HAND-ASSISTED LAPAROSCOPIC NEPHROURETERECTOMY:INITIAL CASE REPORT

ＣａｓｅＲｅｐｏｒｔ:Ａ 4 7 ｙｅａｒ ｏｌｄｍａｎｈａｄｗｉｔｈａｎｉｎｔｅｒｍｉｔｔｅｎｔｇｒｏｓｓｈｅｍａｔｕｒｉａｆｏｒｍｏｒｅｔｈａｎｏｎｅｙｅａｒ.Ｏｎｐｈｙｓｉｃａｌｅｘａｍｉｎａｔｉｏｎｔｈｅｋｉｄｎｅｙｓｗｅｒｅｎｏｔｐａｌｐａｂｌｅａｎｄｔｈｅｒｅｗｅｒｅｎｏｂｉｌａｔｅｒａｌｃｏｓｔｏｖｅｒ ｔｅｂｒａｌａｎｇｌｅｔｅｎｄｅｒｎｅｓｓ.Ｌａｂｏｒａｔｏｒｙｉｎｖｅｓｔｉｇａｔｉｏｎｒｅｓｕｌｔｓｗｅｒｅｎｏｒｍａｌｅｘｃｅｐｔｆｏｒｈｅｍａｔｕｒｉａ .Ｓｕｓ ｐｅｃｔｅｄｃａｎｃ…     

腹腔镜联合药物治疗子宫内膜异位症合并不孕症疗效分析

目的探讨腹腔镜联合药物治疗子宫内膜异位症合并不孕症疗效。方法回顾分析2006年3月至2009年8月在泰州市中医院治疗子宫内膜异位症合并不孕症患者共58例,分为两组：常规开腹＋口服内美通组21例;腹腔镜＋促性腺激素释放激素类似物（GnRH-a）组37例,比较两组间的手术效果、术后妊娠率、复发率等情况。结果腹腔镜＋GnRH-a组的有效率、妊娠率明显高于开腹＋内美通组,且复发率较低,差异具有显著统计学意义（P〈0.05）。结论腹腔镜＋GnRH-a能提高治疗的有效率和妊娠率,减低复发率,是治疗子宫内膜异位症合并不孕症较理想的治疗方法。     

不同方法剥除卵巢良性畸胎瘤对免疫功能的影响

目的：探讨腹腔镜与开腹手术治疗卵巢良性畸胎瘤患者对其机体免疫功能造成的影响。方法：研究组卵巢良性畸胎瘤患者给予腹腔镜手术剥除治疗;对照组卵巢良性畸胎瘤患者给予传统开腹手术剥除治疗。观察并记录两组患者治疗前后机体中IL-6（白细胞介素）与T淋巴细胞亚群（CD4／CD8）的含量,并进行统计学分析。结果：研究组与对照组患者治疗前IL-6、CD4／CD8检测结果无明显差异,且P〉0．05,两组患者对比结果无统计学意义;研究组与对照组患者手术后1d与手术后4d IL-6、CD4／CD8检测结果有明显差异,且研究组患者术后4d基本恢复术前水平,P〈0．05,两组患者对比结果有统计学意义。结论：使用腹腔镜治疗卵巢良性畸胎瘤对患者造成的机体免疫功能影响较传统开腹手术小,有利于患者术后恢复机体健康以及预防各类并发症,值得临床推广应用。     

腹腔镜十二指肠溃疡穿孔修补12例报告

目的 评价腹腔镜修补十二指肠球部溃疡穿孔的效果。方法 对12例十二指肠球部溃疡穿孔的病人行电视腹腔镜缝合修补，观察其疗效及并发症。结果12例均在腹腔镜下成功修补，术后恢复快，平均住院6天，无手术并发症。结论 电视腹腔镜十二指肠球部溃疡穿孔修补术是安全有效的手术方法。     

Gasless laparoscopy for benign gynecological diseases using an abdominal wall-lifting system

