Objective To investigate feasibility of ovarian preservation in early youth endometrial cancer (EC).Methods We searched the database.All the calculations and statistical tests were performed with the Revman 5.2 software.The odds risk (OR) of cancer recurrence or death was taken as observation index.Results The experimental group was compared to control group,the risks of relapse and death were similar.The combined OR of all relapse risk was 0.87 with a 95％ of confidence interval (0.44 ～ 1.70).While the combined OR of all death risk was 0.70 with a 95％ of confidence interval (0.42 ～ 1.15).Conclusions The present data show that ovarian preservation in early youth EC is feasible because the treatment can not increase the risks of relapse and death.However,this conclusion needs to be further confirmed with high-quality randomized clinical trials.

It has been widely accepted in modern pharmaceutical industry that quality cannot be tested into products , instead quality should be built-in by design . However , the implementation of Quality by Design ( QbD ) in development , manufacture and supervision of traditional Chinese medicine ( TCM ) still remains to be a challenge . The program of safety re-evaluation of TCM injections provides an opportunity to practice QbD approach in TCM industry . This paper discussed some potential ways that improve the quality of TCM injec-tions base on QbD related tools , including identification of critical quality attributes , critical process parameters and critical material attributes, development of design space and control strategy.

ObjectiveTo explore the value of MRI in diagnosis of chronic injury of the elbow in young athletes,and to discuss the optimization of imaging sequences.MethodsA total of 34 athletes (40 elbows) aged 6-16 years underwent MR examination on axial,sagittal and coronal planes.The characteristics of MRI were analyzed.ResultsThe anatomy of parenchyma and bones in elbow joint were displayed clearly by using axial TIW,sag T1W,T2W,sag STIR and PDW sequences.The thickening of periosteum and arthroedema were displayed well with sagittal T2W and STIR sequence,while bone marrow,ligament injury and synovitis were displayed well with PDW sequence.ConclusionMRI can display clearly the injury of bones and muscles in young athletes with chronic injury of the elbow.Optimization of imaging sequences is of importance in the depicting and diagnosis of chronic injury of bone and muscles.

Objective To investigate the value of cluster cate forpatients with ventilator-associated pneumo-nia (VAP) in the intensive care unit. Method Three hundred fifty-four consecutive patients with mechanical ven-tilation support in the Emergency Intensive Care Unit of Nanjing First Hospital from January 2006 to September 2007 were included in this study. The cluster care included elevating patient's head and chest to at least 30 de-grecs to the horizontal level, intensiving frequency of oral-pharyngeal nursing with thorough suction, washing hands, changing ventialtor tube at shorter regular interval, closely observing temperature, sputmn, WBC count, pu-turn, white blood cell count, chest X-ray examination and respiratory tract bacterial culture etc. Another 398 me-chanical ventilated patients with conventional care in the Hospital from January 2004 to November 2005 were taken as control. The t -test and X2 -test were used for analysis. Results The morbidity of VAP was significantly de-creased after cluster care(16.6 % vs. 24.6% P<0.01), the length of intensive care unit stay (LOS) was shorter in patients with cluster care than those in patients of control [(10.75±5.86) d vs. (14.26±9.40) d, P <0.05]. Conclusions Pneumonia associated with mechanical ventilation can be effectively reduced by the cluster care.

