Objective: To observe the clinical effects of combination of propofol,fentanyl and in surgical abortion. Methods: A total of 184 early-pregnant women were randomly divided into two groups.The women in group Ⅰ received propofol 2.5 mg/kg intravenously(n=92),the women in group Ⅱ received the combination of propofol,fentanyl and atropine intravenously(fentanyl 1 ?g/kg,atropine 0.5 mg,propofol 1 mg/kg)(n=92).To compare the efficacy of those two kinds of anesthesia,many measurements were taken, which included the total dose of propofol applied,induction time,recovery time,self-walking time,operative time,blood loss during the abortion,dilatation of the uterine cervix,blood pressure,heart rate,breathe,pain caused by injection and post-operation uterine contraction. Results: Many differences were found in the group who received the combination of propofol with fentanyl and atropine,when compared to those measurements in the group received propofol only.Significantly less(amount) of propofol was needed.The induction time was significantly shorter.The slowing of heart rate,dropping of blood pressure and reduction of breathing were significantly less.The dilation of the uterine cervix was more complete and took much less time.The pain caused by injection and post-operation contraction was significantly less frequent and less severe. Conclusion: Applying the combination of propofol,fentanyl and atropine has several clinical benefits which include less propofol need,less inhibition to the respiration and cardiovascular system,and less pain caused by injection and post-operation contraction.

Objectives:To observe the clinical effects of combination of propofol and misprostol in surgical abortion. Methods:240 women opting for voluntary surgical abortion were randomly allocated to 3 groups, receiving propofol plus misoprostol, lidocaine and routine menthods, respectively. Comparation was made on the effects of easing pain, cervical dilatation, surgical complications, bleeding amount, uterus contraction, patient satisfaction, etc. Results:The propofol and misoprostol group has higher efficacy and safety in surgical abortion than other 2 groups. Conclusions:Application of propofol and misoprostol in surgical abortion should be a recommended choice when patient can afford.

Objective To analyse the mutation of pathogenic gene TSC2 in tuberous sclerosis complex (TSC). Methods Using polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), all the 41 exons of TSC2 gene were analyzed in 4 TSC cases(include 1 suspect case) from one family and 1 sporadic TSC case ,and compared with the kin familial controls and kinless normal controls. Results Missense mutation on exon33 1346S→P (4037T→C) of TSC2 was found in 4 familial cases, and no mutation of TSC2 gene was found in the sporadic case and all the health controls. Conclusion Missense mutation on exon33 (1346S→P,4037T→C)is a new discovery in TSC2 gene of patients with TSC.

OBJECTIVE:To compare the economic value between patent application and know-how,the two measures for intellectual property rights protection of traditional Chinese medicine.METHOD:The legal features of intellectual property rights protection for Chinese traditional medicine were analyzed and its economic value was evaluated with economic model.RESULTS&CONCLUSION:The know-how has a greater economic value to enterprises under the current intellectual property rights protection system.

Complaints of medical consumers are caused by a good many factors,which aim at distincting medical pur?pose further,asking for economic compensation and justice,and punishing complained individual or complained hospital.It’s a realistic proposition on howto treat,reduce and avoid complaints,and maintain a correct attitude by units which ac?cept the complaints.

Objective To estimate the frequency of heart valvular involvement in Chinese patients with Takayasu arteritis (TAK) and its correlation with other clinical features. Methods Ninety-one patients with TAK were studied and their clinical manifestations, laboratory test, vascular images and echocardio - gra-phic findings were retrospectively reviewed. The data were compared between patients who had heart valvular involvement and those who had not. Mann-Whitney U-test or Student's t-test, Chi-squared test or Fisher's exact test were used for analysis. Results Aortic regurgitation and mitral regurgitation were both confirmed in 20 (22%) patients. Tricuspid regurgitation and pulmonary valve regurgitation were observed in 10 (11%) and 2 (2%) patients, respectively. Older age at onset, longer disease duration, hypertension and involvement of the ascending aorta were all significantly more frequent in TAK patients with aortic regurgitation (t=2.903, P<0.01; Z=-2.759, P<0.01; χ2=7.918, P<0.01; Z=-4.454, P<0.01) than those without. However, the constitutional symptoms and acute phase reactants [erythrocyte sedimentation rate (ESR) and C reactive protein (CRP)] were not statistically different between patients with and without valvular regurgitation (P>0.05). Aortic valvular pathology examination of the three TAK patients who had underwent aortic valve replacement showed no inflammatory cell infiltration. Conclusion This study has demonstrated that heart valve involvement is common in patients with TAK, mainly in the form of regurgitation, and which may be secondary to hypertension and other cardiovascular complications. We should pay more attention to the screening and treatment of heart valvular involvement in TAK patients.

Objective To investigate the differential diagnostic values of CT bronchial sign for peripheral solitary pulmonary lesions(SPLs).Methods One hundred and eleven patients with peripheral SPLs were scanned using multi-slice helical CT(MSCT),and multiplanar reconstruction was performed to show the relationship between the lesion and bronchus,the diffefences between the benign and malignancy were compared by using chi-square test.Results Bronchial cutoff rate in malignant lesions(47/95,49.5%)was markedly hi er than that in benign lesions(10/42,23.8%.X12=7.896,P＜0.05),the frequency of type Ⅰ and type Ⅱ air bronchogram presented in malignant lesions(10/11.8/9)was higher than benign lesions(1/11,1/9.X2=6.975,4.818,P＜0.05),but type Ⅳ in benign lesions(12/17)was more common than that in malignant lesions(5/17.X2=7.390,P＜0.05).No significant difference was found in bronchus ran at the periphery of the lesion and bronchus dragged by the lesion between benign(9/24.1/4)and malignant lesions(15/24,3/4.X2=0.641,0.062,P＞0.05).The focal bronchial wall thickening in malignancy(21/22)was markedly higher than benign lesions(1/22.X2=4.185.P＜0.05),whereas the extensive thickening in benign lesiom(4/7)was more common(3/7.X2=8.650,P＜0.05).Conclusion CT bronchial sign is very important in the differentiation of benign and malignant pulmonary lesions.

