Primary cytoreductive surgery followed by platinum-based chemotherapy represents the standard treatment for patients with advanced ovarian cancer.But some patients with advanced ovarian cancer still have suboptimal residual disease after the primary debulking surgery.Neoadjuvant chemotherapy has been suggested as an alternative strategy to achieve no residual disease.It is important to find methods to estimate the likelihood that cytoreductive surgery will leave no residual disease.A number of studies have evaluated the use of serologic markers (such as CA125),imaging modalities (such as CT,PETCT,MRI),and laparoscopic surgery to determine which patients are ideal predictors for neoadjuvant chemotherapy.As a new approach of assessment for preoperative evaluation regarding cytoreduction,laparoscopic surgery deserves further research.

Objective To investigate the effect on thyrotropin (TSH) levels of pregnant women and their newborns in different delivery ways. Methods The serum TSH levels of 213 pregnant women and the umbilical cord blood TSH levels of their newborns (140 cases from normal vaginal delivery, 38 cases from cesarean section, 35 cases from low forceps delivery) were tested by immunoradiometric assay. Urinary iodine was detected from pregnant women before delivery. Results In pregnant women, the mean serum level of TSH in the forceps group [(4 13?0 69) mU/L] was significantly higher than those of the normal birth group [(2 58?0 87) mU/L, P

Ultrasound-based molecular imaging technique is a role in positioning based on the conventional ultrasonic detection technology in combination with the targeted ultrasound contrast agent.It is a new technology to detect the changes of target tissue molecular level in vivo state.This article reviews the principles of ultrasound-based molecular imaging and its application in the evaluations of early inflammatory response,neovascularization,and vulnerable plaque in carotid atherosclerosis.

Objective To improve the image intensifying X-TV system by replacing the light-conduct camera with CCD camera for future usage.Methods The low luminous and high sensitive CCD camera was used in the X-ray auto exposure dose control.Results Through the practical improvement,the CCD X-TV system met the clinical requirements.Conclusion It is an effective way to replace the old light-conduct camera with CCD camera,and it also helpful for the alternative solutions for X-TV.

Objective To evaluate the therapeutic effect of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation for the treatment of lower thoracic disc herniation.Methods From June 2000 to June 2010,36 cases of lower thoracic disc herniation were treated with method of posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation,including 23 males and 13 females,with an average of 42 years old(range,22-61 years old).The courses of disease were from 21 days to 69 months,with an average of 22 months.The lesion locations were T10-11 for 12 cases,T11-12 for 15 cases and T12L1 for 9 cases.Each of the patients underwent X-ray and MR examination,31 of them underwent CT scanning.Twenty-five cases were central protrusion type,7 cases were para-central protrusion type,4 cases were lateral protrusionstype.The clinical results were evaluated by Otanni scored system.Results The operative time was 135-220 min,with average of 155 min.The blood loss was 350-800 ml,with average of 460 ml.All patients were successfully operated without neurological symptoms aggravation and accidents.Cerebrospinal fluid leakage occurred in 12 cases,which was treated by continuous suture or dura patch repair.Two cases with giant disc herniation suffered from muscle strength decrease of lower limbs after surgery,which gradually recovered after drug treatment of hormones,dehydration,high-pressure oxygen and nerve nutrients.Postoperative X-ray examinations showed that there were no internal fixation loosening.The followed-up period was 14 days to 48 months,mean 4 months.According to Otani scored system,there were excellent results in 12 cases,good results in 18 cases and poor results in 1 case.The clinical satisfaction rate was 83.3%.Conclusion Posterior laminectomy and transfacet discectomy combined with interbody fusion and segment fixation is a safe and effective surgical procedure for the treatment of lower thoracic disc herniation.

Objective To evaluate the clinical effect of one-stage posterior-anterior approach surgery for patients with cervical fracture and dislocation combined with locked facet.Methods A retrospective review was conducted on 21 cases of cervical dislocation and fracture combined with locked facet treated by one-stage posterior-anterior approach surgery between April 2011 and December 2012.There were 16 males and 5 females at age ranging from 23 to 61 years (mean,38.3 years).Posterior unlocking reduction by partial facetectomy and lateral mass screw fixation was performed,followed by anterior decompression,internal fixation and interbody fusion by titanium meshes.Outpatient or telephone follow-up was performed to evaluate bone fusion and recovery of neurologic function.Results Mean operation time was 140 minutes (130-210 minutes) and mean blood loss was 340 ml (range,150-600 ml).All incisions got primary healing with no operation-correlated complications.Five patients complicated with severe lung infection after surgery and one died of respiratory failure two week later.Titanium meshes achieved bone fusion within 3-9 months (mean,6 months) after surgery.At a mean follow-up of 17 months (range,12-30 months),there was no implant breakage and mesh displacement or collapse.According to the American Spinal Injury Association (ASIA) score,preoperative neurologic deficit restored by mean one grade at final follow-up.Conclusion One-stage posterior-anterior approach surgery is an ideal choice for cervical fracture and dislocation combined with locked facet,for it provides unlocking reduction,canal decompression,and rigid reconstruction of the anterior-posterior column.

Objective:To determine the current situation of patients with diabetic foot and influencing factors in Jinyang community of Shanghai. Methods:A total of 1400 patients with diabetes registered in community management from January 2019 through December 2019 were randomly selected for survey. All patients completed the screen for diabetic foot and then were divided into control group （n=159） and observation group （n=1 241） according to the occurrence of diabetic foot. Patient's demographics and medical history were recorded， including gender， age， history of long-term smoking， course of disease， history of trauma infection， fasting blood glucose， 2 h postprandial blood glucose （2hPG）， glycosylated hemoglobin （HbAlc）， blood lipid level， history of hyperglycemia， diabetic nephropathy， and diabetic retinopathy. Univariate and multivariate logistic analyses were performed with these possible influencing factors. Results:Univariate analysis showed that the incidence of diabetic foot was not significantly associated with gender， age， history of trauma infection， course of disease or blood lipid level （P>0.05）， whereas had statistical significance with long-term smoking history， fasting blood glucose and 2-hour diabetes mellitus PG， HbAlc， history of hypertension， diabetic nephropathy and diabetic retinopathy （P<0.05）. Multivariate logistic analysis showed that the incidence of diabetic foot was not statistically associated with gender， age， history of trauma infection， course of disease or blood lipid level （P>0.05）； it was significantly associated with long-term smoking history， fasting blood glucose and 2-hour diabetes mellitus PG， HbAlc， history of hypertension， diabetic nephropathy and diabetic retinopathy （P<0.05）. Conclusion:There are multiple influencing factors of diabetic foot in Jinyang community. We should take corresponding measures to control the blood glucose level of diabetic patients and reduce the incidence of diabetic foot.