Objective:To explore the ultrasonic classification in cesarean scared pregnancy (CSP)and its effect on guiding the clinical treatment.Methods:The clinical data of 41 patients with CSP in the Third people's hospital of Chengdu from January 2013 to January 2016 were analyzed retrospectively.Diagnosis was confirmed according to the diagnostic criteria for ultrasound imaging by Godin etal and the history of cesarean section.Patients were divided into type Ⅰ group and type Ⅱ group through measuring the outside uterine muscle layer thickness of pregnant bursa,based on the criteria by Vial et al.Type Ⅰ:MTX intramuscular injection followed by ultrasound guided Dilation and Curettage(D&C)3 days later.Type Ⅱ]:Uterine artery chemo-embolization (UACE)followed by ultrasound guided D&C 2 days later,or lesion resection and repair of the uterus by trans-abdominal or laparoscopic or trans-vaginal operations 2 days later.Results:The outside uterine muscle layer of pregnant bursa in type Ⅱ] was more thinner than that in type Ⅰ (2.1 ± 1.1 mm vs 3.7 ±0.6 mm,P ＜ 0.05).The number of abortion in type Ⅱ was more than that in type Ⅰ (2.8 ± 0.7 vs 1.5 ± 0.6,P ＜ 0.05).There were no statistically significant differences in age,amenorrhea duration and the number of cesarean section (P ＞ 0.05).Patients from two group were treated successfully,and there was no statistical significance about,intraoperative bleeding volume,preoperative serum levels of β-HCG and average recovery time of serum β-HCG(P＞0.05).The average hospital stays and cost in type Ⅰ were less than that in type Ⅱ,with statistical significance (4.7 ± 2.5 vs 8.6 ± 2.7 days,5234.6 ± 1688.8 vs 15668.4 ±4623.4 RMB,P ＜ 0.05).Conclusions:The ultrasonic classification of CSP plays a directive role in making treatment option,with reliabe effect and the good prognosis.UACE as a pretreatment which can control intraoperative bleeding,is an effective method for CSP.For its higher cost,UACE should be selectively used in type Ⅱ[CSP,with cost-effective.MTX intramuscular injection used in type Ⅰ CSP before D&C is reliable and cost-effective.

Objective To explore the changes and significances of serum leptin and interleukin-1?(IL-1?)before and after treatment with risperidone in children with schizophrenics.Methods Thirty-one cases with first-episode children with schizophrenia were chosen in patient group.Their body weight and height were measured before and 8 weeks after treatment with risperidone to calculate the body mass index(BMI),and their fasting serum leptin and IL-1? were assayed radio-immunity method.Thirty-one healthy controls were measured at the same time.Results BMI and the level of serum leptin in patients of post-treatment increased significantly compared with those of pre-treatment(all P

Objective To explore the clinical characteristics of Mycoplasma pneumoniae pneumonia (MPP) with different imaging changes in children.Methods Hospitalized patients with MPP during September 2012 to August 2013 in Beijing New Century Children's Hospital were retrospectively reviewed.The data including clinical features,laboratory tests,treatment and prognosis were collected.The patients were divided into 3 groups according to the radiological findings,including interstitial infiltration (group 1),intralobular infiltration (group 2) and segmental or larger infiltration (group 3).The clinical data were compared among the 3 groups.Results The percentages of patients in the 3 groups were 18.8％ (36/191 cases) in group 1,39.8％ (76/19 cases) in group 2 and 41.4％ (79/191 cases) in group 3,respectively.In 144 cases of MPP patients older than 3 years old,48.6％ (70/144 cases) were segmental or larger infiltration.The incidence of higher fever,hypoxemia and elevated C-reaction protein and lactate dehydrogenase in group 3 [50.6％ (40/79 cases),87.3％ (69/79 cases),78.5％ (62/79 cases),29.1％ (23/79 cases)] were higher than those in group 1 [5.6％ (2/36 cases),61.1％ (22/36 cases),19.4％ (7/36 cases),0] and group 2 [10.5％ (8/76 cases),67.1％ (51/76 cases),14.5％ (11/76 cases),3.9％ (3/76 cases)],and the differences were significant(all P ＜ 0.01).Patients in group 3 had higher risk of cardiac and/or liver impairment,refractory MPP,and treated by glucocorticoids and bronchoalveolar lavage [41.8 ％ (33/79 cases),29.1％ (23/79 cases),94.9 ％ (75/79 cases),50.6％ (40/79 cases)].The hospital stay was (9.48 ±3.26) d in group 1,(9.24 ±2.97) d in group 2,and (12.09 ±3.01) d in group 3,respectively,and the difference was significant among 3 groups (F =19.348,P =0.005),the hospital stay in group 3 was longer than that in the other 2 groups (t =4.210,5.931,all P =0.000),while there was no difference between group 1 and group 2 (P ＞ 0.05).Patients in group 1 with wheeze were more co-mmon,and were treated by Azithromycin earlier than that in group 3 [(5.08 ± 3.43) d vs.(4.16 ± 2.20) d],the difference was significant(t =2.498,P =0.014),while the incidence of hypoxemia was common than that in group 2 (x2 =3.176,P =0.012).Conclusions MPP patients with segmental or larger infiltration are older than patients in the other groups,and present with severe complications,higher inflammatory factors,longer hospital stay,and higher risk for refractory MPP.Glucocorticoids and bronchoalveolar lavage are usually used in these patients.Patients with interstitial infiltration are prone to manifest with wheeze and hypoxemia,and its diagnosis and treatment by Azithromycin are usually delayed.Therefore,pediatrician should pay more attention to MPP patients with different imaging changes,in order to diagnose and treat the patients timely.

