Objective To discuss the clinical value of the "three-step" diagnostic routine in the diagnosis of cervical high-grade lesions. Method The women with the abnormal thinprep cytology test (TCT) underwent colposcopy and biopsy,the pathobiology result was the diagnostic standard. The sensitivity and specificity of the cervical high-grade lesions was calculated. Results The identify rate of the cervical high-grade lesions from the abnormal TCT was 22.3% (340/1524), the sensitivity was 27.1% (92/340), the specificity was 97.5% (1154/1184). The sensitivity of colposcopy was 47.9% (163/340), the specificity of colposcopy was 96.4% (1141/1184). Conclusion TCT with high sensitivity is used for preliminary screening, the colposcopic examination is used to pinpoint and evaluate the lesions,the detection rate and accuracy of cervical high-grade lesions can be improved.

To investigate the culture method for epidermal stem cell in vitro. Rat skin was peeled from the subcutaneous tissue gently, and cut into small pieces, then incubated for 24h in 0 25%trypsin in a 4℃ shaker. The epidermis was separated from the dermis, and shaken for 10min in 0 25% trypsin at 37℃ to dissociate into single cells. Digestion was terminated by the addition of culture medium +10% serum, and the cells were gently centrifuged and resuspended in the culture medium, which constituted EMEM without calcium, supplemented with 0 05mmol/L CaCl 2 , 9% chelexed FBS, 4ng/ml EGF, 0 5?g/ml gentamicin, and 50% fibroblast conditioned medium (CM ). The CM ( EMEM without calcium, 0 05mmol/L CaCl 2 , 9% chelexed FBS, 0 5?g/ml gentamicin ) was collected from freshly isolated primary neonate fibroblast cultures after 48h, which were passed through a filter with 0 45?m pores, and stored at -20℃ for use. 1?10 6 /ml epidermal cells were incubated for 10～15min at 37℃ on dishes coated with collagen Ⅳ, then the nonadherent cells were rinsed off. The adherent cells were grown to confluency. Cultures were subcultured in a solution of TGG for 5～10min. Once free of the dish, cells were centrifuged, resuspended in fresh medium, and then cultured at 1?10 5 /ml. Cultures were observed for colony formation under a phase contrast microscope, and the structure of the rapidly adherent cells was observed under electron microscopy; the expression of ? 1 integrin and K19 was detected in the rapidly adherent cells and colony cells with SP immunohistochemical methods. The results showed that the cells selected by rapid adherence to collagen type Ⅳ formed large colonies at 7 days, and showed a im mature feature under electron microscopy, manifesting ? 1 integrin and K19 expression. It is suggested that epidermal stem cells could be cultured in vitro .

The development of sweat glands is a very complex biological process, which involves many factors. In this study, the correlation between epidermal growth factor (EGF), matrix metalloproteinases (MMP 2,MMP 7) and development of sweat glands in human embryos was explored. Furthermore, the mechanism(s) underlying the induction of epidermal stem cells into sweat gland cells was elucidated. Skin biospies of human embryos obtained from spontaneous abortions at different gestational ages from 11 to 31 weeks were used. The dynamical expression of EGF, MMP 2, MMP 7 and keratin 7(K7) in developing sweat gland cells or extracellular stroma surrounding the sweat gland cells were examined with S P immunohistochemical methods. The localization of the cellular sources of MMP 2 and MMP 7 was examined with in situ hybridization. The results showed that at 14 20 wk of gestation, a gradual increase of EGF immunoreactivity was observed not only in developing sweat gland buds but also in extracellular stroma surrounding the buds,and the expression intensity peaked at 20～22 wk of gestational age. All mRNA positive buds or cells in developing sweat glands contained corresponding immunoreactive proteins. The immunostaining for K7 appeared in early sweat gland buds at 14～16wk of gestation, and from then on, K7 was concentrated in developing sweat gland cords or cells. It is suggested that the morphogenesis of sweat gland in human fetal skin begins at 14～16wk of gestational age, and essentially completes by 24wk. There is a close relationship among EGF ,extracellular matrix remodeling and morphogenesis of sweat glands, and EGF is one of the inducers in the development and maturity of sweat gland buds or cells.

Objective To analyze the clinical management of women with atypital squamous cells(ASC).Methods During Sep 2003 to Sep 2008,a totle of 956 women in our department were diagnosed with ASC by cytological test,they were further biopsied under the colposcope.The result of TCT,colposcopic test,biopsy and the highrisk factor were recorded and analysed;the based the biopsy were analyzed by the X~2-test;the high-risk factors and the odds Ratio(OR) were counted by SPSS10.0.Results Among the women with ASC,the rate of cervical intraepithelial neoplasia(CIN) diagnosed by the biopsy under the colposcope was 50.7% ,the rate of the high-grade lesion over CINII Was 13.3% ;if the colposcopic test were low-grade lesion,the rate of the cases which biopsys were the highgrade lesion over CINII,was 8.3% ;the high-risk factors which caused the cervical high-grade lesion were the number of sex-partners over 3,the age less than 20 yearold when the sex were made,the cervical erosion,the result of TCT with ASC-H.Conclusion Among the women with ASC,the biopsy shows multiformity;the rate of CIN and the highgrade lesion is also high;if TCT is ASC,the colposcopie test is advised;if the woman who has the high-risk factors,biopsy is advised.

ObjectivesTo discuss the value of the three kinds of surgical management to treat high-grade cervical intraepithelial neoplasia. MethodsThe study was conducted on 136 patients who underwent LEEP、CKC 、hysterectomy ,to compare the change of the postoperative biopsy result,the rate of cure and pregnancy. ResultAmong the postoperative biopsy result,66. 4% was consitent with pretreating histopathology,but 3.6% was upgrade,30.0% was downgrade; there were no statistical difference in the rate of cure of the three kinds of surgical management and in the rate of pregnancy of the two kinds of conization. ConclusionThe three kinds of surgical management to treat high-grade cervical intraepithelial neoplasia were effective,while LEEP was the best way.

