Objective To explore the efficacy of hysteroscopy combined with laparoscopy in the diagnosis and treatment of Herlyn-Werner-Wunderlich syndrome (HWWS).Methods The clinical data of 23 patients with HWWS from January 2009 to December 2015 treated with combination of laparoscopy and hysteroscopy were retrospectively analyzed.The patients had different degrees of dysmenorrhea (17 cases),abnormal vaginal discharge (17 cases),and infertility (4 cases) before surgery.During followup,we observed the symptom and pregnancy outcomes after surgery.Results The patients were followed up for 3-36 months (average,24 months).The vaginal irregular bleeding and abnormal secretions disappeared in 17 patients;dysmenorrhea relieved partly in 17 cases;4 patients who had fertility requirements gave birth to babies.Conclusion Combination of hysteroscopy and laparoscopy sufficiently clears genital malformation of HWWS and solves the lower genital tract obstruction.

Unilateral absence of a pulmonary artery in congenital heart disease may be considered as a risk factor for the surgical treatment of the basic anomaly especialy in cyanotic type of patients. This paper presents 9 such cases: tetralogy of Fallot in 7, dextrocardia and PDA in 1 and truncus arterio-sus with persistent left superior vena cave in one. Absence of left pulmonary artery was present in 7 cases and of right in two. Corrective surgical treatment were performed on 7 patients with tetralogy of Fallot. Two of them died in the early postoperative period. It was recommended that valved extracardiac conduit or woven dacron patch with pericardial monocusp be used for reconstruction of the outflow tract of right ventricle to alleviate the pulmonary regurgitation which was aggravated by higher pulmonary vascular resistance. Appropriate and active management of postoperative low cardiac output is also vital important.

Objective To analyze antimicrobial resistance of hospital-associated methicillin-resistant Staphylococ-cusaureus(HA-MRSA)and community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA),and provide reference for clinical treatment and rational antimicrobial use. Methods From May 2013 to June 2014, Staphylococcus aureus in a hospital were collected and analyzed,strains were identified and performed antimicrobial susceptibility testing by using VITEK 2 Compact system,diagnosis of HA-MRSA and CA-MRSA were confirmed in combined with clinical symptoms.Results A total of 84 MRSA isolates were isolated (61 were HA-MRSA strains,23 were CA-MRSA).Resistant rates of HA-MRSA and CA-MRSA to penicillin G and oxacillin were both 100.00% ;to ampicillin/sulbactam was 100.00% and 95.65% respectively;to compound sulfamethoxazole was 39.34% and 34.78% respectively. Antimicrobial resistant rates of HA-MRSA to gentamicin,tetracycline,erythro-mycin,clindamycin,levofloxacin,ciprofloxacin,moxifloxacin,nitrofurantoin,and rifampicin were all higher than CA-MRSA,the difference were significant(all P<0.001).Conclusion Antimicrobial resistance of HA-MRSA and CA-MRSA are all serious,monitor should be intensified,antimicrobial use should be chosen according to antimicro-bial susceptibility testing result.

Aim To investigate the effects of homocysteine on monocyte chemoattractant protein-1(MCP-1),intercellular cell adhesive molecule type-1(ICAM-1),vascular cell adhesive molecule1-1(VCAM-1)mRNA expression and the protective effects of arecoline,PPVP,DMHPPP and simvastatin in cultured bovine aorta endothelial cells,thereby to explore possible mechanisms by which the compounds affect the formation of atherosclerosis(AS).Methods Bovine aorta endothelial cells were cultured in vitro with indicated concentration of HCY for indicated time.After the cells were harvested at the specified situation,the MCP-1,ICAM-1 and VCAM-1 mRNA expression was detected by reverse transcription-polymerase chain reaction(RT-PCR) and normalized to the mRNA level of ?-microglobulin in the absence or in the presence of homocysteine or land arecoline,PPVP,DMHPPP and simvastatin,respectively.Results The expression of MCP-1,ICAM-1 and VCAM-1 mRNA all increased dose-and time-dependently after treatments with 0.1,0.5,5.0 mmol?L~(-1) HCY for 6 h and 0.1 mmol?L~(-1) HCY for 3,6,12,24 h,respectively.Compared with control group,after the bovine aorta endothelial cells were incubated with 10 ?mol?L~(-1) arecoline,PPVP,DMHPPP,simvastatin for 20 h in advance,respectively,the injury effects which were subsequently induced by 0.1 mmol?L~(-1) HCY for 6 h could be prevented.Conclusions Cultured bovine aorta endothelial cells could express MCP-1,ICAM-1,VCAM-1 mRNA at a low level,and HCY could induce a higher expression.The over expression could be blocked by arecoline,PPVP,DMHPPP and simvastatin.

