Objective To compare the effect of methotrexate combined with laparoscopic surgery on pregnancy outcome of patients with tubal pregnancy treated with conservative treatment.Methods 96 patients who were diagnosed of tubal pregnancy,fertility requirements and no clinical data given birth were analyzed retrospectively.Depending on the method of treatment was divided into 46 cases of methotrexate and laparoscopic group of 50 patients.Postoperative intrauterine pregnancy,ectopic pregnancy and secondary infertility situation again were compared.Results Laparoscopic group in intrauterine pregnancy rate was 70.0％,which was significantly higher than that in the methotrexate group(47.8％),and the difference was statistically significant(x2 =13.229,P ＜ 0.05) ;laparoscopic ectopic pregnancy rate was 14.0％ against 17.4％ with methotrexate group,the difference was not statistically significant(x2 =2.037,P ＞ 0.05) ; methotrexate group was 34.8％ of secondary infertility was significantly higher than thatin the laparoscopic group (16.0％),the difference was statistically significant (x2 =12.784,P ＜ 0.05).Conclusion Laparoscopic surgery after conservative treatment of tubal repregnancy outcome is better than methotrexate.

OBJECTIVE:To discuss the use of allopurinol for the reduction of serum uric acid level in patients with chronic kidney disease complicating hyperuricacidemia so as to delay the progression of chronic renal disease.METHODS:A total of 47 patients with chronic kidney disease complicating hyperuricacidemia were randomly divided into treatment group and control group:the treatment group was given allopurinol 100～200mg?d-1 in addition to the antihypertensive therapy as adopted in the control group or the common therapy for 12 months.RESULTS:As compared with the control group,serum creatinine level was lower and the rate of renal function deterioration was significantly decreased in the treatment group(P

Objective To explore and classify the subjective opinions of nurses on whistle- blowing, and identify the subjective characteristics of each type. Methods This study applied Q -methodology, protocols which could determinate subjective opinions of nurses on histle-blowing were set up and underwent interview investigation, data of the interviews went through Q-factor analysis. Results Most nurses had a positive attitude toward whistle - blowing because it could prevent any nursing activity not based on expertise and professional ethics from causing disadvantages for patients. At the same time, however, they requested the creation of a legal framework in which whistle-blowing was done in a way to increase trust among colleagues. Meanwhile, some nurses showed resistance to whistle - blowing. Conclusions Whether whistle - blowing can reach its aims depends on nurses' attitude toward it. Most Korean nurses support whistle-blowing. Nursing activity not based on expertise and professional ethics and causing disadvantages for patients can be avoided if a legal framework is established for whistle-blowing.

Objective To explore the clinical effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on post-stroke depression (PSD). Methods Sixty PSD patients were randomly divided into an rTMS group and a control group, each of 30 patients. In addition to conventional treatment, rTMS group members were given high-frequency rTMS treatment for 10 d while the control group were given sham stimulation. In order to test the efficacy, the two groups were compared using the Hamilton depression rating scale (HAMD) before and after 10 and 30 days treatment. Results After 10 days of treatment the rTMS group had significantly lower HAMD scores than before treatment, and average HAMD scores differed significantly between the rTMS group and the controls, with the former performing significantly better. There was no obvious difference in HAMD scores after 30 days of treatment between the two groups. Conclusions High-frequency rTMS is a safe and effective treatment for PSD.

Delayed cerebral vasospasm is the leading cause of death in patients with subarachnoid hemorrhage. A good in vivo animal model of cerebral vasospasm after subarachnoid hemorrhage helps to understand the occurrence, development of this cerebral vasospasm, and the complicated and various pathophysiological mechanisms. It will provide important information for clinical interventions

Objective To explore the risk factors for hospital acquired pneumonia (HAP) in patients with neural-intensive care unit (NICU).Methods The clinical data were analyzed retrospectively for 207 patients in NICU ≥ 5 d,to determine possible risk factors with HAP.Results The incidence of HAP was 14.01％(29/207).Correlation analysis showed that old age,disturbance of consciousness,dysphagia,vomiting,low pre albumin,NICU residence time ≥ 30 d,indwelling nasogastric tube,the use of the acid-blocking drugs,tracheal intubation,tracheal incision,mechanical ventilation and deep bronchoscopic suctioning were the related factors of HAP (P ＜ 0.05 or ＜ 0.01),but blood glucose,sedative drugs were unrelated with HAP (P ＞ 0.05).Conclusion There is a high incidence of NICU in patients with HAP,taking comprehensive measures actively,reduce risk factors,can effectively control the occurrence of HAP in NICU.

