Objective To evaluate the efficacy of mifepristone combined with cardiopulmonary suppository combined with psychological intervention in the termination of scar uterine pregnancy.Methods60 cases of maternal women with scarring uterine pregnancy during our period from March 2015 to December 2016 were selected as the experimental group in the course of this study.Maternal 60 with no scarring uterine pregnancy was selected as the control in this study group.Related medical staff need to strengthen communication with patients, understand the negative thoughts of the patient's heart, use their expertise to solve doubts for patients, eliminate anxiety and anxiety, improve patient treatment compliance, the establishment of patient treatment confidence;experimental group and control group of patients Were treated with mifepristone, oral use, the patient in the third day of drug treatment should be tested card pregnant suppository to take, the drug selected fasting medication, placed in the vagina on the dome.To compare the therapeutic effect of the experimental group and the control group and the adverse reaction.ResultsAfter treatment, 60 cases in the experimental group, the total effective number of cases in the treatment of patients with a total of 55 cases, the number of invalid cases in the treatment of patients, the effective rate was 91.7%.The control group of 60 patients, the total effective number of cases for the treatment of 48 cases, the number of invalid cases in the treatment of patients, the effective rate was 80.0%.The results showed that there was significant difference between the experimental group and the control group (P<0.05).After treatment, there was no significant difference in the time of vaginal discharge, the amount of vaginal bleeding and the time of uterine contraction.In the control group, there were 8 cases of adverse reactions, the probability was 13.3%, in the experimental group, the number of cases of adverse reactions occurred in the number of cases, the probability was 6.7%.There was significant difference between the experimental group and the control group in the incidence of adverse reactions(P<0.05).ConclusionMifepristone combined with carboprost suppository in the treatment of psychological intervention combined with the termination of good uterine scar effect, low incidence rate of adverse reaction, high treatment efficiency, high safety, with further clinical promotion and application significance.

Objective To investigate the clinical festures and CLCN1 gene mutation screen on a myotonia congenital kindred.Methods The clinical data of 22 patients in the myotonia congenital kindred were analysed. Results There were total 68 people in 5 generations, including 24 patients in 4 generations .Both male and female were suffered. All patientes of this kindred showed myotonia with onset the illness from the infant, and 16 cases accompanied with hypermyotrophy.The levels of creatases and dielectric in serum were normal in all the cases. Spontaneous myotonic electric potential were observed on electromyography( EMG ) in 2 cases.The proband was found in light microscope by biopsy that muscle fibers arranged loosenly , size of them mismatched , transverse striation was unclear and some of them was hyperplasia and hypertrophy. Muscle cells degenerated gently with a few inflammatory cells infiltration. No mutation was found in the whole 23 extrons of CLCN1 gene in the 3 patients.Conclusions This kindred accords with the autosomal dominant heredity form Thomsen's disease. The affected numbers have the typical clinical characteristics. No mutation is found when 23 extrons of CLCN1 gene screened in the patients which indicate the genetic heterogeneity may be exist in this kindred.

Objective To analyze the clinical effect of neoadjuvant chemotherapy( oxaliplatin combined with S-1) in the treatment of advanced gastric cancer,and to detect its influence on expressions of vascular endothelial growth factor(VEGF) and matrix metalloproteinase-2(MMP-2).Methods A total of 70 patients with advanced gastric cancer were randomly divided into research group ( n=35 ) and control group ( n=35 ) .The patients in the control group were given surgery treatment and general drug chemotherapy,while the patients in the research group were given the neoadjuvant chemotherapy on the basis of the control group.The incidence of cancer recurrence and the expressions of MMP-2,VEGF of the two groups were observed.Results In the research group,the expressions of MMP-2 or VEGF were significantly different before and after chemotherapy(χ2 =10.03,χ2 =9.11,all P<0.01). The 3-year survival rate in the research group(71.43%) was significantly higher than 45.71% in the control group,there was significant difference(χ2 =11.70,P<0.05).Conclusion Neoadjuvant chemotherapy can reduce the expressions of MMP-2 and VEGF in tumor tissues,indicates that it may play an important role in patients with advanced gastric cancer and can be used in clinic.

