Objective:In vitro fertilization and embryo transplantation in patients with endometrial implantation window phase of natural killer cell ( uNK ) influence on the endometrial microvascular and uterine artery pulsatility index and embryo implantation.Methods:A retrospective analysis of our hospital from January 2009 to July 2013 the implementation of in vitro fertilization and embryo transfer(IVF-ET) clinical data of 37 patients,according to whether the success of pregnancy and at least 2 times for IVF-ET failure into success group(26 cases)and the failure group(11 cases),compared two groups of research object during the window of implantation in the uterus endometrial uNK cell marker CD56+, uterine artery pulsatility index, vascular endothelial marker F8 factor,alpha smooth muscle actin( alpha SMA) and myosin heavy chain( SMM) and the relationship between the expression of difference.Results:Success group based FSH 3.52±0.68(mU/ml),basal antral follicles of 9.44±2.53 compared with the failure group differences were not statistically significant(P>0.05).The successful group of uNK cells of 27.18±5.94(%),MVD 6.79±1.74 (%) ,αSMA 33.72 ±4.19 (%) , SMM 25.19 ±5.83 (%) were significantly higher than the expression rate of IVF-ET assisted reproductive failure group(P<0.05).The number of uNK cells,the proportion of endometrium during the window of implantation and MVD of 37 patients withαSMA and SMM coloring cell number proportion were positive correlation significantly( r=0.472,P=0.000<0.005),(r=0.426 ,P=0.000<0.005),(r=0.512,P=0.000<0.05).Success group during the window of implantation in the uterine artery PI=0.94±0.28,PI=0.87±0.29 failure group,differences between the two groups was not statistically significant(t=0.688,P=0.493>0.05).Conclusion:During the window of implantation in the endometrium of natural killer cells and endometrial angiogenesis was significantly associated with successful pregnancy, may have a certain relationship;uterine artery PI and pregnancy outcome successful has no obviously relationshhip.

Objective To observe the influence of early postoperative enteral feeding on gastrointestinal motility after subtotal gastrectomy. Methods From December 1999 to February 2001,18 patients with advanced gastric cancer who had underwent gastrectomy were randomly allocated into enteral nutrition(EN) group ( n =9) and control group( n =9). The migrating motor complex (MMC) was recorded by Synectics MicroDigitrapper antroduodenal manometry and data was analyzed by Polygram software. Results MMC disappeared after subtotal gastrectomy in all patients,the first MMC recurred from 34 mins to 4 hours after the operation,while there was no significant difference between two groups. However,MMC in EN group was different from those in normal group which was lack of phase -Ⅱ at the early postoperative stage,the variation of MMC trended to become normal during 72 hours of consecutive observation. Compared with control group,the duration of MMC-phase-Ⅲ,area under the curve,transmit speed and motility index were different in EN group. Conclusion Early postoperative enteral feeding can help re-build the normal gastrointestinal motility .Further studies about patients' selections and nutrition preparations are needed.

Evoked potentials which can monitor spinal cord function in operation continuously and timely has been widely used in spinal orthopedics. However, intraoperative evoked potentials are affected by the technique in a variety of factors, how to improve the accuracy of intraoperative monitoring is still a problem to explore. In this paper, intraoperative nerve monitoring application and intraoperative potential reasons for the changes in the spine surgery orthopedic surgery were reviewed.

