Objective To investigate the feasibility and the short-term efficacy of laparoscopic surgery for the treatment of uterine malignant tumors. Methods Laparoscopic radical hysterectomy and pelvic lymphadenectomy was performed in 25 cases of cervical cancer and 24 cases of endometrial cancer from February 2003 to March 2005 in this hospital.Of the 49 cases,a selective paraaortic lymphadenectomy was carried out in 5 cases. Results All the operations were successfully performed under laparoscope except for 1 case of conversion to open surgery.The operating time was 190?45 min,the blood loss during operation was 172?99 ml,and the number of excised lymph nodes was 17?6.Surgical complications occurred in 8 cases(8/49,16%),including 1 case of bladder injury,1 case of internal iliac vein injury,3 cases of urinary retention,1 case of vesicovaginal fistula(VVF) at the 6 postoperative month,and 2 cases of lymphatic cyst.Follow-up observations were carried out for 1~12 months in 21 cases,12~24 months in 17 cases,and 24~27 months in 4 cases.No recurrence was seen.Conclusions Laparoscopic surgery for the treatment of uterine malignant tumors is safe and feasible and offers significant short-term effects.

Objective To investigate the clinical value of laparoscopic myomectomy.Methods A retrospective analysis was made on clinical data of 58 cases of laparoscopic myomectomy(Laparoscope Group) and 52 cases of open myomectomy(Open Group) from October 2002 to February 2004 in this hospital.Results The laparoscopic operation was all accomplished.The Laparoscope Group had significantly shorter operation time(58.0?11.2 min) than the Open Group(69.4?10.3 min)(t=(-5.535),(P=0.000)),less intraoperative blood loss(71.6?34.8 ml) than the Open Group(149.1?38.9 ml)(t=-11.029,P=0.000),lower postoperative pyrexia rate(21/58) than the Open Group(39/52)(?~2=16.642,P=0.000),shorter hospital stay(4.5?1.6 d) than the Open Group(7.6?2.1 d)(t=-8.760,P=0.000),higher total hospitalization costs (6 511.3?566.7 yuan) than the Open Group(6 286.8?387.5 yuan)(t=2.398,P=0.018),higher costs for anesthesia and operation(1 566.7?154.7 yuan) than the Open Group(946.6?156.6 yuan)(t=20.868,P=0.000),and lower costs for postoperative medication(703.5?140.2 yuan) than the Open Group(1 278.4?237.6 yuan)(t=-15.643,P=0.000).Follow-up observations in 56 cases in the Laparoscope Group and 50 cases in the Open Group for 18~34 months(mean,26 months) revealed no statistical differences in recurrence rate and pregnancy rate between the two groups.Conclusions Laparoscopic myomectomy has advantages of little hemorrhage,fast recovery,short hospital stay,and low complication rate,being one of ideal methods for the treatment of hysteromyoma.

We have been in charge of the teaching of the curriculum of Obstetrics & Gynecology for foreign students from Pakistan since the year of 2005,and hitherto there have been two grades of foreign students who have received this course.We have accumulated some experience through the practice of teaching,and discovered some shortcomings and problems,which are summarized as three respects:teachers and equipment,study of students,and cooperation of patients.In allusion to the shortcomings and problems,we think that we should take measures and make improvement in the respects of teachers,students,patients and so on,in order to improve the quality of the teaching for foreign students in our school.

Objective To investigate the feasibility,reliability,and complications of laparoscopic second-look exploration for ovary epithelial cancer.Methods The operation was performed under general anaesthesia.The 4-port laparoscopy was carried out.Physiological saline was used to wash the abdominal and pelvic cavity for cytological examination.Then the exploration of abdominal and pelvic cavity was performed,adhesions were dissected,and multiple punch biopsies(at more than 20 sites) were conducted in the abdominal and pelvic cavity.Results All the operations were completed successfully.The operative time was 61.3?16.7 min,and the hemorrhage volume was 98.7?32.1 ml.Positive findings were encountered in 4 cases(28.6%),3 of which(21.4%) were identified by the naked eye and 1 of which was identified by microscope,and negative findings,10 cases(71.4%).Of the 4 cases of positive findings,the tumor was located at the pelvic peritoneum or the paracolic sulci peritoneum.No abdominal organ injuries occurred,and no conversion to open surgery was needed.Delayed healing of umbilical incision happened in 1 case.Of the 10 cases of negative findings,recurrence of tumor was observed in 1 case(10.0%) at 48 months after operation.Conclusions Laparoscopic second-look exploration for ovary epithelial cancer is feasible,with advantages of minimal invasion,fast recovery,and good patient's tolerance.

