Objective To discuss the safety and efficacy of gasless laparoscopy in gynecological surgery.Methods A total of 58 patients who received gasless laparoscopic surgery from October 2006 to December 2007 were enrolled in this study.Among the patients,31 underwent ovarian cystectomy,23 received myomectomy,3 laparoscopic-assisted transvaginal hysterectomy(LAVH),and 1 salpingectomy(because of ectopic pregnancy).One trocar was used in 13 cases(ovarian cystectomy in 11 and myomectomy in 2) with the assistance of hysteroscopic resectoscopy,two trocars were employed in 27 cases(ovarian cystectomy in 11 and myomectomy in 16),and three trocars in 18 cases(ovarian cystectomy in 9,myomectomy in 5,LAVH in 3,and salpingectomy in 1).The instruments employed in this study were purchased from Daoke Co.Results All of the 58 surgeries were successfully completed.In the patients received ovarian cystectomy,the mean intraoperative blood loss was(46.8?10.1) ml(ranged from 10 to 200 ml),and the mean operation time was(66.3?6.7) min(30-150).While in the patients underwent myomectomy,the mean intraoperative blood loss was(94.3?8.2) ml(10-400),and the mean operation time was(104.3?6.7) min(60-180).For the 3 cases of LAVH,intraoperative blood loss was 100,200,and 150 ml;and operation time was 255,240,and 135 min,respectively.The salpingectomy was finished within 30 min.None of the 58 patients developed complications during and after the operations.They were discharged from the hospital in(7.9?1.6) days,and were followed up for 3 to 6 months,during which no complications occurred.Conclusions Gasless laparoscopic surgery is safe,effective,and minimally invasive for gynecological diseases.The procedure can be used for eldly patients and those who cannot tolerate general anesthesia due to cardiovascular diseases.

Objective To evaluate the value of gasless laparoscopic myomectomy(GLM)using a subcutaneous abdominal wall lifting system for leiomyomas.Methods The surgical outcomes,including operation time,intraoperative blood loss,recovery time of gastrointestinal function,hospital stay,complications,and cost of GLM using a subcutaneous abdominal wall lifting system(GLM group)and laparoscopic myomectomy with pneumoperitoneum(LM group)were compared.Results No intra-or post-operative complications occurred in both of the groups.No significant difference was found in the operation time and blood loss between the GLM and LM groups [(99.2?35.4)min vs.(102.7?28.8)min,t=-0.411,P=0.682;(77.0?48.3)ml vs.(89.6?53.8)ml,t=-0.940,P=0.351].While the GLM group had significantly shorter recovery time of gastrointestinal function and hospital stay [(1.8?0.5)d vs.(2.1?0.3)d,Mann-Whitney U=304.000,P=0.013;and(8.7?2.9)d vs.(10.3?3.1)d,t=-2.031,P=0.047],and lower cost [(6372.8?784.7)yuan vs.(7984.6?1048.7)yuan,t=-6.657,P=0.000].Conclusions Since GLM does no results in longer operation time and more blood loss than LM with pneumoperitoneum,it is suitable for large leiomyoma.The patients have quicker recovery,shorter hospital stay,and lower hospital cost after GLM.

Objective To summarize and analyze the results of our university graduates' participation in the national medical licensing examination in order to investigate the clinical medical teaching reform.Methods There were 770 candidates who took the NMLE from 2011 to 2013.Excel 2007 was used to statistically analyze the total score,passing rate,average score and mastery rate for each subject,and average score and mastery rate at different cognitive level.Results In these three years,our candidates' total pass rate was higher than the national average total pass rate,respectively higher 17.11％,18.10％,17.82％;the pass rate of practical skills examination was also higher than the national average pass rate,respectively higher 7.30％ and 7.19％ and 5.90％;the pass rate of theory examination was higher than the national average pass rate,respectively higher 12.91％,12.97％ and 14.29％.The average score and mastery rate for each subject,the average score and mastery rate at different cognitive level were also all higher than those of the national average of medical colleges.Conclusions National medical licensure examination can be used as an important reference,through optimization of medical curriculum and teaching mode,optimization of clinical practice skills training system and optimization of clinical practical skill evaluation system etc.,to further improve the clinical medical personnel training mode.