Objective To compare the dosimetric difference of volumetric modulated arc therapy (VMAT) plans for the loco-regionally advanced nasopharyngeal carcinoma (NPC) patients using 6 MV X-ray flattening filter-free (FFF) and flattening filter (FF) modes.Methods Ten previously treated patients with loco-regionally advanced nasopharyngeal carcinoma were retrospectively included and replanned using FFF and FF VMAT,respectively.Meeting all clinical criteria,the dose-volume histograms (DVH),dose distribution of target volume and organs at risk (OARs),target conformity index (CI),total monitor unites (MUs) and treatment time were compared across the plans.Results VMAT plans suing either FFF and FF modes can meet the clinical objectives.The maximum and mean target dose of FFF VMAT plans were significantly higher than that of FF VMAT plans (t =-0.31,-O.35,P ＜ O.05).Yet the planning target volume (PTV) CI of FF mode was slightly better than of FFF mode (t =5.42,P ＜0.05).The maximum doses of lenses in FFF VMAT plans were lower than that of FF VMAT plans (t =25.87,17.45,P ＜ 0.05),and other OARs displayed no significant difference.The mean total MUs of FFF and FF VMAT plans were (699 ± 16) and (628 ± 12) MUs respectively.The mean treatment time of two modes were consistent (about 2 min).Conclusions The plan qualities of FFF and FF VMAT plans were comparable and both clinically acceptable.The OARs at the edge of radiation field,such as lens,could be spared better using FFF VMAT mode.The total MUs of FFF VMAT plans were higher than FF VMAT plans,yet were delivered within the same time.

Objective To investigate the pharmacokinetics of propofol when combined with remifentanil in patients with liver cirrhosis.Methods Ten patients (5 males, 5 females) with liver cirrhosis scheduled for endoscopic esophageal varix ligation (test group) and 10 cases (5 males, 5 females) with normal liver function scheduled for gastroscopy (control group), aged 18-55 yr, weighing 40-75 kg, were studied. The patients were unpremedicated. All the patients received iv injection of propofol 1.5 mg/kg and remifentanil 0.5 μg/kg, and 5 min later propofol 0.5 mg/kg and remifentanil 0.2 μg/kg was given again. Blood samples were taken from radial artery before administration and at 2, 5, 10, 15, 20, 30, 45, 60, 80 and 120 min after administration for determination of the plasma propofol concentration using gas chromatography-mass spectrography. The pharmacokinetic parameters were calculated using DAS 2.0 software.Results The pharmacokinetics of propofol was best described by a three-compartment open model. There was no significant difference in the distribution half-life, elimination halflife , terminal half-life, area under the curve and transfer rate constant between the two groups ( P ＞ 0.05) . The apparent volume of distribution of propofol and clearance were significantly increased in test group compared with control group (P ＜0.01) .Conclusion When propofol combined with remifentanil is used in patients with liver cirrhosis, the apparent volume of distribution of propofol and clearance are significantly increased, while no changes in the other pharmacokinetic parameters are found.

ObjectiveTo observe and evaluate the role of cervical cytological examination in 1946 cases in gestation, and at 2 months and 6 months after delivery, and treatment for abnormal cases.MethodsThe thinprep cytologic test samples of 1946 cases from external cervical orifice and cervical cavity were collected. The cytological diagnosis was performed according to TBS-diagnosis and classification system.ResultsIn 1946 samples, there were 160 inflammatory samples (8.2%), including bacterial vaginitis 51 cases (2.6%), trichomonal vaginitis 49 cases (25.%), candidal vaginitis 58 cases (3.0%); typical epithelial cells 105 cases (5.4%), including atypical squamous cells (ASUCS) 70 cases (3.6%), low-grade squamous intraepithelial lesions (LSIL) 29 cases (1.5%), high-grade squamous intraepithelial lesions (HSIL) 5cases (0.2%), the carcinoma in situ 1 case (0.05%); human papilloma virus (HPV) 32 cases (1.6%), including HPV combined with atypical squamous cells 21 cases (1.1%), HPV combined with LSIL 10 cases (0.5%). Large mass of cases with a abnormally result of cervical cytological examination had a normal childbearing, the cases that re-examination after birth showed carcinoma in situ and HSIL treated by conization, and others treated with physical treatment.ConclusionCervical cytology examination has positive effect on prevention and treatment of precancerous changes and carcinoma in gestational women. Cervical lesions less likely get worse during pregnancy. Conservative management is possible if regular cytology, copolscopy and bioposy performed when necessary. Re-examination at two and six months after birth is necessary for determining treatment method.

Recent study demonstrated that insulin-like growth factor-1(IGF-1) could have benefits to improve the learning memory.Exercise can increase IGF-1 level in hippocampus.IGF-1 may mediate exercise inducing learning memory;one of the possible mechanism is that the IGF-1 and brain derived neurotrophic factor(BDNF) has a common regulatory capacity over calcium/calmodulin-dependent protein kinase Ⅱ(CAMKⅡ),mitogen-activated protein kinase Ⅱ(MAPKⅡ) and synapsin-1,and the convergence of multiple signaling pathways mediate synaptic plasticity and improve learning memory.

