Objective To assess the value of laparoscopy in the diagnosis and treatment of abdominal emergency during pregnancy.Methods Clinical data of 40 cases of abdominal emergency at 7~17 gestational weeks(mean,13.2 weeks) from June 1997 to October 2004 were retrospectively reviewed.There were 16 cases of uterine with ectopic pregnancy,3 cases of twisted ovary,5 cases of pedicel torsion of ovarian cyst,5 cases of acute cholecystitis,and 11 cases of acute appendicitis.The diagnosis and treatment were conducted under laparoscope. Results The confirmative diagnosis was clarified under laparoscope in all the cases.Except 1 case of conversion to open surgery,the operation was accomplished laparoscopically in all cases. The operation time was 25~70 min(mean,38.2 min).Surgical complications occurred in 1 case.During postoperative follow-up observations,there were 3 cases of threatened abortion,3 cases of inevitable abortion,and 1 case of premature delivery. Conclusions Laparoscopic operation is safe and effective for acute abdominal emergency during early-to-middle pregnancy.

Objective To investigate the effect of adrenomedullin on rat renal tubular epithelial cell line (NRK-52E) apoptosis induced by hypoxia-reoxygenation (HR) injury and its mechanism.Methods NRK-52E cells were cultured and randomly allotted to the following 4 groups:control group,HR group,empty plasmid + HR group,ADM + HR group.NRK-52E cells were transfected with pcDNA3.1-myc-his B empty vector or pcDNA3.1-ADM by transfection complex comprising optimal proportion of plasmid and Fugene HD reagents.Cells were counted by trypanblau and cell survival rate was computed.The concentration of lactate dehydrogenase (LDH) was detected by spectrophotometric method to evaluate cell vitality.The apoptotic rate of NRK-52E cells was measured by flow cytometry.The transfer efficiency was detected by immunocytochemistry.The mRNA expressions of ADM,Bax,Bcl-2 and Fas were determined by Semi-quantitative RT-PCR,and active caspase-3,8,9 protein expression were examined by Western blotting.Results Compared with control group,the expression of ADM significantly increased in HR group (P ＜ 0.05).The expression of ADM significantly increased in ADM + HR group than that in empty plasmid + HR group.Compared with control group,in HR group,the living cell counts and cell survival rate significantly decreased; the LDH concentration in media,apoptotic rate and the levels of Bax,Bcl-2,Bax/Bcl-2,Fas,active Caspase -3,8,9 significantly increased (all P ＜ 0.05).Compared with HR group,in ADM + HR group,the living cell counts and cell survival rate significantly increased; the LDH concentration in media,the cell apoptotic rate and the levels of Bax,Bax/Bcl-2,Fas,active Caspase-3,8,9 significantly decreased,while Bcl-2 was promoted (all P ＜ 0.05).The above indexes had no differences between empty plasmid + HR group and HR group (all P ＞ 0.05).Conclusion The increased expression of ADM can inhibit NRK-52E apoptosis induced by HR,and the mechanism might be achieved by inhibiting mitochondrial and death receptor-mediated apoptotic pathways.

Objective To investigate the clinical value of laparoscopic hysteromyomectomy.Methods The clinical data of 98 cases of laparoscopic hysteromyomectomy(LM)and 76 cases of transabdominal Myomectomy(TAM)were retrospectively analyzed and comparison was made on the operative time,operative blood loss,postoperative blind enema time,body temperature recovery time,the rate of postoperative complicating disease and hospitalization after operation.Result Though the mean opertative time is the same,the mean operative blood loss,the mean body temperature recovery time,postoperative blind enema time,and the mean hospitalization was smaller in LM group than in TAM group(P＜0.05).Conclusion Laparoscopic hysteromyomectomy has the advantage of minimal invasion,short in-hospital days,fast recovery and low complication rate,which is an ideal treatment of hysteromyoma.

Objective To investigate the role and mechanism of resveratrol in a rat model of complex region-al pain syndrome type Ⅰ(CRPS1). Methods 50 male SD rats were divided into control group(group A),sham operation group(group B),model group 1(group C),model group 2(group D),and model group 3(group E). Groups A,B and C received 5%DMSO;group D received ISO-1 of 1 mg/(kg·d);and group E received resveratrol of 20 mg/(kg · d)for 14 days. Pain behaviors were assessed on days 0,7,and 14. Serum levels of MIF and TNF-αwere detected by ELISA. MIF ,total ERK1/2 and p-ERK1/2 in sciatic nerve were detected by Western blot. Re-sults On days 7 and 14 after treatment,resveratrol injection,similar to ISO-1,significantly improved the pain threshold;serum levels of MIF and TNF-α were significantly decreased;expressions of MIF ,total ERK1/2 and p-ERK1/2 in sciatic nerve were also decreased significantly in group E,which were significantly lower than group C (P < 0.05). Conclusions Resveratrol can significantly improve pain threshold ,decrease expressions of MIF and p-ERK1/2 in a rat model of CRPS1,which might be involved in the inhibition of ERK signaling pathway.

