ObjectiveTo explore the clinical effect and safety evaluation of marvelon on dysfunctional uterine bleeding in adolescent patients.Methods120 adolescent patients with dysfunctional uterine bleeding were randomly divided into control group and experience group with 60 patients in each group.Control group was given oral administration of premarin and experience group received marvelon oral treatment.Clinical effect,the time of control bleeding and completely stop bleeding and incidence of adverse reaction were compared between two groups.ResultsThe total effective rate in experience group was much higher than that in control group (100.0％ vs 90.0％,x2 =6.316,P ＜ 0.01 ) ;The time of control bleeding and completely stop bleeding in experience group were much lower than that in control group( t =6.638,8.542,all P ＜ 0.01 );The incidence of adverse reaction in experience group and control group were 11.7％ and 65.0％ respectively with significant difference( x2 =36.099,all P ＜0.01 ).ConclusionMarvelon on dysfunctional uterine bleeding in adolescent patients is beneficial to rapid and effective hemostasis with less adverse reaction rate and better tolerance.

Objective To investigate the cost-effectiveness of four drugs in treatment of bacterial vaginitis and improve clinic rational drug use.Methods 361 bacterial vaginitis out-patients were treated with lactobacillus vaginal effervescent tablets(92 cases),lacidophilin vaginal capsules(88 cases),shuangzuotai vaginal effervescent tablets(90 cases),metronidazole vaginal effervescent tablets(91 cases).The therapeutic effect,drug cost and therapeutic effect were evaluated by cost effectiveness analysis 7d after treatment.Results The overall response rate of lactobacillus vaginal effervescent tablets,lacidophilin vaginal capsules,shuangzuotai vaginal effervescent tablets,metronidazole vaginal effervescent tablets were 78.26％,76.14％,83.33％ and 78.02％,respectively.The overall response rate was no significant difference between four groups (0.06),and metronidazole vaginal effervescent tablets had the lowest cost effectiveness rate (C/E,0.26).Conclusion The metronidazole vaginal effervescent tablets is better schedule in treatment of bacterial vaginitis.

Objective To explore the effect of docosahexaenoic acid(DHA)on the neuro-logical outcome as well as the expression of interleukin-1β,interleukin-6 and interleukin-10 after acute spinal cord injury(SCI).Methods One hundred and eight Sprague-Dawley rats were randomly divided into a spinal cord injury group(group A),a DHA treatment group(group B)and a sham operation group(group C),each with 36 rats.SCI models were established in the rats of groups A and B using a version of Allen's weight drop method(T10 level).Group C had removal of the lamina only.Ten minutes later,group A was injected with 5% ethanol in saline(the MT solvent)and group B with 500 mg/kg of DHA preparation.Basso beattie bresnahan locomotor rating scale(BBB)was used to detect locomotors function at 10,24,48 and 72 hours after operation.Rats were sacrificed at 72 h after operation,IL-1β,IL-6 and IL-10 levels in serum were detected in 6 rats of each group.Results BBB locomotor rating scale indicated that hindlimb motor function in Groups B was higher than that in Group A at 10,24,48 and 72 hours after operation.There was a significant difference in locomotor rating score between DHA injection group and control group(P<0.05).The specimens of group A showed inflammatory reaction and ulceration at 72 h:Group C showed the highest levels of IL-10 in serum ,while Group A showed the lowest level.The differences were statistically significant.Group A had the highest levels of IL-1β and IL-6 while group C had the lowest.The difference between group B and groups A and C was significant.Conclusion DHA could play protective role by balancing the reconstruction of the anti-inflammatory response and inflammation in rats with acute spinal cord injury.

Objective To investigate the role of PAG in migraine Methods A transformed superior sinus stimulation migraine model was applied to observe Fos expression and co localization of 5 HT with Fos in PAG following the stimulation of dual matter adjacent to the superior sagittal sinus in rats Results 5 HT immunoreactive neurons, densely located in ventrolateral and ventromedial sectors, were found throughout the PAG Fos like immunoreactivity neurons were obviously increased in stimulated group than in unstimulated and control groups The double labelled neurons accounted for 15 0%?2 8% of 5 HT immunoreactive neurons and 24 0%?4 3% of Fos like immunoreactivity The double labelled population mainly distributed in ventrolateral sector Conclusions It suggests that neurons in PAG, especially in ventrolateral sector in caudal segment, might be excited in migraine model of rat The excited cells and 5 HTnic neurons might have a similar distribution pattern in PAG, with part of excited cells being 5 HTnic neurons Other types of excited neurons and the subtype of 5 HT receptor were not included in the experiment, and would be studied further as to getting a better understanding of the pathophysiology of migraine

