Objective To evaluate the clinic application effects of laparoscopy in the diagnosis and treatment of abdominal difficult and complicated diseases.Methods The clinical data of 64 cases of agnogenic abdominal diseases underwent laparoscopic exploration and biopsies were retrospectively analyzed.All the patients were difficult cases to diagnose,who have one or more clinical situations,such as abdominal pain,ascites of unknown origin,abdominal mass and intestinal obstruction,and obscure hemorrhage of small intestine.Results Definite diagnosis was made in 62 patients after laparoscopy (96.9％).In patients with ascites,abdominal mass,intestinal obstruction and hemorrhage of small intestine,the definite diagnostic rate were 93.3％,100.0％,100.0％ and 6/6,respectively.The complication rate of laparoscopic exploration was 1.6％ (1/64).Underwent laparoscopic exploration,14 of 64 cases (22％) were treated by operation.Among them,8 cases (8/14) were treated by therapeutic laparoscopy,and other 6 cases (6/14) were treated by abdominal surgery without any comliactions.Conclusion Laparoscopic exploration is safe and effective in diagnosis and treatment of abdominal difficult and complicated diseases.

OBJECTIVE:To study the pharmacokinetics of lidocaine and bupivacaine in children undergoing epidural anesthesia so as to evaluate the safety and efficacy of this anesthetic method.METHODS:A total of 30 children who were expected to undergo surgery for undescended testis,hernia or high ligature for hydrocele were assigned to receive 2% lidocaine(5 mg?kg-1) plus 0.75% bupivacaine(1.875 mg?kg-1)(single epidural dose) by epidural anesthesia.Plasma concentrations of lidocaine and bupivacaine were determined by HPLC.Pharmacokinetics parameters were calculated and fitted by using DAS ver 2.0 pharmacokinetic program.RESULTS:The plasma concentration-time curves of lidocaine and bupivacaine were in line with a two-compartment model.The main pharmacokinetic parameters of lidocaine vs.bupivacaine were as follows:tmax 27.0 vs.33.0 min;t1/2? 43.97 min vs.73.52 min;Cmax 2.411 mg?L-1 vs.1.475 mg?L-1;AUC0～∞ 144.714 mg?min?L-1 vs.168.541 mg?min?L-1.CONCLUSION:The dosages of the local anesthetics injected into the epidural cavity of children are proven to be safe and effective.

AIM To investigate the effects of apoptosis and the expression of telomerase hTERT mRNA activity of HL-60 cells treated with As 2O 3 in different concentrations. METHODS HL-60 cells was cultured with As 2O 3 in different concentrations for 48 hours, then, cell apoptosis was detected with flow cytometry and the expression of telomerase hTERT mRNA was determined with RT-PCR respectively. RESULTS The percentage of the apoptosis in HL-60 cells were 2 28%?0 40%?2 55%?0 22% and 47 57%?2 79% respectively, as the cells were treated with 0 1 ?mol?L -1,1 0 ?mol?L -1,5 0 ?mol?L -1 As 2O 3 for 48 hours. The difference was significant between 5 0 ?mol?L -1 and 0 1～1 0 ?mol?L -1 groups(P

Parkinson's disease(PD) is one of the most common neurological degenerative diseases with unknown causes and pathogenesis,and may be associated with genetic and environmental factors.Recent studies showed that PD had genetic basis.Genetics research of PD has been a hot topic nowadays,which provides hope for revealing the pathogenesis of PD.

The arterial supply of the lower end of the human femur in 100 specimens, ranging in age from the newborn to 87 years, was studied by the perfusion method. Its blood supply is derived from the medial and lateral superior genicular arteries, the descending genicular artery and the middle genicular artery. A complete extracapsular anastomotic ring, surrounding the supracondylar portion of the lower end of the femur, is formed by the medial and lateral superior genicular arteries and the descending genicular artery in 55?4.97%. Its incomplete anterior part is linked by the periosteal arterial network in 45?4.97%. The vessels at the metaphyseal side of the growth plate end in a brush-like pattern, intimately connected to the hypertrophic layer of cells of the growth plate, each vessel turning back in a sharp loop. The anterior and posterior metaphyseal arteries which arise from the extracapsular anastomotic ring and network supply the supracondylar area. The medial and lateral epiphyseal arteries, arising respectively from the descending genicular artery and both superior genicular arteries, supply the medial part of the medial condyle and the lateral part of the lateral condyle. The anterior and intercondylar epiphyseal arteries, arising respectively from the periosteal network and the mildle genicular artery, supply the intercondylar area. The epiphyseal arteries which anastomose with each other in the ossific area of the epiphysis form the precapillaries and capillary network. The anastomotic branches between the epiphyseal arteries, ranging from 25 to 100 microns in diameter, form the arterial plexus in the epiphysis. With the closure of the epiphyseal plate, a free anastomosis is established between the metaphyseal and the epiphyseal vessels. The clinical significance of the topographical characteristics, the course and the distribution of the arterial supply to the lower end of the femur were discussed.