Objectives: The use of gasless laparoscopy with an abdominal wall-lifting device for benign gynecological diseases was compared to conventional laparoscopy with CO_2 pneumoperitoneum. Methods: From February 2007 to July 2007, 76 women with uterine and/or adnexal benign diseases and candidates for laparoscopic surgery were recruited in this study. Thirty-two women underwent gasless laparoscopic surgery and 44 women underwent pneumoperitoneum laparoscopic surgery. Results: Diverse pathologies, including adnexal cyst, uterine myoma and ectopic pregnancy, were treated successfully with gasless laparoscopic surgery. Compared with the patients in the pneumoperitoneum group, the similar hospital stay (P=0.353) and in-traoperative blood loss (P=0.157) were observed. However, the mean operative time in the gasless group was significantly longer than that in the pneumoperitoneum group (P=0.003). No severe intraoperative or postoperative complications were found in either group, except for one case of laparotomic conversion in the pneumoperitoneum group due to dense pelvic adhesions. The total hospital charges were significantly less in the gasless group than in the pneumoperitoneum group (P=0.001). In 38 cases of ovarian cyst resection, the mean operative time in the gasless group remained longer than that in the pneumoperitoneum group (P=0.017). The total hospital charges were also significantly less in the gasless group than in the pneumoperitoneum group (P<0.001). Con-clusion: Our preliminary results demonstrated that the laparoscopic procedure using the gasless technique was a safe, effective method to treat benign gynecological diseases. Moreover, it was easy to master. As a minimally invasive treatment, gasless laparoscopic surgery provides a good choice to patients in the undeveloped regions in China without increasing the patients' and the government's burden significantly.     

电视腹腔镜下卵巢良性畸胎瘤手术17例报导

目的 探讨微创手术技术治疗卵巢良性畸胎瘤的可行性。方法 应用电视腹腔镜技术对17例患卵巢良性畸胎瘤的患进行手术治疗。结果 手术成功率100％，无明显手术并发症发生。结论 电视腹腔镜技术治疗卵巢良性畸胎瘤是微创手术，具有手术时间短、出血少、恢复快等特点，有替代开腹手术之可能。     

妇科电视腹腔镜手术中转开腹的分析

目的 分析必要的中转开腹在妇科腹腔镜手术中对减少并发症的临床应用价值。方法 对296例采用电视腹腔镜手术技术的妇科手术进行总结分析，探讨其中转开腹的原因。结果 296例患者中有287例在电视腹腔镜下顺利完成，9例因各种原因术中转为开腹完成手术，中转开腹率3．1％。结论 妇科腹腔镜手术中遇到严重的盆腔粘连，内出血止血困难，泌尿道损伤，未预计的恶性肿瘤，尝试新手术失败，及时中转开腹是明智的选择。     

A minimally invasive approach to undergraduate anatomy teaching

Anatomy is one of the cornerstones of medical education. Unfortunately, sufficient evidence has accumulated to suggest a worldwide decline in the resources and time allocated to its teaching. Integration of anatomy with clinical medicine has been frequently advocated as the solution to this academic crisis. Consequently, new ways of harnessing clinical relevance to the teaching of anatomy must be sought to make it applicable to contemporary clinical practice. Human cadavers have been used to teach laparoscopic skills to surgical trainees for some time. More recently, centers in the United States have piloted the use of minimally invasive techniques in the teaching of anatomy to undergraduates. We believe that the use of laparoscopy on human cadavers may also be used to complement the teaching of anatomy to United Kingdom and European medical students. This would not only familiarize students with the topography and morphology of human anatomy, but also with the concept of manipulating anatomical structures to achieve a clinical outcome. Other benefits include improved three‐dimensional orientation, increased dexterity, and development team‐working skills amongst students. A UK feasibility study is currently underway. Anat Sci Ed 1:46–47, 2008. © 2007 American Association of Anatomists.     

