10 mm)were showed by DSA.On nonenhanced CT,there were 3-4 low density nodules and 4 isodensity nodules.Thirty-two nodules was high density and 8 nodules was low density in arterial phase,33 and 7 nodules were low density and isodensity respectively in portal venous phase,39 and 1 nodule were low density and isodensity respectively in delayed phase.Conclusion The MSCT is excelled DSA in detection satellite nodule of HCC,especially smaller than 10 mm nodule.

Objective To summarize the clinical characteristics of recurrent endometrial carcinoma.Methods A total of 22 cases of recurrent endometrial carcinoma from January 2006 to December 2015 were enrolled.Primary diagnosis of endometrial carcinoma were made in our hospital,with complete clinical data and standard NCCN staging operation.The recurrence of endometrial cancer was confirmed by pathological diagnosis after second surgery or biopsy.Clinical data were retrospectively analyzed.Results The median age of primary diagnosis was 52 years old (rang,44-63 years old).And the most common clinical symptom was postmenopausal vaginal bleeding (54.5％,12/22).There were 18 cases (81.8％) of endometrial adenocarcinoma,3 cases (13.6％) of serous adenocarcinoma,and 1 case (4.5％) of clear cell carcinoma.As to the muscular layer infiltration,there were 14 cases (63.6％) ＜ 1/2,7 cases (31.8％) ＞ 1/2 and 1 case (4.5％) involving the whole layer.There were 4 cases (18.2％) of positive pelvic lymph node and no para-aortic lymph nodes metastasis.As to the postoperative clinical pathologic stage,there were 12 cases (54.5％) of FIGO Ⅰ A,5 cases (22.7％) of FIGO Ⅰ B,1 case (4.5％) of FIGO Ⅱ,and4 cases (18.2％) of FIGO ⅢC1.The median recurrent time was 4 years (rang,1.5-7 years),without obvious self-conscious symptoms,including serum CA125 elevated in 12 cases (54.5％) and positive ultrasound,CT or X-ray examination findings in 10 cases (45.5％).As to the recurrence location,14 cases (63.6％) were in the pelvic cavity,6 cases (27.3％) of retroperitoneal lymph nodes,1 case (4.5％) of anterior abdominal wall accompaning lung metastasis,and 1 case (4.5％) of lung metastasis.Three patients accept Lynch syndrome screening,of which 2 cases were positive.Conclusions Muscular layer infiltration is common in recurrence of endometrial cancer,with no obvious clinical symptoms.Pelvic cavity is the most common location of recurrence.

A higher school wants to possess a highlight status in the international educational market,it must launch an attack actively,compete and grab market,anneal ourselves to boost up competition.So,to drive the lasting development of foreign medical students' education in our school,we must progress with time,and deepen reform.

Objective To compare the costs of laparoscopy and laparotomy in the operative treatment of ovarian cysts. Methods Patients with ovarian cysts who were operated on by laparoscopy (83) or by laparotomy (65) in the Peking University Third Hospital from June 2000 to August 2001 were retrospectively analyed.Patients' hospital stay,time taken for the patients to return to work,hospital charges,costs because of inability to work and total costs (including the direct medical costs,direct non-medical costs and indirect costs) were compared between the two groups. Results The mean hospital stay and the mean time taken for the patients to return to work were statistically shorter in the laparoscopy group than those in the laparotomy group.The mean hospital charges were significantly higher and the mean costs of without work were significantly lower in the laparoscopy group.The total costs in the two groups were similar (no significant difference). Conclusions According to the mean income of the people in Beijing,the costs of laparoscopy in the operative of the ovarian cysts are not higher than that of lapatomy.

Objective:To observe the effect of applying tuina to exterior-interiorly connected meridians for post-stroke upper limb spasticity.
Methods:A total of 150 patients with post-stroke upper limb spasticity were randomly allocated into a treatment group (n=75) and a control group (n=75) by the random number table. Patients in the treatment group received tuina on exterior-interiorly connected meridians, whereas patients in the control group received standard rehabilitation therapy. The therapeutic efficacies in both groups were observed after 3 weeks of treatment.
Results:The total effective rate in the treatment group was 89.3%, versus 61.3% in the control group, showing a statistically significant difference (P<0.05). After the treatment, the muscle tones by the modified Ashworth scale (MAS) were significantly improved in both groups (bothP<0.05); and the improvement of muscle tone was more significant in the treatment group than that in the control group (P<0.05).
Conclusion:Applying tuina to exterior-interiorly connected meridians can obtain an exact efficacy for post-stroke upper limb spasticity.

[ABSTRACT]OBJECTIVETo explore the clinical characteristics of benign paroxysmal positionalvertigo(BPPV) after sudden hearing loss and to observe the curative effect. METHODS36 patients with BPPV after sudden hearing loss were observed.And their therapeutic findings were compared with that of the 50 patients with primary BPPV and 40 patients of sudden hearing loss without vertigo. RESULTSBPPV after sudden hearing loss occurred in the hearing loss ears, of which 27 cases were posterior semicircular canal lithiasis and 3 cases were horizontal semicircular canal lithiasis. The 36 patients with BPPV after sudden hearing loss and 40 patients with primary BPPV were cured after several times of reposition maneuver treatment.The efficiency of 40 patients of sudden hearing loss without vertigo was higher than that of 36 patients with BPPV after sudden hearing loss.CONCLUSIONBPPV after the sudden hearing loss mainly occurs in the posterior semicircular canal. The therapeutic efficacy of canalith repositioning maneuver for the secondary BPPV was similar to that of the primary BPPV.The therapeutic efficacy of sudden hearing loss without vertigo was superior to sudden hearing loss with BPPV.