Aim To investigate the regulatory effects of Iptakalim hydrochloride(Ipt) on excess expression of monocyte chemoattractant protein-1(MCP-1), intercellular cell adhesive molecule type-1(ICAM-1),vascular cell adhesive molecule1-1(VCAM-1) mRNA in bovine aortic endothelial cells cultured with high concentration D-glucose.Methods The endothelial cells were divided into three groups: control,model and Ipt group.The MCP-1,ICAM-1 and VCAM-1 mRNA was detected by reverse transcription-polymerase chain reaction (RT-PCR).Results Compared with control group,MCP-1,ICAM-1 and VCAM-1 mRNA expres sion of model group all increased after treatments with 25 mmol?L~(-1) D-glucose for 16 h,respectively.Compare with model group,the excess expression of MCP-1,ICAM-1 mRNA was blocked by 1～10 ?mol?L~(-1) Ipt added for 20 h in advance,respectively but no significant effect was found in the expression of VCAM-1 mRNA.Conclusion High concentration of D-glucose induced excess expression of MCP-1,ICAM-1 and VCAM-1 mRNA,respectively.The excess expression of MCP-1,ICAM-1mRNA is inhibited by Ipt.

This article described the importance of mechanism refonil in the graduate student training and presented its contents.Also,It summarized the characteristics of the reforill proposals in some universities,and analyzed the problems required to attend and solve ia the refogln.The characteristics of the proposals included to set up innovative fund by university,to perform the student awarded police of tutor leading,to establish the scientific system in recruiting students.By analyzing the problems developed during the reform four measures were lannched,which included to establish evaluating system in assessing students,to create a good relationship between students and tutors,to improve the ability and morality of tutors,and to adjust the management method of research funding.It would be possible to reach the objective of perfecting the reform proposal during the implementation of the measures.

Lung cancer is one of the most frequent malignant tumors. Target therapy is a milestone of non-small cell lung cancer (NSCLC) treatment in the 21st century. Biomarker detections have provided a solid foundation for individualized treatment. This review mainly focused on significance of EGFR mutation detection in EGFR tyrosine kinase inhibitors (EGFR-TKIs) as first line, second line and maintenance therapy in NSCLC. Simultaneously, this review introduced predicting significance of EGFR FISH test for the response of TKI treatment, and analyzed potential predictive biomarkers for antiangiogenic agents and status of antiEGFR monoclonal antibody in NSCLC individual therapy.

Objective To investigate the influence of diabetes on the early complications after pancreaticoduodenectomy in patients with pancreatic cancer,and to provide reference for clinical diagnosis and treatment.Methods A total of 179 patients with pancreatic cancer confirmed by pathology underwent pancreaticoduodenectomy were divided into 81 cases of diabetes group and 98 cases of non-diabetes group according to the level of blood sugar.The fast blood glucose of patients in diabetes group were controlled at 5.6-11.2 mmol/L before surgery,the clinical and pathological data,surgery-related complications and systemic complications of two groups were compared.Results Of 179 patients,5 patients (2.79％) died of severe infection combined with cardiac and respiratory failure.Firm pancreatic texture occurred more in diabetes group than that in non-diabetes group(79.0％ vs 42.9％,x2 =13.62,P＜0.01),but no statistically significant difference in duration of operation,total bleeding,length of stay in hospital,diameter of pancreatic duct,tumor size,pathological pattern,whether reserved pylorus and methods of anastomosis between the two groups (P ＞0.05).There was no statistically significant difference in the incidence of pancreatic fistula,delayed gastric emptying,hemorrhage and infection between diabetes group and non-diabetes group (P ＞ 0.05),but the incidence of respiratory failure (4.9％ (4/81)),cardiac failure (9.9％ (8/81)) and renal failure (1.2％ (1/81)) in diabetes group were significantly higher than that in non-diabetes group (2.0％ (2/98),3.1％ (3/98),0(0/98);P=0.031,0.014,0.007).The incidence of pancreatic fistula was 26.3％ (47/179),and that of patients combined with diabetes (38.3％ (18/47)) and firm pancreatic texture (40.4％ (19/47)) were statistically lower than patients without diabetes and soft pancreatic texture (x2 =8.53,P ＜ 0.05;x2 =11.20,P＜0.01).Conclusion Pancreatic cancer has a big risk in pancreaticoduodenectomy,and those with diabetes would not increase the risk of pancreatic fistula,delayed gastric emptying,hemorrhage and infection when blood glucose is well controlled before surgery,but it has severe impact on systemic complications,so the perioperative blood glucose should be well controlled.