Objective To study the effect of transvaginal ultrasound on the size of gestational sac and drug abortion, and to explore the relationship between the effect of drug abortion and the gestational sac size.MethodsIn our hospital in July 2016 were treated 50 cases of drug abortion of pregnant women as the research object in the process in February 2015, a retrospective analysis of 50 cases of pregnant women, patients were divided into gestational sac and greater than 10 and less than 10mm to 25mm 25mm three.Transvaginal ultrasound was performed before taking the medicine.After 7 days, the patients were examined by transvaginal ultrasound.The results showed that 7 patients had abortion failure, and the other 5 patients had incomplete abortion.ResultsTransvaginal ultrasound monitoring results can be obtained, the gestational sac size of less than 10 mm in patients with a total of 13 cases, abortion in patients with failure of the 2 cases, incomplete abortion in 4 cases, complete abortion in 7 cases, abortion failure probability was 15.4%.The gestational sac size ranged from 10mm to 25mm in a patient with a total of 25 cases, with a miscarriage of failure in a total of 2 patients, incomplete abortion in a total of 2 patients, complete abortion in a total of 21 patients, and a miscarriage probability of failure of up to & 8%.The gestational sac size is greater than 25 mm in patients with a total of 12 cases, the abortion of the failure of the patients in the 4 cases, incomplete abortion in the 2 cases, complete abortion in the 6 cases, the probability of abortion failure was 33.3%.Therefore, there was a significant difference between the three groups in the rate of abortion failure (P<0.05).ConclusionThe process of drug abortion in pregnant women, the use of transvaginal ultrasound monitoring, can monitor the situation of pregnant women with gestational sac in a certain extent, and that the effect of drug abortion, is conducive to the treatment and the subsequent operation, thereby reducing the pain of patients, improve the success rate of miscarriage.

The concept of Biomedical Engineering is introduced,as well as its advantages and clinical application.The characteristic of Biomedical Engineering which combing biomedicine with engineering is discussed by examples along with its innovative practice in clinic.Advices on future developing of Biomedical Engineering are brought forward.

Objective To compare the curative effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) with that of simple TACE in treating large liver cancers.Methods A computer-based search assisted by manual searching for TACE+MWA vs simple TACE clinical control trials for large liver cancers was conducted.The patient survival,tumor response and complications were enrolled in the scope of analysis.Results A total of 16 papers met the inclusion criteria,which included 1199 patients in total.Meta-analysis indicated that one-,2-and 3-year survival rates of TACE+MWA group were better than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The complete response (CR) rate and partial response (PR) rate of TACE+MWA group were higher than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The stable disease (SD) rate and progressive disease (PD) rate of TACE+MWA group were lower than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).Conclusion For the treatment of large liver cancers,TACE +MWA is superior to simple TACE.(J Intervent Radiol,2017,26:225-231)

Objective To describe the interpositional omentum and demonstrate its clinical significance.MethodsCT and clinical data of the cases whose suprahepatic gaps widen were reviewed and the contrast of CT was adjusted to observe further.ResultsIn 1 916 cases with upper abdominal CT data,suprahepatic gap was widen in all 152 cases,and 119 cases showed fat density(6.21％ ).There were 3 cases of trauma and 3 cases of acute abdomen in the 119 cases CT in the 119 cases displayed free gas under diaphragma,but displayed fat density after contrast adjusted.There were 11 cases undergoing operations,1 for sigmoid rupture 4 liver cirrhosis and portal hypertension,3 gastric cancer,and 1 acute cholecystitis,1 bile duct carcinoma and Ⅰ case congenital cystic dilatation of common bile duct.The other 108 cases did not undergo surgical operation.ConclusionsInterpositional omentum is a clinical phenomenon that the omentum was shift in suprahepatic gap covering the liver surface.It is not rarely,the incidence rate being 6.21％ ( 119/1 916) in our study.The occurrence mechanism may be similar to that of Chilaiditi syndrome.It is difficult to differentiate interpositional omentum from free gas under diaphragms on CT plain scan picture,but it is easy after contrast adjusted of CT.Free gas under diaphragma should not be identify incorrecdied and patients should not undergo unnecessary surgical procedure.

