Objective To study the clinic diagnostic value of transvaginal color Doppler ultrasound(TVCDU)in fallopian tube interstitial pregnancy.Methods US 2D images,blood distribution and frequency spectrum of 28cases with fallopian tube interstitial pregnancy proved by pathology were analyzed retrospectively.Results Before the operation,17 cases of fallopian tube interstitial pregnancy were diagnosed by US(17/28,61%),the signs included asymmetrical enlargement uterus,bulging uterine angle on one site,pregnancy sac or mass in the bulging uterine angle,the mass was discontinuance with the endometrium,which enveloped thin or thick muscle.The fallopian tube interstitial pregnancy could be divided into three types on US: blastula type(N=7),inhomogeneous mass type(N=16) and rupture type(N=5).Conclusion TVCDU is of important clinic value in the early diagnosis and differential diagnosis of fallopian tube interstitial pregnancy.

Azone ( 1桪odeylazacyclohenptan-2-one) is one of the best skin penetration enhancers. It can increase the permeability of skin for some hydrophobic compounds, so that it is possible to be admi-nistrated through skin. The effects of Azone on permeability of skin of a-Asarone, Nicorandil and Nitroglycerin were studied by flow through diffusion cell with radioactivity tracer.The results showed that the different concentrations of Azone gave different enhancement. The penetration of the 3 drugs was enhanced about 1-fold by

Purpose To evaluate apoptosis in renal tissue of diffuse proliferative lupus nephritis and therelationship between the existence of apoptosis cells in renal tissue and histopathological or clinical changes.Methods Apoptosis was detected by in situ nick-end labeling techniques (TUNEL) in renal biopsies from 25patients with type Ⅳ LN, 12 patients with IgAN, 4 patients with MsPGN, and 3 patients with APSGN. Normalrenal tissue obtained at nephrectorny for hypemephroma in 4 adults was used as control. In addition, proliferatingcells were identified by proliferating cell nuclear antigen(PCNA) in these patients. Results Compared to otherproliferative glomerulonephritis and control,the patients with lupus nephritis had less apoptosis cells, higher ratio ofPCNA+ cells/TdT+ cells/(P/T) in renal tissues;Ratio of P/T in glomeruli and tubulointerstitium correlated withthe chronicity index, r=0. 498 3(P = 0. 013 2), r = 0. 839 9(P＜ 0.001 ), r = 0. 661 4(P = 0. 003 3),respectively. Ratio of P/T in glomerulus and tubule had positive correlation with 24 hour urinary protein, r =0.855 4(P＜0.001),r=0.713 4(P=0. 001); negative correlation with Ccr, r = - 0. 488 0(P =0. 013 3)and r = - 0. 722 9(P = 0. 001), which in tubules positively correlated with Scr, r = 0. 410 7 (P = 0.041 4 ).Conclusions Apoptosis is insufficient in proliferative lupus nephritis. Intense proliferation without followingincrease in apoptosis may be related to chronic progressive renal histopatholcgical changes.

Objective To investigate the effect of sufentanil combined with remifentanil on anesthesia in emergency traumatic brain injury . Methods Retrospective analysed a total of 80 the clinical data of patients with traumatic brain treated in Yuyao Municipal People’s Hospital from March 2015 to August 2016 received surgical treatment in emergency, accorded to the intraoperative anesthesia were divided into remifentanil group and combined anesthesia group(remifentanil combined with sufentanil anesthesia group).The changes of MAP,HR and stress indexes in two groups were observed,awakening quality and complication rate between the two groups were compared.Results Before anesthesia,there was no difference between the two groups of MAP and HR levels,10 minutes after the anesthesia,the beginning of the operation and the end of the operation,the combined anesthesia group was higher than that of the remifentanil group ( P<0.05 );there was no significant difference in blood glucose and cortisol levels between the two groups before and after anesthesia,and the indexes of 12h after operation were lower than those in the remifentanil group (P<0.05);two groups of patients with respiratory recovery time,recovery time,eye opening time command and extubation time showed no significant difference between the two groups;nausea and vomiting,incidence of bradycardia and other complications had no significant difference.Conclusion Sufentanil combined with remifentanil in emergency brain trauma surgery anesthesia was better,has little effect on the mean arterial pressure and heart rate,low complication rate.

