Objective To evaluate the vascular changes of uterus and ovary in women with recurrent spontaneous abortions(RSA).Methods Fifty women were enrolled into this study: women with RSA(RSA group,30 cases) and normal women with sterility(control group,20 cases).In the mid-luteal phase of a non-pregnancy cycle,transvaginal pulsed Doppler ultrasonography of the uterine artery and ovarian artery were performed.Resistence index(RI),pulsatility index(PI),endometrial thickness,serum estradiol, progesterone were determined.Results ①The endometrial thickness in RSA group was less than that in the control gruop[((8.3)?(1.7))mm and((9.4)?(1.2))mm,respectively,P

The single brain metastases of lung cancer is defined as limited brain metastases .Mechanism of brain metastasis from lung cancer remains to be further studied .Based on surgery ,radiotherapy ,and chemother-apy,the comprehensive treatment on limited brain metastasis of non -small cell lung cancer gets a better result , however ,the indications for combination therapy must be strictly controlled .Increasing radiation doses of local tumor area,followed by whole-brain radiotherapy,can improve tumor local control rate and prolong overall sur-vival.Prophylactic irradiation of whole brain showed no evidence on prolonging the overall survival .For patients with poor general state,targeted drugs combined with whole brain radiotherapy can be tolerated well ,as well as prolonged the overall survival to ertain extent .

Recently,the incidence rate of small cell lung cancer in elderly patients has been increasing . The mainly therapeutic approach of small cell lung cancer consists of radiotherapy ,chemotherapy and surgery ,with the treatment purpose of prolonging survival time and improving life quality .As the huge development of accurate radiotherapy technology occurred in the past a few years ,radiotherapy could play more and more important roles in the treatment with elderly patients .Yet,there is no unified standards of treatment for small cell lung cancer in eld-erly patients.Therefore,we give a review on the latest processes and research on the treatment of small cells lung cancer in elderly patients .

Objective To evaluate the value of transvaginal ultrasonography in diagnosis of ovarian pregnancy. Methods Ultrasound features of 21 cases of ovarian pregnancy were retrospectively studied in comparison with those of surgery and pathology. Results All the cases were diagnosed extrauterine pregnancy and suggested 3 cases with the lesion localizing inside the ovary,3 cases superficial to the ovary, 1 case unclear localization and 2 cases misdiagnosed as tubal ectopic pregnancy, the correct localization was made in 66.7 % of 9 unruptured cases by endovaginal sonography. Twelve ruptured cases were unclear localization by endovaginal sonography. The sonographical appearance of ovarian pregnancies showed normal or little bigger uterus, empty uterine cavity, a gestational sac or inhomogenous strong echoes interior or superior to the ovary, or complex mass in the adnexal area with abundant free fluid in the pelvic. Conclusions Transvaginal sonography is of diagnostic value in ovarian unruptured pregnancy.

Primary tracheal tumor is an uncommon disease in clinical oncology .It tends to be misdiag-nosed in very early stage ,as well as lack of standards for staging and treatment nowdays .The main strategy for the treatment of primary tracheal tumors is surgical comprehensive treatments .But as the huge development of modern radiotherapy technology the past a few years ,radiotherapy could play more and more important roles in the treat-ment of tracheal tumors.Meanwhile,the application of tracheal scaffold have provided the patients with tracheal tumors some new choices on the treatments .Yet,there are no guildline for the standard of the surgery ,the dose of the radiotherapy and the definition for the tumor target volumes .Here,we give a review on the latest process and research on the treatment of primary tracheal tumors .

Objective To explore the radiosensitizatian of paclitaxel in human lung adenocareinoma cells. Methods A human lung adenocarcinoma cell line A973 was used in this study. The cytotoxicity of paclitaxel was investigated by using clonngenic assay to define the IC10,IC50 and IC90. The cells received either radiation(with different doses) alone or paclitaxel administrated before and after irradiation. Cell survival fractions were determined by clonogenic assay. Single hit multi-target model was used to determine survival curve parameters. Flow cytometry was performed to analyze the cell cycle distribution. Results The IC10, IC50 and IC90 of paclitaxel in A973 cells were 0.5,2.6 and 8.7 nmol/L,respectively. According to Do,Dq and SF2 value,the sensitivity enhancement ratio(SER) of IC10 was 0.97,1.01 and 2.00 when paclitaxel was added before irradiation, and 0.97,1.02 and 1.02 when after irradiation ; The SER of IC50 was 1.06,129.00 and 2.61 when paclitaxel was added before irradiation, and 0.94,220. O0 and 2.14 when after irradiation ;The SER of IC90 were 1.00,220. 00 and 2.09 when paclitaxel was added before irradiation,and 0.98,220.00 and 2.09 when after irradiation. The IC10 of paclitaxei failed to increase G2+M arrest of A973 cells.The maximal G2+M accumulation was reached at 2 h and 18 h after IC50 and IC90 of paclitaxel treatment,respectively. Conclusions Paclitaxel is able to enhance the radiation sensitivity of A973 cells. Sequence of treatment is not associated with radiosensitivity. Moderate and high dose of paclitaxel combined with low-dose radiation can produce the best effect of radiosensitiation.

Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.
Humans ; Wrist ; Intensive Care Units ; Critical Care ; Hand ; Upper Extremity ; Restraint, Physical

Objective:To explore the expectations and values of patients with malocclusion on participation in shared decision-making of orthognathic surgical protocols, and to provide references for further development of clinical shared decision-making models.Methods:Based on the expected value theory and descriptive qualitative research methods, using purposive sampling, 13 patients with malocclusion in the Ninth People's Hospital of Shanghai Jiao tong University School of Medicine from May to August in 2021 were selected for semi-structured interviews. The interview data were sorted, classified and refined by traditional content analysis.Results:Two themes were extracted: patients' ability beliefs about their ability to participate in shared decision making for orthognathic surgery(decision support ability, psychological coping ability and environmental adaptability), and task values for shared decision making for orthognathic surgery(interest value, acquisition value).Conclusions:Low level of patients′ ability beliefs in shared decision-making, active physician guidance facilitates patient participation, but the depth of patient participation is influenced by factors such as information support, cultural climate, and physical space for shared decision making. It is suggested that the magnetic role of physicians should be actively played, the shared decision-making team should be strengthened, at the same time, hospital manager should enhance shared decision making propaganda to increase the acceptance and participation of patients in shared decision making so as to improve the quality of shared decision-making.

Objective: To compare the efficacies of two training protocols, i.e. the multimedia instruction and the conventional method, in periodontal surgery teaching for undergraduate students. Methods: One hundred and twenty-three dental undergraduates in their pre-clinical training course were recruited and divided into two groups according to the learning grade matching principle: the experimental group (multimedia instruction, 60 students) and the control group (conventional method, 63 students). The teaching aim was to train the students gingivectomy and periodontal flap surgery by using the pig jaws. The conventional teaching method of teacher-demonstrating and student-practicing was used in the control group, and the practice time of the students′ for each surgery was 45 minutes. A standardized teaching video combined with the teachers′ explanations of the key steps was used in the experimental group. The students′ practice time for each surgery was 60 minutes. The efficacy of teaching protocol was evaluated by the teachers according to the scoring criteria set by the teaching group. Results: In gingivectomy training, accuracy of fixed points, angle of postoperative gingival margin and morphology of gingiva of the experimental group were better than those of the control group. The experimental group also had more complete and continuous excised gingivae and more thorough adjacent gingival removal. The total scores of the experimental group were significantly higher than those of the control group (92.8±2.6 vs. 89.9±3.7, P<0.05). In periodontal flap surgery training, the experimental group operated the blade around the shape of the tooth better in internal bevel incision than the control group. Additionally, the incision position of internal bevel incision, periosteal integrity after flapping and flap depth of the experimental group were better than those of the control group. Besides, the experimental group had smoother flap edge and more thorough debridement. The total scores of the experimental group were significantly higher than those of the control group (92.2±4.1 vs. 89.2±4.4, P<0.05). Conclusions The teaching efficacy of multimedia instruction was better than that of the conventional method. Its value needs to be further tested in future teaching practice.

The performance appraisal of public hospitals is the most official and authoritative assessment and evaluation of tertiary public hospitals in China,and it is an important measure to guide hospitals to improve their internal management level and achieve high-quality development.In this study,a data monitoring management system based on the performance appraisal indicators of national tertiary public hospitals was developed and constructed through intelligent collection and reporting,report in-tegration,visual analysis,data drilling,etc.,which realized the one-stop dynamic management of indicators,optimized the data filling process of national examination indicators,improved the data quality and credibility,and promoted the integration of na-tional assessment and hospital assessment.the intelligent management level of the hospital has been improved,which provides strong support for the hospital's refined operation management and scientific decision-making.