Objective To investigate the clinical curative effect of laparoscopic surgery assisted gonadotropin-releasing hormone agonist ( GnRH -a ) goserelin in the treatment of the severe ovarian endometriosis ( OEM ) . Methods The clinical data of 300 patients with severe OME who received the laparoscopic conservative surgery were retrospectively analyzed.The patients were divided into three groups according to whether assisted the postoperative drug treatment:goserelin group 100 cases, gestrinone group 100 cases, no drug group 100 cases.All patients were followed up for 2 years,the relief situation of pelvic pain,the recurrence rate,pregnancies situation of the patients who had fertility requirements and drug adverse reaction were observed.Results ( 1 ) The pelvic pain remission rates of the GnRH-a group,gestrinone group and no drug group were 98.0%,89.0%,74.0% respectively,the GnRH-a group,gestrinone group were obviously higher than that of no drug group,the differences were statistically significant (χ2 =4.723,4.182,all P<0.05).Goserelin group and the gestrinone group had no statistically significant difference (χ2 =2.012,P>0.05).Follow-up 2 years,the recurrence rates of the goserelin group,gestrinone group and no drug group were 6.0%,14.0%,29.0% respectively,the goserelin group was significantly less than gestrinone group and the no drug group,the gestrinone group was lower than that of the no drug group,the differences were statistically sig-nificant (χ2 =4.982,4.667,all P<0.05).(2)The natural pregnancy rates of the goserelin group,gestrinone group and no drug group were 35.9%(14/39),34.2%(13/38),25.0%(10/40) respectively,there were no statistically significant differences among the three groups(χ2 =1.374,P>0.05).(3)The incidence rate of the tidal fever and night sweating of the goserelin group was higher than the gestrinone group,the incidence rate of the vaginal bleeding, acne and elevated aminotransferase was lower than that in gestrinone group, with statistically significant differences (χ2 =5.028,4.876,4.394,4.876,all P<0.05).Conclusion The laparoscopic conservative surgery assisted gose-relin in the treatment of severe OME can improve the treatment effect,reduce the postoperative recurrence rate,and have less adverse reaction,but cannot increase natural pregnancy rate.

Objective Polycystic ovary syndrome(PCOS)is the common endocrine diseases of reproductive age women and is characterized by obesity clinically.TCMholds that the fat is more likely to have phlegm -dampness constitution.So there is a close correlation between each other.This article mainly from the perspective of phlegm wet treatment fueling PCOS research.

TCM gel paste is a new transdermal medicine delivery system, with a lot of advantages, which has been widely used in clinic. By searching domestic research literature about TCM gel paste in recent years, this article reviewed from patent overview, matrix, transdermal absorption enhancer, preparation technology, quality evaluation, clinical efficacy and safety, problems and prospects, with a purpose to provide references for clinical medication of TCM gel paste.

Objective To investigate the effective mechanism, time and rational dose of radiotherapy of epileptic rat. Methods To make rat model of epilepsy, and give 0, 24,12 or 6Gy X ray irradiation, and then detect the amino-acid contents in frontal lobe of those rats in 1 hour, 24 hours or 1 week after radiotherapy. Results Glu and GABA are the key amino-acids in radio effection. After 12Gy or 24Gy irradiation there were low Glu, high GABA and low Glu/GABA in frontal lobe of rat. After 1h, 24h and 1 week irradiation, the contents of GABA raised up while the ratio of Glu/GABA declined with a remarkable decline at 24h. Conclusions Radiotherapy to epileptic rat may set off a rapid and enduring change of GABA and Glu transmitters, and 12Gy may be the rational radio dose for epileptic rat.

Objective To investigate the clinical significance of central venous oxygen saturation (ScvO2) monitoring in the patients after cardiac operation.Methods Fifty patients after cardiac operation were randomly selected into this study.After the patients entered ICU 2 h,ScvO2,mixed venous oxygen saturation (S(v)vO2),lactate (Lac) were detected at the same time and oxygen extraction rate (O2ER) was calculated.Fifty patients were divided into three groups according to the level of ScvO2,group A (ScvO2 ＜0.65,23 patients),group B (ScvO2 0.65-0.75,18 patients),group C (ScvO2 ＞ 0.75,9 patients).The correlation among ScvO2,S(v)vO2,O2ER were analyzed.The correlation between ScvO2 and Lac in each group were calculated.The level of Lac in three groups were compared.The incidence rate of complications,ventilator time and ICU stay time were compared.Results The level of ScvO2,S（v）O2,O2ER,Lac in 50patients were 0.656 ±0.086,0.639 ±0.081,0.356 ±0.084,(2.6 ± 1.3) mmol/L.The level of ScvO2 had significantly positive correlation with S(v)O2 (r =0.688,P ＜ 0.01),and had significantly negative correlation with O2ER (r =-0.640,P ＜0.01).In group A,the level of Lac had significantly negative correlation with ScvO2 (r =-0.772,P ＜ 0.01).In group C,the level of Lac had significantly positive correlation with ScvO2 (r =0.717,P ＜ 0.05).In group B,the level of Lac had no significant correlation with ScvO2 (r =-0.358,P ＞0.05).The level of Lac in group A and group C was significantly higher than that in group B [(2.0 ± 0.9),(4.8 ±2.1) mmol/L vs.(1.6 ±0.5) mmol/L] (P ＜0.05 or ＜0.01).The incidence rate of hyoxemia,low cardiac output syndrome and renal functional lesion in group A were significantly higher than those in group B (P ＜ 0.05).The incidence rate of liver functional lesion and renal functional lesion in group C were significantly higher than those in group B (P ＜ 0.05).The ventilator time and ICU stay time in group A andgroup C were significantly longer than those in group B (P ＜ 0.05).Conclusions ScvO2 is an ideal index to judge oxygen equilibrium in early period after cardiac operation.The lower and supranormal ScvO2 both suggest tissue hypoxia,resulting in increased postoperative complications and prolonged treatment.

