Objective To explore the clinical efficacy of the interventional recanalization for infertile women with fallopian tube obstruction. Methods 636 infertile patients with fallopian tube obstruction diagnosed by hystero-salpin-gngraphy were treated with interventional tubal recanalizafion under X-ray. Results Among 636 patients with 984 complete fallopian tubes obstruction,there were 804 recanalization in tile 984 fallopian tubes and the successful rate of recanalization was 81.71%. Among 252 fallopian tubes with not complete obstruction ,there were 252 recanali-zation in the 252 fallopian tubes and the successful rate of recanalization was 100%. The all successful rate of reca-nalization was 88.3%. These patients pregnancy rate was 28.30% in one year and the second fallopian tube obstruc-tion rate was 6.79%. There was 4 ectopic pregnancy. Conclusions Interventional tubal recanalization has important application in the diagnosis and treatment for infertile women with fallopian tube obstruction, h has merit, such as simple, safe and good effect.

Objective To evaluate the effect of hydrogen-rich saline on autophagy in the spinal neurons of rats with neuropathic pain.Methods Sixty pathogen-free male Sprague-Dawley rats,aged 8-l0 weeks,weighing 220-250 g,were randomly assigned into 3 groups (n=20 each) using a random number table:sham operation group (S group),neuropathic pain group (NP group),and hydrogen-rich saiine group (H group).Neuropathic pain was produced by chronic constriction injury of the sciatic nerve in the rats anesthetized with chloral hydrate.Hydrogen-rich saline 5 ml/kg was injected intraperitoneally once a day for 7 consecutive days in group H,while the equal volume of normal saline was given instead in S and NP groups.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL)were measured at 1 day before operation (T0) and 1,3,5 and 7 days after operation (T1-4).The animals were sacrificed after measurement of pain threshold at day 7 after operation.L4-6 segments of the spinal cord were harvested to detect the expression of autophagy-related proteins microtubule-associated protein 1 light chain 3 Ⅱ (LC3 Ⅱ),Beclin-1 and p62 by Western blot.Results Compared with group S,the MWT was significantly decreased,and the TWL was significantly shortened at T2-4,and the expression of LC3 Ⅱ,Beclin-1 and p62 was significantly up-regulated at T4 in NP and H groups (P＜0.05).Compared with group NP,the MWT was significantly increased,and the TWL was significantly prolonged at T2-4,and the expression of LC3 Ⅱ and Beclin-1 was significantly up-regulated,and the expression of p62 was significantly down-regulated at T4 in group H (P ＜0.05).Conclusion The mechanism by which hydrogen-rich saline reduces neuropathic pain is related to induction of autophagy in the spinal neurons of rats.

Objective: To analyze the clinical characteristics, diagnosis, treatment and prognosis of patients with multisystemic sarcoidosis in order to improve the clinical diagnosis and treatment. Methods: A multisystemic sarcoidosis patient presenting with cranial nerve involvement as the first symptom was admitted to Beijing Hospital, and the clinical manifestations, imaging and pathological features were analyzed.And the related literatures were reviewed and summarized. Results: The sarcoidosis patient presented with weakness in the limbs, bilateral paralysis, visual floaters and subcutaneous masses.Chest CT showed multiple symmetrical lymph nodes in the mediastinum and bilateral hilum, with multiple ground-glass and grid-like densities in both lungs.The subcutaneous mass biopsy showed non-caseous granulomas, which was often considered as sarcoidosis.The condition improved after glucocorticoid treatment, while it relapsed after drug withdrawal, with new-onset of shoulder and knee pain.The endobronchial biopsy showed non-caseous granulomas.And the symptoms of the patient were relieved after the retreatment with glucocorticoid. Conclusions Multisystemic sarcoidosis is a rare clinic entity, and cranial nerve involvement as the first symptom is rarer.The diagnosis and treatment of multisystemic sarcoidosis are often delayed due to atypical symptoms.Although patients with sarcoidosis are sensitive to glucocorticoid therapy, those with extra-pulmonary involvement are more likely to relapse.Therefore, not only standardized treatment but also continuous monitoring of disease changes must be needed in clinic.

