Objective To explore the curative effect of the umbilical single port laparoscopic salpingectomy for tubal ectopic pregnancy.Methods 296 cases with tubal pregnancy were divided into single-hole group and the conventional group.Mter the operation,incision cosmetic results and patients'satisfaction were compared and analyzed in two groups.Results (1) The anal exhaust time of single hole group and conventional group was (32.6 ± 11.6) h,(34.1 ± 10.2) h (P =0.883).The intraoperative blood loss was (48.7 ± 15.2) ml (41.5 ± 10.9) ml (P =0.313).There was no significant differences(P ＞ 0.05).Operative time of single hole group was (62.6 ± 21.6) min,which was longer than that of the conventional group (42.7 ± 17.6) min,the difference was statistically significant (P =0.000).The ambulation time and demand analgesia patients of single-hole group were significantly lower than the conventional group(P =0.003,P =0.001).(2) In single-hole group,cosmetic results determined a good rate of 96.8％ and patients expressed dissatisfaction rate of 1.2％.cosmetic results of the conventional group judged good rate of 86.4％.patients expressed dissatisfaction rate of 9.3％.The judged good rate of cosmetic results between the two groups had statistically significant difference (P =0.004),and patients expressed dissatisfaction rate of single-hole group was lower than the conventional group.Conclusion For patients with tubal pregnancy,the trekking transumbilical single hole laparoscopic salpingectomy is a more minimally invasive,feasible and safe gynecological surgical procedures and with better cosmetic results,although there is a certain degree of difficulty.

Objective To investigate values of Wb -dwi on diagnosis of osseous metastases compared with Spect materials.Methods 20 cases with osseous metastases underwent Wb -dwi and Spect.The bones were divided into 6 groups:skull,collarbone,trunk bone,haunch bone,upper limb bone,lower limb bone.the high uptake regions on Spect and high signal on Wb -dwi for positive groups or positive lesions were recorded.Meanwhile,the total num-bers of positive groups and positive lesions in different groups were also recorded.Finally,the diagnostic sensitivity and specificity of Wb -dwi and Spect were calculated,which was based on the total numbers of positive groups. Results Wb -dwi showed 69 positive groups,the numbers of positive lesions in each group were 2,1,85,55,22,12. Spect showed 66 positive groups,the numbers of positive lesions in each group were 4,3,79,47,20,18.The diagnostic sensitivity and specificity on Spect were 81.1%,80.3%.The diagnostic sensitivity and specificity on Wb -dwi were 86.9%,84.3%.No statistical difference was assessed between the sensitivity and specificity of two methods. Conclusion Compared with Spect,the Wb -dwi can show more osseous metastasis lesions and has higher sensitivity on diagnosis osseous metastases.In additional,it can demonstrate primary tumors and extraskeletal metastasis lesions.

[Objective]To study the clinical result of Endo-Model rotating-hinge prosthesis in the treatment of severe knee deformity. [Method]Twenty-two patients(10 males and 12 females;12 right knees,8 left knees,and 2 bilateral knees) were selected for total knee arthorplasty using Endo-Model rotating-hinge prosthesis.The average age was 56.2 years.All the patients were evaluated by HSS score system.[Result]All incisions healed at one-stage and all malformations were corrected.The functional result was good.Mile deep vein thrombosis was found in one case after operation.All the patients were followed up for 6-55 months.No infection or prosthetic loosening was developed.[Conclusion]Endo-Model rotating-hinge prosthesis is an effective and reliable prosthesis for severe knee deformity.

OBJECTIVEThis paper aims to study the effects of gossypol acetic acid (GAA) on proliferation and methylation level of human MutL homologue 1 (hMLH1) gene in human tongue cancer cell line Tca8113.

METHODSThe MTT assay was used to determine the effects of the acid on the proliferation inhibition in Tca8113 cells treated with different GAA concentrations. Nested methylation-specific polymerase chain reaction (nMSP) was used to detect the change in the methylation level of hMLH1 after 48 and 72 h with 30 and 15 micro mol L(-1) GAA treatment.

