Objective To explore the types, clinical pathologic and immunohistochemical features of spindle cell tumors of the uterine and broad ligament. Methods Clinical pathological files of spindle cell tumors in the uterine and broad ligament from 2007.12 to 2015.12 were reviewed. Results The primary sites of the 145 cases was cervical in 11 cases (7.58%), uterine body in 119 cases (82.07%), the broad ligament in 12 cases (8.28%), and uterine or cervix and the abdominal wall in 3 case (2.07%). Histopathological types of the 145 cases was smooth muscle origin in 126 cases (86.90%), of which 120 cases had benign leiomyoma, 3 cases had uncertain malignant potential and 3 cases had leiomyosarcoma;endometrial stromal origin in 15 cases (10.34%), including endometrial stromal nodule (5 cases), endometrial stromal sarcoma (10 cases); endometrial stromal- variant (3 cases, 2.07%), including endometrial stromal nodule associated with smooth muscle differentiation (2 cases), endometrial stromal sarcoma associated with smooth muscle differentiation (1 case); gastrointestinal stromal tumor (1 case, 0.68%). Conclusions Origin of spindle cell tumors of the uterine and broad ligament is mainly smooth muscle, endometrial stromal origin, and endometrial stromal tumor variants, and gastrointestinal stromal tumors in rare cases. We need to combine the clinical site, pathological morphology and immunohistochemistry for diagnosis and differential diagnosis.

At present,the treatment for non-small cell lung cancer (NSCLC) consists of surgery,radiation,chemotherapy,targeted therapy,etc.The epidermal growth factor receptor (EGFR) gene mutation opened a new era of individualized treatment.Multidisciplinary treatment come next after the combination of different treatment approaches,and the modality of targeted therapy like epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in combination with radiation was included.The present work reviews clinical progress for the EGFR-TKI combined with radiotherapy in advanced NSCLC.

Objective To conclude the results of electrophysiological (EP) mapping and ganglianated plexis (GPs) ablation during the minimally invasive atrial fibrillation (AF) surgery.Methods During the period of Sep 2007 to May 2010 to-tally 185 paroxysmal atrial fibrillation cases were recruited receiving the minimally invasive AF surgery with video assistance.The EP mapping was used to test the dual direction block after ablation and the distribution of GPs was recorded.The sinus rhythm rate was followed up after surgery.Results All the minimally invasive surgery were performed successfully withoutdeath in the hospital.There was no permanent pacemaker implant and other serious complications.EP mapping results showed92％ pulmonary vein (PV) potential to the left atrium (LA) could be isolated with the dual direction block for the paroxysmal atrial fibrillation cases.And there were 89％ GPs positive,higher rate than the persistent AF.There were more GPs positive in the right PV area than the left and 86％ GPs lied at the LA domain,not the PV orifice.At least 5 or 6 ablation lesions were needed to get the dual direction block and denervation of the GPs.The sinus rhythm rate after surgery after 3,6,12 and 24months is 83.7％,82.4％,85.4％ and 83.9％.The 12 months follow up data showed the cases with more GPs positive (＞6) had 81.3％ sinus rate and the less GPs positive (≤2) group with 52.6％.Conclusion The EP mapping and GPsablation techniques during the minimally invasive AF ablation surgery could get good sinus rhythm rate during the long term follow up.

Objective To investigate the clinical efficacy of adefovir dipivoxil in antiviral treatment of chronic hepatitis B and its effect on peripheral blood T lymphocyte subsets.Methods 40 cases of patients with chronic hepatitis B were selected from The Fourth People’s Hospital of Qinghai in October 2009 to June 2012,the patients were given the antiviral treatment of adefovir dipivoxil.Before treatment,3 months,6 months and 12 months after treatment,the changes of liver function indicators of alanine transaminase(ALT),aspartate transaminase(AST)and total bilirubin(TBiL),and hepatitis B virus-DNA(HBV-DNA)were recorded;the total effective rate was observed;the peripheral blood T lymphocyte subsets changes was tested and analyzed by flow cytometry.Results The ALT,AST and TBiL of the patients all improved good,and the indicators of ALT,AST and TBiL after 12 months decreased significantly than before treatment,the HBV-DNA testing of the patients recovered negative,the difference was statistically significant (P<0.05 );the total effective rate of hepatitis B patients is 92.5%;the peripheral blood T lymphocyte subsets has no significant improvement in patients after antiviral treatment for 3 months.After the treatment for 6 months and 12 months,the CD4 +T and CD4 +/CD8 +T were significantly higher than those before treatment,there was no significant changes in CD3 +T and CD8 +T before and after treatment.Conclusion Adefovir dipivoxil has a good clinical efficacy in antiviral treatment of chronic hepatitis B,and can significantly improve the patients’liver function,improve peripheral blood T lymphocyte subsets imbalance.

