Objective To evaluate the clinical efficacy of laparoscopic surgery combined with GnRH agonist in the treatment of endometriosis. Methods From January 2008 to January 2012, 205 patients with endometriosis underwent conservative laparoscopy surgery in our hospital .According to whether the patients accepted the therapy of GnRH-a and the time of the treatment after surgery, patients were divided into three groups:group A was treated with conservative laparoscopic surgical (73 cases), group B was given GnRH-a for 3 months after surgery (68 cases), and group C received GnRH-a for 6 months after surgery (64 cases).These patients were followed up for 24 months after surgery .The recurrence rate and pregnancy rate were compared among the three groups . Results The postoperative recurrence rates within one year were 4.4%(3/68) in the group B and 3.1% (2/64) in the group C, which were all lower than that of the group A (13.7%, 10/73).There was no difference between the group A and B (χ2 =3.628, P=0.057), while the rate of group C was significantly lower than that of the group A (χ2 =4.771, P=0.029).The cumulative recurrence rates in the group B and C were respectively 13.2%(9/68) and 10.9%(7/64), which were significantly lower than that of the group A [27.4%(20/73); χ2 =4.322, P=0.038; χ2 =5.839, P=0.016].There were no differences about the natural pregnancy rate within 2 years postoperatively among the three groups (χ2 =0.812, P=0.666), but for those who underwent IVF-ET after laparoscopy, the pregnancy rates in group B and C were respectively 78.9% (15/19) and 80.0% (16/20), which were significantly higher than that of the group A [47.6% (10/21); χ2 =4.177, P=0.041; χ2 =4.630, P=0.031]. Conclusions Laparoscopic surgery combined with GnRH-a is highly effective in the treatment of endometriosis , which can effectively reduce the recurrence rate .Application of GnRH-a for 3-6 months after laparoscopic surgery can improve the pregnancy rate in those who accept the treatment of IVF-ET.

Objective To observe the variation of the levels of γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis before and after treatment.Methods A total of 159 patients with brucellosis were enrolled from the Second People's Hospital of Tianjin between September 2009 and August 2014,of which 122 were with acute phase and 37 with subacute stage.γδT cells,CD4+ and CD8+ T lymphocytes in peripheral blood of all patients before and after treatment were detected by flow cytometry.Thirty healthy controls were also enrolled.Measurement data were analyzed using t test and nonparametric Kruskal-Wallis test.Results The medians of γδT cells,CD4+ and CD8+ T lymphocyte counts of brucellosis patients with acute stage before treatment were 84.0/μL,780.5/μL and 774.0/μL,respectively,and those with subacute stage were 76.0/μL,887.0/μL and 890.0/μL,respectively.Those in control group were 49.0/μL,772.5/μL and 592.5/μL,respectively.γδT cells (U=114.5,P =0.001) and CD8+ T lymphocyte counts (U=1 185.5,P =0.003) in acute phase group were elevated than control group.γδT cells (U=359.0,P=0.013),CD4+ T lymphocyte counts (U=325.5,P=0.004) and CD8+ T lymphocyte counts (U=316.5,P=0.003) in subacute phase group were increased than control group.CD4+ T lymphocyte counts in subacute phase group were elevated than acute phase group (U=1 619.0,P=0.009).There were 31 patients with acute phase and 30 patients with subacute phase who completed 6-week treatment.γδT cells ([120.7 ± 104.9]/μL vs [82.2 ±85.3]/μL;t=3.568,P=0.001),CD4+ T lymphocyte ([802.1±300.6]/μL vs [663.0±280.6]/μL;t=2.904,P=0.007) and CD8+ T lymphocytes counts ([908.1±422.7]/μL vs [651.1±241.7]/μL;t=3.885,P=0.001) of brucellosis patients with acute stage before and after treatment were significantly different.γδT cells ([67.1± 38.4]/μL vs [48.4±32.1]/μL;t=2.695,P=0.012),CD4+ T lymphocytes ([817.1± 147.4]/μL vs [650.8± 196.5]/μL;t=5.301,P＜0.01) and CD8+ T lymphocytes counts ([703.7±191.5]/μL vs [537.4±186.0]/μL;t=5.152,P＜0.01) of brucellosis patients with subacute stage after treatment were significantly decreased compared with those of patients before treatment.Conclusions γδT cells,CD4+ and CD8+ T lymphocytes in patients with acute and subacute brucellosis are all in a state of immune activation.The levels of activation are highly correlated with disease progression.And detection of the variation of these cells contributes to understand the immune state of the acute and subacute brucellosis.