Background Idiopathic macular epiretinal membrane (IMEM) shows a high incidence and affects visual function of patients.The primary management of IMEM is vitrectomy,but the study on prediction of visual acuity after operation by optical coherence tomography (OCT) is seldom.Objective This study was to evaluate the predicting ability of OCT for preoperative visual outcome for IMEM patients who received vitrectomy.Methods The clinical data of IMEM patients with vitrectomy from March 2009 to May 2013 were retrospectively analyzed in People's Hospital Peking University.Forty-nine eyes of 48 cases were divided into continuous group (19 eyes of 18 cases) and discontinuous group (31 eyes of 31 cases) based on whether the extraretinal layers were intact on OCT,including retinal pigment epithelium (RPE),inner and outer segment of photoreceptors (IS/OS) and external limiting membrane (ELM).Central foveal thickness (CFT) by high-resolution spectral-domain OCT and best corrected visual acuity (BCVA) (LogMAR) before surgery and 12 weeks after surgery were recorded and compared between the two groups,and the correlations of shift of CFT with the shift of LogMAR vision was analyzed by unitary linear regression to evaluate the value of OCT in predicting postoperative vision.Writen informed consent was obtained from each patient prior to any medical operation.Written informed consent was obtained from each patient before surgery.Results In 12 weeks after operation,reflective strips of RPE layer,IS/OS and ELM layer were intact in 18 eyes of the continuous group after vitrectomy.The number of eyes with discontinuous strip in RPE layer decreased to 1 eye after operation from 6 eyes before operation,and the number of eyes with IS/OS reflective strip discontinue decreased to 19 eyes after operation from 29 eyes before operation,and that with ELM layer discontinue decreased to 15 eyes after operation from before operation in the discontinuous group.The improvement of LogMAR BCVA was increased with the decline of CFT values with a negative correlation between them (R2 =0.298,B =0.001,P =0.000),and postoperative LogMAR visual acuity improved 1 line whenever CFT reduced by 100 μm.LogMAR BCVA was 0.4±0.19 before surgery and 0.36±0.21after surgery in the continuous group,showing a insignificant difference between them (t =0.876,P=0.393).In the discontinuous group,the postoperative IogMAR BCVA was significantly higher after operation (0.46±0.26) than 0.82 ±0.41 after operation (t =6.206,P =0.000).The increase value of LogMAR after vitrectomy was 0.3 in the discontinuous group,which was superior to 0.0 of the continuous group.Conclusions The continuity of extraretinal layers and CFT by OCT are closely associated with the improvement of vision after vitrectomy in the eyes with IMEM.Postoperative vision is better in IMEM eye with continuous retinal reflective strips before operation,and majority of IMEM eyes can improve vision after operation.Preoperative OCT seems to be an important diagnostic tool for the selection of patients who benefit or not from surgery to certain extent.

The technique of nipple-areola complex (NAC)-sparing mastectomy (NSM) facilitates the breast reconstruction due to preserving the skin and NAC of breast in the treatment of breast cancer. Key issues still remain controversial in NSM, in terms of the role of radiotherapy combined with NSM and sequence of radiotherapy and NSM, which arise from the consideration of the oncology safety. Some investigations addressed that post-NSM external beam irradiation and intra-operative radiotherapy (IORT) combined with NSM could reduce the local recurrence rate. Based on the appropriate patient selection and good quality of surgery, radiotherapy would be applied in different strategies of combination with NSM according to the risk of local recurrence of the cancer.

It is important to analyze the epidermal growth factor receptor ( EGFR) mutation before makingstrategyonnon-small cell lung cancer ( NSCLC) patients scheduled to EGFR tyrosine kinase inhibitor ( TKI) therapy .Digital PCR is a new generation of molecular diagnostic technique that provides ultra-highersensitive, specific and absolute nucleic acid quantification based on its unique principle.The application of digital PCR indetecting circulate tumor DNA can be the truly tumorliquid biopsy, helps to acquire the accurate EGFR mutation status from peripheral blood and screen out the most appropriate patients for TKI therapy.This breakthrough technology will also contribute to tumor surveillance and drug resistance monitoring.

[Summary] From November 2013 to March 2014, 3D laparoscopic operations were carried out in 14 cases in the department of urology of our hospital .The operation went smoothly , without conversions to laparotomy .The operation time was 54-466 min, with an average of 180 min.The intraoperative blood loss was 5 -400 ml, with an average of 70 ml.No pressure sores or operation complications occurred.The medical staff participating in the operation generally felt a good 3D vision, without sense of vertigo.We deem that during urological operations which have different operation postures , it is very important to protect both laparoscopic system and operation area from pollution .Timely and properly wearing 3D glasses, application of one-eye-detection method for lens sharpness , and the switching between 2D and 3D modes can reduce and relieve visual fatigue .

Immunohistological methods were used to investigate the presence of s-100 protein in 16 cases of malignant mesothelioma (MM) and 20 metastatic gastrointestinal adenocarcinoma of peritoneum. Positive staining for s-100 protein was observed in 14 of 16 MM, while it was negative in all metastatic gastrointestinal adenocarcinoma of peritoneum. Since antibodies to s-100 protein are readily available as standardised commercial products, the combined immunolocalisalion of s-100 protein should prove to be an efficient routine means of differentiating MM from difficult cases of metastatic gastrointestinal adenocarcinoma of peritoneum, in both necropsy and surgical cases.

The paper defines the quality of emergency medical care and analyzes its influencing factors from such angles as policy assurance, hospital support, organizational structure, cultivation of professional personnel, scientific management, interdisciplinary coordination, emergency care equipment, and the system of technological access. The goal is to improve the quality of emergency medical care so as to meet the needs of the broad masses of people for emergency medical care.