RESULTSMTT assay results showed the growth and proliferation inhibition of Tca8113 cells in the experimental GAA group after 24 h to 72 h of GAA treatment. The nMSP results indicated that the average optical density of hMLH1 in the Tca8113 cells significantly changed after the GAA treatment (30 micro mol L(-1) GAA for 48 h and 15 micro mol L(-1) for 72 h) (P<0.05) compared with that of the control group.

CONCLUSIONGAA does not only inhibit Tca8113 proliferation but also has a demethylation effect on the hMLH1 gene. These phenomena may be part of an underlying tumor-suppression mechanism of GAA.

Background Spectral-domain optical coherence tomography (SD-OCT) can quantitatively analyze some ocular parameters in vivo.Although human ocular parameters have been obtained by SD-OCT,few studies were performed in animal experiment.Objective This study was to investigate the anterior and posterior segment parameters of C57BL/6 mice and pigmented rabbits using SD-OCT in vivo.Methods Some anterior and posterior segment ocular parameters,including the central corneal thickness (CCT),anterior chamber depth (ACD),white-to-white (WTW),optic nerve head (ONH) depth/width and retinal thickness,were measured in 8 eyes of 4 health SPF C57BL/6 mice and 12 eyes of 6 health SPF pigmented rabbits using SD-OCT.Results For C57BL/6 mice,Cornea,iris,lens in pupil area were clearly exhibited by SD-OCT.Mean CCT,ACD and WTW were (96±9)μm,(460±8) μm and (2.86 ± 0.41) mm pre-mydriasis,respectively,the corresponding values of post-mydriasis were (96±8) μm,(356±20)μm and (2.87±0.62)mm.There were no statistical differences of CCT and WTW between pre-and post-mydriasis (t =0.478,P =0.647 ; t =-0.737,P =0.485).ACD of post-mydriasis was significantly shallower than that of baseline (t =-13.022,P＜0.001).For the pigmented rabbits,the thickness of corneal thinnest point,retinal thickness,ONH depth and width were (370 ± 10) μm,(175 ± 4) μm,(1.35 ± 0.51) mm and (4.52±0.82) mm,respectively.Conclusions As a non-contact and non-invasive technology,SD-OCT can provide not only high resolution cross-sectional ocular images,but also high precise quantitative parameters for both C57BL/6 mouse and pigmented rabbit in vivo.

Objeetive To evaluate the protective effects of decorin on the inner blood-retinal barrier function under high-glucose plus hypoxia conditions,and explore its potential mechanism.Methods The human umbilical vein endothelial cells (HUVEC) were cultured,and the effect of decorin with different concentrations on HUVEC viability was determined by using the cell counting kit-8 assay (CCK-8).At different hours after incubation under high-glucose plus hypoxia conditions (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),the suppression effects of various concentrations of decorin on the vascular endothelial growth factor (VEGF) expression of HUVEC was detected by enzyme-linked immunosorbent assay (ELISA).HUVEC were divided into normal control group (5.5 mmol · L-1 D-glucose),high-glucose plus hypoxia group (25 mmol · L-1 D-glucose + 100 μmol · L-1 CoCl2),mannitol control group(5.5 mmol· L-1 D-glucose +19.5 mmol · L-1 mannitol) and decorin treatment group (25 mmol · L-1 D-glucose+ 100 μmol · L-1 CoCl2 + 100 nmol · L-1 decorin).HUVEC barrier function was evaluated by detecting transepithelial electrical resistance (TER) and permeability of fluorescein isothiocyanate-dextran (FITC-dextran).The content of tight junction proteins (claudin-5,occludin,and ZO-1) and p38 mitogen-activated protein kinase (MAPK) phosphorylation were examined by Western blotting.Results According to the results of CCK-8,the survival rates of HUVEC in all groups were more than 90％,different concentrations of decorin showed no significant effect on HUVEC survival (all P ＞ 0.05).According to the results of CCK-8 and ELISA,the stimulation of hypoxia for 48 hours and 100 nmol · L-1 decorin was taken as the condition of further experiment.At 14 days,TER of HUVEC reached its peak of (170.67 ±9.07) Ω.TER of high-glucose plus hypoxia group (97.33 ±6.11)Ω was significantly lower than that of decorin treatment group (157.67 ± 11.72)Ω (P ＜0.05).The FITC-dextran permeability of high-glucose plus hypoxia group increased to (2.12 ±0.07) times of normal control group(P ＜0.05).Decorin reversed this effect to (1.16 ± 0.03) times of normal control group (P ＜ 0.05).The expression of claudin-5,occludin and ZO-1 in high-glucose plns hypoxia group were 0.38 ±0.05,0.43 ±0.02,0.25 ± 0.02,compared to the normal control group (0.72 ±0.05,0.90 ±0.01,0.75 ±0.02),there were statistical differences (all P ＜0.05).The expression of claudin-5,occludin and ZO-1 m decorin treatment group were 0.65 ±0.08,0.87 ±0.03,0.60 ±0.01,there were statistical differences compared with high-glucose plns hypoxia group (all P ＜0.05).The ration of p-p38 MAPK/p38 MAPK in high-glucose plus hypoxia group (0.88 ± 0.02) was increased,while the decorin treatment group (0.58 ± 0.04) reached the level of the normal control group (0.56 ±0.02),there was statistical difference compared with high-glucose plns hypoxia group (P ＜0.05).Conclusion Decorin can protect the HUVEC barrier function under high-glucose plus hypoxia conditions and inhibit the activation of p38 MAPK signaling pathway.So it may be used to treat diabetic retinopathy.

