Objective To evaluate the application of Endoscopic ultrasonography (EUS)in preoperative diagnosis of gastric cancer and staging. Method 78patients were assigned to EUS and gastroscope examination before operation,the staging result were compared with pathological staging result. Result Compared with pathological staging,the accurate rate of EUS in T staging and N staging before gastric cancer was 85.9% and 80.77%. Conclusion EUS can be used in judgment of gastric cancer staging accurately,may be of significance in the decision of operation plan.

Neurobiology,one of the important subject in life science frontier,comprises extensive and comprehensive contents.It is significant and essential for each discipline of medicine to offer this course.During last several years of teaching and practice,some methods,skills and ideas have been utilized and summarized.Modem medical education,by offering this course,will accord with the development concept of the transition from biomedicine to bio-psycho-social medical model,and this course will provide the substantial foundation for cultivating qualified medical students.

Objective To observe the sedative and analgesic effects of local anesthesia with midazolam and sufent-anil for patients in ophthalmologic plastic surgery. Methods A total of 160 patients (ASA I-II) were randomly divided into two group using a random number table, 80 cases in each group, groupⅠ: local anesthesia and groupⅡ: local anesthesia with midazolam (0.05 mg/kg) and sufentanil (0.1μg/kg). Values of bispectral index (BIS), systolic blood pressure (SBP), dia-stolic blood pressure (DBP), heart rate (HR), respiratory rate (RR), oxyhemoglobin saturation(SpO2) and visual analogue scale (VAS) were recorded after patients entered into the operating room, during the time of injection of local anesthesia, at the beginning of the procedure, 20 min after the surgery and after operation. It was also recorded including hypoxemia, ap-noea, restlessness, nausea and vomiting and the duration of surgery. Results There were no significant differences in age, gender, weight and duration of surgery between two groups of patients. There was a significantly lower BIS value before inject-ing local anesthesia, at the beginning of the surgery and 20 min after the surgery compared with that of time point that pa-tients entered into the operating room in groupⅡ(P<0.05). In groupⅠthere were significantly higher values of SBP, DBP and HR during the injection of local anesthesia, at the beginning of the procedure, 20 min after the beginning of the proce-dure and after the surgery than those of time point that patients entered into the operating room;the value of RR was signifi-cantly increased during the injection of local anesthesia, at the beginning of the procedure and 20 min after the beginning of the procedure than that of time point that patients entered into the operating room (P<0.05). Compared with before anesthe-sia induction, values of SBP, DBP, HR and RR were significantly decreased in groupⅡ(P<0.05). There were significantly lower levels of SBP, DBP, HR and RR during the local anesthesia injection to the time after surgery in groupⅡthan those of groupⅠ. The value of VAS was significantly higher during the time of injection of local anesthesia and during the surgery in groupⅠthan that of groupⅡ(P<0.05). There were 15 patients with restlessness in group I, which were higher than those of groupⅡ(3 patients with restlessness). There were 3 patients with nausea and 3 patients with anoxemia and no apnea in group Ⅱ. Conclusion The conscious sedation with midazolam and sufentanil is an effective anesthetic technique for patients in ophthalmo-logic plastic surgery.

Objective To compare the treatment effects of minimally invasive exfoliation's point of varicose veins pump-stripping surgery and traditional treatment of varicose veins of lower extremity surgery.Methods 106 cases with lower extremity varicose veins were simple randomly divided into A,B groups.A team exfoliation new minimally invasive devices for minimally invasive varicose veins stripping point-pumping operation,B group is the traditional line of lower extremity venous stripping pump surgery,after the results of comparative assessment.Results Hemorrhage (15.3 ± 5.4) mL,operation time (58.9 ± 14.3) min,hospitalization time (4.8 ± 1.3) d and operation cost (5124.5 ± 524.7) yuan of group A were lower than those of group B [(65.4 ± 25.1) mL,(72.5 ± 18.6) min,(6.8 ±2.4) D and (6 179.6 ± 623.8) yuan] (P =0.023,0.035,0.019,0.027).Conclusion The minimally nvasive exfoliation's saphenous vein high ligation stripping point-pumping operation not only small wounds,easy to operate,and less post-operative complications and rapid recovery,and on the cost of hospitalization is superior to traditional surgery.

The authors discussed the retention and revision of the Regulations on the Handling of Medical Malpractice following the enforcement of the Tort Liability Law.These discussions also covered the amendment of the concept of medical malpractice,and the reforms to make on the medical malpractice appraisal system built upon the Regulations following the enforcement.In the meantime of applying the Law to judge cases of medical malpractice,the Regulations as an administrative regulations issued by the State Council,should be revised before playing its role in preventing medical malpractice,medical dispute handling,and penalising medical institutions and medical workers of malpractice.

Objective The aim of the study is to investigate whether the progressive incremental exercise can induce the change in bone maximum force.Methods One hundred and seventy healthy SD rats,aged 3 months,were used as samples after adaptive exercise for one week,and then they were divided to a basic control group(C_0),8 control groups and 8 exercise groups according to the training duration(2W,4W,6W,8W,9W,11W,13W and 15W).Based on Bedford and our pre-study.the longest training duration of the rats was 15 weeks.The maximum force(F) of femoral bone and the 2nd lumbar vertebrae(L_2)were tested by three-point bending test and compressive test separately.Results It was shown that there was no pronounced difference in F of femoral bone between con trol groups and exercise groups.But significant differences in F of L_2 were found between the control groups and exercise groups(P<0.001).Conclusions Changes in different degree were found in the F of femoral bone and L_2 during the process of growth.The differential effects of incremental exercise on F were caused by the difference in training intensities and in the bone types.

