Adjuvant therapy of breast cancer in the child-bearing period tends to affect ovarian function of patients.Adjuvant chemotherapy has a great damage for ovarian function,and tamoxifen's extent of the damage is not yet clear,but gonadotropin-releasing hormone (GnRH) has a protective effect on ovarian function.In the adjuvant therapy,synthetic weigh the pros and cons,make the best individualized programs,is the future direction of the treatment of breast cancer.

Objective To evaluate the clinical efficacy of combination of Beyond cold light whitening and fluoride removing material bleaching sys-tem for treatment of dental fluorosis. Methods Ninety patients with light,medium and heavy dental fluorosis were recruited for the study and ran-domly divided into three groups. Thirty patients with 180 dental fluorosis from the A group were treated with microbrasion and etch and Beyond cold light bleaching. Thirty patients with 175 dental fluorosis from the B group were treated with microbrasion and beyond cold light bleaching. Thirty pa-tients with 180 dental fluorosis from the C group were treated with etch and Beyond cold light bleaching. The effects of whitening were evaluated by Vita shade guide matching after treatment. Results Good lightening efficacy and 100%bleaching efficacy was achieved in the light dental fluorosis subjects from all the three groups. The Shade value improvement and overall efficacy of observer group were better than the control groups for the me-dium and heavy fluorosis(P<0.05). Conclusion For moderate to severe dental fluorosis,combination of orderly methods ofmicro-polished-etch-Beyond cold light-bleachingis more effective and convenient.

Seven cases of typical salpingian diverticulum were identified by hysterosalpinography (HSG). The differentiation diagnosis of the disease was discussed. HSG is believed to be the method of choice for the diagnosis of this disease.
Adnexal Diseases/*radiography ; Diagnosis, Differential ; Diverticulum/*radiography ; *Fallopian Tubes ; Hysterosalpingography

Objective:To investigate the comorbid depressive symptoms,anxiety symptoms and suicide risk in people with alcohol abuse.Methods:Totally 1992 community residents were recruited by probability proportionate to size sampling.They were assessed with the Alcohol Use Disorders Identification Test (AUDIT),Depression Sub-scale(PHQ-9 )and Anxiety Subscale (PHQ GAD-7 )of Patient Health Questionnaire,and Suicide Risk Screening Scale of Mini-International Neuropsychiatric Interview (MINI).Results:The AUDIT screening positive cases was 298 (15.1%).The rates of depression symptom (53.4% vs.42.3%),anxiety symptom (35.9% vs.27.0%)and suicide risk (5.7%vs.3.2%)in alcohol abuse group were all significantly higher than that in non-abuse group (Ps<0.0 1 ).Conclusion:It is important to conduct assessment of related psychological problems in screening of alco-hol abuse,in order to provide effective intervention timely.

Objective To investigate the effect of different excipients of propofol on blood lipids and liver function during orthotopic liver transplantation. Methods Forty ASA Ⅲ- Ⅳ patients aged 40-64 yr weighing 50-75 kg undergoing orthotopic liver transplantation were randomly divided into 2 groups ( n = 20 each): propofol medium-chain triglycerides/long-chain triglycerides (MCT/LCT) group (group M) and propofol LCT group (group L). Anesthesia was induced with penehyclidine 1 mg, midazolam 0.04-0.06 mg/kg, sufentanil 0.6-0.8 μg/kg and propofol 1.5-2.0 mg/kg. Tracheal intubation was facilitated with vecuronium 0.10-0.15 mg/kg. The patients were mechanically ventilated. Anesthesia was maintained with 1%-2% isoflurane, continuous infusion of propofol blood samples were collected after admission into the operation room (T1), before skin incision (T2), at the end of pre-anhepatic phase (T3), at the end of anhepatic phase (T4) and 30 and 240 min of neohepatic phase (T5, T6 )for determination of plasma concentrations of triglyceride (TG), total cholesterol (CH), high-density-lipoproteincholesterol (HDL-C), low density-lipoprotein-cholesterol (LDL-C), and activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). The changes in parameters from baseline values were calculated. Results Compared with group L, △TG was significant1y decreased at T4-6 in group M ( P ＜ 0.05 ) . There was no significant difference in △CH, △HDL-C, △LDL-C, △AST and △ALT,plasma concentrations of TG,CH, HDL-C and LDL-C,and activities of AST and ALT between the two groups ( P ＞ 0.05). Conclusion The effect of the two formulations of propofol on liver function is comparable. Propofol MCT/LCT exerts less effect on blood lipids during liver transplantation and is more suitable for this type of surgery.

