Development of Abdominal Vacuum Extractor Characterized by Portability and Constant Negative Pressure Which Applying to Battlefield / 中国医疗器械杂志

There are some problems such as difficulty of pressure control, inconvenience of use and carry, congested easily and dredged hardly in clinical application of vacuum extractor in common use. For solving the above problems, researchers have designed a new portable and pressure stabilized abdominal drainage system which was composed of integral double spherical aspirator and separated double cannula. The new apparatus has achieved good effects in drainage which is suitable for not only rescuing of abdominal trauma and war wound, but also abdominal surgery that manifested as sucking safe and effective, using easily and convenient, that was verified by testing.

The implementation of PBL guided by MDT in clinical teaching of war wound and trauma caused by compound factors / 中华医学教育探索杂志

Objective To explore the value of practicing PBL which was guided by MDT in teaching diagnoses and treatments of war wound and trauma caused by compound agents.Methods An emulational war wound case caused by compound factors was designed and a multi-disciplinary team been organized,then totally 45 interns who would graduate in 2017 were divide into two groups randomly,experimental group which had 23 cases received PBL model combined with MDT followed six step procedure which included case preparation by teachers,independent analysis and group discussion by interns,problem extraction by teachers and division of solution by interns before class,then answering and debating problems by interns in class,conclusion and reporting after class in the end,while the control group which had 22 cases received traditional teaching model in accordance with common case discussion in class including characteristics of patient,diagnosis and diagnostic basis,examinations needed to carry out,first aid measures and professional treatments.The effect of new teaching model was evaluated by assessment in class and questionnaire after class.The data was analyzed through Chi-square test by SPSS 22.0.Results Class assessment showed 18 (78.3％) interns in experimental group displayed good abilities of proposing,analyzing and resolving medical problem,as well as good presentation and speech skills.Questionnaire survey showed that not only clinical teaching of war wound and trauma could meet the demands of talent training in battle-field rescue,but also displayed new model,which could help interns to enhance abilities of first-aid and treatment of war wound on future war field,reinforce the consciousness of military medical support and service.In addition,it could clear confusion more professionally and strengthen teamwork and overall importance.Conclusion Applying PBL combined with MDT in teaching diagnoses and treatments of war wound and trauma can not only help interns to review and retain important knowledge of related subjects,but also improve the abilities of interns in clinical diagnoses and treatments,and moreover,it merges the medical knowledge and war wound cure together organically.In short,the new model is well worth applying in clinical teaching and military medical education because of its excellent effects.

Influence of artificial CO2 cavity on MMP-2 and VCAM-1, ICAM-1 expression in MDA-MB-231 cell / 中华内分泌外科杂志

Objective To investigate the influence of in vitro artificial CO 2 cavity on matrix metallopro-teinase 2(MMP-2), adhesion molecule vascular cell adhesion molecule 1(VCAM-1), and intercellular adhesion molecule 1(ICAM-1)expression in MDA-MB-231 cell.Methods An in vitro artificial CO2 cavity model was es-tablished.MDA-MB-231 cells were exposed to CO2 under the pressure of 7 mmHg for 1, 2 and 4 hours, respective-ly.MMP-2 concentration was measured by enzyme linked immunosorbent assay (ELISA).VCAM-1 and ICAM-1 ex-pression were measured by flow cytometry 0, 24, 48 and 72 hours after CO2-insufflation.Hypoxia group was ex-posed to 0 mmHg helium for 1 h, and the control group was exposed to 37℃incubator only .Results Compared with that in the control group , MMP-2 expression in the 1, 2 and 4 hours treatment group was significantly elevat-ed at 0 hour(F=15.045, P<0.05), and the MMP-2 expression in the 2 hours CO2 treatment group was signifi-cantly elevated after 24 hours compared with that in the control group and 1, and 4 hours CO2 treatment group (F=5.976, P<0.05).The VCAM-1 expression was significantly elevated at 0 hour and after 24 hours in the 1, 2 and 4 hours CO2 treatment group compared with that in the control group ( F1 =18.321, F2 =20.443, P<0.05), and significantly declined after 72 hours in the 4 hours CO2 treatment group compared with that in 1, and 2 hours CO2 treatment group(F=15.045,P<0.05).ICAM-1 expression was significantly elevated at 0 hour in hypoxia group and 1, 2, 4 hours CO2 treatment group compared with that in the control group , Meanwhile it was higher in 2 hours CO2 treatment group than in 1 hours and 4 hours CO2 treatment group(F=73.765, P<0.05). ICAM-1 expression was significantly elevated after 24 hours in 2 and 4 hours CO2 treatment group compared with that in the control group and 1 hour CO2 treatment group(F=46.322, P<0.05), and it was significantly elevat-ed after 48 hours in 2 hours CO2 treatment group compared with that in the control group and 1, and 4 hours CO2 treatment group(F=22.315, P<0.05).Conclusion The expression of MMP-2, adhesion molecule VCAM-1, and ICAM-1 in MDA-MB-231 cells is elevated after exposure to artificial 7 mmHg CO2 cavity, and CO2 cavity of mastoscopy may modulate the metastasis capacity of breast tumor cells .

