Objective To explore the clinical efficacy and surgical techniques of vaginal sacrospinous ligament fixation,which was used for treatment of uterine prolapse and vaginal prolapse of the top.Methods 25 patients with uterine prolapse and vaginal vault prolapse were treated with VSSLF,and its feasibility and effiency was analyzed.Results All patients were successfully conducted the surgical indexing method based on POP-Q,25 cases of uterine prolapse,vaginal anterior and posterior wall prolapse and urinary incontinence and other symptoms all had been corrected.There was no intraoperative and postoperative bleeding or pelvic organ injury in surgry.25 patients recovered well after operation,postoperative morbidity,not observed in other complications associated with surgery.All the patients were followed up for 24 months,patients'cervix 4 cm from the hymen edge,related symptoms disappeared or improved significantly.Conclusion Vaginal sacrospinous ligament fixation is a safe,simple,effective and minimally invasive surgery for uterine prolapse and vaginal prolapse of the top.

Objective To establish the rational antibiotic treatment by accurate screening of highlevel aminoglycoside (HLA) resistant enterococci in clinical laboratory. Methods A single HLA gentamicin 500 μg/ml and streptomycin 200 μg/ml for agar dilution method, and gentamicin 120 μg/disk and streptomycin 300 μg/disk for disk diffusion method were used as parallel screening tests to detect high-level aminoglycoside resistance in 172 enterococci strains. Antibiotic time-kill test was performed to verify the accuracy and reliability of both methods. Results The resistant rates of the two methods for HLA gentamicin were 60.0％ and 59.3％, respectively. While for HLA streptomycin, both were 61.1%. In disk diffusion tests of 172 enterococci strains, the resistant rates for penicillin, ampicillin and vancomycin were 16.9 %,14.0%, and 1.7%, respectively. β-lactamase from 80 strains enterococci were all negative. Conclusion High-concentration aminoglycoside disk diffusion method is a simple, reliable method for screening the HLA resistant enterococci in clinical laboratory. The results can provide a rational base for physicians to treat enterococcal infections.

Objective To explore the ovarian tumor's characteristics, diagnosis and treatment during pregnancy.Methods A retrospective analysis of 156 cases of ovarian tumor was carried out.Results About 152 cases were dignosed as benign,accounting for 97.44%.The majority of which were demoid cysts and grout cystadenomas,two cases were bordline grout papillary cystaadenoma,other 2 cases,one was some of immature teratoma, another was immature teratoma.67 cases were diagnosed by ultrasound during the first trimester, accountting for 80.72%, among 17 urgent operations,10 cases caused by torsion,7 cases caused by rupture.43 cases operated by term,among which 39 cases were tradion operations,4 cases were laparoscopic surgery.18 cases made the examination of CA125 before operation,as a result,13 cases elevated,AFP examination were made in 10 cases,7 cases elevated.Full-term birth was in 152 patients, accounting for 97.44%.Conclusion Majority ovarian tumor during prenaney were benign;Ultrasound examination combined with tumor marker were important in diagnosis and detection ovarian tumor during pregnancy; The individual operation therapy should be chosen, according to the tumor's properties, gestational weeks, and patients' will;Timely open surgery or laparoscopic surgery should not affect the pregnancy outcome.

Objective To investigate the development status of tumor radiotherapy in the Xinjiang Uygur Autonomous Region.Methods A questionnaire survey we used last time was conducted by letter,Email,telephone or fax to investigate all the medical institutions in the Xinjiang Uygur Autonomous Region for researching the current status of radiotherapy academic settings,human resources,allocation of radiotherapy facilities and standardization of medical practices.Results Up to the end of January 2015,there were 30 medical electron linear accelerators,21 simulated locators,10 breach-loading brachytherapy machines,31 treatment planning systems and 5γ or X knives in Xinjiang.Radiotherapy was carried out in 20 medical institutions,including 14 three-dimensional conformal radiotherapy and 9 intensity modulated radiation therapy,8 breach-loading brachytherapy,3 stereotactic radiotherapy,and 2 volumetric modulated arc therapy.There were 280 radiation personnel (except nurses),including 159 radiation oncologists,40 radiotherapy physicists and 81 radiotherapy technologists.There were 1167 hospital beds and 855 cancer patients received radiotherapy on average every day.Conclusions Although radiation personnel has increased,radiotherapy facilities have been improved,hospital beds and patients received radiotherapy also have become more,the improvements are needed for cause of imbalance in precise radiation therapy development.

