Objective To investigate the clinical efficacy and safety of medroxyprogesterone acetate in the treatment of endometrial atypical hyperplasia patients.Methods 98 cases of endometrial atypical hyperplasia patients were randomly divided into study group and control group with 49 cases in each group, study group were treated with medroxyprogesterone acetate treatment, and control group were given estradiol valerate tablets treatment.Two groups of patients were treated for 3 ~6 menstrual cycles, and clinical curative effect of two groups was compared.Results After treatment, the PBAC score and endometrial thickness inspection results in study group and control group respectively decreased significantly compared with before treatment (P<0.05), and the above indexes in study group were significantly lower than control group (P<0.05).After treatment, the hemoglobin value in two groups at 1st, 2nd, 3rd month after treatment was significantly higher than before treatment (P<0.05), and hemoglobin values at 1st, 2nd month after treatment was significantly higher than control group (P<0.05).The effective rate of study group (95.92%) was significantly higher than that of control group (81.63%, P<0.05).The recurrence rate during six months was 4.08% in study group, 8.16% in control group, and the difference was not statistically significant.Conclusion The efficacy of medroxyprogesterone acetate is better than estradiol valerate tablets in the treatment of endometrial atypical hyperplasia patients, which is safe and effective.

Described in this paper are the history of patient libraries in Japan, and the current situation, forms and types of provided service , objects of service , training of qualified personnel in patient libraries of Japan , society of patient libraries and its activities with the important role ofreadingin the recovery of patients taken into account , in order to promote the establishment of patient library and its development in our country .

Objective To explore the relapse prevention effect of community independent skills in patients with schizophrenia.Methods 100 patients with schizophrenia from May 2014 to February 2015 were analyzed and divided into the observation group and the control group by using the computer random grouping.The standardization of community rehabilitation training was taken in the control group patients,whike independent skill training was taken in the observation group patients.The clinical curative effect of the study for a year were evaluated through SAPS, BPRS,SDSS,SANS and ITAQ for all the object.Results There was no statistical significance of ITAQ,SDSS,SAPS and SANS score difference in all the research objects before the rehabilitation treatment has (P >0.05 ).ITAQ, SDSS,SAPS and SANS score of the observation group were better than that of the control group after 8 weeks, 26 weeks and after 1 year,the difference was statistically significant(P <0.05).Recurrence rates of the observation group and control group were 16% and 40% respectively,and hospital admission rates were 10% and 32% respec-tively,the difference was statistically significant(P <0.05).The adherence were significant between the two groups (χ2 =6.92,P <0.05).Medication adherence to drug management ability were better in the observation group than the control group(χ2 =41.558,P <0.05).Conclusion The community independent skill training have an remarka-ble effect on the rehabilitation of patients with schizophrenia,and can improve the residual symptoms of schizophrenia after rehabilitation.It can help people with schizophrenia to maintain a good long-term positive effect,which is worth further clinical research and extension.

Objective:To discuss management and use for electrocardiogram (ECG) monitor during detection and repairing.Methods: To solve the problems in the process of management and use of electrocardiogram (ECG) monitor through detection and repairing of this equipment, and will discuss the management measures of ECG monitor. Furthermore, the effective quality control measures for ECG monitor will be raised.Results: Qualified rate of ECG monitor is 80.47%.It is useful to improve measure of quality control by PDCA.Conclusion: Quality control will improve the utilization rate of medical resources, and reduce investment costs of these resources.

As the hallmark sequelae of juvenile dermatomyositis(JDM),the calcinosis still bothers approxi-mately one third of the patients,but it was considered a good prognostic sign. Today,however,it is universally acknow-ledged that the calcinosis is instead deemed a marker of the special state and inappropriate treatment for JDM. The treatment of based on disease process,including the biological agents and other immunomodulator,which have been not the radical therapy. However,it is a crucial to alleviate the calcinosis that controlling the long - term chronic inflamma-tion for JDM.

Objective To explore the application and the clinical curative effect of Ilizarov technique in infected tibia defect with soft tissue defect .Methods It was case series retrospective study .Fifteen patients (6 women ,9 men;age 23-54 ,average 38) with infected tibia defect combined soft tissue defect between March 2008 and March 2012 were treated with Ilizarov external fixa‐tion .The average length tibia defect was 7 .7 cm(3 .0 -21 .0 cm) ,The average area of soft tissue defect was 7 .5 cm2 (3 .6 -18 .4 cm2 ) .Ilizarov external fixation was applied in the operation .Results All 15 patients were followed up and the mean time was 16 .2 months (range ,8-36 months) .The average time of the bony healing was 12 .3 months (range ,7 -28 months) .The docking site was bony healing after rapid compression in 4 cases .The docking site was not bony healing in 2 cases .The docking site achieved bony healing by accordion technique in one case ,and bone grafting in the other case .The skin and hypodermis were embedded in the docking site in 9 cases .The skin and hypodermis were displaced in 3 cases ,and bone grafted at the same time in the other 6 cases . The soft tissue defect gradually become small and healed at last in the 14cases .One case with large soft tissue defect was cured by skin grafting .According to Paley′s evaluation criteria ,12 cases were excellent ,2 good ,1 moderate ,giving a good to excellent rate of 93 .3% .Conclusion Ilizarov technique is a safe and effective method to treat infected tibia defect with soft tissue defect which can completely debride infected lesions ,repair the soft tissue defect ,cure bone nonunion and restore the limb length .