Ciliated hepatic foregut cyst: report of first case in China and review of literature

INTRODUCTIONCysticlesionofliverisgenerallydividedintoparasiticandnon-parasiticones.Ciliatedhepaticforegutcyst(CHFC)isnon-parasitic,andfirstusedbyWheelerandEdomondson(1984)todescribethehepaticcysticlesionarisingfromtheembryologicforegut.Ciliatedforegutcystmostlyoccursinthetracheobronchialtreeandesophagus,andisrarelyfoundintheliver.Accordingtotheforeignlitera-ture,therewere72casesreported,noneinChina.Recentlyweperformedalaparoscopichepatectomyforamassintheleftlobe.Thepostoperativepatho-l…     

Ciliated hepatic foregut cyst: report of first case in China and review of literature

Objective: To report the first case of ciliated hepatic foregut cyst in China, and review of literature to introduce the characteristics of this disease for doctors to recognize this disease. Method: Report the clinical procedure of diagnosis and treatment for the first case of ciliated hepatic foregut cyst in China, and to review the embryologic genesis, incidence, clinical manifestation, radiologic features and therapeutic principle of this disease. Results: We performed the resection for ciliated hepatic foregut cyst under laparoscopy; the patient recovered well after the procedure. Conclusion: Ciliated hepatic foregut cyst is quite rare clinically, belongs to non-parasitic, solitary and unilocular cystic lesion, is always less than 4 cm in diameter, mostly seen in the left lobe, and has the tendency of malignant change. It should be removed as soon as diagnosed.     

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

Objective: To investigate the relationship between post-operative cognitive dysfunction (POCD) and regional cerebral oxygen saturation (rSO₂) and β-amyloid protein (Aβ) in patients undergoing laparoscopic pancreaticoduodenectomy. Methods: Fifty patients undergoing elective laparoscopic pancreaticoduodenectomy received five groups of neuropsychological tests 1 d pre-operatively and 7 d post-operatively, with continuous monitoring of rSO₂ intra-operatively. Before anesthesia induction (t ₀), at the beginning of laparoscopy (t ₁), and at the time of pneumoperitoneum 120 min (t ₂), pneumoperitoneum 240 min (t ₃), pneumoperitoneum 480 min (t ₄), the end of pneumoperitoneum (t ₅), and 24 h after surgery, jugular venous blood was drawn respectively for the measurement of Aβ by enzyme-linked immunosorbent assay (ELISA). Results: Twenty-one cases of the fifty patients suffered from POCD after operation. We found that the maximum percentage drop in rSO₂ (rSO_{2, %max}) was significantly higher in the POCD group than in the non-POCD group. The rSO_{2, %max} value of over 10.2% might be a potential predictor of neurocognitive injury for those patients. In the POCD group, the plasma Aβ levels after 24 h were significantly higher than those of pre-operative values (P<0.01). After 24 h, levels of plasma Aβ in the POCD group were significantly higher than those in the non-POCD group (P<0.01). Conclusions: The development of POCD in patients undergoing laparoscopic pancreaticoduodenectomy is associated with alterations of rSO₂ and Aβ. Monitoring of rSO₂ might be useful in the prediction of POCD, and Aβ might be used as a sensitive biochemical marker to predict the occurrence of POCD.     

“品位”在理想学校构建中的作用探析——以昆山市柏庐实验小学为例

学校是人才的摇篮,一所有品位的学校应该为学生未来的发展奠定坚实的基础。急功近利不从容、东施效颦没特色、随波逐流无自我、言行不一短眼光,这是办学品位不高的四种现象。因此,培育有品位的阳光学生、打造有品位的教师团队、建设有品位的校园文化、追求有品位的素质教育,将是有品位的学校发展的目标。     

创新高职院校学生党建工作方法

阐述了创新高职院校学生党建工作的必要性,探索了将理论学习与实践锻炼相结合,端正学生入党动机;在校表现与实训环节相结合,建立健全选拔机制;专人培养与民主评议相结合,规范完善发展程序;定期考核和关键考察相结合,严格学生党员管理的主要创新内容。     

Performing Chinese Diasporic Identity through Mandarin: The Case of Italian-Schooled Chinese Migrant Youth in Prato (Italy)

Italian-schooled Chinese migrant youth in Prato enact a Chinese diasporic identity which develops as a result of the diasporic stance they manifest through Mandarin-speaking practice, in addition to other practices associated with Mandarin. Being children of Chinese migrants with limited Italian literacy, the youth speak a Chinese dialect and Mandarin with parents. Interestingly, they show a propensity to communicate in Mandarin with Italian-speaking peers when they choose to speak a variety of Chinese with them. They also seek alternative means of engaging with and learning Mandarin, even though it is not a school curriculum subject. The youth’s diasporic stance derives from being considered Other in their situated social field. In fact, their practices associated with Mandarin are strategies they implement to deal with exclusionist discourse. This finding emerged from a study of the youth’s linguistic repertoire, language practice, and discursive constructions of self. Data collection comprised questionnaire completion and oral data.     

