Objective To explore the efficacy and safety of methotrexate combined with hysteroscopic in treatment of cervical pregnan-cy. Methods The data of 14 patients with cervical pregnancy were analyzed retrospectively. Results All patients were given combination therapy of mifepristone and methotrexate firstly,and they were discharged after bloodβ-HCG logarithmically decreased for further observation. Hysteroscopic surgery were applied whenβ-HCG level decreased to 100 mIU/mL. Conservative treatment received success in all 14 cases. It required 14~35 days,averagely (26. 5 ± 2. 7) days, methotrexate dosage of 50~150 mg,averagely (75. 5 ± 15. 0) mg, and mifepristone of volume 150~450 mg,averagely (275. 0 ± 54. 5) mg to make the bloodβ-HCG level decreased to 100 mIU/mL. The bleeding volume during hysteroscopy surgery was 5~50 mL,an average of (35. 6 ± 5. 2)mL. Conclusion Methotrexate combined with hysteroscopy is safe and fea-sible for treatment of cervical pregnancy.

Objective To examine the frequency of coexisting endometrial carcinoma with preoperative diagnosis of endometrial atypical hyperplasia (EAH).Methods From Apr 2002 to Apr 2007,61 consecutive patients diagnosed as EAH who underwent total hysterectomy in our department were retrospectively analyzed.Patients were stratified as 44 premenopausal cases and 17 menopausal cases.The patients were divided into 2 groups depending on whether or not cancer cells were found by histology in removed uterus (cancer group vs EAH group) to explore valuable predictive risk factors for concomitant endometrial carcinoma through reviewing the clinical data.Logistic regression analysis and logistic regression equation are used to evaluate the risk of coexisting endometrial carcinoma with preoperative diagnosis of endometrial atypical hyperplasia.Results Endometrial thickness and the type of EAH were selected into the equation in premenopausal cases,showing statistically significant differences(P ＜ 0.001) and the overall accuracy was 86.4％.Menopausal years and the type of EAH were selected into the equation in menopausal women,also showing statistically significant differences (P ＜ 0.04)and the overall accuracy was 82.4％.Conclusions Endometrial thickness and the type of EAH are valuable in predicting the risk of endometrial carcinoma in premenopausal women.Menopausal years and the type of EIN are valuable in prediciting the risk of coexistance with endometrial carcinoma in menopausal women.

Objective:To analyze the effect of Doula delivery combined with labor analgesia on the delivery process and delivery outcomes of primiparas.Methods:Retrospectively selected 200 primiparas treated in Beijing Friendship Hospital, Capital Medical University from January 1, 2019 to September 30, 2019 as the research objects.All patients underwent labor analgesia, and were divided into 100 cases in the Doula group and 100 cases in the control group (without Doula delivery) according to whether or not Doula delivery was performed.T test of two independent samples and chi square test were used to compare the labor process and delivery outcome of the two groups.Results:The natural delivery rate in the Doula group was 76%(76/100), which was significantly higher than the control group (61%(61/100)), and the difference was statistically significant (χ 2=5.214, P=0.022). The time of the first, second and third stage of labor in Doula group was (8.35±3.59), (1.07±0.26), (0.54±0.19) h, and that in the control group was (10.94±4.76), (1.86±0.63), (0.78±0.21) h, respectively.There were significant differences between the two groups (t value were 10.354, 5.312 and 8.169, respectively; P value were 0.016, 0.042 and 0.039, respectively). The neonatal asphyxia rates of Doula group and control group were 1% (1/100) and 3% (3/100) respectively, and there was no significant difference between the two groups ( P=0.621). The incidence of postpartum hemorrhage in the Doula group and the control group was 3% (3/100) and 10% (10/100) respectively, and the incidence of postpartum urinary retention was 0 (0/100) and 6% (6/100), respectively.The success rate of early sucking was 98% (98/100) and 90% (90/100) respectively, and the difference between the two groups was statistically significant (P value were 0.045, 0.029 and 0.017, respectively). The hospitalization time of Doula group was (3.17±0.85) d, which was significantly shorter than that of the control group (5.64±1.29) d)( t=6.359, P=0.031). The visual analogue pain score of 2 h postpartum in Doula group was 3.49±0.98, which was significantly lower than the control group (5.82±1.06)( t=9.327, P<0.001). Conclusion:Doula delivery combined with labor analgesia can effectively reduce the pain of uterine contraction, promote natural delivery, reduce the rate of cesarean section, help to improve the quality of obstetric medical service, improve patient satisfaction, it is worth promoting in the condition of the hospital.

