Objective To discuss the effectiveness and safety of selective iliac artery embolization in treating severe postpartum hemorrhage.Methods Eighteen cases of postpartum severe hemorrhage were treated by embolizing iliac artery with gelatin and/or steel coil.4-26 months later,5 cases were scanned with 16 layer MD(multi-detector)spiral CT with pelvic artery reconstruction and hormones(E2?P?T?FSH?LH?PRL)examination taken in 8 cases.Results Arteries were re-opened in cases embolized with gelatin.Two possible results may occur in those embolized with steel coil including one with uterus mainly supplied by ovarian arterian assisted by re-opened uterus artery and the other mainly fed by re-opened uterus artery.Hormones of the 8 cases were normal.Two women got re-pregnant after embolization.No serious complication related to embolization was found.Conclusion Iliac arterial embolization is safe and effective for the control of severe postpartum hemorrhage.(J Intervent Radiol,2006,15:218-220)

Objective To evaluate the quality of examination papers of otolaryngology among students of grade 2007 in the first clinical college of Chongqing Medical University.Methods Totally 202 copies of examination papers of otolaryngology from grade 2007 students in our college were taken as research references.SASS 15.0 software was used to statistically analyze total score of every student and score of each question.Mean score,standard deviation,difficulty coefficient and discrimination coefficient of each question were counted and normality test was conducted.Results Scores were in negative skewness distribution,with mean score of 80.9,standard deviation of 10.9,the lowest score of 56.5,the highest score of 98.0,difficulty coefficient of 0.781,and discrimination coefficient of 0.308.Conclusions Examination papers are well designed and discriminated and can objectively reflect students' command of the course.However,distribution of sores is unreasonable and examination paper is relatively easy to complete,indicating the weakness in the teaching process.

Objective To investigate the risk factors for severe hypoglycemia in the treatment of type 2 diabetes mellitus (T2DM) and to provide scientific rationales for the prevention of hypoglycemia in treating diabetes.Methods Clinical data of 49 T2DM patients with severe hypoglycemia (hypoglycemic group) and 98 T2DM patients without hypoglycemia as control group were retrospectively analyzed.Severe hypoglycemia was defined as that patient requiring assistance for intaking carbohydrate to alleviate hypoglycemia and plasma glucose concentration was less than 3.9 mmol/L.Clinical and biochemical indexes were analyzed by the single-factor analysis.Logistic regression model was established by multi factors regression analysis,and the receiver operating characteristic (ROC) curve was used to assess the performance of the logistic regression model.Results The mean serum glucose level was (2.3±0.7) mmol/L during hypoglycemia in hypoglycemia group.The mean age was higher in hypoglycemia group than in control group [(76.2±6,5) years vs.(69.8±11.5) years,P=0.001].The mean glycosylated hemoglobin Alc (HbAlc) level was lower in hypoglycemia group than in control group [(6.4±0.8)％ vs.(9.1± 2.5)％,P＜0.001].Endogenous creatinine clearance rate (Ccr) was lower in hypoglycemia group than in control group [(46.8±21.0) ml/min vs.(74.2 ± 24.5) ml/min,P＜0.001].Logistic regression analysis indicated that female and HbA1c level were the independent risk factors for severe hypoglycemia (OR=11.83,0.91 and 0.18,95％CI:1.82 76.93,0.86-0.97 and 0.08-0.44,respectiely] ; T2DM therapies with insulin and insulin secretagogues increased the risk of hypoglycemia (OR＝12.31 and 5.36,95％CI:1.70-88.88 and 1.08-26.56); however,duration of diabetes,body mass index (BMI),and urinary microalbumin (UMA) had no correlation with severe hypoglycemia (all P＞0.05).The area under the ROC curve was 96.5％ by the logistic regression model.Conclusions Gender,Ccr,HbA1c,insulin and insulin secretagogues are the main risk factors for severe hypoglycemia in T2DM patients.Preventive interventions of hypoglycemia should be taken earlier for the patients with the high risk factors.

