Objective To investigate effects and techniques of laparoscopic assisted transvaginal hysterectomy (LAVH). Methods Laparoscopic assisted transvaginal hysterectomy was carried out in 121 patients with hysteromyoma, cervical intraepithelial neoplasia grade Ⅲ, uterine adenomyoma, ovarian tumor, or atypical hyperplasia of endometrium, which were all indications for uterus resection. Results LAVH was performed successfully in 117 cases, whereas a conversion to open surgery was required in 4 cases because of serious adhesion, the success rate being 96 7% (117/121). The mean operating time was 95 min (range, 58~192 min). The mean amount of intraoperative blood loss was 120 ml (range, 100~250 ml). The postoperative hospital stay was 5~8 days. Conclusions LAVH was associated with mild trauma, slight intestinal disturbance, and quick recovery. Whether or not an operation is successful is related to the size, shape and mobility of the uterus, vaginal space, and operator’s skills and experience.

Objective To investigate the efficacy and safety of hysteroscopic treatment for submucous uterine myoma.Methods From January 2000 to December 2004,a total of 168 women with submucous leiomyoma of the uterus were treated by hysteroscopy in our hospital.According to the type of the myomas,electro-resection was performed in different ways.For the patients with massive hemorrhage or older than 45 years,the endometrium was resected during the operation.Results The operation was completed in all the cases within 5 to 65 minutes mean,(27.6?12.1)minutes].The mean blood loss was(40.1?10.2)ml(8-50 ml).After the surgery,2 patients developed uterine perforation,3 had hyponatremia,and 5 showed transient fever.Among the patients,160(95.2%)were satisfied with the outcomes of the surgery.Conclusions Transcervical electro-resection by hysteroscopy is a minimally invasive,safe,and effective method for submucous uterine myoma.Preoperative preparation,strict indication criteria,and intraoperative monitor are three key points to avoid operation-related complications.

Objective To discuss with micro-tympanoplastic operation with osteo retention on treating cholesteatomatous otitismedis. Methods Choose 33 cases cholesteatomatous otitis medis patients who toke the tympanoplastic with osteo retention operation,then analyze the postulate and method of the operation, curative effect and complication after operation. Results Follow up with those patients by 12-72 months, and when 3-4 months after operation we endoscopiced the ears, could see that 43 cases of patients ear mastoid process and tympanic sinus were covered with epithelium, those mastoid cavity were well epithelial metaplasia;and the middle ear was separate from mastoid cavity; 39 cases patient of transplant eardrums are heal up (39/43, 90.7%). 2 cases have perforation of the tympanic membrane toke place after 4 months and 6 months with the operation, and it will heal up by anti-inflammatory drug and laser burning, 1 case had tympanic sinus hyperplasia with granulation tissue, and also had grassery juice; after taken anti-inflammatory drug and change bandage for 15 weeks, the symptom disappear. 1 case had grassery juice of operation cavity, after taking anti-inflammatory drug and physiotherapy, the symptom disappear in 24 weeks. After operation the pure tone audiometry shows that air conduction raise (16.8±6.8) dB HL, hearing raise up to:79.1%(34/43). Conclusion Base on right indication of operation choose, taken combined therapy of ambi-operation period, focus of infection are thoroughly cleaning up. Tympanoplastic with osteo retention are treating well with patients of cholesteatomatous otitismedis.

Objective To evaluate the effect of enteral nutrition by a polymeric formula in patients with severe acute pancreatitis (SAP).Methods Fifty-eight patients with SAP were randomly divided into polymeric group (29 cases) and semi-elemental group (29 cases),and the two groups of patients were treated in accordance with the conventional SAP management protocol,nasojejunal tube was endoscopically inserted for enteral nutrition.The polymeric group received enteral nutritional suspension (TPF),and the semi-elemental group received the same quantity of VIVONEX TEN.The gastrointestinal tolerance (VAS score),incidence of diarrhea,infection,28-day mortality rate,and length of hospital stay was evaluated.Nutritional parameters were evaluated by pre-albumin,albumin,alanine aminotransferase,C reactive protein at the time of admission and one week later.Results The two groups of patients were comparable in terms of VAS score,incidence of diarrhea,infection,28-day mortality rate,and length of hospital stay (P ＞0.05).And the levels of prealbumin,albumin,alanine aminotransferase,C reactive protein after admission were not statistically significant (P ＞ 0.05).Conclusions Compared with the semi-dement formula,the price of polymeric formula is cheap,configuration is convenint,enteral nutrition is well tolerated,and it is suitable for early enteral nutrition in SAP.