Objective To evaluate the clinical effect and safety of oxycodone in the anesthesia for percutaneous microwave ablation (PMWA) in liver cancer when the scope of ablation involving liver capsule.Methods Thirty-eight patients scheduled for percutaneous microwave ablation of liver cancer abutting capsule, including 32 males and 6 females, aged 41-75 years, with ASA grade Ⅰ or Ⅱ.Patients were randomly divided into 2 groups:oxycodone group (group O,n=20) and fentanyl group (group F, n=18).Before the puncture, a loading dose of oxycodone 0.1 mg/kg was given intravenously in group O, a loading dose of fentanyl 1 μg/kg was given intravenously in group F.After successful puncture, both groups were induced by Propofol 1.5 mg/kg, followed by Propofol infusion at 4-7 mg·kg-1·h-1 in two groups.The changes of MAP, HR, SpO2 and RR before, during and after operation were recorded.Body movement and respiratory depression were recorded.The total amount of propofol,the postoperative recovery time, postoperative nausea and vomiting, and postoperative 4 h VAS scores were recorded.Results There was no significant difference in general condition and intraoperative condition of ablation operation between the two groups.The incidences of respiratory depression and body movement in group F were significantly higher than those in group O.There was no significant difference in the incidences of postoperative nausea and vomiting between the two groups.VAS score 4 h after operation in group F [(3.9±2.0) score] was significantly higher than that in group O [(1.7±0.9) score] (P＜0.01).There was no significant difference in HR between the two groups at each point.Compared with before surgery, the MAP during surgery in group F was significantly increased (P＜0.05),the RR during surgery in groups F and O were significantly lower (P＜0.01 or P＜0.05).The RR during surgery in group F was significantly lower than that in group O(P＜0.05),but there was no significant difference at the other points between the two groups.Conclusion Oxycodone can be used safely and effectively for percutaneous microwave ablation of liver cancer when the scope of ablation involving liver capsule.It has lower incidence of respiratory depression, effectively alleviates intraoperative pain and reduces postoperative pain.

Objective To make an interpretation for the time-related evolving process of magnetic resonance imaging (MRI) signal of hepatic tumors after microwave ablation (MWA) treatment.Methods A total of 56 patients with malignant hepatic tumors (56 lesions in total) were enrolled in this study.Upper abdominal MRI plain scan and enhanced scan were performed in all patients at the second day,one month and 6 months after MWA treatment.The MRI signal features of ablation zones at different time points on T1WI,T2WI,DWI as well as on contrast-enhanced T1WI were documented,and the judgment of whether there was tumor recurrence was made.Results Two days after MWA,the ablation zone was manifested as target-like structure on T1WI and T2WI,which was characterized by central high signal ablation zone with low signal band around on T1WI and low signal ablation zone surrounded by high signal band on T2WI.One and 6 months after MWA,the volume of ablation area was atrophied,the target-like structure could still be observed on T1WI and T2WI,and the signal of ablation zone became intensified.Contrast-enhanced MRI revealed that abnormal high perfusion sign could be observed around the ablation zone,and on MRI scans performed at two days,one and 6 months after MWA,the ablation zone showed no enhancement.DWI indicated that two days after MWA the signal around the ablation zone was heightened,which decreased gradually in one and 6 months after MWA.Conclusion The signal of the ablation zone of hepatic tumor after MWA is evolving over time.Correct interpretation of MRI signal of ablation zone is helpful for the judgment of curative effect and for the making of therapeutic plan.

Objective To investigate the effect of soluble endothclial protein C receptor(sEPCR) on natural killer(NK) cells and Th17 cells of epithelial ovarian cancer(EOC) patients and further to study the mechanism of the occurrence and development of epithelial ovarian cancer.Methods 35 cases with epithelial ovarian cancer were selected as the experimental group,and 35 healthy women were chosen as the control group.Peripheral venous blood sample(8 ml)was extracted from each subject.Plasma,serum and peripheral blood mononuclear cells(PBMCs) were obtained from the blood sample.ELISA was used to detect the level of plasma sEPCR and serum IL-17 and IL-21.Flow cytometry was used to detect proportions of NK cells and Th17 cells in PBMCs.Results Compared to the control group,the level of plasma sEPCR in the experimental group increased significantly(P ＜ 0.05).The level of serum IL-17,IL-21 and proportion of NK and Th17 cells in PBMCs significantly decreased(P ＜ 0.05).Correlation analysis showed that sEPCR was negatively correlated with IL-17,IL-21,Th17 cells and NK cells,and the correlation coefficient r was-0.71,-0.62,-0.68 and-0.79,respectively.Conclusion sEPCR in epithelial ovarian cancer patients possibly promotes the proliferation of tumor cells through inhibition of NK and Th17 cells.