Objective To improve the detail of the surgery for cicatricial ectropion,and the the effect was investigated. Methods Based on 46 patients withⅡ,Ⅲdegree cicatricial ectropion admitted to our department,choose the junction of normal skin and scar tissue as the incision line according to the degree of ectropion and local situation,and to reserve and recover the orbicularis oculi muscle as possible. The released areas exceeded separately the external canthus and reached the level of eye fissure,take advantage of full-thickness skin graft to correct the parallel lines and make fixation to the eyelid ectropion fusion skin graft on external canthal ligament. Results After followed up for 6 months to 2 years,46 cases of eyelid skin grafts survived completely and eyelids were in good reduction,with none case of incomplete eyelid closure. Conclusion Choose the surgical incision and the released areas in a proper way to reserve the structural integrity of orbicu-laris muscle and make skin graft fixation to inner and external canthal skin can prevent effectively the recurrence of ectropion and improve surgical progress.

Objective To explore the influence of the extract of wen-pi-tang on the memory and SOD and MDA of normal mice and cerebral ischemia reperfusion mice.Method The mice were divided into normal group,sham operation group,model group,aqueous extract and alcohol extract of wen-pi-tang (1.0 g/kg,0.5 g/kg,0.25g/kg).Model mice with cerebral ischemia reperfusion were made by blocking bilateral common carotid artery.The influence on memory behavior of normal mice and mice with cerebral ischemia reperfusion were tested by gavage for 10 days with extract of wen-pi-tang through step-down and step-through tests.Then SOD activity and content of the MDA were tested.Result In step-down test,compared with normal group,extract of wen-pi-tang with all doses made normal mice' latency longer,error frequency fewer,with high does clearest (P＜0.05)(latency:(187.17±99.00) s,(270.73±44.73) s,(260.45±63.78) s,error frequency(1.75± 1.71) times,(0.45±0.69) times,(0.75±0.97) times) ;in step-through test,compared with normal group,aqueous extract with high and middle doses and alcohol extract with longe doses could made latency of cerebral ischemia reperfusion mice longer and error frequency fewer (latency(157.15±84.91) s,(250.63±58.98) s,(251.12±78.22) s,(245±84.82) s,error frequency(2.15± 1.22) times,(0.75±0.89) times,(0.75± 1.16) times,(0.625 ±0.92) times) (P＜0.05) ; extract of wen-pi-tang with high and middle does increased SOD activity obviously compared with normal group(P＜0.05),and the content of MDA was obviously lower compared with normal group(P＜0.05,P＜0.01).Conclusion Extracts of wen-pi-tang can improve the memory function of normal mice,and the memory of cerebral ischemia reperfusion mice.The mechanism can be related to the increase of SOD activity and the decrease of the content of MDA.

Objective To elucidates the effects of HPV18 E6 siRNA targeting at human papillomavirus(HPV)18 E6 gene on the proliferative activity of HeLa cells and chemotherapy sensitivity.Methods HPV18 E6 expression of HeLa cells was inhibited by siRNA interference,the change of P53 and P21 proteins expression level was measured by Western blot.MTT assay was used to detected proliferative activity and sensitivity to paclitaxel liposome of HeLa cells.Results After inhibition of E6 expression,P53 and P21 proteins increased and the growth of HeLa cells was decreased(P ＜0.01).The inhibition rate of HeLa was markedly increased after transfection of HPV18 E6 siRNA and paclitaxel liposome.Conclusion HPV18 E6 siRNA can effectively silence gene expression of E6 and inhibit proliferation of HeLa cells.HeLa cells are more sensitive to combine HPV18 E6 siRNA with paclitaxel liposome than that of control groups.

