Objective To study clinical effect of laparoscopy combined with gestrinone in treatment of ovarian endometriosis cyst and the prognoisi of patients. Methods A randomized, controlled, prospective study was used in this study, 78 patients with ovarian endometriosis cyst were selected in Sichuan province panzhihua city miyi people's hospital from august 2012 to august 2014, and were randomly divided into observation group and control group, 39 patients in each group. Patients in the observation group were treated with laparoscopy combined with gestrinone (2.5 mg/time, two times per week, for 6 months) intervention; patients in the control group were treated with laparoscopic intervention. After six months, the postoperative serum FSH (Follicle Stmi Ulating Hormone, FSH), Estradiol (E2) and Estradiol levels, ovarian biggest plane average diameter (D), the level of MMP-9 and TIMP -1 level, pregnancy outcome of two groups were compared and the outcome and the recurrence rate 18 months after treatment were followed up. Results Six months after treatment, the E2 and FSH levels in the observation group were better than control group, with statistically significant difference (P<0.01);the postoperative serum levels of MMP-9 and TIMP-1 in Observation group were better than control group, with statistically significant difference (P<0.01);there were 20 patients of D≤2 cm, 19 patients of D>2 cm, the postoperative ovarian shrink rate was 51.28% in the observation group; there were 5 patients of D≤2 cm, 34 patients of D>2 cm ovarian shrink ratio was 12.82% in the control group, the ovarian shrink ratio of observation group was obviously higher than control group, with statistically significant difference (P<0.01) . Follow-up for 18 months, the recurrence rate was 5.13%in the observation group, which was significantly lower than thatin the control group (25.64%), with statistically significant difference (P<0.05);the pregnancy rate was 66.66%and 30.77%in the Observation group and control group, respectively, the difference had statistical significance (P<0.01) . Conclusion Laparoscopic surgery combined with gestrinone can protect ovarian function of patients with ovarian endometriosis cyst, improve pregnancy outcomes, and reduce recurrence rate, and has good clinical value.

Objective To observe and analyze the four changes of plasma D- dimer and coagulation in pregnant women at different stages of pregnancy, and to explore the value of the test. Methods The subjects of this study were 120 pregnant women who underwent routine physical examination in our hospital, according to different stages of pregnancy (early pregnancy, middle pregnancy, late pregnancy, and before delivery) Four D- dimer and four blood coagulation tests were performed in pregnant women, and the results were observed and compared. Results During the pregnancy, D- dimer has increase trend (P<0.05); early in pregnancy, pregnancy and late pregnancy, PT has shortened(P<0.05); pregnancy, APTT has shortened (P<0.05), at the end of pregnancy and parturient period, showing a significant shortening (P<0.05); phenomenon in early pregnancy to mid pregnancy stage, FIB increased significantly (P<0.05), and at the end of pregnancy to perinatal period, with a sharp increase (P<0.05). Conclusion It is of great significance to perform dynamic monitoring of of plasma D- dimer and coagulation four indices in pregnant women during pregnancy.

Objective To observe the regulation effect of transforming growth factor alpha(TGFα) on expression of glutamate transporter(GLAST)and ingestion activity of retinal M(u)ller cells in mice.Methods To take the retinal tissue of Kunming mouse at postnatal 7～10 day.and then cultured M(u)ller cells according to literature.The 3～4 generation cultured cells of the same primary cell were divided into two groups at random:①TGFα group:maintained in different concentrations of TGFα as 50,75,125 and 150 ng/ml,3 holes in each concentration;②Control group:cultured by Eagle culture medium which improved from Dulbeccon and contained 20%fetal calf serum.The influence of different concentrations TGFα on GLAST activity in M(u)ller cells were observed by L-3H-glutamate uptake detection;the expression of GLAST mRNA in M(u)ller cells was determined by RT-PCR;the expression of GLAST protein was detected with immunocytochemical staining.Results With the increase of TGFα concentration.both L-3H-glutamate uptake and GLAST mRNA expression were increased.The L-3H-glutamate accumulation had got to the maximum uptake at concentration of 125 ng/ml,which was 266% of that in control group,meanwhile,the expressions of GLAST mRNA also got to the maximum as 4 times of control group.Immunocytochemical staining indicated that the effect of 125ng/ml TGFα on expression of GLAST protein was higher than that in the control group,the differences between two groups were statistically significant(P＜0.05).Conclusion TGF-α can increase GLAST activity through up-regulating the expression of GLAST mRNA and protein.

Synthetical therapy of laryngeal carcinoma will be a tendency in clinical practice.The induction chemotherapy plays an important role in it.The induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer were applied widely and the significant experiences had also been reported widely. The references of induction chemotherapy of laryngeal cancer were summarized in this paper.

