Robotic Surgery is a novel minimally invasive surgery which is advanced from the endoscopic surgical techniques.This new technique has a promising future to be applied in clinics because of the distinct and compelling advantages compared with the traditional endoscopic surgery,including true three-dimensional endoscopic vision,increased freedom of movement of instruments and tremor filtration.We review the potential applications,advantages,limitations of the da Vinci Surgical System in otolaryngology.

Objective To investigate the effects of Chinese herbal compound formula on plasma endothelin and serum nitric oxide of diabetic rats. Methods The selected SD male rats were induced by streptozotoc (53 mg/kg i.p) and the model rats were divided at random into model contrasted group (MCG), Chinese herbal compound formula treated group (CTG) and ramipri treated group (RTG) while the normal contrasted group (NCG) was set up.CTG were supplied with decoctions of Chinese herbal compound formula, RTG were supplied with solution of ramipri, MCG and NCG were supplied with water. Eight weeks later, the rats were killed and their blood were collected at the same time. Changes of PG, RW/BW, 24 hUAlb, plasma ET, serum NO were observed. Results BG, RW/BW, UAlb, ET and NO of MCG, CTG and RTG were more evidently increased than that of NCG (P

Objective To compare the bronchial blocker and double-lumen tube for one-lung ventilation in the elderly patients undergoing minimally invasive direct coronary artery bypass (MIDCAB).Methods Thirty six patients of both sexes,aged 65-78 yr,with the left ventricular ejection fraction ≥ 45％,with body mass index ＜ 30 kg/m2,of ASA physical status Ⅱ or Ⅲ (NYHA Ⅰ-Ⅲ),scheduled for elective MIDCAB in the left thorax,were randomly divided into 2 groups (n =18 each):double-lumen endotracheal tube group (group D) and bronchial blocker group (group B).Anesthesia was induced with midazolam 0.05 mg/kg,etomidate 0.3 mg/kg,fentanyl 10μg/kg and cisatracurium 0.15-0.20 mg/kg.The patients were intubated with a left-sided double-lumen endotracheal tube 5 min later in group D.The patients were intubated with a single-lumen endotracheal tube 5 min later,and then Coopdech bronchial blocker was inserted into the primary bronchus in group B.The patients were mechanically ventilated.Before induction of anesthesia,at 2 min before intubation,immediately before and after intubation,and at 1 and 2 min after intubation,mean arterial pressure (MAP),heart rate (HR),and mean pulmonary arterial pressure (mPAP) were recorded and rate-pressure product (RPP) was calculated.The requirement for vasoactive drugs was recorded during induction of anesthesia.Lung collapse developed after the pleura was opened was also recorded.Surgical exposure was scored at the end of operation.Results Compared with group D,MAP,HR RPP and mPAP were significantly decreased after intubation,the requirement for nicardipine and esmolol was decreased,and no significant change was found in the requirement for atropine and metaraminol,rate of lung collapse and score of surgical exposure in group B.Conclusion Compared with doublelumen tube,bronchial blocker can provide sufficient exposure of the surgical filed,and intubation-induced fluctuation of hemodynamics is small in the elderly patients undergoing MIDCAB.

Objective To explore the clinical efficacy of three dimensional (3D) laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity combined with type 2 diabetes mellitus.Methods The retrospective cross-sectional study was conducted.The clinical data of 28 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Qinghai Red Cross Hospital between January 2013 and April 2016 were collected.All the patients underwent 3D LSG.Observation indicators:(1) surgical and postoperative recovery situations;(2) follow-up and metabolic indexes changes.Follow-up using outpatient examination and telephone interview was performed to detect complications of patients after discharge and usages of antidiabetic drugs or insulin up to February 2017.Body mass,body mass index (BMI),hemoglobin (Hb),albumin (Alb),fasting serum C-peptide,fasting blood sugar,2-hours postprandial blood glucose (2HPBG) and glycosylated hemoglobin (GHb) were detected at month 1,3,6 and 12 postoperatively.Measurement data with normal distribution were represented as (x)±s.Repeated measurement data were analyzed by the repeated measures ANOVA.Count data were evaluated by the proportion.Results (1) Surgical and postoperative recovery situations:28 patients underwent successful 3D LSG,without conversion to open surgery.Operation time,volume of intraoperative blood loss,time of postoperative gastrointestinal function recovery and time of postoperative drainage tube removal were (133 ± 20) minutes,(45 ± 22) mL,(2.5 ± 1.2) days and (3.4 ± 0.9) days,respectively.There were no postoperative complications and perioperative death.Duration of hospital stay was (7.1 ± 1.5) days.(2) Follow-up and metabolic indexes changes:28 patients were followed up for 6-12 months,with a median time of 8 months.During the follow-up,there was no death or severe complications.Body mass,BMI,Hb,Alb,fasting serum C-peptide,fasting blood sugar,2HPBG and GHb from pre-operation to month 1,3,6 and 12 post-operatively were decreased from (113±26) kg to (78± 14) kg,from (44±6) kg/m2 to (35±5) kg/m2,from (157±19) g/L to (140±13) g/L,from (43±5)g/L to (40±4)g/L,from (2.50±0.37) μg/L to (1.20±0.33) μg/L,from (10.5±2.0)mmol/L to (5.6±0.5)mmol/L,from (16.3±3.1)mmol/L to (7.9±0.9) mmol/L,from 9.2％± 0.9％ to 6.8％ ±0.6％ with statistically significant differences between preoperative and postoperative indicators (F=396.47,328.20,111.10,21.28,161.06,127.80,243.40,234.64,P＜0.05),and showing a downward trend.Of 28 patients,25 had complete remission of type 2 diabetes mellitus at 12 months postoperatively and 3 had partial remission,with an effective rate of 100.0％ (28/28).The excess weight loss was 63％± 16％.Conclusion 3D LSG is safe and effective in the treatment of obesity combined with type 2 diabetes mellitus,with a good shortterm outcome.

