Objective To investigate the risk factors and outcomes of uteroplacental apoplexy complicating severe placental abruption in order to enhance the accuracy of early diagnosis and decrease the complication of mother and fetus.Methods A retrospective study of clinical data was conducted in 180 cases of placental abruption complicating uteroplacental apoplexy in 58 cases who delivered in the First Central Hospital of Tianjin from January 2007 to December 2011.Risk factors,clinical characteristics and outcomes were compared between the 58 cases complicating uteroplacental apoplexy (experimental group) and the other 122 cases without complicating uteroplacental apoplexy (control group).Results The incidence of placental abruption was 1.3％ (180/14 333),with the rate of uteroplacental apoplexy complicating placental abruption was 0.4％ (58/14 333) of all deliveries and 32.2％ (58/180) of all abruption cases.The duration of disease was significantly longer and the rate of placenta implanted on the posterior wall of uterus was significantly higher in the experimental group (9.14 ± 8.47) h; 63.9％ (23/36)) than in control group (5.88 ±4.31) h; 43.4％ (36/83)) (t =3.426,x2 =6.461 ; P ＜ 0.05).There were significant differences between the experimental group (12.1％,12.1％,13.8％ and 60.3 ％) and the control group (2.5 ％,2.5 ％,0.8％ and 11.5 ％) in postpartum hemorrhage,DIC,acute renal failure and stillbirth (x2 =6.919,6.919,13.929 and 47.388 respectively,P ＜ 0.05 or P ＜ 0.01).Conclusion Long duration of disease and posterior-wall placenta are risk factors for uteroplacental apoplexy complicating placental abruption which may lead to a poor maternal-fetal prognosis.

1 cm. Postoperative pathological findings showed negative cut surface. No hemorrhage or bile leakage were seen after operation. The abdominal drainage tube was indwelled for 3~4 d. The postoperative hospital stay was 3~5 d. Follow-up checkups for 1~20 months (mean, 12.5 months) revealed no tumor recurrence or incision implantation. All the patients survived. Conclusions Laparoscopic regular hepatic left lateral lobectomy can be carried out safely and effectively in clinically selected patients.

Objective To reveal the hepatitis A vaccine (HepA) coverage among pre-school children in Shandong province before Hepatitis A vaccine was introduced to the EPI and to provide evidence for improving the strategy for hepatitis A control.Methods A cross-section survey was conducted among children aged between 2 and 6 years old in Shandong province in March 2008.The study population was selected by random sampling method and HepA immunization history was obtained by immunization record or recall.Results 78.90% had received one dose of HepA at least.The coverage rate decreased with age and the differences in three age groups were statistically significant (x 2 =11.54,P=0.02).The coverage rates among the boys and girls were 77.67% and 80.30% respectively,the difference was not significantly(x 2 =1.17,P=0.28).The HepA coverage rates among the children living in the eastern areas and in the richer areas were higher than the centrale and western areas and poverty areas,the difference has statistic significance (x 2 =27.25,58.17,P

Objective To evaluate the therapeutic effect and safety of Huangqi Danshen Drop Pill (HDP) for angina pectoris (AP) due to coronary heart disease (CHD) classified as qi- deficiency and blood- stasis syndrome. Methods A multi- center, randomized, double- blind, double- simulation, positive- controlled, parallel group trial was adopted. 209 cases of AP due to CHD classified as qi- deficiency and blood- stasis syndrome were enrolled in this study: 104 in HDP group and 105 in Yangxinshi Tablets group. Results The markedly effective rate was 43.27 % , total effective rate 86.53 % , and total effective rate in improving TCM symptoms 92.31 % in HDP group, which were better than those in Yangxinshi Tablets group(P

Intertrochanteric fracture,a common kind of injury in orthopaedic surgery,often requires surgical intervention,especially the unstable ones.Since far back in 1995,Baumgaertner et al.recommended using the distance between the screw tip and femoral head apex (tip-apex distance,TAD) as a predictor of the risk of lag screw cutout,the importance of TAD has been recognized by orthopaedic surgeons.This concept has been widely accepted in practice,and even used as a standard in determining the helical blade position.It is not clear,however,whether the helical blade system is equal to lag screws in terms of TAD.After the limitations of TAD had been reported,Kuzyk et al.proposed a tip-apex distance referenced from the calcar (Cal-TAD) as a predictor of lag screw cutout to improve the concept further.In this article,these concepts and the latest clinical applications of TAD and Cal-TAD are reviewed based on the publications available.

