Thoracic and cardiovascular surgery teaching is the focal and difficult point in the whole surgery teaching.This article introduces the authors'reform by using advanced multimedia and image equipment to enhance teaching effect in both theory and practice,using the modern modes such as logic guide,case study and inter-communication to inspire students'passion and by emphasizing basic skill and asepsis environment to build normative teaching in thoracic and cardiovascular surgery.

[Summary] This paper reported the surgical cooperation in 72 cases of da Vinci robot operations between September 2014 and December 2014 in this hospital .All the 72 cases of total laparoscopic operation by using the da Vinci robot assistance were successfully completed, without robot faults caused by mismatch and nursing complications caused by improper nursing .We believe that nurse training with robot surgical system and qualification certification , preoperative patient visits , reasonable arrangement of operation room , careful observation with skilled coordination with the robot , proper postoperative placement of the robot , and maintenance and disinfection of the machine are crucial to a successful surgery .

Objective To investigate the relationship between the serum concentration of neuron-specific enolase (NSE) and the brain damage severity and the prognosis of acute head injuried patients. Methods Early serum levels of NSE were measured in 70 patients with acute head injury by radioimmunoassay. The concentration of NSE was analysed by combining with GCS and GOS systems. Results NSE levels in serum of patients with major(a), minor(b) head injuries and control individuals(c) were (25 78 ? 10 80)ng/ml, (19 58 ? 8 91)ng/ml and (9 51 ? 2 79)ng/ml respectively, differences of which were significant (P a-b

AIM:To establish a HPLC diagitized fingerprint for Ixeris sonchifolia Hance Injection to serve as a digitized method criteria for its overall quality control. METHODS: The chromatographic fingerprints were obtained by injecting 20 ?L of the sample solution each time on a Century SIL BDS column (250 mm?4.6 mm, 5 ?m) with the gradient elution solvent system composed of 1% acetic acid water and 1% acetic acid acetonitrile. The flow rate was 1 mL/min, the column temperature was maintained at (30?0.15)℃ and the detection wavelength was set at 265 nm. The chromatographic fingerprints were charateristically digitized and evaluated by the software of the digitized evaluation system of traditional Chinese medicine fingerprint with the super information characteristics to give the 42 parameters such as chromatographic fingerprint index (F), chromatographic fingerprint resolution index (RF), which could thoroughly disclose the hidden information in the fingerprints. Meanwhile, the apparent molecular weight, the peak position, the elution fore index and the pseudo peak area were marked in terms of the principle of QSPR when the two peaks were selected as the reference peaks. RESULTS: 21 co-possessing peaks were selected as the fingerprint peaks of Ixeris sonchifolia Hance Injection by taking caffeic acid peak as the reference peak to establish the digitized fingerprint and obtain the important digital information about its quanlity control. The stabilities among different batches of samples were evaluated by the dual qualitative and dual quantitative similarity method. CONCLUSION: This new digitized fingerprint method with good precision and reproducibility can be perfectly applied to the quality control over Ixeris sonchifolia Hance Injection. Digitized fingerprint obtained from the dual qualitative and dual quantitative similarity method maybe extend further to assess and control the quanlity of TCM.

Objective Thermal burns of the anterior chest disfigure the female breast, and the postburn breast deformity is a sequela of severe scar contraction of the burned chest. For deformities that affected the mammary development, museulocutaneous flaps were used. Here we introduce our experience in using the latissimus dorsi myocutaneous island flap in burned breast reconstruction. Methods During the past 7 years, 7 female patients with such deformities required reconstruction, the expanded or unex-panded latissimus dorsi musculocutaneous island flaps were used in the partial reconstruction of burned breast. In the mild deformities group (2 cases), unexpanded latissimus dorsi musculocutaneous island flaps were used. For patients with undeveloped mammary glands (5 cases), expanded latissimus dorsi musculocutaneous island flaps were used. Results The procedure was performed in 7 patients and all the flaps were alive, with significant improvement of breast appearance. The complication rate was low. There were no deformity and dysfuction in the donor site. Conclusions The technique has many advanta-ges: beautiful contour of breast, good blood supply of the flap, no donor site morbidity. It provides the plastic surgeon with an excellent, safe and consistently successful method for burned breast reconstrue-tion. This experience has led to development of surgical principles and techniques tailored to this particu-larly difficult problem.

Objective To investigate the pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis, and to summarize the clinical experience.Methods160 patients with cholelithiasis were analyzed.The proportion of patients with biliary tract infection was counted.The bile and venous blood were collected and the distribution of pathogens was detected.The patients were also analyzed for the drug resistance.ResultsThe incidence of biliary tract infection was 62.5%, the positive rate of bile culture was 62.5%, and the positive rate of blood test was 37.5% for 160 patients with cholelithiasis.Gram-positive bacteria include Escherichia coli, Enterococcus faecium, Staphylococcus, Gram-negative bacteria, including Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, etc.;Gram-positive bacteria for the large Methicillin and erythromycin resistance is higher, Gram-negative bacteria for ampicillin and levofloxacin higher resistance.ConclusionThe pathogen distribution and drug resistance of biliary tract infection in patients with cholelithiasis are analyzed.The clinical pathogens are widely distributed.At the same time, the pathogens have different resistance to different antimicrobial agents.Therefore, clinical use should be reasonable choice when using antimicrobial agents, With a view to give full play to drug effects.

