Objective To investigate the value of laparoscopic operations for the diagnosis and treatment of acute or chronic pelvic inflammatory diseases (PID). Methods A series of 83 patients with PID diagnosed and treated by laparoscopic technique from January 1999 to December 2003 were retrospectively analyzed. Results Conversions to open surgery were required in 2 patients because of serious pelvic adhesions. No complications were observed. The diagnostic accordance rate before and after the surgery was 63.9% (53/83): 74.3% (26/35) in patients with acute PID and 56.2% (27/48) in patients with chronic PID. Among 35 patients with acute PID, the duration of operation was 20~75 min (mean, 44.7 min) and the postoperative hospital stay was 3~12 d (mean, 6.2 d). Postoperative pyrexia occurred in 28 patients, whose temperatures returned to normal within 5 days. The blood routine examination results were restored to normal levels in 26 patients at 2 days after operation. Out of 48 patients with chronic PID, the length of operation was 20~130 min (mean, 75 min) and the postoperative hospital stay, 2~8 d (mean, 5.5 d). Postoperative pyrexia occurred in 5 patients and a complete recovery of temperature was observed within 3 days. The blood routine examinations revealed normal findings in 42 patients at 2 days after operation. Follow-up checkups for 3 months in all the patients found no relapse. Conclusions Prompt application of laparoscopic operations is of importance in increasing diagnostic accuracy, improving curative efficacy, and preventing possible complications.

Objective To investigate effects of laparoscopy in the early diagnosis of atypical tubal pregnancy.Methods We retrospectively studied clinical records of 36 cases of "probable tubal pregnancy" from January 2003 to May 2005 in this hospital.All the patients were given transvaginal ultrasonography and serum ?-human chorionic gonadotropin examinations.Then laparoscopy was performed to clarify the diagnosis.The accordance rate before and after the laparoscopy was evaluated. Results After laparoscopy,26 patients were confirmed as having ectopic pregnancy(oviduct,25 patients;ovary,1 patient) and 3 patients were excluded for having ectopic pregnancy,the confirmative diagnosis rate being 80.5%(29/36).The diagnosis could not be identified with certainty in 7 patients,2 of whom were cured with radix trichosanthis and 5 of whom were afterwards clinically diagnosed as having tubal pregnancy(1 patient) or intrauterine early pregnancy(4 patients).Conclusions Laparoscopic management at proper time is the best choice in the diagnosis of ectopic pregnancy,especially in early-stage or atypical cases.

Objective To evaluate the clinical value of laparoscopic procedure for benign ovarian diease. Methods 1387 cases of benign ovarian diease diagnosed from Jannary,1995 to February,2001 according to patient's age,history,ultrasound exam and tumor markers and laparoscopy were retrospectively analyzed in this study. Results 531 cases postoperatively diagnosed as endometriotic cyst,254 cases teratoma,139 inflammatory masses,121 serous cystademona,67 cases mucinous cystadenoma,128 parovarian,140 simple ovarian cyst,3 cases brenner tumor,1 case borderline mucinous cystadenoma,1 case mucinous cystadenocarcinoma,1 case endometrioid carcinoma and 1 case malignant brenner tumor.99.7% of preoperative diagnosis of benign ovarian diease was consistant with that done postoperatively laparoscopy were performed in All of the patients except for two cases of ovarian carcinoma,who were given laparohysterectomy. Conclusions Laparoscopic management for benign ovarian diease has much the same effect that laparotomy does.It should be encouraged to be clinically applied for it's quicker recovery,shorter hospitalization duration,less morbidity,and so on.

Objective The effect of hypoxia inducible factor-1α( HIF-1α) , p-glycoprotein ( p-gp) and human papillomavir-us(HPV) infection on non-small cell lung cancer (NSCLC) and their interrelationship are still not clear .The article aimed to study the relationship between HIF-1αand P-gp, their role in the occurrence , development and multidrug resistance of NSCLC , as well as the in-terrelationship among HIF-1α, p-gp expression and HPV infection . Methods By using immunohistochemistry , the expression of HIF-1αand p-gp was detected in 60 NSCLC tissues and 20 benign lung disease tissues .PCR was employed to detect the expression of HPV16/18 DNA. Results The positive expression rate of HIF-1αand p-gp was 48.3% and 60.0% respectively in NSCLC, but there was no positive expression of HIF-1αand p-gp detected in the benign lung disease group (P<0.05).The expression of HIF-1αwas in positive corelation with p-gp in NSCLC (r=0.313, P<0.05).The detective rate of HPV DNA was 41.7% in NSCLC group and 5.0%in the benign lung disease group , and there was a significant difference between them (P<0.05).The positive expression rate of HIF-1αin HPV DNA positive group and negative group was 52.0% and 45.7% respectively, which showed no significant difference (P>0.05).The positive expression rate of p-gp in HPV DNA positive group and negative group was 64.0% and 57.1%respectively, which showed no significant difference too (P>0.05). Conclusion HIF-1αand p-gp are involved in the occurrence, development and multidrug resistance of NSCLC .HPV infection may be one of the etiological factors in the carcinogenesis of NSCLC . However , neither the HIF-1αexpression nor the p-gp expression is associated with HPV infection .

