-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 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.

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.

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.

ObjectiveTo explore the relationship between fat content of postmenopausal osteoporosis patients and bone mineral density (BMD).Methods144 female osteoporotic patients with the age of 50～75 years were choosen from guangdong province from October 2010 to January 2011.According to TCM syndrome differentiations,these patients were divided into kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group and Qi stagnancy and blood stasis group.Four groups of patients were performed total body fat content detection.The data were analyzed by software SPSS 16.0.ResultsComparing of L1～4 average BMD in four groups showed:BMD of Kidney Yang deficiency group was maximum,followed by spleen and kidney Yang deficiency group,and the BMD of Qi stagnancy and blood stasis group was minimum.Comparison between the four groups showed statistical significance (P＜0.05).Comparing of body fat content Iin the four groups showed:the body fat content in the kidney Yang deficiency group was minimum,followed by spleen and kidney Yang deficiency group,and body fat content in Qi stagnancy and blood stasis group was maximum.Pair-comparison in kidney Yang deficiency group,liver-kidney Yin deficiency group,spleen and kidney Yang deficiency group showed no statistical significance (P＞0.05).While these three groups showed statistical difference when comparing with Qi stagnancy and blood stasis group (P＜0.05).The body fat content and L1～4 average BMD had negative correlation.ConclusionOsteoporosis in Qi stagnancy and blood stasis group was more serious than the other three other groups.Fat content was negatively related with bone density.

Objective To investigate whether HA affects the inflammatory cytokines and chemokines of synoviocytes. Methods FLS were derived from the SD mice with knee OA by papaya enzyme and stimulated by IL-1. Then, FLS were cultured with 600 ~ 800 kDa HA. Anti-CD44 blocking experiments were determined. The expressionsof TNF-γ, IL-1 , IL-6 , MMP-3 , MMP-9 , CX3CL1 , CCL11 , CCL2 , CXCL12 were detected by RT-PCR. In addition, the tunel test was used to detect the apoptosis rate. Results MMP-3, CX3CL1 and CCL2 gene expression were down regulated by HMW-HA in unstimulated FLS and TNF-α,MMP-3, CX3CL1 and CCL2 expression were decreased by HMW-HA in IL-1-stimulated FLS. CD44 blocking inhibited the down-regulatory effects of HMW-HA. Besides, HMW-HA promoted cell apoptosis under condition of inflammation. Conclusion HMW-HA has an anti-inflammatory effect by down-regulating of pro-inflammatory cytokines and chemokines and promoting apoptosis, possibly through the interaction of CD44 and HMW-HA.

Comparing the definition,classification,quantity,core capacity construction and the supervision mode of Chinese and the United States specialist nurses,there was a gap between them.The training for the specialist nurses in China was at the initial stage.The advanced experience should be learned from America to provide the reference for building the core capacity and supervision mode of the specialist nurses.