Objective To evaluate the clinical efficacy of laparoscopic surgery combined with GnRH agonist in the treatment of endometriosis. Methods From January 2008 to January 2012, 205 patients with endometriosis underwent conservative laparoscopy surgery in our hospital .According to whether the patients accepted the therapy of GnRH-a and the time of the treatment after surgery, patients were divided into three groups:group A was treated with conservative laparoscopic surgical (73 cases), group B was given GnRH-a for 3 months after surgery (68 cases), and group C received GnRH-a for 6 months after surgery (64 cases).These patients were followed up for 24 months after surgery .The recurrence rate and pregnancy rate were compared among the three groups . Results The postoperative recurrence rates within one year were 4.4%(3/68) in the group B and 3.1% (2/64) in the group C, which were all lower than that of the group A (13.7%, 10/73).There was no difference between the group A and B (χ2 =3.628, P=0.057), while the rate of group C was significantly lower than that of the group A (χ2 =4.771, P=0.029).The cumulative recurrence rates in the group B and C were respectively 13.2%(9/68) and 10.9%(7/64), which were significantly lower than that of the group A [27.4%(20/73); χ2 =4.322, P=0.038; χ2 =5.839, P=0.016].There were no differences about the natural pregnancy rate within 2 years postoperatively among the three groups (χ2 =0.812, P=0.666), but for those who underwent IVF-ET after laparoscopy, the pregnancy rates in group B and C were respectively 78.9% (15/19) and 80.0% (16/20), which were significantly higher than that of the group A [47.6% (10/21); χ2 =4.177, P=0.041; χ2 =4.630, P=0.031]. Conclusions Laparoscopic surgery combined with GnRH-a is highly effective in the treatment of endometriosis , which can effectively reduce the recurrence rate .Application of GnRH-a for 3-6 months after laparoscopic surgery can improve the pregnancy rate in those who accept the treatment of IVF-ET.

Objective:To summarize the application of hospital electronic medical record system and implementation experience, for the scientific and reasonable construction of digital hospital provides design scheme. Methods: The electronic medical record to the patient as the center including the establishment of hospital medical records, doctor's orders, all kinds of inspection, inspection reports and other information. Results: The uniform ultimate implementation of electronic health record standard, electronic data from medical records and medical information barrier-free exchange, realize the integration and sharing of electronic medical records information inside the hospital. Conclusion: The electronic medical record system to improve the clinical efficiency in hospital application, provide auxiliary functions for clinical decision making.

The study intended to evaluate the efficacy and safety of patient-controlled intravenous analgesia with remifentanil for labor. Three hundred and two parturients at 37 -42 week of gestation received remifentanil (0. 1μg · kg-1 ·min-1 ) as patient-controlled intravenous analgesia for labor (analgesia group) and their clinical results were compared with those of 221 parturients in labor without intravenous analgesia (control group). Maternal monitoring, including pain scores(VAS), delivery mode, side effects, laboring time was performed for both groups. There was a significant decrease (P ＜0. 01) of pain scores in analgesia group compared with those in control group. Parturients in analgesia group experienced a significantly shorter first stage, than those in the control group ( P ＜ 0. 01). There were no differences between two groups in the rate of cesarean section and instrumental delivery. And there were no significant differences for newborns with Apgar scores less than 7 at the point of one minute. Patient-controlled intravenous analgesia with remifentanil for labor is an effective and safe procedure, which can significantly relieve pain, shorten first stage of labor and has no effect on the delivery mode and Apgar scores of neonates.

Objective To investigate two different hysterectomy ( total abdominal hysterectomy and total laparoscopic hysterectomy ) on short-term efficacy and influence on sexual functions . Methods The retrospective records of 100 cases of total laparoscopic hysterectomy ( TLH) and 100 cases of total abdominal hysterectomy ( TAH) from January 2009 to December 2012 were reviewed.The operation time, intraoperative blood loss, postoperative hospital stay, and sexual satisfaction at 12 months postoperatively were compared between the two groups . Results The operation time was longer in the TLH Group than that in the TAH Group [(128 ±11) min vs.(87 ±33) min, t=-11.787, P=0.000].The intraoperative blood loss was less in the TLH Group than that in the TAH Group [(108 ±37) ml vs.(155 ±28) ml, t=-10.129, P=0.000].The hospital stay was shorter in the TLH Group than that in the TAH Group [(5.5 ±1.9) d vs.(8.2 ±1.6) d, t =-10.870, P =0.000].There were no significant differences between the two groups in sexual frequency (Z=-1.300, P=0.193), libido (Z=-0.564, P=0.573), achievement of orgasm (Z =-1.591, P=0.112), sexual intercourse disorder (Z =-0.478, P =0.633), and the overall satisfaction (Z=-0.083, P=0.934).Extent of dyspareunia was worse in the TLH Group than in the TAH Group (Z=-3.752, P=0.000). Conclusions TLH has less blood loss and shorter hospitalization time than TAH .Hysterectomy has a certain influence on sex functions .Differences in the sexual satisfaction are not statistically significant between the two procedures .

