Objective:To evaluate the efficiency and safety of fraxiparin in the treatment of patients with ACS. Method:137 patients with acute coronary syndrome(ACS)were randomly assigned to fraxiparin treatment and enoxaparin treatment for 7 days.Result:129 cases completed the whole trial and the results were obtained from ITT.The heart death rate was not statistically different between the two groups during the treatment.No Q segment acute myocardial infarction occurred.Both drugs statistically decreased CK CKMB and TnT.There was no significant difference between the two groups regarding these changes.Only two minor adverse reactions occurred and became normal soon after nadroparin withdrew. Conclusion:Fraxiparin and enoxaparin had similar efficiency and safety in the treatment of patients with ACS.

Objective To investigate the effect of the modified and controllable sigmoid colostomy in ostomy operation.Methods Sixty patients were divided into two groups.The control group (30 cases) received extraperitoneal sigrnoid colostomy while the experimental group (30 cases) received modified and controllable sigmoid colostomy.Postoperative complications caused by sigmoid colostomy,artificial anal function,psychological disorder,life quality,and the level of tumor marker between two groups were compared.Results In experimental group,4 patients (13.33％,4/30) at postoperative 6 months and 1 patient (3.33％,1/30) at postoperative 12 months suffered from complications caused by sigmoid colostomy.The incidence rate of complications caused by sigmoid colostomy was higher in control group[30.00％(9/30) and 10.00％(3/30)],but there was no significant difference (P ＞ 0.05).In experimental group,the defecate controllable and times were increased,18 patients (60.00％,18/30) could freedom control defecation,14patients (46.67％,14/30) defecation times ≤3 at postoperative 12 months.But there were 11 patients (36.67％,11/30) and 8 patients (26.67％,8/30) in control group,there was significant difference (P ＜0.05).The rate of human communication disorders,self abasement,anxiety and disappointment in experimental group at postoperative 12 months were significantly lower than those in control group (P ＜ 0.05).The rate of pessimism,loneliness and fear between two groups had no significant difference (P ＞ 0.05).In the evaluation of QLQ-C30 scale,aside from recognition function and financial straits had no significant difference(P ＞ 0.05),others scores in experimental group were significantly better than those in control group (P ＜ 0.05 or ＜ 0.01).In the evaluation of QLQ-C38 scale,the scores in experimental group at postoperative 12 months were significantly better than those in control group (P ＜ 0.01 or ＜ 0.05).At postoperative 12 months,the level of carcinoembryonic antigen,cancer antigen 125 and cancer antigen 199 in experimental group were significantly lower than those in control group (P ＜ 0.05).Conclusion The modified and controllable sigrnoid colostomy has the advantages,less complications,controllable,simple,safe and it is worthy of application more widely in clinical practice.

Maxillary sinusitis is a common condition in nose section. Traditional operations are always have more complications and easy to relapse, seriously affectting the quality of patient's life. The application of functional endoscopic sinus surgery (FESS) makes a qualitative progress on surgical treatment of maxillary sinusitis. In re- cent years, the researchs found that there are still unsatisfactories to long-term curative effect of some patients With the development of minimally invasive, people begin doubting its "functional". Recently, some new treat- merits have emerged in the world, but their safety and effectiveness needs further research. To seek for a better treatment, this article reviews the development and the existential problems of maxillary sinusitis surgery.
Endoscopy ; Humans ; Maxillary Sinusitis ; surgery ; Nose ; physiopathology ; surgery ; Recurrence

Objective　To investigate the relation between ovarian blood-flow resistance index (RI) measured with color Doppler ultrasound and the dosage of pituitary desensitization medication in controlled ovarian hyperstimulation cycle.Methods　Thirty infertile females were randomized into group at routine dose of gonadotropin releasing hormone agonist (GnRHa) (group A) and group at reduced dose of GnRHa (group B).Ovarian arterial blood-flow RI was checked on cycle day 8 and on the day of human chorionic gonadotropin ( HCG) administration with transvaginal color Doppler ultrasound.Results　The ovarian arterial blood-flow RI on cycle day 8,the total dosage and the duration of human manopausal gonadotropin (HMG) administration were significantly reduced in group B. In both groups,the ovarian arterial blood-flow RI was significantly decreased in the ovary with more dominant follicles (follicle diameter >10 mm) compared with the opposite one.Conclusions　In controlled ovarian hyperstimulation cycle,compared with routine protocol of GnRHa administration,reduced dose of GnRHa could decrease the ovarian arterial blood-flow RI,the total dosage and the duration of HMG administration without reducing pregnancy rate.

Objective: To understand the effect of bilingual teaching in the course of clinical epidemiology for the 7-year clinical medical undergraduates.Method: There were totally 45 clinical medical undergraduates selected to respond the questionnaire.The method of Focus Group Discussion had been used in the study.Results:91.11% of the students thought bilingual teaching was necessary for them and 73.33% thought the proportion of English teaching was reasonable,but 68.89% of them were not satisfied with the text book.80% said they could understand the teaching on the whole,but not clearly and deeply enough.86.67% of the students were content with the course.Conclusion:Bilingual teaching could help students to improve their professional English capability and English listening level.The key to the interest of bilingual teaching is teacher.The mode of teaching and text book should be improved.

