Endometriosis is a common gynecologic disorder defined by the presence,growth,and invasion of endometrial tissue outside the uterine cavity.Although many hypotheses have been proposed,the etiology of the disease remains an enigma.Recent studies have suggested that factors within the peritoneal fluid contribute to endometriotic implant invasion,neovascularization,and proliferation.Chemokines,especially ENA-78,similar to IL-8,are postulated to play an essential role in the local inflammatory reactions seen in endometriosis.

Objection]To study the clinical effect of self-prescribed jianpihuazhuoxiaoyu decoction in treating the patients with non-alcoholic liver of fat. [Methods]45 patients were treated with self-prescribed Jianpihuazhuoxiaoyu decoction in treatment group and other 45 patients with Polyene Phosphatidylcholine Capsules and Ursodeoxycholic Acid. Observe the patients'body mass index(BMI),radiological changes,liver function(AST/ALT) and lipids(TG/TC/HDL/LDL). [Results] The total effective rates were 91.3%,82.6% respectively, compared with the control group,the treatment group significantly improved liver function,lipid content decreased,obesity weight was effectively controlled and reduced,sonogram also showed improvement in the texture of the liver,compared with control group there were significant differences(P<0.05),difference was statistically significant.

Background Neovascular glaucoma (NVG) is a serious eye disease with a variety of causes.It results from the secretion of growth factors by hypoxic retinal tissue,such as vascular endothelial growth factor (VEGF),but anti-VEGF treatment alone dose not completely inhibit neovascularization.Our previous study found that platelet-derived growth factor-c (PDGF-C) is also an important factor in pathological angiogenesis.However,the role of PDGF-C in the development of NVG remains unknown.Objective This study was to quantitatively detect the levels of VEGF and PDGF-C in the aqueous humor of patients with NVG and provide a basis for the anti-angiogenesis therapy.Methods A prospective cohort study was carried out.Sixty-two eyes of 62 patients with advanced NVG and 11 control subjects with age related cataract were included in Xijing Hospital of the Fourth Military Medical University from January 2014 to August 2015.Ten of 62 NVG eyes received retinal photocoagulation and/or cryotherapy,and 16 eyes resulted from central retinal vein occlusion,20 eyes from diabetic retinopathy,5 eyes from postopeartion of retinal detachment,4 eyes from Eales disease and 7 eyes from unknown cause.Iris neovascularization of grade Ⅱ was found in 13 eyes,grade Ⅲ in 29 eyes and grade Ⅳ in 10 eyes.Aqueous humor specimen was collected for 0.1-0.2 ml during the surgery,and the contents of VEGF and PDGF-C in the aqueous humor were detected by ELISA assay.Written informed consent was obtained from each subject prior to any medical procedure.Results The VEGF and PDGF-C concentrations in the aqueous humor were (1 138.17±69.31) ng/L and (29.80±1.64) ng/L in the NVG group,respectively,which were significantly higher than (679.54±49.81) ng/L and (18.60±1.85)ng/L in the control subjects (t=20.95,20.49,both at P＜0.01).The VEGF and PDGF-C concentrations in aqueous humor were (1 095.99±52.71) ng/L and (28.55±0.94) ng/L in the retinal photocoagulation group,showing significantly decreases in comparison with (1 146.28±69.57) ng/L and (30.04± 1.64) ng/L in the untreatment group (t =-2.160,P =0.034;t =-2.760,P =0.008).The VEGF content in aqueous humor was positively correlated with PDGF-C content in the patients with NVG (r=0.346,P=0.006).However,the aqueous levels of VEGF and PDGF-C were not significantly different among various primary disease groups and different iris neovascularitation gradings (all at P＞0.05).Conclusions Both VEGF and PDGF-C contents in the aqueous humour are considerably elevated in NVG patients.Retinal photocoagulation and/or cryotherapy can inhibit the release of VEGF and PDGF-C in the aqueous humor.PDGF-C may be a target for the treatment of NVG.

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.

Objective To study the clinical features of invasive pulmonary aspergillosis (IPA) with chronic obstructive pulmonary diseases (COPD),so as to provide evidence for early diagnosis and treatment.Methods A retrospective analysis was made upon clinical data,diagnosis,treatment and prognosis of 53 patients with IPA and COPD admitted between January 2005 and February 2011 collected in a respiratory unit of the Second Xiangya Hospital Affiliated Central South University.Results There were 53 cases of diagnosed as IPA with COPD,with history of using broad-spectrum antibiotics.And there were 43 cases using steroids more than 2 weeks,51 with obvious breathlessness,and 20 with fever.Early stage didn't present characteristical changes on CT scan.However,after disease progression,32 cases had maculas shadows and nonspecific consolidations in bilateral lung,14 with solitary or multiple nodules,4 with solitary or multiple air crescent sign,and 2 with halo sign.Four patients of COPD with IPA underwent bronchoscopy examination.In fungi pathogeny,sputum positive rate and galactomannan positive rate were 56.6％ and 52.8％,respectively.A total of 53 cases received antifungal treatment.Among 37 cases which underwent mechanical ventilation,24 received noninvasive ventilation and 13 received invasive ventilation.There were 33 cases which were improved and cured,and 20 cases which had no relief after half-a-month treatment or withdrew treatment.Among them,13 cases died because of multiple-organ failure (5/15) or acute renal failure (8/15).Conclusions Early suspected diagnosis,timely examination in allusion to IPA,actively searching for etiological and imaging evidences,early established diagnosis and antifungal treatment would improve prognosis of patients with COPD combined IPA who have history of high doses of cortieosteroids,obvious breathlessness and non-response to antibiotics.

