Objective To investigate the clinical efficacy of B-Lynch suture in the treatment of massive hemorrhage during cesarean section. Methods Thirty-six patients with massive hemorrhage during cesarean section were applied with B-Lynch suture when bleeding was not controlled through conventional treatment. Results The bleeding of 36 cases were all controlled effectively when treated with B-Lynch suture,no one was operated again because of poor blood circulation or rebleeding, avoided hysterectomy, no postoperative complications occurred, there was no abnormal of uterine involution and the menstrual time.Conclusions The operation of B-Lynch suture is easy, hemostasis rapidly,reliable,persistently,and with high success rate. It can reserve the uterus maximumly, reserve the fertility function of the patient. It is the effective surgical hemostasis in the treatment of massive hemorrhage during cesarean section, and without special equipment, suitable for primary hospital use when emergency,worthing promotion.

Objective This study aimed to accurately understand medical teaching design research status and development trend to provide practical basis for the future of the medical teaching practice.Methods CNKI academic journal articles from January 1,2000 to December 30,2013 were retrieved,using search item for the subject,the retrieval word for instructional system design or instructional design,and the retrieval subject for medicine,and matches are precise retrieval way,and a total of 298 articles were retrieved.The common word analysis method was used to compare the high frequency keywords,analyze the key words in the article,and study the high frequency keywords clustering.Results In the two stages from 2000 to 2006 and from 2006 to 2013,research on medical teaching design of the courseware,distance education and other traditional E-learning-frequency gradually reduced,and vocabulary frequency related to education informationization of new situation such as cooperative learning,teacher education and constructionism and so on increased.In addition,in the second stage,some fresh words related to new technologies and new media appeared,such as interactive electronic whiteboard,virtual reality technology and so on.According to the correlation of keywords in 2007-2013,we found that the current medical teaching design research mainly gathered in three aspects such as classroom teaching,information technology supporting the reform of medical teaching and the training of medical teaching practitioners.Conclusion The research concluded that today and the future of medical teaching design research will mainly focus on three aspects such as effective teaching,the diversification of teaching supported by information technology and open medical education research under the Internet environment.

Oral mucositis is a common and serious complication secondary to chemo-radiotherapy for head and neck cancer that has a high morbidity and affects the treatment outcomes. Currently available interven-tions such as three-dimensional conformal radiotherapy and intensity-modulated radiation therapy are directed at minimizing local radiation exposure and providing symptomatic relief. Recently, a number of new treatment mo-dalities have been expected to be introduced for reduction of severity and duration of mucositis, such as kerati-nocyto growth factor, amifostine, zinc sulfate,anti-inflammation agents,glutamine,etc. These efforts are likely to improve the life quality of cancer patients significantly.

OBJECTIVE: To explore the correlation among platelet activation, inflammatory factor changes and vascular restenosis following intravascular stent implantation.METHODS: Chinese Journal Full-Text Database and Pubmed were retrieved using search terms of intracranial arterial, stents,stenosis, elevated platelet activation, and inflammatory factors from January 1999 to June 2009. The language was restricted within Chinese and English. Simultaneously, platelet activation and inflammatory factor changes were acted as evaluation indexes. Accordingly, clinical research regarding treating intracranial artery stenosis with intravascular stent implantation was included. The animal experiment or other treatment methods were excluded.RESULTS: A total of 650 papers were obtained by initial search with computer. According to inclusion criteria, the related papers were analyzed. Platelet activation, inflammatory reaction and inflammatory factor were the focuses of research concerning restenosis following intravascular stent implantation. Platelet thrombus was the main factor to cause acute vascular occlusion, and the activated platelet aggravated the damage of endothelial cells, which induced over proliferation of smooth muscle cell. As a kind of foreign body, the stent implantation was closely associated with complication, such as formation of thrombosis, acute vascular occlusion, vasovagal reflex and immune reaction, which lead to reconstruction of vessel wall and in-stent restenosis.CONCLUSION: It is effective to cure vascular restenosis by undergoing antiplatelet therapy prior to implantation, controlling inflammatory reaction, as well as inhibiting vascular smooth muscle cell proliferation following intravascular stent implantation.

Seven cases exhibited segmental bile duct dilation with filling defects. One case only showed dilatation of lobar bile ducts. Conclusion MRI features of IPNB are helpful for distinguishing IPNB from other hepatic lesions.