Form 2008 to 2009, four patients with complex thoracic aortic disease, including aortic aneurysms and dissections, were successfully treated in our department with a new treatment approach: hybrid procedure. Combined open surgery and endovascular repair were performed in these patients without deep hypothermia or circulatory arrest. Compared to those who underwent traditional open surgery in the same period, time of mechanical ventilation and ICU stay was decreased in these four patients. All of them were discharged soon after operation without postoperative complications or death. The result suggests that this new approach could be an option for thoracic aortic disease, but long-term and large-population studies are still required to demonstrate the safety and validity.

Background Corneal confocal microscopy can denamically offer the morphological image of corneal cells at cellular level.To find out the dynamic change of corneal thickness and morphology of corneal cells with aging is very important for the design of corneal refractive surgery.ObjectivePresent study is to find out the important relevance of dynamic change of corneal thickness and morphology of corneal cells with aging and the design of corneal refractive surgery and investigate the influence of age on central corneal tissue and characterize precisely the anatomy of cornea by in vivo confocal microscopy.Methods122 eyes of 122 normal subjects were enrolled in this study with the age from 18 through 80 years old.The subjects were diagnosed as emmetropia in the Center of Tianjin Medical University from August 2003 to December 2007.All eyes were examined in vivo by confocal microscopy.The cell morphology,cell density and corneal thickness were measured by confocal microscopy.The relationship of central corneal tissue change and age was evaluated.ResultsThe density of corneal superficial basement epithelial cells showed a significantly negative correlation with age (r=-0.355,P=0.017).The keratocyte density in the anterior and posterior stroma indicated a significantly negative correlation with age (r_1=-0.462,P=0.001;r_2=-0.403,P=0.016).The thickness of corneal epithelium cells had a significantly negative correlation with age (P=0.02).The mean value of total corneal thickness and stromal thickness in high myopic eyes was (523.2±26.20)μm and (468.4±20.72)μm respectively,presenting a significantly negative correlation with age (r_1=-0.552,P=0.014;r_2=-0.545,P=0.035).A significantly negative correlation was also found in endothelial cell areas and density with age (r_1=0.417,P=0.004;r_2=-0.598,P=0.002).The percentage of polymorphological corneal endothelial cells was considerably increased(r=0.417,P=0.004)but that of pleomorphism cells was significantly decreased in >60-year-old population compared with younger subjects (r=-0.598,P=0.002).The morphology of corneal basement cell,anterior stroma cytocyte and endothelial cell were normal in younger subjects,and enlargement of the cells in size,decreases of number and density of the cells were found in >60-year-old subject.ConclusionThe anatomy and histology of the central cornea in young subjects exist discrepancy from older ones.The corneal hisological changes with aging include thinner thickness of epithelium,thinner thickness of cornea,decreased density of keratocyte and endothelial cells and increased size of endothelial cells.Corneal thickness is asymmetric and seems to undergo age-related anatomic changes.

Background Endoscopic cyclophotocoagulation(ECP) is a new approach to treat refractory glaucoma.But,the histopathological change of ciliary body after ECP has not been reported yet.ObjectivePurpose of the present study is to explore the histopathologic change of ciliary body after ECP and investigate the mechanism of lowing intraocular pressure(IOP) of ECP and compared with trans-scleral cyclophotocoagulation (TSCP).MethodECP was performed on the right eyes of 30 adult pigmented rabbits and TSCP was taken in the fellow eyes.Other two normal pigmented rabbits were as control group.The clinical examinations were performed in day 1,3,5,7,14,28,42 and 56 after operation under the slim lamp to evaluate the inflammatory reactions of conjunctiva,sclera and cornea,and the IOP was detected in the same time points.The animals were sacrificed and the eyeballs were extracted for the examination of structure of ciliary body under the light microscope in day 7,14,28,42 and 56 after surgery respectively.ResultsThe mild inflammatory response and local opacity of lens were seen under the slim lamp in the eyes after ECP,and severe inflammatory reaction was in the eyes received TSCP.No opacity of lens was found after TSCP through the observing period.The lowing-IOP extent was significantly higher in ECP group than TSCP group after operation(P＜0.01).The structure of ciliary body epithelium was normal in normal rabbit eyes.The disruption of ciliary body epithelium,especially for non-pigment epithelial layer,edema of ciliary process were seen in the early period after ECP.Fourty-two days later,the irregulation of ciliary body epithelium and atrophy of ciliary process were exhibited under the light microscope.In TSCP group,the edema,blooding and damage of ciliary process were seen,but slight inflammatory response was in the ciliary epithelium.After 42 days of surgery,atrophy of ciliary body,irregular proliferation of pigmental and non-pigmental epithelial cells,thinness of sclera and scarring of ciliary stroma were revealed.ConclusionCompared with TSCP,ECP can selectively destroy ciliary epithelium effectively and thoroughly and therefore reduce IOP.The adverse effect of ECP is the opacity of lens.Less damage of adjacent tissue is found in ECP compared with TSCP.