Implementation of personalized medicine concept in the clinical teaching of gastrointestinal surgery / 中华医学教育探索杂志

Objective To explore the value of applying personalized medicine in the clinical teaching of gastrointestinal surgery. Methods Totally 100 undergraduates in grade 2008 were ran-domly assigned to experimental class (EC) and control class (CC), with 50 cases in each group. The experimental class accepted personalized medical teaching through introducing idea and method of personalized medicine. The control class accepted conventional teaching. The effect of teaching was evaluated by questionnaire survey and examination. The data were analyzed through t-test and Chi-square test. Results Questionnaire survey of satisfaction showed that 88 students (88%) were inter-ested in the new course, 91 students (91%) thought that the new mode of teaching was better than the old one. Questionnaire survey of teaching effect showed that in EC:44 students (88%) thought that the new course could increase interests of clinical question;43 students (86%) thought that the new course could optimize the process of diagnosis and treatment of gastric cancer;40 students (80%) thought that the new course could strengthen the communication between doctors and patients; 42 students (84%) thought that the new course could widen the minds in diagnosis and treatment;45 students (90%) thought that the new course could enhance the ability of dialectical thinking;while in CC, the proportions of the above issues were 24(48%), 23(46%), 26(52%), 25(50%) and 26(52%) (all P<0.05). Furthermore, there were statistical difference in auerage scores bertween EC and CC [(86.26 ±5.72) vs. (77.00 ±6.16)] (P=0.000). Conclusions Personalized medicine is suc cessfully practiced in the teaching course of gastric cancer, which not only meets the requirement of personal-ized medicine, but also guides the reformation of clinical teaching to certain extent.

Impact of different pneumoperitioneal pressure on pathomorphism and function of intestines following laparoscopic radical gastrectomy / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of different pressures of CO2 pneumoperitioneum on pathomorphism and function of intestines following laparoscopic gastrectomy (LG).</p><p><b>METHODS</b>Forty-eight gastric cancer patients were prospectively enrolled in the study. Among them, 36 patients scheduled for elective LG were randomly assigned to low pressure group (LP), middle pressure (MP), and high pressure group (HP) with 12 cases in each group. The CO2 pneumoperitoneum pressure was maintained at 8-10 mmhg in LP, 11-13 mmhg in MP, and 14-16 mmhg in HP. The control group was open gastrectomy group (OG) in 12 cases. The intestinal pathomorphism and level of plasma D-lactic acid before, during and after operation, and postoperative intestinal function of four groups were examined and compared.</p><p><b>RESULTS</b>There were no statistical differences in preoperative data among the four groups(all P>0.05). LG group was associated with a lower rate of surgical complications than OG (8.3% vs. 41.7%, P<0.05). No obvious damage of intestinal mucosa was found in OG group. Damage degree of intestinal mucosa after operation in LP, MP and HP groups was 0-1, 1-2, and 2-3 respectively. There was significant change in intestinal pathomorphism after operation in both HP and MP groups. The levels of D-lactic acid before operation were not significantly different among all the four groups, but increased significantly in each group after operation (all P<0.05). HP group had the highest level of plasma D-lactic acid and presented with delayed bowel sound return (4.5 d), time to first flatus (5.4 d), and intake (6.0 d) as compared to the other 3 groups (all P<0.05).</p><p><b>CONCLUSIONS</b>Laparoscopic radical gastrectomy is safe and minimally invasive. Higher pneumoperitoneal pressure is harmful to the recovery of intestinal mucosa and function. Therefore the pneumoperitioneum pressure should be maintained as low as possible under clear visualization during operation.</p>

