Objective To assess clinical efficacy of the combined laparoscopic technique for superficial bladder neoplasms involved uretetic orifice. Methods A totsl of 12 patients with bladder neoplasms involved ureteric orifice were treated and reviewed.The clinieal tumor stage was Tis in 6,T1 in 6.During the procedure,the transurethral resection of bladder neoplasms was performed firstlythe extent including 0.5-1.0 cm formal bladder tissue around ureteric orifice,deep to superficial muscle of bladder,then ureteroneocystostomy was done with transperitoneal laparoscopic technique.Results The operations were successfully in all 12 cases.The average procedure time was 2.2 h.The average volume of hemorrhage was 25 ml.The double J stents were removed 3 months postoperatively.Six months after surgery intravenous pyelography(IVU)and cystography showed no ureter obstruction in all cases,Ⅰ-Ⅱ degree vesicle-ureteral reflux in 2 cases.One year after surgery custography showed Ⅰ-Ⅱdegree vesicle-ureteral reflux in 4 cases,Ⅱdegree relux in 3 cases.During 324 months' follow-up,B type ultrasound and IVU showed moderate hydronephrosis in 1 case,mild in 5. Conclusion The treatment of combining laparoscopic technique for superficial bladder neoplasms involved ureterie orifice might be an effective and safe method.

We establish the new capacity-based teaching mode in clinical teaching of nursing obstetrics and gynecology.We have obtained more satisfied teaching quality.

Introduction to the specific practice and policies of the hospital for academic promotions. The emphasis is placed on "quality priority" and "work performance", making an overall assessment of the applicants on their professional virtue, academic skills, research outcome and social services. Among all these indicators, appraisal of the clinical skills and teaching skills is prioritized,encouraging the creativity and incentives of clinicians for clinical and teaching work.

Objective To explore the short-term clinical outcome of percutaneous posterior lumbar interbody fusion using B-twin stand-alone expandable spinal spacer in the degenerative lumbar diseases.Methods From January 2006 to March 2009,41 consecutive patients with lumbar degenerative disc diseases were enrolled and 44 intervertebral spaces were observed in this study.There were 20 males and 21 females,with an average age of 57.51(ranging from 31 to 77 years old).Indications for treatment included degenerative lumbar disc herniation(LDH) with intervertebral instability or Ⅰ? spondylolisthesis(25 cases),LDH with intervertebral space collapse(15 cases) and lumbar discogenic pain(1 case).Fusion segments included 3 cases of L3,L4 and L5,3 cases of L3 and L4,27 cases of L4 and L5,and 8 cases of L5 and S1.After percutaneous discectomy and endplate,curettage were meticulously carried out.A B-twin expandable spinal spacer was introduced into the intervertebral space and then expanded and an allograft cancellous bone of 4 to 5 g was implanted around the B-twin in the intervertebral space.The whole operation was monitored by C-arm fluoroscopy.The clinical outcome was evaluated by JOA scale and X-rays and CT examination before the operation,and 1 week,3 and 12 months after the operation.Results After follow-up of 3 to 38 months(mean 16 months),all the patients were evaluated,and excellent was obtained in 13 cases,good in 21 cases,fair in 5 cases,and poor in 2 cases.The excellent and good rate was 82.93% according to the JOA scale.X-rays and CT showed that the subsidence of the B-twin was found in 3 cases,and 1 case was significantly subsided by more than 20%.Cage shift was seen in 1 case.Conclusion Percutaneou posterior lumbar interbody fusion with B-twin is efficient with minimal surgical trauma,blood loss,better rehabilitation and reliable short-term outcome.Strict indications and pinpoint skills for surgery are the precondition to obtain satisfactory outcome in the treatment of degenerative disc disease.

0.25. Conclusions Modified Stamey bladder neck suspension is an effective treatment for type Ⅰ female stsees urinary incontinence.

We establish the new student-centered teaching mode and reform the evaluation system in clinical teaching of nursing obstetrics and gynecology. We have got more satisfied teaching quality.

An introduction to the practice of introducing the“ surgeon qualification admittance system”in the hospital and a description of its management framework,basic principles,rules of classification for surgical operations,application and approval procedure,and supportive management regulations.The authors hold that this system has normalized behavior of medical activities,clarified operation authorities of medical doctors at various levels,and intensified the awareness of risk exposure.Therefore this system can safeguard the quality and safety of surgical operations and its efficiency to a great extent,in addition to better building the team and backup forces.

