Objective To investigate the indication, occasion and risk predication of cesarean hysterectomy and interventional treatment. Methods The clinical data of 9 patients with low cesarean section postpartum hemorrhage that underwent hysterectomy after interventional treatment from January 2012 to January 2013 were analyzed which included surgical indication, disease characteristics, procedure time, bleeding volume and other parameters. Results The most common surgical indication for cesarean that caused postpartum hemorrhage was dangerous placenta previa, accounting for 56%, followed byⅢdegree of placental abruption and preeclampsia. The surgical bleeding of cesarean accounted for 62%-70%of the total amount of bleeding. The total time of rescue was 7.4 ± 1.4 hours. The total amount of bleeding was 7 100 ± 2 250 mL. The occurrence of coagulation disorder was significantly correlated with surgical time and amount of blood loss. Conclusion For postpartum hemorrhage caused by cesarean section with risk factors such as scar uterus, placenta previa, placental abruption, many pregnant prolific and others, we must relax indications of hysterectomy. With future treatment potential, the early intervention of postpartum hemorrhage also plays an important role in reducing hysterectomy rate, reducing intraoperative and postoperative blood loss.

A novel series of bis-nicotine derivatives (3a-3i) were designed, synthesized and evaluated as bivalent anti-Alzheimer's disease agents. The pharmacological results indicated that compounds 3e-3i inhibited both acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) in the micromolar range (IC50, 2.28-117.86 micromol x L(-1) for AChE and 1.67-125 micromol x L(-1) for BChE), which was at the same potency as rivastigmine. A Lineweaver-Burk plot and molecular modeling study showed that these derivatives targeted both the catalytic active site (CAS) and the peripheral anionic site (PAS) of AChE. Besides, these compounds could significantly inhibit the self-induced Abeta aggregation with inhibition activity (11.85%-62.14%) at the concentration of 20 micromol x L(-1).

A series of tacrine-methoxybenzene hybrids (5a-5i) were designed, synthesized and evaluated as inhibitors of cholinesterases (ChEs). All the compounds had better ChEs inhibitory activities than tacrine with IC50 values at the nanomolar range. Compound 5h exhibited the strongest inhibition on acetylcholinesterase (AChE) with an IC50 value of 6.74 nmol x L(-1) and compound 5f showed the most potent inhibition on butyrylcholinesterase with IC50 value of 3.83 nmol x L(-1). Kinetic and molecular modeling studies showed that these hybrids targeted both the catalytic active site and the peripheral anionic site of AChE.

Objective To explore the learning curve characteristics of Mckeown-type minimally invasive esophagectomy and effects of the para-recurrent laryngeal nerve lymphadenectomy on efficacy.Methods The retrospective cohort study was conducted.The clinicopathological data of 163 patients with esophageal squamous cell carcinoma (ESCC) who underwent Mckeown-type minimally invasive esophagectomy in the Affiliated Tumor Hospital of Xinjiang Medical University between January 2011 and December 2015 were collected.According to the para-recurrent laryngeal nerve lymphadenectomy in the different learning curve stages (early,medium and later stages),49 patients who didn't undergo right para-recurrent laryngeal nerve lymphadenectomy were allocated into the group A,65 who underwent para-recurrent laryngeal nerve lymphadenectomy were allocated into the group B,and 49 underwent bilateral para-recurrent laryngeal nerve lymphadenectomy were allocated into the group C.Observation indicators:(1) comparisons of intra-and post-operative recovery among groups;(2) comparisons of follow-up and survival among groups;(3) correlation analysis between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival up to April 2017.Measurement data with normal distribution were represented as-x±s.Comparison among groups was analyzed using the ANOVA,and pairwise comparison was done using the independent-sample t test.Measurement data with skewed distribution were described as M (range),and comparison of count data was done using the chi-square test.The survival time was calculated by the Kaplan-Meier method,and Log-rank test was used for survival analysis.Correlation analysis was done by Spearman rank correlation.Results (1) Comparisons of intra-and post-operative recovery among groups:patients in the 3 groups underwent successful Mckeown-type minimally invasive esophagectomy of ESCC,without conversion to open surgery.The operation time,total number of lymph node dissected,number of thoracic lymph node dissected and volume of intraoperative blood loss were respectively (395±94) minutes,14.7±6.9,9.6±5.4,(175± 100) mL in the group A and (329±67) minutes,20.4±9.1,11.4±7.3,(117±49) mL in the group B and (301±51)minutes,25.8±11.0,14.8±10.1,(115±50) mL in the group C,with statistically significant differences in above indicators among groups (F=21.962,1.992,5.775,12.744,P＜0.05),between group A and group B (t =3.135,3.741,4.324,4.375,P＜0.05) and between group A and group C (t=5.120,3.415,5.712,6.130,P＜0.05).There was no statistically significant difference in operation time and volume of intraoperative blood loss between group B and group C (t =2.325,2.459,P＞0.05).There were statistically significant differences in total number of lymph node dissected and number of thoracic lymph node dissected between group B and group C (t =2.751,3.245,P＜0.05).Cases with unilateral recurrent laryngeal nerve injury,anastomotic leakage and pneumonia were respectively 7,8,7 in the group A and 17,19,10 in the group B and 11,15,10 in the group C,with no statistically significant differences (x2 =0.968,3.292,0.773,P＞0.05).Number of lymph node dissected at right and left para-recurrent laryngeal nerve were respectively 0,0 in the group A and 1.9±1.8,0 in the group B and 2.6±2.1,1.1±0.8 in the group C.Of 35patients with unilateral recurrent laryngeal nerve were treated with symptomatic and supportive treatment of neuro nutrition,18 encountered permanent hoarseness and 17 recovered well.Patients with anastomotic fistula and pneumonia were improved by sufficient drainage and antibiotic therapy.(2) Comparisons of follow-up and survival among groups:149 of 163 patients were followed up for 17-65 months,with a median time of 32 months,including 43 in the group A,61 in the group B and 45 in the group C.Survival time of patients who received follow-up was recpectively (31.3±2.6) months,(32.2± i.6) months and (25.5±2.5) months in group A,B and C,with no statistically significant differences (x2=4.412,P＞0.05).(3) Correlation analysis between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy:results of correlation analysis showed that there was a significant negative correlation between operation time or volume of intraoperative blood loss and cases of learning curve of Mckeown-type minimally invasive esophagectomy (r=-0.632,-0.451,P＜0.05),showing a decreasing trend in operation time and volume of intraoperative blood loss with increasing surgical cases.Conclusions The operation time and volume of intraoperative blood loss are gradually declining with learning curve process of Mckeown-type minimally invasive esophagectomy.Para-recurrent laryngeal nerve lymphadenectomy cannot increase the incidence of recurrent laryngeal nerve injury,with more completely lymphadenectomy.