Objective To discuss the value of three-dimensional (3D) transrectal ultrasound (3DTRUS)in diagnosing prostatic diseases.In this study ,73 patients were examed.Methods 73 patients underwent three-dimensional reconstruction of prostatic ultrasonic echo were performe.At sametime we did 2DTRUS in these 73 patients.We compare these two groups` ultrasonic echo characteristics.Results 3DTRUS can provide more detailed three-dimensional makeup of prostatic lesions when compared with 2DTRUS.Overall informative value 3DTRUS in detection of prostatic lesions was 94.5%,2DTRUS is 83.6%.3DTRUS produced a significantly higher detection rate (P

Objective To discuss the influence of μ-opioid receptor ( OPRM1) and CYP3A gene polymor-phism on analgesic effect of fentanyl for abdominal hysterectomy patients .Methods 198 cases of gynecologic anes-thesia patients who were treated by elective abdominal hysterectomy surgery ,were selected in the hospital .The rela-tionship between the fentanyl consumption of intravenous analgesia and OPRMI and CYP 3A gene polymorphisms was detected by using polymerase chain reaction-restriction fragment length polymorphism detection .Results In 198 pa-tients,OPRM1 genotyping was 186 cases,the other 10 patients failed to typing were excluded ,including 89 cases of type A/A,type A/G 76 cases,type G/G 21 cases,OPRM1 the frequency of A118G allele was 31.7%.No statistically significant differences were found in mean VAS score of CYP 3A4*1/*1,CYP3A4*1/*1G,CYP3A4*1G/*1G instantly after operation in the three groups and 24h postoperation.By using analysis of variance with body mass ,age and intraoperative volume as a covariate factors after first 24h fentanyl consumption ,the difference was statistically sig-nificant among the three groups (P<0.05),CYP3A4*1G/*1G group was significantly lower than that in CYP3A4*1/*1G group and CYP3A4*1/*1 group,there was no significant difference between CYP 3A4*1/*1G group and CYP3A4*1/*1 group (P>0.05).In addition,because the OPRM1 A118G interacts with CYP3A4*1G, reducedthe quantity of expression of opioid receptor carrying CYP 3A4*1 and OPRM1 A118G/G,and thus more fent-anyl was needed postoperation to achieve the same effect .Conclusion It provided a theoretical basis and reference for clinical application of personalized medicine by analyzing the gynecological patients μopioid receptor gene A118G and CYP3A4*1G polymorphism.

OBJECTIVETo evaluate the safety and effectiveness of Shengji Ointment (SO) (by external use) in treating infective ulcer patients with yang syndrome (YS).

METHODSA multicenter, stratified, randomized controlled clinical study was used in this study. A random digit table was formed in the ratio of 3:1,440 infective ulcer patients of YS from 5 centers were recruited, 330 in the treatment group (external use of SO, exchange once every 24 h) and 110 in the control group (external use of Votalin, exchange once every 24 h). The therapeutic course consisted of 21 days. The ulcer area, wound depth, pain degree were observed before treatment at day 3, 7, 14, and 21, and safety indices monitored at the same time.

RESULTSThe ulcer area was significantly reduced in the treatment group after 21-day medication, obviously superior to that of the control group (P = 0.002). Ulcer areas at different time points were analyzed. From the 7th day of medication the reduced area was obviously less in the treatment than in the control group (P = 0.002). Besides, the longer the more obvious difference. Compared with the control group, the healing rate of ulcer area, the pain disappearance rate, and the healing rate of ulcer depth were all obviously improved in the treatment group (all P < 0.01). No adverse event occurred in the two groups.

CONCLUSIONSExternal use of SO was safe and effective in treating infective ulcer patients with YS. It could accelerate wound healing with better analgesic effect.