Objective To determine and compare the daily cost of various ophthalmic solutions for glaucoma in China. Design Investigative study. Participants The majority ophthalmic solutions for glaucoma available in our country were included in the research. Methods Five bottles of each solution were tested separately by five researchers. After the number of drops and the actual volume for each bottle were calculated, the mean number of drops per bottle and the mean volume per bottle were determined. The volume per drop was calculated by dividing the mean volume per bottle by the mean number of drops per bottle, and the cost per drop was calculated by dividing the market price by the mean number of drops in a bottle. The number of days for both eyes usage per bottle was calculated by dividing the mean number of drops in a bottle by the number of drops required daily for both eyes. The cost per day was calculated by multiplying the cost per drop by the number of drops required daily for both eyes. Main Outcome Measures The number of days for both eyes usage per bottle and the daily cost: for both eyes usage per bottle. Results 1. The volume per drop ranged from 0.027 ml(Lumigan) to 0.053 ml(Chengrui and 0.5%Zhenrui). 2. The cost per bottle ranged from 5.7Yuan(Malaisuan Saimaluo'er) to 338Yuan (Xalatan). 3. The number of days for both eyes usage per bottle ranged from 52d (Lumigan) to 12d ( Zhenrui). 4. The daily cost for both eyes usage from expensive to cheap were Xalatan 7.51Yuan, Travatan 6.30 Yuan, Lumigan 3.84 Yuan, Alphagan 3.36 Yuan, Dilijian 2.97 Yuan, Pailiming 2.83 Yuan, 2%Zhenrui 2.34 Yuan, Betagan 2.11 Yuan, Beiteshu 2.0 Yuan, 0.5% Zhenrui 1.49 Yuan, 2%Huming 1.29 Yuan, Mikelan 1.21 Yuan,1%Huming 0.85 Yuan, Chengrui 0.63 Yuan, Malaisuan Saimaluo'er 0.23 Yuan. Conclusions The daily cost of ophthalmic solution for glaucoma ranged wildly. These data may be useful in selecting ophthalmic solution for glaucoma therapy.

Objective To construct a home-care service package for the urban disabled elderly that satisfy their demands and improve the efficiency of service. Methods From August to October, 2014, a total of 285 disabled (mild, medium and severe) elderly from a cluster sampling were investigated with the self-designed questionnaire about home-care demands among them. An initiatory service package was drawn to meet the demands reported by 40% of them or above. The package was consulted by a group of 15 experts using Delphi method. Results The final service package included 11, 19, 20 items of care for the mild, medium and severe disabled elderly, respectively. Conclu-sion The disabled elderly home-care package in Zhengzhou has been created based on the demands among disabled elderly.

OBJECTIVE:To evaluate the quality of anticoagulant therapy in patients who took warfarin and provide data sup-porting for strengthening the management of these patients. METHODS:A retrospective analysis of related clinical data of 214 pa-tients who meet the inclusion criteria was performed. RESULTS:The average time for patients took warfarin was (321.64 ± 189.50)d,average times for tested INR was(12.01±7.03)times in clinic;when anticoagulant therapy,INR<2.0 accounted for 51.96%,2.0≤INR≤3.0 accounted for 39.13%,and INR>3.0 accounted for 8.91%;patients with target INR≤2.0 accounted for 45.33%,target INR=2.5 accounted for 38.32%,and target INR≥3.0 accounted for 0.93%;the average TTR was (50.80 ± 22.32)%;and there was no statistical significance in the TTR of different ages and diseases(P>0.05). CONCLUSIONS:The anti-coagulant therapy in some patients who took warfarin shows poor quality,it needs strengthening the quality management to make it safe and effective.

Objective To investigate the application of field work logs in collection of the disaster information in medical rescue of earthquake.Methods The self-designed work logs were made according to the condition of the wounded in the medical rescue of Lushan earthquake.Through the field work logs,we got first hand information which facilitate statistics,inquiry and subsequent follow-up work.Results By using the field work logs,the rescue workers guaranteed the collection of original data timely and accurately,supplied a number of rich and a-list clinical data and also facilitated the masses in disaster areas looking for their relatives.Conclusions The application of field work logs played a pivotal role in medical rescue of Lushan earthquake.It can be widely extended as a general manner in emergency disaster rescue after further perfection.

