Objective To investigate the safety and clinical effect of laparoscopic radical parametrectomy in the treatment of unexpected cervical cancer . Methods A retrospective analysis was made on clinical characteristics of 15 patients who were diagnosed as unexpected cervical cancer from January 2008 to December 2014.The age of the patients was between 29 and 67 years old, with an average of 43.9 years old.The indications for hysterectomy were cervical intraepithelial neoplasia (CIN) grade 2-3 in 7 cases, uterine myoma in 3 cases, dysfunctional uterine bleeding in 2 cases, uterine prolapse in 2 cases and adenomyosis in 1 case. Pathological results after the hysterectomy included 13 cases of cervical squamous carcinoma and 2 cases of adenocarcinoma .The lesions were all confined to the cervix , with 4 cases of stage ⅠA2 disease and 11 cases of stage ⅠB1 .The lymph-vascular space invasion was found in 4 cases.The operation interval between the two operations was 3-7 d (mean, 4.6 d).They were all given laparoscopic radical parametrectomy . Results The operation time was 212-285 min (mean, 249.6 min), and the blood loss was 250-500 ml ( mean, 376 ml) .Postoperative pathological findings showed no residual disease .Only one patient had left pelvic lymph node mestastasis .Two patients had intraoperative complications , including 1 bladder injury and 1 ureteral injury .There were 3 cases of postoperative complications , including 2 cases of uroschesis and 1 case of lymphocyst .The follow-up time was 6-84 months ( median, 48 months).No recurrence was seen.The 1-, 3-, 5-year survival rates were 100%, 93.3%, 86.7%, respectively. Conclusions Laparoscopic radical parametrectomy in the treatment of unexpected cervical cancer is difficult to perform and has more complications . This surgical method is applicable to those who refused postoperation radiotherapy or required retaining ovarian function .

Objective To probe the etiology and management of restenosis after artificially grafting bypass for chronic ischemia of the lower extremities. Methods In this study 52 cases suffering from postoperative restenosis and obliteration were compared with 32 cases whose artificial grafts remain patent during the same postoperative follow-up period of 3～62 months.Possible risk factors that lead to restenosis were evaluated.Resuits FIB(4.48±1.68)g/L,CRP(9.5±2.6)mg/L and LDL(4.5±1.7)mmol/L were significantly higher in the restenosis group than FIB(3.50±0.72)g/L,CRP(4.0±3.2)mg/L and LDL(2.8±0.9)mmol/L in the patent group(P＜0.01).There were no significant difference between HDL(1.02±0.32)mmol/L in the restenosis group and HDL(1.12±0.28)mmol/L in the patent group (P＞0.05).Reoperation in these 52 cases found severe intima hyperplasia and secondary thrombosis within anastomosis in 42 cases and the remaining 10 cases were found with artificial vessel primary thrombosis.After reoperation,artificial graft remain patent in 28 cases,limb amputation was performed in 10 cases,the grafted bypass were removed due to infection in 3 cases. Five patients died postoperatively.Conclusion The main reason for restenosis after artificially grafting bypass is intima hyperplasia in vascular anastomosis.Higher levels of FIB,CRP and LDL maybe the major high risk factors that lead to intima hyperplasia and artificial graft obliteration.

Objective To establish the fingerprints of 20 batches of Lavandula Angustifolia by HPLC. Methods The determination was performed on a Phenomenex ODS-A column (250 mm× 4.6 mm, 5 μm). The mobile phase was in gradient elute mode with a mixture consisting of acetonitrile and 0.036 mol/L phosphate acid solution. The flow rate was 1.0 mL/min. The temperature was 30 °C. The determine wavelength was 350 nm. The fingerprints of 20 batches of Lavandula Angustifolia were compared and classified by similarity evaluation, cluster analysis, and principal composition analysis. Results Totally 10 chromatographic peaks were extracted as the common peaks of Lavandula Angustifolia, and 2 peaks were identified. The similarity degrees of the 20 batches of Lavandula Angustifolia were above 0.9. All the batches of Lavandula Angustifolia were classified into 3 categories. Conclusion The method is simple and reproducible, and can be used for the standardization and quality control of Lavandula Angustifolia.