Application of case-based discussion combined with translational medicine in clinical teaching of gastrointestinal surgery / 中华医学教育探索杂志

Objective To explore the application of case-based discussion combined with translational medicine teaching method in clinical teaching of gastrointestinal surgery.Methods Totally 100 undergraduates of clinical medicine in grade 2007 and 100 undergraduates in grade 2008 from the second military medical university were divided into experimental class (50 students,25 in discussion class and 25 in comprehensive class) and control class (50 students).Method of case-based discussion was applied in discussion class; method of case-based discussion combined with translational medicine was employed in comprehensive class and traditional method was used in control class.Results Scores in experimental class were superior to those in control class ; questionnaire survey showed that 90％ students thought the new model was better than the traditional model; the interests of students in exploring clinical problem in experimental class were increased (90％ vs.50％ ) ;the sense of mission and responsibility was Strengthened (86％ vs.64％ ) ;the scientific research thinking was more active (80％ vs.48％ ) ; the individual ability and quality were enhanced (76％ vs.50％ ),the depth and width of study were markedly increased (80％ vs.52％ ),the consciousness of independent study and thinking was strengthened (88％ vs.54％ ).Comprehensive class had more obvious improvements in scientific research thinking,individual ability and quality,depth and width of study,independent study and thinking.Conclusions The new teaching model which combined translational medicine with case discussion breaks through the traditional model and adapts to the requirements of modem medicine,it can enhance the teaching effect and worth promoting in educational reform.

Design and manufacture a set of viewable bi-cavity abdominal puncture device / 中国医疗器械杂志

To evaluate the rate of early diagnosis for abdominal trauma, we design a set of visible bi-cavity abdominal puncture device to detect and diagnose abdominal organ disease. This paper simply introduces the design and the use of this device.

Percutaneous transhepatic contrast-enhanced cholangio-ultrasonography:methodology and significances / 中华超声影像学杂志

Objective To establish the method and assess the safety，feasibility and clinical efficacies of percutaneous transhepaticcontrast-enhancedcholangio-ultrasonography(PTCECUS).Methods Twenty-one patients aged(58.5±16.65)years(range 27-93)with biliary obstruction or stricture underwent percutaneous transhepatic cholangiodrainage or ch01ecystodrainage.A dose of more than 50 ml of 0.94% Sono Vue(Bracco，Itay)solution was injected into their bile ducts(n=17)and cholecysts(n=4)through the drainage catheter.Their biliary tracts，cholecysts and duodenums were scanned under contrast pulsed sequencing mode(CPS，Sequoia 512，Siemens)to achieve related contrast-enhanced ultrasonograms.Severity of biliary obstruction were assessed according to the PTCECUS findingswith a comparison toconventionalultrasonography(CVUS)，magnetic resonance cholangiopancreatography(MRCP)and percutaneous transhepatic cholangiography(PTC)in a part of the patients.Results①PTCECUS gave rise to good-quality contrast-enhanced uhrasonograms of biliary tracts.②PTCECUS was superior to CVUS and in consistence with MRCP and PTC in evaluating the severity of biliary tract obstruction.This method helped to make a proper design for biliary drainage.③PTCECUS was more efficient than PTC in that PTC had the patients receive transhepatic puncture and cholangiography in separated departments.④Neither any complications immediate from transhepatic puncture and administration of SonoVue inall the 21 patients，nor those 1 to 8 months late during ultrasound follow up in 14 patients were found.Conclusions PTCECUS，characterized in bettering the display of biliary tracts，especially the severity of obstruction of biliary tracts，is safe through the procedure and valuable in supervising biliary drainage against obstructive jaundice.

