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.

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

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.

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

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 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.

Objective To explore the anatomical basis for the flexor pollicis brevis branch of median nerve transfer to the deep branch of ulnar nerve.Methods Eight fresh upper limb were dissected and observed.The specimen were dissected under the loup.Observed the number of the flexor pollicis brevis branch and measured the distances from pisiform bone to the flexor pollicis brevis branch.Then the transfer operation on the cadaver were imitated.After the anastomosis was completed,the stumps of the nerves were sectioned and stained with HE.The crossing-sectional area and the density of nerve fiber were obtained by Image-Pro Plus version 6.0,then the number of the nerve fiber were calculated.The data analyzed by SPSS 17.0.Results The flexor pollicis brevis branch constantly appear,there were two branches in 2 specimens,one branch in 6 specimens.The flexor pollicis brevis branch could transfer to the deep branch of ulnar nerve by end-to-end surture without tension.The regeneration distances was (37.3 ± 5.76) mm.The crossing-sectional area were (0.0575 ± 0.0086)mm2 and (0.2039 ± 0.0396)mm2,the number were (492.50± 62.62) and (1651.13± 79.01),the density were (8781.4246 ± 1676.2894)/mm2 and (8371.1592 ± 1677.6509)/mm2 in the flexor pollicis brevis branch and the deep branch of ulnar nerve,respectively.There were no significant differences in the density of the nerve fiber between the donor and recipient nerve (P ＜0.05).But there were differences in the crossing-sectional area and number of the nerve fiber(P ＜ 0.05).Conclusion The flexor pollicis brevis branch transfer to the deep branch of ulnar nerve can provide a short regenerating distance,but can supply a part of recipient nerve to reinnervate.

SHG was sulfated by chlorosulfonic acid-pyridine method, and six samples which we got were prepared in different reaction conditions. There is a characteristic absorption peak near 260 nm in UV spectra and there are two characteristic absorption peaks near 1240 cm(-1) and 810 cm(-1) in the FT-IR. Degree of sulfation (DS) was calculated by elemental analysis and turbidimetry. Under the same conditions the absorption peaks become strong with the DS increase. The anticoagulant activity of SHG and sulfated modification samples was evaluated by the classic coagulant assays of prothrombin time (PT), activated partial thrombin time (APTT) live enzymes, and plasma thrombin time (TT). Results show that sulfated SHG has a good anticoagulant activity in vitro, and DS increased activity within a certain range.

Objective To assess prevalence and risk factors of illness within the past 2 weeks among rural residents in Menglian,under the background of essential public health service implemented generally. Methods In February 2012, the questionnaire method was employed to investigate the two-week morbidity in 2011 rural residents sampled by multistage stratified random sampling from Menglian population. Results The prevalence, that of illness within two-week among 2011 rural residents in Menglian, was 97.5‰ (95%CI 84.5‰-110.5‰) . It was lower than that of the rural region IV in China (149.6‰, <0.05) .Its age trend was the same as that of the rural region IV in China,the prevalence in 0-14 years old children,however,was higher than the counterpart in the rural region IV in China. The diseases, which two-week morbidity ranked the top five, were acute upper respiratory infection, acute gastroenteritis, hyperostosis, acute tracheobronchitis and rheumatoid arthritis. The results of multilevel logistic regression model fitted by group-level explanatory variable mountainous area, individual-level random slopes variable gender and other individual background variables indicated that there were across-level interactions between mountainous area and gender ( <0.05), the family income lower than RMB 15000 (odds ration 3.2378, 95%CI 1.9014-5.5130) and age (odds ration 1.0163, 95%CI 1.0002-1.0327) had a positive effect to two-week morbidity, and contrasting to unmarried, married had a negative effect to two-week morbidity (odds ratio 0.4727, 95%CI 0.2534-0.8819) . Conclusions Comparing with that of the rural region IV in China before implementing essential public health service, the two-week morbidity in Menglian was lower. For further elevating the health level of population, the strategies, such as intensifying material and child hygiene in the mountain area, improving sanitary conditions of low income family, and updating health consciousness in single population,would be implemented.

Objective To investigate the teaching effectiveness of preventive medicine and ask the students for feedback on the curriculum in order to reform the teaching methods.Methods Questionnaire survey.Sampling survey.Results 89.2％ of students have realized the importance of preventive medicine.Respectively 16.4％ and 7.5％ of students have no interesting on the curriculum due to teachers'matter and students' idea that the course is uselessness for their major and future career.75.1％ of students are interest in Nutrition and Food Hygiene,35.2％ of students dislike Medical Statistics,and 45.3％ of students think the most tough part is Medical Statistics.78.9％ of students wish to have more practice lessons.30.5％ of students do not ask teachers questions because of no communication with teachers after class.Conclusions Preventive Medicine is still ignored by a few students.The more tough the content is,the less interest the students have. Repeatedly emphasizing the importance of Preventive Medicine in medical education,adopting and combining with the community practical cases in class lectures and frequently communicating between teachers and students after class are suggested.