-4.88) and relative insulin resistant group (IAI≤-4.88), and 42 healthy normal persons were selected as control. Results The frequency of Trp 64Arg mutation of ? 3 AR gene was higher in the resistant group than that in the sensitive group (28.0% vs 15.7%, P

Objective To explore the feasibility of single?incision laparoscopic sigmoid colon vaginoplasty in women with congenital absence of va?gina. Methods Clinical data of thirty?two patients with congenital absence of vagina admitted in Shengjing Hospital of China Medical University be?tween January 2008 and June 2014 was retrospectively analyzed. Nineteen patients underwent laparoscopic assisted sigmoid colon vaginoplasty,and thirteen paitiens underwent single?incision laparoscopic sigmoid colon vaginoplasty. The operation time,intraoperative blood loss,evacuation time and follow up were compared between the two groups. Results In the group of single?incision laparoscopic sigmoid colon vaginoplasty,the opera?tion time was shorter and intraoperative blood loss was less. There was no difference between two groups in evacuation time. There was no infection or leakage of anastomotic stoma of sigmoid colon,and no postoperative stenosis of the neovagina and its length was satisfied. Patients were satisfied with the quality of sexual life after the surgery. Patients underwent single?incision laparoscopic sigmoid colon vaginoplasty were all satisfied with the ap?pearance of abdomen. Conclusion The single?incision laparoscopic sigmoid colon vaginoplasty can simplify the procedure of intestinal anastomo?sis,shorten the operation time,and reduce the intraoperative blood loss. Consequently,the single?incision laparoscopic sigmoid colon vaginoplasty is effective and safe.

Objective To explore the rationale therapy method of hysteroscopic surgery for cesarean scar pregnancy. Methods A retrospective review of medical records of 64 patients with cesarean scar pregnancy admitted in Shengjing Hospital of China Medical University from January 2006 to April 2009 was performed, 27 cases out of them were referred from other institutions, and received various interventions before admission, while 37 cases were admitted to our hospital without prior treatments. Results The diagnosis was confirmed by serum human chorionic gunadotropin-beta subunit (β-hCG) and ultrasound.Sixty-three patients were removed of conceptive tissues underwent hysteroscopy assisted by ultrasonic guidance, while 1 patient underwent hysteroscopic removal of conceptive tissues assisted by laparoscopic surveillance. Seven cases of sixty-four were experienced second salvage operation. Pathological examinations were performed for all cases and 1 case was diagnosed to be choriocarcinoma. Conclusion Hysteroscopic removal of conceptive tissues implanted in the cesarean section scar seems to be a feasible and safe procedure that might be considered as a treatment option and it should be monitor the levels of β-hCG and the residual lesions after surgery.

BACKGROUND:In palatorrhaphy, iodoform gauzes are often used to fill the bilateral relaxation incisions and cover the wound. However, there are a series of postoperative complications, such as fever, loss of appetite, foreign body sensation, secondary bleeding. In order to avoid or reduce the complications after palatorrhaphy, the use of gelatin sponge to fill bilateral relaxation incisions has achieved good clinical results.OBJECTIVE:To compare the clinical effects of different treatments on wound healing after palatorrhaphy.METHODS:110 child patients with cleft palate were selected and assigned into two groups according to admission time. Fifty-four patients who admitted from January 2013 to December 2015 (experimental group) were obturated with gelatin sponge, while the other 56 patients who admitted from January 2008 to December 2012 (control group) were obturated with idoform gauze. The postoperative results of patients were assessed in various aspects, including psychological impact, diet, body temperature, bleeding, and wound healing. The incision scar width was measured at 4 weeks postoperatively.@RESULTS AND CONCLUSION: (1) Patients in the experimental group experienced shorter recovery time than those in the control group (P < 0.05). (2) Patients in the experimental group had substantialy lower incidence of fever postoperatively, and shorter duration of fever than those in the control group (P < 0.05). (3) In comparison to the control group, the experimental group showed less postoperative complications such as bleeding and vomiting (P < 0.05). (4) The incision scar width in the experimental group was significantly narrower than that in the control group (P < 0.05) after 4 weeks. These experimental findings demonstrate the superior effect of gelatin sponge over iodoform gauze and its value in clinical application with better healing, less bleeding, shorter recovery time and no impact on eating.

Objective To investigate the safety and feasibility of laparoscopic removal of exogenous caesarean scar pregnancy (CSP).Methods From January 2009 to May 2011,71 patients with CSP treated in Shengjing Hospital of China Medical University were studied retrospectively.Thirty-nine patients were treated with hysteroscopic excision of CSP,while 32 patients were treated with laparoscopic surgery.The following clinical parameters were compared,including intraoperative blood loss,quantity of postoperative uterine drainage,postoperative hospital days,the time for the mass absorption and the return of β-hCG to normal were studied.Results Two cases in the hysteroscopic group were transformed to abdominal surgery because of introperative bloody loss,the 37 cases underwent hysteroscopic surgery successfully with the ultrasound supervision and guidance.Laparoscopic surgery were successfully completed in all 32 cases.In hysteroscopic group,the operation time,the time for the return of serum β-hCG to normal,postoperative uterine drainage volume and the postoperative hospital stay were (44 ± 18) minutes,(27 ±5) days,(38 ± 12) ml,(3.8 ±0.7) days.While,in laparoscopic group,they were (100 ±21) minutes,(17 ±4) days,(19 ± 6) ml,(3.5 ± 0.6) days,respectively,the differences reached statistically significant (all P ＜ 0.05).But the amount of intraoperative bleeding were was (113 ± 63) ml in hysteroscopic group and (109 ±59) ml in laparoscopic group,the difference was not statistically significant (P ＞0.05).The duration of absorption of mass were (88 ± 17) days in hysteroscopic group.In laparoscopic group,the mass were completely removed.Conclusions Laparoscopic exicion of CSP could be suitable in treatment of exogenous CSP which offers advantages including prompt recovery,blood loss and hospital stays.This management could repair the uterine scars,reduce the reoccurring risk and conservate the fertility potential.

