Objective To investigate the feasibility and safety of laparoscopic surgery of giant hysteromyoma.Methods A total of 56 cases of giant hysteromyoma(at least 1 lesion ≥ 9 cm in diameter) underwent laparoscopic operations from January 2003 to August 2006 in this hospital.There were 30 cases of laparoscopic myomectomy(LM),10 cases of laparoscopic-assisted vaginal hysterectomy(LAVH),1 case of total laparoscopic hysterectomy(TLH),and 15 cases of laparoscopic supracervical hysterectomy(LSH).Results All of the operations were successfully performed under laparoscope.No conversion to open surgery was needed.The operation time was 40～100 min(mean,52 min),and the hemorrhage volume was 10～100 ml(mean,45 ml).Postoperatively,ureterovaginal fistula was observed in 1 case,which was cured by a re-operation of laparoscopic ureteroneocystostomy.Conclusions Laparoscopic operation for giant hysteromyoma is safe and feasible.

Objective To evaluate efficacy and safety of laparoscopic surgery for ectopic pregnancy with hemorrhagic shock.Methods One hundred and thirty women with hemorrhagic shock due to ectopic pregnancy underwent laparoscopic surgery from January 2003 to August 2006,including salpingectomy in 80 cases,partial ovariotomy in 8 cases,uterus wedge resection in 15 cases,salpingotomy in 19 cases,and tubal lesion clearance in 8 cases.Results Laparoscopic surgery was successfully performed in all the cases.Intra-abdominal blood loss was 1000 to 3500 ml,with an average of 1500 ml.The operation time was 30-60 minutes(mean:40 minutes).No postoperative complication occurred.Follow-up was conducted in 106 cases,once in a week in the first month after discharge.Serial ?-hCG levels decreased gradually and reached the normal level 1-2 weeks after operation.Persistent ectopic pregnancy was not found in the studied cases.Conclusions Laparoscopic surgery is a safe and effective treatment for hemorrhagic shock due to ectopic pregnancy,given the skill of an experienced laparoscopist with the aid of optimal anesthesia and advanced cardiovascular monitoring.

0.05).The mean follow-up of the two groups was(11.0?3.2) months and(12.0?2.8) months respectively;no evidence of recurrence was detected during the period. Conclusion Laparoscopy is minimally invasive,safe and effective for uterine malignancy.

Objective To investigate the diagnostic value and therapeutic effect of laparoscopy combined with hysteroscopy in patients with tubal infertility.Methods A total of 133 patients with tubal infertility were treated by laparoscopy combined with hysteroscopy in our hospital from September 2004 to December 2007.All the cases were diagnosed by hysterosalpingography(HSG) and hysteroscopy.Results Totally 225 fallopian tubes were examined in the 133 patients,among which 180 tubes were completely occluded,57 were partially occluded,and 18 were patent.After the surgeries,211 tubes wee patent,24 were partially blocked,while 20 were still occluded.The success rate of the operations was 81.4%(193/237).Follow-up was achieved in 92 patients for 4 to 18 months,in the cases,30 were pregnant during the period(pregnancy rate: 32.6%).Of the 30 cases,2 women had tubal pregnancy;22 women were pregnant in 6 months after the treatments,and the other 8 were pregnant in 6-12 months after the operations.In this group of patients,the pregnancy rate in the women with both patent fallopian tubes was 26.1%(24/92),and in those with single patent fallopian tube was 6.5%(6/92).The pregnancy rate in patients with simple tubal infertility was 22.8%(21/92),while that of those who were complicated with tubal diseases was 9.8%(9/92).Conclusion Laparoscopy combined with hysteroscopy can accurately diagnose tubal infertility,and improve the therapeutic effect.

