Objective To investigate the clinical effect of cervical circular cutting technique in the treatment of cervical intraepithelial neoplasia.Methods 120 patients with cervical intraepithelial neoplasia were selected.They were treated with cervical circular cutting technique,and the effect was analyzed.Results 120 patients after treatment,the obvious effective rate was 76.67 ％ (92/120),the effective rate was 19.17 ％ (23/120),the ineffective rate was 4.17％ (5/120),the total effective rate was 95.83％.The LEEP operation time was controlled at (9.0 ± 0.5)min,the intraoperative blood loss was (16.2 ± 1.2)mL.The postoperative pathologic examination results compared with cervical multi-point biopsy under colposcope had no statistically significant difference (x2 =1.238,P ＞ 0.05).Conclusion The cervical circular cutting technique in the treatment of cervical intraepithelial neoplasia has good effect,can not only completely remove cervical lesions,and has less blood loss,fewer complications,it is worthy of widely use in clinic.

By using the image processing function and programming tomography,the following functions are realized: the contour line,edge line and gradation histogram of medical images are displayed;the selected regions of medical images are freely zoomed;the gray level of discretional regions is displayed using medical image processing tool and the distance of the given points is freely measured.

Objective To investigate the value of real-time three-dimensional echocardiography 17 regional volume curves index in patients with heart transplantation. Methods Sixty patients with heart transplantation (no rejection), ten patients with heart transplantation (rejection), forty subjects with normal left ventricular(LV) function were examined by Philips iE33 with a X3-1 probe. Results Parameter index of 17 segment time to minimal systolic volume in patients with heat transplantation (rejection) were more than those in patients with heart transplantation (no rejection) and in subjects with normal LV function(all P <0.05). Parameter index of 17 segment time to minimal systolic volume were not significantly different in patients with heart transplantation (no rejection) compared with subjects with normal LV function. Parameter index of Tmsv16-SD (%), Tmsv12-SD (%) and Tmsv6-SD (%) show higher sensitivity and specificity for forecast rejection after heart transplantation. Conclusions Real-time three-dimensional 17 regional volume curves index can fast forecast early rejection after heart transplantation.

Objective To investigate longitudinal systolic function of transplanted heart using two dimensional speckle tracking echocardiography and tissue Doppler imaging.Methods 56 consecutive patients with heart transplant were recruited,according to myocardial biopsy and 1 year's follow up,they were divided into non-rejection group (group A) and rejection group (group B).36 healthy controls (group C) were also randomly recruited.Left ventricular ejection fraction (LVEF),pulmonary arterial systolic pressure,tricuspid annular plane systolic excursion (TAPSE),tricuspid annular plane systolic velocity (TAS') and global longitudinal strain (GLS) were calculated via Qlab 9.0 analysis software offline.Results Compared with group C,LVEF was reduced in group B (P ＜0.01).Differences of GLS,TAPSE,and TA-S' among groups were all statistically significant (P ＜0.01),group B＜group A＜ group C.LVEF,TAPSE and TA-S' were correlated with GLS (r =-0.64,r =-0.69,r =-0.71 ; all P ＜ 0.01).Conclusions Left and right ventricles were a functional unity,the systolic function of which was impaired in patients with heart transplant.

Objective To evaluate the effect of edge-to-edge technique of anterior mitral valve prolapse using transthoraeic echocardiography(TTE). Methods Nineteen patients with anterior mitral valve prolapse underwent randomized operation using edge-to-edge technique. The grade of mitral regurgitation(MR),mitral valve are (MVA), the diameter of left atrial(LAD) and left ventricle(LVD), left ventricular ejection fracion(LVEF) and pulmonary artery systolic pressure(PASP) were evaluated. Results All the patients with anterior mitral valve prolapse had severe MR before the operation whereas the degree of MR changed into absence to mild degree after the procedure. There were significant statistic differences between pre- and post edge-to-edge procedure:LAD(51.63±10.03)mm vs (44.79±9.22)mm, P = 0.000, LVD(59.37±8.29)mm vs (52.68±7.31)mm, P = 0.000 ; PASP (45.37±18.34)mm Hg vs (33.00± 9.43)mm Hg, P = 0.002,1 mm Hg = 0.133 kPa;MVA(4.13±0.24)cm<'2> vs (2.90±0.28)cm<'2>, P = 0.000,while LVEF changed little[(66.0±9.0)% vs (67.0±6.0) %, p = 0.751]. Conclusions The edge-to-edge technique is a simple and effective surgical method which can remain subvalve structure,restore the normal morphology of left atria,left ventricle and maintain the function of left ventricle.

Background and objective Pre-operative assessment of mitral valve(MV)anatomy is essential to surgical design in patientsundergoing MV repair.Although 2-dimensional(2D)echocardiography provides precise information regarding MV anatomy,RT-3DTEE could increase the understanding of MV apparatus and individual scallop identification.We aimed to investigate the value of RT-3DTEE in MV repair. Methods RT-3DTEE was performed in six patients with mitral valve prolapse(MVP) by using Philips IE33with X7-2t probe.Preoperative RT-3DTEE studies were compared with surgical findings in patients undergoing surgical mitral valverepair,and quantitative evaluation was performed by QLab 6.0 software before and after surgicalmitralvalve repair.Results RT-3DTEE could display dynamic morphology of MV,the location of prolapse,and spatial relation to the surrounding tissue.It couldprovide surgical views of the valves and the valvular apparatus.These resuIts were consistent with surgical findings.The quantitativeevahuation before and after surgical MV repair indicated that anterolateral to posteromedial diameter of annalus.anterior to posteriordiameter of annulus,perimeter of annullus.,and area of annalus in projectionplane were significantlv smaller after operation comparedwith those before operation(P＜0.05).The length of posterior leaflet,,the area of anterior and posterior leaflet,the maximal prolapseheight,the volume of leaflet prolapse and the length of coaptation in projection planewere significantly reduced after operation(P＜0.05).Conclusion RT-3DTEE is a unique new medality for rapid and accurate evaluation of mitral valve prolapse and miwal valverepair.