Objective To investigate the significances of monitoring urine neutrophil gelatinase -associated apolipoprotein (NGAL)and kidney injury molecule -1 (KIM-1)levels before and after coronary intervention in early predication of contrast -induced nephropathy.Methods The clinical data of 249 patients with coronary heart disease undergoing percutaneous coronary intervention were collected.All patients were divided into contrast -induced nephropathy group(n =21 )and non -contrast -induced nephropathy group(n =228)according to whether had contrast -induced nephropathy.Before surgery and 4h,12h,24h,48h,72h after surgery,the levels of serum creatinine were tested.Before surgery and 4h,12h,24h,48h after surgery,the levels of urinary NGAL and KIM-1 were detected by using enzyme -linked immunosorbent assay(ELISA).Results Compared with before surgery,the serum creati-nine level of contrast -induced nephropathy patients after surgery 48h[(101.7 ±20.3)μmol/L]was elevated,the difference was statistically significant(t =15.972,P <0.05).Compared with before surgery,the urinary NGAL levels of contrast -induced nephropathy patients after surgery 4h ~48h were (12.3 ±1.6)μg/L,(14.5 ±1.5 )μg/L, (14.1 ±1.2)μg/L and (14.3 ±1.4)μg/L,which were significantly elevated(t =8.672,11.817,15.942 and 17.641,all P <0.05),and the urinary KIM-1 levels after surgery 24h and 48h were (5.1 ±0.9)μg/L and (5.5 ± 1.3)μg/L,which were elevated,the differences were statistically significant(t =9.672,14.381,all P <0.05).The urinary NGAL levels of contrast -induced nephropathy patients after surgery 4h ~48h were higher than non -contrast-induced nephropathy patients,and the urinary KIM-1 levels after surgery 24h and 48h were higher than non -contrast -induced nephropathy patients,the differences were statistically significant(t =17.838,19.370,13.996, 18.172,2.792,3.307,all P <0.05).Pearson correlation analysis showed that the urinary NGAL levels after 4h and urinary KIM-1 levels after 24h were positively correlated with serum creatinine levels after surgery 48h(r =0.698, 0.576,all P <0.05).ROC curve analysis showed that urinary NGAL levels in predicting contrast -induced nephrop-athy,the area under the curve was 0.963 (95% CI:0.931 ~0.995 ),sensitivity was 85.7%,and specificity was 94.3%,for urinary KIM-1 levels,those were 0.839 (95%CI:0.768 ~0.909),81.0% and 72.8%.Conclusion The urinary NGAL levels of contrast -induced nephropathy patients after interventional treatment 4h were increased, and the urinary KIM-1 levels appeared increased after surgery 24h,which were earlier than serum creatinine.They were expected to be early indicators for determining acute kidney injury and predicting contrast -induced nephropathy after intervention treatment.

Objective:To observe influence of cardiac resynchronization therapy (CRT ) on ventricular remodeling and inflammation in patients with chronic heart failure (CHF) .Methods :A total of 84 CHF patients treated in our hospital from Jun 2012 to Feb 2015 were selected , according to randam number table , they were randomly and e‐qually divided into routine treatment group (received routine medication ) and combined treatment group (received CRT based on routine treatment group) .Left ventricular ejection fraction (LVEF) ,left ventricular end -diastolic dimension (LVEDd) ,6min walking distance (6MWD) ,levels of high sensitive C reactive protein (hsCRP) ,inter‐leukin (IL)‐6 and tumor necrosis factor (TNF)–αwere compared between two groups before and three months after treatment .Results:Compared with before treatment ,three months after treatment ,there were significant rise in LVEF and 6MWD ,and significant reductions in LVEDd ,levels of hsCRP ,IL‐6 and TNF‐α in combined treatment group ( P<0.05 or < 0.01 ) ,while there were no significant improvements in above indexes in routine treatment group .Compared with routine treatment group ,there were significant rise in LVEF ± [(29.42 ± 4.32)%vs .(37.16 ± 4.72)% ] and 6MWD [ (232.66 ± 40.54) m vs .(304.12 ± 51.65) m] ,and significant reductions in LVEDd [ (64.35 ± 7.81) mm vs .(57.64 ± 6.12) mm] ,levels of hsCRP [ (23.21 ± 3.45)μg/ml vs .(16.31 ± 2.02)μg/ml] ,IL‐6 [ (22.08 ± 3.82)μg/ml vs .(15.79 ± 2.09)μg/ml] and TNF‐α[ (32.66 ± 5.66)μg/ml vs .(23.23 ± 3.12)μg/ml] in combined treatment group , P<0.05 or <0.01. Conclusion:CRT can significantly reduce levels of hsCRP ,IL‐6 and TNF‐αin CHF patients ,which may be the main mechanism delaying ventricular remodeling and improving cardiac function .