Objective To investigate the relationship between the resting heart rate (RHR) and target organ damage (TOD) in elderly patients with metabolic syndrome(MS). Methods 264 elderly patients with MS were divided into four groups according to the level of RHR: RHR1 group, RHR<65 beats/minute (bpm) (46 cases) ;RHR2 group, 65≤RHR<75 bpm (77 cases);RHR3 group, 75 bpm≤RHR<85 bpm (89 cases);RHR4 group, RHR≥85 bpm (52 cases).Electrocardiography, echocardiography, carotid uhrasonography, crcatinine clearance rate (Ccr) and quantitative assay of 24 hours' albuminuria were performed. Results (1) Compared with RHR1, RHR2 and RHR3 groups, RHR4 group showed higher levels of carotid intima-medial thickness (IMT), carotid arterial diameter (CAD), left ventricular mass index (LVMI) and albuminuria(P< 0.05 or P<0.01), and lower levels of left ventricular ejection fraction (LVEF) and Ccr (all P< 0.01). (2) The IMT, CAD, LVMI and albuminuria were positively correlated with RHR (r=0.33, 0.23, 0.61, 0.58, respectively, all P<0.01). However, the LVEF and Ccr were negatively correlated with RHR (r=-0.59, -0.51, all P<0.01). (3) Logistic multivariate analysis showed that RHR and pulse pressure (PP) had effects on myocardial hypertrophy, coronary heart disease, heart failure, cerebral stroke and renal dysfunction(P<0.05 or P<0.01). Except heart failure, PP played a more important role than RHR. Coneinsions RHR may be an independent risk factors for TOD in elderly patients with MS,and RHR regulation is important for the development of MS in the elderly.

Objective:To investigate the fatigue damage mechanism of porcelain,and its relation with the microscopic defects in clinically failed all-ceramic crowns.Methods: Collecting the bilayered all-ceramic crowns failed in vivo.The fractured surfaces and occlusial surfaces of failed crowns were examined by an optical microscope followed by detailed fractography investigations using a field emission scanning electron microscope.When chemical impurities were of concern,energy-dispersive X-ray spectroscopy analysis was performed to examine chemical composition.A standard practice for fractography failure analysis of advanced ceramics is applied to disclose the fracture mode,and damage character.Results: Three types of fracture features are defined as breakdown of the entire crown,and porcelain chipping-off/delamination.Alumina crowns were usually characterized by breakdown of the entire crown,while zirconia crowns by porcelain chipping-off and delamination.The fatigue damage of porcelain was classified into surface wear,cone crack,and porcelain delamination.The observed microscopic defects in this study included air bubbles and impurity particles.Conclusion: The multi-point occlusial contacts were recommended in all-ceramic restorations clinically.The thickness of porcelain is important for the anti-fatigue ability of porcelain.Cautions have to be taken to avoid contaminations during the veneering processes.

OBJECTIVE To comprehend the changes in the spectrum of clinically isolated pathogenic bacteria and their drug resistance,and to analyze their tendency.METHODS Totally 5746 pathogenic bacteria isolated from clinical samples of the inpatients in our hospital during 1997-2004 and their drug resistance was statistically(analyzed).RESULTS Most of clinically isolated pathogenic bacteria were Gram-negative.The detected rate of Gram-positive bacteria tended to rise,while the detected rate of fungi obviously increased year after year.Gram-positive cocci and Gram-negative bacilli were resistant to commonly used antibacterials in different degrees,(especially) to ampicillin.The sensitive rate of Gram-positive bacteria was high to vancomycin,while the sensitive rates of Escherichia coli and Klebsiella pneumoniae to imipenem were high.CONCLUSIONS The structure of(nosocomial) infection(pathogens) and their drug resistance patterns are changing continuously.It should be(emphasized) to inspect(bacterial) tolerance in order to select antibacterial reasonably.

Objective:To explore diagnostic value of dynamic electrocardiogram (DCG) combined esophageal electro‐physiological examination (EEE) for sick sinus syndrome (SSS) .Methods :A total of 74 cases suspecting SSS ,who presented 24h mean heart rate <55 beats/min in DCG ,were selected .After DCG examination ,all subjects received EEE . Diagnostic value of single and combined examinations wereexplored .Results:Compared withthe SSS positive rate of single DCG and single EEE(87.8% ,86.5% ) ,theSSS positive rate ofDCG combined EEE(97.3% ) was sig‐nificantly rose ,P<0.05 both .Conclusion:Dynamic electrocardiogram combined esophageal electrophysiological ex‐amination can evaluate sinus node function from different angles ,which can significantlyincrease SSS diagnose rat .