Objective To determine staging accuracy of double contrast-enhanced ultrasonography (DCUS)after neoadjuvant chemotherapy,and to evaluate effect during neoadjuvant chemotherapy for advanced gastric carcinoma(AGC).Methods A total of 29 patients with AGC diagnosed by endoscopy were examined and staged using ultrasound after taking oral contrast agent and bolus injection of SonoVue (DCUS)pre-and post-neoadjuvant chemotherapy.T-stage accuracy of post-neoadjuvant chemotherapy and pathological T status of postoperative were compared.All of the subjects were divided into two groups according to RECIST(Response Evaluation Criteria in Solid Tumors):chemotherapy benefit group(22cases,including:complete response 0 cases.partial response 14 cases,stable disease 8 cases)and progressive group(7 cases).The findings of DCUS of AGC tissues were assessed by auto-tracking contrast quantification(ACQ)software.The baseline intensity(BI)and peak intensity(PI)of gastric carcinoma tissues were measured automatically,and the enhanced intensity(EI)of gastric carcinoma tissues was calculated manually(EI =PI-BI).The quantitative analysis findings of DCUS of each patient pre-and postneoadjuvant chemotherapy between two groups were compared adopting repeated measures method.Results The overall accuracy of T staging in AGC patients after neoadjuvant chemotherapy were 65.52％ by DCUS,and 0,42.86％and 92.86％respectively for T2 stage,T3 stage and T4 stage.The agreement of this method was weak between T-stage accuracy post-neoadjuvant chemotherapy and pathological T status of postoperative.The Kappa value was 0.33.The difference value of PI and EI between pre-and postneoadjuvant chemotherapy in AGC patients for benefit group was more than that in progressive group.The main effect of BI in AGC tissues between pre-and post-neoadjuvant chemotherapy was no significant difference between two groups(P＞0.05).Conclusions Restaging by DCUS after neoadjuvant chemotherapy in AGC patients was found to be inaccurate.However,the difference value of PI and EI between pre-and post-neoadjuvant chemotherapy in AGC tissues for benefit group was more than that in progressive group.Thus,the value of PI and EI by ICUS may be a useful clinical parameter with which to evaluate the effect during neoadjuvant chemotherapy and guide therapeutic regimen for AGC patients.

BackgroundOsteopontin is highly expressed in many metastatic tumors,but its expression in uveal melanoma and the relationship of osteopontin with metastasis is still under investigation.Objective This study was to investigate the relationship between osteopontin expression and uveal melanoma metastatic potential.Methods Fifty samples of uveal melanoma were collected in Beijing Tongren Hospital.The expressions of osteopontin in the samples were detected using immunohistochemistry,and expressions of osteopontin mRNA in different metastatic potential uveal melanoma cell lines (MU M-2B,C918,OCM-1A) were analyzed using quantitative polymerase chain reaction (Q-PCR).ResultsOsteopontin was positively expressed in 10 samples of 13 patients with metastasis and 14 samples of 37 patients without metastasis,showing a significant difference between them (x2=5.888,P=0.000).There were 11 samples and 13 samples exhibiting the positive expression of osteopontin in 15 epithelial type and 35 non-epithelial type of uveal melanoma respectively with the significant difference (x2=5.510,P =0.000).The positive expressing numbers of osteopontin were 20 tumors of 30 affected tumors and 4 tumors of 20unaffected ciliary tumors with the significant difference (x2 =10.470,P =0.000 ).No significant differences in the expression of osteopontige were found between different gender,age,eyes,largest basal diameters and invasion of scleral canal( P =0.536,0.256,0.802,0.848,0.555 ).The relative expression value of osteopontin mRNA was in turn 1.00±0.04,0.91 ±0.03,0.08±0.01 in MUM-2B,C918,OCM-1A with the significant difference among three cell lines( F=33.135,P＜0.05).The osteopontige mRNA expression was significant enhanced in high metastatic potentialcell lines( MUM-2B,C918 ) compared with low metastatic potential cell lines( OCM-1 A) (P＜0.05 ),but no significant difference was seen between two high metastatic potential cell lines(MUM-2B,C918) (P=0.804).Conclusions Osteopontige expression is associated with the uveal melanoma cell line invasion and metastasis potential.These results imply that osteopontige expression maybe an indicator of uveal melanoma invasion and metastasis ability.

Objective To study the desired therapeutic effect of vaginoplasty using sigmoid colon or peritoneum for entire vaginal atre-sia.Methods From May 2015 to October 2015,8 patients with complete vaginal atresia in our hospital performed vaginoplasty using sigmoid colon or peritoneum successfully.The operation methods,prognosis and therapeutic effect and quality of sexual life of two groups were com-pared and analyzed to investigate a perfect operative method and ideal nursing.Results Laparoscopic vaginoplasty using the peritoneum compared with that using sigmoid colon has advantages of shorter time of operation,less bleeding,less trauma and quicker recovery.However, artificial vagina using sigmoid colon was much more similar to a natural vagina in morphological and physiological characteristics,merely ac-companied by excessive mucus discharge during the postoperative period.At lower risk of vaginal adhesion and stenosis,laparoscopically as-sisted vaginoplasty using sigmoid colon graft also puts high technical requirements.Two patients normally developed uterus menstruate regular-ly.Four patients without uterus and 2 patients with rudimentary uterus experienced good sexual intercourse after vaginoplasty.Conclusion Patients with complete colpatresia who have normal womb should creat a patent and functional vagina until adolescence to restore its physio-logical and reproductive function.Anatomical reconstructive treatment of vaginal agenesis for patients with absent or hypoplastic uterus can be postponed till the late teens or in the adult.Both laparoscopic sigmoid vaginoplasty and peritoneal vaginoplasty achieve a minimal-invasive, cosmetic,natural lubricous, smooth artificial vagina for patient’ s sex life satisfactory.