The arterial supply of the human tibia in 50 specimens, ranging in age from 4 to 87 years, has been studied by the arterial perfusion method. The tibia is supplied principally by branches of the anterior and posterior tibial arteries and the peroneal artery, with additional contributions from the inferior genicular arteries, the middle genicular artery and from the infrapatellar branch of the descending genicular artery. There is a continuous arterial anastomosis in the periosteal network on the non-articular surface of the tibia. The segmental periosteal ring arteries dividing into ascending and descending branches, connect with the branches from above and below to form the longitudinal anastomoses along the anterior, medial and the lower one-third of lateral tibial borders. The epiphyseal-metaphyseal regions are copiously supplied by vessels entering from the periphery and by the nutrient artery. With the fusion of the epiphyseal plate, a free anastomosis is established between the epiphyseal and metaphyseal nutrient vessels. The whole of the marrow and the inner two-thirds or three-quarters of its cortex are supplied by the nutrient artery. The outer third or fourth of the cortex is supplied by the periosteal vessels. Because the cortical longitudinal and transverse capillary systems are profusely anastomosed with each other and with the periosteal and endosteal circulatory networks, the blood can flow in either direction, depending on physiological conditions.The clinical significance of the arterial distribution to the tibia is briefly discussed.

[ ABSTRACT] AIM:To study the effects of soybean isoflavones on mitochondrial ultrastructure, neuronal apopto-sis and expression of cytochrome C, caspase-9 and caspase-3 in the rats with cerebral ischemia/reperfusion.METHODS:Adult healthy SD rats ( n=60 ) were randomly divided into 3 groups: sham group, ischemia/reperfusion injury ( I/R ) group and soybean isoflavone ( SI) pretreatment group.Soybean isoflavones (120 mg· kg-1 · d-1 ) were fed by gastric lav-age for 21 d.The global ischemia/reperfusion model of the rats was established by blocking 3 vessels, and then reperfused for 1 h after 1 h of ischemia.The morphological change of the cerebral cortex cells was observed under light microscope. The mitochondrial ultrastructure of the cerebral cortex cells was determined by transmission electron microscope.The apop-totic rate of the cerebral cortex cells was detected by flow cytometry.The expression of cytochrome C, caspase-9 and caspase-3 in the cerebral cortex cells was determined by semi-quantitative RT-PCR and immunohistochemical techniques. RESULTS:Disintegration of mitochondria membrane and disappearance of the mitochondrial cristae were seen in I/R group.Compared with I/R group, the change of ultrastructure of mitochondria was significantly improved by soybean isofla-vone pretreatment, and the neuronal apoptotic rate was also significantly decreased (P<0.01).The mRNA expression and protein content of cytochrome C, caspase-9 and caspase-3 in I/R group were obviously higher than those in sham group ( P<0.01).Compared with I/R group, the mRNA expression and protein content of cytochrome C, caspase-9 and caspase-3 in SI group were significantly decreased (P<0.01).CONCLUSION: Soybean isoflavones attenuate cerebral ischemia/reperfusion injury by stabilizing the structure of mitochondria, preventing cytochrome C release to the cytoplasm, inhibiting the activation of caspase-9 and caspase-3 and decreasing cell apoptosis.

Objective:To observe the effect of calcitonin gene-related peptide (CGRP) on the expression of osteoprotegerin (OPG) and receptor activator of nuclear factor-kappaB ligand (RANKL) in osteoblast cells through an in vitro breast cancer cell and osteoblast cell co-culture system. Methods:The metastatic breast cancer MDA-MB-231 or MDA-MB-435 cells were co-cultured with osteoblast MG63 cells to establish an in vitro microenvironment of bone metastasis of breast cancer. After treated with CGRP(1?108 mol/L),OPG and RANKL mRNA and protein expressions in osteoblast MG63 cells were examined by RT-PCR and Western blotting. Results:Expression of RANKL in osteoblast MG63 cells was up-regulated at both mRNA and protein levels when osteoblast MG63 cells were co-cultured with breast cancer MDA-MB-231 or MDA-MB-435 cells,while those of OPG in osteoblast MG63 cells were both down-regulated (P

Objective To compare the clinical and follow-up results of different ways of operation for the treatment of patients with hilar cholangiocarcinoma ,and to explore its e key technology and related prognosis .Methods 31 out of 50 patients with biliary and partial liver resection(control group) ,19 patients with hemihepatectomy (observation group) .Radical resection rate and surviv-al rate were compared in the two groups .Results radical resection rate control group and observation group was 35 .48% (11/31) and 68 .42% (13/19) ,the difference was statistically significant (P=0 .014);the difference of 1 ,3 ,5 year survival rates between the two groups were statistically significant (P= 0 .03) ,observation group :85 .4% ,58 .6% ,32 .2% ,control group:86 .1% ,65 .2% , 20 .0% .Conclusion Radical resection is still the most important measures the patients for cure and long-term survival ,radical re-section rate ,survival rate ,and prognosis could be improved greatly by improving operation skills and experience accumulation ,com-bined with hepatectomy .

Objective To investigate the correlation between the frustration tolerance and personality of medical college students and to discuss its promoting strategies.Methods Totally 460 college students were selected randomly.Questionnaire of frustration tolerance and scale of Eysenck personality inventory(EPQ) were used and the measurement data were compared with correlation analysis and regression analysis of SPSS 13.0.Results Correlation was significant between frustration tolerance (total score and 6 inducing factors) and personality (EPQ factors) of college students ； personality (EPQ factors)of students could predict their frustration tolerance and corresponding t value was -4.85,P ＜ 0.01 (psychoticism),6.93,P ＜ 0.01 (extraversion),-11.15,P ＜ 0.01 (neuroticism).Conclusions Personality of college students are greatly influenced by their frustration tolerance.Targeted anti-frustration ability training should be conducted according to the different personality characteristics.