Objective To investigate the safety and feasibility of uterine arterial embolization (UAE) combined with hystersocpic excisionl of exogenous cesarean scar pregnancy (CSP). Methods Totally 67 patients with exogenous CSP treated with selective UAE combined with hysterscopic surgery in Shengjing Hospital of China Medical University were analyzed retrospectively; 35 patients in Group A (thickness of the cesarean scar>3 mm), while 32 patients in Group B (thickness of the cesarean scar≤3 mm). The following clinical parameters including operative time, intraoperative blood loss, quantity of postoperative uterine drainage, postoperative hospital days, the time for the mass absorption and the return ofβ-hCG to normal were compared. Results All hysterscopic procedures were successfully completed in Group A, and only one case underwent a second hysteroscopic excision due to the 1-month postoperative ultrasound examination indicating a mass located in the cesarean scar and a slow decline of β-hCG. Three cases of Group B were transformed to laparoscopic or laparotomy operation and 7 cases underwent a second surgery. The volume of introperative blood loss was (97±41) ml in Group A and (161±92) ml in Group B, the difference was statistically significant (P<0.01). But the operative time, quantity of postoperative uterine drainage, postoperative hospital days, the time for the retrun ofβ-hCG to normal and the mass absorption in Group A were (36±9) minutes, (38±13) ml, (3.5±0.5) days, (26±5) days, (82±17) days, in Group B were (37± 9) minutes, (42 ± 16) ml, (4.0 ± 0.7) days, (28 ± 8) days, (88 ± 15) days, respectively, the differences were not statistically significant (all P>0.05). Conclusions For exogenous CSP, when the thickness of cesarean scar is ≤3 mm, whether or not undertaking UAE, it should be seen as contraindication of hysterscopic surgery. UAE combined with hysterscopic surgery for the treatment of exogeous CSP with the cesarean scar thickness>3 mm is safe and feasible according to patients condition and should be performed by experienced hysteroscopist.

The electroencephalography (EEG) has a wide range of content, complex graphics and abstract theory. Meanwhile, there are differences in professional level, learning ability and subjective initia-tive among refresher doctors. In order to improve the quality of teaching, and to better serve the refresher doctors, the following strategies have been applied in the teaching process. We not only make the training target according to the actual condition of every refresher doctors, but also make them take a correct atti-tude towards study and follow the teaching arrangement. Besides, we not only orient at the operational skills training, including electrode installation, EEG evoked test, Point-of-Care test to eliminate the interference, but also promote the refresher doctors to seek the law of the diagram in the actual interpretation process with longitudinal development view and horizontal comparison perspective. Furthermore, we not only stan-dardize their report, but also broaden their view.

Objective To evaluate the rationale of lowering the cutoff value of normal fasting plasma glucose (FPG) by studying the cardiovascular risk factors in subjects with different FPG levels and different glucose tolerance states. Methods A population-based survey of diabetes was undertaken in 1994, data from 15564 Chinese adults (age≥25) who adopted 75 g-oral glucose tolerance test were analyzed. Results (1) The frequencies of BMI≥25 kg/m 2 , hypertension, hypertriglyceridemia, metabolic syndrome were increasing with graded FPG levels at a 0.56 mmol/L interval. FPG at 5.0-5.6 mmol/L level overweight frequency elevated significantly (P=0.001), and FPG at 5.6-6.1 mmol/L level the metabolic syndrome and other components also elevated (P

Objective:To probe the different influence of pericardial devascularization by preserving vagus trunk(VTPPD) and pericardial devascularization (PD) on portal hypertensive gastropathy (PHG).Methods:77 patients with portal hypertension were divided into VTPPD and PD group,the VTPPD group included 36 cases,and PD group included 41 cases.Varices of esophagus and fundus of stomach and PHG were observed by gastroscopy before and 3 weeks after operation in all cases,and compared postoperative incidence of PHG in the 2 groups.Results:In all cases,Varices of esophagus and fundus of stomach disappeared or relieved obviously.The incidence of PHG in VTPPD group before operation was 55.6%(20/36),and that after operation was 69.4%(25/36),the former was not higher statistically(P=0.224);the incidence of PHG in PD group before operation was 61.0%(25/41),and that after operation was 87.8%(36/41),the former was not higher than the latter statistically(P=0.005);and the postoperative incidence of PHG in PD group was higher significantly than that in VTPPD group (P=0.048).There were 8(22.2%,8/36)patients whose degree of PHG aggravated in VTPPD group,and there were 19(46.3%,19/41)patients whose degree of PHG aggravated in PD group,the rate of the former was significantly lower than that of the latter(P=0.027).Conclusion:Comparing with the classic portoazygous devascularization,VTPPD can reduce the incidence and the degree of PHG.

A 56-year-old man with 1-year history of palpitation, heat intolerance and sweating, was diagnosed as thyrotropin (TSH) -secreting pituitary adenoma based on the symptoms of hypermetabolism, enlarged thyroid gland, inappropriately increased serum TSH concomitantly elevated plasma thyroid hormones and a pituitary tumor demonstrated on magnetic resonance imaging. Long-acting octreotide formulation was administered at a dose of 20 mg intramuscularly. Tumor volume shrinkage and improvement of thyroid function was achieved after a single drug injection; and the thyroid function returned to normal in 28 days. It is suggested that long-acting octreotide formulation might be used as a routine therapeutic approach prior to pituitary surgery, which may enhance the effectiveness of surgery and postoperative recovery.