To investigate the relationship between serum retinol-binding protein 4(RBP4) and gestational diabetes mellitus (GDM) in Chinese Han pregnant women.195 (23-42 years) pregnant women were recruited (July 2005 to December 2007) from the Department of Gynecology and Obstetric in Ruijin Hospital during their visiting for routine prenatal examination.99 subjects belonged to GDM group,and 96 belonged to the group with normal glucose tolerance (NGT).65 non-pregnant healthy women served as control.Serum RBP4 was measured using sandwich enzyme linked immunosorbent assay (ELISA).Pregnant women had higher level of serum RBP4 than that of non-pregnant control.The concentration of serum RBP4 was significantly increased in GDM group as compared with NGT group[(43.04±1.85 vs 33.84±2.17) rag/L,P<0.01].Multiple stepwise regression analysis showed that triglycerides and homeostasis assessment for insulin resistance (HOMA-IR) were independent variables of RBP4 (r2 =0.165) in pregnant women.The results suggest that serum RBP4 level is significantly increased in pregnant women.Women with GDM had even higher RBP4 level than that of normal pregnant women,and RBP4 levele was positively correlated with triglycerides and HOMA-IR.

Objective:To explore the application of the flipped classroom based on the production-oriented approach (POA) theory in the teaching of standardized training in the Department of Joint and Sports Medicine.Methods:A total of 37 standardized training physicians who rotated in the Department of Joint and Sports Medicine in Zhongnan Hospital of Wuhan University from January 2019 to December 2019 were selected as the control group, and the traditional teaching was adopted. Another 39 standardized training physicians who rotated from April 2020 to March 2021 were selected as the study group, and the flipped classroom based on POA theory was adopted. At the end of the rotation, the scores of theoretical knowledge and practical operation skills, the scores of mini-clinical evaluation exercise (Mini-CEX) and the teaching satisfaction were compared. SPSS 22.0 was used for t-test and Chi-square test. Results:The various scores and total score of theoretical knowledge and practical operation skills in the study group at the end of rotation were significantly higher than those in the control group ( P < 0.05). There was no significant difference in the various scores and total score of Mini-CEX between the two groups at the time of admission ( P > 0.05). The above scores in the two groups at the end of rotation were significantly higher than those at the time of admission ( P < 0.05), and the above scores of the study group were significantly higher than those of the control group ( P < 0.05). The overall teaching satisfaction rate of the study group was higher than that of the control group ( P < 0.05). Conclusion:The application of the flipped classroom based on POA theory in the teaching of standardized training in the Department of Joint and Sports Medicine can significantly improve the teaching effect and quality, and improve the clinical comprehensive ability and teaching satisfaction of the standardized training physicians, which is worthy of popularization and application.

Objective To investigate the efficacy of kinesio taping(KT)in the treatment of pain,function,range of motion and muscle strength in patients with knee articular osteoarthritis(OA).Method Forty patients with knee articular OA diagnosed in our hospital from January 2021 to January 2023 were selected.We randomly divided them into two groups,each with 20 cases.The observation group received KT therapy,while the control group received sham bandage therapy.Visual Analogue Scale/Score(VAS)was used to assess the degree of activity and nocturnal pain,KOOS score was used to assess the functional status of patients,digital goniometer was used to measure the range of activity and hand-held force meter was used to assess muscle strength.The evaluation time includes before treatment and on the 12th day of treatment.Result Compared with before treatment,the pain,function,range of motion,and muscle strength of patients in the control group and KT group were significantly improved after treatment.And compared with the control group,the KT group also significantly improved the above indicators after treatment.Conclusion KT therapy has significant efficacy in relieving short-term pain and improving functional limitations in knee osteoarthritis.