The mode of using standardized patients has been applied in cardiothoracic surgery teaching to assess students efficiency.It alleviates the conflict of the shortage of resource for clinical teaching and improves the quality of teaching and achieves good results.

Objective To investigate the possibility of using the results of breast ultrasound and Cohen-classification to determine the gynecomastia patients' subtype, and to evaluate the effectiveness of different surgical methods based on the classification. Methods In the past 3 years, 40 patients with gy-necomastia were treated in this hospital. The patients" age ranged from 18 to 50 years, with an average of 21.38. All the patients had the bilateral lesions, and their pathological diagnosis was gynecomastia. The mammary gland resected from each side weighted from 30 to 180 grams. The total fat volume liposucted ranged from 200 ml to 1 200 ml. As a routine, we performed breast ultrasound examination before the op-eration on each patient. According to the different echo, we marked the extent of breast gland on the chest walls and determine the Cohen classification of the patients. For breast tissue hyperplasia, we only resected the gland under the direction of the chest wall marks. For fat tissue hyperplasia, we just per-formed liposuction. For patients with mixed fat and gland hyperplasia, we combined these two methods rationally. If necessary, the procedures was repeated. Results With the help of breast ultrasound exami-nation, the operating procedure was more accurate and simple, as a result, our treatments had less injury and no severe complications. After a following-up of 6-36 months, satisfactory results were achieved, with normal male chest appearance and small obscure scar. Conclusions Male breast surgery is totally different from the females. The Cohen classification has been determined for each gynecomastia patient, based on the results of breast ultrasound examination, which helps choose the surgical methods and procedures and decrease surgical injuries and complications, with satisfactory results.

BACKGROUND: For decades, liposome drug carrier has been used to enhance drug stability and efficacy, reduce drug toxicity and adverse effects. However, they fail to provide long-term delivery due to insufficient stability. Studies have demonstrated that silica is not toxic, with chemically inert and biological compatibility, and can be used as modified material. OBJECTIVE: To characterize the silica coated liposome and investigate the controlled release property. DESIGN, TIME AND SETTING: In vitro observation. The study was performed at the Nanomedicine and Biosensor Laboratory, Biomedical Engineering Center, Harbin Institute of Technology from May 2007 to June 2008. MATERIALS: Dipalmitoylphosphatidylcholine (DPPC) was purchased from Nanjing Kangsente Chemical Engineering Company; tetraethylorthosilicate (TEOS) was purchased from Aldrich, USA. Doxorubicin (DOX) was purchased from Beijing Huafeng United Technology Company; Sephadex G-50 was purchased from Amersham Biosciences, Sweden. All other chemical agents were of analytical purity. METHODS: Liposome was formed from DPPC following the precipitation of silica by sol-gel method. MAIN OUTCOME MEASURES: Zeta-potential and dynamic light scanning were used for zeta-potential measurement and particle size distribution; transmission electron microscopy was used to collect the image of particle morphology; Fourier transform infrared spectroscopy (FTIR) was used to display chemical characteristics of Si-O-Si structure; Spectrophotofluorimetry was used to determine DOX regression equation and was further used for calculation in drug encapsulation efficiency and in vitro release.　RESULTS: ①Silica coated liposome was successfully prepared. ②FTIR proofed the presence of Si-O-Si at 1 166, 1 080, 859 and 526 cm-1. ③The DOX encapsulated silica coated liposome had encapsulation efficiency of 72.4%. ④Drug release profiles showed that sustained release of DOX was achieved after modification of silica on liposome. CONCLUSION: With Si-O-Si as protective layer, the liposome has increased stability and prolonged drug release.

Objective To explore the safety of fat reduction treated by non invasive focused ultrasound.Methods A randomized double-blind and negative control clinical trial was carried out on the excess fat of 40 subjects' abdomen by a JCS-01 non-invasive focused ultrasound device.Subjects received treatments with the device on day 1 and day 7.Observations on the area treated and inquiries on feelings were conducted during treatments.Before the first treatment and 14 days after the treatment,laboratory examinations were performed,including liver function,blood lipid tests,etc.Results 40 subjects participated in the trial and 36 subjects (18 each in both treatment and control groups) accomplished 2 times of treatments,all followed-up and laboratory examinations.During the process of treatments,4 subjects in the experimental group complained about feelings of tepidity or pricking.One subject on blood test of triglyceride showed slightly higher than her early normal result,which fell to the normal level at reexamination.Conclusions Subjects treated by non-invasive focused ultrasound at the area of no more than 500 cm2 every time and at an interval of 6 days manifest little changes on the blood test results,with slightly local reactions but no complaints during follow-up.