Objective To determine the clinical valuation of different ways of hysteroscopic surgery for endometrial polyps. Methods Clinical effects were analysed retrospectively on total 86 patients underwent different ways of hysteroscopic surgery according to women physiological stages, the desire of fertility and clinical symptoms, the mean followed-up duration was (18±6) months. Results Among 86 cases, after polyps resected. In 53 cases menstrual change, 48 cases were cured, 5 cases were invalid. In 20 cases dysmenorrhea, 16 cases were valid, 4 cases were invalid. In 22 cases secondary anemia, 18 cases were cured, 4 cases recovered. Conclusions Fertile stage: uterine curettage should be undergone for patients without menstrual change after polyps resected; among patients with menstrual change, whole layer of endometria were resected for the ones (more than 40 ages) without desire of fertility and superficial layer of endometria were resected for the others after polyps resected. Perimenopause: uterine curettage should be undergone for patients without menstrual change and whole layer of endometria were reacted for patients with menstrual change after polyps resected. Postmenopause: uterine curettage should be undergone for patients without vaginal bleeding and endometria ablation should be carried out for patients with vaginal bleeding.

Objective To explore the correlations between the levels of glycosylated hemoglobin A1c (HbA1c)and N-Terminal pro-Brain Natriuretic peptide(NT-proBNP)in aged diabetes mellitus(DM)patients with heart failure(HF).Methods 127 patients diagnosed as DM complicated by HF and detected HbA1c and NT-proBNP when admitted into hospital,were divided into three groups according to the levels of HBA1C as follows:group A,4%≤HbA1c≤6.9%;group B,7%≤HbA1≤7.9%;group C,HbA1c≥8%.The levels of NT-proBNP were measured and compared.Results There was no statistical difference between group A and B(P＞0.05),where as the　levels of NT-proBNP in group C increased significantly than that in group A and B(P＜0.01);In group C,HbA1c was linear positively correlated to NT-proBNP(r=0.558,P＜0.01).Conclusion Aged DM patients complicated by HF,the level of HbA1c between 4%and 7.9%was acceptable.Meawhile,HhA1c should the independent risk prediction factor for aged DM patients complicated by HF,which could be used as the guide to the clinical therapy to improve the prognosis.

Objective To observe the effects of green fluorescence protein mediated by lentivirus in bladder, and to de?termine the amount of virus obtained good transfection effects. Methods lentivirus carring GFP gene was perfused using transurethral approach into bladder of guinea pigs. Samples of bladder, liver, kidney and lungs were collected for frozen sec?tions after feeding seven days. The distribution of green fluorescence was observed using laser confocal microscopy. Re?sults The titer of lentivirus was 4 × 108. GFP was found under the mucosa when the amount of lentivirus transurethral was 30μL. GFP was distributed widely in muscle layer using 40μL lentivirus. GFP was detected even stronger in muscle layer when the amount was 50μL. GFP was found in muscle layer when 25μL lentivirus was injected intravenously. GFP was not found in other tissues than in bladder via transurethral perfusion. There was higher GFP in liver, lungs and other organs than in bladder via intravenous injection. Conclusion Lentivirus can mediate GFP transfecting bladder of guinea pig successful?ly and escape the distribution of GFP all over the body intravenously, which will bring new research direction and method for clinical treatment of diseases in bladder.

AIM To investigate the effects of Tongluo Xingnao Effervescent Tablets (Chuanxiong Rhizoma,Angelicae sinensis Radix and Scutellariae Radix) on the learning and memory function in SAMP8 mice,and improvements in cognitive function.METHODS Morris water maze was used to evaluate the change of cognitive function in SAMP8 mice after they were treated with Tongluo Xingnao Effervescent Tablets for 60 d,and the activity of superoxide dismutase (SOD),the concentration of protein carbonyls (PC),the ratio of NAD +/NADH in brain tissue were detected by ELISA,the expression of Nampt,SIRT1 and FOXO3 in hippocampus were measured with immunohistochemical methods.RESULTS Tongluo Xingnao Effervescent Tablets shortened escape latency and obviously increased percentage of time in target quadrant in hidden platform test and increased the times entering the target quadrant in spatial probe test in SAMP8 mice.It evidently enhanced the activity of SOD,the ratio of NAD +/NADH and distinctly decreased the protein carbonyls level.Moreover,Tongluo Xingnao Effervescent Tablets could markedly up-regulate the expression of Nampt and SIRT1,but evidently down-regulate FOXO3 protein expression.CONCLUSION The experimental data show that Tongluo Xingnao Effervescent Tablets can enhance the cognitive function of SAMP8 through regulating Nampt/SIRT1/FOXO3 signal pathway.

