Female ; Humans ; Leiomyomatosis ; diagnosis ; surgery ; Uterine Neoplasms ; diagnosis ; surgery ; Vascular Neoplasms ; diagnosis ; surgery ; Vascular Surgical Procedures ; methods ; Veins

Objective To evaluate the value of endometrial volume measurement and 3-dimensional power Doppler imaging(3D-PDI) in the differentiation between endometrial polyps and endometrial hyperplasia.Methods One hundred and fifty-six women who diagnosed as thick and inhomogeneous endometrium or hyperechogenic focal intrauterine structures by 2D ultrasound were enrolled,including 50 patients with endometrial polyps in the proliferative phase,51 cases with hyperplasia and 55 cases with normal histology or others.All were scheduled for hysteroscopy,dilatation and curettage,and the ultrasound was performed within 24 hours before the procedure. Endometrial volume, vascularity index (VI), flow index (FI) and vascularity flow index (VFI) were measured. These parameters were compared between endometrial polyps group and endometrial hyperplasia group.Results These parameters (endometrial volume,VI,FI and VFI) were all considered statistically significant between two groups.Conclusions Endometrial volume and 3D-PDI are good diagnostic tools in the differentiation between endometrial polyps and endometrial hyperplasia.

Objective To understand the effects of "total quantity control" indexes on community health services and the residents' use of them so as to provide scientific basis for furthering reform in the medical insurance system.Methods A survey was made on the operation of the 3 community health centers of Jiangbin Xincun,Huashanwan and Hejianong in Jingkou District of Zhenjiang by means of direct inquiry and literature review.Results The average annual quantity of medical insurance plans allocated to the centers in the last 4 years involved 810 thousand yuan,the quantity actually fulfilled involved(953.5) thousand yuan,and the estimated annual quantity the centers were capable of fulfilling was valued at(1.45) million yuan,nearly 500 thousand yuan more than the quantity actually fulfilled. Conclusion Total quantity control on community health centers not only hinders the healthy development of community health services and the enthusiasm of the medical workers but also adversely affects the residents'use of health services and their health maintenance.

Objective To investigate the multiple factors correlated to femoral head necrosis in patients over 45 years old with femoral neck fractures after closed reduction and cannulated screws fixation.Methods Three hundred patients with femoral neck fracture were admitted from May 1999 to May 2004 and treated by closed reduction and internal fixation with cannulated screws.We analyzed the multiple factors:age,gender,Garden classification,follow-up time,procedure delay,quality of reduction,time of full-weight-loading,fixation removal, and preoperative traction.Multiple correlation factors were analyzed by SPSS10.0 statistic system.Results Complete case records were documented in 99 cases who were followed up for an average of 24.5 months(range,8 to 60 months).Femoral head necrosis occurred in 15 cases(15.2%).Time of femoral head necrosis was 8 to 50 months after operation.The combination of quality of reduction,preoperative traction,age,and age?fixation re- moval was found to have the most significant influence on femoral head necrosis after internal fixation for femoral neck fractures.Conclusions Good reduction is the most important factor correlated to the outcome of a femoral neck fracture.Age is linked to the risk of necrosis but it is relatively insignificant.Preoperative traction in wrong positions can increase the incidence of necrosis.Garden classification is important in predicting femoral head necrosis and is associated with quality of reduction,but it is not a risk one in the combination of multiple correlation factors that lead to the necrosis.

Objective To discuss teaching methods of TCM lectures for students of Western medicine in colleges and universities.Methods Totally 36 studens majoring in Western medicine from Capital Medical University were involved in the study. The first questionnaire survey showed the interest of those students. According to the students' response, the topics for the lectures were determined. The purpose for the second questionnaire was to investigate the teaching outcomes. Results The recovery rate for the first questionnaire was 100%, and the effective rate was also 100%. Students showed interest in the course of Introduction of TCM Health Maintenance, with few different ideas. The recovery rate for the second questionnaire was 88.89%, and the effective rate was also 88.89%. Students were relatively satisfied with lecture teaching, with few different ideas.Conclusion Lecture teaching can promote students' interest and teaching quality.

Humans ; Pulmonary Embolism ; diagnosis ; therapy ; Venous Thromboembolism ; diagnosis ; therapy

Objective To estimate and optimize the dosage regimen of vancomycin and linezolid for treatment in different Gram-positive cocci infections. Methods The pharmacokinetic data of vancomycin and linezolid were collected, and the pharmacodynamics in vitro of these drugs for staphylococcus epidermidis, staphylococcus aureus, enterococcus faecalis and enterococcus faecium were analysed. The cumulative response fraction (CFR) was evaluated in different dosage regimens of two drugs against four types of bacteria. Results The regimen of 3 500 mg/d vancomycin was recommended for patients with staphylococcus epidermidis infection. The regimen of 2 500 mg/d vancomycin was recommended for patients with staphylococcus aureus infection. The regimens of 3 000 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecalis infection. The regimens of 2 500 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecium infection. Conclusion In application of vancomycin and linezolid for treatment of Gram-positive cocci infections, different dosage regimens should be used in different types of infections.