Objective To analyze the variations of PTPS gene in patients with suspected 6-pyruvoyl-tetra hydropterin synthase deficiency (PTPSD) and to make prenatal diagnosis in high-risk families. Methods Chemiluminescence was used for phenylalanine detection in blood or dried blood spots.Patients with phenylalanine concentration over 120μmol/L were detected by urine pterin analysis, and the activity of dihydropteridine reductase (DHPR) was detected. tetrahydrobiopterin loading tests were performed in suspected patients with abnormal urinary pterin profiles. PTPS gene variation analysis was performed by direct Sanger sequencing based on PCR amplification. Prenatal diagnosis in 7 high-risk families was performed by chorionic villus sampling when the genotype was identified. Results In 656 patients with hyperphenylalanine, 22 cases were diagnosed as PTPSD clinically. 16 variations were detected in the 22 PTPSD cases. The 5 variations, p.Lys77Arg, p.Ile84Phe, c.315-2A>G, c.244-2A>T, c.187-1G>T, were identified as novel variations. Two fetuses carried the same mutation with the proband and therefore were thought to be PTPSD fetuses. Three fetuses carried only one mutant allele and thus were thought to be PTPSD carriers.

AIM: To study the chemical constituents from the leaves of Phyllanthus emblica L. METHODS: The constituents were extracted by percolation with 95% ethanol.Then the extract was separated by systemic solvent separation methods.The ethyl acetate portion from the leaves were separated and purified by silica gel column chromatography and polyamide column chromatography with gradient elution,liquid preparation and recrystal methods.The structures of crystals were identified by physiochemical properties,spectrum analysis and literatures ontrast. RESULTS: Five compounds were isolated and identified.They were ?-sitosterol(Ⅰ);?-carotene(Ⅱ);kaemferol(Ⅲ);quercetin(Ⅳ);avicularin(Ⅴ). CONCLUSION: Chemical compound Ⅴ is isolated from this plant for the first time.

OBJECTIVE To observe the protection of vitamin C on the cardiac injury induced by 50 nm titanium dioxide inmice.METHODS Kunming mice were ad mistered by ig of vitamin C 100,200 and 400 mg·kg -1 for 2 d.And then the mice were ad mistered by ig of nano-TiO2 2 g·kg -1 and vitamin C (100.0,200.0 and 400.0 mg·kg -1 )for 3 d,the interval of treatment with nano-TiO2 and vitamin C was 4 h.The mice were scarified 24 h later after the last ad ministration.Electrocardiogra m (ECG)was determinated by physiological recorder.The myocardial enzy mes activities in serum and superoxide dismutase (SOD)and glutathione peroxidase(GSH-Px)activities in serum and myocardial tissue were determinated by bioche mical method.Cometassay was used to detect the DNA da mage of the heart. Heart tissue was used for histopathological exa mination by HE staining.RESULTS Co mpared with the control,ECG showed higher S-T and T-wave a mplitude of nano-TiO2 2 g·kg -1 (P<0.05).The myocar-dial enzy mes activities significantly increased and activities of SOD and GSH-Px significantly decreased in nano-TiO2 group,compared with the control group(P <0.05).Cometassay showed that olive tail mo ment (OTM)was significantly increased after nano-TiO2 2 g·kg -1 ,compared with the control group (P<0.05).The histopathology showed ede ma of myocardial cells,myofibril disorders and increasing infla mmatory cells.Vita min C 100,200 and 400 mg·kg -1 can decrease S-T in ECG,OTM,myocardial enzy mes activities,increase the SOD and GSH-Px activities in serum and myocardial tissue;reduce myocardial hypertrophy and infla mmatory cells.CONCLUSION nano-TiO2 can induce myocardial injury inmice and vitamin C can alleviate the da mage.The mechanism may be associated with the antioxidant ability of vitamin C inmyocardial tissue.