Objective To compare the values of automated breast volume scanner(ABVS) and conventional ultrasound(US) in the diagnosis of breast microcalcifications.Methods Sixty-eight cases of patients with breast microcalcifications 71 lesions were found by mammography,which were also examined by ABVS and US.The detection rate of microcalcifications under different background which have masses or not by the two methods were compared respectively,and the detection rate in the different pathological types of breast were also compared.All the cases were confirmed with histopathology.Results Sixty-five cases with breast microcalcifications were detected by ABVS and 55 cases detected by US,respectively.The detection rate of ABVS was significantly higher than that of US (91.5％ vs 77.5％,x2 =5.379,P =0.020).Forty-four cases of microcalcifications were found within the masses,but the other 27 cases without mass.The detection rate of microcalcifications within the masses had no siginificant difference between ABVS and US (97.7％ vs 93.2％,x2 =0.262,P =0.609),but ABVS was significantly higher than US (81.5％ vs 51.9％,x2 =5.333,P =0.021) in the detection rate of microcalcifications without the masses.The detection rate of ABVS in microcalcifications for those patients with invasive ductal carcinoma,were found the same as US (both 100％).However,the detection rate of microcalcifications by ABVS was much higher than US (94.1 ％ vs 58.8％,P =0.039) in patients with ductal carcinoma in situ.Conclusions ABVS can improve the detection rate of microcalcifications,especially without mass.The microcalcifications distribution can be observed in the coronal plane of ABVS,which increases the detection rate of ultrasound in the diagnosis of ductal carcinoma in situ.

A series of surveillance and management actions was taken to minimize out-of-plan re-operations. These actions include: 1) Building and completing the surveillance and management mechanism against unplanned re-operations; 2) Building a real-time surveillance and reporting mechanism; 3) Enhancing quality control and continuous improvement at the operating departments; 4) Enhancing the supervision on regulations implementation by quality control departments of the hospital; 5) Enhancing quality control for medical records; 6) Building a feedback mechanism for surveillance results; 7) Building a penalty and reward mechanism. Efforts for one year and a half on such surveillance and management proved successful, as the incidence of out-of-plan re-operations fell from 1.7% before these actions to 1.0% afterwards.

Objective To explore the relationship between the inflammatory reaction and insulin function in children with critically ill.Me-thods Ninty-six children with critical disease in Oct.2003 to Oct.2006 were enrolled in the study.Blood sugar,plasma insulin,C-peptide,tumor necrosis factor(TNF)-?,C reactive protein(CRP)were measured in the peak period and convalescence.Results Blood sugar and plasma levels of insulin,C-peptide,TNF-?,CRP were significantly higher in the peak period than those in the convalescence(Pa

Objective To examine the expression of typeⅠcollagen in pulmonary arteries of rats with monocrotaline(MCT)-induced pulmonary hypertension(PH) and explore the mechanism of pulmonary vascular structural remodeling.Methods Twelve male Wistar rats were randomly divided into 2 groups: the MCT group(n=6) and the control group(n=6),which received a single intraperitoneal injection of MCT solution(60 mg?kg-1,the first day) or 9 g?L-1saline,respectively.After 3 weeks,mean of pulmonary artery pressure(mPAP),the value of right ventricle/(left ventricle plus septum)[RV/(LV+S)] and body weight were measured.Lung sections(HE stained) were observed under lightmicroscope for changes of the pulmonary arteries.The protein expression of typeⅠcollagen in pulmonary arteries was detected by immunohistochemical technique.Results Three weeks after MCT injection,compared with control group,mPAP and RV/(LV+S) increased significantly in MCT group[mPAP:(10.60?2.06) mmHg(1 mmHg=0.133 kPa) vs(32.40?3.24) mmHg,P