Objective　To analyze the influence of multiple variable factors on the occurance rate of pneumothorax associated with transthoracic needle aspiration biopsy of the lung. Methods　Fluoroscopically guided lung biopsies were performed in 46 patients. Variable factors were analyzed including lesion size, location, number of puncture, presence of emphysema and patients position after needle biopsy of the lung. Results　Pneumothorax occurred at 9 (19.6%) of 46 patients and that occurred at 4 (44.4%) of 9 emphysematous patients. Among them 2 necessitated chest drainage tube placement. The pneumothorax occurance rate was 30% (3/10) for lesions of diameter 3cm or less in size. In the dependent group, pneumothorax occurred in 4 of 20 patients (20%). In the nondependent group, pneumothorax occurred in 5 of 26 patients (19.2%). Conclusion　The correlation showed that increasing frequency of pneumothorax with decreasing size of lesions. An increased rate of pneumothorax was correlated with presence of emphysema. Patients with emphysema are more likely to have a symptomatic pneumothorax. No significant differences were found in the incidence of pneumothorax between patients placed with the puncture site dependent after biopsy and those placed with the puncture site nondependent.

Objective To evaluate the efficacy and safety of itraconazole injection in treatmeat of invasive fungal infections.Methods The clinical trial was conducted in 16 patients(17 times)with invasive fungal infection from August 2003 to August 2005,including 1 case confirmed,11 cases(12 times)suspected and 4 cases for empiric treatment.They were treated with iv itraconazole injection in a dose of 200 mg twice daily in the first and the second day,from the third day to 14th day they were given iv itraconazole injection in a dose of 200 mg once daily,and then treated with capsule in a dose of 200 mg twice daily for another 28 days.Two cases were treated with iv itraconazole injection in a dose of 200 mg twice daily for 9 days and 14 days;1 case in a dose of 200 mg once daily for 21 days.Results 62 strains were isolated from 16 patients with invasive fungal infection,including 40 strains in urine cultivate,and 21 strains of tropic candida were primacy.In confirmed and suspected patients,the cure rate was 6/13,the effective rate was 11/13 and the eradication rate was 6/13.The incidence of adverse reaction was 3/24.Conclusion Itraconazole injection is effective and safe in treatment of severe invasive fungal infections,especially in severe ill,old patients for long time use.

OBJECTIVE: To investigate the correlation between C-erbB-2 and angiogenesis of breast cancer and its clinical significance.METHODS: The expression of C-erbB-2,VEGF(vascular endothelial growth factor) and MVD(microvessel density) in breast cancer tissues were detected by two-step immunohistochemical method.RESULTS: For the 50 breast cancer specimens,the positive rate was 44 %(22/50) for C-erbB-2 vs.64%(32/50) for VEGF,and the MVD value was 25.96?11.59.The positive expression rates of C-erbB-2 and VEGF and MVD value in patients with lymph node metastasis of breast cancer were all higher than in those without lymph node metastasis of breast cancer(P0.05).C-erbB-2 expression was positively correlated with VEGF expression(P

Non-muscle invasive bladder cancer (NMIBC) represents the malignant tumor of urinary bladder which is limited to mucosa and submucosal.NMIBC has high recurrence,and can progress to muscle invasive bladder cancer.Adjuvant intracavitary perfusion is beneficial for patients after surgery.There are many drugs for intravesical instillation in clinic.However,the new bladder perfusion drug which is safer and more effective,is always a research hotspot.