BACKGROUND: Autophagy of osteocytes has been found to be implicated in the pathogenesis of steroid-induced necrosis of the femoral head and closely related to apoptosis.OBJECTIVE: To summarize the research progress of autophagy in the pathogenesis of steroid-induced necrosis of the femoral head by studying the interaction between cell autophagy and cell apoptosis as well as osteocytes.METHODS: A computer-based online retrieval of PubMed, Embase and CNKI databases was performed for relevant literatures published from October 1996 to October 2016 with the keywords of steroid, necrosis of the femoral head, cell apoptosis, cell autophagy, osteocyte in Chinese and English, respectively. The articles concerning steroid-induced necrosis of femoral head and cell autophagy were collected, and the redundant and old researches or Meta analysis were removed.RESULTS AND CONCLUSION: Mammalian target of rapamycin, Beclin-1, microtubule-associated protein 1 light chain 3, bone morphogenetic proteins, fork box protein and transcription gene family and transcription factor 4 are closely related to autophagy. The interaction between autophagy and osteocytes is correlated with steroid dose: the autophagy shows protective factor under the low dose corticosteroids; however, with the increase of the dosage, a large number of apoptotic cells, and the phenomenon of bone loss can been observed. Furthermore, the relationship of cell autophagy with apoptosis and bone mass maintenance is still controversial, which needs to be explored in depth via a series of rational experiments.

The information security and privacy protection of electronic health records (HER) are greatly con-cerned by healthcare administrators, healthcare providers and patients in the era of big data and cloud computing. The concepts of information security and privacy protection of HER wre defined according to the systematic investi-gation of related literature, the keys to the information security and privacy protection of HER were summarized, and the advances in research on information security and privacy protection of HER were described.

Objective To evaluate abdominal aortic balloon occlusion during pelvic tumors surgery and mamagement of related vascular complications. Methods We retrospectively analyze the clinical data of 265 pelvic tumor cases from December 2005 to April 2010.Before pelvic tumor operation,we place a sheath by Seldinger maneuvre in common femoral artery and send a balloon catheter in the abdominal aorta below the level of renal artery.The balloon catheter occluded the blood flow below the level of renal artery totally during the time of removing the tumors.After the procedure,we pull the balloon catheter out and normally retain the sheath for 6 hours. Results The procedure was successful in all cases and the average time of abdominal aorta blockade was (66 ± 4) min.There was no abdominal aortic rupture and acute renal dysfunction.Emergency angiography was performed on the operative region to diagnose the cause of massive bleeding after the open surgery in 6 cases.Among them,3 cases underwent embolization of internal iliac artery to stop bleeding and 1 case underwent embolization of lumber artery.Small covered stent was deployed in the common iliac artery to stop bleeding in 2 cases.Thrombosis of femoral artery at the puncture site occurred in 6 cases and bilateral thrombosis developed in 1 case. Blood flow was restowed to the femoral artery by open thrombectomy.Pseudoaneurysm formation around the puncture point occured in 2 cases and they underwent open surgical repair,then recovered well. Conclusions Balloon catheter occlusion of abdominal aorta is an effective method to control the hemorrhage in the pelvic tumors' operation.

Objective To study the clinical efficacy of tolterodine tartrate combined with transcutaneous electrical nerve stimulation(TENS)in the treatment of elderly female patients with overactive bladder(OAB).Methods 30 patients with OAB were randomly divided into single treatment with tolterodine tartrate and combination treatment of tolterodine tartrate and TENS for 10d.The efficacy was evaluated by overactive bladder symptom score(OABSS),patient perception of bladder condition(PPBC),quality of life(QOL),visual analogy scale(VAS)and 5 grade pain scores.Results The post-treatment symptoms of urgent urination and urinary incontinence,OABSS,PPBC,QOL,VAS and 5 grade pain scores in single treatment group[(1.67±1.45)times /d,(1.53±1.25)times /week,(6.67±2.55)scores,(2.07±0.96)scores,(2.07±1.03)scores,(3.67±0.90)scores and(4.07±0.80)scores]were improved as compared with pre-treatment[(6.40±1.45)times /d,(3.93±1.03)times/week,(13.00±1.00)scores,(4.20±0.68)scores,(3.80±0.68)scores,(7.13± 1.19)scores and(9.40± 1.55)](t=8.94,5.74,8.94,7.03,5.44,9.01 and 11.85,all P＜0.01).The above indexes in combination treatment group after treatment[(1.27±0.80)times/d,(1.20±0.77)times/week,(5.33±1.72)scores,(1.67±0.62)scores,(1.47±0.52)scores,(2.93±0.80)scores and(3.40±0.99)scores]were also improved as compared with pretreatment[(6.20±1.26)times/d,(4.00±1.25)times/week,(12.73±1.03)scores,(4.07±0.80)scores,(4.00±0.65)scores,(7.47±0.74)scores and(9.67±1.35)scores](t=12.77,7.36,14.29,9.21,11.77,16.09 and 14.55,all P＜0.01).The VAS and 5 grade pain scores were higher in combination treatment group than in single treatment group(t=4.879 and 2.746,P＜0.01).Conclusions Tolterodine tartrate combined with TENS is safe and effective for the treatment of elderly female patients with OAB,and may alleviate pain and improve quality of life.

