Objective: To analyze the cost of laparoscopy and laparotomy in the treatment of tubal pregnancy.Methods: The selected patients of tubal pregnancy were operated on in our hospital from Jan. 2000 to Jun. 2002. Eighty received laparoscopy and 13 received laparotomy.The off work day, hospital charge, cost of no work and total cost were analyzed and compared.Results: The mean hospital stay and off work days were significantly shorter in the laparoscopy group than in the laparotomy group( P

Objective: To introduce an improved direct method for first puncture and to study the safety of first puncture in laparoscopic surgery.Methods: Four kinds of techniques were used to perform the first puncture on 4 102 patients.Group A: trocar puncture were performed after pneumoperitoneum in 2 492 cases.Group B: trocar puncture was directly through the incision of umbilical skin in 798 patients; Group C: trocar puncture was directly through the incision of umbilic skin,subcutancous fat and fascia in 387 patients.Group D: opened umbilical hole and inserted the trocar shell without puncture in 425 cases.it was a success if entered the abdominal cavity at the first time,it was unsafe if punctured twice and a failure if the needle hadn't entered the abdominal cavity for 3 times or went into the subcutaneous vessels or viscera.Results: There were no vessels and viscera injury during punctures in our study.The puncture results were related to the different methods.Compared with group A, the success rate of group C and D were significantly improved( P 0.05).Success rates of group C and D were significantly higher than that of group A.The success rate was higher in group D than in group C( P

The present study predicts the development of health manpower and level structure of paramedical and pharmacy higher education by methods of dynamic series, tendency extrapolation, grey forecasting and special istic prediction. The results show that in the future 5-10 years, it is suitable for the paramedical and pharmacy higher education lo enroll 50 000-70 000 new students every year, which will account for 35 percent of total medical students of higher medical education. In their level structure undergraduates will gradually reach 30 percent and students receiving 3-year special-i/ed training 70 percent. Some policy suggestions are put forward on the basis of prediction.

The thioredoxin system consists of thioredoxin(Trx),thioredoxin reductase(TrxR)and reduced nicotinamide adenine dinucleo-tide phosphate.Trx is a small redox-active multifunctional protein.Thioredoxin 2,which is localized in the matrix mitochondria,has been shown involved in not only oxidative stress,nucleic acid metabolism,cell grow and apoptosis,but also many diseases such as organism growth and development,oxidative stress damage,cancer and ischemical reperfusion injury.It participates in redox reactions by reversible oxidation of its active center dithiol to disulfide and catalyzes dithio-disulfide exchange reactions involving many thiol-dependent processes.As signaling molecule,Trx2 participates in many signaling pathways.

Congresses as Topic ; Otorhinolaryngologic Surgical Procedures ; Rhinitis ; surgery ; Skull Base ; surgery

Objective To evaluate the renal function response to vasopressin in obstructed and non-obstructed kidney in vasopressin-deficient rats by using dynamic enhanced MRI. Methods This study included 26 vasopressin-deficient Brattleboro(BB)rats.Unilateral ureteral obstruction(UUO) model was set up in 12 BB rats.After releasing UU0 24 h,treatment of AVP was given in 7 non-obstrueted and 7 obstructed BB rats for 6 d.Seyen normal Wistar rats and 7 BB rats were used as control.Dynamic enhanced MRl was performed at 0-60 min following the administration of GadoliniumDTPA(0.05 mmol/kg)and the mean relative signal intensity(RSI)was measured. Results BB rats RSI increase occurred during the first minute,with a maximum mean RSI of(149±10)%in cortex,(155±13)%in medulla and(146±13)%in pelvis.Then,a gradual decrease in the cortical RSI occurred,after which a small increase was observed in Phase 3.BB rats RSI patterns were different from Wistar rats.After AVP treatment,mean RSI of BB rats in cortex,medulla and pelvis reached a maximum of(180±6)%,respectively at 30 sec,followed by a fast decrease at 1 min.Then,RSI decreased gradually.Phase 3 demonstrated a moderate increase in medullary and a relative large increase in pelvic RSI until 30 min after injection,after which RSI returned to baseline.BB rats RSI patterns after AVP treatment were similar to that of Wistar rats.Cortical,medullary and pelvic mean RSI increased slowly compared to non UUO rats.In phase 3,mean RSI of all segments decreased gradually.UUO rats RSI patterns were different from non UUO rats.After AVP treatment in UUO rats,mean RSIs of all segments increased faster compared to UUO rats without AVP.Cortical mean RSI reached a maximum of(193±7)% at 2 mim Mean RSI of medulla were unchanged,but the pelvic mean RSI deereased gradually to a minimum of(77±5)%at 5 min.Phase 3 was characterized by a slight recovcry of all RSIs.UUO rats RSIs were recovered after AVP treatment.The renal blood flow(RBF)of UUO rats was decreased to(1.1±0.1)m1·min-1·100g-1,wherease the RBF was increased to (1.9±O.3)ml·min-1·100g-1 after injecting AVP. Conclusion Dynamic enhanced MRI may provide useful information for distinguishing between kidneys having changes in the renal vasopressin concentration and the kidneys suffer from the obstructed renal damage.

