Objective To investigate the clinical effect of selective uterine artery embolization in obstetrics and gynecology postoperative bleeding.Methods The clinical data of 19 patients with obstetrics and gynecology postoperative bleeding undergoing selective uterine artery embolization were analyzed retrospectively,including 15 cases of cesarean and 4 cases of uterectomy.Results Nineteen patients were uterine artery bleeding.All patients were diagnosed by digital subtraction angiography (DSA) and embolization were disposable success.No complications such as organ necrosis or visceral dysfunction occurred.Conclusions DSA has advantages of minimally invasive,significant effect,less adverse reaction,quick recovery and easier to be accepted by the patients in diagnosis and interventional treatment of postoperative bleeding in obstetrics and gynecology.Selective uterine artery embolization has a wide range of application and development prospect in the field of obstetrics and gynecology.

Objective To explore the effect of multipore-light brown fixation on preventing peripherally inserted central catheter from prolapsing. Methods Randomizedly 82 patients with PICC were equally divided into treatment group and control group. Multipore-Light Brown fixation was used in the treatment group to stabilize catheter , while the routine care was applied in the control group for stabilization . The two groups were compared in terms of prolapse rate and degree of the PICC . Result The prolapse rate and the prolapse degree of the treatment group were significantly lower than that of the control group ( P < 0 . 01 ) . Conclusions The multipore-light brown fixation is more effective in the stabilization of PICC. It can effectively prevent the PICC from prolapsing.

This paper dicusses the significance of drug clinical trials,and summarises the experiences in policy making,personnel trainning,supervising and management in drug clinical trials at the First People's Hospital of Changzhou,which may provide reference for drug clinical trials in China.

Objective To investigate the clear effect of different blood purification techniques on the serum beta2-microglobulin ( β2-MG) of chronic renal failure maintenance hemodialysis patients.Methods Forty chronic renal failure maintenance hemedialysis patients were randomly divided into four groups: hemodialysis group (HD group), high flux dialysis group (HFD group), hemodiafiltration group (H D F group), hemodialysis and absorption group (HD+AP group). The serum β2-MG levels of the four groups were determined and compared before with after the therapy. Results The difference between the serum β2-MG in HD group detected at the first day before and after the therapy was insignificant difference [( 53.49±1.15 ) mg/L vs (49.10±2.31 ) mg/L ] (P > 0.05 ). The difference between the serum β2-MG in HD group detected at the first day before and after the therapy six months later [(55.63±1.30) mg/L] was significant difference (P <0.05). The serum levels at the first day and six months later after the therapy detected in HFD group, HDF group and HD+AP group were significantly decreased compared with those of the first day before the therapy (P < 0.05 ). Furthermore,the serum β2-MG level decreased in HD+AP group was more significant than HFD group and HDF group at six months later (P <0.05). Conclusions Hemodialysis can not clear the serum β2-MG. High flux dialysis, hemodiafiltration and resin absorptive devices associated hemedialysis can clear β2-MG effectively, while resin absorptive devices associated hemodialysis has the better effection after six months.

Objective To investigate the role of ghrelin promoting proliferation of pancreatic β cells and the mechanism of it. Methods Mouse pancreatic β cells(NIT-1)were treated with different concentrations of ghrelin.NIT-1 cells proliferation was measured by MTT incorporation assay,and the cell cycle was measured by Flow Cytometry,and the expression of ERK1/2 and the level of ERK1/2 phosphorylation were determined by Western blot assay.Results With the increase of concentration and the time of treatment,ghrelin promotes cell survival of pancreatic β cells.The S-phase portion was changed after treatment of ghrelin on NIT-1 for 48 hours.The S-phase percentage in the groups where ghrelin concention change from 0 tO 10-9,10-8,10-7 mol/L were(34.5±6.5)%,(42.1±7.4)%,(50.6±5.8)%,(71.4±9.4)%,respectively.Ghrelin also induces phesphorilation of ERK1/2 in NIT-1 cell,and a doseeffect relationship was demonstrated.Conclusion Ghrelin could promote proliferation of pancreatic β cells through activating the MAPK/ERK1/2 signaling pathway and changing the cell cycle.

Objective To observe the level of serum hepcidin and the relationship of hepcidin with renal anemia and micro-inflammation state in peritoneal dialysis(PD) patients.Methods Serum hepcidin,interleukin-6(IL-6),soluble transferrin receptor (sTfR) and erythropoietin (EPO) were measured in 50 PD patients with anemia,30 PD patients without anemia and 40 cases of normal control by ELISA.The indexes of blood routine examination,biochemistry and iron metabolism were also detected at the same time.Results The level of hepcidin in PD patients was significantly higher than that in normal control[(103.65±43.6) μg/L vs (56.39±35.7) μg/L,P ＜ 0.05].Furthermore,the level of hepcidin in PD patients with anemia was higher than that in PD patients without anemia [(122.67±36.6) μg/L vs (83.65±26.4) μg/L,P ＜ 0.05].The results of correlation analysis showed that serum IL-6,sTfR,EPO and ferritin were positively correlated with hepcidin(R =0.821,0.742,0.711,0.531,all P ＜ 0.05),while creatinine clearance of residual kidney in 24 hours and hemoglobin were negatively correlated with hepcidin(R =-0.533,-0.685,all P ＜ 0.05).Conclusions The higher level of hepcidin in PD patients is related with the residual renal function and the micro-inflammatory state.The higher level of hepcidin may induce the iron metabolism imbalance,and then influence the state of renal anemia.The adjustment of hepcidin may provide clinical research value of improving renal anemia and micro-inflammatory state in PD patients.