Objective To evaluate the value of liver acquisition with volume acceleration(LAVA) in the diagnosis of hepatic outflow abnormalities.Methods LAVA was performed in 78 patients with suspected hepatic outflow abnormalities,thrombosis,stenosis,occlusion,or compression,including 71 hepatocellular carcinomas and 7 Budd-Chiari syndrome.Image quality and the presence of venous abnormalities and collaterals were evaluated.Results LAVA images were of diagnostic quality and without artifact in all patients.LAVA clearly showed the vascular anatomy and various disorders.The site,extent,cause of venous obstruction,and collateral pathways were well depicted.Conclusion LAVA is simple to perform and accurate in detecting hepatic outflow abnormalities.

CD8+ T cells play an essential role in defending against viruses,intracellular bacteria,protozoal infections and clearance of tumors since almost all the nucleated cells express MHCⅠ molecule.Following antigen recognition,CD8+ T cells are activated and differentiated to different subsets of effector or memory cells,which could clear the pathogen and form long-term protection.Phenotypic markers,functional properties and anatomical locations are different among these CD8+ T cell subsets.They also show variation in surviving time,proliferation and effector functions when re-challenged with the pathogen or tumor.Multiple signaling pathways and transcriptional factors are involved in CD8+ T cells activation and differentiation,and will be discussed in this review.We will also briefly summary the clinical applications of T cells against tumor or pathogens.

Esophageal squamous cell carcinoma (ESCC) accounts for more than 90% of the confirmed cases of esophageal cancer in Asia, and the degree of malignancy is high. There is a growing number of research on ESCC immunotherapy, particularly programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1). Among them, the most studied PD-1/PD-L1 inhibitors in ESCC are nivolumab, pembrolizumab, camrelizumab, toripalimab, tislelizumab, atozolizumab, SHR-1316 and durvalumab. Some of the clinical trials of these drugs are still in progress, and some have initially shown good results.

Objective:To explore the efficacy of nimodipine combined with ganglioside in the treatment of cerebral hemorrhage and its effect on the expression of serum resistin and oxidized low-density lipoprotein (ox-LDL).Methods:According to the random number table method, 100 patients with cerebral hemorrhage admitted in Central Hospital of Zibo from February 2018 to February 2020 were divided into the single treatment group and the combined treatment group, with 50 cases in each group. In addition to conventional treatment, the single treatment group was additionally treated with nimodipine, and the combined group was additionally treated with nimodipine combined with ganglioside. After 2 weeks of intervention, the efficacy of the two groups was evaluated, and the National Institutes of Health Stroke Scale (NIHSS) scores, Ability of Daily Living (ADL) scores, serum inflammatory factors, resistin and ox-LDL levels were evaluated and recorded between the two groups before and after treatment.Results:The total effective rate of treatment in the combined treatment group was higher than that in the single treatment group: 90.0%(45/50) vs. 74.0%(37/50), and the difference was statistically difference ( P<0.05). After 2 weeks′ treatment, the scores of NIHSS was decreased and the scores of ADL was increased in two groups, and the scores of NIHSS in combined treatment group was lower than that in the single treatment group: (9.41 ± 1.27) scores vs. (12.10 ± 1.65) scores; the scores of ADL in the combined treatment group was higher than that in the single treatment group: (67.82 ± 9.04) scores vs. (59.10 ± 8.75) scores, and the differences were statistically differences ( P<0.05). After 2 weeks′ treatment, the levels of serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), resistin and ox-LDL in the two groups were decreased, and the levels of above index in the combined treatment group were lower than those in the single treatment group: (4.81 ± 1.03) mg/L vs. (6.10 ± 1.73) mg/L, (40.96 ± 9.21) μg/L vs. (56.74 ± 8.93) μg/L, (33.20 ± 7.96) μg/L vs. (44.76 ± 8.43) μg/L, (0.29 ± 0.09) μg/L vs. (0.45 ± 0.13) μg/L, (336.25 ± 69.74) mg/L vs. (372.18 ± 68.52) mg/L, and the differences were statistically differences ( P<0.05). There was no significant difference in adverse reactions between the two groups ( P<0.05). Conclusions:Nimodipine combined with ganglioside has a clear efficacy in the treatment of cerebral hemorrhage. It can effectively inhibit inflammation indicators, reduce serum resistin and ox-LDL levels, promote the recovery of nerve defects, and improve their living ability.

[Summary] Epithelial ovarian carcinoma has the highest fatality rate among gynecologic malignant tumors.Lacking of effective early diagnosis and screening method are the main reasons for its poor prognosis.There is a close relationship between the heterogeneity of epithelial ovarian carcinoma and the diversity of cancerous origins.According to the traditional theory, epithelial ovarian carcinoma derives from germinal epithelium at ovarian surface.The “secondary Mullerian system” theory has challenged above view.This“dualism” theory completely subverts the traditional one.However, both of the theories have their limitations.In recent years, the multiple origins theory of epithelial ovarian carcinoma has gradually become a hot point of discussion.