The plasma arginine vasopressin (AVP) level was measured by RIA in 19 patients with polyuria and polydipsia, and the AVP measurement was compared with indirect tests. The AVP levels were very low in 13 patients with central diabetes insipidus and normal in 6 patients with primary polydipsia. The direct assay was correspondent to the indirect criteria in 89% of the patients. We concluded that the use of AVP assay improves accuracy in the differential diagnosis of polyuria, and is important in the diagnosis of these diseases.

It is a hospital's sacred duty to heal the wounded, rescue the dying and implement humanitarian- ism. The key to the winning of a medical lawsuit by our hospital lay in the fact that it earnestly put into effect the idea of centering on the interests of the patients. The participation of legal advisors in goad time, the objective coverage by the news media, and modem means of management, which guaranteed the authenticity and reliability of the medical documents, all played a role that could not be underestimated in the handling of the medical lawsuit. [

Objective To explore the pattern of lymph node metastasis in patitsen with squamous cell carcinoma of the thoracic esophagus and its significance in lymphadenectomy.Methods The clinical data of 230 patients who received radical esophagectomy with three-field lymphadenectomy was analyzed.The metastatic sites of lymph nodes were correlated with tumor location by chi-square test.Logistic regression was used to analyze the relationship between clinic pathoingical factors and lymph node metastasis.Results Lymph node metastases were found in 133 of the 230 patients(57.8%).The average number of resected lymph nodes was 25.3? 11.4 per patient(range 11～71).The rates of lymph node metastasis were 41.6%,19.44%and 8.3%in the neck,thoracic medi- astinum and abdominal cavity for patients with upper thoracic esophageal carcinoma,33.3%,34.7%and 14%for patients with mid- die thoracic esophageal carcinoma and 36.4 %,34.1%and 43.2 %for patients with lower thoracic esophageal carcinoma.No signifi- cant difference in cervical or thoracic metastatic rate was observed among upper,middle and lower thoracic carcinoma.The difference in lymph node metastatic rate for nodes in the abdominal cavity was significant among upper,middle and lower thoracic carcinoma. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity.Logistic-regression showed depth of tu- mor invasion and angiolymphatic invasion were factors influencing lymph node metastasis.Conclusion Cervical and mediastinal node dissection should be performed independently from tumor location.Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancer than of other locations.Patients with greater tumor grade,depth of tumor invasion and angiolymphatic invasion were more prone to develop lymph node metastasis.

One hundred and fifty ASA Ⅰ-Ⅱ infants scheduled to undergo surgery on unilateral inguinal region,were randomly assigned to 3 groups with 50 in each group.In groups Ⅰ and Ⅱ puncture was performed at traversus abdominis plane under ultrasound-guidance,0.4 or 0.5/kg of 0.25％ ropivacaine was injected respectively.In group Ⅲ the triangle of Petit was positioned through palpating and then 0.5 ml/kg of 0.25％ ropivacaine was injected.HR,RR,SpO2,PETCO2,expired sevoflurane concentration and BIS value at the time of entering the operation room (T1),incision of skin (T2),pulling hernia sac (T3),ending the surgery (T4),waking (T5),the number of pressing the analgesia pump after operation were recorded.The results showed that HR at T2 and T3 of groups Ⅰ and Ⅱ was lower than group Ⅲ (P ＜ 0.05).The were significant differences in case numbers of insufficient intraoperative analgesia among 3 groups(x2 =10.500,P =0.005).The CHEOPS scores and the number of pressing analgesia pump after operation in groups Ⅰ and Ⅱ were lower than those in group Ⅲ (x2 =7.230,P =0.027).Results indicate that ultrasound-guided transversus abdominis plane block is safer and more effective than conventional method for operations of inguinal region in infants; it may reduce dose of local anesthetics and postoperative use of analgesics.

Objective To investigate the relationship between the expression of KAI1 mRNA and the clinicopathological parameters and prognostic outcome of patients with gastric Callcer. Methods The expressions of KAI1 mRNA in 70 samples of gastric cancer tissue and 18 samples of benign gastric lesion were detected by in situ hybridization.Results The positive rates of KAI1 mRNA expression in benign gastric lesion and gastric cancer tissue were 94%(17/18)and 31%(22/70),respectively.The expression of KAI1 mRNA was influenced by tumor difierentiation degree and the state of lymph node metastasis.The positive rate of KAI1 mRNA expression was gradually decreased as the increase of invasion depth and the tumor clinical stages.The 5-year survival rate of patients with positive expression of KAI1 mRNA WaS higher than these with negative expression of KAI1 mRNA.Conclmions The less and down-regulation of KAI1 gene expression may be involved in the occurrence and development of gastric cancer.KAI1 gene might be a valuable indicator for early diagnosis and predicting the malignancy and metastasis potential of gastric cancer and the prognosis of patients with gastric cancer.

Objective To establish a method for the content determination of c hlorogenic acid in Yinren Granules. Methods The content of chlorogenic acid wa s detected by HPLC. HPLC was performed with Shim- Pack CLC- ODS column(150? 6.0 mm, 5 ? m) at room temperature, 3 % methyl alcohol- methanol( 79 ∶ 2 1) as mobile phase, the detection wavelength at 327 nm, the flow rate being 1. 2 mL/min and sample loop volume being 10 ? L. Results Chlorogenic acid has a good linearity within 0.102～ 1.02? g (r=0.999)and the average recovery was 98. 17 % with RSD being 1.31 % . Conclusion This method is simple, accurate and can be used for the quality control of Yinren Granules.

