Objective-To-investigate-the-feasibility-of-total-laparoscopic-hysterectomy-for-complicated-hysteromyoma-,-such-as-broad-ligament-myoma,-lower-uterine-fibroids,-or-cervical-myoma.-Methods-From-December-2009-to-December-2012,-we-performed-laparoscopic-hysterectomy-on-166-patients-with-complicated-hysteromyoma-and-on-170-patients-with-common-hysteromyoma-.-The-operation-time-,-intraoperative-blood-loss-,-recovery-time-of-gastrointestinal-function-,-postoperative-morbidity-,-and-the-rate-of-conversion-to-laparotomy-were-compared-between-the-two-groups-respectively-.-Results-No-significant-differences-were-detected-in-operation-time-[(112.2-±15.3)-min-vs.(110.3-±16.1)-min,-t=1.088,-P=0.277],-intraoperative-blood-loss-[(117.0-±35.3)-ml-vs.(110.8-±37.8)-ml,-t=-1.525,-P=0.128],-recovery-time-of-gastrointestinal-function-[(20.8-±2.7)-h-vs.(21.3-±2.3)-h,-t=1.797,-P=0.073],-postoperative-morbidity-[6.3%(10/159)-vs.7.3%(12/165),χ2-=0.124,-P=0.725],-and-the-rate-of-conversion-to-laparotomy-(4.2%vs.2.9%,χ2-=0.397,-P=0.529)-between-the-two-groups-.Both-the-groups-were-followed-up-at-1,-2,-and-6-months-after-procedure-,-and-none-of-the-patients-showed-severe-postoperative-complications-.-Conclusions-Total-laparoscopic-hysterectomy-for-complicated-hysteromyoma-is-feasible-.To-prevent-complications-,-it-should-be-converted-to-laparotomy-timely-when-the-myoma-has-a-wide-base-or-is-located-at-lower-position-.

OBJECTIVE:To investigate the market demand for residence drug allocation and dispatch in Kunming. METHODS:A questionnaire was carried out about the residence drug allocation and dispatch market in plan.RESULTS & CONCLUSION:The target market of residence drug allocation and dispatch is initially established,and the market holds the promising future in Kunming.

Objective To investigate the feasibility of VTQ value of spleen in noninvasive assessment of staging of liver fibrosis in patients with hepatitis B.Methods VTQ values of spleen were measured in 56 patients with hepatitis B by using ARFI technique and liver biopsy was performed.The patients were then grouped according to the stages of liver fibrosis stage.The results were analyzed by the intergroup comparison,Pearson Correlation analysis,and receiver operating characteristic curve (ROC curve).Results There was positive association of the VTQ value with the stages of liver fibrosis,whose correlation coefficient was 0.83 (P ＜ 0.05);There was no significant difference between the spleen VTQ value and the liver fibrosis S1 and SO (P ＞ 0.05),whereas there were significant differences among other groups (P ＜ 0.05).The area under the ROC curve was 0.95,the cut-off value was 2.79m/s,and the specificity and sensitivity were 81.8％ and 91.7％ respectively.Conclusions The VTQ value measured by ARFI technique has a better value in noninvasive diagnosis of stages of hepatitis B liver fibrosis.

Objective To study the evaluative values of amplitude integrated electroencephalogram (aEEG) in screening neonatal seizures.Methods The aEEG and video electroencephalogram (VEEG) on 32 patients with seizures hospitalized in Peking University First Hospital was conducted on the same day.The parameters of aEEG including the integrated spectra band,background rhythm and primitive electro signal were analyzed and compared with VEEG.Results Seizures presented clinically by 12 cases were detected by VEEG,and their electric discharges were detected by aEEG.The sensitivity of aEEG was 100%.VEEG showed electric discharges during intermediate stage in twenty cases and thus the seventeen of this group were detected by aEEG with its sensitivity of 87% and 100% in the specificity.The positive and negative predictive values of aEEG were 80% and 100%,respectively.But aEEG could not discriminate the attack stage or intermediate stage electric discharges.The abnormal background activity was detected by VEEG in 13 cases and the sensitivity of aEEG was 100% and the specificity was 83%.The positive and negative predictive value by aEEG were 76% and 100% respectively.The electric discharges of 32 cases were detected by VEEG whenever they were in attack stage or intermediate stage.All electric discharges could be detected through primitive electro signal by aEEG.The electric discharges in 3 cases were not detected by integrated spectra band from aEEG,but were detected by primitive electro signal from aEEG.Conclusions The sensitivity and specificity in the screening of neonatal seizures by aEEG is useful and could be applied clinically as a simple and safe screening method for recognizing neonatal seizures.

