Objective To evaluate the relationship between thyroid autoantibodies (ATA)and pregnancy outcome of infertility women after assisted reproductive technology (ART). Methods Relevant studies were identified by searching PubMed, Cochrane library, CNKI and CBM. Results 7 studies were appropriate for meta-analyses and total 4165 patiens were included. Meta analysis shows that the pregnancy rate difference between ATA positive patients and controls have no significance, but the miscarriage rate is greater significant between them. In the meta-analyses, the presence of thyroid antibodies was associated with an increased risk of miscarriage (OR 1.85, 95%CI 1.32~2.59), compared with the absence of thyroid antibodies. Conclusion Pregnant women with thyroid antibodies have an increased risk of complications, especially miscarriage. Future research,should focus on the treatment and thyroid disease on pregnancy outcome.

Radical pancreaticoduodenectomy is extremely important for patients who suffered from pancreatic head cancer achieving long-term survival.Accurate understanding on composition of resection margin of pancreaticoduodenectomy specimens is pivotal for standardized labeling and testing.Standardization of pathological examination and accurate diagnosis of surgical margin status play an important role in prognosis of patients.Currently,different centers have a different definition of surgical margins for pancreatic head cancer.In this paper,based on the related literature,the authors discuss issues related to surgical margins of pancreatic head cancer.

Objective Orthogonal design was employed to determine the best techniques in processing Carbonized Imperata Cylindrical. Methods UV was used to detect the absorption force and tannis in Carbonized Imperata Cylindrica by different kinds of processing methods. Results The best technique is to bark the drug for 4 minutes at 270 ℃. Conclusion The optimized processing technique was proved to be reasonable by the repeated test.

AIM:To compare the analgesic efficacy and safety of intravenous morphine or epidural morphine combined with bupivacaine in postoperative children.METHODS:48 children scheduled for selective inferior belly or lower limb surgery under general anaesthesia or epidural anesthesia for ASA I or II,age from 3 to 10 years old,were randomly divided into 3 groups(n=16 each).Group A was given intravenous morphine for postoperative analgesia,group B was given epidural morphine in combination with bupivacaine,group C was given nonsteroidal anti-inflammatory drugs orally or pethidine intramuscularly in need as the control group.When the patients were fully awake in the recovery area,heart rate(HR),blood pressure,peripheral oxygen saturation(SpO2),respiratory rate and pain were recorded at 2,4,8,12,24 and 48 h postoperatively,side-effects were also noted.Pain was assessed using an objective pain score(OPS).RESULTS:There was no significant difference of OPS between group A and B,and the efficacy and duration of analgesia in group A and B were significantly better than those in group C(P

This article reviewed occurrence of ADR of clinical external use of 50 Chinese medicinal herbs, such as Verbascum Thapsus, Ranunculus Sceleratus, and Euphorbia Esula. It summarized from foundation, property, efficacy, clinical manifestation, and classification of ADR, and discussed early warning ways of ADR from TCM external use, with a purpose to provide references for TCM reasonable medication.

AIM: To explore the long-term efficacy of Q-factor guided laser epithelial keratomleusis ( LASEK ) for myopia and astigmatism with positive Q-factor.
METHODS: There were 158 eyes which were myopia and astigmatism with positive Q- factor taken in two groups randomly: 86 eyes accepted Q - factor guided LASEK as observation group and 72 eyes accepted routine LASEK as control group. The difference between the two groups about all data was similar. The uncorrected visual acuity ( UCVA ) and the best corrected visual acuity ( BCVA ) as well as diopter, ocular tension, corneal topography, Keratometry value K, aspherical factor Q, Higher-order aberrations ( HOA ) , corneal thickness by ultrasound and, contrast sensitivity ( CS ) , Haze were examined and compared before and after surgery. All the cased were followed up for 14d, 1, 3, 6, 12mo. And there were no statistical difference among the data before surgery.
RESULTS: After 12mo there were no statistical difference between the two groups about UCVA and BCVA. But the safety index of observation group was 1.10, that of control group was 1. 07. The validity index of observation group was 1. 06, that of control group was 0.99. The HOA of observation group was 0. 45±0. 17μm, and that of control group was 0. 72±0.25μm, there was statistically significant difference (t=-8. 193,P=0. 000). Q factor of observation group was 0. 41±0. 17, that of control group was 0. 77±0. 22, there was significant difference (t=11. 377,P = 0. 028). The contrast sensitivity of 3mo post surgery of patients in the observation group returned to the level of before surgery. But in the control group the contrast sensitivity of the patients did not returned until 6mo.
CONCLUSION:Q-factor guided LASEK for myopia and astigmatism with positive Q-factor is stable, safe and effective. The operation allow for reducing the high order aberrations, maintaining the most asphericity of cornea, saving more in corneal tissue, which cause faster recovery of contrast sensitivity, less haze and better visual quality.