Objective To explore hemopurification clinical nurse specialist's effects and barriers,in order to provide evidences to define their value,to remove their barriers,to promote their effects.Methods A qualitative study was adopted in this study.In-depth interviews were conducted on 3 charge nurses in hemopurification and 10 hemopurification clinical nurse specialists.Results The effects of hemopurification clinical nurse specialist can be concluded as effects to patients,to nursing,to medical systems and to hemopurification clinical nurse specialist themselves.Barriers of hemopurification clinical nurse specialist can be concluded as medical environments,the process of nursing developing,ambiguous role of clinical nurse specialist.Conclusions The practice of hemopurification clinical nurse specialists have played various effects,but there were some barriers in their practice.The roles of clinical nurse specialist should be clarified,and guarantees in managements and regulations should be provided for their practice.

Objective To test the reliability and validity of CRIES-13(Chinese edition). The Children Revised Impact of Event Scale (CRIES-13) was recommened for diagnosing PTSD of children. Methods In the last third of the September 2008,according to the suffering condition,600 students were choosed who were fit for the research standard as subjects in two middle schools randomly. The viability of CRIES-13 was weighted by testretest reliability,Cronbach' s alpha,Split half reliability. The validity of CRIES-13 was analysed by content validity ,criterion validity,construction validity. Results In the test-retest reliability of CRIES-13, the Spearman correlation coefficient of total,intrusion factor,avoid factor,high warkening factor were 0.79, 0.75, 0.71, 0.75. Significant correlation were found among these scores. The Cronbach' s alpha of population was 0. 81. The Cronbach' s alpha of three factors was 0. 79 ( intrusion factor) , 0. 71 ( avoid factor), 0. 65 ( high awarkening factor). CRIES-13's split-half reliability was 0. 85. In the content validity test,the Spearman rank correlation coefficient between total score and each item was 0. 83 (intrusion factor), 0. 75 (avoid factor), 0. 85 (high awarkening factor). The correlation between intrusion factor and avoid factor was 0.63. The correlation between avoid factor and high awarkening factor was 0.41. The correlation between intrusion factor and high awarkening factor was 0.41. In struction validity, variance orthogonal rotation factor analysis was adopted and got three general factors. Their cumulative contribution to total variance was 55.52%. In the criterion validity test,significant correlation was found between intrusion factor and SDQ emotional factor and depression scale total score. Significant correlation was found between high awakening factor and SDQ emotional factor and depression scale total score. Conclusion The reliability and validity of CRIES-13 was good. It could be used extensively.

Objective To evaluate left ventricular torsion and systolic function of the segment by speckle tracking imaging(STI) and real-time three-dimensional echocardiography(RT-3DE) in patients with heart transplantation. Methods Twenty patients with heart transplantation and twenty subjects with normal left ventricular function were examined by Philips iE33 with a X3-1 probe and GE Vivid 7 with M4S probe.Results There were two subjects(100% ) with clockwise rotation in control group patients, but eight patients (40 % ) with clockwise rotation in heart transplantation group. And heart transplantation group were divided into two sub-groups (group A with counterclockwise rotation and group B with clockwise rotation) based on the direction of rotation. In apical level,the systolic peak of the angle of rotation of anterior septum,posterior wall,inferior wall, posterior septum in group A was less than that of control group( P ＜0.05), all segmental systolic peak of the angle of rotation in group B was reduced compared with control group( P ＜0. 05),however all segmental systolic peak of rate of rotation in group A and group B was not significant different compared with control group ( P ＞0. 05) ,all segmental diastolic peak in early and late of rate of rotation in group B was obviously higher than that in control group and group A ( P ＜0. 05), while all segmental diastolic peak in early and late of rate of rotation in group A was not significant different compared with control group( P ＞0.05). The displacement and the parameter index of 17 segment time to minimal systolic volume in group A and group B were not significant different compared with control group( P ＞0. 05), but left ventricular angle of torsion was decreased in group B compared with control group and group A( P ＜0.05). Conclusions STI and RT-3DE can rapidly evaluate function of left ventricular torsion and function of segmental systole and systolic synchrony in patients with heart transplant.

Objective The Children's Revised Impact of Event Scale (CRIES-13) is used for Screening PTSD of children. The reliability and validity of CRIES-13 is good. To research the demarcation points of CRIES-13 (Chinese version) based on the reliability and validity analysis,and to improve the useful value of the scale.Methods In late September 2008, according affected condition, students were choosed who were fit for the research standard as subjects in two middle schools. First,general questionnaire (self-writing) and CRIES-13 were applied to the subjects. Second, according to K-SADS-PL, physician carried out diagnosis meeting and evaluation to 310 students who were classified by stratified rand sampling. Critical point of CRIES-13 was divided by K-SADSPL. The assessment value of it were sensitivity, specificity, veracity, PPV, NPV. The right choice of division was measured by ROC curve. Results When the critical score was higher than 30, the score of Se ( 0. 833 ), Sp(0. 836) and NPV (0.97) was in the high level. Conclusion When the critical score is higher than 30, the scale have a good discrimination for PTSD, non-PTSD and it can be used extensively.