Eight-year medical program is a new style of medical education and a necessary trend of economic rapid development.In China,the clinical skill training system for eight-year medical students is exploring.Early contact with clinical practice,application simulation medicine and holding reading lecture were used for eight-year medical students of grade 2004 in pediatric clinical clerkship and were confirmed to have better effect.

Objective:Venous indwelling needle has been widely used in clinical treatment as a replacement of scalp acupuncture, and keeps constantly upgrading. Emergency use and nutrient supply by intravenous infusion through venous indwelling needle. The article discusses venous indwelling needle in clinical treatment for dermatological patients. Methods:It compares different complications through two different puncture and sealing methods of venous indwelling needle. Results:It summarizes highly possible complications during and after operating venous indwelling needle, and it proves that the latest puncture and sealing methods of venous indwelling needle could be better for those patients with skin damage, according to the different states of their skin and vein. Conclusion:For dermatological patients, their skin and vein could be protected effectively through the latest clinical methods of venous indwelling needle. The occurrence of many complications and patients’ pain could also be reduced.

AIM:We conducted an evaluation of clinical data with meta analysis to investigate the preventive effect of 5-aminosalicylic acid (5-ASA) on inflammatory bowel disease ( IBD)-associated colorectal cancer ( CRC) or dys-plasia (Dys) (IBD-CRC/Dys).METHODS: The information was retrieved from the main databases such as PubMed, Web of Science, the Cochrane Library, etc.All full-text articles about the prevention of IBD-CRC/Dys by 5-ASA were in-cluded if they conformed to the standards.The odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. According to the types of IBD and the treatment course, the subgroup analysis was conducted, respectively.RESULTS:Fifteen articles were selected, including 5 038 IBD patients.Pooled analysis showed a protective association between 5-ASA and IBD-CRC/Dys (OR=0.53, 95%CI:0.37~0.76).Among them, both ulcerative colitis patients (OR=0.45, 95%CI:0.27~0.77) and Crohn disease patients ( OR=0.39, 95% CI:0.16~0.97) with 5-ASA therapy were less likely to develop CRC/Dys compared with those without 5-ASA treatment.5-ASA treatment for 1~20 years shows a pre-ventive benefit (OR=0.43, 95%CI:0.25~0.74).However, a minimum 5-ASA exposure of 2~6 months did not show a preventive benefit (OR=0.59, 95%CI:0.26~1.34).CONCLUSION:5-ASA protects against CRC/Dys in IBD pa-tients.Additionally, the protective effect is treatment time dependent.Treatment course for 1~20 years shows an evident preventive benefit.

Objective To investigate the clinical efficacy of Ilizarov bone transport combined with dressing change in the treatment of acute tibial osteomyditis accompanied with massive soft tissue defection.Methods From July 2009 to september 2012, 14 patients with acute tibial osteomyelitis associsted with large-area soft tissue necrosis and defection were treated in Traumatic Orthopaedics Department of the Central Hospital of Binzhou.All cases were Gustillu Ⅲ type open fracture, and Ⅲ C type injury in 11 casas accompanied with vascular injure.Associated with contralateral lower limb in 4 casas.They were 10 male and 4 female,aged from 21 to 45 years old(average age of 35 years old).The duration from injury to surgery ranged from 12-24 days,averaging of 19 days.All cases were treated first with excision of the infected or necrosis bone segment and soft tissue.The wound keep opening, followed by llizarov bone transport combined with dressing change to repair the bone and soft tissue defection.The clinical efficacy was assessed using the Paley's evaluation system at the last follow-up.Results All the patients were followed up for 24 to 36 months (average of 27 months).The bone defection rapaired was from 5 to 1 3 cm(average of 7 cm).The mean duration of distraction was 4 months, range from 2 to 6 months.All cases' gain s.ufficient soft tissue coverage the later period of Ilizarov bone transport.All the fracture and bone defection were cured.Infection were cured in 13 cases, and 1 case converted to chronicle osteomyelitis, and the cure rate was 93％.According to the Paley' s system, the bone union was excellent in 11 cases, good in 2 cases, and fair in 1 Cases, with a good-to-excellent rate was 93％.The functional outcome was excellent in 10 cases,good in 2 cases,and fair in 2 cases,with a good-to-excellent rate of 86％.Conclusion Ilizarov bone transport and dressing change is one reliable and effective treatment of tibial acute infected and soft tissue defection.