Objective To compare the clinical efficacy of transvaginal hysterectomy(TVH) and laparoscopic-assisted vaginal hysterectomy(LAVH).Methods The study retrospectively analyzed 75 cases of TVH(TVH Group) and 69 cases of LAVH(LAVH Group) from January 2004 to October 2004.All the patients were diagnosed as having benign uterine diseases,without uterine prolapse and less than 20 gestational weeks.Results Compared with the LAVH Group,the TVH Group had a shorter operative time(83.6?19.4 min vs 133.7?48.1 min;t=-8.317,P=0.000),less blood loss(116.4?55.3 ml vs 186.1?292.1 ml;t=-2.028,P=0.000),and lower total cost of operation(4733.27?577.81 yuan vs 7471.30?1042.17 yuan;t=(-19.702),P=0.000).There was no significant difference in the incidence of postoperative pyrexia between the TVH Group(4.0%,(3/75)) and the LAVH Group(8.7%,6/69)(?~2=0.670,P=0.413).Conclusions As compared with laparoscopically assisted vaginal hysterectomy,transvaginal hysterectomy has shorter operative time,less blood loss,and lower cost of operation.

Objective To explore the management alternatives to tr aumatic periprosthetic femoral fractures after hip replacement. Metho ds A retrospective analysis was done on five cases of traumatic perip rosthetic femoral fractures posterior to hip replacement admitted in from June 1 998 to June 2003. There were two males and three females, with age range of 52- 71 years (average 59 years). One case suffered from traffic accident and the oth er four from slipping. Three cases had received hip replacement for femoral head aseptic necrosis, the other two for femoral neck non-union. Total hip replacem ent was carried out in four cases (five hips) and femoral head replacement in on e. These traumatic periprosthetic fractures occurred from one month to 17 years after hip replacement. According to classification to periprosthetic fracture of Vancouver (1995), there were 3 cases of type B and 2 type C. Two cases (one cas e of type B and one type C) were treated with traction and conservative treatmen ts, two (type B) with long shaft prosthesis revision combined with shape memory saw tooth embracing fixator or wires and one (type C) with anatomical plate inte rnal fixation. Results All 5 cases were followed up for f rom two months to five years and attained fracture union with no complications s uch as infection, nonunion or fixation breakage. Conclusions Traumatic periprosthetic femoral fractures after hip replacement are hard to deal with. The management alternatives differ according to fracture site, prost hesis loosening, bone quality and general status of patients. Classification cri teria and corresponding managements of periprosthetic fractures of Vancouver are proved to be suitable guidelines.

Child ; Coronary Aneurysm ; diagnostic imaging ; physiopathology ; Coronary Thrombosis ; diagnostic imaging ; physiopathology ; Coronary Vessels ; diagnostic imaging ; physiopathology ; Female ; Humans ; Mucocutaneous Lymph Node Syndrome ; complications ; diagnosis ; diagnostic imaging ; physiopathology ; Ultrasonography, Doppler

ObjectiveTo analyze the sickbed setup and utilization in the general rehabilitation center and offer gists for strengthening hospital optimize project of sickbed setup.MethodsThe factual sickbed demand, standard sickbed demand and the ratio of confessing and requiring were counted and analyzed.ResultsThe sickbed turnover times of the internal medicine and ICU were accord with request, but the rate of sickbed utilization was higher, the sickbed utilization rate of the other section offices were higher. The sickbed turnover times were lower compared with control lever.ConclusionThe hospital manager should take some measures for optimize sickbed setup, and strengthen manage to improve the medical quality.

Objective To investigate the relationship between serum leptin(LP) level and glycometabolism in pregnancy with abnormal glucose challenge test(GCT) and the corresponding outcome of pregnancy. Methods Serum LP level,fasting serum insulin(FINS) and fasting blood glucose(FBG) levels were measured by radioimmunoassay in 23 patients with abnormal GCT but normal oral glucose tolerance test(OGTT),20 with impaired glucose tolerance(IGT),20 with gestational diabetes mellitus(GDM)(studied groups above) and 30 normal pregnant women(control group).LP,FINS,FBG, insulin resistance index(HOMA-IR) and ?-cell function index(HOMA-IS) were compared among the groups and the outcomes of pregnancy were observed. Results ①There were significant differences in LP,FINS,FBG,HOMA-IR and HOMA-IS between the studied groups and the control group(P0.05).③There were signi-ficant differences in the gestational weeks of delivery,cesarean section rate and neonatal weight between the studied groups and the control group(P0.05). Conclusion Both insulin secretion and insulin resistance are elevated in pregnancy with abnormal glycometabolism,and are closely correlated to the increased serum level of LP.There existed abnormal glycometabolism in patients with abnormal GCT but normal OGTT,which is correlated to the outcome of pregnancy.