Objective]Summary of the role of adipokineson insulin resistance and the effective components and mechanisms of traditional Chinese medicine and its extract in recent years to improve insulin resistance.[ Methods]Consulting CNKI, VIP database, PubMed database about adipokines to improve insulin resistance and effective components of traditional Chinese medicine research literature, summarize the main adipokines and traditional Chinese medicine for improving IR by interfering with the adipokines.[Result]Leptin, adiponectin and resistin and other factors play a key role in the formation of insulin resistance and diabetes.The research on the effect of Chinese herbal medicine extract and its active components on the improvement of insulin resistance by the intervention of the adipokines is also increasing.[Conclusion]The inflammatory reaction mediated by the adipokines is one of the important factors that lead to insulin resistance, traditional Chinese medicine can effectively improve the type 2 diabetes insulin resistance caused by adipokines.

Objective To examine the effect of carbon dioxide pneumoperitoneum on local pancreas pathological changes, serum levels of amylase, IL-6, E-selectin and P-selectin in rats with severe acute pancreatitis (SAP). Methods Fifty healthy male SD rats were randomly divided into 3 groups: CO2 experiment group ( n =20): SAP was induced by injecting 5% sodium taurocholate through retrogradely common biliopancreatic ducts via duodenal papilla,and then CO2 pneumoperitoneum was established at a pressure of 12 mmHg for 30 min; SAP group ( n = 20): The rats were treated as same as CO2 experiment group, excepting CO2 pneumoperitoneum; Control group (n = 10): Abdomen was incised and nothing was done to duodenum and pancreas except for moving them softly. The blood samples were gathered for examining serum levels of amylase, IL-6, E-selectin and P-selectin, and histopathologic examination of pancreas was done.Results Compared with control group, the pancreatic pathologic histology score, serum levels of amylase,IL-6, E-selectin and P-selectin were significantly higher in the CO2 experiment group and SAP group (P =0.000). The levels of IL-6 were significantly lower in CO2 experiment group compared to SAP group (P =0. 000). There was no significant difference between CO2 experiment group and SAP group in pancreatic pathologic histology score( P =- 0.294), the levels of serum amylase ( P = 0.073 ), E-selectin and P-selectin. Conclusions CO2 pneumoperitoneum has no adverse effect on the changes of pathological histopathology and the levels of IL-6, E-selectin and P-selectin in SD rats with SAP.

Cinobufacini is an aqueous extract of Bufo bufo gargarizans Cantor dried skin, which has been widely used for cancer therapy in China. So far, its active components are still not very clear. In previous reports, bufadienolides with low-concentration were usually studied because of their anticancer effects. However, the high polarity constituents in cinobufacini are less investigated. The present study found that more than 50% contents of cinobufacini were water-soluble peptides. Then, in vitro anticancer experiments were carried out, including human stomach cancer cell lines BGC823 and MCG803, human colon cancer cell lines DLD-1 and HT-29, and human pancreatic cancer cell line MIAPACA-2. The IC50 for these cell lines model were ranged from 25-123 microgmL(-1). The results indicated that these peptides showed similar activity with cinobufacini injection. As a conclusion, this study provides a new and further understanding of anticancer components in cinobufacini injection.