This article was aimed to study the effect of resveratrol on steroid-induced diabetes mellitus (SDM) in rats and the related mechanism. SD rats were randomly divided into the normal control (NC) group, SDM group, low dosage of resveratrol (LDR) group, middle dosage of resveratrol (MDR) group, and high dosage of resveratrol (HDR) group. All groups were tested on the change of blood glucose, insulin resistance (IR), adiponectin and tumor necrosis factor-α(TNF-α) in serum. The rate of cellular apoptosis in pancreas islet and the expression of BCL2 in rats were also observed. The results showed that compared with the SDM group, the blood sugar, IR, TNF-αlevel, and the ratio of pancreas islet cellular apoptosis in serum of the MR group and HDR group were lower (P<0.05). The expres-sion of adiponectin and BCL2 protein were up-regulated in the MR group and HDR group (P<0.05). It was conclud-ed that resveratrol can protect rats against the injury from MDR and HDR of SDM. This protective effect is possibly mediated by down-regulating the blood glucose, IR, inflammation factors in pancreas islet, and up-regulation of BCL2 protein, in order to inhibit cellular apoptosis in pancreas islet.

Lymphatic malformations including macrocystic and microcystic malformation are congenital benign vascular disease. The incidence in children is much higher than adults and they most often occur in head and neck. There are a variety of diagnosis and treatment methods in lymphatic malformations. This paper reviewed the recent literatures with respect to the pathology, imaging and treatment of the lymphatic malformations in children. And we detailed the advantage and disadvantage of surgical excision, sclerotherapy, laser ablation and drug treatment of lymphatic malformations particularly in children. Surgical excision continues to be integral to treat in many cases when the lesions involve the eye socket or are large enough to affect breathing, but it should not be overused without consideration of the histologic types and extent. In addition, cervicofacial macrocystic lesions tend to sclerotherapy while superficial mucosal microsystic lesions are amenable to laser therapy. In order to obtain the best treatment outcomes, the treatment protocol should be individualized and comprehensive.
Child ; Head ; pathology ; Humans ; Laser Therapy ; Lymphatic Abnormalities ; diagnosis ; therapy ; Neck ; pathology ; Sclerotherapy ; Treatment Outcome

Objective_To study the significance of fascin protein expression in ductal intraepithelial neoplasia ( DIN) and invasive ductal carcinoma ( IDC) .Methods_Thirty cases of usual ductal hyperplasia ( UDH) , 30 ca-ses of flat epithelial atypia (FEA,DIN1a), 15 cases of atypical ductal hyperplasia (ADH,DIN1b), 2 cases of DCIS grade1(DIN1c),10 cases of DCIS grade2(DIN2)and 18 cases of DCIS grade3(DIN3)were immunohisto-chemically investigated using monoclonal antifascin antibody and compared with 120 cases of invasive ductal carci-noma (IDC).Results_Fascin protein expression was not found in normal breast tissue, UDH, FEA (DIN1a), ADH(DIN1b),DCIS grade1(DIN1c)and DCIS grade2(DIN2),but only seen in 2 of 18 cases of DCIS grade3 (DIN3)(11.1%), and 18 out of 120 cases of IDC (15%).Fascin protein expression was correlated with ER neg-ative( P<0.05) , PR negative( P<0.05) , tumor grade( P<0.05) and axillary lymph node status( P<0.05) , but not correlated with age,location,tumor sizeand HER2 expression.Conclusions_Fascin protein expression seems to be a late event, usually present in carcinoma.Targetting the fascin pathway may be a noval therapeutic strategy of mammary carcinoma.

Objective To investigate the value of interventional embolism in diagnosing etiological factor and treatment of the late stage of hemorrhage of uterus post-cesarean section.Methods Angiography and embolism through super-selective bilateral internal iliac artery and uterine artery in 56 patients with late stage of hemorrhage in uterus after cesarean section were performed with Seldinger technique.Results All patients were treated successfully and no complication presented.Conclusion Interventional embolism is of important value in treating the late stage of hemorrhage in uterus after cesarean section.

Objective To discuss the medical treatment responsibility caused by unpredictable harm.Method In medical treatment,the court usually applies the "Equitable Responsibility" principle to settle the medical conflicts caused by unpredictable harm,this poses certain limitations.Result The fact that hospitals being liable for compensation or reparation ignores the mutual risk-sharing responsibility of hospitals and patients.Conclusion To establish the system of medical accident insurance is one of the best measure to solve the medical conflicts caused by unpredictable harm.