In order to improve bilingual teaching in clinical epidemiology,a multidimensional teaching mode with flexible method was constructed.And it was proposed that based on the student-centered learning,the content of teaching should be adjusted,English should be used logically and clinical courses and practice should be closely connected.The new teaching method was proved successful.

Objective To discuss the surgical therapy of primary leiomyosarcoma of the inferior vena cava(PIVCLS).Methods Retrospective analysis of was made 5 patients of PIVCLS from Oct 2009 to May 2011 hospitalized in Department of Vascular Surgery,Provincial Hospital Affiliated to Shandong University.All patients underwent surgical resection,combined with reconstruction of bilateral renal vein and distal inferior vena cava using artificial vascular graft.Results Surgical resection was performed successfully in all patients.The mean operation time was 166.6 min,with mean blood loss 1 560 mL.Leiomyosarcoma intruding the inferior vena cava and right renal vein were observed in all patients during operation.The mean size was 12 cm × 10 cm× 8 cm.The diagnosis of PIVCLS in 5 patients was confirmed by postoperative pathologic examination.All patients did not present lower extremity swelling after surgery and discharged from hospital with normal blood (BUN) and (CREA).All patients were administrated with oral warfarin therapy after discharge.No clinical relapse and pulmonary embolism was observed during the follow-up (range 3 months to 12 months).The ultrasound revealed the patency of artificial vascular grafts in all patients.Conclusions Surgical resection combined with reconstruction of bilateral renal vein and distal inferior vena cava using artificial vascular graft is an effective and feasible treatment of PIVCLS.Leiomyosarcoma is completely eliminated and important abdominal viscera are protected well during the procedure because of minimal impact on hemodynamics.The incidence of postoperative pulmonary embolism also decreases obviously.

Objective To investigate the clinical values and characteristics of whole body bone ima-ging (SPECT/CT)in detecting bone metastases in the preoperative patients with lung adenocarcinoma or squa-mous cell carcinoma for staging and determining the best treatment plan.Methods Eighty-two preoperative patients with primary pulmonary adenocarcinoma or squamous cell carcinoma performed 99 Tcm-MDP SPECT/CT whole-body bone imaging.One week before surgery,parts of positive lesions performed MRI scan.The differ-ence of the incidence of bone metastasis was analysed by χ2 test.Results In all 82 patients with lung cancer, there were 38 adenocarcinomas and 44 squamous cell carcinomas.Bone metastases were detected in 38 cases, the incidence rate was 46.3%.Of which,among lung adenocarcinoma,the incidence rate was 57.9% (22 /38),and the incidence rate was 36.4% (1 6 /44)in lung squamous cell carcinoma,and the difference was sta-tistically significant (χ2 =1 2.66,P =0.027).The most common area was bilateral ribs,followed by vertebra, pelvis,bones of the extremities and skull.Conclusion Lung adenocarcinoma compared with squamous cell carcinoma is prone to bone metastases,and bone metastases are more common in bilateral ribs.It has important value that whole body bone imaging in screening for bone metastases of pre-operative patients with lung cancer for staging and making the treatment plan.

Objective To evaluate the clinical value of low field strength MRI in judging the invasion of myometrium of endometrial carcinoma in staging Ⅰ.Methods 32 cases with endometrial carcinoma approved to be clinical staging Ⅰ pathologically were evaluated by MRI before operation.The staging results of MRI were compared with pathologic results and analysed with statistic methods.Results According to 1988 FIGO staging the staging of the lesions was further carried out,including stage Ⅰa in 6,stage Ⅰb in 18 and stage Ⅰc in 8 cases.Compared with pathologic results,the sensitivity and specificity of MR in evaluating myometium invasion were 92% and 83% respectively,the staging accurate rate was 78%.Conclusion The endometrial carcinoma stage Ⅰ can be staged further by low field strength MRI,MRI has significant advantage in estimating the invasion of myometrium.

Objective To discuss the diagnosis and surgical treatment for carotid body tumors (CBT). Methods Retrospective analysis was made on 16 cases of carotid body tumors hospitalized in Shandong Provincal Hospital from January 2003 to October 2010. All patients were diagnosed by digital subtraction angiography, including 3 case of Shamblin type Ⅰ,11 cases of Shamblin type Ⅱ and 2 cases of Shamblin type Ⅲ. Three cases of type Ⅰ and 3 cases of type Ⅱ underwent carotid body tumor resection. Three cases of type Ⅱ underwent carotid body tumor plus external carotid artery resection, 3 cases underwent carotid body tumor plus external carotid artery resection plus carotid artery repairment, 2 cases did carotid body tumor plus external carotid artery resection plus internal carotid artery reconstruction. One of type Ⅲ underwent carotid body tumor plus external carotid artery resection plus carotid artery repairment, and the other one underwent carotid body tumor plus external carotid artery resection plus internal carotid artery reconstruction. Results Diagnosis of CBT was confirmed by pathology in all cases. There was no postoperative death、hemiplegia and blindness. The cranial nerve injury was caused in 7 cases, accounting for 43. 75%. 13 cases ( 81. 25% ) were followed up for 2 to 76 months ( mean 42 months), no tumor recurrence and metastasis was found. Conclusions Digital subtraction angiography (DSA) is important in the diagnosis and therapy of carotid body tumor. Surgical treatment is the choice of therapy for carotid body tumors.