Objective To study the effect of ultrasound guided curettage after methotrexate and mifepristone in the treatment of endogenous caesarean scar pregnancy.Methods A retrospective analysis was performed on 43 patients of endogenous caesarean scar pregnancy undergoing treatment of ultrasound guided curettage after methotrexate and mifepristone.Results 39 cases were successful,4 cases were transformed to laparotomy because of intraoperative blood loss,7 cases of bleeding after curettage were successful by uterine carity placed double lumina Foley catheter. Conclusion Ultrasound guided curettage after methotrexate and mifepristone is a safe,effective,little trauma and low cost method in the treatment of endogenous caesarean scar pregnancy,it especially adapts to primary hospital.

Objective:To evaluate the effect of enteral rehabilitative therapy in improving graft structure recovery in rat small bowel transplantation.Methods:Fourty eight recipients of rat allogeneic heterotopic small bowel transplantation(SD→Wistar rat)were dvided into 4 groups randomly according to the presence or absence of glutamine or rhGH in TPN regimen.Cyclosporine A was used as the immunosuppressant.The morphological mucosal indices of transplanted gut were observed and compared.Results:The application of rhGH and glutamine-enriched TPN,especially the enteral rehabilitation therapy which composed both these two agents,can promote the recovery of graft structure significantly compared with standard TPN support.On the postoperative day 14,in the enteral rehabilitation therapy group,all the morphological indexes of transplanted gut recovered to the preoperative state.Conclusion:Enteral rehabilitation therapy is appropriate to the host metabolic status,so it can improve the graft structure recovery more effectively.

0 05).Conclusion:Intraoperative lymphatic mapping with methylene blue is easily performed in early breast cancer patients.To determine the sentinel lymph node and status of axillary lymph node metastasis by pathological examination of the stained lymph nodes,there was hight false negative rate and unacceptable rate of misdiagnosis.So,its feasibility need further evaluation.[

Objective To explore the related risk factors of central lymph node metastasis ( CLNM) of papillary thyroid microcarcinoma ( PTMC) and the application value of central lymph node dissection ( CLND) . Methods Totally 251 patients who were confirmed as PTMC by pathological biopsy were selected as the research object, and they were divided into the metastasis group (n=42) and the non-metastasis group (n=209) according to the status of lymph node metastasis. The general datum of the two groups were retrospectively analyzed, and the indexes with significant differences after univariate analysis were analyzed by non-conditional Logistic regression analysis. Treated the patients with lymph node metastasis through CLND, and the occurrence rate and recurrence rate of related complications were recorded during the 1 to 3 years of follow-up. Results The comparison of the location of the tumor, complicated adenoma, Hashimoto’ s thyroiditis, nodular goiter, and hyperthyroidism between the two groups was not statistically significant (P>0. 05). In the metastasis group, the rate of patients aged less than 45 years old and the percentage of male patients were both significantly higher than the non-metastasis group, and the difference was of statistical significance (P<0. 05). There were 25 cases (59. 5%) whose tumor diameter were 5~10 mm, 12 cases (28. 6%) with multiple lesions, and 22 cases (52. 4%) breaking through the envelope in the metastasis group, which were significantly higher than 70 cases (33. 5%), 23 cases (11. 0%) and 67 cases (32. 1%) in the non-metastasis group, and the differences were statistically significant (P<0. 05). In the metastasis group after operation, there was 1 cases (2. 3%) of hoarseness, 6 cases (14. 3%) of local numbness, 1 case (2. 3%) of nerve invasion, and 2 cases (4. 8%) of vascular invasion, and there was no choking cough report. During the period of 1 to 3 years of follow-up, there were only 2 cases of recurrence and the recurrence rate was 4. 8%. Conclusion Central lymph node metastasis mostly occurs in the male patients with PTMC who are less than 45 years old. And the main characteristics are diameter of tumor over 5 mm, multifocal lesions, with envelope penetration symptom and so on. In clinic, patients who meet the above-mentioned condition should be taken as the primary concern and given related prevention measures to reduce the occurrence risk of central lymph node metastasis. To treat patients with papillary thyroid microcarcinoma through central lymph node dissection can receive good curative effect and effectively improve the prog-nosis quality, and it is worthy of clinical promotion.

Objective To compare the outcomes of arthroscopic coracoacromial ligament augmentation and clavicular hook plating in treatment of acromioclavicular joint dislocation.Methods From March 2008 to March 2012,47 patients with acute closed type Ⅲ-Ⅴ acromioclavicular joint dislocations underwent an arthroscopic repair with coracoacromial ligament augmentation and suture (ligament augmentation group,23 patients) and with AO clavicular hook plate (hook plate group,24 cases).Mean age of the patients (32 males and 15 females) was 34.8 years (range,17-45 years).There were 32 left and 15 right injuries.Postoperative outcome was assessed through radiographic examination,American Shoulder and Elbow Surgeon (ASES) score and Karlsson scoring method.Results Mean period of follow-up was 18 months (range,12-24 months).In ligament augmentation group ASES score improved from (28.7 ± 7.3) points preoperatively to (96.3 ± 6.9) points postoperatively (t =51.34,P ＜ 0.05).In hook plate group ASES score improved from (29.3 ± 7.6) points preoperatively to (83.6 ± 8.5) points postoperatively (t =43.78,P ＜ 0.05).Postoperative radiographic examination showed well joint reduction of all patients.Good and excellent results with the Karlsson score accounted for 96％ (22/23) in ligament augmentation group and 71％ (17/24) in hook plate group (x2 =9.05,P ＜0.05).Conclusions Efficacy of coracoacromial ligament augmentation and suture for the treatment of acromioclavicular joint dislocation is better than clavicular hook plate.Coracoacromial ligament augmentation and suture are associated with lower incidence of shoulder pain and shoulder activity limitation,shorter recovery time,fewer complications and early activities.