OBJECTIVE To monitor hospital infection continuously in five years in order to learn the rule of dynamic movements and its characters.METHODS To analyze the documents by prospective monitoring and retrospective(investigation).RESULTS The number of discharged inpatients increased year by year while the infection rate(developed) smoothly.Its average rate was 6.88%.CONCLUSIONS The aim to take hospital infection under control has(accomplished).

Objective To study the changes of iodine source and the nutritional status of iodine after termination of iodized salt supply in the areas with different water iodine concentrations in Shanxi province,in order to provide scientific bases for developing strategies on control and prevention of iodine deficiency disorders,and to study the cut-off value of water iodine level where iodized salt supply should be stopped.Methods In 2010 in Shanxi province,6 villages with 100％ of non-iodized salt consumption rate were selected as the survey spots based on the iodine concentration in drinking water of 0-,50-,100-,150-,300-,≥500 μg/L.Villages'iodized salt supply was terminated thoroughly.In each village,20 children aged 8 to 10 were selected.At the same time,women of childbearing age 18 to 50 years old and adult men aged 18 to 60 were selected from the same families as the children.Diet surveys were conducted by the method of 3 days recall on all subjects.Drinking water samples,staple foods,supplementary foods and urinary samples of all subjects were collected and the iodine concentration was determined by arsenic-cerium catalytic spectrophotometry.Results ①In the villages of water iodine 25.9,70.6 μg/L,the medians urinary iodine of children,women and men were all ranged from 100 to 199 μg/L,which meant their iodine nutrition levels were appropriate.In the village of water iodine 109.0 μg/L,the medians urinary iodine of children,women and men were all ranged from 200 to 299 μg/L,which meant their iodine nutrition levels were more than appropriate.In the villages of water iodine 225.8,430.0,581.2 μg/L,the medians urinary iodine of children,women and men were all ≥ 300 μg/L,which meant their iodine nutrition levels were too high.②)In all the 6 villages,the intaking amount of iodine met and exceeded the standard recommended intake of dietary iodine by ICCIDD/UNICEF/WHO (8 to 10-year-old children ≥ 120 μg/d,women of childbearing age and adult men ≥ 150 μg/d).But in the village of water iodine 581.2 μg/L,the iodine intake was exceeded the daily maximum safe intake (children aged 8 to 10 ≤800 μg/d,women of childbearing age and adult man ≤ 1000 μg/d).③The amount of iodine ingestion from drinking water was increased with the water content of iodine.When water iodine exceeded 100 μg/L,the amount of iodine ingestion from drinking water was higher than from food intaking,and became a main resource of iodine in the human body.Conclusions In the counties of iodine concentration in drinking water above 100 μg/L in high iodine areas of Shanxi province,the water iodine becomes the most important source of iodine,and iodine nutritional level is more than appropriate or possible excess.It is recommended that in areas of high water iodine of Shanxi province,the standard cut-point of water iodine value is set to 100 μg/L.

Objective To investigate the influence of misoprostol and carboprost methylate for preoperative vaginal placement on the clinical index, the cervical dilatation degree and adverse reactions of patients with submucous myoma of uterus by hysteroscopic surgery.Methods150 patients with submucous myoma of uterus by hysteroscopic surgery were chosen in the period from August 2013 to August 2016 in Yiwu Maternal and Child Health Care Family Planning Service Center and divided into two groups including group A (75 patients) with misoprostol and group B (75 patients) with carboprost methylate for preoperative vaginal placement;and the operation time, the intraoperative blood loss, the recovery time of gastrointestinal function, the effects of cervical dilatation, the width of cervical dilatation and the adverse reactions incidence of both groups were compared.ResultsThe operation time and the intraoperative blood loss of B group were significantly better than A group(P<0.05).There was no significant difference in the recovery time of gastrointestinal function between the two groups.The effects of cervical dilatation in group B were significantly better than that in group A(P<0.05).The width of cervical dilatation in group B were significantly larger than that in group A(P<0.05).There was no significant difference in the adverse effects incidence between the two groups.ConclusionCompared with misoprostol, carboprost methylate for preoperative vaginal placement in the treatment of patients with submucous myoma of uterus by hysteroscopic surgery can efficiently shorten the operation time, reduce the operation bleeding, improve the effect of cervical dilatation and not increase the adverse reactions risk.

Objective To study the effect of small dose mifepristone in the treatment of uterine fibroids.Methodsfrom January 2013~2015 year in January 100 cases of uterine fibroids were treated in Yiwu Maternal and Child Health Care Family Planning Center as the research object in the course of the study, patients began taking mifepristone in menstruation third days to 5 days, taking a total of 6.5 months, after the observation of its long-term use of low-dose mifepristone after treatment, changes in sex hormone the level of the effect of low-dose mifepristone in the treatment of patients with uterine fibroids and patients in the body, including the effects on the endometrium.The clinical symptoms and signs, the changes of hormone levels and the results of B-ultrasound were followed up.ResultsAll of the 100 patients were treated with low dose mifepristone for a period of time, all of them had amenorrhea.Before treatment, the level of estradiol in patients was (298.5±156) pmol/L, and the level of progesterone (2.8±1.3) was pmol/L.After 6.5 months of treatment, the level of estradiolof the patients was(228.4±114)pmol/L, and the level of progesterone(1.3±0.5)pmol/L was pmol/L.The results showed that the levels of progesterone and estradiol in patients after treatment were significantly lower than those before treatment, with statistical difference (P<0.05).There was no significant change in endometrial thickness after long-term low-dose mifepristone treatment (P>0.05).After treatment, the total effective number of cases was 92 cases, the effective rate was 92%.ConclusionSmall dose of mifepristone for uterine fibroids clinical treatment effect is good, to a large extent, improve the effective rate of treatment and high safety, with the clinical significance of further promotion and application.