Objective:To explore the corration of pathological classification of brainstem glioma with MRI imaging. Methods: The clinical data of 98 patients with BSG was retrospectively analyzed. of 98 patients, 66 cases were low level of brainstem gliomas, 32 cases were high level of brainstem gliomas. MRI images of different pathological grading of BSG were analyzed. Results:Glioma growth way was similar between the two groups and there was no statistical significance. But the proportion of basal artery circumvolutio, necrosis, growth across the midline of the high level group were significantly higher than the control group, there was a significant statistical significance (P<0.01). And the proportion of the cystic lesion in patients of low level group was obviously higher than that of high level group, with significant difference (P<0.01). of high level group patients with a ratio of tumor>2 cm in diameter was higher than the control group, and the difference was statistically significant (P<0.05). The improved forms of high level group were mainly wreath, wall nodules (P<0.01), and improved significantly stronger than the low level group (P<0.01). The main uniformity of high level group in show was characteristics with less uniformity (P<0.01). The MRI measuring minimum thickness was similar between the two groups and had no statistical significance. But MRI measuring thickness, the ratio and gap between maximum thickness and minimum thickness of high level group were bigger than the value of low level group, with statistically significant difference (P<0.001). Conclusion:MRI imaging and MRI enhanced characteristics of brainstem glioma may predict and judge the malignant degree and pathological grading of brainstem glioma.

The treatment of relapsed and refractory multiple myeloma has always been a problem among hematologic malignant tumor treatment.Compared with the initial therapy,there are worse therapeutic effects and more affecting factors of selecting treatment since the existence of drug resistance in relapsed myeloma.In this review,the therapeutic effects of single and combinational use of several novel agents such as thalidomide,lenalidomide and bortezomib were evaluated in treating relapsed and refractory multiple myeloma.The clinical results of some new anti-myeloma agents were also reported.

Objective To examine whether diabetes mellitus increases the risk of pneumonia mortality among seniors in the U.S. general popula-tion. Methods&Results The NHANES III follow-up study data were used. After excluding individuals from other minorities, being hos-pitalized with pneumonia in the previous year at baseline, or death of pneumonia during the first year of follow-up, a total of 3,707 subjects aged 65 years or older (1,794 men and 1,913 women) who had no missing information on variables for the analysis were included. Approxi-mately 16% of seniors at baseline were diabetics, which was defined as either having been diagnosed by a physician, currently taking pills/insulin lowering blood glucose, or HbA1c higher than 6.4%. During an average 11 years of follow-up, a total of 98 deaths due to pneu-monia were recorded (ICD-10:J12-J18). Cox-regression models were used to estimate the risk association between pneumonia mortality and diabetes mellitus. After adjustment for the covariates at baseline, the hazard ratios of pneumonia death were 1.30 (95%CI:0.64-2.70) for pre-diabetics and 2.28 (95%CI:1.18-4.39) for diabetics, respectively. Among those covariates, only age (HR (95%CI);1.16 (1.13-1.20)), gender as female (0.35 (0.22-0.61)) and physical fitness measured as having no problem walking 1+mile during the previous month (0.38 (0.20-0.67)) reached statistical significance. Conclusions The results suggest that diabetes mellitus is a strong risk predictor of pneumonia mortality and the evaluation of physical fitness may also be useful in the risk prediction of pneumonia mortality for seniors.

BACKGROUND:There is a certain relationship between bone marrow mesenchymal stem cels and articular cartilage, and its celular functional status is one of the causes of osteoarthritis.
OBJECTIVE:To explore the correlation between functional status of bone marrow mesenchymal stem cels and disease progression in patients with osteoarthritis.
METHODS:The clinical data of 45 patients were colected, including 15 cases undergoing arthroscopic knee cruciate ligament reconstruction (control group), 15 cases of mild osteoarthritis (mild osteoarthritis group), 15 cases of severe osteoarthritis (severe osteoarthritis group). Bone marrow mesenchymal stem cels from three groups were culturedin vitro to observe the morphological changes. Proliferative and differentiation ability was detected and compared between the three groups.
RESULTS AND CONCLUSION:At 24 hours of primary culture, the bone marrow mesenchymal stem cels were arranged in regular pattern and spindle-shaped in the three groups with no morphological differences. At 14 days of chondrogenic induction, toluidine blue staining was positive for bone marrow mesenchymal stem cels, but there was stil no difference in the chondrogenic ability in the three groups. Cel counting kit-8 results showed that the proliferative ability of cels was strongest in the control group and weakest in the severe osteoarthritis group. These findings indicate that there is a certain correlation between the functional status of bone marrow mesenchymal stem cels and the progress of the disease.