[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 .

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.

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 compare the perinipple round-block technique with the conventional periareolar round-block technique in areolar reduction operations.Methods A total of 37 patients who underwent areolar reduction operations in our department were randomly allocated into two groups:Group A (19 patients) received a conventional periareolar round-block technique,while group B (18 patients) through a new perinipple round-block technique.In the latter approach,an intraareolar donut of pigmented skin was deepithelialized,and the exposed areolar dermis was then telescoped inward and stretch-anchored to an imaginary circular line situated beneath the breast skin areola junction.The roundblock technique was then utilized to approximate the skin edges,resulting in a minimal scar,totally inconspicuous,confined to the immediate perinipple area.The operative time,perioperative complications,scars,absorption time of the skin folds,the sensation of the nipple-areolar complex and the patients' satisfaction were compared between the two groups.Results The mean operative time of group A and group B was 40.5 min and 45.8 min,respectively (P＜0.05).No perioperative complications were found in these two groups.No patient had experienced permanent nipple sensory changes.The skin folds absorption time of group A was 4.34 months,while the time of group B was 8.78 months (P＜0.01).The perinipple round-block technique produced a more inconspicuous scar with a better aesthetic results.Conclusions The traditional periareolar round-block technique leaves a sharply demarcated areola by a circular scar which has a totally unnatural and artificial look.As for the perinipple round-block technique,the incision as well as any residual cutaneous wrinkling or puckering is well concealed by the dome of the nipple and the areolar,but it needs a longer skin folds absorption time.

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 study the clinical effect of qi supplementation combined with rehabilitation on the severity of fatigue after ischcmic stroke in patients with qi deficiency. Methods Ninety ischemic stroke patients with qi deficiency were randomly divided into 3 groups of 30. The treatment group was treated with an oral decoction of qi-supplementing Chinese medicine and also rehabilitation. The Western medicine control group was treated with a Chinese medicine placebo, Western medicine and rehabilitation. The blank control group was treated with the Chinese medicine placebo and rehabilitation. All groups were evaluated using a stroke-specific quality of life scale ( SSQOL) and a fatigue severity scale (FSS) before and 4 weeks after treatment. Results After treatment, the average SS-QOL and FSS scores had improved significantly compared with those before treatment, especially in the two treatment groups. There was a significant difference between the treatment group and the Western medicine control group,and between the treatment group and the blank control group on both scales. There was also a significant difference between the Western medicine control group and the blank control group in terms of SS-QOL scores, but not FSSscores. Conclusion All 3 treatments alleviated fatigue in ischemic stroke patients with a qi deficiency. Qi supplementation combined with rehabilitation was the most effective, followed by Western medicine combined with rehabilitation.

Pancreatoduodenectomy (PD) is considered as a complex and difficult surgical procedure even to the experi-enced surgeons, and it is thought to be the last frontier for mini-really invasive surgeons. Laparoscopic PD, despite the initial enthusiasm towards it, discourages laparoscopic surgeons by its long operating time and procedure-related fatigue resulting from technical difficulties associated with laparoscopic instruments and unstable camera platform. Although robotic surgical system with its known advantages has successfully overcome the limita-tions of traditional laparoscopic surgery, and completed the com-plex and advanced surgical procedures required in PD, reports on robot-assisted (laparobotic) PD remain few. Furthermore, there has not yet been a single report detailing PD techniques modified to take advantage of the Da Vinci platform. In this report, laparobotic PD was successfully performed on 7 patients. Five patients underwent pyloric preserving PD and 2 had stand-ard PD. All the 7 patients have been followed up till January 2009. The overall mean operative time was 326 minutes (290-400 minutes) and the mean length of postoperative stay was 10.2 days (5-30 days). There was no mortality. Five patients had perioperative complications but went on well after manage-ment. The stepwise cando-cranial approach PD is a unique approach, which is ideal for robotic platform. Although it has been shown to be feasible, safe, efficient, and reproducible in this small series, a larger scale multi-institutional study is needed to validate its efficacy.

AIM:To detect the changes of cardiac functions of septic mice in the early stage of sepsis. METHODS:Health male Kunming mice were used in the study. The techniques of 2D,Mmode and Doppler echocardiography were applied to evaluate the cardiac functions before cecal ligation and puncture(CLP) as baseline and at time points of 12 h,24 h,36 h,48 h and 168 h after CLP. The mice survived for 168 h(7 d) were considered as survivals. RESULTS:Compared to the baseline at the time point of 24 h after CLP,the blood volumes of heart return decreased significantly in the early stage of sepsis induced by CLP. LVEDV reduced by 46%. Notable compensatory responses of the hearts in septic mice were observed,especially the systolic functions,in which LVEF and LVFS increased by 27% and 39% ,respectively. However,the compensatory responses of diastolic function were weaker than the systoles. E/A ratio and EDT decreased by 30% and 25% respectively at the time point of 24 h. CONCLUSION:The strong compensatory cardiac functions are one of the factors for supporting the septic animal to survive. Protection of the cardiac functions especially the diastoles is important in the treatment of septic patients.