Objective:To evaluate the effectiveness of microport extraction of the impacted mandibular third molar removal.Meth-ods:According to the systematic review and meta-analysis,the randomized controlled clinical trials published till October 2012 were searched and collected using the method of evidence-based medicine.Results:8 clinical research papers including 1 915 subjects were collected.Complication of microport extraction(958 cases)was less than that of traditional operation(957 cases).Conclusion:Microport extraction of impacted mandibular third molar may reduce the complications.

Objective To analyze the incidence and risk factors of microalbuminuria in newly diagnosed and hospitalized type 2 diabetes mellitus patients,and to provide the theoretical basis for therapy of diabetes and diabetic chronic complications.Methods The blood glucose,lipid profile,24h-urinaryalbumin,fasting and postprandial serum insulin and peptid C were measured in 286 newly diagnosed and hospitalized type 2 diabetic patients from Mar.2006 to Sep.2009.Microalbuminuria was defined as the 24h-urinary albumin between 30 to 300 mg twice.Insulin resistance index (HOMA-IR) was recorded and all the patients received fundus examination by ophthalmologists after expansion of the pupil to ensure whether there was retinopathy or not.Results (1)The incidence rate of microalbuminuria in this study was 19.58％ (56/286).(2)Normal albuminuria group and MA group combined DR were 19.57％ (45/230) and 33.93 ％ ( 19/56 ) respectively,and the difference was statistically significant( x2 =5.349,P =0.021 ).Compared with control,the FPG,HbA1c and HOMA-IR were significantly higher in microalbuminuria group ( FPG:[ 11.08 ± 1.76 ] mmol/L vs [9.24 ±1.65]mmol/L,t =-6.148,P ＜0.001;HbA1c:[11.54 ± 1.59]％ vs [9.39 ± 1.64]％,t =-7.533,P ＜0.001 ;HOMA-IR:[3.73 ±0.42] vs [3.50 ±0.30],t =-3.774,P ＜0.001 ).(3) Pearson correlation analysis revealed microalbuminuria was positively correlated with FPG( r =0.460),HbA1 c ( r =0.499),HOMA-IR( r =0.308)and combined DR(r =0.405)(P ＜0.01).(4)Stepwise multiple regression analysis revealed that FPG (ββ =- 0.804,P ＜ 0.01 ),HbA1 c (β =- 0.455,P ＜ 0.01 ) and combined DR (β =1.527,P ＜ 0.05 ) were independently risk factors of microalbuminuria.Conclusion The development of microalbuminuria in newly diagnosed and hospitalized type 2 diabetic patients is associated with FPG,HbA1c and HOMA-IR,and will be easier to merge diabetic retinopathy.