Objective To investigate the value of otolith-repositioning maneuver combined with medical treatment on benign paroxysmal positional vertigo in the elderly patients.Methods 176 elderly people who suffered from benign paroxysmal positional vertigo were randomly divided into observation group and control group (n=88,each).All patients were treated with basal medicine treatment and compulsive position for 21 days,and patients in the observation group were treated with otolith repositioning maneuver added on the basis.The clinical efficacy and adverse reactions were observed and compared between the two groups after treatment.Results The curative rate and effective rate were higher in observation group than in control group at 2,3 weeks after treatment [50.0％ (44/88) vs.11.4％ (10/88),70.5％ (62/88) vs.47.7％ (42/88),77.3％ (68/88) vs.29.5％ (26/88),93.2％ (82/88) vs.86.4％ (76/88),x2 =37.32,73.32,37.32,53.43,respectively,all P＜0.05].Dizziness combined with nausea and vomiting,and walking instability were both found in the two groups,which had no statistical difference (x2 =3.25,P＞0.05).Patients in observation group developed arrhythmia and Tumarkin otolith crisis after treatment.The transfer rate of surgery was lower in observation group than in control group (x2 =45.43,P＜0.01).Conclusions Otolith-repositioning maneuver combined with medical treatment have good clinical effect and safety on benign paroxysmal positional vertigo in the elderly.

Objective To provide ideal endometriosis animal models for research new treatment methods. Methods 64 Sexual mature without pregnant SD rats who has regular oestrous cycle were underwent operation that autologous endometrium were transplanted to peritoneum and subcutaneous with lancet gently cut tissue of where to transplant in the rut, and compared the model of peritoneum and subcutaneous after 4 weeks.Results The general success rate of autologous endometrium transplantation in rat estrus was 93.3%,and the peritoneum transplantation success rate was 51.7%, subcutaneous was 88.3%, the difference of the two place transplantation has statistical significance. Compare the two parts of volume of endometriosis,there was no statistically significant difference.Conclusion Using the lancet to establish the endometriosis model has a high success rate, and subcutaneous model is better than peritoneum.

[ABSTRACT]OBJECTIVETo explore the clinical characteristics of benign paroxysmal positionalvertigo(BPPV) after sudden hearing loss and to observe the curative effect. METHODS36 patients with BPPV after sudden hearing loss were observed.And their therapeutic findings were compared with that of the 50 patients with primary BPPV and 40 patients of sudden hearing loss without vertigo. RESULTSBPPV after sudden hearing loss occurred in the hearing loss ears, of which 27 cases were posterior semicircular canal lithiasis and 3 cases were horizontal semicircular canal lithiasis. The 36 patients with BPPV after sudden hearing loss and 40 patients with primary BPPV were cured after several times of reposition maneuver treatment.The efficiency of 40 patients of sudden hearing loss without vertigo was higher than that of 36 patients with BPPV after sudden hearing loss.CONCLUSIONBPPV after the sudden hearing loss mainly occurs in the posterior semicircular canal. The therapeutic efficacy of canalith repositioning maneuver for the secondary BPPV was similar to that of the primary BPPV.The therapeutic efficacy of sudden hearing loss without vertigo was superior to sudden hearing loss with BPPV.

Objective To understand the disinfectant resistance of clinically isolated Escherichia coli (E.coli)and carriage of disinfectant resistance genes.Methods Disinfectant resistance gene sugE (c ),sugE (p ),qacEΔ1 ,and qacE of 82 isolates of E.coli were detected with polymerase chain reaction (PCR),minimal inhibitory concentra-tions (MICs)were measured with agar dilution methods.Results Among 82 E.coli isolates,positive rates of dis-infectant resistance gene sugE (c ),sugE (p ),qacEΔ1 ,qacE,sugE (c )+qacEΔ1 ,and qacE+qacEΔ1 +sugE (c ) were 84.15% (n=69),1 .22% (n=1),76.83% (n=63),73.17 % (n=60),68.29% (n=56),and 59.76% (n=49)respectively.There was no significant differences in carriage status of four disinfectant resistance genes be-tween extended-spectrumβ-lactamases (ESBLs)-producing and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains (all P >0.05);MIC values of benzalkonium chloride,cetylpyridinium chloride,am-monium bromide,and triclosan for 82 isolates of E.coli were all > standard stain;MIC values of chlorhexidine for 32 isolates of E.coli were all > standard stain,for 50 other E.coli strains were all ≤ standard strain.There were no significant difference in MIC values of benzalkonium chloride,cetylpyridinium chloride,ammonium bromide,and triclosan between ESBLs-and non-ESBLs-producing strains,as well as cefepime sensitive and resistant strains(all P >0.05);while MIC values of chlorhexidine showed a significant difference (both P <0.05).Conclusion Detection rates of disinfectant resistance gene qacE,qacEΔ1 ,and sugE(c)in E.coli from clinical specimens are high,MICs of disinfectants such as benzalkonium chloride for E.coli are generally higher than standard strain.

Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiac conduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed, such as difficulty of sinus electrode implantation, coronary sinus injury and bleeding, still one third CRT cases remain unchanged cardiac function.Recently the epicardial lead CRT therapy by the cardiac surgeons appears promising to provide better clinic resynchronization.The aim of this research is to explore the clinical value of surgical epicardial lead CRT for the cardiomyopathy heart failure with micro-invasive thoracoscopy techniques. Methods During April 2007 to Sep 2009 eleven patients were diagnosed as advanced heart failure with cardiac dysynchronization proven by the ECG and tissue Doppler echo examination. The dysynchronization parameters of tissue Doppler echo includes left ventricle maximize delay time , the left dysynchronization index (Ts-SD), the inter-ventricle mechanical delay time (IVMD), left ventricle end-dilation diameters (LVEDD) and the left ventricle ejection fraction (LVEF). All the patients got the consent agreement before the surgery. In the hybrid operation room the right atrial and ventricle endocardial electrodes were placed firs guided by X ray under the general anesthesia and double lumnen incubation. Then the thoracoscope techniques were used to explore the left ventricle lateral wall. The right atrial and ventricle electrodes were connected into the three chamber pacemaker. The Tissue Doppler Echo TEE technique was used to check which part of the left ventricle lateral wall is suitable for the idea CRT therapy. Usually the latest activated part of the left ventricle wall is the goal place. Then the epicardial electrode was fixed with 4-0 prolene suture at the idea place. All the cases were performed by the same surgeons group in the same medical center. The resynchronization features were examined after surgery and during the follow up. Results The endocardial and epicardial electrodes were implanted successfully without any serious complication. All patients were weaned and discharged without any adverse cardiac episodes. There is no mortality during the follow up period. All the patients received the β-blokers, diuretics, ACEI/ARB and other traditional medicine for the heart failure.The Tissue Doppler showed the E peak wave separated form the A peak which means the good resynchronization between the atrium and the ventricle. After surgery during the follow up the left ventricle maximize delay time decreased from (393.4 ±40.2 ) ms to ( 102.1 ± 34.6) ms, the left dysynchronization index (Ts-SD) decreased from (145.2±29.3)ms to(51.0±21.4) ms, the inter-ventricle mechanical delay time (IVMD) decreased from (59.1 ±23.4) ms to (31.2 ± 11.5 ) ms, left ventricle end-dilation diameters increased from (73.1 ± 13.4) mm to (63.2 ± 6.7) mn and the left ventricle ejection fraction increased from 0.32 ±0.04 to 0.41 ±0.07. Conclusion The micro-invasive surgical synchronization therapy could get good CRT result for the cardiomyopathy heart failure patients. Some patients traditionally in the waiting list for the heart transplant could be considered for the CRT therapy candidates.

ObjectiveTo detect glucose-6-phosphate isomerase (GPI) in knee joint synovial fluid of active rheumatoid arthritis (RA) and explore the correlation between GPI and anti-cyclic citrulline peptide antibody (anti-CCP).MethodsGPI and anti-CCP in the synovial fluid were measured by enzyme linked immunosorbent assay(ELISA) from 22 patients with active RA and 37 patients with active osteoarthritis (OA).Student's t-test was used for intergroup comparison and Spearman's analysis was used for correlation analysis.ResultsThe level of GPI and anti-CCP in the synovial of active RA [ (9.6±8.4) μg/ml,( 14.61 ±18.64) U/ml] was significantly higher than that of active OA[ (0.9±1.8) μg/ml,(1.42±0.09) U/ml)].There was positive correlation between GPI and anti-CCP (r=0.447,P=0.037).ConclusionHigh expression of GPI is shown in active RA synovial fluid.It is suggested that GPI as an antigen that may participate in chronic synovitis,bone destruction and joint malformation.Both GPI and anti-CCP may be the laboratory markers for the diagnosis of RA.