OBJECTIVE To discuss the clinic presentation,imaging characteristics and surgical management of the external auditory canal cholesteatoma (EACC) with invasion of the tympaniccavity and the mastoid. METHODS This was a retrospective study including the clinical data of 14 cases of EACC invading tympanic cavity and mastoid from 1998 to 2003 . RESULTS All 14 cases showed different bone erosion in the four walls of external auditory canal with extention to the mastoid . Pars flaccida perforation were found in 4 cases with invasion of the cholesteatoma into the tympanic cavity, the ossicular chains were compressed or destroyed. The bony mastoid segment of facial canal was destroyed in 3 cases . Cerebral plate destruction and congenital stenosis of external auditory canal were found in one case respectively. According to the extent of disease, modified radical mastoidectomy was performed in 8 cases and radical mastoidectomy in 5 cases , meatoplasty in one case. The post-operative hearing of 10 cases with intact ossicula chains were normal.One case with compression,shift of ossicules also got normal audition after the operation. The hearing threshold of the air condition in 3 cases with ossicular disruptions got 15 to 20dB of improvement among the language frequency after reconstruction of ossicular chain. The 14 cases were followed-up from 18 months to 5 years and no recurrences were found. CONCLUSION The exact etiology of EACC still remains unclear. There is some difficulty in diagnosing external auditory canal cholesteatoma (EACC) invading the tympanic cavity and the mastoid because of its untypical clinic presentation . High-resolution temporal bone CT scan could help to find out the primary lesion and determine the range of the pathological changes, and choose the proper surgical approach.

Objective To analyze the different spreading patterns and the prognostic factors of nasopharyngeal adenocarcinoma (NPAC).Methods The clinical and radiological data of 39 pathologically confirmed consecutive cases of NPAC were retrospectively reviewed.Results In the 1 1 patients with CT/MRI-detected cranial nerve (CN)involvement,there were ACC (n=7),CAC (n=2)and MEC (n=2)(P <0.05).Lymph node metastasis occurred in 40% of CAC,7.7% of ACC and 1 6.7% of MEC (P =0.035). Significant differences were observed in 5 year OS and DFS rates between patients with and without CT/MRI-detected CN involve-ment (P <0.001;P =0.001).In 1 9 patients with early stage disease (stageⅠ-Ⅱ),significant difference was observed in 5 year OS rate between the surgical treatment group and non-surgical treatment group (P =0.038),and the difference was not significant in DFS (P =0.056).Conclusion CT and MRI are valuable tools not only for discovering the different spreading patterns of NPAC, but also for its prognosis.

Objective To establish an ion chromatography method to determine the content of galactosamine in heparin sodium sample. Methods The content of galactosamine was determined by the ratio of response value of galactosamine and glucosamine.The determination was performed on an Dionex ICS, and the separation was carried out on a Amino acids capture column (30 mm ×3 mm), Series protect column (30 mm × 3 mm)and analytical column CarboPac PA20 (150 mm ×3 mm).The mobile phase was 14 mM potassium hydroxide solution at a flow rate of 0.4 mL/min; the column tempertature was at 30℃; the injection volume was 10μL.Results Glucosamine hydrochloride had good linearity within the range of 1.013 -16.211μg/mL(Y=2.303 4X+0.824 2,r=0.998 3), the average accuracy was 92.7%, and RSD was 3.2%(n=9), the limit of detection was 0.101 3μg/mL, and the limit of quantitation was 0.337 7μg/mL.D-Galactosamine hydrochloride had good linearity within the range of 0.010 2 -0.162 5 g/mL, (Y=31.157X-0.114 4,r=0.999 3).The accuracy was 102.1%, RSD was 2.4%(n=9).The limit of detection was 0.001 0μg/mL, and the limit of quantitation was 0.003 4μg/mL.The determination of galactosamine in 3 batches of heparin sodium raw material was not detected, (0.02 ±2.1)%, (0.03 ±1.5)%, respectively, which were all lower than the limit value (1%) of United States Pharmacopeia regulation.Conclusion The method for the determination of galactosamine in total hexose amine is successfully developed , which could be used as reference for improvement of the quality standard of heparin sodium.