Objective To investigate the risk factors of contrast-induced renal nephropathy(CIN)in patients with coronary disease treated with interventional therapy and summarize the nursing strategies. Methods One hundred and twenly CHD patients treated with PCI were selected.Logistic regression analysis was done to screen out the risk factors of CIN. Result The main risk factors included renal inadequacy,advanced age,diabetes and contrast dosage(all P<0.05). Conclusion Risk assessment before PCI,rational use of contrast and preventive nursing measures are essential for the prevention and reduction of CIN.

Objective To explore the major types and characteristics of the patients with cilioretinal artery occlusion. Methods Ten patients(10 eyes)with cilioretinal artery occlusion were gathered.Fundus examination and fluorescein angiography were used for the analysis of the clinical manifestations in ten patients. Results Of the ten patients,the isolated occlusion of a cilioretinal artery(which we defined as typeⅠ)was revealed in four patients,the central retinal vein association with cilioretinal artery occlusion(type Ⅱ)was revealed in four patients,central retinal artery association with cilioretinal artery occlusion(type Ⅲ)was revealed in two patients. The images of fundus fluorescein angiography showed fluorescein filled of cilioretinal artery slow,and completely filled of cilioretinal artery late. The visual prognosis is satisfied in typeⅠ,but worse in type Ⅱ and the worst in type Ⅲ. Conclusions The visual prognosis of cilioretinal artery occlusion is different due to the various clinical manifestations revealed. Fundus fluorescein angiography could be used to identify the type and evaluate the visual prognosis of cilioretinal artery occlusion.

Objective To investigate the clinical features ,diagnosis and treatment of cesarean scar pregnancy (CSP) .Methods We retrospectively analyzed the medical history ,clinical manifestation ,diagnoses ,treatments and outcomes of 42 patients with ec‐topic pregnancy in the cesarean scar .Results All cases got diagnosed by transvaginal ultrasound .The error rate of first diagnosis was 40 .4% (17/42) .There were 25 cases of conservative therapy ,in which 12 cases were resolved with laparoscopic surgery and 1 case resolved with open surgery ;in the first process 15 cases were carried out laparoscopic surger in which 1 case were converted to laparotomy ;abdominal surgery were underwented in 1 case and were cured .Only one case underwent abdominal total hysterectomy as of failure after uterine artery embolization .After initial conservative treatment 3 cases were hospitalized again and 2 cases under‐went reoperation .41 patients were successfully retained the uterus and normal menstrual cycle returned at two months after opera‐tion .Conclusion The early diagnosis for CSP mainly depended on ultrasound and the thickness of incision muscle layer is an impor‐tant basis for choice of treatment .Checking the thickness of incision muscle layer for CSP mainly depended on ultrasound ,and lapa‐roscopic surgery is an ideal method for diagnosis and treatment of CSP .

Objective To investigate the significance of endoglin in the angiogenesis of ovarian carcinoma.Methods Immunohistochemical assay was used to investigate 70 tissue samples of pathologically identified epithelial ovarian tumor(including 31 specimen of benign and 39 of malignant)from December 2000 to December 2003 in our department using monoclonal antibodies against CD34 and endoglin.Microvessels density(MVD)was counted by experienced pathologists.Results No significant difference of MVD for CD34 was observed in the ovarian cystadenoma and ovarian carcinoma.In contrast,an increment of MVD for endoglin from low-grade to high-grade dysplasia and that from earlier stage to later stage was statistically significant.Conclusion Endoglin may be a valuable marker for assessing neovascularization in the process of ovarian carcinoma development and for predicting the risk of ovarian carcinoma development.

Objective To evaluate the effects of different laparoscopic approaches for hysteromyomectomy. Methods Hysteromyomectomy was performed on 126 patients who required surgical treatment and preservation of the uterus from August 2000 to December 2002 with different laparoscopic approaches. A follow-up for 2-28 months was conducted in all patients. Results There were 70 cases of subserous fibroids, 53 cases intramural fibroids, and 3 broad ligament fibroids in those 126 patients. The average diameter of the fibroids was 6.1 cm (3-12 cm). The diameter of the fibroids less than 5 cm was found in 33 patients (26.2%), but equal to or larger than 5 cm in 93 patients (73.8%). A single myoma was found in 57 patients (45.2%), but numerous myomas in 69 patients (54.8%). Hysteromyomectomy, hysteromyomectomy and uterine artery blockage, and hysteromyomectomy and temporary uterine artery blockage were performed on 26, 70, and 30 patients, respectively. Operations were successful in all patients. There were no intra- and post-operative complications. Conclusion Different laparoscopic approaches for hysteromyomectomy can result in satisfactory clinical outcomes when different case properties and different requirements of patients are taken into consideration.

Objective To investigate the possibility and efficacy of laparoscopic peritoneal vaginoplasty for the treatment of congenital absence of vagina. Methods A total of 4 patients with congenital absence of vagina underwent laparoscopic peritoneal vaginoplasty. Results Operations were performed successfully in the 4 cases. The mean operative time was 114 min (range: 90-160 min), and the mean postoperative hospital stay was 5.4 d (range: 5-6 d). There was no complication in all patients. Conclusion Laparoscopic peritoneal vaginoplasty is a safe, minimally invasive, and reliable method for the treatment of congenital absence of vagina.