Objective To investigate the value of otolith-repositioning maneuver combined with medical treatment on benign paroxysmal positional vertigo in the elderly patients.Methods 176 elderly people who suffered from benign paroxysmal positional vertigo were randomly divided into observation group and control group (n=88,each).All patients were treated with basal medicine treatment and compulsive position for 21 days,and patients in the observation group were treated with otolith repositioning maneuver added on the basis.The clinical efficacy and adverse reactions were observed and compared between the two groups after treatment.Results The curative rate and effective rate were higher in observation group than in control group at 2,3 weeks after treatment [50.0％ (44/88) vs.11.4％ (10/88),70.5％ (62/88) vs.47.7％ (42/88),77.3％ (68/88) vs.29.5％ (26/88),93.2％ (82/88) vs.86.4％ (76/88),x2 =37.32,73.32,37.32,53.43,respectively,all P＜0.05].Dizziness combined with nausea and vomiting,and walking instability were both found in the two groups,which had no statistical difference (x2 =3.25,P＞0.05).Patients in observation group developed arrhythmia and Tumarkin otolith crisis after treatment.The transfer rate of surgery was lower in observation group than in control group (x2 =45.43,P＜0.01).Conclusions Otolith-repositioning maneuver combined with medical treatment have good clinical effect and safety on benign paroxysmal positional vertigo in the elderly.

Objective　To obtain genetic characterization of the HA1 of new isolates of influenza A （H1N1） virus. Methods　Virus was amplified in embryonated chicken eggs， the virion DNA was transcribed into cDNA by reverse transcriptase， cDNA amplified by PCR， the products of PCR were purified. Afterward， DNA sequence analysis was performed by the dideoxy-mediated chain termination method， using synthetic oligo nucleotide primers. Results　The HA1 domain of new isolates of influenza A （H1N1） virus showed that their HA1 genes were 981 nucleotide in length coding for a HA1 protein with 327 amino acids， deletion of a glycosylation site and an amino acid. The homology of amino acid sequences of protein molecules on HA1 domains of new influenza A virus when compared with A／Guifang／10／94（H1N1） and A／Bayern ／07／95 （H1N1） viruses，was 92.8％ and 91.3％ respectively； The homology of amino acid sequences of protein molecules on HA1 domains of A／Jingjun／11／98（H1N1） when compared with A／Jingjun／13／98（H1N1） or A／Jingjun／807／97（H1N1） viruses，was as high as 98％； The homology of amino acid sequences of protein molecules on HA1 domains of A／Guifang／10／94（H1N1） when compared with A／Bayern／07／95（H1N1） viruses was as high as 96％. Conclusions　The HA1 gene of　new H1N1 virus strains is　different from those of A／Guifang／10／94 （H1N1） and A／Bayern／07／95（H1N1）， they will probably be new mutation strains.

Objective To synthesis,nine N-[3-(2-furanyl)-acryloyl]-N'-substituted benzyl piperazine derivatives were synthesized and evaluated for their primary biological activities.Methods First, the furylacrylic acid was synthesized, Then the target compounds could be obtained by direct furylacrylic acid with the different substituted benzyl piperazine derivatives.In the biological active experiments, taking the different concentrations, comparing with the blank test, the inhibitory effect of the target compounds on VSMC proliferation was investigated by MTT.Results The successful synthesis of nine new compounds.The method was mild and get high yields.The structures of these compounds were confirmed by IR 1 H-NMR, MS, and elemental analysis.The results of preliminary activity test showed that the synthesized products exhibited inhibitory activity at different concentrations , and the highest inhibitory rate was 15μg/mL.Pharmacological results showed that the compounds 3e, 3f and 3 g showed the moderate inhibitory activities against vascular smooth muscle cells proliferation were higher than other compounds , and were worth further studying.Conclusion The synthesized compounds have inhibitory activities and could very well lead to the development of novel types of treat atherosclerosis drug .

Objective To evaluate clinical outcome and complications of mesh-augmented vaginal reconstructive surgery in treatment of pelvic organ prolapse. Methods From Feb 2007 to Jan 2009, meshaugmented vaginal reconstructive surgery were performed on 66 women with pelvic organ prolapse stage Ⅲ-Ⅳ. Pre and postoperative symptoms, pelvic organ prolapse quantitation (POP-Q) stage and pelvic floor distress inventory-short form 20 (PFDI-20) measurements were studied to assess anatomic and quality-of-life outcome. Operative complications were also analyzed. Results Totally 65 patients underwent successful surgeries. The rate of follow-up was 97% (63/65) with a median follow-up of 17. 2 months. Subjective cure rate and objective cure rate were both 97% (61/63) at 6 and 12 months after surgeries, 51 women completed PFDI-20 measurements and scores were 102 ± 50 before surgery, 16 ± 21 at 6 months and 15 ± 20 at 12 months. It reached statistical difference when scores were compared before and after surgeries ( P ＜0. 05). Among 66 patients, 2 patients underwent organ injuries, 2 had recurrent prolapse, 4 had meshrelated complications and 1 had severe de novo stress urinary incontinence. Six patients underwent second surgery. Conclusions Mesh-augmented vaginal reconstructive surgery in treatment of pelvic organ prolapsed brought satisfied clinical outcome. The incidence of mesh-related complications was low and secondary operative interventions were effective.