Objective To investigate demography of sensory tricks in cervical dystonia (CD),and to discuss the relationship between sensory tricks and the function of sensorimotor integration of cerebral cortex,meanwhile to explore potential worthiness using sensory tricks in the management of CD.Methods We recruited 75 patients (23 male,52 female,male female ratio:1:2.26;aged 19-72 years,mean (42.45 ± 13.09) years) admitted to the Dystonia Clinic Center of the First Affiliated Hospital of Dalian Medical University from March 2016 to April 2013.Standardized questionnaire on sensory tricks was used to investigate the sensory tricks first recognized in 75 patients retrospectively.Median nerve somatosensory evoked potential via multipoint recording was measured in 43 CD patients who manifested as simple rotation of neck.Bilateral amplitudes of P22/N30 derived from F (3,4) were compared.Results Frequency of sensory tricks in CD was 85.53％ (64/75) in our research.As disease progressed,the type of sensory tricks used by patients may transform from one to another or even disappear.No statistically significant differences were found in ages among patients using classic sensory tricks,forcible tricks and patients without sensory tricks,whereas the complexity of the disease showed increased tendency among the three groups.Bilateral P22/N30 amplitudes of patients with classic sensory tricks showed no significant differences.P22/N30 amplitudes contralateral to the head turn were significantly higher than ipsilateral in patients using forcible tricks ((3.16 ± 1.71) μV vs (2.47 ± 1.28) μV,t =2.243,P=0.038) and patients without sensory tricks ((3.62 ±1.58) μV vs (2.73 ±1.14) μV,t=2.893,P=0.023).Tsui scores among patients using classic sensory tricks (9.36 ± 3.52) and forcible tricks (12.67 ± 5.00) or patients without sensory tricks (15.18 ± 4.07) had statistically significant differences (classic sensory tricks vs forcible tricks,t =-3.020,P =0.004;classic sensory tricks vs patients without sensory tricks,t =-4.452,P =0.000).Conclusions Types of sensory tricks used by patients are associated with severity of the disease.Different types of sensory tricks may reflect status of adaptive compensatory mechanism of the cerebral cortex.

Objective To explore the application value of single intensifying screen cassette in examination of Kashin-Beck disease through X-ray photographing.Methods Single intensifying screen cassette and traditional changing bag with exposure conditions were used to check right wrists of 110 children in Kashin-Beck disease areas.The FJ personal dosimeter was used to measure exposure dose.Photo graphing quality and diagnosis effect were assessed.Results The radiation dose of children in single intensifying screen cassette group was (207 ± 39)μsv/h,while in the traditional changing bag group was (1425 ± 63)μsv/h.The difference between the two groups was statistically significant(t =140.16,P ＜ 0.05).The high-quality photograph rate of the two methods was 94.55％ (104/110) and 92.73％ (102/110),respectively,and the difference was not statistically significant(P ＞ 0.05).The good photo rate in the single intensifying screen cassette was 96.36％ (94/110),which was significantly higher than that of the traditional changing bag group[44.55％ (49/110),x2 =70.92,P ＜ 0.01].Conclusions X-ray radiation dose in single intensifying screen cassette group is smaller than that of the traditional changing bag group,and the image quality of the radiograph of the new method is also superior.It has a good practical value in the X-ray examination of Kashin-Beck disease.