Objective To investigate the effect of lower limb rehabilitation training robot combined with task-oriented training on walking ability after stroke. Methods From February 2014 to August 2015,74 consecutive patients with post-stroke who received rehabilitation therapy and met the inclusion criteria admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were collected prospectively. They were all the patients with the first-ever stroke for 1 to 12 months. They were divided into either an observation group (n = 39)or a control group (n = 35)according to whether they were treated with the lower-limb rehabilitation robot. The patients of both groups received task-oriented training,2 times a day,once for 20 min,5 days a week for 12 weeks. The observation group was also treated with the lower-limb rehabilitation training robot,1 time a day,once for 30 min,5 days a week. Berg balance scale,Fugl-Meyer assessment (FMA),timed up-and-go test (TUG)and knee flexion active range of motion (KFAROM)were used to assess the efficacy. Results (1)After treatment,the Berg scale and FMA scale scores were increased in the observation group and the control group compared with before treatment. There was significant difference (Berg scale:28 ±9 vs. 22 ±9,29 ±9 vs. 24 ±9;FMA scores:47 ± 8 vs. 36 ± 8,40 ± 6 vs. 36 ± 7;all P < 0. 01),however,there was no significant difference between the two groups (P <0. 05),and there was significant difference in FMA scores between the 2 groups (P < 0. 01 ). The differences of Berg scale scores in the observation group and the control group were 10. 75 + 0. 30 and 4. 71 + 0. 14 respectively before and after treatment. There was no significant difference between the 2 groups (t = 0. 95,P = 0. 345). The differences of FMA scores in the observation group and the control group were 5. 8 ±0. 6 and 4. 9 ±0. 8 before and after treatment (t =5. 16,P <0. 01). (2)After treatment,the tug test and KFAROM of the observation group and the control group were better than those before treatment. There were significant differences (TUG test:35 ± 13 s vs. 56 ± 18 s,53 ± 17 s vs. 58 ± 18 s;KFAROM:82 ± 24° vs. 60 ± 23°,63 ± 23° vs. 57 ± 26°;all P < 0. 01),and there were significant differences between the 2 groups (all P < 0. 01). The differences of the TUG test in the observation group and the control group before and after treatment were 21. 5 ± 5. 0 and 4. 6 ± 0. 6 s respectively. There was significant difference between the 2 groups (t = 9. 55,P < 0. 01);the differences of KFAROM in the observation group and control group before and after treatment were 5.8 ±0.6° vs. 4.9 ±0.8° respectively. There was significant differences between the 2groups (t =4.17,P <0. .01). Conclusion Lower limb rehabilitation training robot combined with task-oriented training may improve the lower extremity motor function,walking ability,knee flexion joint activity of the patients after stroke,but the improvement effect of the lower limb balance is not obvious.

Aim: To investigate the enhancement of enhancers on matrine in vitro and in vivo. Methods: The permeability of matrine across rat intestine was determined by non-everted intestinal sacs model in vitro, and the in vivo activity was assayed in a model of acute liver injury in mice. Sodium deoxycholate (SDC) was selected as the enhancer Candidate. Results: Among the tested absorption enhancers, only polysorbate 80 (Tween 80) and SDC showed to be capable of increasing the transport of matrine through small intestinal mucosa in rats.Enhancement ratios of 1.6 was observed for 0.5% SDC solutions with the best absorption enhancement for matrine in vitro, it was chosen to conduct hepatoprotective study in vivo. In mice with acute liver injury, combination of matrine with 0.5% SDC demonstrated considerably more activity than matrine along after oral administration. Conclusion: The results indicated that the absorption of matrine could be significantly improved by the absorption enhancer.

Objective To explore the feasibility of virtual touch tissue quantification(VTQ) technique in noninvasive assessment of transjugular intrahepatic portosystemic stent shunt (TIPSS).Methods Twenty-four patients were enrolled in this study.Shear wave velocity(SWV) of the liver and spleen were obtained by VTQ technique on one day before TIPSS insertion and one week after TIPSS placement,and the portal vein pressure was measured while placing the TIPSS.The correlation between SWV of the liver and spleen and portal venous pressure were analysed.In addition,fourteen patients were followed up for one month after TIPSS placement.Results There was significant difference in portal vein pressure pre [(27.82 ± 4.07) mm Hg] and post [(16.26-± 3.10) mm Hg] TIPSS insertion.The SWV of the liver in patients pre and post TIPSS measured (2.43 ± 0.37)m/s and (2.40 ± 0.34)m/s,respectively.The SWV of the spleen in patients pre and post TIPSS were (3.49 ± 0.40)m/s and (3.08 ± 0.39)m/s,respectively,there was significant difference (P =0.000).However,SWV of the liver pre and post TIPSS placement was no significant difference(P =0.130).And as well as the patients which were followed up for one month after TIPSS placement.A significant,direct,linear correlation(r =0.602,P =0.000) was found between SWV of the spleen and portal vein pressure,but liver SWV was not correlated with the portal venous pressure.Conclusions SWV of the spleen measured by VTQ technique has a significant correlation with portal vein pressure.Hence,the spleen SWV based on VTQ technique can be used as a non-invasive method for quantitatively in monitoring the portal vein pressure as the function of the TIPSS.However,evidence to support a similar role for liver stiffness is lacking.