Stereotactic excision of benign breast lesions using the Mammotome system / 中国微创外科杂志

Objective To discuss the clinical value of u ltrasound-guided stereotactic biopsy and excision using the Mammotome system in the treatment of benign breast lesions. Methods A retrospecti ve analysis was made on the efficacy of ultrasound-guided Mammotome biopsy and e xcision in the management of 61 patients clinically diagnosed as having benign b reast lesions between October 2001 and October 2002. Results T he lesions were histologically confirmed as fibroadenoma in 51 patients and mast opathia in 10 patients. The operative time was 20.6?4.1 min. All procedures w ere performed smoothly. Of the 61 patients, no infection or breast deformity occ urred on short-term follow-up examinations (1 month) except for mild subcutaneou s hemorrhage in 3 patients, and no obvious scarring was seen on long-term follow -up (2 years). Recurrence was found in only 2 patients. Conclusions Treatment of benign breast diseases by the Mammotome system can offer comp lete excision of the lesion, minimal invasion, a low recurrence rate, and good c osmetic outcomes.

The effect of fragile histidine triad gene on the growth and apoptosis of pancreatic adenocarcinoma cells / 中华消化杂志

Objective To study the effect of fragile histidine triad (FHIT) gene on pancreatic adenocarcinoma cells growth and tumorigenicity and explore the mechanism of FHIT gene in suppressing the deve lopment of pancreatic adenocarcinoma. Methods By the method of liposome transfection, pRC/CMV FHIT plasmid was transfected into 1990 cell lines which lose all of FHIT gene. Integration and expression of exogenous FHIT gene were confirmed by RT PCR and Western blot technique. 1990 pFHIT cell growth was observed in regular culture medium and tumorigenicity in nude mice. Its DNA was analyzed by electrophoresis. Results The growth of the cells transfected with FHIT gene (named as 1990 pFHIT cells) was suppressed significantly, and the tumorigenicity of the 1990 pFHIT cells was dramatically inhibited in nude mice as compared with that of the parental 1990 cells. Significantly increased apoptosis in 1990 pFHIT was found. Conclusions The growth and tumorigenicity of pancreatic adenocarcinoma cell can be inhibited by transduced exogenous FHIT gene. It's spectulated that FHIT suppress the development of pancreatic adenocarcinoma by the path of apoptosis.

A meta-analysis of early minimally invasive surgical treatment versus conventional treatment in patients with severe acute pancreatitis / 中国普通外科杂志

Objective To analyze and compare the effect of early minimally invasive surgical treatment and conventional treatment for patients with severe acute pancreatitis.Methods According to the including criteria,eight randomized-controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed and analyzed by using Revman 4.2 software.Results Compared with conventional treatment,early minimally invasive surgical treatment was associated with a significantly lower incidence of mortality(RR=0.35,95%CI:0.20～0.63,P

Efficacy of intraperitoneal sustained-release chemotherapy with 5-FU on mice bearing H22 ascitic tumor / 第二军医大学学报

Objective:To evaluate the inhibitory effect of intraperitoneal sustained-release chemotherapy with 5-FU on the growth of H22 ascitic tumor in mice.Methods: Mouse H22 ascitic tumor model was established by intraperitoneal injection of(0.2 ml) H22 ascitic cells(4?10~(6)cells) and the animals were subsequently divided into 4 groups randomly, namely,the saline control group(received saline),peritoneal chemotherapy group(received common 5-FU),sustained-release chemotherapy group(received sustained-release 5-FU),and negative control group(received control sustained-release agent).The survival times of the mice were recorded in all groups.The apoptosis rates of H22 ascitic cells were analyzed with flow cytometry 9 and 12 days after injection of H22 cells and the proliferation index was calculated.Electron microscope was used to observe H22 cells 12 days after peritoneal injection.Results: The average survival time of peritoneal chemotherapy group([13.7?1.7] d) was significantly shorter than that of sustained-release chemotherapy group([15.3?2.0]d)(P

Inhibitive effect of interferon-? on hepatic metastasis in human colon cancer orthotopic xenotransplanted in nude mice / 中国普通外科杂志