0.05).CART vaccine at 10?g significantly depressed the analgesic effect of morphine analgesia (P

Purpose:To study the effect of EGCG(extracts fr om green tea) on cell cycle in human breast cancer cell line and its mechanism. Methods:Cell proliferation assay kit was used to produce the dose-response curve. Flow cytometric assay was used to evaluate the cell cycle changes on MDA-MB435 cells with and without EGCG. The expression of protein was detected by Western blot. Results:EGCG could inhibit the proliferation of the breast canc er cells MDA-MB-435, 40 ?g/ml EGCG induced G 0 /G 1 phase arrest and the entrance to S phase. Both mRNA and protein level of p21 waf1/cip1 were up regulated in MDA-MB435 cells when treated by 40?g/ml EGCG. Conclus ions:Green tea can inhibit the growth of human breast cancer cells, perhaps by means of p21 and therefore inhibiting the progression of the cell cycle.

Objective To analyze the operative effect of fracture of ulna coronoid process and evalu- ate the repairing effect of reconstruction of combined injury of ligamental structure or radius head.Methods During 2001 to 2004,16 cases(14 males and 2 females)of fractures of ulna coronoid process,aged 18-54 years(mean 36.6 years),were treated operatively in our department.Routine medial approach on the elbow or anterior trance-joint approach was used.Once reduction was achieved,screws or Kirschner wires were used to fix the fracture and the capsule was repaired at the same time.If there was combined fracture of the radius head or rupture of the collateral ligament,simultaneous repair or resection was applied.Functional exercise was requested in all patients.Results The follow-up was 8 to 24 months.Fracture union needed 4 to 6 weeks. Average Mayo elbow score was 80.Conclusion Ulna coronoid process fractures need active therapy. The radius head should be reserved as complete as possible during treatment.It is necessary to work out a standard management plan,and a notice should be taken to ligamental structure examination.

Objective To identify the high-touched object surface in different special intensive care units(ICUs) through the observation and statistical analysis on the number of touching with common object surfaces in different ICUs, so as to provide basis for hospital environmental management.Methods Direct observation method was used to observe the daily activities of health care workers, the number of touching with various common object surfaces was recorded, Poisson distribution was adopted to statistically analyze the data.Results The average number of touching from high to low was as follows : medical record folder(n=28.00), chair(n=18.38), emergency rescue cart(treatment cart, n=17.29), bed surface(n=13.90), intravenous infusion line(n=13.76), medical pen(n=13.38), and intravenous transfusion pump(n=11.81), these objects accounted for 64.01% of all surface touching number.Different special ICUs were slightly different, general ICU high-touch object included the first 6 categories;cardiothoracic surgery ICU included the above 7 categories besides keyboard and mouse;internal medicine ICU included the first 6 categories and mobile phone.Conclusion High-touched object surface varied with different special ICUs of the same hospital, hospital should make the corresponding disinfection management measures according to the actual situation of high-touched surface of each department, so as to reduce the incidence of healthcare-associated infection.

Objective To explore the levels of sense of coherence,social support and coping style of permanent colostomy,and explicit the relationships among the three variables.the structural equation model(SEM) was used to investigate the relationship of the three variables in order to provide the theory basis for patients with permanent colostomy. Methods Self designed questionnaire,Sense of coherence scale, Medical Coping Modes Questionnaire and social support Scale were used to investigate 172 permanent colostomy patients from two grade 3 class A hospitals in Harbin. Results The total score of SOC in patients with permanent colostomy was (65.09 ± 11.71) points;The total score of social support in patients with permanent colostomy was (42.60 ± 7.26) points;the three subscales of medical coping modes questionnaire in descending sequence were avoidance, confrontation and acceptance-resignation with (18.53 ± 2.82), (17.37 ± 5.48), (9.49 ± 3.25) points. The abusive social support and coping style were significantly correlated to sense of coherence (P< 0.01 for both). Moreover, sense of coherence can be predicted directly by social support,and predicted indirectly via the mediating effect of coping style. Conclusion Effective measures should be taken to improve social support and via coping style to improve sense of coherence.