Objectives To evaluate the efficacy and safety of single-incision versus conventional laparoscopic cholecystectomy.Methods We searched electronic databases (PubMed,EMBASE,Cochrane Library,Chinese Biomedicine databases) from January 2000 to April 2012.Personal contact with experts in the field of laparoscopic cholecystectomy was performed to identify further potentially relevant clinical trials.Randomized controlled trials conducted on single-incision versus conventional laparoscopic cholecystectomy were analysed to compare conversion rates,blood loss,operation time,postoperative complications,wound satisfaction score,postoperative pain score and postoperative duration of hospitalization.Data were extracted by two reviewers independently.Statistical analysis was performed by using the RevMan 5.1 software.Results Twelve studies involving 915 patients met the inclusion criteria.When compared with conventional laparoscopic cholecystectomy (LC),the singleincision laparoscopic cholecystectomy (SILC) group showed no significant difference in conversion rate (OR=0.70,95％CI: 0.13～3.77,P=0.68),postoperative complications (OR=1.13,95％CI:0.72～1.78,P＝0.59) and postoperative pain scores (WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57) . There was a significant increase in operative blood loss (WMD ＝ 1.43,95 ％ CI: 0.09 ～2.78,P＜0.05),increase in operative time (WMD=16.79,95％CI: 9.05～24.52,P＜0.01),but an increase in wound satisfaction score (WMD=1.28,95％CI..1.09～1.47,P＜0.01).The postoperative duration of hospitalization was significantly shorter (WMD =-0.30,95％ CI:-0.58 ～-0.02,P＜0.05).Conclusions Current evidence suggests that there is no significant difference in conversion rate or postoperative complications between SILC and LC.Although SILC requires a longer operative time and there is more blood loss when compared with LC,the SILC is superior in wound satisfaction score and in duration of hospitalization.

Objective To investigate the relationship between non muscle-invasive bladder can-cer and polymorphisms of DNA repair genes among Han nationality in Shanghai. Methods From January 2006 to June 2008, 94 patients with non muscle-invasive bladder cancer and 304 controls were enrolled. Known single nucleotide polymorphism(SNP) in the XPC, XPG, XRCC1 genes were detec-ted by TaqMan real-time PCR. After adjusted for age, sex, and smoking, interaction effects of the genotypes and non muscle-invasive bladder cancer risk, genotypes and clinical and pathological features of bladder cancer were analyzed using unconditional Logistic regression. Results After adjusted for age, sex, and smoking, the XPC 939 Lys/Gln, XPC 939Gin/Gin genotype and XPG 1104 Asp/His, XPG 1104 His/His genotype were more frequent in patients with non muscle-invasive bladder cancer, adjusted OR=1.89, 95%CI 1.14-3. 23 and OR=1.07,95%CI 0.86-1.87, respectively. The XRCC1 Arg399Gln polymorphisms were not significantly associated with non muscle-invasive bladder cancer, adjusted OR= 1.15, 95% CI 0.55-2.40. There were no significant associations between tumor clinical and pathological features in patients who possessed either the XPC or XPG polymor-phisms (P>0.05). Conclusion XPC Lys939Gln and XPG Asp1104His may modulate non muscle-invasive bladder cancer risk among Han nationality in Shanghai.

ObjectiveTo observe the rehabilitative effect of patients with shoulder-hand syndrome after stroke by manipulation treatment. MethodsThe patients with shoulder-hand syndrome were randomly divided into two groups, manipulation group (180cases) and control group (128 cases). Patients in the manipulation group were regularly given a passive quantitative movement on shoulder, elbow and hand joints,while patients in the control group were irregularly given a passive movement or ordered to perform an autonomic movement. The signs and symptoms of patients in these two groups were not much different. The rehabilitative effects were compared 3 months later. ResultsSigns and symptoms in the manipulation groups improved much better than that of the control group. Conclusions The manipulation treatment for the post-stroke patients with shoulder-hand syndrome is the method that is simple, effective and easy to perform.

Percutaneous coronary intervention(PCI) has become one of the most important therapeutic methods for atherosclerotic heart disease(AHD),but the following complications such as stent thrombosis and restenosis af- fected its long-term efficacy.Platelet activation was a key component of thrombosis of during perioperative period PCI.As one of the most effective antiplatelet drugs,clo- pidogrel has been established its important role in preven- ting thrombosis during perioperative period of PCI.After several large-scale clinical trials in recent years.

OBJECTIVETo study the effect of Guishen Pill (GSP) on expression levels of Oct-4, MVH, and Egr-1 in mice with diminished ovarian reserve (DOR).

METHODSTotally 40 female C57BL/6J mice were randomly divided into 4 groups, the normal control group, the model group, the GSP group, and the dehydroepiandrosterone (DHEA) group, 10 in each group. Pregnant mare serum gonadotropin (PMSG), human chorionic gonadotropin (HCG), and prostaglandin F2α (PGF2α) were sequentially administrated to produce superovulation. The DOR model was established by exposing to ozone inhalation. Mice in the GSP group were intragastrically administered with GSP at 0.3 mL. Those in the DHEA group were intragastrically administered with DHEA at 0.3 mL. Equal volume of normal saline was intragastrically administered to mice in the normal control group and the model group. All mice wer treated for 21 days. Serum levels of estrogen (E2), progestogen (P), and anti-Müllerian hormone (AMH) were measured by ELISA. Changes of Oct-4, anti-AMH, and early growth response gene-1 (Egr-1) mRNA in ovaries were dtected by Real-time PCR.