Objective To explore the effect and adverse reaction of priming regimen CAG in treatment of acute myeloid leukemia in elderly.Methods 32 elderly patients with acute myelogenous leukemia were treated with CAG regimen and 25 cases with standard chemotherapy regimen( DA regimen). The effect and adverse reaction were compared between the two groups. Results There was no significant difference of the complete remission rate and effective rate between the two groups. The recovery time of bone marrow and death rate of CAG the regimen group were superior to those of the DA group. Conclusion CAG regimen was effctive and safe for elderly patients with acute myeloid leukemia.

Objective To evaluate the therapeutic effects of methamphetamine (MA) dependence and the repairment of DA neuronal function by SPECT corpus striatum DAT visual digital neural molecular imaging techniques.Methods 25 MA dependent patients (BPRS score ≥ 35) were treated by self-designed treatment program for more than 6 months.The clinical therapeutic effects were scored with reducing rate of BPRS.MA dependent patients were examined by SPECT corpus striatum DAT imaging before and after treatment,while healthy volunteers were examined only once.The SPECT corpus striatum DAT images were analyzed visually and quantitatively.Results The reducing rate of BPRS showed that the total effective rate was 80.0％.Visual analysis of SPECT corpus striatum DAT images showed that the distribution of DAT in the corpus striatum was regionally reduced or defected in various degrees before treatment,and was significantly increased after treatment.Quantitative analysis showed that the bilateral striatal V ((19.26 ± 2.85) cm3),m((20.22±2.99) g) and Ra(4.78±0.79) ％) of MA dependent patients were significantly lower compared with those of the healthy volunteers(respectively (35.39±4.42) cm3,(37.16±4.64) g and (7.93± 0.86) ％) (all P＜ 0.01) before treatment and were significantly improved (P＜ 0.01) after treatment (V:(22.80±4.28) cm3,m:(23.93± 4.49) g and Ra:(5.64 ± 0.99) ％) with a 76.0％ corpus striatum DAT improvement rate.However,the bilateral striatal V,m and Ra of MA dependent patients after treatment were still lower than those of the healthy volunteers (P＜0.01).There was no significant difference between the striatal DAT improvement rate and the BPRS reduction rate (P＞ 0.05).Conclusion SPECT corpus striatum DAT visual digital neural molecular imaging techniques are reliable in the evaluation of the treatment programs for MA dependence and the repair of DA neuronal function.

Objective To investigate the time and implant selection in conversion from external fixation to internal fixation of tibial shaft fracture.Methods Data of 57 cases of tibial shaft fracture fixed externally followed by internal fixation from February 2003 to February 2012 were analyzed.Internal fixation (intramedullary nails or plates) initiated within 2 weeks (Group A,n =.35) and over 2 weeks (Group B,n =22) were compared in outcomes.Results One infection (3％) and four poor bone healing (11％) were observed in Group A.Five infections (23％) and three poor bone healing (14％) occurred in Group B.For intramedullary nail fixation,no infection was observed in Group A but infection rate of44％ was found in Group B.For plate internal fixation,infection rate was 8％ for both groups.Conclusions The conversion from internal fixation to internal fixation had better start within 2 weeks,with better resuhs,lower rate of infection and safer in comparison with that over 2 weeks.In addition,pin-tract infection is the high risk factor for infection after the conversion of the fixation.

Objective To evaluate the short-term results of ARCH plate in cerical expansive open-door laminoplasty(ELAP)for OPLL.Methods From June 2010 to September 2011,a total of 12 cases with OPLL underwent open-door ELAP by ARCH plate fixation and were followed up in our hospital.8 cases were males and 4 cases were female.The average age was 60.5 years.The neurological effect was evaluated by use Japanese Orthopedic Association(JOA)scoring criteria for cervical myelopathy.The ana-tomical effect was analyzed by compare roentgenogram and CT before and after surgery.Results The JOA scores were improved for 39% after the operation,while the saggital diameters of the cervical spinal canaldural after operation was enlarged for 82%(P<0.05).X-ray films and CT scan after operation that there was no occurrence of re-close of door,there was no occurrence of anchor loosing.Conclusion For OPLL,ELAP using ARCH plate fixation bring less occurrence of re-close of door,slight postoperative neck AS,and satisfactory clinical outcomes.