Objective To study the effect of low-dose FK778 in preventing chronic renal al- lograft rejection in rats.Methods The rat model of chronic renal allograft rejection was established by using micro-surgery technique.The recipients were divided into two groups.The recipients in the study group were treated with FK778 at a dose of 5mg?kg~(-1)?d~(-1)dissolved in carboxymethylcellulose by means of gavage and the controls were treated with carboxymethylcellulose.Urinary protein con- centrations were measured every 4 weeks for 24 weeks.On 24th week after operation,the rats were killed and the kidney grafts were taken out for histological and immunohistological examinations as well as quantitative real-time RT-PCR analysis.Results After 24 weeks of treatment,proteinuria, the severity of chronic rejection,glomeruIosclerosicytes and monocytes/macrophages in the study group were significantly milder than in control group.And the expression of TGF-?mRNA and PDGF-B mRNA was significantly reduced in the study group as compared with that in the control group.Conclusion Low-dose of FK778 might prevent the rats from chronic renal allograft rejection.

Objective To explore the effect of the thyroid morphologic change,the initiating treatment time and the thyroid function(serum FT_4,TSH)on mental development in children with congenital hypothyroidism (CH).Methods After diagnosed,52 cases of CH were orally administrated with L-T_4,then their mental and physical development were monitored and thyroid morphologic changes were observed by thyroid imaging(~(99m)TcO_4) and type B ultrasonography.The Bayley test was performed at the age of 10 to 30 months and expressed as mental developmental index(MDI)and psychomotor developmental index(PDI).Analysis was conducted upon treatment timing and thyroid morphologic changes.Results The MDI in those cases with morphologic abnormalities treated within 90 days was significantly lower than that with normal morphology(91?20 vs 105?15,P

Objective To analyze the clinical characteristics, risk factors and prevention measures of nosocomial infection in senile patients with hematologic disorders. Methods The clinical data of 581 senile patients with hematologic disorders from July 2005 to June 2007 were retrospectively analyzed. Results The nosoeomial infection rate was 30.5%(177/581). The 581cases developed nosocomial infection for 254 times [43.7% (254/581)]. Lower respiratory tract infection was the most frequent infection site, followed by intestinal infection and upper respiratory infection. The species were predominated by Gram-negative bacillus (67.1%) . The risk factors of nosocomial infection were non-remission of malignant diseases,chronic underlying diseases, long time hospitaliation, community infection, granulocytopenia, invasive manipulation and application of adrenocortical hormone and antibiotic. Conclusions The nosoeomial infection rate is high in senile patients with hematologic disorders and it can be decreased by taking prevention measures according to the risk factors.

Objective To investigate the influence of indomethacin to the unite treatment effect on chronic phase myeloid leukemia (CML-CP) with interferon alpha-2b (IFNα-2b) and low dose cytarabine (LD-Ara-C).Methods 22 CML-CP patients were randomly divided into two groups.Control groups (10 cases) injected with IFNα-2b (3 million units),injection frequency was q.o.d,the duration of treatment was about 3-18 months,cytarabine (Ara-C) by slowly intravenous driped (30 mg/d).In this treatment schedule,every course of treatment sustained 10 days,and with a 2 weeks interval.During this process,patients in treatment group were treated with hydroxyl urea only when their WBC in peripheral blood exceed 20×109/L,otherwise,discontinue it.Treatment group (12 cases),on the first day of treatment with IFNα-2b and Ara-C,added indomethacin (25 mg) through oral administration,the frequency was t.i.d.During treatment in the two group,the end point of observation was completely hematology ease,at the same time,these indicators in the two groups needed to be compared,the time when WBC begin to fall,the time when WBC fall to normal range,the time when immature cells returned to normal,the time which complete hematological remission and the highest temperature of patients after IFNα-2b was subcutaneous injected.Results The time when WBC begin to fall in treatment group was (4.2±2.7) d,and the time was (5.0±2.5) d in control group (t =0.714,P ＞ 0.05).In treatment group,the time when WBC fall to normal range was(10.0±4.5) d,and the time was (12.0±4.5) d in control group (t =1.036,P ＞ 0.05).The time when immature cells returned to normal in treatment group was (14.2±4.8) d,and the time was (19.0±3.6) d in control group (t =2.609,P ＜ 0.02).The time which complete hematological remission was achieved in control group was (45.8±5.6) d,but it was (53.9±10.5) d in control group (t =2.314,· P ＜ 0.05).Meanwhile,the fever degree after IFNα-2b was subcutaneous injected obviously achieved improvement in treatment group (x2 =12.041,P ＜ 0.005).Conclusion The advantage of indomethacin to the unite treatment with IFNα-2b and LD-Ara-C on CML mainly lays in which cound alleviated the adverse reaction such as flu-like of IFN,and more,there are synergy effect in antagonist CML.

Background & Objective: Early life stresses, such as social isolation, have lasting effects on the development of emotion and behavior, in which vasopressin plays important roles. This study aimed to assess the possible association of central release of vasopressin with social isolation. Methods: The social isolation model was performed in male mice who endured 6-week social isolation after weaning. Vasopressin expression in the paraventricular nucleus of hypothalamus (PVN) was measured with immunohistochemistry. Released vasopressin from PVN was measured with radioimmunoassay. Results: Vasopressin immunoreactive cells number decreased in the PVN, medial parvocellular division in social isolation-reared mice, compared to the group-reared counterparts. Social isolation decreased short social exposure-induced vasopressin release from PVN. Isolation-reared mice exhibited anxiogenic profile and difficulty in social recognition. Conclusions: This study provides new evidence for the important role of vasopressin in the development of emotional and social behaviors.