Current hospital information system has to be reconstructed to satisfy futural requirements. The reconstruction improves the network structure, network performance, bandwidth, manageability and safety of current system, and makes it reliable and expandable.

Objective To observe the influences of modified constraint-induced movement therapy (mCIMT)on lower-extremity walking ability and femoral artery blood flow among elderly patients with stroke. Methods Totally 67 patients with stroke were randomly divided into mCIMT group(n =35) aged ( 73.2 ± 5.2 ) years and neurodevelopmental treatment (NDT) group ( n =32) as control aged(76.4 ± 3.8) years.Patients in control group exercised by NDT 2 h/time,2 times/d,5 d/week for 6 weeks. Patients in mCIMT group exercised including: up and down exercise,100-120 times/d; movement flatbed exercise for 16-20 min/d; upstairs and downstairs exercise,balance training,standing in a single leg exercise,mandatory exercise time of lower-extremity about 4 h/d,5 d/week for 6 weeks.The patients were assessed for lower-extremities motor function using maximum walking speed (MWS),Berg balance scale (BBS),timed up to go test (TUGT) and Fugl-Meyer(FMA-L) at pre-treatment and post-treatment.The change of femoral artery blood flow velocity and lumen diameter on the affected lower limb were observed by color Doppler. Results There were no differences in the above scores,lumen diameter and blood flow velocity before treatment between the two groups (P＞ 0.05).After treatment,the scores of MWS (56.68 ± 6.57vs.45.61 ± 5.34),BBS(46.84 ± 4.05vs.29.84 ± 4.05),TUGT ( 14.55 ± 8.25vs.25.35 ± 8.70)were higher in mCIMT group than in NDT control group (t=15.09,17.38,15.25,all P=0.001)while no difference in FMA-L score between the two groups was found (35.24 ± 7.62 vs.31.32 ±3.28,t=19.99,P＞0.05).Lumen diameter of femoral artery [(9.05±1.15) mm vs.(8.05±0.68)mm,t=6.72,P=0.001] and blood flow velocity[(92.55±18.25)cm/s vs.(69.35 8.7)cm/s,t=6.83,P=0.001] were increased in mCIMT group as compared with NDT group. Conclusions The mCIMT therapy is better in improving the lower-extremity walking function and blood flow velocity of femoral artery.

Objective To evaluate endovascular therapy and open surgery for subclavian artery occlusion disease. Methods In this study, 69 patients received endovascular therapy (44 patients)or open surgery(25 patients)from January 2002 to July 2007.Balloon dilatation was carried out in 3 cases and 43 stents was placed in 41 cases. Results All procedures were successful. In endovascular therapy group, the ratio of healthy/dieased side of mean blood pressure was improved from 0.66±0.14 to 0.96±0.13(t=9.532,P＜0.001＝;in surgery group, the ratio improved from 0.63±0.16 to 0.95±0.18(t=8.236,P＜0.001＝.Sixty-one discharged patients were followed up for 2～49 months(mean 16.7 months),in endovascular group, restenosis occurred in 1 patient 1 year after the therapy, in surgery group, all prothesis remained patent and there was no complication related to prothesis. Conclusions Both endovascular therapy and surgery were the effective methods for subclavian artery occlusion, and endovascular therapy is preferred for less invasiveness.

Objective To investigate the treatment and prevention for postoperative complications of abdominal aortic aneurysm(AAA)in open surgery.Methods 329 AAA patients received open surgery from January 1991 to August 2009.The postoperative complications were analyzed retrospectively.Results 30 d mortality rate was 0.91%,the incidence of postoperative complications was 19.1%(63/329),including cardiac dysfunction in 21 cases,respiratory insufficiency in 15 cases,myocardial infarction in 6 cases,renal failure in 5 cases,arrhythmia in 6 cases,cerebral infarction in 2 cases,artery embolism of lower extremity in 2 cases,wound dehiscence in 2 cases,incisional hernia in 1 case,ecchymoma in 1 case and deep vein thrombosis in 2 cases.One patient died of acute myocardial infarction,one died of renal failure after 20 d dialysis,1 patient died of premature ventricualr contraction and fibrillation ventricular.Other patients recovered well. Conclusions Cardiac dysfunction and respiratory insufficiency are the main postoperative complications of AAA.Preoperative evaluation.careful intraoperative maneuvre and postoperative care ale the key to improve the treatment effectiveness.

Objective:To compare the perioperative complications of carotid endarterectomy with patch angioplasty or primary closure.Methods:The clinical data of 492 carotid endarterectomy patients at the Vascular Surgery Department of Anzhen Hospital from Mar 2003 to Dec 2016 was analyzed retrospectively.Results:There were 364 cases (74%) in the patch angioplasty group and 128 cases (26%) in the primary closure group. The incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than that in the primary closure group (0.8% vs. 3.9%, P=0.031), and there was no difference in the incidence of the remaining perioperative complications. By subgroup analysis, the incidence of perioperative ischemic stroke was significantly lower in the patch angioplasty group than in the primary closure group when the diameter of the internal carotid artery was <5 mm (0.7% vs. 6.0%, P=0.001), whereas there was no difference between the two groups when the diameter of the internal carotid artery was ≥5 mm. Conclusions:Carotid endarterectomy with patch angioplasty can reduce the incidence of perioperative cerebral infarction, especially in cases with an internal carotid artery diameter <5 mm.