Objective To determine the relationship between end-tidal carbon dioxide tension (PET CO 2 )obtained from the distal ends of the tracheal tube and arterial pressure of carbon dioxide (PaCO 2 ) compared with the sidestream capnometer in infants with congenital heart disease. Methods Twenty infants undergoing congenital heart disease surgery,12 males and 8 females,aged 3-48 months,ASA physical statusⅠ-Ⅲ were enrolled.Measurements of PET CO 2 were obtained from the distal ends of the tracheal tube using a sterile 22 G catheter that was inserted into the tube and from the proximal end with a sidestream capnometer in 20 intubated infants with congenital heart dis-ease.The data including PET CO 2 and the arterial PaCO 2 were obtained both after the anesthesia induc-tion and the CPB.Results The data of PET CO 2 obtained from the distal ends of the tracheal tube after the anesthesia induction [(36.8 ±2.7)mm Hg vs.(32.5 ± 1.4)mm Hg,P <0.05 ]and the CPB [(40.8±2.5)mm Hg vs.(36.5±1.6)mm Hg,P <0.05]were both higher than those from the proximal end with a sidestream capnometer.The difference between PaCO 2 and PET CO 2 obtained from the distal ends of the tracheal tube after the induction [(7.1 ±0.7)mm Hg vs.(1 1.4 ± 1.5 ) mm Hg,P <0.01]and the CPB [(9.3±1.2)mm Hg vs.(13.5±2.3)mm Hg,P <0.01]were sig-nificantly lower than that between PaCO 2 and PET CO 2 obtained from the proximal end.Distal side-stream PET CO 2 correlated with the PaCO 2 (R 2 =0.94 after induction and R 2 =0.93 after the CPB,P<0.05).However,the proximal PET CO 2 with the sidestream capnometer correlated very poorly with PaCO 2 whether after the induction (R 2 = 0.68,P < 0.05 )nor the CPB (R 2 = 0.66,P < 0.05 ). Conclusion We conclude that the PET CO 2 obtained from the distal ends of the tracheal tube provides accurate estimates of the PaCO 2 in critically ill infants with congenital heart disease.

respectively)was significantly higher than that for digital anterograde venography (0.684 and 0.587,P =0.026,respectively).Conclusion Diagnostic accuracy and detection rate of residuaI or recurrent varicose veins with CT phlebography are found to be more superior than that with digital anterograde venography which has high guidance value in preoperation and assesses the efficacy of post-surgery treatment.

Objective To analysis the correlation between coronary atherosclerosis and levels of glycated hemoglobin (HbA1c) and endothelin(ET ) ,furthermore to explore the clinical significance of the two indexes in the department of cardiology .Methods 572 inpatients were divided into four groups according to the blood glucose level and coronary angiography results :negative control group with 40 patients ,simplex DM group with 50 patients ,simplex CHD group with 262 patients ,CHD+DM group with 220 pa-tients .The HbA1c and ET levels in the four groups were monitored ,and the correlations between the two indexes and coronary ath-erosclerosis were analysed by Logistic regression analyses .Results HbA1c level :control group and CHD group < DM group 0 .05) .ET level :control group < CHD group and DM group < CHD+DM group .No significant differences were observed between CHD group and DM group(P>0 .05) .After adjusted the potential risk factors such as age ,sex ,body mass index ,smoking ,the history of hypertension and blood glucose levels with binomial Logistic regression analysis the content of ET was relevant to the onset of CHD ,however HbA1c not .Conclusion ET has obviously correlation with coronary atherosclerosis ,however the simplex DM may cause false posi-tive interferences .Combined determination of HbA1c and ET is beneficial in the preliminary diagnosis of CHD and DM .

Objective To assess the diagnostic and curative efficacy of laparoscopy combined with hysteroscopy for tubal infertility. Methods A combined use of laparoscopy and hysteroscopy was performed in 62 cases of tubal obstructive infertility (124 oviducts), which had been tentatively diagnosed by lipiodol hysterosalpingography (HSG). Results Out of the 62 cases, 11 cases (22 oviducts) were found bilaterally unobstructed (17.7%, 22/124), 8 cases (8 oviducts) were found unilaterally unobstructed (6.5%, 8/124). Tubal interstitial or isthmus obstruction was observed in 40 oviducts (32.3%, 40/124) and hydrosalpinx in 54 oviducts (43.5%, 54/124). The consistency ratio between lipiodol HSG and endoscopy in the diagnosis of tubal obstruction was 75.8% (94/124). Tubal catheterization under hysteroscope and laparoscope was adopted in the 40 ducts of interstitial or isthmus obstruction, and 30 were cured, 5 perforated and 5 failed. Laparoscopic salpingostomy and salpingolysis was employed successfully in 54 tubes. Conclusions Combined use of hysteroscopy and laparoscopy is useful in the diagnosis and treatment of tubal obstruction and infertility tentatively diagnosed by HSG.