RESULTSCompared with the model group, serum levels of E2, P, and AMH, as well as contents of estrogen receptor (ER), progestogen receptor (PR), MVH, and Oct-4 mRNA significantly increased in the GSP group and the DHEA group (P < 0.05).

CONCLUSIONGSP could improve expression levels of Oct-4, MVH, and Egr-1 mRNA in DOR mice and their ovarian function.

Animals ; Anti-Mullerian Hormone ; metabolism ; Dehydroepiandrosterone ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Early Growth Response Protein 1 ; metabolism ; Estrogens ; Female ; Mice ; Mice, Inbred C57BL ; Octamer Transcription Factor-3 ; metabolism ; Ovarian Reserve ; Ovary ; Pregnancy ; Receptors, Estrogen ; metabolism ; Superovulation

Objective To investigate the viability of analysis of hemodynamic changes with color Doppler flow imaging in the prediction of acute rejection in transplanted liver.Methods Sixty-eight patients enrolled in the study were categorized into three groups:transplanted liver without acute rejection [rejection activity index(RAI) 0-3,n =24],transplanted liver with mild acute rejection (RAI 4-5,n =23),transplanted liver with moderate and severe acute rejection (RAI 6-9,n =21).All the patients were confirmed by pathology.The color Doppler flow imaging were performed in all the patients within 24 hours and 1 week after biopsy.Results In transplanted liver with moderate and severe acute rejection,the peak systolic velocity of portal vein (PV-PSV) was (31.4 ± 14.1)cm/s,significantly lower than that in transplanted liver without acute rejection,which was (45.1 ± 17.7)cm/s (P ＜0.05).A week later after steroid therapy,the PV-PSV in transplanted liver with moderate and severe rejection was increased to (46.7 ± 21.8)cm/s(P ＜0.05).Patients with acute rejection were associated with the decrease of the PVPSV (P ＜0.05).Conclusions The decrease of PV-PSV may have some clinical value in evaluation the acute rejection in transplanted liver.

Two endophytic-bacteria isolates of G18 and F19 were isolated from the stem of Taxus chinensis. The G18 and F19 were respectively classified into Psudomonas sp. and Stenotrophomonas sp. based on biological characteristics and 16S rDNA sequence analysis. The bioactivity analysis showed that the fermented broths of the G18 and F19 exhibited antagonistic activities against three pathogenic bacteria, and had good antagonistic effectiveness to Verticillium dahliae and Colletotrichum gloeosporioides, respectively. The G18 can degrade salicylic acid, and the F19 can do dichlorvos.

Pigment epithelium-derived factor (PEDF) is an antiangiogenic factor which is effective in tumour inhibition in a variety of tumours and has not yet been studied in bladder tumour before. In this study the expression of PEDF, interleukin-1α (IL-1α) and -8 (IL-8) in bladder tumours was investigated. Immunohistochemistry was performed on 64 bladder tumour and 23 normal uroepithelium samples. Expression change of the factors was compared with clinicopathological parameters. Correlations between PEDF, IL-1α and IL-8 were analyzed. None of the factors was in relation to gender, tumour occurrence, and size or onset pattern. PEDF (P=0.014) and IL-1α (P=0.049) expression was down-regulated with grade progression. PEDF expression was lower in normal uroepithelium than in papillary urothelial neoplasm of low malignant potential (PUNLMP) (P=0.000) and carcinoma (P=0.009) whilst IL-1α (P=0.000 and P=0.000 respectively) and IL-8 (P=0.000 and P=0.023 respectively) expression was higher in the same grouping. PEDF expression had a negative correlation with IL-8 in PUNLMP (P=0.049, r=-0.578) as well as in tumour grouping (P=0.033, r=-0.276). Deranged expressional change of PEDF, IL-1α and IL-8 could be in relation to loss of differentiation from normal uroepithelium to papillary lesion and eventually to carcinoma.

To study the equipment modular allocation in the emergency medical unit after Beijing emergency public affairs. Using an improved Delphi method, 25 experts from various fields in Beijing were involved into two rounds consultations. The questionnaire of the first round consultation was formed based on analysis of emergency rescue equipment. Based on the result of the first round consultation, the questionnaire of the second round consultation was set up. The two rounds of questionnaires had the responding rates of experts 100% respectively, and the au-thoritative coefficients of the experts were 0.81 and 0.88. An emergency medical rescue equipment solution with three de-grees modular configuration in Beijing was made based on the consultations and experts' advices. The solu-tion develops the emergency medical service ability of mobile medical units and vehicle-mounted mobile hospital. LUO Ying and GAO Hong-wei are the first authors who contributecl equally to the article.

Objective To revise the Symptom Distress Scale for postoperative patients with pituitary tumor and to test its reliability and validity. Methods On the base of previous qualitative interview and literature review, Delphi consultation was performed to identify items of the Symptom Distress Scale for postoperative patients with pituitary tumor. By convenience sampling method, totally 191 patients from four first-class ternary hospitals in Jiangsu province were investigated effectively by this scale. Results A scale of 4 factors and 16 items was identified by expert interviews, item analysis, exploratory factor analysis and the four factors could explain 69.812%of the variance. The Cronbachαcoefficient of the scale was 0.920, the content validity index was 0.915, and the interrater reliability was 0.860. Conclusions Symptom Distress Scale for postoperative patients with pituitary tumor has good reliability and validity to assess the symptom distress of pituitary tumor patients after operation.