Hypertriglyceridemia is one of the clinical manifestations of hypothyroidism.Besides regulating thyroid hormone axis,thyroid stimulating hormone (TSH) also has the effect on up-regulated expression of inflammatory cytokines.Synthesis of inflammatory factors can promote the expression of apolipoprotein B48 (ApoB48) in intestinal mucosal epithelial cells,suggesting that TSH may up-regulate the expression of ApoB48 by inducing inflammation; while theoratically,low-level of thyroid hormones can inhibit the synthesis of ApoB48.At the same time,since ApoB48 is the important cause of hypertriglyceridemia,there is a contradiction that it is difficult to explain the clinical phenomenon of hypertriglyceridemia induced by hypothyroidism.Therefore,hypothyroidism may affect the expression of ApoB48 by high level of TSH and low level of thyroid hormones,leading to hypertriglyceridemia.

Objective To explore the effect on ultrasound localization method with radial artery cannulation in infants.Methods Sixty infants (1 month-1year old)undergoing elective surgical proce-dures required artery pressure,were randomly divided into two groups:ultrasound localization group (group B):the infants were used of portable B ultrasound probe in the wrist with two dimensional ul-trasound image to determine the body position of the radial artery;control group (group C):tradi-tional palpation determine the radial artery puncture position.One puncture success rate,total punc-ture success rate,the period of puncture time and incidence of complications were recorded;MAP, the radial artery diameter,the vertical distance from the ultrasound probe to the skin and the length from the puncture spot to the radial artery were also measured.Results The success rate of first puncture in group B was higher than that of group C (P <0.05),the times of puncture and procedure time were significantly less than those of group C (P <0.05),the incidence of hematoma was lower than that in group C (P <0.05).Conclusion The application of ultrasound-guided method for radial artery cannulation is safe and reliable with accurate localization,highly successful rate of puncture at first time,lower complication and shorter time for placement.

BACKGROUND: Changing the local environment of spinal injury promotes the repair and regeneration of injured nerve and recovery of partial nervous function of spinal cord. Transplantation of olfactory ensheathing cells can improve the local internal environment of injured spinal cord.OBJECTIVE: To probe into the effect and safety of transplantation of olfactory ensheathing cells on functional repair of spinal cord and nerve in patients with obsolete spinal injury DESIGN: Self-control experiment.SETTING: Wards of the Department of Surgery, Taian Rongjun Hospital of Shandong Province.PARTICIPANTS: Totally 48 patients admitted for obsolete spinal injury in the Department of Surgery, Taian Rongjun Hospital, between June 2004 and July 2005 were recruited. There were 39 males and 9 females, aged 7 to 59 years with the mean of 36 years.METHODS: ①Cell culture: Olfactory bulb of aborted fetus was digested into single olfactory ensheathing cells, which were then cultured and puri fied for 1 to 2 weeks, and finally made into single cell suspension. ②Operation and cell transplantation: Under general anesthesia, the purified single cell suspension (about 0.05-0.20 mL) of olfactory ensheathing cells was injected into the corresponding spinal injury site through multiple points with home-made syringe of 0.45 mm in diameter. Stitches were taken out at postoperative 10 to 14 days. ③Evaluation of spinal function: Injury Scoring Standard made by American Spinal Injury Association (ASIA) was used for scoring, comparison and statistical analysis at postoperative 1 day and 2 weeks to 2 months. ④Spinal function of 48 patients was observed or followed up through telephone at postoperative 3 weeks to 1 year.MAIN OUTCOME MEASURES: Changes of postoperative sensory function of the patients. Changes of postoperative motor function of the patients. Changes of postoperative automatic nervous system of the patients.RESULTS: ①All the 48 patients had improvement in spinal function, and continued improved tendency was found in the observation and follow-up through telephone at postoperative 3 weeks to 1 year. ②Scoring by ASIA for sensory function was higher after operation than before operation (touch sensation: 56.9, 51.2, P ＜ 0.01; pain sensation: 55.2, 48.3, P ＜ 0.01). Sensory function was improved obviously at the lower shift of sensory level,generally more than 2 segments. ③Scoring by ASIA for motor function was higher after operation than before operation (44.8, 40.7, P ＜ 0.01), but the improvement was slow. ④Scoring by ASIA for automatic nervous system was higher after operation than before operation (18.0, 14.5, P ＜ 0.01); diaphoresis, increased enterokinesia and other automatic nervous system improved earliest.CONCLUSION: Transplantation of olfactory ensheathing cells promotes the spinal and neurofunctional recovery of patients with malignant spinal injury, and the therapeutic method is safe.

BACKGROUND: The application of mesenchymal stem cells derived from umbilical cord cultured in serum-containing medium has some obstacles. OBJECTIVE: To establish serum free medium system for primary culture of umbilical cord-derived mesenchymal stem cells. METHODS: Wharton’s Jel y was isolated from umbilical cord, minced, 1-3 mm3, and subsequently incubated in either serum containing medium or serum free medium. Some cells were harvested on days 11, 14 and 17 for some detection. Based on the minimal criteria established by the International Society for Cel ular Therapy in 2006, mesenchymal stem cells were assayed with colony forming unit-fibroblast. RESULTS AND CONCLUSION: The mesenchymal stem cells grew rapidly in serum free medium condition compared with serum containing medium. On day 11, the number of colonies was larger in serum free medium condition than that in serum containing medium. Thus, serum free medium could maintain properties of mesenchymal stem cells and provide possibility a credible alternative to serum containing medium for primary culture of umbilical cord-derived mesenchymal stem cells.