Objective To explore the thoracic CT manifestations and pathologic basis of pulmonary Wegener granulomatosis (WG),in order to improve the diagnostic accuracy.Methods Eighteen patients with pulmonary WG confirmed by pathology were collected.All the patients underwent CT scan and enhanced scan with 64-slice volume CT.CT features and clinical symptoms were retrospectively reviewed.Results The pathological manifestations of 18 cases with pulmonary WG were miscellaneous,including necrotizing granuloma infiltrated with inflammatory cells,intrapulmonary vasculitis,parenchymal necrosis,hemorrhage of pulmonary alveolus,microabscess and so on.Thoracic CT manifestations:multiple nodules were seen in 7 cases,multiple masses were detected in 4 cases,cavitations showed in 10 cases,peripheral wedge-shaped shadows showed in 2 cases,ground-glass attenuation and consolidation showed in 2 cases,bronchial wall thickening in 2 cases,solitary pulmonary nodule or mass in 3 cases,pleural effusion was seen in 5 cases.All the nodules,masses and cavitations demonstrated inhomogeneous and ring enhancement on contrast-enhanced images.Some patients presented with varied kinds of the above lesions,which could transform each other and became more or less.Conclusions Pulmonary WG has many pathological manifestations,resulting in the variety of the thoracic CT manifestations.The main manifestations are multiple nodules and multiple masses,necrotic cavitations.The feeding vessel sign to a nodule or mass and ring-shade cavity are relatively characteristics to diagnose pulmonary WG.The correct diagnosis could be established on the bases of understanding of the special developments and pathology of the lesions.

Objective To investigate the effects ofBushen Gujing Recipe in treating early diabetic nephropathy (DN).Methods Sixty patients of early DN with Yin-Yang deficiency syndrome were randomly divided into treatment group and control group, 30 cases in each group. The control group was treated with conventional western medicine treatment, and the treatment group was treated withBushen Gujing Recipe combined with the conventional therapy. The treatment course was three months. The clinical efficacy, integral of TCM syndrome, and urinary albumin excretion rate (UAER) of the two groups were compared.Results After the treatment, the integral of TCM symdrome of the treatment group was lower than control group, showed a statistically significant difference (P<0.05). The total effective rates of clinical efficacy were 81.48% (22/27) in treatment group, and 64.00% (16/25) in control group. The therapeutic effect of treatment group was better than control group (P<0.05). UAER showed a statistically significant difference between two groups (P<0.05).Conclusion Based on the western medicine treatment,Bushen Gujing Recipe can improve the symptoms of patients, alleviate the injury of kidney, and has good efficacy on DN.

Objective To investigate the prevalence of metabolic syndrome in patients with maintenance hemodialysis, and to analyze the potential risk factors. Methods The clinical data of 472 patients with maintenance hemodialysis from 7 blood purification centers were collected. Patients were divided into the MS group and the non-MS group. The demographic data , anthropometric examinations , dialysis prescription and results of laboratory were compared between these two groups. Multivariate Logistic regression analysis was performed to analyze the risk factors of MS. Results The morbidity of MS was 34.75%. There were significant differences in weight , waist circumference , waist-hip ratio , frequency of dialysis , time of hemodialysis perweek , urea reduction ratio, urea clearance index (Kt/v), iron, intact parathyroid hormone (iPTH), leukocytes, high sensitivity C-reactive protein (hs-CRP) between these two groups (P < 0.05, resectively). Multivariate Logistic regression analysis revealed that iron (OR = 1.084, P = 0.042), iPTH (OR = 1.754, P = 0.035), waist-hip 1ratio (OR = 2.013,P = 0.021), hs-CRP (OR = 4.245,P = 0.000)were correlated with MS. Conclusion The morbidity of MS in patients with maintenance hemodialysis is higher. Iron, iPTH, waist-hip ratio, hs-CRP are potential risk fctors of MS for the patients with maintenance hemodialysis.

Objective To evaluate the accuracy of core needle biopsy (CNB) in diagnosing breast masses and its coherence with immunohistochemical (IHC) examination results of estrogen receptor (ER), progesterone receptor (PR) and Her2 protein between pre-and post-chemotherapy in invasive breast cancer. Methods The results of 516 CNB cases from June, 2005 to April, 2008 were analyzed retrospectively. The pathological examination was performed by two pathologists independently. Results 484 cases of malignant tumor, carcinoma in situ and phyllodes tumor were found in this group with the sensitivity of 96.7%. Sixteen cases of false negative (3. 3% ) were demonstrated by surgical biopsy. The accurate rate of CNB was not influenced by the maximum diameter of masses ( P = O. 423 ). The agreement rate of IHC results of ER, PgR and Her2 between pre- and post-chemotherapy were 90. 3%, 76. 8% and 82.5%, respectively. Conclusion CNB is a useful diagnostic method with a satisfactory accuracy in any size of breast masses. Given the histological heterogeneity of invasive breast cancer and the influence of ehemotherapy, the coherence of prechemotherapy IHC for ER, PgR and Her2 is not optimal with that of post-chemotherapy.