ObjectiveTo investigate the clinical value of intrafascial hysterectomy with intact ascending uterine artery.MethodsA total of 78 cases of simple hysterectomy patients were divided into group A (underwent intrafascial hysterectomy with intact ascending uterine artery) and group B(underwent modified intrafascial hysterectomy) with 39 cases each by random digits table.The operation time,the amount of hemorrhage,the postoperative complications,the ovarian function and the quality of sexuality were studied and compared.ResultsThree cases were lost in group B.There were no statistical differences in operation time,the amount of hemorrhage,postoperative hemorrhage,postoperative pyrexia,the quality of sexuality between two groups(P ＞0.05).There were significant differences in follicule-stimulating hormone and estradiol level in group B compared with those before operation (P＜ 0.05).There was significant difference in climacteric symptom between two groups [ 5.13％ (2/39) vs.22.22％ (8/36) ](P ＜ 0.01 ).The ascending uterine arteries and the ovarian branch of both sides were showed 100％ in group A.ConclusionsIntrafascial hysterectomy with intact ascending uterine artery has less influences on the blood flow of the ascending uterine arteries and the ovarian branch,there is slight influence on ovarian function and has no obvious influence on the quality of sexuality.The forward clinical effects should be studied further.

Objective To study the expression and clinical significance of TNF related apoptosis-inducing ligand(TRAIL) and Caspase-3 in the bone marrow mononuclear cell(BMMNC) of aplastic anemia(AA) ,and to approach their effect on the apoptosis of haemopoietic stem cell in AA patients.Methods The TRAIL and Caspase-3 expression in 15 cases with newly diagnosed AA patients and remission patients,and 15 cases with normal bone marrow patients were detected by flow cytometry and microplate reader. Results The TRAIL expression of newly diagnosed AA patient, emission AA patients and control group was ( 5.94 ± 2. 57 ) ％, ( 2. 87 ± 1. 72 ) ％ and ( 3.01 ±2. 06)％ respectively,the Caspase-3 expression of newly diagnosed AA patient, emission AA patients and control group was ( 1. 3840 ± 0. 0236), (0. 8018 ± 0. 0126) and ( 0. 7441 ± 0. 0112 ) respectively. The TRAIL and Caspase-3 expression of newly diagnosed AA patient were significantly higher than the remission AA patients and control group,the difference was significant( all P ＜0. 05) ;The TRAIL and Caspase-3 expression of control group were higher than the remission AA patients, but the difference was not significant ( all P ＞ 0. 05 ). Conclusion The TRAIL and Caspase-3 had high expression in the BMMNC of AA patients, and the apoptosis induced by TRAIL and Caspase-3 should play an important role in the pathogenesis of AA.

Objective To investigate the treatment of complicated upper urinary tract calculi. Methods 138 cases of upper urinary tract calculi were treated by the combination of extracorporeal shork wave lithotripsy (ESWL),ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy were reviewed.There were 110 cases of complex ureteral stone and 28 cases of complex kidney stone among the group.All cases had variable degree of hydronephrosis.The treatment program for complex upper urinary tract calculi was initially,ESWL and followed by ureteroscopy and pneumatic lithotripsy in 24 hours.For the complex kidney stone and upper ureteral stone,which was difficult for ureteroscopy lithotripsy.The program was firstly percutuneous minimal pyelostomy,ESWL after 5～7 days,then urteroscopy lithotripsy and lithotomy through the fistula in 24 hours. Results Total stone-free rate was 97.1%(134/138),in ureteral stone group was 100%(110/110),in kidney stone group 85.7%(24/28).Satisfactory result has been observed in all cases. Conclusions The endoscopic manipulation become easy and fast by means of endoscopic manipulation in the treatment of complex upper urinary tract calculi.This technique is minimally invasive and has less complications,it increases the stone-free rate.