BACKGROUND:Though the high-resolution CT(HRCT)could identify the inner structures of temporal bone.its tiny parts could hardly be observed accurately and clearly by the imaging examinations of auriculotemporal portion,with the influence of scanning layers as well as the partial volume phenomenon.However,it could be easily identified by the combination of thin sections and HRCT images.OBJECTIVE:To introduce a method which could locate the posterior tympanum and its neighboring structures using HRCT images and to provide an anatomical base for the imaging diagnosis and operative treatment on this area.DESIGN,TIME AND SETTING:The observations between the auriculotemporal sections and CT images were finished both in thc Department of Sectional and Imaging Anatomy,Medical College,Nanchang University and the Center of Medical lmageology.Jiangxi Provincial People's Hospital from July 2004 to June 2007.MATERIALS:Fifteen normal adult cadaveric heads(30 sides)which fixed by 100 g/L formaldehyde were scanned,with all the samples provided by the Department of Anatomy,Medical College,Nanchang University.The main equipment was GE Hi-speed Nx/i Sys CT equipment (GE Company,USA).METHODS:Tb obtain CT images of temporal bone(depth 1.00 mm,thickness 1.00 mm),15 normal adult cadaver heads were scanned by CT method taking callthomeatal line(CML)as the baseline.After that,specimens of auriculotemporal portion from temporal bone were taken,decalcified,desiccated and embedded.Sequential sections(thick 1.00 mm)were made.MAIN OUTCOME MEASURES:Comparing sequential sections with CT image,identified respectively the fossa incudis,chorda eminence,styloid eminence,tacial recess,sinus tympanl,ponticulus promontoni,suprameatal spine,etc.RESULTS:The depth of fossa incudas was about(1.49±0.05)mm,the distance from the fossa to pyramid segment of facial nerve was(5.67±0.1 4)mm.The distance from the medial wall of posterior tympanic sinus to the horizontal segment of facial nerve was(3.1 2±0.1 5)mm.The average distance from suprameatal spine to the vertical segment of facial nerve was (16.73±1.24)mm,to chorda tympani nerve(15.87±1.14)mm,to promontory(21.84±2.43)mm.CONCLUSION:Comparing the sectional antomy and CT image of auriculotemporal potion of temporal bone is valuable for the diagnosis and treatment of otopathy.

Objective:To explore the influencing factors of false-positive serological reaction of syphilis.Methods:A total of 166 patients with false-positive serological reaction of syphilis (false-positive group), 145 patients diagnosed with early syphilis without treatment (positive control group) and 124 persons undergoing entry physical examination (negative control group) were included from January 2017 to February 2020 in Beijing Tongren Hospital, Capital Medical University. The gender, age and underlying diseases of the three groups were compared. Logistic regression was used to analyze the influencing factors of false-positive serological reaction of syphilis. The efficacies of chemiluminescence immunoassay (CLIA) and toluidine red unheated serum test (TRUST) were compared. Paired t test or chi-square test was used for statistical analysis. Results:In the false-positive group (166 cases), the age of 117 cases were more than 50 years old and 49 cases <50 years old. There were significant differences in age ((53.1±13.8) vs (24.7±2.8), t=22.56, P<0.01), autoimmune disease (36.7%(61/166) vs 6.5%(8/124), χ2=35.93, P<0.01), hepatitis (9.6%(16/166) vs 3.2%(4/124), χ2=4.92, P=0.026) and tumor (6.6%(11/166) vs 0.8%(1/124), χ2=4.68, P=0.030) between the false-positive group and the negative control group. There were significant differences in gender (there were 91(54.8%) males and 75(45.2%) females in the false-positive group, and 103(71.0%) males and 42(29.0%) females in the positive control group, χ2=8.67, P=0.003), age ((53.1±13.8) vs (34.4±12.9), t=20.13, P<0.01) and autoimmune disease (36.7%(61/166) vs 6.9%(10/145), χ2=39.14, P<0.01) between the false-positive group and the positive control group. Multivariate logistic regression analysis showed that gender (odds ratio ( OR)=2.692, 95% confidence interval ( CI) 1.504-4.816, P=0.001), age ≥50 years old ( OR=30.512, 95% CI 15.959-58.335, P<0.01), autoimmune disease ( OR=2.677, 95% CI 1.258-5.695, P=0.011) and hepatitis ( OR=4.408, 95% CI 1.799-10.799, P=0.001) were the influencing factors of false-positive serological reaction of syphilis. In the false-positive group, the positive rate of TRUST was 84.9% (141/166), which was higher than that of CLIA (23.5%(39/166)). The difference was statistically significant ( χ2=126.25, P<0.01). CLIA was 1.0-10.0 cut off index (COI) in 36 patients, and >10.0 COI in three patients.The difference was statistically significant ( χ2=52.51, P<0.01). The titers were ≤1∶4 in 139 patients and≥1∶8 in two patients with TRUST positive.The difference was statistically significant ( χ2=262.35, P<0.01). The sensitivity and specificity of CLIA were 95.2% and 96.0%, respectively, and those of TRUST were 77.2% and 91.1%, respectively. Conclusions:The influencing factors of false-positive serological reaction of syphilis include patients age ≥50 years and with autoimmune disease or hepatitis. The false-positive rate of TRUST is significantly higher than CLIA.