Objective To investigate the effects of preconditioning with emulsified isoflurane(eISO)on inflammatory response to myocardial ischemia-reperfusion(I/R)injury in rats.Methods Forty SD rats of both sexes weighing 250-280 g were randomly allocated into 4 groups(n =10 each):groupⅠ sham operation(S);group Ⅱ myocardial I/R + normal saline(NS); group Ⅲ I/R + eISO and group Ⅳ I/R + 30％ intralipid(Ⅱ.)(vehicle for eISO).Myocardial ischemia was induced by occlusion of anterior descending branch of left coronary artery for 30 min followed by 180 min reperfusion.NS,30％ intralipid and elSO 2 ml/kg were infused iv over 30 min at 30 min before myocardial ischemia in groups Ⅱ,Ⅲ and Ⅳ respectively.The animals were killed at the end of 180 min repeffusion.Their hearts were removed for determination of infarct size and myocardial NF-κB p65 and ICAM-1 expression(by immuno-histochemistry)and plasma concentration of TNF-t(by radioimmunoassay).Results Myocardial I/R induced myocardial infarct and significantly increased plasina TNF-a concentration and myocardial ICAM-1 and NF-κB p65 expression in gro up Ⅱ,Ⅲ and Ⅳ as compared with'sham operation group (Ⅰ).Plasma TNF-a concentration and myocardial ICAM-1 and NF-kB p65 expression were significantly lower in group Ⅲ(eISO)than in group Ⅱ and Ⅳ.Conclusion Down-regulation of myocardial NF-kB and ICAM-1 expression and inhihition of inflammatoy response are involved in the mechanism by which preconditioning with iv elso protects against myocardial I/R injury.

[Objective] To discuss the therapeutic effect of different methods in the treatment of intertrochanteric femur fracture. [Methods]Totally 118 middle aged or old patients with intertrochanteric femur fracture were fixed with dynamic hip screw (DHS), Gamma nail or PFNA.[Results]Totally 112 cases were followed up, and the average time was 16 months, in those 45 patients were fixed with DHS: 29 were excellent, 11 cases were good, and 5 were poor, and the excellent to good rate was 88.9%; 36 patients were treated with Gamma nail, and the excellent, good, poor results were 28, 2, 1, respectively, and the excellent to good rate was 96.8%; 36 patients were fixed with PFNA, and the excellent, good, poor results were 29, 6, 1, respectively. The differences were significant (P=0.02, analyzed by Logistic regression with SPSS software). The excellent and good superiority of Gamma nail and PFNA were 5.1552 and 2.3726 times compared to DHS, and there was significant differences between the groups.[Conclusion]Surgical treatment of intertrochanteric femur fracture can improve the functional recovery and reduce the complication incidence, and PFNA fixing method can shorten the operative time, reduce the bleeding and the therapeutic effect is reliable, and suitable for old patients combined with osteoporosis.

Objective:To explore the effect of Fitness Qigong(Yi Jinjing)exercise on blood lipid and free radical metabolism of the elder women.Methods:The subjects of this experiment were 64 elder women who were divided into 2 groups randomly:exercise group(34 cases)and control group(30 cases).The exercise group practiced 40-50min pre time,six times pre week for six months,and the control group had no exercise with collective or individual scheme.The indexes of TC,TG,HDL,LDL,SOD,GSH-Px and MDA of the elder women were measured before and after 6-month exercise.Results:After six months Yi Jinjing exercise,the exercise group showed increase in HDL(P0.05),increase in SOD and GSH-Px(P0.05).Conclusion:Fitness Qigong(Yi Jinjing)exercise had the positive effects on blood lipid metabolism,and can suppress lipid peroxidation and maintain high antioxidative capacity of elder female individuals.

Objective To study the possible relationship between mitochondrial DNA(mtDNA)and hereditary ataxia(HA).Methods Polymerase chain reaction(PCR)was used to amplify 4 mtDNA segments of 30 patients with HA、some of their relatives and 35 volunteers.The point 3243、8993、8344 and point 11778 lied in the 4 mtDNA segments respectively.For the PCR products of point 3243 and 8993,restriction fragment length polymophism(RFLP)was performed to search for A3243G、T8993G or T8993C point mutations.For point 8344 and 11778 PCR products,single strand conformation polymorphism(SSCP)was executed to detect mutations.The HA patients’ results of SSCP were compared with their relatives and volunteers’.Sequencing would be carried out to find out exact mutations in those subjects whose SSCP results were abnormal.Results We had not found the A3243G、T8993G or T8993C point mutations in our study.All subjects’ mtDNA segments of point 8344 had not been found mutations.However,a new mtDNA point mutation-A11893G-was identified in 2 patients and 1 relative without symptoms from pedigree 1.Conclusion This new point mutation of mtDNA might be related to HA.