Objective To evaluate the value of polymerase chain reaction (PCR) combined with probe detection method in diagnosis of Mycoplasma pneumonia (MP) pneumonia (MPP) in children and to analyze the factors influencing the diagnostic accuracy,and to identify the rate of MP mutation for drug resistance and the involving factors.Methods Two hundred and twenty-five children with MPP hospitalized in the Department of Respiratory Medicine,Beijing Children's Hospital,Capital Medical University between June 2015 and March 2016 were enrolled in this study.Nasopharyngeal swab samples from the participants within 24 hours of admission were detected by using PCR combined with fluorescence probes for MP-DNA and macrolide-resistant mutations.The information of age,sex,clinical symptoms,course of disease,duration by admission,the history of macrolide treatment and the increase or decrease of quadruple or more serum MP antibody titer were extracted from medical records within 4 weeks of treatment,which received further correlation analysis with the detection rate of MP-DNA and the drug resistance mutation.Results The sensitivity of the MPP by using the method of PCR combined with fluorescence probes was 80.4％ (181/225 cases),while the specificity was 98.0％ (99/101 cases).The MP-DNA positive rate for patients with double MP antibody 4 times increased during treatment was 88.8％ (71/80 cases),which was significantly higher than that of patients with antibody titer ≥1 ∶ 160 [75.9％ (110/145 cases)],and the difference was sigmficant(x =5.443,P =0.020).The positive rate of MP-DNA of patients had no obvious association with gender,age,and disease duration and macrolide treatment history before admission.Macrolide-resistant mutation rate of MP-DNA was 85.1％ (154/181 cases),macrolide-resistant mutation rate of MP for patients finishing one course of macrolide treatment when admission(89.6％)was higher than that of the patients without using macrolide and the patients treated with macrolide but not finishing one course of treatment (71.9％ and 86.6％),and the significant difference among the three groups was observed(x2 =4.454,P =0.035).Conclusions PCR combined with fluorescence probe for MP-DNA detection has a high accuracy for the diagnosis of MPP,and the overall mutation rate is high,suggesting that the clinical treatment of MPP needs to be adjusted according to drug resistance in children.

Objective:To explore the pathogenesis of multiple organ dysfunction syndrome(MODS)with respect to the bal- ance of Th1/Th2.Methods:Eighteen healthy male minipigs,weighing 22-30 kg,were randomly divided into two groups: MODS group and control group.Double-hit method including hemorrhagic shock and endotoxiemia was used to establish the porcine MODS model.The peripheral vein blood samples were collected at different time-points(before bloodletting,before en- dotoxin injection,1 h,24 h,48 h and 72 h after endotoxin injection)in the two groups.The spleen samples were collected after death of the animals.Plasma levels of IFN-?and IL-4 were detected by enzyme-linked immunosorbent assay(ELISA).Real- time PCR was used to detect the expression of IFN-?,IL-4,T-bet and GATA-3 mRNA(The latter 2 were the key transcription factors associated with Th1/Th2 response)in the spleen samples.Results:The plasma levels of IFN-?and IL-4 quickly reached the peak values 1 h after the endotoxin injection,then the level of IFN-?decreased quickly.The ratio of IFN-?/IL-4 was signifi- cantly lower than the baseline value 72 h after endotoxin injection(P=0.000).The ratio of IFN-?/IL-4 mRNA in MODS group was obviously lower than that in the control group(P=0.020);the ratio of T-bet/GATA-3 was also lower in MODS group (P=0.038).Conclusion:The shift from Th1 to Th2 occurs in the progress of MODS.

Aged ; Aged, 80 and over ; Blood Platelets ; chemistry ; Humans ; Receptor, PAR-1 ; blood ; Receptors, Thrombin ; blood ; Renal Dialysis ; Uremia ; blood ; therapy