Objective To investigate the correlation between the degree of pathogenetic condition and cogni-tive impairment in young OSAHS patients. Methods Sixty-three patients (18～44 years old) were divided into 3 groups according to the assessment criteria regarding the degrees of pathogenetic conditions of hypoxemia and its persistence time: mild group(the lowest SaO2 ≥ 85 %, n = 20 ), moderate group (the lowest SaO2 : 65 ～ 84 %, n =24), and severe group (the lowest SAO2<65%, n= 19). Twenty-five healthy young adults were selected as the control group. All the subjects were tested with event-related potential, namely P300, the polysomnogram and the mini-mental state examination scale(MMSE). Results P300 latency in patients of three OSAHS groups was sig-nificantly prolonged as 326.1±12.7, 346.9±19.1, and 34.9±18.3 ms, as compared with those of control group: 311.9±18.3 ms (P< 0.05, respectively). In severe group, P300 latency was markedly increased compared with mild and moderate groups(P<0.01, P<0.05, respectively). No obvious differences were observed between mild and moderate groups(P=0. 095). The difference of hypoxemia lasting time could influence the P300 latency, such as when the hypoxemia lasting time was 4～60 seconds, the latency was 338. 12±13.7 ms, and when the hypoxemia lasting time increased to 60 ～ 140 s, the latency was prolonged to 354.74±16.7 ms(P = 0. 031 ). There was no difference among all groups in the P300 amplitudes. The MMSE scores for all patients were within normal limits andthere were differences between serve and control group(RA -RB=9. 91, P= 0. 003). Conclusion Among patients with OS-AHS, the impairment of cognitive function is con'anon. The degrees of pathogenetic conditions of hypoxemia and its lasting time may be used to evaluate the impairment degree of cognitive function in patients with OSAHS.

Objective To investigate the early changes of CD4 + T cells and the relevant cytokines in blood of patients with severe trauma.Methods Sixty-one consecutive patients with trauma admitted into the 97th Hospital of PLA from September 2009 to November 2011 were enrolled in this study.The exclusion criteria included:① Patients were younger than 18 or older than 75 years.②Patients received blood transfusion.③Those suffered from immune system disorders,tumors or diabetes,or recent history of virus,bacteria or parasites infections.④ Those had current or recent treatment with corticosteroids or immunosuppressive drugs.According to ISS score ≥ 16,there were 61 traumatic patients divided into mild trauma group and severe trauma group.Seventeen healthy volunteers were taken as control subjects.At admission,the peripheral venous blood samples of patients were taken to count the number of CD3+,CD4 +,CD8 + T cells by flow cytometry and to detect TNF-α,INF-γ,IL-1,IL4,IL-6 and IL-12 levels in plasma by enzyme linked immunosorbent assay,meanwhile the ratio of Th1 / Th2 type cytokine were calculated.Data were analyzed with t test and ANOVA or Kruskal-Wallis test by using SPSS version 16.0package.P value ＜ 0.05 was considered to be statistical significance.Results Compared with control group,mild trauma and severe trauma groups showed a similar decrease in number of CD3 + T cells,and severe trauma group showed a most significant decrease in number of CD4 + T cells.Severe trauma group had a lower INF-γ level compared with control group; IL-1 level in both mild trauma and severe trauma groups were lower than that in the control group; INF-γ/ IL-6 in severe group was significantly lower than that in the mild group.However,INF-γ IL-6 in mild group was higher than that in the control group.Conclusions The early stage of severe trauma exhibits a significant decrease in number of both CD3 + and CD4 +T cells,accompanied by a significant reduction in most of cytokines,and has a tendency of shift to Th2 type cytokine.Therefore,the changes of immune cells should be promptly and successively monitored after severe trauma.

ObjectiveTo investigate the effect of vitamin D supplementation on the outcome of acute ischemic stroke in young patients with vitamin D deficiency.MethodsThe prospective controlled study was used to select the consecutive young patients with acute ischemic stroke.Vitamin D deficiency was defined as 25-hydroxyvitamin D (25(OH)D) ≤50 nmol/L.The Patients with vitamin D deficiency were randomly divided into an intervention group and a routine treatment group according to the random number table method.Routine treatment group didn't receive the drug intervention for vitamin D deficiency, and the intervention group received daily oral alfacalcidol 0.5 μg.After 1 year of treatment, the 25(OH)D levels were examined again;the adverse reactions during the drug treatment were monitored;the modified Rankin Scale (mRS) was used to evaluate the functional outcome and 0-2 was defined as good outcome.ResultsThere are 94 patients (53.41%) with vitamin D deficiency among 176 young patients with acute ischemic stroke.They were randomly divided into either an intervention group or a routine treatment group (n=47 in each group).At the end of the follow-up, the good outcome rate (82.98% vs.63.83%;χ2=4.414, P=0.036) and serum 25(OH)D level (85.83±10.53 nmol/L vs.39.10±11.18 nmol/L;t=20.860, P<0.001) in the intervention group were significantly higher than those in the routine treatment group.During the follow-up period, there was no loss to follow-up or death events in both groups.Only 2 cases of nausea and 1 case of dizziness were observed, and the incidence of adverse reaction was 6.38% in the intervention group.ConclusionsVitamin D supplement can increase the vitamin D levels and improve functional outcome in young patients with acute ischemic stroke and vitamin D deficiency.