论五言诗的韵律与体式的意义

在中国的旧体诗中,在《诗经》《楚辞》之后,首先发展起来的是汉魏六朝时代的五言诗,唐代人称此为古诗,以别于唐代人按严格体式和韵律写的属于＂近体诗＂范畴的五言绝句、五言律诗、五言长律。由于五绝、五律诗每句中的5个字是前两字一顿、后三字一顿的句法结构,正是与七绝、七律诗句的后5字构词顿数相同,以至与许多词的五字句顿式一致,所以五言律句的构制,就成了诗词写作合于韵律的必须具备的实践准备条件。在五言诗的写作上,五言绝句的难度更大,因为每首诗只有20个字,且要独立成章,因此必须立意集中,不枝不蔓;文字精妙,难于增减;借端托寓,蓄意深微;意到辞工,不假雕饰。由于五言绝句的体式精微,施展的天地极小,所以历来虽有名篇,却少有独擅此体的名家。     

Parents’ attitudes towards students with a background of migration—Does the background of migration matter?

As linguistic heterogeneity in classrooms is rising constantly, it was shown that attitudes play a role in the inclusion of students with migrant backgrounds. This paper focuses on attitudes of parents towards students with a migrant background and how variables such as parents’ level of education, cultural differences, and their own background of migration shape their attitudes. To this end, data from 876 parents (486 mothers and 390 fathers) was assessed, and it was found out that parents with a migrant background displayed more positive attitudes towards the inclusion of students with a background of migration in contrast to parents without a migrant background. Moreover, fathers displayed more positive attitudes towards students with lower cultural differences compared to students with higher cultural differences. Furthermore, mothers with a higher level of education had more positive attitudes towards students with a migrant background compared to mothers with a lower level of education.     

What's in a name? Students with dyslexia: their use of metaphor in making sense of their disability

Research and practice involving children and adults with dyslexia has tended to focus on identifying difficulties in developing literacy skills and associated cognitive variables. Comparatively few investigations have focused on affective factors or on finding ways of enabling those with dyslexia to express their own attitudes, thoughts and feelings about these difficulties. As part of an intensive investigation into the self-concepts of pupils attending a residential special school for boys with dyslexia, Robert Burden, Professor of Applied Educational Psychology at the University of Exeter, together with his research assistant, Julia Burdett, carried out semi-structured interviews with 50 boys. One element of the interview was a request to each interviewee to construct a mind picture or image of what dyslexia represented to him. The results revealed a number of powerful images illustrating both surmountable and insurmountable barriers to learning, together with feelings of confusion and inadequacy. The conclusion is drawn that metaphors provide a potentially helpful means of exploring the deep-rooted thoughts and feelings of children and young people diagnosed with dyslexia. The authors conclude by discussing some possible implications of this form of investigation for future research and intervention with those experiencing dyslexia and a wide range of other disabilities.     

Access constraints experienced by physically disabled students at a South African higher education institution

Abstract

Current developments in government law and policies have created the hope that people living with a disability will enjoy the same rights and privileges as the non-disabled. Unfortunately, only 2.8% of disabled persons have access to higher education. The aim of this study was to determine if a group of students, living with a physical disability, experienced constraints with regard to access to a South African higher education institution. This study, following a two-phase sequential mixed method approach, consisted of a questionnaire survey, a focus group discussion, and individual interviews. It was found that students living with a physical disability experienced constraints relating to the accessibility of the relevant higher education institution. Since access constraints affect the lives of students living with a disability, it is necessary to provide guidelines to universities on how to address these challenges.     

基础教育课程改革对高师院校的挑战

基础教育课程改革对教师素质提出了新的标准和更高的要求,教师职业的门槛进一步提高。高师院校作为基础教育师资的主要培养基地,如何应对基础教育课程改革,与基础教育课程改革积极互动,培养出具有创新意识和创新能力的新型师资,以满足社会的需要,这将是高师院校今后一个时期改革和发展的重要方面。