Objective To discuss the diagnosis and management for lower uterine segment pregnancy.Methods Clinical data of 6 cases of lower uterine segment pregnancy between January 2005 and February 2006 were retrospectively analyzed.Results Five patients had a history of caesarean section,while another one had undergone repeated pregnancy.Uterine artery embolization(UAE) in combination with methotrexate(MTX) injection was carried out in 2 cases,and uterine artery embolization only,MTX injection only,and total hysterectomy were employed in 1 case,1 case,and 2 cases,respectively.Conclusions Previous caesarean section and repeated pregnancy are risk factors of the occurrence of lower uterine segment pregnancy.Uterine artery embolization in combination with methotrexate injection is a safe and reliable management option.

Objective To explore effect of two methods for treating extravasation of venous indwelling needles.Methods A total of 96 patients with extravasation at transfusion were randomly divided into experiment and control groups with 48 cases in each group. Magnesium sulfate wet packing was used in the control group and external application of potato chips in the experiment group.The two groups were compared in terms of time for curative effect to occur and time for recovery.Result The time for curative effect to occur and time for recovery in the experiment group were both significantly shorter than those of the control group.Conclusion External application of potato chips is effective in reducing extravasation during venous transfusion.It is simple and free from side effects.

The records of 10 consecutive cases that sustaining traumatic CCF were retrospectively reviewed.The age of cases ranged from 18 to 55 years old, and all of them were complicated with fracture of orbit and base of skull.The causes of injuries, the characteristics of ocular manifestations,the findings in CT or cerebral angiography, and methods of treatment of CCF were analysed. The results showed that 9 cases were cured by operation (90%). The cavernous sinus fistulae were closed. The ocular signs such as exophthalmos, vascular murmur in eyelid and conjunctival swelling disappeared.One case had remaining exophthalmos.Nine patients who were cured were followed up for 6 months to 10 years.No ocular signs recurred in all cases. In 2 cases there were mild complications.It suggested that the pulsating exophthalmos,vessel murmur in eyelid and marked conjunctival vessel dilatation were the characteristics of ocular manifestations in CCF. Endovascular embolization with detachable balloon or spring coil is currently the treatment of choice and it is efficacious and safe in traumatic CCF.

Objective To summarize the perioperative nursing care of the elderly patients with hip fracture.Methods There were 95 elderly patients with hip fractures admitted to hospital and received the fixation of artificial joint replacement and preoperative and postoperative nursing care from June 2010 to September 2013.Results Ninety-five patients were recovered and discharged from the hospital. They had stayed the hospital for 11 to 28 days and the average time was(17.5±2.5)d.One patient had developed pneumonia after surgery and one patient had incision infection.After treatment both patients were cured.Conclusions When the elderly patients with hip fracture stayed in the hospital,the nurses should give them good care.The nurses should provide them with mental care based on their psychological and physiological characteristics,help the patients to prevent the complications,guide the patients through rehabilitation training,enhance daily living and promote the patients’health as soon as possible.

OBJECTIVE To avoid the hospital(infection) in the dental surgery operating room.METHODS The(international) ISO quality standard was applied to establish the quality control the hospital infection.RESULTS The quality control for the hospital infection was guaranteed in the dental surgery operating room,and the items (observed) were in the allowance of the legislations for the hospital infection.Zero case of hospital infection(happened.) CONCLUSIONS It is useful for the hospital infection administration in the dental surgery operating room to apply the international ISO quality standard.

Objective:To investigate the effect of pidotimod on the expressions of IL-2 and IL-10 of patients with genital herpes(GH) and obverse its curative effect and quality of life of the patients.Mehtods:45 cases of outpatients with GH were selected as experimental group wich were given pidotimod orally 0.8g per day for 3 months.Observe the curative effect and value the quality of life before and 3 months after and 6 months after the treatment respectively.Detect the change of the expressions of IL-2 and IL-10 of the blood plasma of the GH patients.Select 30 healthy people as control group.Results:The recurrence rate of the experimental group during 1-3 month,4-6 month,7-9 month after treatment were 60.0%、42.2%and 22.2%respectively.The scores of quality of life and the total evaluation of quality of life itself (G1) and health condition(G4) at 3 and 6 month after treatment rising significantly than before treatment,and it is more obviously at 6 months after treatment than 3 months after treatment.Before treatment,the level of IL-2 of experimental group is significantly lower than that of control group,while the level of IL-10 of the experimental group is significantly higher than that of control group.3 and 6 months after treatment,the level of IL-2 rising significantly,while the level of IL- 10 reducing significantly.The change is more obviously at 6 months after treatment than 3 month after treatment either in the IL-2 rising or the IL-10 reducing.Conclusion:There is cellular immune function disorder in the GH patients.Pidotimod has a certain curative effect on the GH patients.It can reduce the recurrence rate of GH and improve the quality of life of the patients.Maybe it can enhance the cellular immune function of the body through rising the level of IL-2 and reducing the level of IL-10.