Objective To investigate the feasibility of laparoscopic radical hysterectomy and abdominopelvic lymphadenectomy in the treatment of malignant uterine tumors.Methods Laparoscopic radical hysterectomy and abdominopelvic lymphadenectomy was performed in 62 cases of biopsy-confirmed early-stage malignant uterine tumors from February 2003 to August 2005.There were 26 cases of endometrial cancer and 36 cases of cervical cancer.Pelvic lymphadenectomy was conducted in all the cases;while selective lymphadenectomy of peripheral lymph nodes of the abdominal aorta was performed in 5 cases,followed by laparoscope-assisted vaginal hysterectomy(LAVH).Results The operation was completed under laparoscope in 61 cases,and a conversion to open surgery because of venous injuries was encountered in 1 case.The operation time was 165～265 min(mean,217 min);the intraoperative hemorrhage volume was 150～1200 ml(mean,260 ml);the number of excised lymph nodes was 13～23(mean,17).Bladder injury happened in 1 case and was successfully repaired under laparoscope.Postoperatively,urine retention developed in 4 cases and lymphatic cyst occurred in 5.Follow-up checkups for 1~28 months in 61 cases showed 1 case of recurrence at 3 postoperative month(stage Ⅱ_B cervical adeno-squamous carcinoma,withdrew from the treatment and died 4 months later).Conclusions Laparoscopic radical hysterectomy and abdominopelvic lymphadenectomy is safe,feasible,effective,and reliable.

Objective To observe the effect of wound specialist group on preventing and managing pressure ulcer in operation. Methods The knowledge about pressure ulcer and ability of risk assessment for pressure ulcer of operating room nurses were tested and the incidenc-es of pressure ulcer were compared before and after the intervention of the wound specialist group. Results After the intervention of the wound specialist group, the passing rate of nurses in operating room increased from 58.23%to 94.11%in pressure ulcer theory (χ2=29.63, P<0.001) and from 56.96%to 95.29%in new type of dressings paste (χ2=33.80, P<0.001), and the rate of pressure ulcer risk factor assessment increased from 56.38%to 93.35%(χ2=5828.07, P<0.001), accuracy of assessment increased from 56.23%to 96.78%(χ2=4674.89, P<0.001). The incidence of intraoperative acute pressure ulcer decreased from 1.5‰to 0.22‰(χ2=17.59, P<0.001). Conclusion The intervention of wound specialist group may improve the awareness of assessing risk factors of pressure ulcer in the operation room and standardize the oper-ation to prevent pressure ulcer, and reduce the incidence of pressure ulcer in operation.

Objective To observe the therapeutic efficiency of naoxintong capsule on the patients with moderate obstructive sleep apnea hypopnea syndrom ( OSAHS ) of cognitive dysfunction. Methods Sixty pa?tients of moderate OSAHS were randomly divided into treatment group and control group, 30 cases in each group. Patients in the treatment group were given naoxintong capsule,three goals,three times a day,at the same time,with double level positive pressure ventilation therapy for 3 months. Patients in the control group accepted double level positive pressure ventilation therapy for 3 months. The questionnaires of Montreal Cognitive Assess? ment( MoCA) were administered to assess cognitive in all the patients before and after treatment. Results There was no statistically significant difference in term of MoCA score between the two groups before treatment( t=0. 14,P>0. 05). After treatment,the MoCA score of the treatment group was (25. 83+1. 70),of control group was (22. 70+2. 51),the difference was statistically significant(t=5. 62,P<0. 05). The visual space and execu?tive function,naming,attention,language,abstract,delayed recall and directional score in the treatment group af?ter treatment were (5. 03±0. 81) points,(2. 90±0. 31) points,(4. 73±0. 58) points,(2. 63±0. 49) points, (1. 97±0. 18) points,(3. 93±0. 98) points,(5. 03±0. 56) points respectively,compared with before treatment ((4.07±0.79) points,(2.17±0.59) points,(3.40±0.50) points,(2.03±0.49) points,(1.80±0.41) points,(2. 87±0. 73) points,(4. 03±0. 77) points),the differences were statistically significant (t=6. 55, 6. 89,13. 36,5. 29,2. 41,4. 87,6. 60;P<0. 05) . The naming,attention,language,abstract,delayed recall and di?rectional score in the control group after treatment were ( 2. 77 ± 0. 43 ) points, ( 4. 07 ± 0. 75 ) points, ( 2. 20 ±0. 55) points,(1. 87±0. 35) points,(3. 10±0. 66) points,(4. 67±0. 71) points respectively,ompared with be?fore treatment((2. 30±0. 65) points,(3. 43±0. 68) points,(2. 00±0. 70) points,(1. 73±0. 45) points,(2. 93 ±0. 58) points,(3. 93±0. 69) points),the differences were statistically significant(t=5. 04,4. 34,2. 26,2. 11, 2. 41,6. 28;P<0. 05) . MoCA score in treatment group than the control group have improved significantly in visu?al space and executive function,attention,language and delayed recall,directional ( t=4. 51,3. 80,3. 22,3. 86, 2. 23,P<0. 05) . Conclusion Naoxintong capsule can improve cognitive dysfunction in patients with moderate OSAHS.