Objective To evaluate the effects,safety and economic cost of long-term home noninvasive ventilation (NIV) therapy in elderly patients with chronic hypercapnic respiratory failure.Methods A total of 128 elderly patients with chronic hypercapnic respiratory failure were randomly assigned to two groups:the NIV group (n=66) with conventional therapy in addition to long-term home NIV therapy,and the control group (n=62) with conventional therapy alone.Compared were parameters before and after two year follow up,which included dyspnea grade,scale for accessory muscle use,scoring for emotional disorders,mean pulmonary pressure (mPAP) by electrocardiography,arterial blood gas,the times of pulmonary infection and hospitalization rates,the duration of hospitalization invasive ventilation,the duration of in RICU and in hospital stay,tracheal intubation rates and mortality.The medical cost was calculated.Results After two years,the differences in the dyspnea grade,scale for accessory muscle use,anxiety scores,depression scores,mPAP,arterial PaCO2 and PaO2,hospitalization rates,the times of pulmonary infection,the days of hospitalization for exacerbation in the home NIV group [2.2± 0.2,2.4 ± 0.3,4 ± 1,5.3 ± 1.2,(36.6±5.2)mm Hg,(50.2±4.5)mm Hg,(63.5±4.2)mm Hg,(1.3±0.2) times/year,(2.4±0.2) times/year,(15.8 ± 4.4) days/times] were statistically significant compared to the control group [4.1±0.2,4.9±0.5,12±3,11.3±1.6,(45.2±5.2)mm Hg,(67.3±4.5) mm Hg,(48.3±4.3)mm Hg,(5.4±0.4)times/year,(8.9 ±0.3) times/year,(38.5± 6.3) days/times] (all P＜0.01).The duration of invasive ventilation,the days in RICU and in hospital stay,tracheal intubation rates on admission to the hospital were significantly decreased in the home NIV group [(8.2 ± 2.2)days,(9.6±3.1) days,(15.8±4.4) days,(2±0.2) times/two years],as compared with the control group [(15.8±3.4) days,(18.6±4.4)days,(38.5±6.3)days,(8.0±0.8) times/two years].The mortality was decreased significantly in the home NIV group (3.0 ％)compared with the control group (29.0％) (P＜0.05).The medical cost in two years was significant lower in the home NIV group [(6.4 ± 0.5) thousand yuan],compared with the control group (18.4 ±0.6) thousand yuan (P＜0.01).Conclusions Long-term home NIV therapy in patients with chronic hypercapinc respiratory failure is effective,safe and can decrease the mortality and medical cost.

Objective To investigate the selection of recipients,operative technique, and perioperative management of lung transplantation.Methods From June 2013 to September 2016, 9 patients with pulmonary lymphangioleiomyomatosis un-derwent lung transplantation at Affiliated Wuxi People's Hospital.There were 9 females aged from 23 to 52 years.Chest en-hancement of CT in 9 patients prior to transplantation suggests multiple different sized thin-walled cystic shadows in whole lung. Nine patients received bilateral sequence lung transplantation ( BSLT) .The pathological findings after the operation indicated that cells of the abnormal proliferation of smooth muscle diffused around the bronchi , vessels and lymphatics , and widened the alveolar septum, which was consistent with the pathological changes in the patients with PLAM .We analyzed the differences of oxygenation index, forcedexpiratory volume at 1 sec(FEV1), and DLCO％ pred.Using paired t test to compare these indica-tors, P<0.05 was considered statistically significant.Results The oxygenation index was increased from(210 ±55) mmHg (1 mmHg=0.133 kPa) to(400 ±80)mmHg after treatment, the difference was statistically significant(P<0.05).The FEV1 was increased from(1.0 ±0.2)L to(2.8 ±0.4)L, and the difference was statistically significant(P<0.05).The DLCO％pred was increased from(27.5 ±2.5)％ to(75.0 ±10.0)％, and the difference was statistically significant(P<0.05).Fi-nally, 8 patients were discharged from the hospital, and the pulmonary function was good.1 patients died of infection and acute rejection on the 13 day after operation.Conclusion Lung transplantation is effective in the treatment of chronic thromboem-bolic pulmonary hypertension , and long-term survival requires further investigations .Lung transplantation is the only effective means for the treatment of end-stage pulmonary lymphangioleiomyomatosis .Bilateral sequence lung transplantation is the first choice.

