Objective To assess the cesarean section scar morphology and size with transvaginal ultrasound and the healing of incision diverticulum after the repairing operation.Methods Forty cases with cesarean section scar defects needed repairing operation,40 cases of cesarean section without symptoms and 40 cases of vaginal delivery were involved.The scar condition and measured the size of cesarean section defects were observed.For the 40 cases needed repairing operation,the healing of the scar and measured the size of the defects were observed which still existed before and after the surgery.For the transvaginal delivery cases the thickness of uterine isthmus were measured.Results After the scar defects repairing operation,there were 9 cases who still had diverticulum,but the defects were smaller than that before operation (P <0.05).The symptoms were relieved.Among the 40 asymptomatic cases,there were 1 1 cases had defects,but the diverticulum were smaller than that of needed operation patients (P < 0.05 ). Conclusions The transvaginal ultrasound is a noninvasive and convenient method to observe the cesarean section scar.

Objective To observe the expression of fibroblast specific protein-1 (S100A4) in human lung cancer,and investigate roles of S100A4 in the infiltration and metastasis of lung cancer. Methods Immunohistochemical S-P method was used to detect the expression of S100A4 in 50 lung cancer tissues and 6 normal lung tissues. Results The expression of S100A4 was up-regulated in lung cancer tissues.Significant differences of the expression rates of S100A4 was found between lung cancer and normal groups (P

Objective To study the surgical diagnosis and treatment of renal tuberculosis(TB). Methods The clinical data of 42 cases with renal TB were analyzed retrospectively and the experiences of clinical diagnostic and treatment were summarized. Results Cystic irritation symptoms(78.6% ,33/42)and gross hematuria(64. 3%,27/42)were the most common symptoms in these patients. Abnormal urine were found in 83.3 % cases. Acid-fast stains on urinary sediment were positive in 28.6%(12/42)of cases. The diagnostic accuracy of B-ultrasonicgraphy,IVU,retrograde pyelography and CT examination in these patients were 19.0%(8/42),33.3% (14/42),26.2%(11/42)and 71.4%(30/42)respectively. Among all cases enrolled in the study,6 patients received antiphthisic medicine treatment,3 of them were cured and the other 3 accepted nephrectomy and partial ureterectomy after 6-12 months because of severe renal function impairment 36 cases received surgical treatment. In the 39 cases treated with operation,all of them were proved to carry renal tuberculosis by the postoperative pathological examinations. Conclusions The medical history,urine analysis,image examination should be considered synthetically in the clinical diagnosis of renal tuberculosis. The patients should be followed up closely during antiphthisic treatment period. Seriously damaged or nonfunctioning kidney should be removed promptly.

ObjectiveTo analyze the relationship between expressions of Indoleamine 2,3-dioxygenase (IDO) and B7-H1 with clinico-pathological features and their prognostic significance in pancreatic cancer (PC).Method95 patients who underwent radical pancreaticoduodenectomy for PC were studied.The IDO and B7-H1 expressions in tissue specimens were determined by immunohistochemistry.ResultsIDO and B7-H1 expressions were higher in pancreatic carcinoma tissues than in normal pancreatic tissues (P＜0.05).IDO and B7-H1 expressions positively and significantly correlated with pathological grades and tumour-node-metastasis (TNM) stages (P＜0.05).They were prognostic of poor cancer-specific survival.After adjusting by the Cox proportional hazards regression models (P＜0.05),only a combined IDO/B7-H1 expression served as an independent prognostic marker.ConclusionsIDO and B7-H1 were expressed in PC,and they were important markers for malignant progression of PC.A combined IDO/B7-H1 expression served as an independent prognostic marker for PC.

Objective To investigate the influence of diameter of liver outflow vein on portal hypertension and artificial blood vessel (ABV) patency rate in Budd-Chiari syndrome (BCS) patients undergoing atrial caval shunting (ACS).Methods We recruited 209 patients,who had undergone ACS for Ⅱ type of BCS.Those patients with unobstructed liver outflow vein were included into group A and the patients with stenosed liver outflow vein into group B.Free portal pressure (FPP) was measured before and after ABV opening.Portal vein velocity (Vpv),liver function,spleen volume and function,esophagogastric varices and ABV patency were evaluated postoperatively.Results After ABV opening,FPP decreased significantly in group A than group B (t =10.45,P ＜ 0.05).Vpv accelerated significantly in group A 2 weeks after operation than group B (t =12.81,P ＜ 0.05).Apparent improvement of liver function,spleen function and esophagogastric varices and reduction of spleen volume were observed in group A patients than group B patients (P ＜ 0.05).Reduction of esophagogastric varices in group A was better than in group B (x2 =44.73,P ＜ 0.05).By postoperative follow up,ABV patency of group A was higher than group B (P ＜ 0.05).Conclusions Patency status of liver outflow vein significantly influences postoperative portal vein pressure and closely correlats to ABV patency rate after ACS.