Objective To explore the feasibility of laparoscopically assisted one-stage anorectoplasty for the treatment of intermediate imperforate anus. Methods Under laparoscopic visualization, the rectum was mobilized. Then the rectourethral (or rectovaginal) fistula was repaired laparoscopically (6 cases) or through perineal approach (4 cases). Afterwards a tunnel was made through the center of pelvic floor musculature by combined use of laparoscopic and perineal approach. The rectum was pull-through the perineum and anastomosed with skin. At Last the colostomy was closed. Results Laparoscopically assisted anorectal pull-through was successfully performed in all cases. The mean duration of laparoscopic dissection was 32.8 minutes (range, 25~78 minutes). The mean blood loss was 5.3 ml (range, 2~10 ml). No blood transfusion was needed. The intraurethral catheter or cystostomy tube was removed on the 11th postoperative day. No intraoperative complication was encountered and all infants had uneventful postoperative recovery without wound infection. During a follow-up for 3~66 months (mean, 45 months), the fecal continence evaluation showed excellent in 8 cases and good in 3 cases. Conclusions Laparoscopically assisted anorectoplasty is an effective and minimally invasive technique for the treatment of intermediate imperforate anus. This technique has advantages of simple performance, accurate identification of the center of the pelvic floor musculature, and low infection rate.

Objective To explore the relationship between human papilloma virus(HPV)andUreaplasma urealyticum (UU)in-fection in women.Methods A total of 412 outpatient women were checked for 23 HPV DNA types by PCR-RDB.The patients were divided into observation group with HPV infection and control group(random selection 50 cases without HPV infection).UU was detected by real-time quantitative PCR in two groups.Results The HPV positive rate was 12.86%(53/412).16 of 23 HPV types were detected.HPV52 was the most common type.The positive rates of UU for observation group(60.38%,32/53)was sig-nificantly higher than control group(30.00%,15/50),P <0.05.Conclusion The reproductive tract HPV infection in women is re-lated to UU infection.It should be paid attention to in the clinical treatment.

OBJECTIVE:To assess the feasibility of production and effects of Tobramycin eye drops prepared in this hospital for treating ocular infections .METHODS: 77 patients with external ocular infections were randomly divided into two groups with imported Tobrex as control drug to compare the effects.Assessment was made according to Gwon project results.RESULTS: Overall improvement rates were 92.7% in Tobramycin eye drops group and 94.4% in control group without significant difference between two groups(P＞ 0.05) .CONCLUSION: The technology of Tobramycin eye drops production is simple, therapeutic effect is satisfactory, and the production in hospital is feasible.

Objective To summarize our preliminary experience and evaluate the clinical value of laparoscope diagnosis and treatment for annular pancreas in neonates.Methods A retrospective review of laparoscope diagnosis and treatment for annular pancreas in 9 children from September 2009 to January 2013 was performed.Among them,5 were male,4 were female.The age was ranging from 1 to 13 d.A lowerpressure pneumoperitoneum of 5 ～ 8 mm Hg (1 mm Hg =0.133 kPa) was used.Eight cases of diamond duodenal anastomosis were performed under laparoscope after the diagnosis was established,and 1 case underwent procedure through slightly enlarged umbilical port site.Results Eight cases of diamond duodenal anastomosis were performed under laparoscope,and the operation time was 80 ～ 140 min (mean 105 min),in 1 case it was performed through umbilical port incision,the operation time was 64 min,and the length of incision was about 2.5 cm.Feedings were started at postoperative day 4 to 7 (mean 5 d),and patients were discharged at postoperative day 8 to 14 (mean 10 d).The cases were followed-up for 3 ～ 20 months (mean 6.7 months),and I case complicated with anal atresia died of pneumonia 6 months later.Other cases were uneventfully recovered and symptoms were alleviated with normal gastroenterological function,no preoperative symptoms recurred,and the nutrition and growth status was excellent.Conclusions Annular pancreas can be diagnosed through laparoscopy.Laparoscope diagnosis and treatment for annular pancreas has the advantages of small incision,micro-invasion and faster recovery,can be safely performed in neonatal period.

Objective To survey the CT radiation dose to cancer patients,and to compare it with diagnostic reference level (DRL) provided by newly issued national standard.Methods Computed tomography dose index weighted (CTDIw) of 5 CT equipments was measured by the standard phantom with typical scanning protocol and radiation dose parameters including average computed tomography dose index volume (CTDIvol),dose length product (DLP),75％ DLP with 900 adult and 300 pediatric cancer patients were collected.According to age stage,effective dose was estimated.Results The measured CTDIw for head scanning was on the same level with DRL,while lumbar vertebra and abdominal scanning were lower than DRL.To adults,DLP of cerebrovascular enhanced scanning and effective dose of abdominal enhanced scanning were the highest.To pediatric patients,there was no significant difference in DLP among different ages.Conclusion CTDI only reflects the dose contribution from a slice,but do not reflect the cumulative dose.For the patients need multiphase scanning,because they may be exposed to high dose,national standard should provide DLP value as the diagnostic reference level.Using individual scanning protocol is an effective method to reduce radiation dose of pediatric patient.