Objective To investingate the role of inflammation in coronary atherosclerosis and the relationship between the inflammatory factors and coronary risk score. Methods 56 patients with acute coronary syndrome were studied, among them 26 cases were diagnosed as acute myocardial infarction (AMI) and 30 unstable angina pectoris (UAP). The study group was compared with a control group of 30 cases who were identified as normal by coronary angiography. The concentrations of serum sICAM-1 and hsCRP were determined by ELISA assay. The coronary risk score was recorded in patients with UAP. Results Serum sICAM-1 levels were significantly elevated in patients with AMI or UAP compared with that of control group, while higher hsCRP level was observed only in the patients with AMI compared with those with UAP and the control group. By linear regression analysis, only serum sICAM-1 levels were correlated with coronary risk score (r=0.445, P

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.

Objective To study and evaluate the clinical effect of laparoscopic therapy in endometriosis com-plicated with polycystic ovary. Methods To retrospectively analyze 33 cases of endometriosis complicated with poly-cystic ovary and observe the results of symptomatic relief rate and pregnancy rate after laparoscopic therapy. Results The postoperative eumenorrhca rate, dysmenorrhea relief rate, auto-ovulation rate and pregnancy rate were 90.9%, 100% ,87.9% and 60.6% respectively. Conclusions The clinical symptoms of endometriosis complicated with polyeystic ovary are not predominance. This study confirms the laparoscopic therapy in endometriosis complicated with polycystic ovary is an effective approach to increase the symptomatic relief rate and pregnancy rate.

Objective To observe the antitumor effect of 153Sm-DTPA-c (CGRRAGGSC) on MHCC97-H human liver cancer using a nude mice model.Methods 153Sm-DTPA-c(CGRRAGGSC) was indirectly synthesized by the reaction of 153SmC13 with DTPA-c(CGRRAGGSC).Western blot was used to detect the expression changes of IL-11 receptor of eight different cell lines.20 MHCC97-H tumor-bearing nude mice were randomly divided into four groups by random number table method with five mice in each group,administered with different activities of 153 Sm-DTPA-c (CGRRAGGSC) by tail vein injection (5.5,11.0,22.0 MBq/0.2 ml and physiological saline/0.2 ml in turn).All nude mice were terminated after 16 d then the tumor tissue was observed and analyzed with microscopy,electron microscopy and immunohistochemistry for Ki-67,Bc1-2 and IL-11 receptor.Western blot was used to evaluate the expression changes on IL-11 receptor of tumor tissue at different doses.Results After administration with 153 Sm-DTPA-c(CGRRAGGSC),the central region in the early stage of tumor became dry,necrosis,and crusting.In the late stage,tumor continually grew surrounding necrosis tissue.The inhibition rates in the low,middle and higher dose group were (22.72 ±2.76)％,(34.65 ±2.36)％ and (85.13 ±5.78)％,respectively(F =89.32,P ＜ 0.05).The morphologic results showed that tumor structures were severely damaged along with radiation dose.The results of immunohistochemistry showed that the IL-11 receptor-positive cells in the control group and 5.5 MBq group was (84.13 ± 5.71) ％ and (61.57 ± 5.98) ％ (t =13.62,P ＜0.05),respectively.The Ki-67 and Bcl-2 positive cells were decreased in the injection group (t =20.91,6.68,P ＜0.05).Western blot analysis showed that the expression of IL-11 receptor protein decreased with antitumor-effect of radiation.Conclusions 153Sm-DTPA-c (CGRRAGGSC) effectively depresses the growth of MHCC97-H human liver cancer and suppresses the expression of IL-11 receptor,and hence could be a promoting agent for the treatment of MHCC97-H human liver cancer.

Traditional Chinese medicine placebo has been put more and more attention to. However, there is no ac-cepted quality evaluation method for TCM placebo. How to evaluate TCM placebo objectively and quantitatively is a common problem in the industry of Chinese medicine. New technologies such as the Intelligent Sensory Technique have been used to establish the placebo evaluation methods which are suitable for TCM characteristics. This article provided the basis for establishing scientific, rational and objective evaluation guiding principles for TCM.

Objective To investigate the clinical value of serum Haptoglobin (Hp)levels in cervical cancer patients.Methods Serum Hp (with immunoturbidimetry method),SCC,CA125 (with electrochemiluminescence immunoassay method)level were detected in 45 patients with cervical cancer,37patients with cervical benign disease and 41 female healthy controls.Re-sults Serum Hp level of cervical cancer patients (mean:1.69 g/L)was strongly higher than the level of cervical benign dis-ease patients (mean:0.90g/L)and healthy subjects (mean:0.69 g/L)(t=3.26,4.42,P=0.001,0.000,respectively).Hp level rises highly in the early stage of cervical cancer.The area under receiver operating characteristic curve (AUCROC)of Hp was 0.853 which was higher than SCC (AUC=0.751)and CA125 (AUC=0.494).The sensitivity of Hp,SCC,and CA125 were 87%,49% and 29% respectively.The specificity of Hp,SCC and CA125 were 68%,88% and 83% respective-ly.Three tumor markers combined together could produce a positive detection rate of 93%.Conclusion The detection of Hp has clinic significance on diagnosis of cervical cancer,and it’s possible to become a serum tumor marker.