Objective To evaluate the value of transvaginal two-dimensional ultrasound(2D-TVS)and transvaginal three-dimensional ultrasound (3D-TVS) in the diagnosis of intrauterine lesions with abnormal uterine bleeding.Methods Intrauterine lesions for 171 patients underwent 2D-TVS followed by 3D-TVS in the same session.Within 10 days of the sonographic session,each patient underwent pathologic histology examination after hysteroscopy examination or surgery therapy,which was considered the reference standard.For each of the two imaging methods,sensitivity,specificity,and accuracy were calculated.Results The results of 2D-TVS and 3D-TVS had good agreement with pathological results in endometrial hyperplasia,endometrial polyps,uterus submucous myoma and endometrial cancer.For 2D-TVS,sensitivity was 84.5％,71.4％,86.8％,66.7％,and specificity was 86.7％,90.7％,97.0％,98.7％,respectively; For 3D-TVS,sensitivity was 91.4％,87.3％,92.1％,83.3％,and specificity was 93.8％,96.3 ％,97.7 ％,98.7 ％,respectively.The diagnose accordance rate of the 3D-TVS for intrauterine lesions was statistically higher than that of the 2D-TVS (89.5％ vs 78.9％,P ＜0.05).Conclusions The sensitivity and diagnose accordance rate of 3D-TVS was higher than that by 2D-TVS,3D-TVS plays an important role in the diagnosis and differential diagnosis of intrauterine lesions.

The basic nursing quality is an important dial of the general administration level and the basic personnel quality of a hospital.Many causes have led to the down trend of the basic nursing quali- ty.After a specific analysis of the causes of such a trend,important measures and solutions have been put forth,The first is to strengthen the moral education of the profession and upgrade the quality of the nursing staff.The second is to adopt the "group responsibility" administration and gradually carry out a systimatic integrated nursing so that a transformation of nursing models is put to practice,The third is to broaden the outlet of human resources so that personnel are rationally employed and the rate of job— taking raised.The last one is to heighten the initiative of the nursing staff through the rational opera- tion of the "incentive"mechanism in accordance with the law of values.

ObjectiveTo investigate the extracorporeal clearance rate of imipenem in severe infection patients in the mode of continuous vena-venous hemofiltration (CVVH) during continuous renal replacement therapy (CRRT), in order to approach if the concentration of imipenem in plasma could achieve effective levels of anti-infection, and to explore the effect of time and anticoagulation measure on imipenem clearance during CRRT treatment.Methods A prospective observational study was conducted. All adult severe infection patients complicating acute kidney injury (AKI) in the Department of Critical Care Medicine of the Fourth Hospital of Hebei Medical University from March 2013 to September 2014, who were prescribed imipenem as part of their required medical care, and CRRT for treatment of AKI were enrolled. 0.5 g doses of imipenem was administered intravenously every 6 hours or 8 hours according to random number table, and infused over 0.5 hour. The unfractionated heparin was used for anticoagulation in the patients without contraindications, and no anticoagulation strategy was used in the patients with high risk of bleeding. At 24 hours after first time of administration, postfilter venous blood and ultrafiltrate samples were collected at 0, 0.25, 0.5, 0.75, 1, 2, 5, 6, and 8 hours after imipenem administration. The concentration of imipenem in above samples was determined with liquid chromatography-mass spectrometer/mass spectrometer (LC-MS/MS).Results A total of 25 patients were enrolled. Thirteen patients received imipenem intravenously every 6 hours, and 12 patients, every 8 hours. The anticoagulation was conducted with heparin in 13 cases, and 12 cases without anticoagulation. The intra-day precision, inter-day precision, matrix effect, and recovery rate in low, medium, and high concentration of plasma and ultrafiltrate, and the stability of samples under different conditions showed a good result, the error of accuracy was controlled in the range of±15%. With the application of Prismaflex blood filtration system and AN69-M100 filter, under the mode with CVVH, the total clearance rate of imipenem was (8.874±2.828) L/h when the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1, the total CRRT clearance rate of imipenem in vitro was (2.211±0.539) L/h, which accounting for (30.1±15.7)% of the total drug clearance. In 6 hours interval dosage regimen, the percentages of the time> 4×minimum inhibitory concentration (MIC) at specific 4×MIC of 2, 4, 6, and 8μg/mL of imipenem were more than 40% of the dosing interval. But in the 8 hours interval dosage regimen, when the level was above the 4×MIC of 4μg/mL, maintaining time would drop below 40% of the dosing interval, with significant differences compared with that in 6 hours interval dosage regimen [4×MIC = 2μg/mL: (60.84±20.25)%vs. (94.01±12.46)%,t = 4.977,P = 0.001; 4×MIC = 4μg/mL: (39.85±15.88)% vs. (68.74±9.57)%,t = 5.562, P = 0.000; 4×MIC = 6μg/mL: (27.58±13.70)% vs. (53.97±8.36)%,t = 5.867,P = 0.000; 4×MIC = 8μg/mL:(18.87±12.43)% vs. (43.48±7.83)%,t = 5.976,P = 0.000]. No significant change in sieving coefficient of imipenem was found within a short time (6 hours), which indicated that there was no effect of anticoagulation on clearance of imipenem by AN69-M100 filter, and no statistical significance was found with repeated measure analysis (F = 0.186, P> 0.05).ConclusionsThe clearance rate of imipenem is increased significantly in vitro under the mode of CVVH with the actual dose of replacement fluid was (31.63±1.48) mL·kg-1·h-1 in severe infective patients with severe sepsis complicating AKI, affecting the level of plasma drug concentration, need to adjust the dosage regimen. When the time of the dosing interval was shortened, the concentration of imipenem in patients' plasma could be increased significantly. In a short period of time, the sieving coefficient of imipenem through AN69 filter is not affected by anticoagulation measures and time cleaning efficiency will not decline.