To develop a new-type portable composite emergency treatment device with multi functions to e-liminate the deficiencies of the existing emergency treatment devices. Mechanics calculation and intensity analy-sis were involved in the design of the device by analyzing the characteristics of pre-hospital first aid in the primary med-ical facilities and the allocation of conventional medicine and materials. The device adopted a chest-like structure with some versatile truckles at the corners of the bottom, which could be transformed into the emergency materials storage chest, emergency trolley, emergency bed, worktable or stretcher. The device was versatile, mobile and convenient, and could be used for CPR, simple operation, transfusion and etc. The device can be employed for emergen-cy treatment of battle injury at war time, pre-hospital first aid at peace time or emergency support in the responses to the emergencies.

Objective To explore the clinical effect and safety of Wenxin granule combined with metoprolol on arrhythmia in elderly patients with coronary heart disease (CHD).Methods 186 elderly CHD patients with arrhythmia were divided into 3 groups according to therapy:group A (n=62,treated with Wenxin granule),group B (n=60,treated with metoprolol) and group C (n=64,treated with Wenxin granule plus metoprolol).Clinical effect and adverse effect were retrospectively analyzed.Results The excellence rate and total efficiency rate were higher in group C than group A andB [53.1％ (34 cases) vs.32.3％ (20 cases),30.0％ (18 cases); 93.8％ (60 cases) vs.40.3％ (25 cases),40.0％ (24 cases) ; respectively,all P＜0.05].There were no significant differences in the incidence of adverse effect in the 3 groups [4.8％ (3/62),8.3％ (5/60) vs.8.3％ (5/64),all P ＞0.05].Conclusions Wenxin granule combined with metoprolol improves clinical effect,decreases premature beat and has a better safety for elderly CHD patients with arrhythmia,which is worthy of clinical application.

Objective To study the relationship between tacrolimus blood level/dose and the genotype of CYP3A5 at 6th month after lung transplantation.Method Forty-six cases of lung transplant recipients who received the surgery between January 1st,2011 and January 1st,2013 served as the research subjects,and the genotypes of these patients were measured.These patients were divided into 3 groups (CYP 3A5 * 1 * 1,CYP 3A5 * 1 * 3,CYP 3A5 * 3 * 3) according to their different genotypes.The dose of tacrolimus and daily intake were detected at 6th month after surgery in each group,then the level/dose of tacrolimus was calculated.Result In all 46 recipients,5 of them were CYP 3A5 * 1 * 1 homozygous genotype,20 CYP 3A5 * 1 * 3 heterozygous genotype and 21 CYP 3A5 * 3 * 3 homozygous genotype.Under the condition of holding tacrolimus blood level between therapeutic range,there was significant difference in the dose of tacrolimus between the CYP3A5 * 1/ * 1 and * 1/* 3 versus * 3/* 3 genotypes (P＜0.01),but there was no significant difference between CYP3A5 * 1/* 1 genotype and * 1/* 3 genotype.Conclusion Tacrolimus dosing in lung transplant patients is associated with CYP 3A5 gene polymorphisms.

Facing the new problems under the background of new era,with the establishment of the market economy of our country and the improvment of the medical health system,how to solve medical health problems,how to strengthen the modernization management of state-owned hospital,and how to improve their comprehensive strength become the focus of the health research.With the internal and external environment analysis and the strategic management theory,this paper puts forward the development strategy and the support system of the children's hospital of Chongqing Medical University.