Objective To discuss the metabolic characteristics and significance of peripheral blood cell and T lymphocyte subgroup in patients with air condition disease.Methods Thirty-six patients diagnosed as air condition diseases with fever and 30 patients diagnosed as non-fever patients enrolled this study as observation group(fever group and non-fever group respectively),and 30 health population were used as control.The changes of peripheral blood cell and T lymphocyte was measured using regular blood examination and flow cytometry.Results(1)No significant diffence on white blood cell was found between the three groups(F =1.89,P =0.134);(2)The percentage of neutrophils was(68.13 ±5.67)％,(53.24 ±8.36)％ and(61.25 ±6.31)％ respectively in the fever,non-fever and control group,respectively.Compared to the non-fever and control group,the percentage of neutrophils were significantly higher(t =6.64,9.13; P =0.018,0.027 respectively).No signiciant difference in the percentage of neutrophils was found between the non-fever group and control group(P =0.356,0.125).The percentage of lymphocyte percentage was(31.66 ±7.11)％,in the fever group,which was significantly higher than those of(43.67 ±8.17)％ and(30.98 ± 8.76)％ in the nonfever and control group(t =5.59,4.98 ; P =0.022,0.021 respectively).(3)The percentage of CD4 + was (36.351 ± 6.531)％,(42.676 ± 5.169)％ and(39.253 ± 5.461)％ in the fever,non-fever and control group,respectively.The percentage of CD4 + in the fever group was significantly lower than that in the non-fever group(t =1.28,P =0.039),whereas the percentage of CD4 + in the non-fever group was significantly higher than that in the control group(t =3.80,P =0.048).The percentage of CD8 + was(28.084 ± 7.344)％,(21.186 ± 6.331)％ and(24.607 ± 7.108)％,respectively.Compared to nonfever group,the percentage of CD8+ was significantly higher(t =3.17,P =0.016).(4)The ratio of CD4 +/CD8 + was(1.629 ±0.554)％、(2.380 ± 0.391)％,and(2.079 ± 0.659)％.Compared to the non-fever and control group,the ration in the fever group was siginificantly lower(t =19.21,P ＜ 0.001 ; t =6.98 ; P =0.006),whereas compared to the control group,the ratio in the non-fever group was significantly higher(t =8.68,P =0.031).Conclusion The changes of T subgroup show the unbalance immunity function network in patients with air condition disease.

Objective To investigate the technique of b iliary reconstruction and treatment of biliary complications in orthotopic liver transplantation (OLT). Methods From Feb. 1999 to Jan. 2003, OLT was performed in 103 patients with end-stage l iver disease. OLT was performed with standard techniques with or without a veno -venous bypass. Reconstructions of biliary tract were performed using choledoc hocholedochostomy (CDC) or Roux-en-Y choledochoje- junostomy (RCDJ). CDC was carried out in 94 cases, with T tube (CDCT) in 62 cases and without T tube (CDCO ) in 32 cases respectively. Among the 32 cases without T tube, 11 had a small tu be placed in the common bile duct through the recipient cystic duct. RCDJ was pe rformed in 9 cases without internal stent. Diagnosis of the biliary complication s after OLT was based on the clinical manifestations, ultrasound findings, MRCP and ERCP. All the patients were followed up regularly after discharge for 12 to 48 months. Results The overall incidence of biliary complications in 103 patients after OLT was 7 .8% (8/103). Of the 62 cases of CDCT posttransplant, biliary complications occ urred in 6 cases ( 9.6% ), including 4 cases of bile leaks following OLT and 2 cases of bile leaks following T-tube removed. Of the 32 patients subject to CD CO, 1 ( 3.1% ) had stricture of anastomosis. Of the 9 cases subject to RCDJ, one patient was complicated with bile leaks at the anasto mosis. Two cases of the bile leaks were drained reoperatively, and others were k ept adequate drained. The patient with stricture of CDCO was cured by balloon di latation and stent placed endoscopically. No death associated with biliary compl ications occurred. Conclusions Bile leaks and stricture of anatomosis are the common biliary complications afte r OLT. Good blood supply to biliary tract and surgical technique are the keys to prevent biliary complications after OLT. The timely endoscopical and radiologic al technique is a valuable nonoperative precedure for diagnosis and treatment of biliary complicat ions.

Objective To survey the clinical effect of combination therapy of Ninggan-Tiaozhong decoction and psychological intervention for chronic atrophic gastritis (CAG).Methods 80 cases CAG were randomly divided into a treatment group (treated with Ninggan-Tiaozhong decoction and psychological intervention) and a control group (treated with Ninggan-Tiaozhong decoction),with 40 cases in each group and performed a therapy for 12 weeks.The clinical efficacy and the change of Symptom Checklist (SCL-90)and Self-Rating Anxiety Scale(SAS) before and after treatment were evaluated.Results After 12 weeks of treatment,the total effective rate was 90.0％ in the treatment group,and 74.4％ in the control group.The treatment group was better than the control group(x2=4.255,P＜0.05).After psychological intervention,SCL-90 and SAS score (39.5±4.3,1.3± 0.6)was significantly reduced in the treatment group than the control group (51.4±3.2,1.5±0.3),(P＜0.05).Conclusion The combination therapy of Ninggan-Tiaozhong decoction and psychological intervention used in CAG is effective to relieve symptoms and to improve life quality of patients.