Objective To explore the clinical effect of laparoscopic uterine artery occlusion combined with uterine myomectomy for uterine myomas.Methods 120 patients with uterine fibroids were selected and randomly divided into research group and control group according to the digital table,60 cases in each group.Patients of the control group directly received conventional laparoscopic myomectomy,and patients of the research group received uterine artery occlusion before laparoscopic myomectomy.The intraoperative blood loss,operative time,postoperative anal exhaust time,hospitalization time of the two groups were observed and recorded.The patients were followed up with menstrual with improvement and luteinizing hormone,estradiol,follicle stimulating hormone.Results The intraoperative blood loss,operative time,postoperative anal exhaust time,menstrual improvement,fibroids relapse and other indicators of the research group were better than those of the control group,the differences were statistically significant [(82.85 ± 19.32) mL vs.(153.26 ± 21.18) mL,(60.56 ± 12.21) min vs.(153.38 ± 21.34) min,(15.62 ± 1.66) h vs.(25.03 ± 1.98) h,96.7 ％ vs.78.3 ％,3.3 ％ vs.16.7 ％,t =28.06,27.67,28.21,x2 =9.21,5.92,all P ＜ 0.05].Two months after operation,the E2 and FSH levels of the research group were significantly different with those before operation (t =3.90,3.51,all P ＜ 0.05),but after 12 months,there were no statistically significant differences in E2,FSH and LH compared with before operation (t =0.42,0.50,P =0.68,0.62).There were no statistically significant differences in E2,FSH and LH compared with before operation at two or twelve months after operation(t =0.19,0.39,0.69,P =0.85,0.70,0.49;t =0.58,0.20,0.37,P =0.56,0.83,0.71).Conclusion Uterine artery occlusion before laparoscopic myomectomy can significantly reduce blood loss,shorten the operation time,speed up the recovery and reduce the recurrence rate,and its influence on ovarian function is temporary and reversible,it is worthy of clinical popularization and application.

Objective:To survey and evaluate the situation of present clinic use of antidiabetic drugs,estimate their consuming trend and discuss the rational methods in applying antidiabetic drugs.Method:The drug purchasing data during the years of 2002 to 2006 in hospitals were compared,and statistically analyzed with Microsoft Excel.Result:Ac- counting approximately 52%-72% in total antidiabetie DDDS,sulfonylureas and bigunides were most commonly used.In- sulin and?-Glycosidase inhibitors also took more than 25%-35% share in total DDDs.Some other new drugs and tradi- tional Chinese medicine were less than 10% in total DDDs.The first line of antidiabetic drugs included mefformin,gliclas- ide,acarbose,glipizide and insulin.Conclusion:Clinical application of antidiabetic drugs was reasonable in Nanjing dis- trict.The cost of diabetes patient is the main factor which will influence the application of antidiabetic drugs normatively and continuously.

Dead-in-bed syndrome (DBS) is a rare but devastating sudden death condition that mainly affects young patients with type 1 diabetes.Its mechanism is quite complicated and may involve multiple factors.Acute onset of recurrent and severe nocturnal hypoglycemia,abnormal cardiac repolarization,genetic factors,and obstructive sleep apnea may all contribute to ventricular arrhythmias and even sudden death.The future research plans include elucidating and understanding the underlying mechanisms and triggers for DBS,developing a risk stratification system,using real-time continuous glucose monitoring system to detect severe nocturnal hypoglycemia,and initiating appropriate therapeutic interventions to uhimately prevent the tragedy.

Objective To evaluate the curative effect and safety of Niaoshit on g pill in the treatment of urinary calculus.Method Multi- center randomized co ntrolled clinical trial was adopted. Three hundred and twenty cases were accepte d to the study, in which 200 cases were treated by Niaoshitong pill and 120 case s by Shilintong tablet as control. The effect of both groups was observed. Resul t 107 cases (53.5 % ) were cured, 53 cases(26.5 % ) effective, the total effe ctive rate being 80.0 % in the treatment group, and 27 cases(24.5 % ), 42 cas es (38.2 % ), and 62.7 % respectively in the control group. In a open group of 120 cases ,54 cases (45.0 % ) were cured, 44 cases (36.6 % ) were effective , the total effective rate being 81,6 % .Conclusion Niaoshitong pill can mark edly improve the clinical symptoms and exerts a strong lithagogue effect. It can promote the elimination of calculi after external blast lithotrity or ureterosc opic lithotrity, prevent the formation of 'stone street', and reduce the strictu re formed by the damage of ureter.

