ObjectiveTo summarize and investigate the occurrence,clinical features and treatment of cesarean scar pregnancy.Methods33 cases of cesarean scar pregnancy were retrospectively analyzed.Results10 cases of vaginal massive hemorrhage after uterine curettage,9 cases of subtotal hysterectomy,1 case was cured by MTX treatment,13 cases were cured by conservative treatment of uterine curettage after chemotherapy treatment,10 cases of successful uterus-saving by excision of lesion and uterine repair.ConclusionTransvaginal sonography was an important method in diagnosis of cesarean scar pregnancy and,the key to success was to select the appropriate individual treatment according to classification by transvaginal sonography.

Objective　To explore a new way of treating refractory residual gallstones by endoscopy. Methods　Choledochfiberscope(CHF) combined with air pressure ballistic lithoclast(APBL) under ureterscopy were used on 28 cases of large or impacted residual gallstones. Results　All refractory stones were crushed and extracted completely in 1-3 times, including sufficient once in 16, twice in 10 and thrice in 2. No severe complications were occurred in this series. Conclusions　This procedure is a safe, effective, simplicity, less complication and no heat injury methods. It is proved to be a new way of treating refractory residual gallstones, especially for large or impacted lithiasis. It is worthy for clinical application widely in the future.

Clinic genetic testing have make rapid progress in recent years , and have been widely applicated in genetic disease diagnosis , infection disease diagnosis and personalized treatment .The aim of this article is to pay attention to the ethical issues raised by genetic testing .The important ethical problems are proposed accompany with prenatal , adolescent, and adult genetic testing respectively .We should adopt responsible best ethical practices in the provision of genetic testing , promote the widely application of gene detection in clinic orderly.

Objective To explore a new way of treating refractory residual gallstones by endoscopy. Methods Choledochfiberscope(CHF) combined with air pressure ballistic lithoclast(APBL) under ureterscopy were used on 28 cases of large or impacted residual gallstones. Results All refractory stones were crushed and extracted completely in 1 3 times, including sufficient once in 16, twice in 10 and thrice in 2. No severe complications were occurred in this series. Conclusions This procedure is a safe, effective, simplicity, less complication and no heat injury methods. It is proved to be a new way of treating refractory residual gallstones, especially for large or impacted lithiasis. It is worthy for clinical application widely in the future.

Objective To investigate the results of hearing screening in newborns and infants so as to explore the appropriate clinical strategy of hearing screening among newborns and infants. Methods Transiently evoked otoacoustic emission(TEOAE) was used to examine the hearing of newborns and infants. Those who fail the initial screening underwent secondary screening with TEOAE. Acoustic brain-stem response(ABR) was used to monitor the hearing of those who failed the secondary screening. Results A total of 6 150 infants were taken hearing screening but only 5 597(91%) passed the first screen,A total of 103 newborns were hearing screening but only 93(90. 29%)for the first screen. Conclusion Hearing screening in the procedure with TEOAE helps identify infants with hearing loss as early as possible so as to conduct appropriate intervention and pormote development of speech and language.

In recent years, the morbidity rate of pediatric asthma showed a rising trend.The typical symptom of recurrent wheezing(＞ 3 times/year) in infants is the starting point for the diagnosis of asthma in children and may be the early clinical manifestation of asthma.Chronic airway inflammation, which inducing airway hyperresponsiveness is the main pathophysiology of recurrent episodes of wheezing.Monitoring of fractional exhaled nitric oxide (FeNO) is a simple, fast, effective, and noninvasive marker of airway inflammation in asthma.The concentration of nitric oxide can effectively reflect the airway inflammation and is positively correlated with the severity of airway inflammation.Monitoring airway inflammation is helpful to diagnose and treat the asthmatic children, and for predicting asthma exacerbation, guiding and monitoring the asthma.Thus, this review will discuss FeNO measurements among wheezing infants and asthmatic that have been identified in large-scale studies recently.

Objective To investigate the clinical application of procalcitonin (PCT),pre-albumin (PA)and white blood cell (WBC)detections in children infectious diseases.Methods 116 children inpatients of infectious diseases in our hospital were select-ed for conducting the study and divided into the non-bacterial infection group (56 cases)and the bacterial infection group (60 cases) according to the different pathogenic microorganisms.Other 64 children with healthy physical examination in the outpatient depart-ment were taken as the control group.The blood PCT,PA levels and WBC count were detected in 3 groups,and which before and after treatment in the bacterial infection group were detected.The differences in PCT,PA levels and WBC count were compared a-mong the groups.Results The blood PCT level and WBC count in the bacterial infection group and the non-bacterial infection group were all higher than that in the control group,while the PA level in the bacterial infection group was lower than that in the non-bacterial infection group and the control group,the differences had statistical significance (P <0.05);the PCT level and WBC count after treatment in the bacterial infection groups were lower than those before treatment,while the PA level after treatment was higher than that before treatment with statistical difference (P <0.05).Conclusion The detection of PCT,PA and WBC count can be used as the indexes for diagnosing infectious diseases in children,and provides reference for the judgment of prognosis.