Objective To investigate the diagnosis,treatment and prognosis of neonates with severe acute respiratory distress syndrome (ARDS) according to Berlin definition.Methods A retrospective study was carried to analyze the clinical features about diagnosis,treatment,chest X-ray findings,mortality,complications and ventilator parameters in 86 neonates with severe ARDS admitted in the NICU from January 2005 to December 2013.Results (1)Among the 86 cases,55 were cured,and 31 died with 36.0％ mortality.(2) Chest X-ray showed there was decreased lucency of bilateral lungs with ground-glass appearance,lung texture with thick chaos or dot flakes or patchy shadows in 36 neonates; diffuse infiltrates and extensive confluent consolidation shadows in bilateral lungs along with peripheral air brornchograms in 26 cases; heart shadow and diaphragmatic surface disappeared like a white lung change in 24 cases.(3) Persistent pulmonary hypertension of newborn as a complication occurred in 68 cases with 79.1％ incidence.(4) Eighty-six cases were categorized into survival group and death group.The results showed compared with the survival group,the neonates in death group required higher FiO2,and PaO2,and lower PaO2/FiO2 before mechanical ventilation (P ＜ 0.01),but needed higher initial PIP of mechanical ventilation (P ＜ 0.01).Conclusions Neonatal ARDS is still a kind of critical condition with high mortality and lack of evidence-based diagnostic criteria so far.The therapeutic strategy for neonatal ARDS should be a comprehensive measures in addition to appropriate respiratory support.

Objective To determine the dynamic changes in adenosine monophosphate-activated protein kinase (AMPK) in neurons of neonatal rats suffering from hypoxic ischemic brain injury.Methods Twenty-four-hour old and seven-day old neonatal rats were used in this study.A classic primary cortical neuron oxygen glucose deprivation (OGD) model and neonatal rat hypoxic ischemic encephalopathy (HIE) model were employed.Lactic dehydrogenase (LDH) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) were used to evaluate neuron viability and damage.The expression of phosphorylated adenosine monophosphate-activated protein kinase (P-AMPK),phosphorylated activated protein kinase (P-Akt) and Cleaved Caspase-3 in neurons and brain tissue was measured by Western blot at different time points after OGD or HIE.The Student-t test was used for statistical analysis.Results (1) Compared with the control group,LDH levels at 2,4,8 and 24 h after OGD were higher (all P＜0.05) and optical absorption levels of MTT were lower (all P＜0.05).(2) Levels of P-AMPK in the OGD group were higher than those in the control group,and showed a time-dependent increase at 30 min and 2,4,8 and 24 h (all P＜0.05).The expression levels of P-AMPK in the HIE group were higher than those in the control group (0.345 ± 0.038,0.387 ± 0.112 and 0.618 ± 0.075 at 1,3 and 7 days after HIE,and 0.132±0.032 in the control group,all P＜0.05).(3) The levels of P-Akt increased above the control levels at 30 min (0.991 ±0.134 vs 0.304±0.050),reached a maximum level at 2 h (1.183± 0.107),and then gradually declined,whereas the levels of Cleaved Caspase-3 started to increase at 30 min,and remained elevated at 24 h (all P＜0.05).Conclusion Following hypoxic ischemic brain damage,the expression of P-AMPK is significantly increased in both in vivo and in vitro studies in a time-dependent manner.

ObjectiveTo evaluate the application of 18fluoro-deoxyglucose positron emission tomography (FDG-PET) to the staging and predicting outcome in patients with lymphoma.Methods 41 patients with newly diagnosed lymphoma(median age 57 years)were explored with FDG-PET prior to and after 4 cycles of chemotherapy.With a median follow-up of 30 months (range 10-68 months),the value of FDG-PET to staging and predicting clinical outcome was assessed. Results The maximum standardized uptake value (SUVmax) of nodal and extranodal lesions was 9.7±6.9 and 8.4±6.8 respectively prior to treatment.There were significant difference (P＜0.05) in aggressive non-Hodgkin's lymphoma and indolent non-Hodgkin's lymphoma,no significant difference(P＞0.05)in non-Hodgkin's lymphoma and Hodgkin's lymphoma(HL), B-cell neoplasms and T-cell neoplasms,germinal center B-cell-like DLBCL and activated B-cell-like DLBCL. In 41 patients, 22 patients (54 ％)were detected extranodal focus by FDG-PET before chemotherapy. FDG-PET imaging upstaged in 6(15％)of initial lymphoma patients.There were 15 patients (37 ％) in stage Ⅰ and Ⅱ and 26 patients(63 ％)in stage Ⅲ and Ⅳ by FDC-PET scan.1 patient (7 ％) in stage Ⅰ and Ⅱ,6 patient (23 ％) in stage Ⅲ and Ⅳ died of disease progression during follow-up.After 4 cycles of chemotherapy,the FDG-PET was negative in 41％(17/41),positive in 59 ％(24/41) respectively.1 patient(6 ％)died of disease relapse among 17 patients who were FDG-PET negative, 6 patient (25 ％)died of disease progression among 24 patients who were FDG-PET positive during follow-up. Conclusion FDG-PET scanning plays an important role in the pretreatment staging and prediction of the prognosis after 4 cycles of chemotherapy in patients with lymphoma.Thus it may offer the potential for change in treatment paradigms.