Objective To reveal the therapeutic efficacy of scalp acupuncture plus rehabilitation training in treating spastic cerebral palsy, by evaluating the Comprehensive Function for the Disabled Children and modified Ashworth Scale (MAS) before and after the intervention.Method Sixty patients with spastic cerebral palsy were divided into a treatment group and a control group by following a single-blind randomized design, 30 cases in each group. The treatment group was intervened by scalp acupuncture plus rehabilitation training, while the control group was by rehabilitation training alone. The improvements of comprehensive function and muscle tension, as well as the correlation between age and therapeutic efficacy were observed respectively after 2-month and 4-month treatment. Result There were significant differences in comparing the muscle tension score between the two groups respectively after2-month and 4-month treatment (P<0.01); the total effective rate was 86.7% in the treatment group versus 63.3% in the control group, and the difference was statistically significant (P<0.05); in the treatment group, there was a significant difference in comparing the therapeutic efficacy between different age groups (P<0.05).Conclusion Scalp acupuncture plus rehabilitation training can produce a better result than rehabilitation alone in treating spastic cerebral palsy; the younger the patients, the better the prognosis.

were measured at the end of inspiratory.ResultsThe differences of following parameters were statistically significant between the healthy control group, mild PH group, moderate PH group and severe PH group: velocity time integral of ventricular systolic wave (SVTI), velocity time integral of ventricular diastolic wave (DVTI), AR, AR/S, ARVTI/SVTI, AR/(S+D), ARVTI/(SVTI+DVTI,F=2.940, 2.838, 3.373, 7.681, 3.478, 12.052, 4.806;P<0.05,<0.05,<0.05,<0.01,<0.05,<0.01,<0.01). Correlation analysis showed that ratio of AR/(S+D) was positively correlated with pulmonary artery mean pressure (r= 0.575,P<0.01). ConclusionsThe ratio of AR/(S+D) of MHV Doppler flow spectra was correlated with pulmonary artery mean pressure. The ratio increased along with the increasing of pulmonary pressure in CHD patient. The Doppler echocardiographic detection of MHV flow had a certain reference value for the diagnosis of PH. The ratio of AR/(S+D) could be a new non-invasive parameter for evaluating PH.

Purpose The mean pulmonary artery (MPAP) has been widely used as an important parameter to diagnose and evaluate pulmonary hypertension (PH).The purpose of this paper is to compare the efficacy of two methods in evaluating PH,including estimating pulmonary artery systolic pressure (PASP) using Doppler ultrasonography to measure tricuspid regurgitation (TR) velocity,and directly using the peak velocity of TR.Materiasl and Methods From January 2012 to June 2013,eighty patients with left-to-right shunt congenital heart diseases (CHD) planned for closure procedure in Tangdu Hospital of the Fourth Military Medical University and the General Hospital of Shenyang Military region were included in this prospective study,who underwent right heart catheterization to measure pulmonary artery pressure,and underwent Doppler ultrasonography to measure the peak velocity ofTR.Results Using catheter-measured MPAP of≥ 25 mmHg as diagnostic reference,the false positive rate was 62.96％,and the false negative rate 0％ when the estimated PASP of ＞30 mmHg determined by TR method was used to diagnose PH.There was high diagnostic agreement when peak velocity of TR was used to diagnose PH.When 320 cm/s and 340 crn/s were used as diagnostic cutoff values,false positive rates were 14.81％ and 7.41％,and false negative rates were 15.91％ and 20.45％,respectively.Conclusion In patients with left-to-right shunt CHD,peak velocity of TR measured on echocardiography can be used to diagnose PH which overcomes the high false positive rate in estimation method.It is more suitable to diagnose PH when the MPAP is used as the diagnostic criterion.

Objective To analyze the changes of superior vena cava SVC spectra in patients with pulmonary hypertension PH and screen the proper parameters of SVC to predict PH Methods Eighty patients with congenital heart disease who underwent right heart catheterization for the measurement of pulmonary artery pressure were included SVC Doppler ultrasound was performed before the catheterization The cut-off point of SVC parameters in the prediction of PH was analyzed using receiver operator characteristic curve ROC curve Results Eighty subjects were included and there were 61 patients in PH group and 10 patients in the control group whose spectra pattern had four waves The data of the 9 subjects whose SVC spectrum were not four waves were excluded from the analysis Diagnostic criteria for PH was pulmonary artery systolic pressure PASP more than 30 mmHg measured by right heart catheterization The analysis of the peak velocity of SVC waves showed that ventricular systolic wave S reduced ventricular reversal wave VR reduced and the ratio of atrial reversal wave and ventricular systolic wave AR S increased in the PH group Compared with the control group their differences were statistically significant t =2 244 2 063 -2 896 P =0 028 0 043 0 005 The ROC curve showed that the ratio of AR S had better diagnostic effect than other parameters On the ROC curve of AR S when the ratio of AR S was 0 45 the sensitivity was 73 77% and specificity was 80 00% respectively for predicting PH When AR S was used to distinguish the control group from patients with moderate and severe PH group the sensitivity was 82 86% and specificity was 80 00% respectively Conclusions Using the ratio of AR S 0 45 as a cut-off for prediction of PH shows a good sensitivity and specificity which might be an alternative method for assessing PH
alternative method for assessing PH.

