Objective To evaluate the mid-long term effects of hysteroscopic treatment of abnormal uterine bleeding(AUB).Methods A total of 432 patients admitted from January 2002 to November 2005 with AUB were treated with hysteroscopy.All the patients were followed for at least 12 months.Among the 432 patients,391 were diagnosed as having benign lesions,including endometrial polyp in 96 patients(22.2%),submucous myoma in 38 patients(8.8%),and endometrial hyperplasia in 257 patients(59.5%),receiving transcervical myoma resection or transcervical endometrium resection.The other 41 patients were diagnosed as having stage Ⅰ endometrial carcinoma,and a total hysterectomy and bilateral adnexectomy with selective pelvic lymphadenectomy was performed.Results All the operations were successfully completed,without uterine perforation or other complications.During a follow-up of 12～57 months(mean,39 months) in the 391 patients with benign lesions,amenorrhea was found in 63 patients(16.1%,63/391),hypomenorrhea( 1.5 cm in 8 patients,and a second hysteroscopic endometrial resection was given at 5～19 months after first operation.All the 8 patients were further followed for 18～36 months,with findings of amenorrhea in 5 of them and hypomenorrhea in 3.All the 41 patients with stage Ⅰ endometrial carcinoma survived without recurrence during a follow-up period for 26～41 months(mean,38 months).Conclusions Hysteroscopic treatment can be the first choice for treating non-malignant AUB.Pre-operational pathological examination and ultrasonography can enhance the safety and efficacy of the operation.

Objective To evaluate the mid-long term effects of laparoscopic treatment of ovarian endometriosis cysts.Methods Clinical data of 209 cases of ovarian endometriosis cysts treated by laparoscopic operation from January 2002 to December 2005 were retrospectively analyzed.All the patients were followed for at least 12 months(12-54 months).There were 115 cases of unilateral ovarian cyst enucleation,62 cases of bilateral enucleation,11 cases of unilateral adnexectomy,and 21 cases of unilateral adnexectomy combined with contralateral cyst enucleation.Oral gestrinone was administrated in patients without childbearing intentions,while in patients demanding a child,no drug was given and an early pregnancy was encouraged.Results Conversions to open surgery were required in 7 cases.No complications occurred.Ovarian endometriosis cysts recurred in 17 cases(8.1%),including 7 cases of stage Ⅲendometriosis and 10 cases of stage Ⅳ endometriosis.Of the 35 cases of infertility,intrauterine pregnancy was obtained in 16 cases,with a pregnancy rate of 45.7%.The pregnancy occurred at 4-29 months after operation(within 2 years in 10 cases).Of the 157 cases of dysmenorrhea,a complete relief was achieved in 95 cases(60.5%)and an improvement was obtained in 62 cases(39.5%).Conclusions Laparoscopic treatment is suitable for all stages of ovarian endometriosis cysts.Postoperative drug administration and long-term follow-up are necessary to lower the recurrence rate.

When the body is attacked by trauma and infection,the serum C-reactive protein( CRP) con-centration which is produced by the liver will increase.CRP participates in the body′s humoral immunity through regulating the phagocytic cells to clear the pathogenic bacteria and necrotic tissue.The occurrence and develop-ment of malignant tumor is associated with complex inflammatory response pathway.Serum CRP concentration will change with the progress and remission of tumor.CRP is associated with differentiation of benign and malignant, the early diagnosis,the pathological stage,the lymph node metastasis,the organizational characteristics,the prog-nosis,and the treatment of malignant tumor.It is expected to be a clinical screening indicator of malignant tumor.

Objectives To investigate the correlation between dietary fatty acids intake of pregnant women and neonatal anthropometry at birth. Methods Women in early pregnancy were recruited with appropriate value of weight gain in pregnancy. Instant photography was used to assess the dietary situation in both the second trimester and the third trimester to calculate the intakes of food, energy, macronutrients, and fatty acids. The body weight, height and BMI at birth were evaluated with Z scores. The correlation between dietary fatty acids of pregnant women and neonatal anthropometry at birth were analyzed. Results There were 516 pregnant women recruited in this study. The average intakes of polyunsaturated fatty acids (PUFA) and the proportion of total fatty acids in the two trimesters were 15 . 09 g/d, 23 . 93% and 17 . 18 g/d, 24 . 86%. In the second trimester the intakes of n-6 and n-3 PUFA were 14 . 23 g/d and 3 . 45 g/d, and in the third trimester, n-6 and n-3 PUFA were 16 . 08 g/d and 3 . 81 g/d, the average intakes in the third trimester were signiifcantly higher than those in the second trimester (P??0 . 05 ). The intake of DHA ( 64 . 43 mg/d) in the second trimester was lower than that in the third trimester 75 . 12 mg/d, (P??0 . 05 ).The dietary intakes of n-3 PUFA, n-6 PUFA and n-6/n-3 ratio in the second trimester were positively correlated with neonatal BMI r=0 . 142~0 . 189 , P??0 . 05 ). Conclusions The dietary ratio of n-6/n-3 PUFA in the second trimester was positively correlated with neonatal BMI, suggesting that moderately increasing the intake of n-3 PUFA may play a positive role in reducing childhood obesity.

Objective To compare the features of different heating modes cauterization mode and standard ablation mode of Cool-tip on coagulation zone and thermal field distribution in order to provide references for focused and accurate vascular occlusion and explore the primary efficacy of Cool-tip applied to intrahepatic vascular occlusion in living dogs Methods Ex-vivo porcine livers were ablated for 2 4 6 8 minites with cauterization mode and standard ablation mode respectively and the long- and short-axis diameters in the greatest dimension were compared The tissue temperature around the tip midpoint and end of the exposed part of radiofrequency electrode were measured under the circumstance of 4 min ablation by the two modes respectively Animal experiment the intrahepatic vessels of 2 Beagles were ablated with cauterization mode one procedure for each animal and contrast-enhanced ultrasound was used to evaluate the perfusion change of liver tissue Gross anatomy and pathological examination of the liver was performed after 1 week Results In the 2 min 4 min 6 min and 8 min ablation the coagulation volume of cauterization mode and standard ablation mode were 1 01 ± 0 41 cm 3 vs 2 95 ± 0 74 cm 3 1 47 ± 0 33 cm 3 vs 5 03±1 06 cm 3 2 29±0 49 cm 3 vs 9 23±2 53 cm 3 2 70±0 24 cm 3 vs 1 5 89±0 77 cm 3 The coagulation volume was significant smaller in cauterization mode than in standard ablation mode P <0 05 for all The peak temperature of cauterization mode presented on the tip of electrode which averaged 94 4℃ in maximum and maintain around 70 ℃ in the equilibrium phase The peak temperature of standard mode presented on the midpoint of the electrode which periodically variated between 70 ℃- 100 ℃ The result of the animal experiment showed that cauterization mode could be used to occlude the intrahepatic vessel in vivo which induced the ischemia and necrosis in the corresponding area Conclusions Cauterization mode and standard alation mode of Cool-tip have different characteristic in terms of coagulation zone and thermal distribution and carterization mode may have a promising application in intrahepatic vascular occlusion.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.