Objective To summarize the MSCT signs and the key points of differential diagnosis of sclerosing mesenteritises (SM) which were misdiagnosed by clinical and CT,to reduce the misdiagnosis rate.Methods Clinical and MSCT data of 23 misdiagnosed SM patients were analyzed retrospectively.The misdiagnosed diseases,misdiagnosed causes,and differential diagnosis were analyzed.Results SM were mainly misdiagnosed as tumor and infective inflammation.The main causes of misdiagnosis and differential diagnostic features were listed as follows.(1)SM didn't have specific clinical manifestations.(2)The density of the adipose tissue in mesentery increasedmisty mesentery.A clear demarcation between the lesion and the surrounding normal fatty tissue could be differentiated from infective inflammation.(3)The mass-like false capsule had space-occupying effect of displacement of the surrounding structures.However, the blood vessels were encapsulated by the mass-like false capsule with fat ring around, which could be differentiated from fat-containing tumors.(4)The soft mass was formed at the root of the mesentery.The fat halo sign and mild enhancement of the mass can be differentiated from lymphoma and carcinoid.Conclusion SM is easily misdiagnosed both in clinical practice and medical imaging.Recognition of differential diagnostic features of MSCT can reduce the misdiagnosis rate.

Objective To explore the optimal screw fixation of anterior column lag screw fixation in the treatment of acetabular anterior column fractures by finite element method.Methods Firstly,CT scanning images from one healthy adult volunteer (male 30),were transferred into Materialise Mimics Innovation Suite 16.0 software,then three-dimensional (3D) models of pelvic were reconstructed and stored in stereolithography format.Then Imageware 12.0 software (EDS,USA) was used to produce the optimal and safe channel of the screw for acetabulum anterior column fixation.Three types of screw fixation were generated,i.e.(1) geometric algorithm screw channel,(2) in-out-in channel,(3) free screw channel.Secondly,all model data were transferred into Ansys 12.0 software to establish the finite element model.Gravity load were defined as 600 N,1 200 N,and 2 400 N,and the Von Mises the parameters of peak stress and deformation were recorded.Results Respectively load of 600 N,1 200 N,2 400 N force to normal hip and geometric algorithm screw channel, in-out-inscrew channel,free screw channel,the comparison between groups of hip by stress and hip deformation,with a given loading force of hip by stress and hip deformation increase gradually,the two were positively correlated,including screw by stress at slightly higher than that of normal hip,while the stress of hip by geometric algorithm screw channel andin-out-inscrew channel were similar,and that by free screw channel increased significantly.There was no significant difference between groups in the hip deformation.With a given loading force (600 N,1 200 N,2 400 N) on geometric algorithm screw channel、 in-out-inscrew channel and free screw channel,the deformation is gradually increased,and there were positively correlated.With the stress on geometric algorithm screw channel,it was significantly reduced compared with the latter two,and in-out-in screw channel suffered the biggest stress.Conclusion Through the finite element analysis,the geometric algorithm screw channel can be used as a safe and effective way for acetabulum anterior column fracture.

Objective To research the expression of Sp3 andβ‐Catenin in HCC and study the assessable factors of them for prognosis in patients with hepatocellular carcinoma .Methods Western blot and RT‐PCR methods were used to detect the expres‐sion of Sp3 andβ‐Catenin in HCC and the liver tissue beside tumor among 49 cases .We analyzed the difference of these two indexes expressed in HCC and the liver tissue beside tumor .Then we detected the correlation between these two indexes and the character of clinic pathology ,and researched the correlation between Sp3 and the prognosis of HCC .Results The high expression rate of Sp3 in HCC was higher than that of liver tissue beside tumor(P<0 .05) according to Western blot and RT‐PCR ,the same toβ‐Catenin (P<0 .05) .Expression of Sp3 andβ‐Catenin were both related with size of tumor and degree of differentiation .Positive correlation existed between these two indexes according to Western blot method(r=0 .681 ,P=0 .000) and RT‐PCR method(r=0 .641 ,P=0 .000) .The prognosis of cases with high expression of Sp3 was poorer than the low expression cases(P<0 .05) .Conclusion Sp3 plays a promoter role in occurrence of HCC ,which is correlated with the grade malignancy of HCC .Sp3 might participated in occur‐rence and development of HCC via the Wnt pathway .