OBJECTIVETo observe the effects of acupuncture on mRNA of the neurotransmitter serotonin transporter (5-HTT), 5-HTreceptor (5-HTR), norepinephrineα2 receptor (NEαR) in brain tissue in rats with post-stroke depression.

METHODSForty male SD rats were randomly divided into a normal group, a model group, a medication group and an acupuncture group, 10 rats in each one. The model of post-stroke depression was established by occlusion of middle cerebral artery and chronic unpredictable mild stress method. After model was successfully established, the rats in the normal group and model group received no treatment; the rats in medication group were treated with intragastric administration of fluoxetine (2 mg/kg); the rats in acupuncture group were treated with acupuncture at "Baihui" (GV 20), "Fengfu" (GV 16), "Shenmen" (HT 7) and "Taichong" (LR 3) for 20 min, during which manual stimulation was given once, once a day, 7 days as one course, and totally 3 courses were given with an interval of one day between courses. The changes of rat behavior and 5-HT, NE were observed after intervention; the RT-PCR method was applied to observe the mRNA of 5-HTT, 5-HTR, NEαR in hippocampus, raphe nucleus and locus coeruleus.

RESULTSAfter treatment, compared with the normal group, the Zea Longa score in the model group was increased, while sugar water consumption, the number of horizontal and vertical movement of open-field test was reduced (all<0.01); compared with the model group, the Zea Longa score in the medication group and acupuncture group was reduced, while sugar water consumption, the number of horizontal and vertical movement of open-field test were increased (<0.01,<0.05); compared between the medication group and acupuncture group, the behavior changes were not significantly different (all>0.05). After treatment, compared with the normal group, the content of 5-HT and NE in brain tissue and mRNA expression of 5-HTT, 5-HTR in hippocampus, raphe nucleus and locus coeruleus in the model group were reduced (all<0.01), but the mRNA expression of NEαR was increased (<0.01);compared with the model group, the content of 5-HT and NE in brain tissue and mRNA expression of 5-HTT, 5-HTR in hippocampus, raphe nucleus and locus coeruleus in the medication group and acupuncture group were increased (<0.01,<0.05), while the mRNA expression of NEαR was reduced (all<0.01). The differences between medication group and acupuncture group were not significantly different (all>0.05).

CONCLUSIONSAcupuncture could significantly improve behavioral change in rats with post-stroke depression, which may be related to the regulation of 5-HT, NE in cerebral cortex as well as mRNA expressions of 5-HTT, 5-HTR, NEαR in hippocampus, raphe nucleus and locus coeruleus.

【Objective】 To investigate the protective effects of aflexible sleeve penile protection device on reducing postoperative pain and wound edema in patients after circumcision. 【Methods】 A total of 54 patients who underwent circumcision at Yan’an Branch of Peking University Third Hospital during Feb.1 and May 31, 2023 were enrolled.The patients were randomly divided into the experimental group and control group, with 27 patients in either groups.Patients in the experimental group were treated with a flexible sleeve penis protection device after surgery, and patients in the control group were treated with traditional gauze bandage after surgery.Postoperative pain, wound edema and complications were compared between the two groups. 【Results】 In terms of pain, the visual analogue scale of the experimental group was significantly lower at 6 hours [(1.7±0.9) vs.(3.3±1.9), P<0.001] and 2 days [(2.0±1.3) vs.(3.3±1.3), P<0.001] after surgery than that of the control group, but there were no statistically significant differences between the two groups on the 4th and 7th postoperative days (P>0.05).In terms of edema, the edema score of the experimental group was significantly lower than that of the control group on the 2nd postoperative day [(2.0±1.0) vs.(4.0±0.8), P<0.001] , the 4th postoperative day [(1.5±1.2) vs.(2.6±0.9), P<0.001] , and the 7th postoperative day [(0.9±1.3) vs.(2.3±1.5), P<0.001] .There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). 【Conclusion】 The flexible sleeve penile protection device has significant effects of reducing early postoperative pain and reducing edema in patients undergoing circumcision.