Anterior ischemic optic neuropathy (AION) is the ciliary artery-circulatory disorders for the supply of optic nerve head area before the sieve plate prozone and sieve plate district, result in the insufficient blood supply of the optic nerve head and ischemia hypoxia, edema. Clinical manifestations of the type with non-artery inflammatory neuropathy and artery inflammatory neuropathy, which would both eventually lead to the irreversible damage to the optic nerve. In the early phase of AION, the main method is giving a glucocorticoids intravenous drip and a periglomerular injection (or retrobulbar injection) in time, but using the glucocorticoids for a long time or in quantity can cause a series of complications. Therefore, the combination of traditional Chinese and western medicine treatment of AION has become more and more significant in clinic.

Objective:To get a rapid and stable method of induction of rapid cultivation and maturation of Dendritic Cells(DC) from human peripheral blood in vitro.Methods:Cultured plastic-adherent monocytes were isolated from tumor patient peripheral blood mononuclear cells and GM-CSF(1 000 u/ml),IL-4(500 u/ml) were added in the cells at 0 h,which were separated into four groups.Poly(I ∶ C)(Polyriboinosinic Polyribocytidylic Acid) were added in the first group cells at 24 h and the DC cells were collected at 48 h;TNF-? in the second group cells were added at 24 h and the cells were collected at 48 h;Poly(I ∶ C) were added in the third group cells at 36 h and the cells were collected at 72 h;TNF-? were added in the last group cells at 36 and the cells were collected at 72 h.Results:The results of flow cytometer showed that the third group got the most mature DC.The dendritic cells from the third group have significant stimulatory activity in allogeneic lymphocyte proliferation.Conclusion:The method of rapid cultivating and maturating of Dendritic Cells from human peripheral blood in vitro induced by Poly(I ∶ C) is rapid,stable,economical and simple.It may facilitate future studies of DC and its clinical application.

Objective To investigate the intervention of trans-theoretical model on the risk factors in the patients with prediabetes.Methods One hundred and twenty-two patients with pre-diabetes in a tertiary hospital of Zhengzhou City were selected and randomly assigned to control group and intervention group.The control group received the routine diabetic health education,while in addition to the routine health education,the intervention group was assisted by TTM interventional measures.The blood glucose,body mass index(BMI) and negative emotion were compared between the two groups.Results The blood glucose and BMI after intervention in the two groups were decreased,moreover the decrease level of fasting blood glucose and BMI in the intervention group was higher than that in the control group,and the difference was statistically significant(t=4.963、2.061,P＜0.05).The anxiety and depression emotion scores after intervention in the intervention group were [(3.47 ±1.07) and (0.30 ± 0.46)],before intervention were (7.74 ± 4.00) and(7.25 ± 4.50),The difference was statistically significant(P＜0.05),Moreover the anxiety and depression emotion scores after intervention in the intervention group were lower tghan those in the control group with statistical difference(t=3.300、2.054,P＜0.05).Conclusion The intervention measures based on TTM has significant advantage for controlling the risk factors of pre-diabetes and preventing diabetes than the conventional health education.