Objective To determine the expression of indole-2,3 dioxygenase (IDO) in human acute leukemia,and to investigate its correlations with clinicopathological parameters and prognosis in acute leukemia.Methods The expression of IDO in protein and RNA levels was detected by immunohistochemistry and real-time quantitative RT-PCR,respectively,and the correlations of IDO with clinicopathologic features and prognosis of acute myeloid leukemia (AML)-M5 were analyzed.Results The positive rate of IDO protein was 63.3 ％ (38/60) in human acute leukemia,while it in AML (34/49,69.4 ％),especially in AML-M5 patients (29/35,82.9 ％),was significantly higher than that of acute lymphoblastic leukemia (4/11,36.4 ％).The expression of IDO protein in healthy human peripheral blood mononuclear cells was negative.The RNA expression level of IDO in AML-M5 or non AML-M5 patients were significantly higher than that of healthy people (P ＜ 0.001),and AML-M5 patients had significantly higher IDO RNA level than that in non AML-M5 patients (P ＜ 0.05).The IDO gene expression was not correlated with sex,age and drug sensitivity,while it was closely related with these factors in the patients without complication of pulmonary infection.IDO could not act as an independent prognostic marker.Conclusion The expression of IDO in AML-M5 patients is significantly higher than that in non AML-M5 patients and healthy people.The positive expression of IDO is associated with poor prognosis of AML-M5 patients,but it is not an independent poor prognostic indicator.

Objective To understand the awareness status of malaria control knowledge of primary and secondary school stu-dents in malaria endemic areas of Shandong Province,so as to provide the baseline information for formulating the malaria control strategy. Methods A cross-sectional survey was conducted in 5 TypeⅡmalaria-endemic counties in Shandong Province. A struc-tured questionnaire survey was administrated to students in primary and secondary schools. Results A total of 1 884 students were completed with the questionnaires and all were effective. The total awareness rate of malaria control knowledge was 65.9%, and 54.7% of the students knew the transmission route of malaria and only 31.5% of the students were aware of the preventive methods of malaria. There were significant differences of the awareness scores of malaria control knowledge among different malar-ia endemic areas but there were no significant differences between the awareness rates of male and female students and between two different education levels. Conclusions The awareness of malaria control knowledge of primary and secondary school stu-dents in Shandong Province is poor;therefore,the health education of malaria control knowledge for primary and secondary school students should be strengthened.

Objective　To estimate the value of applying left heart bypass technique in esophageal carcinoma resection and gastroesophageal reconstruction. Methods　The operation was performed under lef t he art bypass. Results　Applying left heart bypass during esophagea l carcinoma resection and gastroesophageal reconstruction increased the probabil ity of the resection. The patient lived better and without operative complicatio n. Conclusion　In case of esophageal carcinoma with invasion of descending aorta by carcinoma, left heart bypass may increase the probability of the resection and enhance the safety of surgical treatment.

Objective To investigate the relevance ratio of abnormal electrocardiogram (ECG) and describe the abnormal ECG index among the residents in Keshan disease (KD) area.To assess the KD illness severity and provide comparable quantitative indicators,provide the scientific basis for elimination of KD.Methods Non probability sampling method was used,and monitoring stations with the highest incidence of KD at the county level were selected in 2012.Clinical examination and 12 lead ECG was carried out.According to The KD Diagnosis Standard (WS/T 210-2011),eight common changes in ECG of KD were scored.According to age and sex group,check the abnormal rate of ECG detection of Keshan disease,while analysed the changes of abnormal ECG index score in latent KD patients and chronic KD patients.Abnormal ECG index to determine:If there was one change,the score was 1 and the abnormal ECG index was 1.And so on,the highest score was 8.Results Totally 61 831 residents were surveyed and 9 634 were found with abnormal ECG,and the relevance ratio of abnormal ECG was 15.58％;totally 3 862 residents had eight ECG changes of KD and the relevance ratio was 6.25％;totally 508 residents were diagnosed with KD and the relevance ratio was 0.82％.The relevance ratio of abnormal ECG among all age groups was statistically different (x2 =3 065.64,P ＜ 0.05).The relevance ratio of abnormal ECG in women was higher than that of men [3.91％ (2 419/61 831) vs 2.33％ (1 443/61 831),x2 =86.30,P＜ 0.05].Abnormal ECG index score was (1.06 ± 0.25) which was not statistically different between gender [men:(1.07 ± 0.27) vs women:(1.06 ± 0.24),t =1.41,P ＞ 0.05].The abnormal ECG index score in latent KD patients was lower than that of chronic KD patients [(1.09 ± 0.30) vs (1.60 ± 0.69),t =-4.87,P ＜ 0.05].In eight ECG changes,the most check out items were T wave and/or ST segment changes (2 816).Conclusions The relevance ratio of abnormal ECG in KD area is at a higher level.The abnormal ECG index can be used to assess the KD illness severity and provide comparable quantitative indicators,in order to provide a new train of thought for the evaluation of KD elimination.