Objective To observe the effect of miR-132 transfection on proliferation and apoptosis of pancreatic cancer SW1990,and to explore the underlying mechanism.Methods The expression of miR-132 in the pancreatic cancer tissue and the adjacent tissues in 28 pancreatic cancer patients were detected by realtime quantitative polymerase chain reaction (RT-qPCR).miR-132 was transfected into SW1990 cells by using liposome method,untransfected cells and cells with missense miR-132 transfection were used as black control and negative control.The proliferation and apoptosis was detected by CCK-8 assay and DAPI staining.The transfected cells were implanted in nude mice as xenograft tumor,and TUNEL was used to detect the apoptosis; immunohistochemistry was used to detect the expression of Ki-67 and mucin-4 protein in the xenograft tumors and mucin-4,HER-2,p-FAK protein in transfected cells.Results The expression levels of miR-132 in pancreatic cancer tissue and adjacent tissues were 0.46 ± 0.11 and 1.24 ± 0.36,and the difference between the two groups was statistically significant (P ＜ 0.05).The expression level of miR-132 in transfected SW1990 cells was 2.95 ± 0.46,which were significantly higher than those in negative control (0.84 ± 0.17) ; the survival rate of transfected cells at 48,72,96 h was 56.5％,44.7％,37.4％ of negative control cells.The apoptosis rate in transfected cells was 41.6％,and the corresponding value was 5.7％ in negative control,and the difference was statistically significant (P ＜ 0.05).The expression levels of mucin-4,HER-2,p-FAK in nagative control were 2.94 ± 0.42,1.75 ± 0.37 and 2.74 ± 0.24,and the corresponding values in transfected cells were 0.76 ± 0.14,0.34 ± 0.04 and 0.27 ± 0.03,and the difference between the two groups was statistically significant (P ＜0.05).In vivo,the growth of xenograft tumors in transfected nude mice was significantly inhibited [(0.23 ± 0.05) vs (0.59 ± 0.13) g,P ＜ 0.05],the apoptosis of xenograft tumor cells was significant increased [(21.7 ± 4.7) ％ vs (5.2 ± 0.7) ％,P ＜0.05].The expressions of mucin-4 and Ki-67 protein in nagative control was 281.34 ± 36.62 and 148.05 ± 21.34,and the corresponding values in transfection group were 64.35 ± 7.16 and 30.75 ± 4.61,and the difference was statistically significant (P ＜0.05).Conclusions miR-132 transfection has an effect of inhibiting proliferation and promoting apoptosis on SW1990 cells,and the mechanism may be down-regulation of mucin-4,HER-2,p-FAK protein rxpression.

Objective To observe the clinical effect of dexmedetomidine combined with butorphanol in preventing tourniquet reaction.Methods Fifty patients(ASA Ⅰ-Ⅱ)with upper limb operation and satisfactory effect of brachial plexus block were randomly divided into the dexmedetomidine group(A)and dexmedetomidine combined with butorphanol group (B),25 cases in each group.The anesthesia drug preparation method in the group A:dexmedetomidine 200μg was added with normal saline 50 mL;in the group B:dexmedetomidine 200 μg,butorphanol 1 mg and normal saline 50 mL altogether.The group A used dexmedetomidine 1 μg/kg load for 15 min and maintained by 0.4 μg · kg-1 · h-1 until the end of operation;the group B was given 0.015 mg/kg butorphanol,then was given medication according the scheme of group A.The VAS score,BIS value,Remsay sedation score,HR,MAP and SPO2 were recorded at the time points:before medication (T0),immediately after the tourniquet inflation (T1),15 min (T2),30 min (T3),45 min (T4),60 min after tourniquet inflation (T5) and 10 min after deflation (T6).The subjective response classification count,respiratory depression,bradycardia and hypotension in the two groups were assessed.pH,PaO2,PaCO2,HCO3-and LAC at T6 were evaluated by theblood gas analysis.Results The VAS score,BIS value,Ramsay sedation score,HR and MAP at T4,T5 had statistical difference between the two groups (P＜0.05).In the group A,the good and poor subjective responses had 9 cases and 4 cases respectively,which in the group B had 13 cases and 1 case,the difference was statistically significant (P＜0.05);there was no respiratory depression,bradycardia and hypotension in the two groups;the blood gas analysis showed no statistical difference between the two groups.Conclusion Applying dexmedetomidine combined with butorphanol in upper and lower limb surgery under brachial plexus anesthesia can significantly prevent the tourniquet reaction,its effect is superior to single use of dexmedetomidine.