Objective To observe the expression of acid-sensing ion channel la (ASICla) and to investigate the effect of intracellular Ca2 + concentration on focal cerebral ischemia in diabetic rats.Methods 108 male Wistar rats were divided into three groups:group A [rats with middle cerebral artery occlusion (MCAO)],group B [rats with MCAO and diabetes (DM + MCAO)],group C [rats with MCAO and diabetes treated with fasudil intervention (DM+ MCAO+ fasudil)] (n=36 each).Samples were obtained at the time points of 1,3,6 and 24 h after ischemia respectively (n=9).Models of MCAO and DM+MCAO were prepared.Rats in DM+MCAO+Fasudil group were treated with fasudil 1 mg/Kg by caudal vein injection after half an hour when DM+MCAO model successfully prepared.ASICla expressions were detected at different time points of ischemia in the 3 groups respectively.Ca2+ concentration in ischemia cortex cells were determined at different time points of ischemia in group B and C.Results ASICla expressions were gradually increased along with the ischemia time in group A and B (group A:0.71±0.10,0.80±0.11,0.86±0.08,0.93±0.09;groupB:0.86±0.11,1.05±0.51,2.42±0.08,2.78±0.04; all P＜ 0.05),and ASICla expressions at different time points were higher in group B than in group A (all P＜ 0.05).Ca2-concentration were gradually increased along with the ischemia time in group B (106.32± 18.6,137.84±14.32,151.94± 18.38,183.61±7.96,all P＜0.05).Compared with group B,the levels of ASICla expression and calcium current were reduced in group C.Conclusions The activation of ASICla increases calcium ion flow internal pathway leading to intracellular calcium overload,which may be one of the reasons for the aggravation of focal cerebral ischemia in diabetes.

Objective To explore the effect of video-based teaching of Lamaze method on delivery among primiparae.Methods One hundred and twenty pregnant women were randomly assigned to the intervention group and the control group with 60 in each.The intervention group received additional train-ing by using the video-based teaching of Lamaze method besides routine antepartum education,while the control group received only routine antepartum education.The cesarean section rate,labor course and neonatal asphyxia were compared between the two groups.Results The rate of natural delivery in the in-tervention group was significantly lower,and the rate of cesarean section caused by social factors decreased,which were all better than those in the control group.Neonatal asphyxia showed no difference between the two groups. Conclusions The video-based teaching of Lamaze method can promote natural delivery,shorten Labor course and worthy of wide application in pregnancy school.

The tumor necrosis factor receptor (TNF-R)-associated factor (TRAF )is an important of multifunctional intracellular signal transduction factors.TRAFs involve in signal transduction of many receptor families,including TNF receptor family (TN-FR),Toll-like receptors interleukin-1 receptors (TLR-IL-1R) family and so on.TRAFs play important roles in innate immunity and acquired immunity.TRAFs could directly or indirectly re-cruit the intracellular domains of receptors in the condition of ac-tivated receptor,which leads to the activation of transcription factors,such as NF-κB and interferon-regulatory factor (IRF), through signaling pathway.And TRAFs ultimately induce im-mune and inflammatory responses and involve in the development of inflammatory autoimmune diseases.

Objective To observe the effects of inhalation salbutamol combined with psychological intervention on the treatment of patients with severe asthma, and evaluate its clinical curative effect. Methods 162 cases with severe asthma were selected from February 2014 to February 2017 in hospital of traditional Chinese medicine in Zhoushan as the research object, which were randomly divided into the control group and the study group with 81 cases in each group. All patients were given nebulized salbutamol, the control group in the perioperative were given routine nursing intervention, at this basis, the study group were given targeted psychological nursing. The effect in the two groups was compared. Results The total effective rate in the study group was 91.36％ (74/81) was significantly better than that in the control group 76.54％ (72/81), the difference was statistically significant (P<0.05). After treatment, cough, shortness of breath, wheezing, chest tightness, lung wheezing were improved significantly , and all the symptoms in the study group was obviously better than those in the control group (P<0.05). Conclusion Aerosol inhalation of salbutamol combined with psychological intervention on the treatment of severe asthma patients has significant curative effect, which can significantly improve the clinical treatment effect, improve the clinical symptoms in a timely manner, and has the value of application and promotion.