Objective:To establish cell lines stably expressing Rab5a and its the inactive mutant Rab5aN133I,analyze the effect of Rab5a on the expression of cytokines in LPS-stimulated RAW264.7 cells .Methods:RAW264.7 cells were transfected with Rab5a and its inactive mutant vector Rab5a N133I separately,and then screened by G418.Rab5a stable expressing cell lines were identified by Real time-PCR.The growth of the stable cell lines was analyzed by MTT assay.After the stable cell lines were stimulated by LPS for different time periods,the expression of iNOS,TNF-αand IL-6 was detected.Results:Rab5a and Rab5aN133I transfection resulted in elevated Rab5a mRNA expression compared with the control cells ( P<0.05 ).Rab5a overexpression enhanced the proliferation of RAW264.7 cells.However,the proliferation of Rab5aN133I cells was significantly slower than the control cells ( P<0.05).Overexpression of Rab5a promoted LPS-induced production of iNOS,TNF-αand IL-6 in RAW264.7 cells (P<0.01). Conversely,overexpression of Rab5aN133I abolished the stimulating effects of Rab5a.Conclusion: Rab5a promoted LPS-induced expression of iNOS,TNF-αand IL-6 in RAW264.7 macrophages in a GTP-binding ability-dependent manner.

Objective: To evaluate the effects of remote ischemic preconditioning (RIPC) on occurrence of postoperative delirium in elderly patients undergoing radical mastectomy. Methods: Sixty elderly patients, aged 65-78 yr, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective radical mastectomy, were allocated into 2 groups (n=30 each) using a random number table method: control group (group C) and RIPC group.Three cycles of 5-min ischemia/5-min reperfusion induced by a blood pressure cuff placed on the upper arm of the right upper arm served as RIPC treatment at 5 min after induction of anesthesia in RIPC group.The blood pressure cuff was only placed on the upper arm of the right upper arm without inflation and deflation in group C. Jugular bulb venous blood samples were obtained at 10 min before anesthesia induction (T₀) and 1, 12, 24, 48 and 72 h after the end of operation (T_1-5) for determination of S-100β protein and neuron-specific enolase (NSE) concentrations in serum.The occurrence of delirium within 72 h after operation was estimated using Confusion Assessment Method for the Intensive Care Unit.The occurrence of hypotension, sinus bradycardia and reintubation was recorded.The Quality of Recovery-15 (QoR-15) was used to evaluate the early postoperative quality of recovery at 1 and 2 days after operation. Results: Compared with group C, the concentrations of S-100β protein and NSE in serum and incidence of delirium within 72 h after operation were significantly decreased at T₁-T₅, and the Quality of Recovery-15 scores were increased at 1 and 2 days after operation in group RIPC (P<0.05). There was no significant difference in the duration of delirium or incidence of hypotension, sinus bradycardia and reintubation between the two groups (P>0.05). Conclusion RIPC can decrease the development of postoperative delirium and is helpful for the early postoperative recovery of elderly patients undergoing radical mastectomy.

Objective:To evaluate the effect of remote ischemic preconditioning (RIPC) combined with postconditioning (RIPostC) on postoperative pulmonary complications in elderly patients undergoing thoracoscopic radical surgery for lung cancer.Methods:Eighty American Society of Anesthesiologists physical status Ⅱ or Ⅲ elderly patients, aged 65-79 yr, with height 155-180 cm, weighing 45-80 kg, were divided into 2 groups ( n=40 each) by the random number table method: control group (group C) and RIPC combined with RIPostC group (group R). RIPC was induced by 3 cycles of 5 min ischemia (cuff inflation to 200 mmHg) followed by 5 min reperfusion (cuff deflation to 0 mmHg) though applying a mercury sphygmomanometer adult cuff to the right upper extremity at 30 min before one-lung ventilation and 30 min before the end of one-lung ventilation in group R. The adult cuff was only bound to the right upper extremity without inflation and deflation in group C. The occurrence of pulmonary complications was recorded within 72 h after operation in both groups.The Quality of Recovery-15 score was used to assess the early postoperative quality of recovery on 1 and 2 days after operation.The number of white blood cells and neutrophils and percentage of neutrophils were recorded at 1 day before surgery and 1 and 3 days after surgery.The postanesthesia care unit stay time and hospital stay time were recorded. Results:Compared with group C, the incidence of pulmonary complications was significantly decreased within 72 h after operation, Quality of Recovery-15 scores were increased at 1 and 2 days after operation, the number of white blood cells and neutrophils and percentage of neutrophils were decreased at 1 and 3 days after operation, and the postanesthesia care unit stay time and postoperative hospital stay time were shortened in group R ( P<0.05). Conclusion:RIPC combined with RIPostC can decrease the risk of postoperative pulmonary complications and is helpful for early postoperative rehabilitation in elderly patients undergoing thoracoscopic radical surgery for lung cancer.