Objective To investigate familial hyperlipoproteinemia and the features of familial hyperlipoproteinemia in Lanzhou . Methods Data were from previous studies on the subject .Families of hyperlipoproteinemia were screening ,questionnaires were col-lected ,physical examination and laboratory data of family members were also colleted to analysis the characteristics of familial hy-perlipoproteinemia .Results A total of 39 familial hyperlipoproteinemia families were enrolled in the study ,including 280 family members .There were 15 core families ,11 single-parent families ,and 13 orphaned families .There were 6 familial hypercholesterol-emia families ,9 familial hypertriglycerides families ,24 mixed familial hyperlipidemia families .The children of the first generation ac-counted for 63 .2% of the total number of people enrolled in the study ,the father generation accounted for 14 .3% ,the children of the second geration accounted for 22 .5% .Conclusion In the survey ,the most common type of familial hyperlipidemia was mixed familial hyperlipidemia .The father generation was majority .The member of core families was less than incomplete families .

Objective To probe into the clinical application value of dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion weighted imaging (DWI) in identifying benign and malignant breast lesions.Methods 60 patients with clinically suspected breast lesions underwent MR examination.Morphologic features,early enhancement rate,time-signal intensity curve (TIC),apparent diffusion coefficient (ADC) value,as well as the differences between ADC values of the surrounding normal tissues and these of the lesions were compared and analyzed.Results The areas under the receiver operating characteristic curves (AUC) of the early enhancement rate,TIC,ADC value,ADC difference value were 0.741,0.808,0.882 and 0.959,respectively;the best diagnostic thresholds for the early enhancement rate,ADC value,and ADC difference value were 163％,1.30× 10-3 mm2/s and 0.47× 10-3 mm-2/s,respectively.The sensitivity of morphologic features,early enhancement rate,type Ⅲ curve,type Ⅱ and type Ⅲ curve,ADC value and ADC difference value in differentiating benign and malignant breast lesions was 53.1％,59.4％,43.8％,90.6％,93.8％ and 96.9％,respectively;the specificity was 85.7％,82.1％,89.3％,57.1％,75.0％ and 82.1％,respectively;the positive predictive values were 81.0％,79.2％,82.4％,70.7％,81.1％ and 86.1％,respectively;the negative predictive values were 61.5％,63.9％,58.1％,84.2％,91.3％ and 95.8％,respectively;and the accuracy was 68.3％,70.0％,65.0％,75.0％,85.0％,90.0％,respectively.Conclusion DCDMRI and DWI play important roles in differential diagnosis of benign and malignant breast lesions,among which ADC difference value is associated with the highest diagnostic capability.Combination of multiple imaging diagnostic methods is necessary to improve the diagnostic accuracy of breast lesions.

Objective: To study the effect of curcumin on cardiac remodeling and heart function change induced by adriamycin in rats. Methods: A total of 50 SD rats were randomly divided into blank control group (n=10), adriamycin group (n=20) and curcumin intervention group (n=20). General conditions of rats, including weight, hair color, diet and activity capacity, were observed. Left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS) and left ventricular end-diastolic dimension (LVEDd) were observed by echocardiography. Rat heart was weighed and levels of cardiac collagen type Ⅰ and Ⅲ were observed using immunohistochemistry method. Results: Compared with blank control group after experiment, there were significant increase in heart weight [(168.53±26)mg vs. (208.34±31)mg], heart weight/body weight [(0.36±0.06) vs. (0.52±0.08)], and significant decrease in body weight [(469.27±34)g vs. (428.47±45)g]; significant increase in LVEDd [(4.87±0.19)mm vs. (7.49±0.83)mm], significant decrease in LVEF [(69.53±6.25)% vs. (41.46±4.38)%] and LVFS [(45.83±3.79)% vs. (17.25±2.92)%] in adriamycin group, P<0.05 all, significant increase in expression rates of collagen type Ⅰ and Ⅲ, P<0.01.Compared with adriamycin group, there were significant increase in body weight (452.46±38)g, significant decrease in heart weight (178.73±38)mg, heart weight/body weight (0.39±0.07); significant decrease in LVEDd (5.96±0.65)mm and significant increase in LVEF (53.12±5.43)% and LVFS (36.57±3.66)%, P <0.05 all; significant decrease in expression rates of collagen type Ⅰ and Ⅲ in curcumin group, P <0.01. Conclusion: Curcumin can improve cardiac remodeling and heart function induced by adriamycin in rats.