Objective To observe the difference between Radix AstragaLi(RA) and Radix Fici Hirtae(RFH) in immune regulation and improvement of anaemia.Methods Fatigue resistance,brain hypoxia and normal hypoxia tolerance were observed to measure the anti-stress function.Bloodletting-induced anemia model and cyclophosphamid-induced anemia model were used to observe the effect of blood enrichment.Phagocytic function of macrophage,serum hemolysin level and delayed type hypersensitivity(DTH) reaction were also detected.Results RA and RFH could improve the fatigue resistance,normal hypoxia tolerance and brain hypoxia tolerance,and increase the red blood cell count and hemoglobin content,enhance phagocytic function of macrophage and serum hemolysin level,and increase the DTH reaction.Conclusion Both RA and RFH have an effect on improving anti-stress ability,immune function and blood enrichment,and there are no significant difference between RA and RFH.

Objective To investigate the associations of baseline serum uric acid, bilirubin levels with short-term outcome in patients with acute ischemic stroke. Methods The clinical data in successive patients with acute ischemic stroke were colected, including the serum levels of uric acid and bilirubin on admission, the National Institutes of Health Stroke Scale (NIHSS) score, and the modified Rankin scale (mRS) score at discharge or at day14 (mRS 0-2 was defined as good outcome, > 2 was defined as poor outcome). Results A total of 162 patients with ischemic stroke were enroled, including 114 in the good outcome group and 48 in the poor outcome group. There were significant differences in proportions of the patients with diabetes melitus (51. 75% vs. 75. 00% ; χ2 = 7. 526, P = 0. 006), previous history of stroke or transient ischemic attack (TIA) (18. 42% vs. 50. 00% ; χ2 = 17. 790, P = 0. 001), as wel as the baseline diastolic blood pressure (87. 061 ± 12. 245 mmHg vs. 82. 375 ± 10. 949 mmHg; t = 2. 293, P = 0. 023; 1 mmHg =0. 133 kPa), high-density lipoprotein cholesterol (1. 604 ± 0. 299 mmol/L vs. 1. 265 ± 0. 206 mmol/L; t =3. 227, P = 0. 002), fasting glucose (2. 875 ± 0. 438 mmol/L vs. 8. 160 ± 0. 592 mmol/L; t = - 4. 761, P <0. 001), uric acid (289. 365 ± 77. 168 μmol/L vs. 248. 206 ± 66. 206 μmol/L; t = 3. 111, P = 0. 002), total bilirubin (14. 673 ± 2. 213 μmol/L vs. 10. 395 ± 2. 714 μmol/L; t = 3. 779, P = 0. 001 ), direct bilirubin (6. 036 ± 1. 392 μmol/L vs. 4. 956 ± 1. 379 μmol/L; t = 2. 088, P = 0. 038), and indirect bilirubin (8. 634 ± 2. 307 μmol/L vs. 5. 439 ± 1. 223 μmol/L; t = 4. 219, P < 0. 001) levels between the 2 groups. Multivariate logistic regression analysis showed that the previous history of stroke or TIA (odds ratio [ OR ] 3. 751, 95% confidence interval [CI ] 1. 395-10. 091; P = 0. 009) and baseline NIHSS score (OR 2. 723, 95% CI 1. 093-6. 783; P = 0. 031) were the independent risk factors for poor outcome of ischemic stroke; while uric acid (OR 0. 357, 95% CI 0. 141-0. 900; P = 0. 029), high-density lipoprotein (OR 0. 262, 95% CI 0. 079-0. 870; P = 0. 029), and indirect bilirubin (OR 0. 117, 95% CI 0. 025-0. 539; P = 0. 006) were independently correlated with good outcome. Conclusions The increased baseline uric acid and indirect bilirubin levels are the favorable factors for good outcome in patients with acute ischemic stroke.