ObjectiveTo compare the influence of laparoscopic and abdominal hysterectomy on cellular immune function. Methods There were 28 patientsreceived laparoscopic hysterectomy (laparoscopic group) and 28 patients treated with abdominal hysterectomy (abdominal group).The surgical effects and the changes of preoperative and postoperative T lymphocyte subsets of two groups were compared.ResultsThe intraoperative blood loss,anal exhaust time,hospital stay and postoperative morbidity of the laparoscopic group were significantly better than those of the laparotomy group[ (84.7 ± 21.7) ml vs.( 108.0 ± 23.8) ml,(19.3 ±4.1) h vs.(23.8 ±3.8) h,(5.12 ± 1.14) d vs.(7.81 ±2.27) d,7.1％ (2/28) vs.17.9％(5/28),P ＜ 0.05 ].CD4 and CD8 in the 1st day after operation of two groups were significantly lower than that before surgery respectively [ laparoscopic group:(38.41 ± 5.52)％ vs.( 40.72 ± 6.46)％,(24.41 ± 3.78 )％ vs.(26.33 ± 4.17)％ ;abdominal group:(38.41 ± 4.97)％ vs.(40.13 ± 6.12)％,(24.41 ±6.32)％ vs.(26.25 ±4.56)％,P ＜ 0.05 ]; but CD4 and CD8 in the 3rd day after operation in the laparoscopic group[ (40.15 ±6.29)％,(27.23 ± 5.12)％] almost returned to normal level before surgery,while CD4 and CD8 in the 3rd day after operation in the abdominal group [ (36.15 ± 5.12)％,(23.15 ± 4.87 )％] still had significant differences compared with that before surgery(P ＜ 0.05).ConclusionsLaparoscopic hysterectomy with less blood loss,rapid postoperative recovery,fewer complications and less impact on cellular immune function,is superior to abdominal hysterectomy.Therefore,it deserves promotion and wide application.

OBJECTIVE To investigate the distribution and drug resistance of pathogens in urinary system infection.METHODS Collected from patients urine specimens of our hospital during Jan 2004 Dec 2008 were cultured,detected and studied drug resistance.RESULTS Among these pathogens,Escherichia coli rated the top one(44%),followed by coagulase negative Staphylococcus,fungi,Enterococcus,Klebsiella pneumoniae,Proteus and Pseudomonas aeruginosa.The Enterobacteriaceae were sensitive to imipenem(100%) and the Enterococcues and Staphytlococcus were sensitive to vancomycin(100%).But they all showed higher drug resistance to other antibiotics.CONCLUSIONS E.coli from urinary tract infection is the most common pathogen.In the treatment of urinary tract infection the commonly used drugs such as gentamicin,ciprofloxacin,etc,have produced a higher resistance.Clinician should pay attention to the changes in their drug resistance and use correctly.

Objective To evaluate the effects of milrinone on plasma levels of C reactive protein (CRP) , TNF-?, IL-8 and IL-10 during and after operation for tetralogy of Fallot performed under cardiopulmonary bypass (CPU) in children.Methods Sixteen ASA Ⅲ-Ⅳ pediatric patients aged l-12yr scheduled for operation for tetralogy of Fallot under CPB were randomly divided into two groups : (1) milrinone group ( M, n = 8) and (2) control group (C, n = 8) . In group M a loading dose of milrinone 50 ?g?kg-1 was given i.v. within 10 min, immediately after aortic unclamping, followed by continuous infusion at 0.2?g?kg ?min-1 . In group C equal volume of lactated Ringer's solution was infused instead of milrinone. Blood samples were taken from the CVP line before anesthesia (T0), 5 min after release of aortic cross-clamp (T1), 5 min after discontinuation of CPB (T2) , at the end of surgery (T3) and 24 h and 48h after operation (T4,5) for determination of plasma levels of CRP, TNF-?, IL-8 and IL-10 by radioimmunoassay.Results There was no significant change in plasma TNF-a concentration in both groups. Plasma CRP level increased significantly at 24 and 48 h after operation (T4 , T5 ) , in both groups and was significantly higher in group M than that in group C. Plasma IL-8 level increased significantly only at T2 and T3 compared to pre-anesthesia value (T0) in group M while in group C it increased significantly from T1-5 (P

