Objective To evaluate the advantages and disadvantages between transabdominal myomectomy(TAM)and laparoscopic myomectomy(LM).Methods We were trospectively reviewed the clinical data of 35 cases of TAM and 30 cases of LM,analyzed adaptation,complication,bleeding quantity and recover time.Results Every patients operated successful.The operation time of LM group was longer than TAM group.The bleeding quantity,recovery time and post-operation in-hospital days of LM group were all shorter than TAM group.Conclusions Laparoscopic myomectomy have advantages of micro invasion,rapidrecovery,less in-hospital days and less complication.

Objective To analyse the dianosis and treatment process in suspicious ectopic pregnancy(67 cases)and explore the value of diagnostic curettage in suspicious ectopic pregnancy.Methods Elect ectopic pregnancy cases in conservative treatment(67cases),divide these cases in two group as the diagnostic curettage group and the control group in random and analysis their success ratio in conservative treatment;time in hospital;expense in treatment.Results The success ratio in conservative treatment were similar in two group ;the time in hospital and expense in treatment was significant lower in diagnostic curettage group.Conclusions Diagnostic curettage was useful in differential diagnosis of suspicious ectopic pregnancy;It can reduce the time in hospital and the expense in treatment.

OBJECTIVETo evaluate the clinical effects of short-segment transpedicular fixation and vertebroplasty via paraspinal intermuscular approach in treating thoracolumbar fractures.

METHODSFrom January 2009 to January 2012,18 patients with thoracolumbar fractures without neurological symptoms were treated with short-segment transpedicular fixation and vertebroplasty via paraspinal intermuscular approach. There were 11 males and 7 females, aged from 52 to 76 years old with an average of 62.2 years. The duration from injuries to surgery ranged from 8 h to 7 d with an average of 4.2 d. According to the Denis fracture classification, 12 cases got compression fractures and 6 cases got burst fractures.

LOCATION6 vertebra with T12, 9 with L1, 6 with L2, and 3 with L3. Anterior vertebral body height, the sagittal Cobb angle, the sagittal index (SI), condition of internal fixation failure and recurrent kyphosis were observed.

RESULTSAll patients were followed up for 12-28 months with an average of 16.5 months. Operation time was from 80 to 130 min with a mean of 95 min and bleeding volume during operation ranged from 100 to 180 ml with a mean of 145 ml. Anterior vertebral body height ratios preoperation, 3 days after operation and final follow-up was 54.3 +/- 2.8, 90.9 +/- 1.5, 88.6 +/- 1.7, respectively; sagittal Cobb angle was (27.8 +/- 2.5) degrees, (5.3 +/- 0.8) degrees, (6.3 +/- 1.4) degrees, respectively; sagittal index was 52.3 +/- 3.8, 89.2 +/- 5.2, 86.4 +/- 4.5, respectively. Data obtained 3 days after operation obviously improved than preoperation, and there was no statistically significant difference between 3 days after operation and last follow-up. No internal fixation failure, neurological complications and recurrent kyphosis were found.

CONCLUSIONTreatment of thoracolumbar fractures with short-segment transpediclar screw fixation and vertebroplasty via paraspinal intermuscular approach can retain the posterior ligament complex and restore the mechanical strength of the anterocentral column,which proved an ideal method for preventing the failure of internal fixation and reduction of post-traumatic segmental kyphosis.

Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Vertebroplasty ; methods

Bacteria ; drug effects ; Communicable Diseases, Emerging ; epidemiology ; microbiology ; Drug Resistance, Bacterial

Objective To investigate the satisfaction status of patients in the Community Health Service Center,and to provide the basis data for reform and development of the Community Health Service Center in future. Methods 481 patients and 9 Community Health Service Center in Shenyang were randomly recruited in this study by the cluster sampling survey.Several trained interviewers used questionnaires to collect requisite information.Results In the all community health professionals,including technical level,therapeutic efficacy,preventive health service, service attitude and requirement satiation,the trust status of patients was the highest,the rates of satisfaction and very satisfaction got to 92.8%.The satisfaction status for preventive health service was the lowest,only 67.7%.In analysis on influencing factors,medical insurance of patients was the important factor for their satisfaction status.There were significant differences in technical level (χ2 =22.61 ,P <0.01 ),therapeutic efficacy (χ2 =21 .52,P <0.01 ), preventive health service (χ2 =1 4.35,P <0.05),service attitude (χ2 =22.43,P <0.01 ),requirement satiation (χ2 =22.30,P <0.01 ),the trust status of patients (χ2 =1 7.81 ,P <0.01 ).In addition,age and education degree also were the factors on the satisfaction status of patients.There were significant differences among different age group in therapeutic efficacy (χ2 =33.38,P <0.01 ),preventive health service (χ2 =24.43,P <0.05 ),requirement satiation (χ2 =26.55,P <0.01 ),the trust status of patients (χ2 =22.39,P <0.05 ).There were significant differences among different education degree in therapeutic efficacy (χ2 =1 5.79,P <0.05),service attitude (χ2 =1 4.63,P <0.05)and the trust status of patients (χ2 =1 3.50,P <0.05).Conclusion The satisfaction status of patients for service attitude is the highest and age,education degree and medical insurance of patients are the important factors influencing satisfaction status of patients.