Objective To establish the rational antibiotic treatment by accurate screening of high level aminoglycoside (HLA) resistant enterococci in clinical laboratory. Methods A single HLA genta micin 500 ?g/ml and streptomycin 200 ?g/ml for agar dilution method, and gentamicin 120 ?g/disk and streptomycin 300 ?g/disk for disk diffusion method were used as parallel screening tests to detect high level aminoglycoside resistance in 172 enterococci strains. Antibiotic time kill test was performed to verify the accuracy and reliability of both methods.Results The resistant rates of the two methods for HLA gentamicin were 60.0% and 59.3%,respectively. While for HLA streptomycin, both were 61.1%. In disk diffusion tests of 172 enterococci strains, the resistant rates for penicillin, ampicillin and vancomycin were 16.9%, 14.0%, and 1.7%, respectively. ? lactamase from 80 strains enterococci were all negative. Conclusion High concentration aminoglycoside disk diffusion method is a simple, reliable method for screening the HLA resistant enterococci in clinical laboratory. The results can provide a rational base for physicians to treat enterococcal infections.

AIM: To investigate the effects of rosiglitazone on fibroblast-like synoviocyte ( FLS )-induced osteoclastogenesis in rheumatoid arthritis ( RA) and the related mechanism.METHODS: RA-FLS were cocultured with peripheral blood monocytes from healthy volunteers in the presence of macrophage colony-stimulating factor ( M-CSF) and rosiglitazone.Osteoclasts were assayed by tartrate-resistant acid phosphatase ( TRAP) staining.Resorption lacunae area was identified by toluidine blue staining and quantified by image analysis software.The mRNA expression of RANKL and OPG was evaluated by real-time PCR, and the protein levels of RANKL, OPG, p-ERK, p-p38 and p-JNK were measured by Western blot.RESULTS:Compared with control group ( without rosiglitazone treatment) , rosiglitazone at concentration of 15 μmol/L significantly decreased the number of osteoclasts (P<0.01) and resorption lacunae area (P<0.05).The expression of RANKL at mRNA and protein levels was significantly down-regulated by rosiglitazone at concentration of 15μmol/L, while the mRNA and protein expression of OPG was up-regulated (P<0.01).Rosiglitazone (15 μmol/L) sig-nificantly decreased the protein level of p-ERK ( P<0.05 ) , but not the protein level of p-p38 or p-JNK ( P>0.05 ) . CONCLUSION:Rosiglitazone inhibits RA-FLS-induced osteoclast formation and its resorption activity by down-regulating RANKL expression and ERK phosphorylation, suggesting that rosiglitazone may inhibit RA osteoclastogenesis and bone re-sorption.

ObjectiveTo investigate the correlation and expression of fragile histidinetriad gene(FHIT) and p53 expressed in normal cervix,cervical intraepithelial neoplasia( CIN),cervial cancer( CC),and the significance of FHIT and p53 in the chnical diagnosis,treatment and prognosis of cervical cancer.MethodsIt was performed immunohistochemieal analysis of formalin fixed,paraffin-embedded 20 normal cervical(NC) biopsies,10 CIN1 samples、20CIN Ⅱ samples、20 CINⅢ samples and 70 cervical cancer samples to detect FHIT、p53expression.ResultsFHIT expressed 100％ (20/20) of normal cervical,60％ (6/10) of CIN Ⅰ,40％ (8/20) of CIN Ⅱ,25％ (5/20) of CINⅢ and 3％ (2/70) of cervical cancer;positive rate among the groups was different (P ＜ 0.05 ).p53 positive expressed in 0％ (0/20) of normal cervical,20％ (2/20) of CIN Ⅰ,35 ％ ( 7/20 ) of CIN Ⅱ,55％ ( 11/20 ) of CIN Ⅲ and 70％(49/70) of cervical cancer:positive rate among the groups was different (P ＜ 0.05 ).FHIT and p53 expression was negatively correlated with CIN and cervical cancer in the cervix ( P ＜ 0.05 ).ConclusionFHIT deletion and p53 overexpression was the early and common cases with the cervical cancer,which were negatively correlated in the pathogensis and development of cervical cancer:FHIT could screen the high risk of CIN,and give the basis of cervical cancer gene therepy.

