Objective To explore the clinical effect of hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps.Methods 126 patients with abnormal uterine bleeding of endometrial polyps were selected,and they were selected and randomly divided into control group and research group according to the digital table,63 cases in each group.The control group received traditional curettage surgery, the research group received hysteroscopic eletrosurgery.The intraoperative blood loss,operative time,length of hospital stay,postoperative menstruation recovery time,therapeutic effect and complications were compared between the two groups.Results The intraoperative blood loss and operation time of the research group were significantly lower than those of the control group (t1=7.44,P1<0.01,t2=7.78,P2<0.01).And there were no statistical differences between the two groups in length of hospital stay and postoperative menstruation recovery time(t1=1.82,P1=0.07,t2=1.71,P2=0.09).The total cure rate of the research group was 100.00%,which of the control group was 92.14%,the difference was statistically significant(x2=8.18,P=0.00).The incidence rate of complications of the research group was 3.17%, which of the control group was 17.50%,the difference was statistically significant(x2=11.08,P=0.00).Conclusion Hysteroscopic eletrosurgery for abnormal uterine bleeding of endometrial polyps has remarkable clinical effects and low incidence of complications,and it is worthy of clinical application.

Objective To explore the influence of follow-up by telephone on adherence and quality of life for breast cancer patients with hormonal therapy.Methods Totally 78 breast cancer patients with hormonal therapy were divided into the intervention group (40 cases) and the control group (38 cases).The control group were carried on routine guidance treatment and enjoined regular subsequent visit.The patients in intervention group were carried on the above-mentioned treatment and also receive regular follow-up by telephone.Through the follow-up by telephone we provided guidance for present and will present problems.Adherence for breast cancer patients with hormonal therapy and cancer rehabilitation evaluation system-short form(CARES-SF) were used to investigate the patients' adherence and quality of life six month after the intervention.Then we compared the adherence and quality of life before,six month of the intervention.The changes of adherence and quality of life scores were analyzed by repeated-measure ANOVA.Results The score of quality of life in the intervention group after 6 month of intervention was (25.43 ± 6.04),while in the control group was (40.61 ± 7.73),the difference was significant between the two groups,P＜0.05.The score of medication adherence in the intervention group after 6 month of intervention was (8.57 ± 6.20),while in the control group was (14.12 ± 6.63),the difference was significant between the two groups,P＜0.05.Conclusion Follow-up by telephone can improve adherence and quality of life for breast cancer patients with hormonal therapy.

[Objective]To evaluate the curative effect,indication and care for cage,the patients with lumbar vertebrae instability were treated by 1umbar interbody ecstatic fusion cage.[Method]There were 42 patients,male 31 and female 11,aged 3 5~78 years(averaged 46 years) and suffered with spondylolisthesis of isthmus non-union in 26 cases and degenerative spondylolisthsis in 1 6 cases,including spondylolisthsis of L3、4 5 cases,of L4、5 23 cases and of L5S1 14 cases.According to Meyerding classification,there were grade-I spondylolisthsis 29 cases and grade-Ⅱ 13 cases.All patients were treated with decompression of lumbar canal,resection of vertebral disc,insertion of ecstatic fusion cage.The curative effect was observed and evaluated.[Result]Patients were followed up for 6 months to 6 years,the results were good rate of JOA scores 95%,the recovery rate of inter-spinal height,reduction and bone fusion rate were up to 98%.[Conclusion]For lumbar spondylolisthesis of grade Ⅰ～Ⅱ,the ecstatic fusion cage has good effect on recovery of inter-spinal height,improvement of bone fusion rate,maintaining lumbar stability,relieving clinical symptom.It is a good curative method for lumbar vertebrae instability.