Objective To observe the neuroprotective effect of celecoxib against degeneration of dopaminergic neurons caused by lipopolysaccharide in vivo.Methods The rat model of Parkinson disease(PD)was established by intranigral injection of lipopolysaccharide.Sprague-Dawley rats were randomly divided into control group,PD group,and celecoxib group.Behavioural changes were recorded,and the expressions of tyrosine hydroxylase(TH)and cyclooxygenase-2(COX-2)were determined by immunohistochmistry and Western blot.Results No behavioral change was found in control group.There was significant difference in the number of circling behavior between PD and celecoxib groups(196.90±9.52 vs 109.30±9.38,P＜0.01).The number of TH-positive cells and the expression of TH protein in rat substantia nigra were significantly higher in celecoxib group than in PD group(P＜0.01).Compared with PD group,the number of COX-2positive cells and the expression of COX-2 protein were significant lower in celecoxib group(P＜0.01).Conclusion Celecoxib has neuroprotective effect on the degeneration of dopaminergic neurons caused by lipopolysaccharide in vivo.

Objective:To investigate the liposoluble constituents in fruit of Cnidium monnieri. Methods:The liposoluble constitu-ents in fruit of C. monnieri were extracted by Soxet extraction. The extracted liposoluble constituents were methyl esterified and then analyzed by GC-MS for the first time. Results:Thirty-nine compounds (85. 33%) were identified from the liposoluble constituents in fruit of C. monnieri. Phytol (15. 98%), hexadecanoic acid (12. 73%), 9,12,15-octadecatrienoic acid (11. 02%), 9-octadecenoic acid (6. 33%) and 9,12-octadecadienoic acid (4. 77%) were the main constituents of the liposoluble constituents in fruit of C. mon-nieri. Conclusion:Phytol, hexadecanoic acid, 9,12,15-octadecatrienoic acid and 9-octadecenoic acid are the active ingredients in fruit of C. monnieri.

Objective To study the epidemic characteristics,distribution of pathogen and clinical characteristics of hand,foot and mouth disease in Shenyang area,2014.Methods Swab specimens was collected from 5 070 cases of hand,foot and mouth disease caces,the F-PCR method was adopted for entero-virus 71 (EV71 ),coxsackievirus A 16(CA16)and universal enteroviruses(EU)detection,and combining the relevant clinical data for comparative analysis .Results June to August was the peak epidemic period.5 070 nasopharyngeal swab specimens were detected positive 3 715 intestinal virus nucleic acid,and the detection rate was 73.27%,including CA16 positive 1 481 (39.87%),EU positive 1 148 (30.90%),EV71 positive 1 086(29.23%).The proportion of EU positive was highest in June(29.71 %).The proportion of EV71 pos-itive(24.78%)and CA16 positive(33.27%)were highest in July,respectively .The proportion of nervous system symptoms in EV71 infection group(88 /1 12,78.57%)was higher than those in EU infection group (97 /147,65.99%)and CA16 infection group (44 /78,56.41 %).The proportion of abnormal myocardial enyzme in CA16 infection group (37 /78,47.44%)was higher than those in EU infection group (48 /147, 32.65%)and EV71 infection group(34 /1 12,30.36%).Conclusion CA16 is the major pathogen causing hand,foot and mouth disease in Shenyang area,2014.Severe hand,foot and mouth is still dominated by EV71 .

The prognosis of malignant tumors of the digestive system is still a matter of close attention in the medical and health field. At present, evaluating the prognosis of patients with digestive system malignant tumors is mainly based on the TNM staging of the tumor after surgery. As one of the ten characteristics of cancer, inflammatory indicators have certain guiding significance for the prognosis and treatment of patients with malignant tumors of the digestive system. As a new type of inflammation index, the systemic inflammatory response index is significantly better than other traditional inflammatory indexes in evaluating the prognosis of patients with digestive system malignant tumors. This article reviews the related studies on the systemic inflammatory response index in evaluating the prognosis of digestive system malignant tumors.

Objective To evaluate the feasibility of application of PBL method on otolaryngology education for medical undergraduates.Methods Totally 61 medical undergraduates of Class 2009 at Peking Union Medical College were enrolled into this study.There are 22 males and 39 females and aged 23-26 years old.They were grouped randomly into two groups: the PBL group (n=29) and the traditional teaching method group (n=32).Questionnaires were collected and statistical analyses were conducted.Results The scores of the evaluations for education of otolaryngology after teaching were much better than those before teaching in the PBL group in most aspects according to the questionnaires (P<0.05).In traditional teaching method group, there are only few aspects` scores much better than those before teaching.Comparing the two teaching methods shows, in most aspects, the scores of PBL group are much higher than those of the traditional teaching method group.ConclusionsCombination of PBL with other teaching method will be an ideal way for medical education in otolaryngology.