly patients selected for OPCABG were divided into patients group (n=28) and control group (n=185) .The patients underwent 320 dynamic volume CT to show their cerebrovascular ,neurological and cognitive functions .The patients were assessed on day 14 after operation .The risk factors for POCD and the association between CT perfusion imaging parame‐ters and POCD w ere comparatively analyzed .Results T he incidence of cerebrovascular disease , diabetes mellitus ,CTA‐detected severe cerebrovascular stenosis and abnormal cerebral pufusion was significantly higher in patients group than in control group (P< 0 .01) .Logistic regression analysis showed that cerebrovascular disease history and abnormal cerebral pufusion were the in‐dependent risk factors for POCD (OR= 1 .837 ,95% CI:1 .075 -3 .141 ,P= 0 .026 ;OR= 3 .224 , 95% CI:2 .073-5 .013 ,P=0 .000) .Conclusion Early detection of abnormal cerebrovascular ste‐nosis ,poor cerebral perfusion and maintainence of stable blood glucose play an important role in reducing the incidence of POCD in elderly patients after OPCABG .

OBJECTIVE:To observe clinical efficacy of acitretin combined with TGP in the treatment of psoriasis vulgaris. METHODS:81 patients were randomized into control group(n=40)and treatment group(n=41). Control group were treated with 0.5 mg?kg-1?d-1acitretin then the dose of acitretin was adjusted to 0.1～0.2 mg?kg-1?d-1after clinical symptom improved.Treat-treatment course. Blood and urine routine,liver and kidney function and the level of blood lipid of 2 groups were detected before and after 8 weeks treatment as well as ADR. RESULTS:The total response rate was 90.2% for treatment group and 62.5% for control group,there were significant difference(P

Objective To investigate and analyze the monitoring status of birth defects of perinatal infants in Hakka of Guangxi Zhuang Autonomous Region,and to provide evidence for reducing the incidence of birth defects and improving prevention decision for the quality of birth.Methods The data of 51 528 cases of perinatal birth defects monitoring were analyzed in Bobai and Luchuan counties in 2015.Results The distribution of birth defects in the perinatal infants of Hakka was more than 75.14%,28.8% of the birth defects occurred in 28 weeks,51 528 cases of perinatal birth in hospital,birth defects of ≥28 weeks in 384 cases.The incidence rate of birth defects was 28.5%, the rate of birth was 7.45‰.The birth defect of ≥28 weeks was diagnosed,35 cases were fetal edema syndrome, accounted for 9.11%.34 cases were congenital heart disease,accounted for 8.85%,30 cases were cleft lip with cleft palate,accounted for 7.81%.Congenital hydrocephalus in 5 cases,accounted for 1.30%;other in 251 cases,accoun-ted for 65.35%.The diagnosed time distribution of birth defects of ≥28 weeks:prenatal diagnosis accounted for 21.18%,postnatal 7 days accounted for 78.82%.The outcome of ≥28 weeks of perinatal birth defects in Hakka:live birth accounted for 73.18%,fetal death accounted for 20.57%,stillbirth accounted for 1.30%,seven days of death accounted for 4.94%.Conclusion The perinatal birth defects in Hakka is live births to the main,the prevention of perinatal birth defects in children live birth measures should be strengthened,the detection of birth defects should be strengthened and the pregnancy of artificial birth defects should be terminated,so as to improve the quality of the birth population.

Objective To explore the efficacy and safety of modified vaginal paravaginal repair (VPVR) in treatment of symptomatic paravaginal defect cystocele(PDCC). Methods This study was an observational case series of 52 consecutive women in Beijing hospital from January 2007 to August 2009, with symptomatic paravaginal defect cystocele. Among them, 6 patients had anterior wall colporrhaphy. Preoperative and postoperative pelvic evaluations were performed with the POP-Q system. All the cases underwent vaginal approach to paravaginal repair, 49 cases underwent vaginal hysterectomy simultaneously. Patients were followed up for 1 to 24 months. Criteria for objective cure were defined as the anterior vaginal walls at grade 0 and firmly apposing to the lateral pelvic sidewalls.Results Of the 52 patients, 30 had grade Ⅱ , 17 had grade Ⅲ, and 5 had grade Ⅳ paravaginal defect cystocele. In all patients the VPVR was performed successfully. No complication happened during and after operation. The average operation time was (65 ±18) min (45-110 min) and estimated blood loss was (95 ± 27) ml (50-200 ml). Patients were followed up postoperatively for 3 to 24months, with a mean of (10. 1±3.1) months. The PDCC recurred in 6 cases, 5 patients had grade Ⅰcystocele and 1 had grade Ⅲ cystocele. Conclusions The vaginal approach to the correction of paravaginal defect cystocele is highly effective in our population.

Objective To document peritoneal tuberculosis mimicking ovarian malignancy in elderly post-menopausal women and to review pertinent literature.Methods The records of 3 women with peritoneal tuberculosis who were managed at Beijing Hospital from January 2003 to September 2009 were reviewed.Results Three patients with peritoneal tuberculosis mimicking ovarian malignancy all presented with the classical symptoms of advanced-stage ovarian carcinoma,including ascites,abdominopelvic masses,elevated serum CA125,bloating and progressive emaciation.Two patients received laparotomy revealing peritoneal tuberculosis but no malignancy.All the patients were treated with anti-tuberculosis chemotherapy.Conclusions Medical awareness of peritoneal tuberculosis is still lacking and many women with this disease are initially thought to have ovarian malignancy and undergo unnecessary extended surgery.Laparoscopy including biopsies seems to be a sufficient and safe method to provide diagnosis of peritoneal tuberculosis.If laparoscopy is not feasible,laparotomy should be performed.Ascites and high level of CA125 do not necessarily indicate that the clinical picture is malignant in post-menopausal women.