Objective To evaluate the heart function of patients who had diastolic dysfunction.Using heart failure echocardiography index(HFEI),which synthesizes the multinomial parameter of echocardiography.The aim is to provide an impersonal,comprehensive and numerable criterion for appraising chronic congestive heart failure.Methods Totally 75 patients with diastolic dysfunction and 37 normal controls were involved in the study.All the subjects were graded by heart failure echocardiography index(HFEI)which was put forward by our hospital and the multinomial parameter of echocardiography was synthesized.At the same time,the scores of heart failure echocardiography index(HFEI)were compared with the outcomes of contemporaneous BNP and the NYHA class.Results The scores of heart failure echocardiography index(HFEI)in diastolic dysfunction group were higher than those in control group(P

Objective To evaluate the efficacy of retroperitoneoscopic radical nephrectomy.Methods From October 2001 to September 2006,a total of 108 patients underwent retroperitoneoscopic radical nephrectomy in our department.The tumors sized 1.0-8.0 cm in diameter with a mean of(4.3?2.9)cm.Before the operation,42 patients were in stage T1N0M0,54 in stage T2M0N0,and 12 in stage T3aN0M0.Results The operation time was 35-180 min with a mean of(63.5?30.3)min,and the blood loss was 20-1500 ml [mean,(75?23)ml].Totally 3 patients were converted to open surgery.The intra-and postoperative complications included hemorrhage caused by the injury of the inferior vena cava or renal artery(4 cases),wound infection(3 cases),and hypercapnia(8 cases).The patients were followed up for 6-36 months(over 12 months in 61 cases),during which 2 patients died of pulmonary metastasis one year after the surgery,1 patent died of liver metastasis 7 months after postoperation,the other 105 patients survived without tumor.The 1-year survival rate was 98.4%(60/61);and 3-year survival rate was 85.7%(18/21).Conclusions Retroperitoneoscopic radical nephrectomy is mini-invasive and effective for renal carcinoma.The patients recover quickly after the surgery.The procedure is worth being wildly used.

Objective To study the mechanism of Ulinastat’s enhancement for antibiotics’curative effects in sepsis Children caused by bacteria. Methods Children with sepsis caused by bacteria were treated with Ulinastat combined with antibiotics (UTI group) and antibiotics only (CON group), The curative effects, GSC scores and APACHEⅡscores in two groups were observed and compared, pre-and post-therapy serum procalcitonin and inlfammatory factors were detected and compared. Results The efifciency rate and GSC score in UTI group were signiifcantly higher than in CON group (P<0.05), but lower in mortality and APACHEⅡscore (P<0.05). hs-CRP, TNF-α, IL-6 and IL-8 of UTI group in one week, two weeks and three weeks post-therapy were signiifcantly lower than in CON group (P<0.05), while IL-10 was higher(P<0.05). Conclusion The Ulinastat can signiifcantly increases antibiotics’curative effects for sepsis Children caused by bacteria though lowering down serum PCT, hs-CRP, TNF-α, IL-6 and IL-8 and increasing IL-10.

Objective:To compare short-term and long-term curative effect of modified double Kirschner wire open reduction and internal fixation (ORIF) and traditional surgery on patients with mallet fingers of avulsion fracture type.Methods:Eighty-five patients with mallet fingers of avulsion fracture type who were admitted to Yongkang Orthopaedic Hospital from January 2016 to October 2018 were enrolled. 45 patients received modified double Kirschner wire ORIF were included in the observation group, while 40 patients who underwent traditional extracting wire fixation were included into control group. The operation time, fracture healing time and complications were recorded. At 3 months after surgery, short-term curative effect was evaluated. After 1-year postoperative follow-up, long-term prognosis was evaluated by finger joint function scoring.Results:The operation time of observation group was shorter than that of control group ( P<0.05). The fracture healing time of observation group was shorter than that of control group ( P<0.05). The good rate of observation group was higher than that of control group (93.33% vs 77.50%) ( P<0.05). In finger joint function score, scores of finger strength, finger flexibility, effects on work and life, and total score in observation group were higher than those in control group ( P<0.05). There was no significant difference in pain degree or appearance satisfaction betwen the two groups ( P>0.05). There was no significant difference in incidence of postoperative complications between the two groups ( P>0.05). Conclusions:The modified double Kirschner wire ORIF for the treatment of avulsion fracture mallet finger has the advantages of simple operation, fast fracture healing and better long-term and short-term curative effect than the traditional wire extraction method.