Endothelium-derived hyperpolarizing factor (EDHF) is the third factor released by en-dothelial cell other than NO and PGI2. It relaxes smooth muscle accompanied by a hyperpolarization in the membrane potential. EDHF may be epoxye-icosatrienoic acids (EETs) formed from arachidon-ic acid by the action of cytochrome P450. It is synthesized and/or released by endothelial cell as a result of an cytosolic Ca2+ increase, which is stimulated by the action of acetylcholine or bradykinin on endothelial cell. EDHF is shown to activate Ca2+-activated K+ channels and induce a hyperpolarization in the membrane potential in vascular smooth muscle. The hyperpolarization of the membrane inhibits the opening of voltage-dependentcalcium channels, allows calcium sequestration and removal mechanisms to lower intracellular calcium, and leads smooth muscle to relaxation. In large conducing arteries, EDHF may provide a secondary system to NO, which assumes primary importance in endothelium-dependent relaxation and inhibits the release of EDHF. However, in small resistance arteries, EDHF appears to be a major determinant of vascular calibre, and may be of primary importance in the regulation of vascular resistance.

Objective To evaluate the efficacy of ureteroscopic pneumatic lithotripsy in the treatment of ureter stones.Methods A total of 186 cases ureteroscopic pneumatic lithotripsy were performed in our hospital.The outcomes of the surgery were analyzed.Results The success rate of the operation was 80.6%(29/36) for the upper ureteral calculi,92.7%(51/55) for the middle,and 100%(95/95) for the lower ones,respectively.Four weeks after the surgery,re-examination showed that the rate of stone removal was 94.1%(175/186).Injuries to the ureter occurred in 5(2.7%) of the cases.Conclusion Ureteroscopic pneumatic lithotripsy is an effective and safe method for ureteral calculi.

Objective:To explore strategies of improving patients' stereotyping of nurses, by analyzing patients′ stereotypes of nurses.Methods:The phenomenological analysis method in qualitative research was used to conduct semi-structured interviews with 12 inpatients by objective sampling method.Results:The patients′ stereotype of nurses could be summarized into three topics, it mainly consisted of three aspects: patients′ cognition of the role of nurses, patients′ stereotype of nurse-patient relationship and factors affecting nurse-patient relationship from patients′ perspective, among which factors affecting nurse-patient relationship included doctors′ attitude towards nurses, public opinion effect of media reports and patients′ negative psychological experience.Conclusions:The prejudice of patients to the relationship between nurses and patients is not optimistic, it is suggested to improve patients′ stereotyping of nurses by reconstructing the ideal role of nurses, building harmonious trusting relationships and providing friendly support from the "others".

AIM:To understand the interaction between a195- kilodalton protein,P195, on the surface of Plasmodium falciparum merozoite and human erythrocyte.METHODS:P195 was expressed in eight fragments in E.coli.After being refolded,the expressed proteins were la- belled with12 5 I,and incubated with human erythrocytes.RESULTS:According to binding assay, three fragments of P195:M3,M6,M9were found to have ability to bind to human erythrocyte. M6,which is equal to amino acid( AA) sequence from384 to595,could bind to human erythro- cytes but not to trypsin treated human erythrocytes,and the binding could be eluted by low p H buffer solution. M3( AA 12 3to 30 2 ) and M9( AA 10 78to 12 51) also have the ability to bind to human erythrocytes,but the binding was not affected by trypsin treatment and low p H buffer elu- tion. CONCL USION:The binding site of M6might be a surface protein receptor of human ery- throcytes,while the binding site of M3and M9might be an intracellular componentof human ery- throcyte.

Objective The study was to investigate a new method of rapid expansion by biomechanical methods. Methods Dogs were set up as animal models. Six areas, 5 cm?8 cm each, were symmetrically designed on a dog. Expanders of 240 ml were implanted in each area. Four groups were divided: A. Injection of 2 weeks. B. Injection of 6 weeks. C. Sham operation group. D. Blank control group. The first two groups were subdivided into three groups respectively according to maintaining times: one week, two weeks and four weeks. The following indexes were measured on the second stage surgery: biomechanical properties of the skin, stress strength, stress strain, stress relaxation and creep, the collagen content and alignment of skin. Results After expansion, maximal stress strength fell off, and stress strain curve moved backward. Relaxation curve fell off as well, as creep curve rose up. With elongation of the maintaining period, viscoelasticity of the skin gradually approximated normal skin, and had less relation with injection time. With the maintaining period increased, the collage content increased distinctly, and the alignment became much order. Conclusion Two week maintaining period is very important for expanded skin to recover the biomechanical properties and the content of collagen and alignment.