Objectives To evaluate the method and short-term result of endovascular repairing for distal tears of Debakey type Ⅲ dissecting aneurysm. Methods In this study the continously existing distal intima tears were repaired using different method in 15 Debakey type Ⅲ dissections after previous successful repair of the proximal entry.All patients have symptoms caused by unclosed distal tears or increased false lumen in abdominal aorta.7 visceral artery tears ( 1 celiac and 6 renal),4 abdominal aorta and 7 iliac artery tears were repaired (3 cases have both viscera and iliac tears).All abdominal aorta entries were repaired by bifurcation stent grafts.Blocking umbrella was used in 1 renal tear,and all other viscera and iliac tears were repaired by small covered stents. Results All endovascular procedures were successfully completed.No any endo-leak occurred in abdominal and iliac entry repairs.One near renal tear was totally blocked by an umbrella which also blocked blood flow from false lumen to right renal artery.One major endo-leak and 2 minor endo-leak occurred in visceral artery tearing repair,all other visceral tears were completely repaired.All patients were followed up from 2 to 10 months (average 5.0 ± 2.0 months).Follow-up CTA revealed false lumen thrombosis in non-endo-leak cases.Three endo-leak cases still have blood flow in false lumen with partly thrombosis. Conclusions In selected patients,salvage endovascular repair for left over distal tears in Debakey Ⅲ dissecting aneurysm after initial repair is feasible and safe.

Objective To explore the relationship between the membranous tissue(MT)and organized thrombus(OT)in membranous obstruction of the inferior vena cava(MOVC),we investigated the related cytokines expression in the membranous tissues in MOVC as well as venous organized thrombi. Methods Using immunohistochemical method the expression of TGFβR,PDGFR,ET-1,FⅧ-rAg, ferritin and α1-antitrypsin were observed in the membranous tissues in 11 cases with MOVC and organized thrombi in 8 cases with deep venous thrombosis(DVT). Results Expression rates of TGFβR,PDGFR,ET-1,FⅧ-rAg, and ferritin in membranous tissues in 11 cases with MOVC and organized thrombi in 8 cases with DVT were as follows: TGFβR:MT 72.3%,OT 50%(P＞0.05);PDGFR:MT 45.5%,OT 100%(P＜0.05＝;ET-1:MT 100%,OT 0(P＜0.05＝;FⅧ-rAg: MT 90.9%,OT 12.5%(P＜0.05＝;ferritin: MT 72.3%,OT 100%(P＞0.05).α1-antitrypasin was not detected in either membranous tissues of MOVC or organized thrombi of DVT. Conclusions ThrovIgh the investigation of the related cytokines expression, it is possible that membranous tissue formation in MOVC is related to the organized thrombus.

Objective To evaluate the surgical results for patients with lower-extremity arteriosclerotic occlusive disease. Methods We performed a respective analysis of 358 patients who underwent various consecutive surgical treatments including open artery reconstruction and intervention in our hospital between 2002 and 2007.Results In this study,358 patients(mean age 66 ± 10;293 male,65female)experienced a total of 413 surgical interventions including traditional bypass,interventional surgery and amputation.Postoperatively 310 patients(86.8%)were followed up from 6 months to 64 months.The 1-year,2-year and 3-year primary patency rates of iliac balloon angioplasty and stent placement were significantly higher than that of femoropopliteal balloon angioplasty and stent placement(P＜0.01),but not higher than that of aortoiliac or aortofemoral bypass(all P＞0.05).The 2-year and 3-year primary patency rates of femoropopliteal bypass above knee were significantly higher than that of femoropopliteal bypass below knee(P＜0.01),but that was not the case in 1-year group.There is no statistical difference in 1-year primary patency rates between femoropopliteal balloon angioplasty and distal popliteal balloon angioplasty (P＞0.05).Amputation rate was 8.7%(37/358).Perioperative mortality was 3.9%(14/358).Mortality during follow-up period was 6.4%(23/358).Conclusion A satisfactory result can be obtained in most patients with the lower-extremity arteriosclerotic occlusive disease by using the appropriate surgical treatment.