Objective The aim of this study was to observe the anesthetic effect of xylazine hydrochloride Injection on Beagle dogs.Methods Anaesthetizing 30 healthy Beagles with xylazine hydrochloride injection, some physiological indexes of the dogs, such as body temperature (T), respiration (R), heart rate (P), and blood pressure (systolic pressure SBP, diastolic pressure DBP), were monitored.Results After using xylazine hydrochloride injection, the body temperature, respiration, heart rate, blood pressure, and peripheral vascular resistance were decreased in the Beagles.Conclusion Xylazine hydrochloride injection can keep a stable induction period, and has advantages including powerful and quick effect, simple method and operation, safe and insignificant toxicity and side effects,and has a better effect of anaesthesia.

Objective:To study the in vitro effect of adipose stromal stem cells(ASC) on phenotype and secretion of cytokines of allogenetic T lymphocytes,and to elucidate the possible roles of ASC for immunomodulation.Methods:ASC was isolated and cultured.The supernatant of ASC and ASC itself were co-cultured with allogenetic T lymphocytes.MTT assays were used to detect the proliferative rates of T cells.Annexin-Ⅴ/PI staining was used to detect apoptotic rates,and flow cytometry to detect the proportion of CD4+CD25+ cells.ELISA was used to detect the secretion of IL-10 and TGF-?1.Reverse transcription-polymerase chain reaction(RT-PCR) was used to detect the expressing level of Foxp3 gene.Results:The supernatant of ASC had no deep impact on the proliferation and apoptosis of T lymphocytes.ASC had the direct inhibitory effect on growth of T lymphocytes,while the stem cells did not affect apoptosis.Both the supernatant of ASC and ASC itself increased the proportion of CD4+CD25+ cells in T lymphocytes,and increasd the level of IL-10 and TGF-?1.They could also up-regulate expressing level of Foxp3 in T cells.Conclusion:ASC can affect the function of T lymphocytes via cell-to-cell contact and secretion of cytokines.By these ways ASC exhibits negative immunomodulation and plays an important role in inducing immune tolerance.

Objective This study examined the value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1)in serum and exhaled ventilator condensate (EVC)in early diagnosis and prognosis of ventilator-associated pneumonia (VAP). Methods A total of 37 adult patients undergoing mechanical ventilation were evaluated after treatment,including 24 patients with infection,13 without infection.Of the 24 patients with infection,10 patients were assigned to ineffective subgroup and 14 to effective subgroup.Levels of sTREM-1 in serum and EVC were measured on days 1,3,5,and 7 for all patients.sTREM-1 in serum and EVC were determined in patients by double antibody sandwich enzyme-linked immunosorbant assay (DAS-ELISA).The early diagnostic and prognostic value was assessed by receiver operating characteristic (ROC)curve analysis.Re-sults On Day 1,the sTREM-1 levels in serum and EVC did not show significant difference between the three groups (P>0.05).On Day 3 and Day 5,the level of sTREM-1 in the infection group was higher than that in the non-infection group (P <0.01).On Day 7,the sTREM-1 levels of serum and EVC in ineffective subgroup were higher than those in the effective subgroup and non-infection group (P <0.01). There were no difference between the non-infection group and effective subgroup (P >0.05).For ROC analysis,area under the curve (AUC)of serum sTREM-1 was 0.897,and AUC of EVC sTREM-1 was 0.909 on Day 3.When the cut-off value of EVC sTREM-1 was set at 4.70 ng/mL on Day 3,the sensitivity was 85.8%,specificity was 92.3%.Conclusions The results suggest that the levels of sTREM-1 in serum and EVC are conducive to the early diagnosis of VAP.The levels of sTREM-1 in serum and EVC on Day 7 are helpful for estimating the prognosis.EVC sample is easier to collect than serum.

Objective To investigate the prevalence of nutritional risk and malnutrition,and the application of nutrition support in hospitalized patients with surgically treated gynecologic malignant tumors.Methods 237 hospitalized patients with malignant tumors receiving surgery in Department of Gynecology of Beijing Hospital from January 1 to December 31,2013 were continuously sampled.Nutritional Risk Screening 2002 (NRS 2002) was performed in the morning the day after admission.NRS 2002 score ≥ 3 was considered indicating nutritional risk.Malnutrition was judged in accordance with NRS 2002.The application of postoperative nutrition support was recorded.Results The nutritional risk screening was applicable in all the patients (100％).The prevalence of malnutrition was 5.1％ (12/237) in the whole study population,9.2％ in the elderly (≥65 years),significantly higher than that in the patients ＜ 65 years (2.7％) (P =0.034).The nutritional risk rate was 21.1％ (50/237),which was 29.9％ in the patients ≥ 65 years and significantly lower in the patients ＜ 65 years (16.0％) (P =0.014).The nutritional risk rate in the patients with ovarian and endometrial cancers was higher the rate in those patients with vaginal and vulvar cancer was lower.47 patients (19.8％)received postoperative nutrition support,all being parenteral nutrition,including total parenteral nutrition in 13 patients (5.5％) and single transfusion (providing two or more than two amongs glucose,fat emulsion,andi amino acids) in 34 (14.3％).Tube feeding was not applied in all the patients.33 cases (66％) in the 50 patients with nutritional risk were supported by parenteral nutrition,while 14 cases (7.5％) in the 187 patients without nutritional risk were supported by parenteral nutrition.Conclusions There is nutritional risk in the patients with gynecology malignant tumors,the rate of which is higher in elderly patents (≥ 65 years) than in the patients of other age groups.Therefore,attention must be paid to ensure adequate postoperative nutrition support in the elderly patients.