Objective To compare the anxiety,depressive and personality characteristics between diabetes mellitus patients with or without diabetic retinopathy (DR),and look for psychological treatment and corresponding prevention measures.Methods 435 diabetic patients were enrolled in this study from April to November 2014 in our hospital,including 178 DR cases (group A) and 257 cases without retinopathy (group B).All the patients completed a questionnaire,the Self-Rating Anxiety (SAS),the SelfRating Depression Scale (SDS) and the big five personality scale (NEO-FFI),and were scored by eye doctors.According to the score,SAS can be divided into mild anxiety,moderate anxiety,and severe anxiety.SDS is divided into depression,mild depression,moderate depression and major depression.NEO-FFI was scored from emotional stability,outgoing,openness,easy-going and sense of responsibility.Multiple linear regression analysis was used to analyze the DR risk factors in those scores and education level,high blood pressure,age,alcohol consumption,occupation and other factors.Results There were 110 cases of mild anxiety,57 cases of moderate anxiety,11 cases of severe anxiety;74 cases without depression,53 cases of mild depression,31 cases of moderate depression,20 cases with major depression in group A.There were 181 cases of mild anxiety,53 cases of moderate anxiety,23 cases of severe anxiety;177 cases without depression,44 cases of mild depression,25 cases of moderate depression,11 case with major depression in group B.Group A patients had higher SAS,SDS scores than group B,the difference was statistically significant (P =0.035).Group B patients had higher NEO-FFI score in outgoing,easygoing,responsibility (P=0.022),lower NEO-FFI score in emotional stability (P=0.014) and same NEO-FFI score in openness(P =0.210)compare to Group A patients.Multiple linear regression analysis results showed that education level,high blood pressure,age,weight,drinking,occupation can affect the degree of changes in the retina (P=0.019).Conclusions Compared with those without retinopathy,DR patients were more prone to anxiety and depression.They also had low score in personality characteristics of outgoing,easygoing,responsibility.

Objective To compare the features of cerebral palsy with pachygyria or periventricular leukomalacia (PVL). Methods 15 children with pachygyria and 35 children with PVL were included. Their diagnosed age, clinical subtype, complications, Gross Motor Func-tion Classification System (GMFCS) were compared. Results The diagnosed age was significantly younger (P<0.001), the GMFCS was lower (P<0.05), the incidence rate of epilepsy was higher (P<0.05), and the intelligence was significantly lower (P<0.001) in the pachygyria group than in the PVL group. Conclusion Cerebral palsy children with pachygyria develope worse than that with PVL, as well as their prog-nosis.

Objective To evaluate the curative effect of conjoined tendon transfer for coracoclavicular ligament reconstruction in the treatment of Rockwood grades Ⅲ-Ⅳ acromioclavicular joint dislocation,c Methods A retrospective case control study was performed for 64 cases of acromioclavicular joint dislocation admitted from October 2007 to August 2014.There were 53 males and 11 females,with age of (43.8 ± 10.5) years (range,23 to 65 years).Rockwood grade Ⅲ was seen in 27 cases and grade-Ⅳ in 37.According to the treatments,26 cases underwent proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction combined with clavicular hook plate (ligament reconstruction group) and 38 cases only treated with clavicular hook plate (internal fixation group).Visual analogue scale (VAS),Constant shoulder score and postoperative complications were compared between the two groups before and after operation.Results All patients were available for a mean follow-up of 3.7 months (range,2 to 4 months).VAS was (7.58 ± 1.03) points in ligament reconstruction group and (7.15 ± 1.03)points in internal fixation group before surgery (P ＞0.05),and was (2.38±0.94)points in ligament reconstruction group and (2.08 ± 0.99) points in internal fixation group 3 months after operation (P ＞ 0.05).Constant shoulder score was (86.46 ± 6.59) points in ligament reconstruction group and (87.68 ± 6.59) points in internal fixation group after operation (P ＞ 0.05).Six cases (16％) had recurrent joint dislocation in internal fixation group,while none of the patients in ligament reconstruction group had recurrence (P ＜ 0.05).Conclusion Improved procedure of proximally based conjoined tendon transfer for coracoclavicular ligament reconstruction can effectively reduce the recurrence rate of acromioclavicular joint dislocation.