9).Renal pathology revealed 3 patients with class Ⅳ, 1 patient with class Ⅱ. Image results showed diffuse pulmonary infiltration lesions. Bronchial lavage fluid was hemorrhage. Three patients recovered after treatment with corticosteroid and intravenous cyclophosphamide therapy. Conclusions Diffuse alveolar hemorrhage is rare serious complications of lupus nephritis. Aggressive immunosuppressive therapy should be started early for a favorable outcome.

AIM To study the expression of brain-derived neurotrophic factor (BDNF) in lymphocytes modified by BDNF gene and its effect on the proliferation and the H 2O 2-induced apoptosis of PC12 cells for the transfer of ex vivo therapeutic gene into central nervous system (CNS) tissue with atraumatic means. METHODS Recombined BDNF cDNA plasmid was transfected by LipofectAMINE into the packing cell line PA317 and G418-resistant clones with highest titer was selected. Rat lymphocytes were infected repeatedly with virus supernatant. The expression of BDNF in rat lymphocytes was assayed by FCM and immunohistochemistry. The proliferation of PC12 cells was evaluated by MTT assay. H 2O 2-induced apoptosis of PC12 cells was determined by PI stain flow cytometry. RESULTS BDNF expressed in rat lymphocytes genetically modified and the concentration of BDNF in the conditioned medium of engineered lymphocytes had a linear correlation with the proliferation of the PC12 cells. The supernatant of lymphocytes modified by BDNF gene decreased the apoptosis of PC12 cells induced by H 2O 2. CONCLUSION Rat lymphocytes genetically modified can express and secret active BDNF in vitro.

Objective To explore the effects of different courses of antenatal dexamethasone on brain development of premature SD rats. Methods The pregnant rats were randomly assigned to 3 groups: 3-dose dexamethasone (group 1), 1-dose dexamethasone group (group 2) and control group. The treated were sacrificed on 19 days of gestation, body and whole brain weight of the offspring rats were measured. Meanwhile the expression o{ neuron specific enolase (NSE) in brains of offspring rats was detected by immunohistochemical staining. The histological structures of baby rat brain were observed under transmission electron microscope. The differences among the three groups were analyzed by ANOVA. Results (1) The body and whole brain weight, the brain and body weight ratio were (1.543±0.052) g, (88.80±7.12) mg, and (5.75±0.38)% in group 1 and (1.584±0.035) g,(98.21±3.71) mg, and (6.20±0.26)% in group 2, both were lower than the control group [(1.696±0.076) g, (111.53±6.29) mg, (6.59±0.48)%], (P<0.01 or P<0.05, respectively). (2) The expression of NSE in cortex in group 1 and 2 were lower than that in control group (0.223±0.054, 0.381±0.041 vs 0.590±0.064) (P<0.01). The expression of NSE in hippocampi in group 1 and 2 were also lower than that in the control group (0.192±0.054, 0.359 ±0.046 vs 0.529±0.068) (P<0.01). (3) Disconnection of nuclei membrane, vacuolization in mitochondria, loss of nueleolus, and disconnection of neurofilaments were observed in the ultrastructure of baby rat brain tissue in both group 1 and 2. Conclusions Antenantal administration of dexamethasone can cause impairment of brain development in premature offspring rats and this might be related to the times of dexamethasone administered.