CD44 is expressed in a number of hematological malignancies, its expression level is related with clinical status and prognosis. Study of CD44 and its monoclonal antibody has significance in diagnosis,prognosis and treatment of malignant hematopoietic system tumors.

Objective To investigate the possibility of reserving uterus during severe postpartum hemorrhage. MethodsA retrospective analysis was conducted on the clinical data of 138 cases of severe postpartum hemorrhage (blood loss ≥2000 ml) from January 1, 2003 to December 31, 2009. Results Among 138 cases of severe postpartum hemorrhage, uterine atony (n= 60, 43. 38 ％ ) was the first cause and the second was placental factor (n= 55, 39.86 ％). The blood loss varied from 2000 ml to 10 000 ml and the mean level was about (3004± 1473) ml. The volume of blood transfusion for these patients varied from 800 ml to 7200 ml. Among these patients, the blood loss of 108 cases reserved uteri was from 2000 ml to 7500 ml, with the average of (2564±932) ml； while for 30 cases performed with hysterectomy, the blood loss was about 2500 to 10 000 ml averagly (4653± 1857) ml (t=8. 57, P=0.00). These patients were divided into two groups according to time series. Twelve cases of hysterectomy were performed during 2003to 2005, and the hysterectomy rate was 0. 47‰; 18 cases of hysterectomy were performed during 2006 to 2009, and the hysterectomy rate was 0. 36‰. The average blood loss of the above two groups was (3783±861) ml and (5233±2124) ml respectively (t=2. 234, P=0. 034). Among all the cases with blood loss ≥ 3000 ml, uteri were reserved in 24 cases with the average blood loss of (3818 ± 1284) ml； while hysterectomy were performed in 27 cases with average blood loss of (4900 ± 1789) rnl (t = 2. 453, P =0. 018). The time for blood loss to 3000 ml in the two groups was (160±129) min and (100±67) min,respectively, and the difference was significant (t=2. 113, P = 0.04).The uteri of six cases with postpartum hemorrhage over 4000 ml were successfully reserved, and average bleeding amount was 5570 ml.Two patients among the 138 women died of amniotic fluid embolism.The perinatal mortality rate was 3. 73％.ConclusionsThe postpartum hemorrhage volume and velocity is the key point to decide whether to reserve the uterus or not.For the population with high risk factors,prophylaxis treatment with prostaglandins should be initiated to reduce the bleeding volume.Uterine packing might be an effective treatment to stop postpartum hemorrhage, especially for those bleeding due to placenta previa.

used at the primary-care settings in China to assess asthma control.

Through demonstrating the satisfaction evaluation system of Singapore hospitals,the article analyzed the differences between the satisfaction evaluation system of Singapore and the system made by Shanghai Municipal Commission of Health and Family Planning.It was concluded that the humanized evaluation methods should be highlighted,the conformity of establishment of evaluation system and policy be focused on,staff incentive mechanism be focused on and perfected,and patients' expectation indicator and perceived quality be considered as strategic tools to improve the healthcare system performance.

Hepatolenticular Degeneration ; Humans ; Nervous System Diseases

Epilepsy is one of the major clinical features of tuberous sclerosis complex, and it is drug-resistant in the majority of cases.Surgical resection is an effective way to resolve the seizures.Precise preoperative evaluation is critical to the surgical outcome.Preoperative evaluation mainly aims to determine the range of the epileptogenic zone and the functional areas that should be preserved.Because of the complexity of the epileptogenic mechanism and brain network, there isn′t a single and specific measure that can accurately position the epileptogenic zone, so it is necessary to comprehensively evaluate and localize the epileptogenic zone by using multiple methods, including collection of a detailed medical history, symptomatic analysis during the attack of seizures, magnetic resonance imaging, positronemission tomography, electroencephalogram, neuropsychological evaluation, etc.In this paper, the rational use of above-mentioned approaches and comprehensive analysis of their results were summarized, which play an essential role in contro-lling seizures in children with tuberous sclerosis complex and refractory seizures.

Cranial irradiation is routinely used for the treatment of almost all brain tumors,but it may cause disastrous injury in brain,especially in the hippocampus that has cognitional and emotional regulation functions.Several studies have investigated the mechanisms of radiation-induced hippocampal dysfunctions such as hippocampal neurogenesis,neurotrophin and neuroinflammation,and provided effective prevention strategies such as exercise,environmental enrichment,anti-inflammatory and intrahippocampal transplantation of neural stem cells.This review discussed the curent progresses and challenges of hippocampal dysfunction induced by cranial irradiation and provided new insights for preclinical and clinical researches.

5-Fluorouracil(5-FU)has been widely used to treat gastrointestinal,head,neck,chest and ovarian malignant tu-mors since 1957. As an analogue of pyrimidine,5-FU plays anti-cancer roles by inhibiting thymioylate synthase and integrating its me-tabolites into DNA and RNA. Although 5-FU is one of the first-line therapeutic compounds for gastrointestinal malignant tumor as a sin-gle drug or in combination with other drugs,its effectiveness is hindered by its low efficiency,which may be due to chemotherapy re-sistance. 5-FU chemotherapy resistance may stem from enzyme abnormality,genetic abnormality and tumor microenvironment. In this paper,we make a review about 5-FU actions and the mechanisms underlying chemotherapy resistance.

Objective To understand the effect of diabetes on the nerve cells injury in hippocampal region by observing the nerve cells changes in this region of ischemia after focal cerebral ischemia reperfusion for rats with diabetes.Methods Sixty healthy male Wister rats were randomly divided into four groups:the control group,sham operation group,normal cerebral ischemia-reperfusion(NIR)group,and diabetic cerebral ischemia-reperfusion(DIR)group.The model of local cerebral ischemia and reperfusion was established by the thread-embolism and cerclage of rats with STZ-induced diabetes.Hematoxylin-eosin(HE)-stained neurons in hippocampal CA1 region were observed by selecting 8 un-overlapped fields under light microscope(?400);the total number of the normal pyramidal neurons with whole cellular organ structure were counted within 100 ?m length in CA1 region.The numbers of positive neurons were presented as mean with standard errors(?s).Significant differences between groups were analyzed by t-test.Results Neuronal loss or apoptotic cells were not found in the control group or sham operation group after observing under light microscope.There were neuronal losses in both NIR and DIR groups,neuronal loss of DIR group being more serious than that of NIR group(P

Objective To evaluate the effect of procedure for prolapse and hemorrhoid(PPH)for the treatment of prolapsed internal hemorrhoids. Methods 23 patients with the third or fourth degree circular prolapsed internal hemorrhoids were managed by means of PPH. Results The mean operative time was 22 minutes,and hospital stay was 3.5 days after operation.Pain in 48 hours after operation was evaluated and 18 cases had no pain(78 3%),5 cases less pain(21 7%).The anastomoses healed in (4～5) weeks and there was no recurrence in (1～6) months after the patients were discharged from hospital. Conslusions Compared with the traditional operation,PPH has the advantages of simpleness,less pain,less complications and quiker recovery,but the cost is higher.