Objective To compare the similarities and differences between the esophageal mucosa lesion pathology before and after endoscopic submucosal dissection (ESD).Methods A total of 110 patients diagnosed as having esophageal mucosal lesions by endoscopic biopsy were treated with ESD at Zhejiang cancer hospital from 2013 to 2014.The results of preoperative and postoperative pathology were compared.Results The consistency rate of preoperative biopsy and postoperative pathologic diagnosis was 61.8％ (68/110).Compared with preoperative pathology,the postoperative pathological results underestimated accounted for 30％ (33/110),the postoperative pathological results overestimated accounted for 8.2％ (9/110).In early esophageal cancer group,consistency rate of preoperative biopsy and postoperative pathologic diagnosis was 75.0％ (18/24),which was higher than that of intraepithelial neoplasia group[58.1％ (50/86)] with significant difference (P ＜ 0.05).Conclusion Preoperative biopsy is not necessarily consistent with postoperative pathology.Though preoperative pathological diagnosis has certain value,it can not completely represent the nature of the lesions.The patients with intraepithelial neoplasia should be actively treated with ESD combined with clinical experiences to get the accurate diagnosis.

Blood glucose levels of 220 days were recorded in 85 type 2 diabetic patients for monitoring glycemia for 48-72 h each one by the continuous glucose monitoring system (CGMS). Frequencies of nocturnal hypoglycemia (blood glucose≤2. 8mmol/L) were estimated when bedtime blood glucose levels were≤4.4mmol/ L,≤5.0mmol/L,≤5. 6mmol/L,≤6.1mmol/L,≤6. 7mmol/L, or≤7. 2mmol/L respectively. Nocturnal hypoglycemia occurred in 39 nights of 220 days (17.7%) of 26 patients and their bedtime blood glucose level was (4.4?2.6)mmol/L with a range from 2. 2 to 12. 6 mmol/L. Using a cut-off of bedtime blood glucose at≤6. 7 mmol/L, area under the ROC curve was reached maximal value (0. 359?0. 046). The positive predictive value was 25% and the negative predictive value was 91. 7%. CCMS is a useful tool to detect unaware nocturnal hypoglycemia.

Objective To present the preliminary experience with laparoscopic ureteral reimp1ant for distal ureteral stricture without everted ureteral nipple or submucosal tunneling. Methods Six patients with distal ureteral stricture underwent transperitoneal laparoscopic ureteral reimplantation.The ureteral was reimplanted into the bladder without everting the ureter or without a tunnel.The seromuscular wall of the ureter was anastomosed eircumferentially to the bladder muscle layer by continuous suture. Results All procedures were successfully performed without any intraoperative complications or need for open conversion.Intravenous urography showed normal drainage without obstruction or reflux during follow-up. Conclusion Laparoscopic ureteral reimplantation might be technically simple and feasible.

Objective To summarize the first 16 eases in mainland China and to discuss the cli-nical experience of robot-assisted laparoseopie radical prostateetomy(RLRP). Methods Sixteen pa-tients with localized prostate carcinoma underwent RLRP with da Vinci S surgical system (Intuitive Surgical Inc.). The age of the patients was 62-76 years, average 69 years. The preoperative t-PSA level was 0.2-79. 2. Ng/ml. The volume of prostate was 9.8-232.9 ml. Fifteen patients were with biopsy-proven prostate cancer, the average Gleason score was 7(4-9). Three were T2a. N0 M0, 4 were T2b N0 M0 and 8 were T2c N0/M0 by clinical stage. One was prostatic intraepithelial neoplasm-Ⅲ. The level of t-PSA in serum and the result of urinary continence were followed up after RLRP. Results All the operations were accomplished successfully. The mean preoperative set-up time of the da Vinci surgical system was 64(60--90)min;the mean operation time was 236(190--390)rain;the mean esti-mated blood loss was 231(50-500)m.L The patients were ambulant between the 2nd and 3rd postop-erative days. Foley catheter was sueeeasfully removed on day 10 to 14, and mean hospital stay was 13 (6-19) days. Two eases had positive surgical margins, the pathological stages were both pT3b N0 M0. The average serum t-PSA was less than 0. 1 ng/ml during a median follow-up of 9(6-12) months. By the conventional definition of urinary continence (0 to 1 pads daily), 94%(15/16) and 100% (16/16)of patients were continent at 3 and 6 months, respectively. Of the patients, 75% (12/16)and 88% (14/16)had no urinary leakage(0 pads daily). Conclusions RLRP is small incision and safe. It is the direction of minimally invasive urologic surgery.