Objective To survey the effects of repetitive transcranial magnetic stimulation (rTMS) on learning,memory and the dendrite morphology of neurons in the CA1 area of the hippocampus in rats with vascular dementia.Methods Thirty-six male SD rats were divided into a control group,a model group and a rTMS group randomly,12 rats in each group.A model of vascular dementia (VaD) was established using the two vessel occlusion method.The rats in the rTMS group were given rTMS treatment.The rats in the other two groups had no therapy.The Morris water maze (MWM) test was used to evaluate the rats' learning and memory abilities on the 30th day after the operation.After the MWM test the dendrite morphology of the pyramidal cells in the CA1 area of the hippocampus was detected after Golgi-Cox staining using light microscopy and the expression of brain-derived neurotrophic factor (BDNF) was detected using immunohistochemistry methods.Results The average MWM escape latency in the rTMS group was shorter than in the model group on the 1 st,2nd,3rd and 4th day.The number of crossings of the platform quadrant in the rTMS group was significantly more than in the model group.The number of branch segments,their total length and the dendritic spine density of pyramidal cell dendrites in the CA1 area of the hippocampus were all significantly lower in the model group than in the control group,but in the rTMS group all these indicators were significantly improvedcompared with the model group.The expression of BDNF in the CA1 area in rTMS group was significantly higher than in the model group.Conclusions rTMS can improve learning and memory in VaD,at least in rats.The mechanism may be associated with rTMS promoting the expression of BDNF in the hippocampus and so improving the dendrite morphology of pyramidal cells.

Objective: To evaluate the safety of application of enteral rehabilitative therapy in small bowel transplantation.Methods: Forty-eight recipients of rat allogeneic heterotopic small bowel transplantation(SD→Wistar)were divided into 4 groups randomly according to the application or not of enteral rehabilitative therapy or cyclosporine A.The pathological changes of graft,IL-2 receptor expression of lamina propria lymphocyte,serum IL-2 concentration,transformation test of spleen lymphocyte and its IL-2 secretion capacity were determined and compared.Results: The enteral rehabilitative therapy may promote the immune function of recipient so to augment the acute rejection of small bowel transplantation.But such effects can be block by the common used immunosuppressant-cyclosporine A.Under the immunosuppression of CsA(10mg?kg -1 ?d -1 ,IM),application of enteral rehabilitative therapy can not induce or promote acute rejection of small bowel transplantation.Conclusion: Enteral rehabilitative therapy can augment the acute rejection of small bowel transplantation,but cyclosporine A can block its immunoenhancement effects.So under effective immunosuppression,application of enteral rehabilitative therapy is safe in small bowel transplantation.

Objective To evaluate the effects of TMS on the brain plasticity and functional outcome after cerebral infarction in rats. Methods Twenty-four male Sprague-Dawley rats were divided randomly into a model group and a TMS group. The rat models of focal cerebral infarction were established with unilateral middle cerebral artery (MCA) suture occlusion method. The rats of TMS group were given additional 4 weeks of TMS treatment commenced at!1 day after infarction (2 times per day, 30 pulses per time), while those in the control group were reared in their original living state. Synaptic substructure in the sensori-motor cortex area was assessed morphologically and quantitatively. Results When compared with the model group, the rats in the experimental group had a significant improvement in terms of their neural functions (P

Objective To study the effects of transcranial magnetic stimulation (TMS) on the expression of c-Fos and brain-derived neurotrophic factor (BDNF) of the cerebral cortex in rats with cerebral infarction. Methods Cerebral infarction models were established by using of left middle cerebral artery occlusion (MCAO) and randomly divided into a model group (n=40) and a TMS group (n=40), in additional, TMS treatment (2 times per day, 30 pulses per time) with frequency of 0.5 Hz and magnetic field intensity of 1.33 Tesla was carried out in TMS group after infarction. The expression of c-Fos and BDNF was measured at 1 d, 7 d, 14 d, 21 d and 28 d after infarction, respectively. Results The positive expression c-Fos and BDNF was detected in the cortex around the infarction areas, while the expression of c-Fos and BDNF was increased significantly in TMS group in comparison to those in model group at 7 d, 14 d, 21 d, 28 d (P

BACKGROUND: Transformation growth factor β1 (TGF-β1) can promote bone marrow mesenchymal stem cells (BMSCs) migration and proliferation, but the underlying mechanisms remain unclear.OBJECTIVE: To observe the invasiveness of TGF-β1 on BMSCs cultured in vitro, and to investigate regulatory effect on Snail and matrix metalloproteinase 2 (MMP-2) expression.METHODS: Rat BMSCs were isolated and cultured with density gradient centrifugalization and adherence method. The influence of different concentrations of TGF-β1 on the BMSC migration was detected using the modified Transwell chambers. Small interfering RNA for Snail gene was synthesized and transfected into BMSCs by liposomel before TGF-β1 was treated, and the expression of Snail and MMP-2 before and after transfection were measured by western blot assay.RESULTS AND CONCLUSION: The exogenous TGF-β1 can induce a dose-dependent increase in cell migration, which peaked at 2 μg/L. The expression levels of Snail mRNA and MMP-2 mRNA were significantly increased after 2 μg/L TGF-β1 treatment. Snail gene can effectively inhibit the expression of MMP-2 promoted by TGF-β1. Experimental findings indicate that TGF-β1 could increase the MMP-2 expression and then promote the BMSCs migration through the upregulation of the Snail expression.