Objective To verify the application value of the Oxford classification in child IgA nephropathy (IgAN) .Methods The clinical and pathological data by renal biospy in 123 children patients with IgAN from January 2010 to September 2013 were collected and retrospectively analyzed .84 cases were followed up .The results were divided into 4 grades(A ,B ,C ,D) based on the manifestations at the end of follow‐up .Finally the pathological analysis was performed .Results Among 123 cases ,the clinical man‐ifestations were dominated by nephrotic syndrome (42 .28% ) ,followed by hematuria complicating proteinuria (24 .39% ) .The scores of 4 pathological indexes were dominated by M 1 (82 .11% ) ,E1 (53 .66% ) ,S0 (59 .35% ) and T0 (82 .11% ) respectively ;the mesangial cells proliferation and endocapillary proliferation were related with the hematuria severity (P<0 .01);mesangial cells pro‐liferation ,endocapillary proliferation and renal tubule atrophy/interstitial fibrosis were related with the edema occurrence ( P<0 .05);the mesangial cells proliferation ,segmental glomerulosclerosis and renal tubule atrophy/interstitial fibrosis were related with the average arterial pressure increase(P<0 .05) .4 pathological indexes were related with 24 h urinary protein amount(P<0 .01);the segmental glomerulosclerosis and renal tubule atrophy/interstitial fibrosis were related with the decrease of the estimated glo‐merular filtration rate(P<0 .01) .84 cases were successfully followed up ,the clinical outcome was grade A in 43 cases(51 .19% ) , grade B in 30 cases(31 .71% ) ,grade C in 8 cases(9 .52% ) and grade D in 3 cases(3 .57% ) .Only the renal tubule atrophy/intersti‐tial fibrosis was related with prognosis(P<0 .05) .Conclusion The Oxford classification has certain relation with clinical indexes of children with IgAN .Only the renal tubule atrophy/interstitial fibrosis are the risk factors of prognosis .

Objective To investigate the clinical significance and relationship of preS1, HBV DNA and HBV-M. Methods PreS1 and HBV-M was detected by ELISA method,and HBV DNA was detected by PCR. Then the results were analyzed. Results In HBV patients,the positive rates of preS1 and HBV DNA had no statistically significant ,they had fine dependability. The detection rate of preS1 in HBeAg(+) group(80.3%) and HBeAg(+)group( 56.3% ) had statistically significant. In some patients,though HBeAg had become negative, HBV still replicated. In HBV DNA replicated patients(≥103 copies/ml) ,the detection rate of HBeAg and preS1 were 51.5% and 70.9% ,they had statistically significant. Conclusion HBV DNA and PreS1 had fine dependability,preSl could reflect the replication of HBV sensitively than HBeAg,it could be used as a reliable new marker of HBV replication in vivo.

Objective: To investigate the antimotion sickness effects of ginsenosides combined with dexamethasone in rats. Methods: Fifty SD rats were randomly divided into 5 groups: normal saline, scopolamine-treated, ginsenosides-treated, dexamethasone-treated and ginsenosides plus dexamethasone-treated groups. There were 10 rats in each group. The rats in each group were fed with corresponding ingredients respectively, and then the rats were exposed to abnormal acceleration for one hour. The motion sickness index, the level of kaolin consumption and the course and time of spontaneous activity were observed. Results: The motion sickness index and the level of kaolin consumption of acceleration-exposed rats in ginsenosides plus dexamethasone-treated group were significantly lower than those in normal saline group. And the course and time of spontaneous activity of acceleration-exposed rats in ginsenosides plus dexamethasone-treated group were significantly higher than those in normal saline group. The level of body weight increment of acceleration-exposed rats in ginsenosides plus dexamethasone-treated group was significantly higher than that in dexamethasone-treated group. Conclusion: Ginsenosides combined with dexamethasone can significantly increase tolerance to acceleration of rats, and the drug combination can decrease side effects of methylprednisolone, such as body weight loss.