Objective: To observe the effects of Astragalus injection, astragaloside IV and formononetin on proliferation and Akt phosphorylation of basal-like human breast carcinoma cell lines MDA-MB-468 and MDA-MB-231. Methods: The effects of different concentrations of Astragalus injection, astragaloside IV and formononetin on proliferation of breast cancer cell lines were assayed by methyl thiazolyl tetrazolium (MTT) assay, and their effects on phospho-Akt were assayed by in-cell Western blot method. Results: The results of the MTT assay showed that the best concentrations of Astragalus injection, astragaloside IV, formononetin and astragaloside IV plus formononetin were 1 g/mL, 80 mug/mL, 40 mug/mL and 10 mug/mL plus 40 mug/mL respectively. After 1- or 2-day culture, Astragalus injection, astragaloside IV, formononetin and astragaloside IV plus formononetin decreased the expressions of p-Akt (Thr 308) and p-Akt (Ser 473) in MDA-MB-468 cells. Formononetin and astragaloside IV plus formononetin down-regulated the expression of p-Akt (Thr 308) protein in MDA-MB-231 cells after 1- and 2-day culture, but had no effects on the expression of p-Akt (Ser 473) protein in MDA-MB-231 cells. Conclusion: Astragalus injection, astragaloside IV and formononetin can inhibit proliferation of breast cancer cell lines MDA-MB-468 and MDA-MB-231, and the antiproliferation effects vary according to their concentrations. And the antiproliferation mechanisms may be related to their down-regulation effects on Akt phosphorylation.

OBJECTIVE To explore the relationship between the change in Toll-like receptor expression and prognosis of severe viral hapatitsis.METHODS The peripheral blood mononuclear cells were separated and the expression of TLR2 and TLR4 mRNA was observed by reverse transcription-polymerase chain reaction(RT-PCR).The level of serum endotoxin was measured by chromogenic substrate Limulus amebocyte lysate assay.The data were analyzed by SPSS 11.5 software.RESULTS The expression of TLR2 and TLR4 mRNA and the level of serum endotoxin of death group before therapy were lightly higher than that of survival group,but after therapy that of death group is higher than survival group(P

Objective To establish a nude mouse model of low rectal cancer with lymph node metastasis, to detect the expression of E-calcium (E-cad) in the serum and transplanted tumor tissue of the mice, and to analyze the role of E-cad in lymph node metastasis of rectal cancer.Methods Human colorectal adenocarcinoma cells (SW-480) were inoculated into the rectal submucosa of nude mice to establish a model of low rectal cancer with lymph node metastasis.120 nude mice were randomly divided into three groups (40 mice in each group).Group A (rectal cancer model group) was injected with dimethylhydrazine and implanted with SW480 cells.Group B (dimethylhydrazine control group) was injected with dimethylhydrazine alone.The group C (control group) received no treatment.Serum E-cad was detected by ELISA.The mRNA and protein expression of E-cad in the tumor tissue was detected by RT-PCR and western blot, respectively.Results The serum level of E-cad in group A was 19.48±1.25 mg/L, significantly higher than those in groups B (2.36±0.18 mg/L) and C (2.15±0.12 mg/L) (t =8.28, 9.01, P < 0.05).The serum levels of E-cad were significantly higher in the nude mice with lateral lymph node metastasis than those without lymph node metastasis (t =10.28, P < 0.05).The protein expression of E-cad in the group A was lower than that in the groups B and C (t =9.81, 7.69, P < 0.05).In the group A, the protein expression of E-cad in the nude mice with lateral lymph node metastasis was significantly lower than that without lateral lymph node metastasis (t =9.36, P < 0.05).The mRNA expression of E-cad in the group A was significantly lower than that in the groups B and C (P < 0.05), and the mRNA expression of E-cad in the nude mice with lateral lymph node metastasis was significantly lower than that in the mice without lateral lymph node metastasis (t =7.85, P < 0.05).Conclusions The serum level of E-cad may be closely associated with the lymphatic metastasis of rectal cancer, and the mRNA and protein expressions of E-cad in colorectal cancer tissue were weak or absent, leading to a decrease of adhesion ability between cancer cells, and promote the invasion and metastasis of cancer cells.