Objective To investigate the clinical significance of laparoscopic operations in gynecologic emergency. Methods We retrospectively analyzed 145 cases of gynecologic emergency dealt with laparoscopic operations in May 1997～August 2001. Out of the 145 cases, tubal pregnancy accounted for 100 cases (Laparoscopy Group), which were further compared with 89 cases of tubal pregnancy in January 1994～April 1997 treated by open operations (Open Group). Results Out of the 145 operations, 139 (95.9%) were successfully carried out under laparoscope, with the conversion to open operations in 6 cases. There were 61 cases of salpingectomy, 28 cases of oviduct fenestration, 11 of fenestration converting into salpingectomy, 16 of partial ovariectomy, 8 of adnexectomy for ovarian cyst pediculotorsion, 4 of cyst resection, 3 for rupture of endometrial cyst of ovary, 6 for pelvic abscess and 2 for pelvic encapsulated fluid. Compared with the Open Group, the Laparoscopy Group had longer length of surgical intervention (t=3.9, P=0.000) and more intraoperative blood loss (t=5.8, P=0.000). Conclusions Laparoscopic operations play double actions both in diagnosis and in treatment for most gynecologic emergencies, being a safe and reliable approach. Laparoscopic salpingectomy (non-oviduct-sparing operations), however, should be chosen for urgent patients.

Objective To investigate the feasibility and safety of hysteroscopic resection of large submucous hysteromyomas. Methods A retrospective study was carried out on 116 patients receiving hysteroscopic resection of submucous hysteromyoma. According to the maximal diameter of the resected myomas, the patients were divided into two groups: the control group,

Objective:To introduce the application of 3D printing technology in standardized residency training of percutaneous precise biopsy.Methods:Twenty-two residents were randomly divided into innovative teaching group and traditional teaching group, with 11 ones in each group. Residents in both groups received standardized training of percutaneous biopsy procedure. Innovative teaching group was given 3D printing template combined with guided operation, while traditional teaching group used bare hand operation. The time spent in biopsy, the times of needle adjustment, the frequency of CT scanning during operation, the positive rate of material sampling and the incidence of complications were compared between the two groups.Results:During the percutaneous lung biopsy, two groups of physicians performed the procedure. There was no significant difference between the two groups in operation time [(22.34±3.12) vs. (23.56±4.21)] and the positive rate of sampling (72.73% vs. 90.91%) ( P> 0.05), but there were significant differences in the times of adjusting biopsy needle during operation [(2.11±0.67) vs. (1.02±0.93)], the frequency of intraoperative CT scanning [(4.35±0.76) vs. (3.12±0.84)] and the incidence of complications (54.55% vs. 27.27%) ( P< 0.05). In percutaneous peritoneal organ biopsy, there was no significant difference among the two groups in the operation time [(16.25±2.89) vs. (15.12±2.59)], the number of CT scans [(3.45±0.79) vs. (2.98±0.23)] and the positive rate (78.57% vs. 88.24%) ( P> 0.05), but there were significant differences in times of intraoperative biopsy needle adjustments [(2.43±0.43) vs. (1.84±0.89)] and the incidence of complications (35.71% vs. 5.88%) ( P< 0.05). Conclusion:The application of 3D printing technology combined with the teaching of three-dimensional guided stent can make percutaneous biopsy technique stylized and standardized. It is of great significance to standardize the operation for improving the quality of medical treatment, and it is worth popularizing in clinical teaching.