Objective To determine the inhibitive effect of interferon-a on hepatic metastasis of colon cancer. Methods Metastatic model of human colon cancer was established by orthotopic implantation of histologically intact human tumor tissue into the colon wall of nude mice.The mice were randomly divided into 4 groups:(1)Control group(receiving saline solution only);(2)5-FU treatment group;(3) IFN-?-2b treatment group;and(4)5-FU combined with IFN-?-2b treatment group(combined group). 5-FU and IFN-?-2b were given via peritoneum injection 1 time/2 days for eight weeks.The mice were killed at nine weeks.The tumors were weighed,the microvessel density(MVD) was detected,and the liver was examined histologically in order to discover the micrometastasis. Results In control group, 5-FU group,IFN-2b group and combined group,the tumor weight was(1.53?0.78)g,(0.87?0.59)g,(0.81?0.43)g and ( 0.23?0.09)g, respectively;the tumor inhibition rate was 0,43.1%,47.1% and 84.9%, respectively;the hepatic metastasis rate was 85.7%,78.6%,21.4% and 0 respectively.MVD in IFN-? group and combined group was significant lower than that in control group and 5-FU group. Conclusions IFN-? can inhibit the growth and hepatic metastasis of orthotopic implanted human colon cancer by inhibiting the tumor angiogenesis.It may be more effective when INF-? combined with cyotoxic agents.

A meta-analysis of early surgical treatment versus nonsurgical treatment in patients with severe acute pancreatitis / 中国普通外科杂志

Objective To analyze and compare the effect of early surgical treatment and nonsurgical treatment for patients with severe acute pancreatitis.Methods Acccording to the including criteria,five randomized controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects,results of the studies were reviewed and analysed by using Revman 4.2 software.Results Compared with nonsurgical treatment,early surgical treatment was associated with a significantly higher(incidence) of mortality(RR 3.42,95% CI 1.81～6.47,P=0.0002) and complications(RR 3.16,95% CI 2.15～4.64,P

Study of breast conservation surgery for early stage breast cancer / 中国普通外科杂志

Objective To evaluate the results of breast conservation surgery combined with radiotherapy for early stage breast cancer.Methods The cinical data of 76 breast cancer patients who underwent breast(conservation) operation plus radiotherapy at Changzheng Hospital in the recent 6 years were retrospectively(analyzed).Results The 3-,and 5-year survival rate was 96.05% and 94.8%,respectively,the 3-,and 5-year local recurrence rate was 5.3% and 6.6% respectively,and the 3-,and 5-year breast conservation rate was 96.05% and 93.3%,respectively.Only one case had chest wall recurrence and there was no mortality.The case with recurrence was a 25-year old unmarried woman,who had an intense desire for breast conservation.After tumor recurrence,mastectomy was performed again and chemotherapy was(administered).The patient is presently alive and in good health.Postoperative cosmetic physical results were(satisfactory) in 80.5% of cases.Conclusions Breast conservation surgery plus radiotherapy can get(satisfactory) results.The important aspects for success of breast conservation treatment are standardization of(resection) and postoperative radiotherapy and integrated systemic therapy.

Minimally traumatic percutaneous removal of multiple breast masses in female patients with ultrasound guidance / 解放军医学杂志

Objective To evaluate the efficacy, safety, and patient acceptance of a vacuum-assisted, hand-held biopsy device(Mammotome) in minimally traumatic percutaneous removal of multiple breast masses in female patients under real-time ultrasound guidance. Methods Forty-three women with 99 low-risk multiple palpable masses were involved in the study. Forty-one breast lesions with the diameter between 9 and 20mm, and 58 with the diameter between 21 and 33mm, were removed by the aid of a vacuum-assisted, hand-held biopsy device with 11-gauge or 8-gauge probes. The pathological examination and follow-up evaluation were performed after the procedure. Results The imaged lesions were completely removed successfully from 27 patients and 16 patients using the 8-guage probe and 11-gauge probe, respectively. Most of the lesions were proved to be breast fibroadenoma by pathological examination. No evidence of recurrence was found by physical examination and the ultrasound evaluation during the follow-up period. Most patients were satisfied with the incision, postoperative breast appearance, and the procedure results. Conclusions Minimally traumatic percutaneous removal of palpable benign breast masses using the Mammotome system with ultrasound guidance is feasible, safe, and yields high patient satisfaction.