Objective To explore clinical value of transvagiTIa ultrasound in diagnosis of cctopie oviductpregnancy.Methods EUB-2000 ultrasound diagnosis meter was used,the vagina probe head frequency is 5～10MHz,after the vagina to the womb,the double-side ovary,the double side oviduct and its periphery organizes to carry on omni-direetionally sweeps looks up.Results Transvagina ultrasound diagnosis ectopic pregnancy center oviduct pot abdomen pregnancy 158 cases,the oviduct canyon department 4 cases,between the oviduct the nature department pregnancy 2 cases,all pass through the cefioseope of our hospital.Coincidence rate was 100%.Conclusion Transvagina ultrasound diagnosis ectopie pregnancy is one of most accurate ultrasound diagnosis methods presendy,suggested various basic units hospital widely develops.

Objective To investigate the feasibility of using low Kv,low iodine contrast Agent concentration (dual low)CT scan techniques in Coronary CTA (CCTA).Methods Seventy-six patients undergoing CCTA were divided into Group A and Group B , randomly.Group A (38 patients)was the dual-low group,which was scanned with tube voltage of 100 kVp,and injected with iso-osmolarity contrast agent visipaque 270 (270 mg I/mL),with iterative reconstruction technique (ASIR 40%).Group B (38 pa-tients)was scanned with 120 kVp,and low osmolarity contrast agent omnipaque 350 (350 mg I/mL)and FBP reconstruction,The images are assessed double-blindly by two experienced radiologists.Five ROIs were placed onto the ascending root of aorta (AO), left main artery(LM),left anterior descending (LAD),left circumflex artery(LCX),right coronary artery (RCA),and the image qualities are evaluated objectively using CT values,noise,signal noise ratio (SNR),contrast noise ratio (CNR),and compared sta-tistically using Paired t-test.The radiation dosages,such as CTDIvol,DLP and ED were also recorded and compared with Paired t-test.Results CTDIvol,DLP and ED of Group A (dual low)decreased 35.7%,38.6% and 38.6% respectively compared with Group B,the iodine intake decreased 22.9%.While the image qualities of the two groups were not significantly different,all images are good enough for diagnosis,with Group A slightly better than Group B in radiologists’scores.Conclusion Voltage 100 kVp, combined with low contrast agent concentration of 270 mg I/mL can fully satisfy the diagnostics need in CCTA,and significantly lower both the radiation dosage and iodine intake.

The present study examined von Willebrand factor (vWF) levels and ADAMTS13 activity in pregnant and severe preeclamptic women in order to shed light on the prothrombotic state in severe preeclampsia. Thirty healthy women of childbearing age, 22 second trimester pregnant women, 30 third trimester pregnant women and 10 severe preeclamptic patients were recruited in this study. ADAMTS13 activity was determined by the FRETS-vWF73 assay and vWF antigen (vWF:Ag) levels by an enzyme-linked immunosorbent assay. The results showed that there were statistically significant differences in plasma vWF antigen levels between the severe preeclamptic and third trimester pregnant women, between third and second trimester pregnant women (P<0.05). The third trimester pregnant women had significantly lower plasma ADAMTS13 activity than second trimester pregnant women (P<0.05). Nevertheless, no significant differences in plasma ADAMTS13 activity were found between severe preeclamptic patients and the third trimester pregnant women (P>0.05). In conclusion, plasma ADAMTS13 activity is normal in severe preeclampsia despite the increased vWF:Ag levels. Prothrombotic state is involved in the pathogenesis of severe preeclampsia, as a result of endothelial injury.

The present study examined von Willebrand factor (vWF) levels and ADAMTS13 activity in pregnant and severe preeclamptic women in order to shed light on the prothrombotic state in severe preeclampsia. Thirty healthy women of childbearing age, 22 second trimester pregnant women, 30 third trimester pregnant women and 10 severe preeclamptic patients were recruited in this study. ADAMTS13 activity was determined by the FRETS-vWF73 assay and vWF antigen (vWF:Ag) levels by an enzyme-linked immunosorbent assay. The results showed that there were statistically significant differences in plasma vWF antigen levels between the severe preeclamptic and third trimester pregnant women, between third and second trimester pregnant women (P<0.05). The third trimester pregnant women had significantly lower plasma ADAMTS13 activity than second trimester pregnant women (P<0.05). Nevertheless, no significant differences in plasma ADAMTS13 activity were found between severe preeclamptic patients and the third trimester pregnant women (P>0.05). In conclusion, plasma ADAMTS13 activity is normal in severe preeclampsia despite the increased vWF:Ag levels. Prothrombotic state is involved in the pathogenesis of severe preeclampsia, as a result of endothelial injury.
ADAM Proteins ; blood ; metabolism ; ADAMTS13 Protein ; Adult ; Blood Coagulation ; physiology ; Case-Control Studies ; Female ; Humans ; Pre-Eclampsia ; blood ; enzymology ; physiopathology ; Pregnancy ; Pregnancy Trimester, Third ; Young Adult ; von Willebrand Factor ; metabolism