Objective To analyze the expression of Yes-associated protein and risk factors in differentiated thyroid carcinoma. Methods Clinical data of 152 patients with differentiated thyroid carcinoma and 27 cases of benign thyroid tumor from Changji Hui Autonomous Prefecture People’s Hospital of Xinjiang, were analyzed retrospectively. According to the expression levels of Yes-associated protein in differentiated thyroid cancer and benign thyroid tumor, univariate Chi-square test and multivariate Logistic regression methods were used to analyze the relationship between Yes-associated protein and gender, age, thyroid stimulating hormone(TSH) level, nodule size, capsule integrity, histological type and lymph node metastasis, in order to find out risk factors in differentiated thyroid cancer. Results The positive rate of expressed Yes-associated protein in benign thyroid tumor group was 66.7%(18/27), which was significantly higher than 31.58%(48/152) of differentiated thyroid cancer group, and the difference was statistically significant(χ2=12.127, P<0.01). Under an optical microscope, changes of Yes-associated protein were found to be mainly located in the nucleus and cytoplasm , and in benign thyriod tumor the degree of staining was deep, strong positive or moderately positive; differentiated thyroid carcinoma was lightly stained or no staining, weakly positive or negative. Chi-square test showed that the expression of Yes-associated protein was not affected by sex, age and pathological type(χ2= 0.419, 0.221, 0.315, all P >0.05); TSH level, nodule size, capsule integrity, lymph node metastasis had an impact on the expression of Yes-associated protein which was down regulated (χ2=4.020, 8.424, 4.386, 6.673, P<0.05 or<0.01). Logistic regression analysis showed that the nodule size was not a risk factor ( odds ratio , OR ) of Yes-associated protein expression (OR=1.929, P>0.05); TSH levels above 4.5 mU/L, lymph node metastasis and envelope incomplete were risk factors that down regulated the expression of Yes-associated protein (OR=2.167, 2.665, 3.048, all P<0.05). Conclusion Yes-associated protein is down regulated in differentiated thyroid cancer. Elevated TSH levels , incomplete capsule and lymph node metastasis are risk factors of Yes-associated protein down expression and differentiated thyroid cancer.

Objeetive To analyze the clinical significance of serial microproteinuria and urease detection in early diagnosis of antibiotics damage to kidney by observing the changes of urine microalbumin/creatinine ratio (mAlb/Cr),transferrin (TRF),IgG,α1-microglobulin (α1-M G),β2-microglobulin (β2-M G),retinol-binding pmtein(RBP) and N-acetyl-β-D-glucosaminidase(NAG).Methods A total of 161 children with pneumonia whose test results were normal of urine protein,blood urea nitrogen (BUN) and serum creatinine (Scr),and had no related history of kidney diseases were selected.All the patients were divided into three groups according to antibiotics for the treatment,the penicillins (penicillin G,amoxicillin and potassium clavulanate,ticarcillin and potassium clavulanate) group,the cephalosporins (cefazolin,cefuroxime,ceftriaxone,cefoperazone,ceftazidime) group and the macrolides (erythromycin,azithromycin) group.Changes of mAlb/Cr,TRF,IgG,α1-MG,β2-MG,RBP,NAG,BUN,Scr levels of the patients one week before and after use the antibiotics were observed,and statistically analyzed.Results In the penicillins group and macrolides group,the results showed that none of the serial microproteinuria and urease changed(all P ＞ 0.05).In the cephalosporins group,the urine mAlb/Cr,TRF,β2-MG and NAG were higher than before using the antibiotics [(15.56 ± 5.98) mg/g vs.(21.08 ± 10.88) mg/g,(1.61 ± 0,14)mg/L vs.(1.66 ±0.14) mg/L,(0.25 ±0.09)mg/L vs.(0.28 ±0.11)mg/L,(4.62 ±3.80) U/L vs.(4.98 ±3.97) U/L,t =-5.11,-3.24,-2.29,-2.04,P ＜ 0.05 ～ 0.001].The levels of BUN and Scr revealed no change in all the patients(all P ＞ 0.05).Conclusion Combined detection of serial microproteinuria and urease has great clinical significance in judgment and warning of early renal damage by antibiotics.

Objective:To investigate the related factors of early postoperative recurrence of glioma patients and to establish a prediction model for early recurrence.Methods:A total of 94 patients with pathologically diagnosed glioma treated at Affiliated Hospital of Xuzhou Medical University from August 2014 to July 2016 were retrospectively analyzed. Kaplan-Meier method was used for survival analysis and log-rank test was carried out. Cox proportional risk regression model was used to analyze the clinical factors influencing early postoperative recurrence of glioma patients, and the prediction model of early recurrence was established.Results:The recurrence rates were 26.6% (25/94) and 39.4% (37/94) at 12 months and 24 months after operation, respectively. Univariate analysis showed that age ( χ2=9.59, P=0.008), degree of tumor resection ( χ2=14.26, P<0.001), Karnofsky performance status (KPS) score ( χ2=19.41, P<0.001), radiochemotherapy ( χ2=5.10, P=0.024) and pathological grade ( χ2=5.83, P=0.016) were significantly associated with early postoperative recurrence in glioma patients. Multivariate Cox proportional hazards regression model analysis showed that pathological grade ( OR=2.64, 95% CI: 1.75-3.97, P<0.001), degree of resection ( OR=0.34, 95% CI: 0.19-0.62, P<0.001) and radiochemotherapy ( OR=2.58, 95% CI: 1.34-4.99, P=0.005) were independent factors influencing early postoperative recurrence in glioma patients. The risk function model expression of early recurrence in glioma patients was h(t)=h 0exp(0.970X 1-1.081X 2+ 0.949X 3). X 1, X 2 and X 3 represented pathological grade, resection degree and radiochemotherapy respectively. Conclusion:High grade pathology and the absence of radiochemotherapy are independent predictors of early recurrence in glioma patients, and complete tumor resection can reduce the risk of early recurrence and improve the prognosis. The model of early recurrence prediction can provide some reference for clinical diagnosis and treatment.