Objective To evaluate the feasibility of using a microsensor motion capture unit (MCU) to assess the reaching characteristics of hemiplegic stroke patients. Methods Twenty-three hemiplegic stroke patients with an average age of (61 ± 11) years and ten normal subjects of matching age were asked to sit on a chair and use the affected arm (for the patients) or the right arm (for the normal subjects) to reach for a cup on a table just in front of the shoulder at arm's length away.Four small sensor boxes which could detect movement and its speed and smoothness in three dimensions were fixed to the subject's spine,upper arm,forearm and hand.The test was repeated four times after two trial runs.The average velocity,peak velocity,degree of joint dispersion,entropy of acceleration,joint coordination and active range of motion ( AROM ) of the shoulder were analyzed.The patients and normal subjects were statistically compared.The results were correlated with Fugl-Meyer upper extremity scores using Spearman correlation analysis. Results All of the measured variables showed significant differences between the patients and normal subjects.In the correlation study,the average velocity,peak velocity,AROM of the shoulder and joint coordination showed significant correlation with the Fugl-Meyer scores.There was,however,no significant correlation between degree of dispersion of the shoulder or elbow joints or the entropy of acceleration ( which represented the quality of movement) and Fugl-Meyer upper extremity scores. Conclusions The results suggest that microsensor MCUs can quantitatively assess the kinematics of reaching among hemiplegic stroke patients.They can provide valuable and objective data about the functional quality of multiple joint movements in three dimensions.

Objective To investigate the risk factors for hospital-acquired pneumonia (HAP) in a neurological intensive care unit (NICU).Methods The patients aged ≥ 18 years admitted in NICU of Nanfang Hospital for ≥ 48 hours from May 2010 to April 2011 were enrolled.The possible risk factors,including the general information,the worst Glasgow Coma Scale (GCS) score,as well as Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores within 24 hours in NICU,whether the occurrence of HAP,whether with some underlying disease or symptoms within the time of study and using specific drug therapy or invasive procedures were investigated retrospectively.The duration of continuous medical interventions was recorded at the same time,and the continuous variables were quantified and stratified.Results A total of 243 patients were enrolled,and 50 (20.6％) of them developed HAP.Univariate analysis showed that the proportions of coma (44.0％ vs.29.0％ ;x2 =4.091,P =0.043) and APACHE Ⅱ score ≥ 15 (60.0％ vs.38.9％ ;x2 =7.232,P =0.007) in the HAP group were significantly higher than those in the non-HAP group.There were significant differences in using antacids (＜ 6 d: 38.0％ vs.19.7％ ; ≥ 6 d: 18.0％ vs.25.9％ ; x2 =7.521,P =0.023),sedatives (＜2 d: 30.0％ vs.37.3％ ; ≥2 d: 46.0％ vs.28.0％ ;x2 =6.064,P =0.048),blood products (＜3 d: 24.0％ vs.9.8％ ; ≥ 3 d: 6.0％ vs.7.3％ ; x2 =7.150,P =0.028),endotracheal intubation (＜ 5 d:24.0％ vs.10.9％ ; ≥ 5d: 26.0％ vs.15.5％ ; x2 =10.698,P =0.005),mechanical ventilation (＜ 4 d:6.0％ vs.7.8％ ; ≥ 4 d: 30.0％ vs.7.8％ ; x2=,P =0.000) and indwelling nasogastric tube (＜ 7 d:56.0％vs.37.3％ ; ≥7d: 42.0％ vs.44.6％ ;x2 =10.410,P =0.005) between the two groups.Multivariate logistic regression analysis showed that mechanical ventilation ≥ 4 d (odds ratio [OR] 6.481,95％ confidence interval [CI] 2.522-16.654; P=0.000),indwelling nasogastric tube ＜7 d (OR 12.504,95％ CI 1.614-96.869; P =0.016) and using antacids ＜ 6 d (OR 2.271,95％ CI 1.042-4.949; P =0.039) were the independent risk factors for HAP in NICU patients.Conclusions Mechanical ventilation,indwelling nasogastric tube and using antacids are the independent risk factors for HAP in NICU patients,and thus it needs to take targeted measures.