Aim To provide practical method for screening human carbonic anhydrase Ⅱ(hCA Ⅱ) inhibitors in drug discovery.Methods hCA Ⅱ protein was obtained from induced BL21(DE3) E.coli containing plasmid pET-28b-hCA Ⅱ.The hCA Ⅱ activity was detected under pH 7.6 and 25℃ by its esterase activity which could decompose PNPA to increase the photoabsorption at 348 nm. After the assay conditions were finally selected, 35 new compounds were tested.Results A practical method for screening hCA Ⅱ inhibitors was successfully constituted by using recombinant hCA Ⅱ protein expressed in E.coli as the source of hCA Ⅱ enzyme.10 new compounds had better inhibitory effect and 9 new compounds had the same inhibitory effect on hCA Ⅱ compared with acetazolamide.Conclusions The hCA II inhibitor screening technique constituted in this work possesses advantages of being reliable, rapid, and practical. 19 new compounds are worth further research for developing high efficiency and low side effect drugs used for high-altitude illness.

Objective:To explore the role of reactive oxygen species(ROS,i.e,H_2O_2 and O_2-) in regulation of respiratory rhythm in the medial area of nucleus retrofacialis(mNRF).Methods: Medullary slices of neonatal SD rats,including hypoglossal nerve(Ⅻn) and mNRF,were made according to Suzue's method.Simultaneous recording of the Ⅻn respiratory rhythmic activity(RRA) with suction electrode and the respiratory neuronal discharge were performed with whole cell patch in the mNRF on the brainstem slice in vitro.The effect of t-butyl hydroperoxide(tBHP) and ?-lipoic acid(?-LA) on the respiratory pacemaker neurons and respiratory rhythm in the mNRF were observed.Results: tBHP significantly decreased respiratory cycle(RC) and increased respiratory amplitude;?-LA significantly increased RC and decreased its amplitude.Meanwhile,?-LA significantly prolonged the action potential of the respiratory cadmium-insensitive pacemaker neurons and reduced its amplitude,but it had no significant effect on the cadmium-sensitive respiratory pacemaker neurons.Voltage steps and ramps showed that ?-LA inhibited both the transient and persistent sodium current of cadmium-insensitive pacemaker neurons.Conclusion: ROS has an excitatory effect on the respiratory rhythm and the cadmium-insensitive respiratory pacemaker neurons through modulating sodium current.

Objective To investigate the relationship between serum albumin, bilirubin and cognitive impairment in patients with mild cognitive impairment (MCI). Methods Serum albumin, total bilirubin, direct bilirubin, indirect bilirubin were analyzed in 89 cases of MCI and 82 cases of cognitively normal control. All of the cases underwent neuropsychological testing by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The risk factors of MCI were subject to Logistic regression analysis. Results The serum level of total bilirubin in MCI group were significantly lower than that in controls (P < 0.05). There was no significant difference in albumin between MCI and control group (P > 0.05). The bilirubin level was positively correlated with MMSE scores and MoCA scores (including attention, delayed recall and abstract) (P < 0.05), while no significant correlation between serum albumin level and scores of MMSE and MoCA (P > 0.05) by using Spearman correlation analysis. Logistic regression analysis showed that age, education level, diabetes and serum bilirubin levels were independent risk factors for MCI. Conclusion Our data show that decreased serum level of bilirubin is positively related to cognitive impairment.