Objective To investigate the expression of vascular growth factors including vascular endothelial growth factor(VEGF), basic fibroblast growth factor(bFGF) and platelet-derived growth factor (p-DGF) in placentae of pregnancy-induced hypertension(PIH) patients and their significance. Methods Placental tissues of 15 normal gravidas and 19 PIH women were collected. The expression of vascular growth factors were detected by immunohistochemistry (PAP) combined with the analysis of computer microphotography. Results The average grey value difference (GVD) of VEGF was 61.6?3.7 in moderate and severe PIH group, which was significantly lower than that of the normal control group (71.1?5.8) and mild PIH (70.9?8.9, P

[Objective] This study compared outcomes of in vitro maturation (IVM) and in vitro fertilization (IVF) intracytoplasmic sperm injection (ICSI) cycles after IVM of immature germinal vesicle (GV) oocytes.[Methods] ICSI was performed on metaphase II (MII) oocytes retrieved in 163 IVF-ICSI cycles (group I;n ＝ 987) or matured from GV stage oocytes in IVF-ICSI ( group II;n ＝ 132) and 37 IVM cycles ( group III;n ＝ 235).Fertilization and cleavage rates and embryo quality were compared among the three groups.[Results] The fertilization rate,cleavage rate and top quality embryos rate were higher in group I than group II and group III (84.9%,98.1%,and 61.6%;72.0%,90.5% and 22.1%l;75.3%,94.4%,and 25.1%,respectively).Blastomere numbers and morphology scores were highest in group I (P ＜ 0.05),but no significant differences existed between group II and group III.[Conclusion] The morphology of embryos developed from in vivo MII oocytes was superior to those from in vitro matured MII oocytes.No significant difference was observed in embryo morphology from immature GV oocytes in IVF and IVM cycles.

Objective To investigate the clinical efficacy of laparoscopic radical gastrectomy in elderly patients with advanced gastric cancer.Methods The clinical data of 85 elderly patients with advanced gastric cancer who were admitted to the Ningbo First Hospital from January 2012 to June 2014 were retrospectively analyzed.Laparoscopic radical gastrectomy was performed on 46 patients (LRG group) and open radical gastrectomy on 39 patients (ORG group).All the patients underwent primary tumor resection for gastric cancer + D2 lymph node dissection,and the postoperative recovery plans were done according to enhanced recovery program.The volume of blood loss,number of lymph node dissected,operation time,intraoperative arterial partial pressure of carbon dioxid (PaCO2),time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,postoperative hemoglobin,duration of hospital stay and occurrence of complications in the 2 groups were analyzed.The follow-up by outpatient examination and telephone interview was carried out on patients up to August 2014.The count data were analyzed by the chi-square test and Fisher exact probability.The measurement data with normal distribution were presented as x ± s and analyzed using the t test.The t' test was used if the data were deficient.Results Surgical procedures in the 2 groups were successfully carried out and no perioperative death occurred.There was no conversion to open surgery in the LRG group.The resection margins in all the patients were negative.The operation time and number of lymph node dissection in the LRG group were (239 ±68)minutes and 27 ± 10,compared with (227 ±50)minutes and 26 ± 10 in the ORG group,with significant differences (t =0.919,0.179,P ＞ O.05).PaCO2 in the LRG group was (41 ± 5) mmHg (1 mmHg =0.133 kPa),which was significantly higher than(36 ± 5) mmHg in the ORG group (t =4.745,P ＜ 0.05).The volume of blood loss was (102 ± 44)mL in the LRG group,which was significantly less than (200 ± 120) mL in the OPG group (t' =-4.807,P ＜ 0.05).The postoperative level of hemoglobin in the LRG was (110 ± 15) g/L,which was significantly higher than (98 ± 27)g/L in the ORG group (t' =2.471,P ＜ 0.05).The time to anal exsufflation,indwelling time of gastric tube,time for out-off-bed activity,time for fluid diet intake,duration of hospital stay in the LRG group were (2.6 ± 0.7) days,(2.1 ± 0.7) days,(1.1 ± 0.3) days,(4.1 ± 0.7) days and (11 ± 4) days,which were significantly different from (4.8 ± 1.5) days,(4.0 ± 1.8) days,(4.5 ± 0.6) days,(5.9 ± 1.8) days and (18 ± 3) days in the OR G group (t' =-8.415,-6.206,-33.831,-5.879,t =9.632,P＜0.05).Eight patients in the LRG group and 15 patients in the ORG group had complications,with the incidence of complications of 17.4％ (8/46) and 38.5％ (15/39),respectively,showing a significant difference (x2 =4.748,P ＜ 0.05).Forty-four patients in the LRG group and 36 patients in the ORG gorup were followed up for 2-25 months,1 patient in the LRG group and 2 patients in the ORG group died and others had full recovery.Conclusions Laparoscopic radical gastrectomy could provide a safe and complete tumor resection for elderly patients with advanced gastric cancer compared with open radical gastrectomy,meanwhile,it can improve postoperative recovery and reduce postoperative complications in elderly patients with advanced gastric cancer.