Objective: Our aim was to study whether the cellular bronchoalveolar lavage fluid (BALF) profile was associated with the parameters of pulmonary function tests. Methods：Lung function tests and BAL were carried out in 18 untreated, non-smoking patients suffering from sarcoidosis and 18 normal subjects. Results：（1）Lung function tests were normal at rest in patients with sarcoidosis（P＞0.05）, the single breath carbon monoxide diffusing capacity decreased (P＜0.05)，and the small airway function decreased too (P＜0.05).（2）The percentage of lymphocytes in BALF of sarcoidosis increased comparing with the normal subjects（P＜0.01），and the ratio of CD+4 to CD+8 in BALF increased significantly in sarcoidosis（P ＜0.05）, furthermore, the increase of both the percentage of lymphocytes and the ratio of CD+4 to CD+8 in BALF of sarcoidosis were well nagatively correlated with the decrease of the percentage of DLCO (r=-0.67, P＜0.01 and r=-0.55, P＜0.05, respectively), the decrease of mid-expiratory flow at 50% of vital capacity (FEF50%) was well correlated with the increase of the percentage of lymphocytes in BALF of sarcoidosis (r=-0.54, P＜0.05). Conclusion：Pulmonary diffusing capacity（DLCO) was significently correlated with BALF lymphocyte phenotype，so was small airway function，and can act as the marker of activity of sarcoidosis.

AIM: To investigate the effects of Lipopolysaccharide(LPS) and interieukin 1 receptor antagonist (IL- 1ra) on mesangial cells proliferation and nitric oxide synthesis. METHODS: Glomerular mesangial cells from SD rats were cultured. The first and second passages of cultured cells were used for the experiment. LPS and LPS plus IL- 1ra were added in cell cultures, respectively. By using chemical method the nitrite in supernatants was measured ,3H- TaR incorporation was determined to evaluate the GMC proliferation. Northern and slot hybridizations were performed to detect the expression of iNOS mRNA. RESULTS: There were expression of iNOS mRNA, more production of nitrite(0.64 + 0.25 vs 0. 12 + 0.06 nmol/104 cell) in supernatants and GMC proliferation(3735 + 1177.9 vs 1785 + 280.6) in LPS group compared to the control. While compared with LPS group, in LPS + IL- 1ra GMC group, expression of iNOS mRNA decreased by 40%, nitrite increased(3.28 + 0.33 nmol/104 cell), proliferation of GMC decreased (818 + 77.27). CONCLUSION: LPS could activate the GMC to express iNOS mRNA and produce more nitrite. IL - 1ra could partially inhibit the effects of LPS on the expression of iNOS mRNA in GMC, but not nitrite. There is no synchronous correlation between NO production and GMC proliferation.

Objective To explore the effect of xuezhikang on blood lipids,vascular endothelial function and redox balance in patients with carotid atherosclerosis.Methods A total of 108 inpatients with carotid atherosclerosis in cardiology department were randomly divided into two groups:xuezhikang group (n = 54) and cholestyramin group (n= 54).Before and after treatment,the levels of total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),nitric oxide (NO),endothelin-1 (ET-1),reduced glutathione (GSH) and oxidized glutathione (GSSG) of all patients were measured.The GSH/GSSG as redox potentials were calculated according to Nernst equation.Results After 12 weeks of treatment,the levels of blood lipids were lower than before treatment in xuezhikang group [TC:(3.94±1.36) mmol/L vs.(5.68±1.47) mmol/L;LDL-C:(2.28±1.11) mmol/L vs.(3.43±1.36) mmol/L;TG:(1.54±0.59) mmol/L vs.(1.73±0.66)mmol/L;t=3.915,4.160,2.187;P<0.01,0.01,0.05,respectively],and the levels of blood lipids also decreased in cholestyramin group [TC:(4.15 ± 1.29) mmol/L vs.(5.73 ± 1.52)mmol/L;LDLC:(2.56± 1.06) mmol/L vs.(3.37± 1.35) mmol/L;TG:(1.69±0.57) mmol/L vs.(1.72±0.67) mmol/L;t=3.760,4.035,1.893;P<0.01,0.01,>0.05,respectively].In xuezhikang group,ET-1,GSSG and GSSG/GSH ratios decreased significantly [(121.71 + 59.11) ng/L vs.(154.43±63.06) ng/L;(30.42± 1.59) μmol/L vs.(33.93±1.74) μ mol/L;-146.1±4.4vs.-142.3±4.3;t=2.168,2.325,4.168;P<0.05,0.05,0.01,respectively],and NO,NO/ET-1 ratios,GSH and GSH/GSSG increased significantly [(64.40 ± 18.86) μmol/L vs.(48.41 ±16.53) μmol/L;(0.54±0.19) vs.(0.33±0.16);(321.27±56.47) μmol/L vs.(286.11±38.23)μmol/L;(10.56±1.70) vs.(8.65±1.18);t=3.725,3.987,3.894,4.168;all P<0.01].Conclusions For patients with carotid atherosclerosis,both xuezhikang and cholestyramin could lower blood lipids efficiently,but only xuezhikang could protect vascular endothelial function partly,and makes plasma redox imbalance shift the balance.