AIM: To observe the effects of norepinephrine (NE) on the cardiopulmonary and lung injury in goats with acute respiratory distress syndrome (ARDS) induced by endotoxin. METHODS: A model of septic ARDS was induced by intravenous infusion of low dose endotoxin in six goats. Then 40?10~ -6 NO inhalation was applied to the animals. After 30 min, combined intravenous infusion of NE at concentration of 0.5 mg?kg~ -1 ?min~ -1 was conducted. The dynamic changes in gas exchange and hemodynamics were measured with the aid of Swan-Ganz catheter. Arterial blood gas analysis before and after the onset of ARDS, 30 min after NO inhalation and combined NE was detected. Histology of the lung was also observed. RESULTS: Inhalation of NO rapidly reduced mean pulmonary arterial pressure (MPAP), increased PaO_2, decreased P_ (A-a) O_2 and Qs/Qt in septic ARDS goats. These decrease and increase were more significant than those in NO inhaled alone when animals received NE. The combination of NO inhalation and NE injection resulted in increase in mean arterial pressure. NO inhalation did not ameliorate lung injury and combined NE intravenous injection ameliorated lung injury. CONCLUSION: Injection of low dose norepinephrine improves the beneficial effects of inhaled nitric oxide on lung gas exchange and ameliorates lung injury in goats with acute respiratory distress syndrome induced by endotoxin.

Objective To study the effects of electrical stimulation of efferent vagus nerve on the endotoxic shock in rabbits. Method Sixteen Newzealand rabbits were randomly divided into 2 groups, namely group S as the stimulation group and group C as the control group). Rabbits were subjected to bilateral cervical vagotomy and had challenge with intravenous injection of lipopolysaccharide (LPS) (E. COLI O111: B4 , DIFCO, USA) in a dose of 600 μg/kg. The distal end of the left vagus nerve trunk was connected to an electric stimulator with bipolar electrode and controlled by an acquisition system. Stimuli with stable voltage (10 V,5 Hz,5 ms) were applied twice to the nerve for 10 minutes just before and after the administration of LPS in group S. At the time before and after the infusion of LPS 30 min,60 min, 120 min, 180 min,240 min and 300 min respectively, the heart rate(HR)and the mean arterial blood pressure (MABP) in each animal were recorded, and blood samples were taken for measuring serum tumor necrosis factor-αa(TNF-α) and interleukin-10 (IL-10). Results Compared with group C,the electrical stimulation of efferent vagus nerve could significantly attenuated the LPS-induced hypotension and de-creased the contents of TNF-α[(38.12±7.85) pg/mL vs. (55.12±7.89) pg/mL, P <0.01], but increased the contents of IL-10[(55.12±9.37)pg/mL vs. (40.15±5.44) pg/mL, P <0.01]afar LPS challenge. Conclusions The stimulation of the efferent vagus nerve can down-regulate systemic TNF-α, production and attenu-ate the development of shock after LPS challenge.

Objective To investigate the clinical effects and complications of uterine artery embolization (UAE) therapy using different embolic agents in treating uterine adenomyosis. Methods During 2004—2011, a total of 45 female patients with uterine adenomyosis were admmitted to authors’ hospital to receive uterine artery embolization therapy. The embolic agents used in the procedures included domestic iodized oil, sodium alginate microspheres and Embosphere microspheres. The patients were randomly divided into group A (n=15, using domestic iodized oil as embolic agent), Group B (n=13, using sodium alginate microspheres as embolic agent) and group C (n = 17, using Embosphere microspheres as embolic agent). After the treatment, all the patients were followed up for over 2 years, focusing on the observation of the clinical symptoms such dysmenorrheal, changes of MRI signs and severe complications. The results were analyzed and compared among the three groups. Results After UAE, the clinical symptoms such as the degree of dysmenorrhea, menstrual quantity, etc. were improved in all patients. Six months after UAE, the obvious remission rate of dysmenorrheal in group A, B and C was 33.3% (5/15), 30.8% (4/13) and 41.1%(7/17) respectively. Twelve months after UAE, MRI scanning showed that the uterine sizes in group A, B and C were reduced to 49.19%, 48.25% and 50.05% respectively. Follow-up examination at 24 months after UAE showed that recurrence of dysmenorrheal in group A, B and C was seen in 2, 4 and 2 cases respectively, and amenorrhea was seen in 2 cases of group A and one case in group C. Conclusion The use of domestic iodized oil, sodium alginate microspheres or Embosphere microspheres as embolic agents in performing super-selective uterine artery embolization for adenomyosis can effectively relieve the degree of dysmenorrheal, decrease the uterine size. In addition to ovarian dysfunction, the uterine cavity adhesion may be also a possible cause of amenorrhea occurring after UAE may. In order to ensure a similar clinical efficacy, the use of granular solid embolic agent is preferred as its safety is possibly higher than the liquid embolic agents.