Objective To recognize the factors which influence the therapeutic efficacy of transurethral resection of the prostate (TURP) and to improve the qualities of TURP. Methods The data of 600 patients with benign prostatic hyperplasia (BPH) were retrospectively studied based on the mastering of TURP.The patients’age ranged from 52 to 92 years,with a mean of 64.8 years.Preoperatively,the volume of the prostate was 16.3～210.4 ml,with a mean of 46.2 ml,measured by color Doppler B-ultrasound.The average maximum urinary flow rate (Qmax) was 8.4 ml/s,and average urinary flow rate (Qave) was 4.3 ml/s.The average residual urinary volume (RU) was 75 ml,and the average IPSS was 23. Results TURP was successfully performed on all the 600 patients.The average resected prostate tissue weight was 31.8 g.The average electric ablation time was 51 minutes.Intraoperative blood transfusion was performed in 38 cases. Aura of transurethral resection syndrome (TURS) occurred in 4 cases,but no TURS occurred.Of the 600 cases,508 cases (85%) were followed up for 1～32 months.Postoperative average Qmax increased to 16.9 ml/s,Qave increased to 10.8 ml/s and RU decreased to 15 ml.Compared with those of preoperation,the differences were statistically significant (P

Objective To observe the curative effect of Yiqi Congming Decoction on tinnitus and deafness. Methods From May 2015 to May 2017 in the first affiliated hospital of Tianjin university of traditional Chinese medicine 74 cases of tinnitus and deafness patients, all patients were diagnosed as tinnitus, deafness, and has been hearing examination, examination and imaging examination of tympanic membrane. All patients were treated with Yiqi Congming decoction, 2 weeks for a course of treatment, a total of 3 courses of treatment. The therapeutic effect of the patients was observed. Results After 3 courses of treatment, 44 cases were markedly effective (59.46%), effective in 22 cases (29.73%), ineffective in 8 cases (10.81%), and the total effective rate was 89.19%. At the same time, follow-up studies were conducted on patients with significant efficacy and no recurrence was observed. Conclusion The method of Yiqi Congming decoction has better curative effect in the treatment of tinnitus and deafness.

Objective To explore the influence of human resources management in emergency department on nurse's anxiety.Methods Self-Rating Anxiety Scale(SAS)was used to investigate 300 nurses in the emergency department in nine secondary level hospitals of Longgang District.Division of human resource management in these hospitals were examined and the correlation between them was statistically analyzed.Results In addition to the three hospitals,nurses anxiety status of the other six hospitals score showed different levels of anxiety,the average scores were above 50,but the hospitals,that the ratio of the three anxiety condition score was less than 50,moderate to severe anxiety were still more than 20.0％,and other six hospitals was up to 66.7％.In the human resource management to achieve excellent and qualified hospital,the anxiety rate was significantly lower than the substandard hospitals.At the same time there was close correlation between the situation of human resource management and nurses anxiety situation.Conclusions Emergency nurses generally have high anxiety,and in hospitals with poor human resource management,career anxiety is even more obvious.That is to say the anxiety of nurses is closely related to emergency department management of human resources.

Objective To investigate the surgical procedure selection for chronic pancreatitis.Methods The clinical data of 80 patients with chronic pancreatitis who were admitted to the Peking University First Hospital from January 2000 to August 2013 were retrospectively analyzed.Thirty-eight patients were with or without pancreatic duct stone,and the dilation of the pancreatic duct was above 7 mm,44 patients were with common bile duct dilation,32 patients were with inflammatory mass in the head of the pancreas,and 3 patients were with splenomegaly and esophagogastric varices.Surgical procedures were selected according to the symptoms and results of imaging examination.The remission or recurrence of pain was judged according to the visual analog scales.Patients were followed up via out-patient examination,mail or phone call till December 2013.Results Choledochojejunostomy was done on 27 patients,Partington-Rochelle pancreaticojejunostomy on 24 patients,PartingtonRochelle pancreaticojejunostomy + choledochojejunostomy on 6 patients,pancreaticoduodenectomy on 7 patients,resection of the body and tail of the pancreas on 4 patients,Beger's procedure on 3 patients,splenectomy on 3 patients,Frey's procedure + fenestration of bile duct in the head of the pancreas on 3 patients,Frey's procedure on 2 patients,common bile duct exploration + T tube drainage on 1 patient.The remission rate of abdominal pain was 95.2％ (60/63).One patient died of abdominal infection and multiple organ dysfunction syndrome perioperatively.Three patients were complicated with abdominal infection,2 with pancreatic fistula,1 with biliary fistula and 1 with abdominal bleeding.All the complications were cured by conservative treatment.Seventy-nine patients were followed up,and the mean time of follow-up was 58.6 months (range,4-156 months).Thirty patients had recurrence or new onset of abdominal pain,and the recurrence rate was 38.0％ (30/79).Of the 32 patients with inflammatory mass in the head of the pancreas,17 received choledochojejunostomy,and the recurrence rate of abdominal pain was 9/17 ; the other 15 patients received pancreatoduodenectomy,Beger' procedure or Frey's procedure,and the recurrence rate of abdominal pain was 1/15.Of the 41 patients without inflammatory mass,10 received choledochojejunostomy,and the recurrence rate of abdominal pain was 7/10; 30 received PartingtonRochelle pancreaticojejunostomy,and the recurrence rate of abdominal pain was 33.3％ (10/30).Conclusions Complete drainage could relieve the symptoms for patients with pancreatic duct dilation.Surgical resection or combined surgical procedure is effective for the treatment of patients with inflammatory mass in the head of the pancreas.