Objective To investigate the effects of crocodilian plasma on 12 bacteria(including G+ bacteria and G-bacteria) lines in vitro.Methods The bacteria CFUs on nutrient broth agar plates were determined after bacteria and crocodilian plasma incubated together for 1h.Then effects of the samples on the survival rate of various concentrations of bacteria were calculated.To evaluate the antibacterial spectrum of crocodilian plasma,the zones of bacterial inhibition were measured through agar disk method.Results and Conclusion Crocodilian plasma had superior bactericidal effects on Escherichia coli M421C1,O111B4,E240-3 LT,Micrococcus catarrhalis,Shiga's bacillus,Pseudomonas aeruginosa and Diplococcus pneumoniae.The results indicated why wound of crocodilian by tearing each other was not susceptible,and crocodilian plasma could be developed a natural antibacterials.

Objective To investigate doctor's screening practice for hepatitis B virus (HBV) infection before immunosuppressive therapy for rheumatoid arthritis (RA) patients and clinical management of RA patients with positive surface antigen of HBV (HBsAg).Methods One hundred fifty doctors who treated RA patients in daily clinic were survied with a modified American College of Rheumatology (ACR) questionnaire which was composed of demographic data and 10 multiple-choice questions.Step-forward logistic regression analysis was performed to find out the influencing factors,then receiver operator characteristic curve analysis and area under the curve were performed to confirm the influencing factors.Results One hundred and thirtytwo effective questionnaires were collected.Before immunosuppressive therapy,HBV screening rate in outpatients with RA was significandy lower than that in hospitalized patients (68.7％ vs 94.6％,x2=31.5,P＜0.01).Only 23.7％(31/131) of doctors considered antiviral treatment for all RA patients with positive HBsAg.One hundred and thirteen doctors had clinical experience of antiviral treatment,but only 30.1％(34/113) and 23.9％ (27/113) of these doctors chose entecavir or adefovir as the antiviral drug respectively,59.3％ (67/113) prescribed antiviral drug before or together with immunosuppressive therapy compared with 40.7％(46/113) after HBV reactivation.Only 20.4％(23/113) of doctors would sustain antiviral treatment until the termination of steroid or disease modifying antirheumatic drugs (DMARDs).During immunosuppressive therapy for HBsAg(+) RA patients,11.4％(15/132) and 30.3％(40/132) of doctors reported no regular monitoring of aminotransferase or HBV DNA respectively.Conclusion Our survey shows that HBV screening rate in outpatients with RA is low and low awareness of antiviral treatment for all RA patients with positive HBsAg,and lack of awareness of indication,choosing of antiviral drugs,initiation,monitoring and duration of antiviral treatment during immunosuppressive therapy.Further medical education on the associated information and importance to collaborate with hepatologists should be emphasized.

Objective To observe the efficacy and safety of tocilizumab on patients with refractory rheumatoid arthritis (RA).Methods Eighteen RA patients who were refractory to disease-modifying antirheumatic drugs (DMARDs) or tumor necrosis factor-α (TNF-α) antagonist were treated with tocilizumab were included into this study.Their clinical disease activity indices,Hospital Anxiety and Depression Scale (HADS)and safety were evaluated regularly.Statistical analysis was conducted with Mann-Whitney U test and x2 test.Results According to clinical disease activity index,44％(8/18) of patients reached treatment target 2 weeks after the first infusion of tocilizumab,and 78％ (14/18) reached treatment target after three infusions of tocilizumab.Fifty-six percent (10/18) of patients had anxiety and 22％ (4/18) had depressive symptoms at baseline.After three infusions of tocilizumab,6％(1/18) had anxiety symptoms and 11％(2/18) had depressive symptoms.The adverse effects included upper respiratory tract infection,aminotransferase elevation and neutropenia (3 patients,respectively).Conclusion Tocilizumab can rapidly and significantly improve the disease activity and psychological state with good tolerance and safety,which can be applied to Chinese refractory RA patients who failed with DMARDs or TNF-α antagonist.