Objective To assess the clinical efficacy of laparoscopic uterine artery blockage for the treatment of adenomyosis. Methods Laparoscopic uterine artery blockage was performed in 38 patients with adenomyosis. Enucleation and excision or vaporization of endometriosis were performed at the same time in patients with chocolate cyst of ovary and endometriosis. Lysis of adhesion and presacral neurectomy were performed in some patients. Symptoms and uterine volumes of all patients were investigated after the treatment. Results Relieved clinical symptoms were found in all 38 patients. Menorrhagia was reduced to (56?16)%. Complete disappearance of dysmenorrhea was found in 17 patients (44.7%), significantly alleviated in 14 patients (36.8%), partially alleviated in 6 patients (15.8%), but ineffectiveness in 1 patient (2.6%). Pain score and classification were decreased significantly (P

Objective To investigate feasibility of laparoscopic anatomical nerve sparing radical hysterectomy (LANSRH) used for locally advanced cervical cancer treatment and evaluate early recovery of bladder function postoperatively. Methods From October 2006 to September 2007, 37 cervical cancer patients with stage Ⅰb1 to Ⅱ a underwent LANSRH(LANSRH group) with pelvic lymphadenectomy matched 25 patients with cervical cancer treated by general laparoscopic radical hysterectomy (LRH,LRH group) with pelvic lymphadenectomy. The data of operating time, blood loss, numbers of lymph node, the length of resected vaginal and paracervix tissue were collected and compared. In the mean time, postoperative recovery of bladder function was evaluated. Results The laparoscopic anatomic nerve-sparing procedure was performed successfully and safely among all patients. (1) There was no remarkable difference in the following clinical parameters between LANSRH and LRH group: median operating time [(175±41) min vs. (178±30) min, P=0.72 ], blood loss [(233±104)ml vs. (218±77) ml, P=0.06], numbers of lymph nodes (13±4 vs. 15±6, P=0.16), resected length of paracervix tissue [(3.6±0.5)cm vs. (3.7±0.6) cm, P=0.43], resected length of vaginal tissue [(3.5±1.0)cm vs. (3.5±0.8) cm, P=0.80]. (2) The mean time of the Foley catheter removed was (10.6±2.7)days(7-17 days)in LANSRH group and (17.2±4.2)days(9-25 days)in LRH group (P=0.02). After Foley catheter removed, 95% (35/37) presented bladder fulfilling sense, 86% (32/37) presented automatic micturition and urination emptying in LANSRH group. However, In LRH group, 88% (22/25) presented bladder fulfilling sense, 76% (19/25) presented automatic micturition and urination emptying. The bladder void function recovery were 68% (25/37) in class 0 and 3% (1/37) in class Ⅱ in LANSRH group, when compared with 40% (10/25) in class 0 and 12% (3/25) in class Ⅱ in LRH group, it reached statistical difference (P<0.05). In the mean time, there was no significant difference in Class Ⅰ bladder void function recovery, which were 24% (9/37) and 48% (12/25). (3) No surgery complications and blood transfusion were observed in LANSRH and LRH group. Postoperative pathology suggested that no tumor cell invasion occurred in paracervix tissue and lymph nodes. During the range of 11 to 19 months follow-up, all patients were alive without tumor recurrence and metastasis. Conclusion LANSRH is safe and feasible surgical management for cervical cancer at early stage and would improve the recovery of bladder voiding function postoperatively by sparing anatomical nerve.

Objective To investigate the relationships between baseline R2? of blood oxygenation level-dependent magnetic resonance imaging(BOLD-MRI) and Semi-quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) in cervical cancer,to lay a foundation for the further development of assessing tumor hypoxia techniques. Methods Twenty-four patients with cervical cancer were subjected to DCE-MRI and BOLD-MRI before treatment,Semi-quantitative parameters(SI-I、MER、Tmax、IAUC) of DCE-MRI and the baseline R2?of BOLD-MRI produced by special post-processing softwares,the relationships between baseline R2?of BOLD-MRI and Semi-quantitative parameters of DCE-MRI were analyzed. Results Significant positive correlations were observed between baseline R2?and Tmax(r=0.423,P=0.014),there were no correlation between baseline R2? and SI-I、MER or IAUC(P>0.05). Conclusion Semi-quantitative parameters of DCE-MRI and baseline R2? of BOLD-MRI respectively reflected the oxygenation of tumor in different principle. The combined use of the above parameters is expected to improve the performance for defining tumor hypoxia.

Objective To study the desired therapeutic effect of vaginoplasty using sigmoid colon or peritoneum for entire vaginal atre-sia.Methods From May 2015 to October 2015,8 patients with complete vaginal atresia in our hospital performed vaginoplasty using sigmoid colon or peritoneum successfully.The operation methods,prognosis and therapeutic effect and quality of sexual life of two groups were com-pared and analyzed to investigate a perfect operative method and ideal nursing.Results Laparoscopic vaginoplasty using the peritoneum compared with that using sigmoid colon has advantages of shorter time of operation,less bleeding,less trauma and quicker recovery.However, artificial vagina using sigmoid colon was much more similar to a natural vagina in morphological and physiological characteristics,merely ac-companied by excessive mucus discharge during the postoperative period.At lower risk of vaginal adhesion and stenosis,laparoscopically as-sisted vaginoplasty using sigmoid colon graft also puts high technical requirements.Two patients normally developed uterus menstruate regular-ly.Four patients without uterus and 2 patients with rudimentary uterus experienced good sexual intercourse after vaginoplasty.Conclusion Patients with complete colpatresia who have normal womb should creat a patent and functional vagina until adolescence to restore its physio-logical and reproductive function.Anatomical reconstructive treatment of vaginal agenesis for patients with absent or hypoplastic uterus can be postponed till the late teens or in the adult.Both laparoscopic sigmoid vaginoplasty and peritoneal vaginoplasty achieve a minimal-invasive, cosmetic,natural lubricous, smooth artificial vagina for patient’ s sex life satisfactory.