Objective To observe the level of homocysteine(Hcy),high sensitive C-reactive protein(hs-CRP)and D-Dimer(D-D) in peripheral blood of patients with coronary heart disease,and to explore their values in clinical diagnosis of the coronary heart dis-ease(CHD).Methods Total of 95 patients with coronary heart disease were selected including 27 patients with AMI,42 patients with UAP and 26 patients with SAP.50 health examination volunteers were served as contro1.The levels of Hcy,hs-CRP and D-D were measured.Results The levels of Hcy in AMI group,UAP group and SAP group were significantly higher than those in con-trol group(P <0.05).The levels of hs-CRP and D-D in AMI group and UAP group were significant higher than control group and SAP group(P <0.05).The level of hs-CRP in SAP group was much higher than the control group(P <0.05),whereas the level of D-D in SAP group was not significantly different from control group(P <0.05).Conclusion The changes of serum levels of Hcy, hs-CRP and D-D are related with the occurrence and development of CHD.The joint detection of Hcy,hs-CRP and D-D can better reflect the severe degree of CHD,and could be helpful for early diagnosis,therapy and prognosis of CHD.

Objective To investigate the effect of ovariectomy and estrogen on secretion function and number of pancreatic islet beta cell in low-dose streptozotocin-induced diabetic rats. Methods Thirty female SD rats were randomly divided into five groups: normal control(NC) group, streptozotocin(STZ) group, ovariectomized(OVX) group, OVX + STZ(OS) group and OVX+STZ+estradiol(OSE) group. OVX, OS and OSE groups underwent ovariectomy, while NC and STZ groups underwent just sham operation. After surgery, OSE group was treated subcutaneously with estradiol 0.2 mg/kg twice weekly. At the end of 3 weeks, STZ, OS and OSE groups were induced by a single intraperitoneal injection of 40 mg/kg STZ. Then eight days later, plasma glucose and insulin levels were tested. The insulin protein, the average beta cell area and the relative beta cell mass were tested by streptavidin peroxidase conjugation method (SP). The quantification of beta cell apoptosis was performed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). The expressions of proliferating cell nuclear antigen(PCNA) protein, Bax and Bcl-2 were tested. Results With the administration of low-dose STZ, the plasma glucose was significantly higher and the insulin secretion curve after glucose loading, △I30/△G30 and modified beta cell function index(MBCI) were lower in OVX group than in other groups(all P<0.05). At the same time, the insulin protein, the relative beta cell mass and the beta cell area were dramatically decreased(all P<0.05). The beta cell apoptotic index was increased (t = 2.957, P< 0.05), the expression ratio of Bcl-2/Bax was decreased (0.41±0.03 vs. 0.76±0.05, P<0.05). Estrogen replacement therapy could obviously inhibit these changes. Compared with OS group, glucose disturbances and insulin secretion were improved dramatically in OSE group(all P<0.05); the insulin content, the relative beta cell mass and the average beta cell area were all enhanced (all P<0.05); the beta cell apoptotic rate was decreased(t =2.482, P<0.05), and the expression tatio of Bcl-2/Bax was increased (0.71±0.05 vs. 0.41±0.03, P<0.05). Conclusions The ovx rats are significantly more susceptible to low-dose STZ toxicity than in control rats. Under the effect of STZ, the ability of insulin secretion of beta cell is obviously decreased, while apoptosis is increased, which induces a higher glucose level and a lower insulin secretion. Administration of estrogen may protect OVX rats from the metabolic disturbances.

Background and purpose:Bladder carcinoma is the most common tumor in the urogenital system in China. For patients with non-invasive bladder cancer, intravesical therapy is an important part of treatment after complete transurethral resection (TURBt). Bacillus Calmette-Guerin (BCG) remains the most effectively used immune agent, and epirubicin (EPI) has been reported to have an improved antitumor activity and high remission rate. However, the results differed significantly from study to study. To compare the efficacy and treatment-induced side effects of intravesical epirubicin versus BCG on postoperative recurrence of non-invasive bladder carcinoma, we completed a meta-analysis of the published literature. Methods:According to the criteria in the paper, we retrieved published comparative studies on intravesical epirubicin versus BCG for non-invasive bladder carcinoma. Data were extracted from each identified paper and Revman4.2 software was used for statistical analysis.Results:6 trials including 1 288 patients were eligible according to the eligibility criteria. Of 657 cases that were treated with epirubicin and 631 with BCG, recurrence occurred in 253 and 184 respectively. Pooling data of a meta-analysis indicated that BCG statistically reduced the incidence of tumor recurrence (Peto OR=1.60, 95%CI=[1.26, 2.03], P=0.000 1). With regard to tumor progression, BCG was also statistically superior to epirubicin (Peto OR=1.70, 95%CI=[1.16, 2.49], P=0.006). 5 studies reported the comparison on main local side effects in terms of hematuria, cystitis or irritative symptoms. Combined results showed that the incidence of hematuria (Peto OR=0.47, 95%CI=[0.35, 0.62], P