Objective To investigate serum NK cell levels in HBeAg positive early pregnancy women with immune activation.Methods Fifty four HBeAg positive pregnant women admitted in Taizhou People's Hospital from September 2010 to April 2013 were enrolled in the study.Among them,the serum HBV DNA load decreased ≥2 log at 12 weeks after pregnancy in 24 cases (immune activation group) and HBV DNA did not decrease in 30 cases (immune tolerance group).The serum level of alanine aminotransferase (ALT),total bilirubin,HBeAg,HBV DNA load and NK cells were measured.Results At week 12 of gestation,the mean ALT levels and ALT abnormality rate in immune active group were higher than those in immune tolerance group [(146.7 ±93.1) vs.(44.1 ± 14.7) U/L,t =2.95,P＜0.05,50.0％ vs.6.7％,x2 =4.97,P ＜0.05].There was no significant difference of HBeAg level between two groups before pregnancy,while HBeAg level in immune activation group was lower than that in immune tolerance group at week 12 week of gestation [(291.8 ± 170.5) vs.(443.7 ± 289.9) S/CO,t =2.81,P ＜0.05].The percentage and absolute number of NK cells in immune activation group were higher than those in immune tolerance group [(26.7 ±9.1)％ vs.(17.1 ±7.8)％,t =2.52,P ＜0.05 and (370.9 ±136.4)/μl vs.(213.2 ±97.8)/μl,t =2.38,P ＜0.05,respectively].Conclusions In HBeAg positive early pregnant women with immune activation,the inhibition of HBV DNA might be associated with the activation of NK cells.

Objective To investigate the expressions of Ki67,p53,CKL,EMA,S-lOO,NSE,CgA,Syn,CEA and nm23 in adrenal tumors and their clinical significance.Methods Clinical data from 157 cases of adre-nal tumor patients were retrospectively reviewed including the clinical informa-tion and pathology data.Expressions of Ki67,p53,CKL,EMA,S-100,NSE,CgA,Syn,CEA and nm23 proteins were studied by immunohistochemistry(SP method)using monoclonal antibodies,and the relationship of their expressions with histopathologic type and clinical imformation was analyzed with SAS v6.12 software.A P value of＜0.05 was considered statistically significant.Results A increase of the expression rate of CKL,S-100,NSE,CgA,Syn and nm23 in adrenal tumors was obsered(P＜0.05).For univariate analysis,the expression of S-100,CgA,Syn was in connection with histopathologie types(P＜0.05).The expression of S-100,CgA,Syn had positive correlation with each other.The expression of CKL,S-100,NSE,CgA,Syn,nm-23 was no difference between adrnalbenign tumors and malignant tumors(P＞0.05),but it was much higher than in normal adrenal tissues(P＜0.05).The expression of Syn in adrenal cortical adenomaa was higher than in adrenal cortical cancers(P＜0.05),the expression of Ki67 in adrenal cortical adenomas was much lower than in adrenal cortical cancers(P＜0.05).The expression of EMA、CKL in adrenal cortical tumors were higher than in adrenal medullary tumors(P＜0.05),the expression of S-100,Syn,NSE,CgA in adrenal cortical tumors were lower than in adrenal medullary tumors(P＜0.05).Conclusions CKL,S-100,NSE,CgA,Syn and nm23 were good markers for adrenal tumors,they could be use for the adrenal tumors diagnosis.Detect Syn and Ki67 simutaneously was helpful to the diagnosis of adrenal cortical tumors.Detect EMA,CKL,S-100,Syn,NSE and CgA simultaneously and combine with clinical data was helpful to diagnosis between adrenal cortical tumors and adrenal medullay tumors.In malignant tumors,blood pressure had positive correlation with the expression of CgA,the size of tumor had neg-ative correlation of blood pressure,no prognostic factor was found.

Warfarin is a well-accepted drug used for preventing thromboembolic diseases. It is important to monitor the dosage of warfarin. Prothrombin time is one of the screening tests of extrinsic coagulation path,which is the first choice to monitor the oral use of warfarin. Standardized prothrombin time, namely international normalized ratio ( INR ) is used to adjust warfarin dosage in clinical practice. Many herbal medicines and foods may enhance the effect of warfarin therapy,and some of them may weaken this effect,which can result in severe clinical complications.