ObjectiveTo evaluate the efficacy of sphenopalatine ganglion stimulation with acupuncture for moderate-to-severe perennial allergic rhinitis.MethodsA total of 50 patients were recruited into a sphenopalatine ganglion stimulation group and a routine acupuncture group according to order of presentation, with 25 in each group. The sphenopalatine ganglion stimulation group received sphenopalatine ganglion stimulation with filiform needle, 1-2 sessions/week for 4 weeks. The routine acupuncture group received traditional acupuncture, withyingxiang(LI 20),yintang(GV29),fengchi(GB20),fengfu(GB16),zusanli(ST36) as the maln points, andyingxiang(LI 20),yintang(GV29),fengchi(GB20),fengfu(GB16),zusanli(ST36) as the adjunct points, 1-2 points from both the maln and adjunct points in each session, 2 sessions/week for 4 weeks. The nasal symptom score (2004 version), the total nasal symptom score (TNSS) and the total non-nasal symptom score (TNNSS) were used to evaluate symptom improvement. The Rhinoconjunctivitis Quality of Life Questionnalre (RQLQ) was used to assess the patients’ quality of life. The time to symptom alleviation, duration of symptom alleviation in every session and the recurrence duration during 1 month after the treatment were compared between the two groups.Results After the treatment, the score of the nasal symptom score (99.74 ± 31.89vs.196.83 ± 31.22;t=-4.912,P=0.001), TNSS (33.63 ± 12.37vs.71.82 ± 19.21;t=-3.463,P=0.003), TNNSS (33.63 ± 12.37vs.71.82 ± 19.21,t=-3.463,P=0.003) in the sphenopalatine ganglion stimulation were significant lower than those in the routine acupuncture group. Compared with the routine acupuncture group, the time to symptom alleviation was significant shorter (13.85 ± 4.21 minvs.45.63 ± 7.87 min;t=-1.763,P=0.008), while the duration of symptom alleviation was significant longer (37.92 ± 9.94 hvs.3.35 ± 1.23 h;t=7.637,P<0.01) after each session in the sphenopalatine ganglion stimulation group. Four weeks after the treatment, RQLQ score in the sphenopalatine ganglion stimulation group was significant lower than that in the routine acupuncture group (8.48 ± 3.71vs.37.68 ± 12.46;F=-7.312,P<0.01). The recurrence duration during 1 month after the treatment in the sphenopalatine ganglion stimulation group was significant longer than that in the routine acupuncture group (4.12 ± 2.15 dvs.23.53 ± 4.63 d;t=-8.879,P=0.003).ConclusionSphenopalatine Ganglion stimulation is superior to routine acupuncture in treatment of patients with moderate-to-severe perennial allergic rhinitis.

Objective To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods From Feb.2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy,effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV( with 10 keV increment) in late arterial phase [(36±13)HU vs. (62±23)HU, (26 ±8)HU vs. (40±15)HU, and (19±6)HU vs. (27±10)HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [ (43 ± 14 )HU vs.(61 ±25)HU and (30 -10)HU vs. (40 ± 16)HU respectively], effective-Z (late arterial phase 7.80 ± 0. 16 vs. 8.05 ± 0. 21, and portal venous phase 7. 87 ± 0. 15 vs 8.02 ± 0. 22 ), concentration of calcium (water) [late arterial phase (5 ±3) g/L vs. (11 ±4) g/L, t= -3.836, P=0.001 and portal venous phase (7 ± 3 ) g/L vs. ( 10 ± 5 ) g/L, t = - 2.071, P = 0. 049 ] and iodine (water) [ late arterial phase (0.38 ±0.24) g/L vs. (0.78 ±0.32) g/L, t = -3.755, P=0.001 and portal venous phase (0.48 ± 0. 24) g/L vs. (0. 72 ± 0. 34 ) g/L, t = - 2. 161, P = 0. 041 ] were lower in serous oligocystic adenoma than those in mucinous cystic neoplasms. In discriminant analysis, multiple parameters [ age, symptom,tumor size, CT values on 40 keV to 50 keV, effective-Z, concentration of iodine (water) in late arterial phase and concentration of calcium (water) in portal venous phase] showed high accuracy (100%, 27/27 )of joint diagnosis between serous oligocystic adenoma (100%, 15/15 ) and mucinous cystic neoplasms (100%, 12/12). Conclusions The serous oligocystic adenoma and mucinous cystic neoplasms had distinct characteristic findings on CT spectral imaging. CT spectral imaging is highly accurate in the differential diagnosis between serous oligocystic adenoma and mucinous cystic neoplasms.

Construction of learning-oriented hospital must establish a clear goal,and under the guidance of the target,comrehensive mearures of whole advancement must be adopted and staffs study must be emphasized according to their different needs to motivate them,and meanwhile incentive mechanism should be established to realize the benign circulation and sustainable development of construction of learning-oriented hospital.