Objective:To investigate the effect of mini-retromandibular and transparotid approach in open reduction and internal fixation of middle or low condylar fractures.Methods:A total of 28 condylar fracture cases which were treated with mini-retromandibular approach from January 2016 to January 2019 in Nanjing Stomatological Hospital were included in this study. These cases included 18 males and 10 females with ameanage of 42.5 years. There were 11 cases of left condyle fractures, 13 cases of right condyle fractures and 4 of bilateral condyle fractures. During the operations, incisions of 2-3 cm long were made on the skin and subcutaneous tissue along the posterior margin of the mandible. Then we performed blunt dissections parallel to the facial nerves, directly passing through the parotid gland and masseter muscles, without the facial nerve injuried. After exposing the fracture line, the fracture ends were fixed and restored with two 4-hole titanium miniplates under direct vision.The medical reviews were performed on the third day and 3-6 months after operation by imaging examination and clinical examination. The contents included: postoperative hematoma, postoperative infection, nerve injury, salivary fistula, maximum mouth opening degree, mouth opening type, occlusal relationship, scar condition, etc.Results:All of the 28 patients had good restoration of fracture ends without nerve injury, salivary fistula or other complications. Only one patient suffered with postoperative infection. After 3 months, titanium miniplate was removed by second operation. The mouth opening of patients ranged 1.5-3.8 cm, with an average of 3.1 cm, which was significantly improved compared to the pre-operation (0.5-2.0 cm, average 1.2 cm). One patient’s chin was slightly deviated to the affected side at the time of opening, and the occlusal relationship was recovered well with intermaxillary elastic traction for 3-5 days.The mouth opening type of other patients was nearly normal. Followed up for 6-36 months, all of the patients had no obvious scars after operation.The patients were satisfied with the operation effect. All patients took postoperative CT and 3D reconstruction 3 to 6 months after operation, which showed that the fracture reduction was good.Conclusions:Mini-retromandibular and transparotid approach is effective, simple, efficient and fast in the treatment of condylar middle or low fracture, without facial nerve dissection. It can not only reduce the operation time and the possibility of facial nerve injury, but also make postoperative scar relatively inconspicuous.

Objective:To investigate the effect of mini-retromandibular and transparotid approach in open reduction and internal fixation of middle or low condylar fractures.Methods:A total of 28 condylar fracture cases which were treated with mini-retromandibular approach from January 2016 to January 2019 in Nanjing Stomatological Hospital were included in this study. These cases included 18 males and 10 females with ameanage of 42.5 years. There were 11 cases of left condyle fractures, 13 cases of right condyle fractures and 4 of bilateral condyle fractures. During the operations, incisions of 2-3 cm long were made on the skin and subcutaneous tissue along the posterior margin of the mandible. Then we performed blunt dissections parallel to the facial nerves, directly passing through the parotid gland and masseter muscles, without the facial nerve injuried. After exposing the fracture line, the fracture ends were fixed and restored with two 4-hole titanium miniplates under direct vision.The medical reviews were performed on the third day and 3-6 months after operation by imaging examination and clinical examination. The contents included: postoperative hematoma, postoperative infection, nerve injury, salivary fistula, maximum mouth opening degree, mouth opening type, occlusal relationship, scar condition, etc.Results:All of the 28 patients had good restoration of fracture ends without nerve injury, salivary fistula or other complications. Only one patient suffered with postoperative infection. After 3 months, titanium miniplate was removed by second operation. The mouth opening of patients ranged 1.5-3.8 cm, with an average of 3.1 cm, which was significantly improved compared to the pre-operation (0.5-2.0 cm, average 1.2 cm). One patient’s chin was slightly deviated to the affected side at the time of opening, and the occlusal relationship was recovered well with intermaxillary elastic traction for 3-5 days.The mouth opening type of other patients was nearly normal. Followed up for 6-36 months, all of the patients had no obvious scars after operation.The patients were satisfied with the operation effect. All patients took postoperative CT and 3D reconstruction 3 to 6 months after operation, which showed that the fracture reduction was good.Conclusions:Mini-retromandibular and transparotid approach is effective, simple, efficient and fast in the treatment of condylar middle or low fracture, without facial nerve dissection. It can not only reduce the operation time and the possibility of facial nerve injury, but also make postoperative scar relatively inconspicuous.