There are 1?024 cases of severe head injury hospita lized． 917 of them were closed head injury (89, 55%), 107 of them were opening head injury(10.45%)． Results: good recover: 326(31.83%)．moderate disability: 185(18.07%), severe inability 139(13.50%), persistent vegetative state　59(5.75%), death 315 (30.76%)． Conclusion: The early diagn osis and treatment of sever head injury is beneficial to the outcome of these patients． Special trea tment to different phrase of severe head injury, especially the moderate hypothermia treatment, co uld improve the outcome of these patients．

Taking Suxi Healthcare Center in Yiwu City, Zhejiang province as an example, the paper analyzed the present mission and organizational characteristics of township healthcare centers in China, especially their dual functionality of community public health and primary medicare. Based on such analysis, it designed a matrix-based model for organizational structure and job performance management for such heslthcare centers. The features are as follows. 1) The two dimensions of the matrix structure refer to the departments for medical treatment and the multi-village doctors team in the community, respectively and jointly offering primary medicare and public health services; 2) Jobs are designed based on the organizational structure and functionality. Every job carries out dual Junctions as described and managed by the job description and target responsibility certificate; 3) The job responsibility certificate is a breakdown of the balanced scorecard of the healthcare center, as divided between the departments for medical treatment and the multi-village doctors team; 4) The balanced scorecard of the township healthcare center is designed based on its strategic mission and developing plan. The entire organizational design and management of the center are built on the strategic orientation and logical programmed research.

Objective To investigate the short-term outcome of laparoscopic adjustable gastric banding (LAGB) for morbid obesity complicated with type 2 diabetes. Methods Eight morbidly obese patients with type 2 diabetes underwent LAGB from October 2006 to August 2007. The weight parameters, fasting (FBG) and 2-hour blood glucose (2hBG), medication for diabetes were assessed 1,3, 6 and 9 months after surgery. Results All of the patients lost weight, with a mean body mass index decreased from (38.7±7.5) kg/m2 before LAGB to (30.5±4.3) kg/m2 9 months after LAGB. The FBG and 2hBG were decreased significantly at month 6 and 9 after LAGB, with normal FBG and 2hBG in 4 patients. At month 9 after LAGB, 3 of 5 patients with insulin treatment before LAGB were changed to oral hypoglycemics, 1 was continuously administered with a reduced dose of insulin, and 4 patients stopped any medication. Conclusion LAGB is an effective procedure in the treatment of morbid obesity complicated with type 2 diabetes with a favorable short-term outcome.

Objective:To investigate the effect of IL-7 on differentiation of thymic T lymphocytes and dendritic cells' differentiation in vitro.Methods:Thymic lobes were apspectically removed from 15-day-old or 16-day-old mouse fetueses and were cultured by the way of fetal thymus organ cultures (FTOC) in vitro.Lobes were cultured in the dishes with or without Interleukin-7(IL-7),then collected the cultured cells respectively.The expression of CD4,CD8,CD11c,B220,Ia,and CD11b was detected by flow cytometry,and the morphology was observed under the ligt microscope.The proliferation of these cells was determined by cell counting.The cultured cells were used as stimulators for allogeneic T cells,whose proliferation were detected later by MTT method.Results:The result of cell counting indicated that the total amount of the thymocytes was decresed obviously after being cultured with IL-7,while the proportion of CD4~+ CD8~+ thymocytes decreased,the proportion of CD4~- CD8~-,and CD4~- CD8~+ thymocytes increased,and no much difference in the amount of CD4~+ CD8~- thymocytes was found.In addition,the amount of B lymphocytes,natural killer cells,and dendritic cells increased in different degree.Conclusion:IL-7 participates in differentiation and development of thymic T lymphocytes and dendritic cells.