Objective To evaluate whether the comparability of 3 automatic blood cell analyzers meet the clinical requirements by conducting the comparative study on the detection results of these instruments.Methods With the Sysmex 2100 automatic blood cell analyzer as the reference instrument,Sysmex 1000i and Abbott 1800 as the experimental instrument,the original quality control provided by the instrument factory and the patient′s fresh anticoagulant blood samples in the laboratory were adopted to monitor for continuous 40 d by these three instruments and the detection results of WBC,RBC,HGB,HCT and PLT were analyzed.Results The detection results of these 3 instruments were statistically tested by the F test,the differences showed no statistical significance (P >0.05)and the bias was in 1/2 of the maximum permissible error range in America department clinical test revised regulations (CLIA′88).Conclusion The detection results by these 3 instruments are comparable and can meet the clinical requirements.

Objective To establish a novel glucocorticoid (GC)-resistant human diffuse large B lymphoma(DLBCL) cell line Toledo/dexamethasone (DEX) by the exposure to DEX,and observe the biological characteristics of resistant and parental cell line,investigate the mechanisms of glucocorticoid-resistance.Methods Toledo/DEX was established by the exposure to DEX,the dose of which was increased gradually and intermittently for long periods of time.Toledo,in the logarithmic growth phage,was incubated in the culture medium containing DEX at the concentration of 1×10-8 mol/L at first.The medium without DEX was replaced after for 96 hours until the cell line re-entered the logarithmic growth phase.Repeat the above steps to acquire the ultimate concentration of DEX in the medium as 1.024 ×10-5 mol/L.The biological characteristics of resistant and parental cell lines were evaluated.Results Toledo/DEX was more invasive in the aspects of ultrastructure,tumorigenicity and drug sensitivity.Meanwhile,Toledo/DEX achieved some stable biological characteristics such as morphology,karyotypes and immunophenotype.Furthermore,GC receptor (GR) α and GR β protein expression analysis showed that GR was involved in the mechanism of the GCresistance.Conclusions Toledo/DEX is a drug-resistant cell line with a stable biology backgroud.These results may help shed light on the knowledge of GC-resistance and lay the groundwork for searching new therapeutics to reverse drug-resistance.

Objective To investigate the characteristics of dysplasia in myeledysplastic syndrome (MDS). Methods 716 samples of adult patients with abnormal blood routine and unelear cause were collected between July 04, 2003 and March 14, 2007. Based on the gold diagnostic standard of WHO MDS classification, all eases were detected on cytomorphology, cytochemical stain, bone marrow pathological assay,cytogenetics, flow eytometry et al. The cytological study of bone marrow on some abnormal hematopaietie cells has a diagnostic value to determine clonal or non-clonal diseases and assess sensitivity and specificity. Results in the complicated various dysplasia of hematopeiefic ceils, the following characteristics can be the main basis of cytomorphological diagnosis: one of granular Auer bodies, micronuclens (MN), or nuclear budding, erythroid nuclear budding, megakaryocytes presented in peripheral blood, myeloblast or prorubricyte exhibited in peripheral blood, ringed sideroblasts>1%. The subordinate basis of cytomorphological diagnosis development of nuclei, ring-shaped nuclei, and aggregation of nuclear chromafin, erythroid multi-nuclei, odd nucleus, mother-daughter nucleus, nuclear fragmentation, vacuole, anisoeytosis and mieromegakaryocytes.Conclusion Cytomorphologic assay is the base for the diagnosis of MDS, however, it presents certain limit,especially when eytomnrphoiogical change does not possess specificity for early MDS. Hereby, it requires to combine other deteetion methods.