Objective: To select highly metastatic cells from human salivary gland mucoepidermoid carcinoma cell clone Mc3. Methods: In situ transplantation of Mc3 cells into submandibular gland of nude mice, in situ transplantation of Mc3 induced lung metastasized tumor tissue among nude mice and cell culture were employed to obtain the wanted cells. Morphological observation, cell growth analysis, flow cytometry, chromosome staining, clonogenic assay and artificial metastasis test in nude mice were used to characterize the cells. Results: Lung metastasis was observed in 3 out of 10 nude mice after 4 cycles of in situ transplantation of Mc3 cell induced lung metastasized tumor tissue. Epidermoid cells with similar morphology to Mc3 were obtained through cell culture and the cells were named M3SP4. M3SP4 cell induced lung metastatic foci were histologicaly proved to be mucoepidermoid carcinoma. Subdiploid karyotype with human chromosome morphology was observed in M3SP4 and Mc3 cells. The population doubling time (h) of M3SP4 and Mc3 cells was 23.9 and 25.9, the percentage of S phase cells in cell cycle 26.8 and 15.3, clonogenecity (%) 54.6 and 30.2, respectively. The artificial lung metastatic potential of M3SP4 cells was 35% higher than that of Mc3 in nude mice. Conclusion: M3SP4 cells are of human mucoepidermoid carcinoma with higher metastatic potential than Mc3. In situ transplantation of mucoepidermoid carcinoma cells or lung metastasized tumor tissue may maintain the metastatic potential of the cells.

ObjectiveTo summarize the experience of gastric D2 operation and evaluate the feasibility and safety of peripheral vascular choroid of lymph node dissection.Methods A retrospective study was adopted to analyze the redical D2 operation procedure and operation results 24 advanced gastric cancer cases,summarizing the experience of D2 radical gastrectomy operation for gastric cancer.The number of resected lymph nodes,operation bleeding volume,postoperative complications were analyzed to evaluate the feasibility and safety of operation.Results All 24 cases undergoing D2 radical gastrectomy operation of advanced gastric cancer were successful,and got the R0 resection.A total of 634 lymph nodes were excised in all the cases,averaged 26.42.A totle of 206 metastatic lymph nodes were found,metastasis rate being 32.49％.Operation bleeding volume was averaged 264.58 mL.The postoperative complication rate was 25％,anastomotic bleeding in 1 case,input loop jejunum fistula of esophageal jejunum anastomosis in 1 case,hyperamylasemia and 2 cases reflux esophagitis in 2 cases respectively.Conclusions D2 radical gastrectomy operation of gastric cancer is safe and feasible on the basis of mastering perigastric anatomy and master of lymph node excision technology and anatomical hierarchy separation.

Objective To investigate the clinical efficacy of endoscopic submucosal dissection (ESD)for the treatment of colorectal tumors, and to analyze risk factors affecting operation time. Methods A retrospective study was conducted using data of 74 cases with colorectal tumor,who underwent ESD in Department of Gastroenterology of Wuhan University Renmin Hospital from January 2014 to September 2015. The clinical efficacy of ESD, occurrence of complications and follow-up results were summarized,and the risk factors of operation time were analyzed. Results The rate of ESD en bloc resection and histological complete resection was 97.30%(72/74)and 89.19%(66/74), respectively. Among the 8 cases of histological non-curative resection, 2 cases received appended surgical procedures because of deep invasion of tumor(SM2),6 cases were given close follow-up according to the pathological result of adenomas. Among the 74 cases, no acute hemorrhage or pneumoperitoneum occurred. Four cases (5.41%, 4/74)had postoperative delayed bleeding, and were successfully treated by endoscopic hemostasis. Four cases(5.41%, 4/74)had intraoperative perforation, and were successfully treated by endoscope. No recurrence or abnormal lesions occurred during the follow-up of 15-35 months. Multivariate linear regression analysis showed that tumor size was a main risk factor for ESD operation time(P=0.000). Conclusion ESD, as a minimally invasive treatment, is safe and effective for the treatment of colorectal tumors,and the tumor size is a main risk factor of ESD operation time.