AIM:To investigate molecular regulatory mechanism of K-ras to girdin protein in COS7 cells and expression of K-ras and girdin in colorectal carcinoma tissues .METHODS:The lentiviral vector carrying K-ras gene was constructed and transfected in the COS 7 cells.The expression of K-ras, girdin proteins and other related proteins in COS 7 cells and colorectal carcinoma tissues was observed by Western blot .RESULTS:The COS7 cells with K-ras over-expres-sion showed an irregular cell morphology .The results of Western blot indicated that the downstream signal protein levels of p-ERK1/2, p-Stat3 and girdin were significantly increased in the COS 7 cells with K-ras over-expression.Transfection with the K-ras siRNA into the COS7 cells significantly reduced the protein levels of p-ERK1/2, p-Stat3 and girdin.In the color-ectal carcinoma tissues (7 cases), 5 cases had higher expression of K-ras and girdin compared with pericarcinous tissues . CONCLUSION:K-ras regulates girdin expression through the signal pathway of K-ras-ERK1/2-Stat3-girdin.

Objective To evaluate the applicated value of color Doppler ultrasonography (CDUS) and CR molybdenum target in the diagnosis of breast nodules.Methods Comparative analysis of 87 patients with breast nodules diagnosed by CDUS and CR molybdenum target were contrasted with postoperative pathology.Results 47 cases of 78 patients with breast nodules were benign lesions.39 cases were correctly diagnosed by CR molybdenum target,41 cases were correctly diagnosed by CDUS,and 44 cases were correctly diagnosed by CR molybdenum target and CDUS.Contrasted with postoperative pathology,the accuracy rates of breast disease diagnosed were 82.5％,75.0％ and 95.0％ diagnosed by CR molybdenum target,CDUS,CR molybdenum target and CDUS.Conclusion There is no significant statistical difference between CR molybdenum target and CDUS in the diagnosis of benign breast nodules.The accuracy rate of breast disease diagnosed by CR molybdenum target and CDUS is better than that diagnosed by CR molybdenum target or CDUS only.The two co-diagnosis are benefit to raise the accuracy rate of breast nodules.

Objective: To evaluate the application value of large flat-panel multifunction digital machine in digestive system. Methods: Exam the gastrointestinal tract and biliary with dynamic detector, and then observe its advantages and disadvantages. Results: All the 13 gastrointestinal cancer lesions and 15 inflammatory lesions were shown clearly, including mucosa. Biliary tomography found two small stones, which were undetected by the general X-ray photography. The excellent rate of the photo was improved to 98%. Conclusion: The advantages of the flat panel detector include the wide range of display, clear image of digital pulse fluoroscopy spot film, the improvement of the diagnostic accuracy and the reduction in radiation dose. The disadvantage is that it is more inconvenient than the remote cradle gastrointestinal machine in rotating the position of the patient.

Objective Retrospective observating the diminishing inflammation and lowering enzymatic effect with diammonium glycyrrhizinate (ganlixin injectionfluid) on hepatitis, such as chronic hepatitis, hepatocirrhosis, drug induced hepatitis and alcoholic hepatitis. Methods The 629 case hepatitis sufferers, including chronic hepatitis with light to middle degree, hepatocirrhosis, drug induced hepatitis and alcoholic hepatitis, were treated with 150 mg diammonium glycyrrhizinate added into 250 ml 5 % to 10 % glucose injection liquid. Another 127 chronic hepatitis sufferers treated with injecho potenl ini were seen as contrast. When the treatment was over, the level of alanine aminotransferase (ALT) and serum bilirubin (SB) and symptom of patients in two groups were analysed. Results The level of ALT and SB dropped more rapidly than that in contrast group, but there were no marked difference in symptoms recover. After 17 days therapy, there are 93.3 % patients with ALT normal level in treating group, but 73.3% in contrast group (P