Objective To search for the technique of increased safety and diminished blood loss through laparoscopic hysterectomy. Methods A technique for dissecting the pelvic retroperitoneum and identifying the ureters and uterine arteries was used in the right pelvic side wall. The left side was used a non-anatomical approach. Visualization of the right ureter necessitate opening the peritoneum of the right pelvic side wall. A technique of identification and dissection the right ureter and the uterine vessels retroperitoneal at the initiation of laparoscopic hysterectomy was used. First, the obliterated hypogastric arteries were identified retroperitoneally. Second,the paravesical and the pararectal spaces are developed. Finally, the ureter and the uterine vessels were easily identified from the pararectal space. Once the retroperitoneal dissection had been completed and vital structures identified, hysterectomy be carried out. Results WT Fifty patients underwent this procedure. Right pelvic side wall versus left mean operation time was 33 min versus 22 min, and the mean blood loss was 12 versus 30 ml. It took 21 min on average to identify the right ureter and the uterine vessels retroperitoneal. Conclusion Identification and dissection of the ureter and the uterine vessels retroperitoneal is an acquired skill. This technique increases safety and diminishes blood loss. The uterine arteries and the uterosacral ligament are confidently desiccated once the path of the ureter near is identified. A non-anatomical approach to laparoscopic hysterectomy may be easier to learn, but it is neither very versatile nor safe.

The ultrasound devices have been widely applied in hospitals.The audio & video teaching system for ultrasonic diagnosis based on network was built for training ultrasonic diagnosis skill.The system should lay emphasis on the design of consulting room,network,server,grouping study and meeting teaching systems.The system construction and application are introduced in combination with actual experiences in hospital.

Objective:To investigate the incidence, risk factors and early prognosis of acute kidney injury (AKI) after heart valve surgery in adults, and to provide evidence for the early prevention and treatment of AKI after heart valve surgery.Methods:Clinical data of patients undergoing heart valve surgery from January 2016 to March 2017 were collected retrospectively. Early postoperative AKI was diagnosed and staged according to Kidney Disease Improving Global Outcomes (KDIGO) clinical guidelines for AKI. Patients were divided into AKI group and non-AKI group according to whether AKI occurred within 48 hours after surgery, and the differences in clinical indexes between the two groups were compared and analyzed. Influencing factors for early postoperative AKI were screened by stepwise multivariate logistic regression.Results:A total of 600 patients were enrolled, including 197 patients in the AKI group and 403 patients in the non-AKI group. The incidence of AKI was 32.83%. In the non-AKI and AKI groups, proportion of renal replacement therapy (RRT) during hospitalization, mechanical ventilation time, intensive care unit (ICU) time and proportion of hospital mortality were different (all P<0.001). In the AKI group, 160 patients (81.22%) were in stage I, 33 patients (16.75%) were in stage Ⅱ, and 4 patients (2.03%) were in stage Ⅲ. The proportion of patients receiving RRT, mechanical ventilation time, ICU time, hospital mortality were also different in patients with AKI of different stages (all P<0.05). Logistic regression analysis results showed that males, body mass index≥24.0 kg/m 2, previous history of cardiac surgery, baseline serum creatinine >115 mmol/L, albumin<35 g/L, aortic occlusion time (AOT)>90 min, blood glucose in ICU after operation>11.1 mmol/L, the difference between the highest blood glucose within 48 hours after the operation and the blood glucose at 0 h after the operation≥2 mmol/L, blood lactic acid in ICU after operation>4 mmol/L and maximum vasoactive drug score within 48 hours after surgery>9 were independent influencing factors for early AKI (all P<0.05). Conclusions:The incidence of AKI within 48 hours after heart valve surgery is over 30%. The independent influencing factors include male, overweight/obesity, previous cardiac surgery, preoperative renal insufficiency, hypoproteinemia, long duration of AOT, post-operative stress hyperglycemia, fluctuating blood glucose levels wildly, hyperlactacidemia, and using more vasoactive drugs. AKI after cardiac surgery affects the early prognosis of patients, the later of the stage leads to the worse prognosis.

Objective To design and verify the reliability of a shoelace tensile test system. Methods Incremental loads of 0-196 N were applied to three tension sensors, each load was repeated nine times, with the load removed and interval of 30 s during the repeated tests. Then output voltage of the sensors under each load was collected. Linear regression analysis was used to explore linear relationship between the collected voltage signal and the incremental load. Accuracy, precision and consistency intervals were used to verify consistency of the measured values with the true load. Bland-Altman analysis and intra-group correlation coefficient (ICC) analysis were used to verify the repeatability and reliability of the tensile sensor. Results There was a significant linear correlation between output voltage signal of the sensors and the load (P< 0. 000 1, R2= 0. 999 9), and ICC of three sensors was above 0. 999 (P<0. 000 1). The mean values of the coefficients of variation of the measured values for three tensile sensors under different loads were 0. 003 8, 0. 002 2 and 0. 003 5, respectively. Conclusions The shoelace tensile test system has high reliability and can be used for real-time acquisition of shoelace tension.

Objective To investigate the effects of shoes type (barefoot, ordinary running shoes, minimalist shoes) and walking speed (jogging, walking at normal speed) on biomechanical parameters of knee joint, so as to provide theoretical reference for scientific fitness. Methods Vicon three-dimensional （3D） motion capture system and Kistler 3D force plate were used to collect biomechanical parameters of lower limbs from 10 subjects during walking at different speed with different shoes. Two-way (2 walking conditions × 3 shoe conditions) repeated measures analysis of variance was used to statistically analyze each dependent variable. Results Compared with jogging, the lateral excursion of plantar center of pressure (COP) was greater, the moment arm in frontal plane, the adduction moment and peak loading rate of knee joint were smaller, but the angular impulse of knee joint in frontal plane was greater. Compared with ordinary running shoes, the stride length was decreased, the lateral excursion of COP was greater, and the moment arm of knee joint in frontal plane, the knee adduction moment, the peak load rate and the angular impulse of knee joint in frontal plane were smaller. Conclusions In order to reduce the angular impulse and peak loading rate of knee joint in frontal plane, it is recommended to jog with small strides for ordinary people with minimalist footwear.

Older adults have decreased control of body balance with aging and are prone to fall. As the primary point of contact between human body and ground, footwear is critical for stability of older adults. The relationship between shoe characteristics and stability of older adults was systematically reviewed to determine the effect of footwear characteristics on stability of older adults. The results show that wearing shoes with shoelaces or velcro, low heels, wide outsole and appropriate soles, or using vibrating insoles and arch support insoles can help older adults improve their stability. Excessive sole spring and low sole hardness may have adverse effects on stability of older adults. This study can provide theoretical references for older adults to choose shoes reasonably and for the manufacturers to design and make shoes to prevent falls.