Objective To assess the efficacy and safety of nebulized hypertonic saline solution in infant with bronchiolitis.Methods From January 2014 to January 2016,95 patients at 3-13 months old in our hospital who diagnosed as bronchiolitis were randomly divided into three groups.On the basis of conventional suit support treatment,the observation group A was given nebulized 3％ hypertonic saline (n =32),the observation group B was given nebulized 3％ hypertonic saline and salbutamol (n =32),and the control group C was given nebulized normal saline (0.9％) and salbutamol (n =31),this therapy was repeated every 6 hours until discharge.The Lowell score,clinical symptoms remission time,days of hospitalization and incidence rate of adverse reaction of the three groups were compared.Results After treatment,the symptoms and signs of the three groups were all improved.The Lowell scores were lower in the two observation groups compared to the control group C in 24,48,72 hours after treatment[(5.81 ±1.53) points and (5.85 ± 1.37) points vs.(6.61 ± 1.54) points,(4.75 ± 1.34) points and (4.72 ± 1.30) points vs.(5.52 ± 1.29) points,(3.19 ± 1.15) points and (3.22 ± 1.16) points vs.(3.90 ± 1.01) points,Z =-1.999,-2.241,-2.518 and-2.002,-2.335,-2.316,all P ＜ 0.05).And the cough,wheezing remission time and pulmonary rales disappearance time,days of hospitalization in the two observation groups were also shorter,there were statistically significant differences [(6.63 ± 1.41) d and (6.56 ± 1.37) d vs.(7.35 ± 1.25) d,(5.19 ± 1.03) d and (5.25 ± 1.05)d vs.(5.87 ± 1.09)d,(5.75 ±1.34)d and (5.72 ± 1.51)d vs.(6.68 ± 1.60)d,(7.25 ± 1.37)d and (7.16±1.48)d vs.(8.10±l.47)d,Z=-2.498,-2.469,-2.359,-2.213 and-2.982,-2.405,-2.373,-2.222,P ＜0.05,or P ＜0.01)].There were no significant differences in the Lowell score,the length of time of cough,wheeze,lung rales disappears and the length of hospital stay between the observation group A and observation groupB[(5.81 ± 1.53) points vs.(5.85 ± 1.37) points,(4.75 ± 1.34) points vs.(4.72 ±1.30) points,(3.19± 1.15) points vs.(3.22 ± 1.16) points,(6.63 ± 1.41) d vs.(6.56 ± 1.37) d,(5.19 ±1.03)d vs.(5.25 ± 1.05)d,(5.75 ± 1.34) d vs.(5.72 ± 1.51) d,(7.25 ± 1.37) d vs.(7.16 ± 1.48) d,Z =-0.164,-0.021,-0.140,-0.295,-0.167,-0.374,-0.233,all P ＞ 0.05].Children in three groups had no serious adverse events (all P ＞ 0.05).Conclusion Nebulized hypertonic saline in the treatment of bronchiolitis can relieve symptoms and signs,shorten the hospitalization time,and has less adverse reaction,it is worthy of clinical use.

Cell mechanics is essential to cell development and function,and its dynamics evolution reflects the physiological state of cells.Here,we investigate the dynamical mechanical properties of single cells under various drug conditions,and present two mathematical approaches to quantitatively character-izing the cell physiological state.It is demonstrated that the cellular mechanical properties upon the drug action increase over time and tend to saturate,and can be mathematically characterized by a linear time-invariant dynamical model.It is shown that the transition matrices of dynamical cell systems signifi-cantly improve the classification accuracies of the cells under different drug actions.Furthermore,it is revealed that there exists a positive linear correlation between the cytoskeleton density and the cellular mechanical properties,and the physiological state of a cell in terms of its cytoskeleton density can be predicted from its mechanical properties by a linear regression model.This study builds a relationship between the cellular mechanical properties and the cellular physiological state,adding information for evaluating drug efficacy.