Purpose] This paper aims to summarize the clinical practice of using Buzhong Yiqi Decoction to treat the obstructed nine orifices. [Approach] After explaining Li Dongyuan’s theory that those obstructed nine orifices reflecting headaches and tinnitus are caused by intestines and stomach diseases,which is in his Suwen On Deficiency and Excess and analyzing several simple cases of using buzhong yiqi decoction to treat the obstructed nine orifices,this paper tries to trace the theoretical origin of Prof. Lian’s practice and present the practical experience of flexible usage of Buzhong Yiqi Decoction. [Result] The outcome of several patients under treatment shows that the short-and-mid-term treatment is very effective. [Conclusion] Prof. Lian’s philosophy of traditional Chinese medicine reflects his attitude that “those patients suffering from insufficiency of primordial Qi and clear Yang failing to distribute”or“clear Yang coming out of stomach”ask for strengthening the spleen and stomach so their stomach recovers to the healthy state. As a result,their Yang Qi has been greatly improved,the spleen and stomach in the middle energizer have returned to their original place,reaching the autonomous regulation of the nine orifices,which has shed some light on the usefulness of Buzhong Yiqi on treatment diseases other than those of spleen and stomach.

Objective To study the status quo of the caring character of baccalaureate nursing students and its related factors.Methods A total of baccalaureate nursing students were recruited from two and three levels of baccalaureate in Nantong district by convenience sampling method and cluster sampling method.The students were investigated with a nurse caring character questionnaire which was developed in the previous study and then an analysis was conducted.Results The caring characters of the nursing baccalaureate students were at the medium level.The caring characters of baccalaureate nursing students were affected by various factors.The linear regression revealed that choosing nursing willingly or not,relationship with familyand sex,among other things had the greatest influence on their caring characters.Conclusions Therefore,importance should be attached to the caring character of baccalaureate students and corresponding guidance and education directed at the various grades should be offered so as to increase their caring characters.

Objective:To investigate the feasibility,effectiveness and safety in the treatment of symptomatic middle cerebral artery stenosis with stenting.Methods:Twelve patients with middle cerebral artery stenosis were treated with stenting from August 2005 to December 2006.Among these patients,9 were male and 3 were female.The meam(SD)age was 69(5.3)years(range 56 to 81 years).The mean(SD)stenosis degree was 84.2%(3.7)(range 50% to 99%).All patients were successfully treated with balloon-expanded stents.and there was not any severe complications.Results:The rate of residual stenosis after the procedures was≤20%.No cerebral ischemic symptoms recurred in the patients over a 6-to 18-month follow-up period.Conclusions:Endovascular stenting is a safe and effective approach in the treatment of symptomatic middle cerebral artery stenosis,and its short-term effect is significant.

[Objective]To evaluate the surgical technique and effectiveness of extra-articular arthroscopic debridement in patients with rotator cuff calcifying tendinitis unresponsive to conservative treatment.[Methods]Arthroscopic debridement was performed in 18 patients(5 males,13 females;mean age 56.4,range 34 to 78) in whom pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis.Arthroscopy was inserted into subacromial interspace and bursectomy was done.Calcified plaques in supraspinatus tendon were explored and eliminated outside shoulder joint under arthroscopy.VAS pain score,Constant-Murley score and plain radiograph was adopted for evaluation before and after surgery.[Results]The mean follow-up period was 9 months(6 to 15 months)[KG-58x].Pain and functional disturbance of the shoulder disappeared or obviously improved.The average VAS pain score was(7.8?0.6) preoperatively and(1.7?0.4) postoperatively.The average Constant-Murley score was(61?7)preoperatively and(91?4)at the last follow-up.Radiograph showed little residual deposits in 2 cases but without preoperative symptoms.No case need rotator cuff repair.[Conclusion]Extra-articular arthroscopic removal of calcium deposits together with bursectomy is effective and reliable in patients with chronic calcifying tendinitis unresponsive to conservative treatment.

Objective To study the application of debridement with arthroscopy in acetabular dysplasia with osteoarthritis. Methods Thirty-two cases in 48 hips acetabular dysplasia with osteoarthritis debrided under the arthroscopy. In this group, male 9 and female 23, the mean age was 38.1 years old (range, 28-52 years old), the left side for 9, right side for 7 and bilateralis for 16. In the 48 hips, X-ray showed that comparatively large acetabular draw with normal position of femoral head in 21 cases (28 hips), large acetabular draw with femoral head lateral shift slightly but did not exceed 1/3 of femoral head in 11 cases (20 hips).MRI demonstrated that intraarticular fluid in 28 hips, subcartilage anormal signal of acetabular and femoral head at weight loading region in 10 hips, signal interruption of glenoid lip of hip in 10 hips. The procdure which included to remove of osteophyma, loose body and hyperplasia synovial membrane, degenerated cartilage on the stress areas of the hip joint, wear and tear of glenoid lip. Results The perianal skin in 2 patients suffered dysesthesia because of the over traction during operation. They recovered 7 days postoperation. Dysesthesias twenty-eight patients (36 hips) were follow-up with an average of 23 months (range, 6 months-3.5 years). After debridement and lavage, the patients released from pain, restored function and the range of the motion. According to VAS evaluation system for pain, the preoperative score was 5-9, with an average of 6.8; the postoperative score was 4-6, with an average of 2. According to Harris hip joint score evaluation system, preoperative score was 58.8?6.15, postoperative score was 89.6?11.3. The excellent in 20, good in 4, fair in 3 and poor in 1. The excellent and good result was up to 85.7%. Conclusion Selectivity debridement and lavage were effective methods for osteoarthritis hip joint acetabular dysplasia. It can delay the developing of course of disease; improve clinical symptom and elevate quality of life.