Objective To observe the effect of electroacupuncture(EA) on the hippocampal expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in rats with vascular dementia(VD),so as to find out the underlying mo lecular mechanisms of EA in treating VD.Methods Thirty-two Wistar rats were randomly divided into a shamoperation group,a model group,a sham-acupuncture group,and an EA group (8 in each group).Permanent bilateral common carotid artery occlusion was performed to model vascular dementia in the model group,the shamacupuncture group and the EA group,while exposure but no occlusion of the bilateral common carotid were performed in the sham-operating group.Novel object recognition test was adopted to prove the establishment of VD rat model.All the rats were kept in an immobilization apparatus while receiving treatments.EA was applied ontoBaihui (GV20) and Zusanli (ST36) in EA group for 30 min,once daily for 7 days.Sham-acupuncture group were treated with needles inserted 0.5 mm superficially.And the sham-operation group and the model group were only immobilized.The protein expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in hippocampal tissue was detected by western blotting.Results The expression of GluA1 in the model group (1.216 ± 0.102) was significantly less than in the sham-operating group (1.918 ± 0.137) (P ＜ 0.05).The expression of GluA1 in the EA group (1.653 ± 0.169) was significantly higher than in the model group (1.216 ± 0.102) and in sham-acupuncture group (1.231 ±0.188) (P＜0.05).The expression of CaMKⅡ in the model group (1.516±0.392) was less than in the sham-operating group (2.187 ± 0.231) (P ＜ 0.05).The expression of CaMK Ⅱ in the EA group (2.733 ±0.387) was significantly higher than in the model group (1.516 ±0.392) and sham-acupuncture group (1.493 ±0.205) (P＜0.05).The expression ofpGluA1 in the model group (1.502 ±0.419) was less than in the sham-operating group (2.253 ± 0.244) (P ＜ 0.05).The expression of pGluA1 in the EA group (2.382 ± 0.308) was significantly higher than in the model group (1.502 ± 0.419) and the sham-acupuncture group (1.498 ± 0.223) (P ＜ 0.05).The expression of pCaMK Ⅱ in the model group (0.394 ± 0.227) was less than in the sham-operating group (0.667 ±0.175) (P＜0.05).The expression ofpCaMKⅡ in the EA group (1.189± 0.346) was significantly higher than in the model group (0.394 ± 0.227) and the sham-acupuncture group (0.408 ± 0.231) (P ＜ 0.05).Conclusion EA can enhance the protein expression and phosporylation of GluA1 and CaMK Ⅱ,causing silent synapses transforming into functional synapses,and consequently,long term potentiation was facilitated and cognitive impairment was improved by EA.

Objective To evaluate the effect of ultrasound-guided botulinum toxin A injection into the salivary glands in treating patients with sialorrhea attributable to brain damage.Methods Nine subjects with sialorrhea attributable to traumatic brain injury (n =5),cerebral infarction (n =3) and hypoxic ischemic encephalopathy (n =1) were recruited into the study.With the guidance of ultrasound,15 units (U) of botulinum toxin type A was injected into the highest and lowest points of the two parotid glands,and 20 U was injected into two points of both submandibular glands.The saliva flow rate and the severity and frequency of sialorrhea were recorded before the treatment and 1 week,4 weeks and 12 weeks later using the Drooling Scoring System (DSS).Results The saliva flow rate before treatment (0.49 ± 0.12 g/min) decreased significantly to 0.24 ± 0.08 g/min after 1 week,but then increased again to 0.28 ±0.12 g/min after 4 weeks and 0.34 ±0.11 g/min after 12 weeks.The average DSS severity score showed the same pattern:4.35 ± 0.48 initially 1.92 ± 0.37 after 1 week,1.92 ± 0.37 after 2 weeks and 2.32 ± 0.64 after 12 weeks.The DSS frequency score,however,remained significantly lower:3.56 ± 0.49 initially,2.01 ± 0.42 after 1 and 4 weeks and 2.28 ± 0.63 after 12 weeks.Conclusion Botulinum toxin type A can effectively improve the salivary secretion and sialorrhea attributable to brain damage.

Objective To observe the clinical efficacy of acupuncture and moxibustion combined with cognitive training in treating cognitive impairment after traumatic brain injury (TBI). MethodsSixty patients were recruited into the study and randomly divided into the control group and the treatment group according to the MINIMIZE software. Patients in the control group were treated with cognitive training and regular treatment. Besides the traditional treatment, patients in the treatment group were additionally treated with acupuncture and moxibution. The treatment lasted four weeks. Mini-Mental State Examination (MMSE) and Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were applied to evaluate the patients’ cognitive function before and after the treatment.Results In the end, there were 27 patients in the control group and 28 patients in the treatment group, because 5 patients withdrew from the study. After treatment, scores of MMSE, LOTCA and their sub-items in the control group and the treatment group increased significantly (P<0.05), and the scores in the treatment group were higher than the control group (P<0.05).Conclusion Combination of acupuncture, moxibution, and cognitive training could help patients after TBI to increase the scores of MMSE and LOTCA, and improve the cognitive impairment caused by TBI. Its therapeutic effect is superior than the pure cognitive training.