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.

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 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.

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 clinical effectiveness of bipolar radio frequency tightening elongated ACL and PCL under arthroscopy.Methods From July 2001 to September 2003, twenty-two patients (average age 28, 19～36 years old; 18 males and 4 females; 15 right knees and 7 left; 9 from sports injury, 7 from traffic accident and 6 by sprain injury) with symptomatic laxity and confirmed elongation with rupture of structure were operated with bipolar radio frequency thermal shrinkage under arthroscopy. The average duration till operation was 6 months from injure. After operation, the patients started functional rehabilitation with protection of unlimited knee orthosis for 12 weeks. Results Twenty cases were follow-up for 4 to 22 months with average of 6 months. Lysholm score from 35.9 preoperation increased to 88.5 postoperation. Most patients had significant improvement in stability and function of knee join(excellent in 12,good in 4 and fair in 2). Conclusion Bipolar radio frequency could be applied to tighten elongated cruciate ligament of continuous structure and avoid potential revision and reconstruction in some cases.

Objective To discuss the value and the effect of radiofrequency treatment of tennis elbow under the arthroscopy. Methods From March 2003 to Jan 2004,eight cases of tennis elbow were treated by TOPAZ with local anesthesia under arthroscopy. Results The effects and functions were satisfactory after radiofrequency treatment. The symptoms of pain were completely disappeared in 7 and obviously relieve in 1. No blood vessel and nerve injury or infection occurred. Conclusion The methods of radiofrequency therapy for tennis elbow under arthroscopy has the advantage of minimum invasion, less pain and earlier rehabilitation.

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 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.