Objective To establishthe sensitivity indexes system for estimating nursing quality which conforms to China's national conditions and have the certain representative among the whole country. Methods After usingStructure-process-outcome as the theoretical framework and surveying the literatures domestic and abroad,a total of 42 nursing management experts from 30 provinces were consulted by the Delphi method,including symposium and two rounds of questionnaire consultation. Results The authority coefficient of the two rounds consultation were 0.89 and 0.91,familiarity coefficient were 0.86 and 0.88 respectively,and the coordination coefficient of expert opinion were 0.20 and 0.25. The sensitivity indexes system for estimating nursing qualityconsists of two level index systems,which were divided into three first level indexes and seven second level indexes. The first level index in-cluded nursing manpower allocation,nursing safety and nursing events,while the second level index includes nurse-inpatient ratio,accuracy rate of identification,the number of medication error events,the number of blood transfusion error events,the number of specimen error events,the number of drug extravasation events and high-risk patient falls (falling bed) incidence. Conclusion The results of this study are reliable. There is a clear definition and interpreta-tion of sensitivity indexes for estimating nursing quality and index monitoring is operable.

Objective To summarize clinical diagnosis and microsurgical treatment method of cerebellopontine angle epidermoid cyst presenting with trigeminal neuralgia.Methods Thirty-seven cases of cerebellopontine angle epidermoid cyst presenting with trigeminal neuralgia treated by microneurosurgery procedure were analyzed retrospectively.Results Complete resection was achieved in 31 cases,and subtotal was achieved in 6 cases,with no operative mortality.Postoperatively,the symptom of trigeminal neuralgia disappeared in 28 cases,was eased obviously in 6 cases,and was eased in 3 cases.The symptom of dizziness in all 6 cases vanished,and hearing in 3 cases was improved.Three cases appeared cerebrospinal fluid leakage,and 4 cases appeared oral herpes.Symptom in 1 case aggravated after 6 months,and oral medicine was ineffective.The pain symptom disappeared after reoperation.Conclusions The suboccipital retrosigmoid approach microneurosurgery is the principal treatment method for cerebellopontine angle epidermoid cyst presenting with trigeminal neuralgia.Microsurgical technique combined with surgical skill is the guarantee for increasing total removal rate of tumors and decreasing complications.

Objective To determine the value of complexed prostate-specific antigen (cPSA) in predicting metastasis in patients with prostate cancer.Methods From January 2012 to April 2014,the clinical data of 74 patients with newly diagnosed prostate cancer in our hospital was retrospective reviewed.The prostate cancer was diagnosed by transrectal ultrasound guided biopsy and postoperative pathologic diagnosis.The patients were divided to 2 groups according to metastases status.There were 38 patients in the group of metastasis and 36 patients in the group of without metastasis.In metastasis group,the bone metastasis was found in 36 cases.There is only one case with lung metastasis and one case with lymph node metastasis.In the group without metastasis,the T stages classification were T1-T2 in 17 cases and T3-T4 in 19 cases.While,10 cases with T1-T2 stage and 28 cases with T3-T4 stage were confirmed in the group with metastasis.There was no statistical significance of T stages and mean age in two groups (P＞0.05).The level of cPSA in the serum was detected by chemiluminescent immunoassay,the level of tPSA,fPSA were detected by electro-chemiluminescent immunoassay,fPSA/tPSA,cPSA/tPSA were evaluated and the corresponding specificity were calculated.The correlation of age with tPSA,cPSA were analysed.The differences in PSA,fPSA/tPSA,cPSA/tPSA were compared between metastasis and non-metastasis group.ROC curve analysis was used to determine the diagnostic value of cPSA and tPSA,In the meantime,area of ROC curves were compared by Z test.Results The age was not related to the value of tPSA (r=-0.09,P=0.12) and cPSA(r=-0.38,P=0.14).The median levels of tPSA,fPSA,and cPSA are 29.88μg/L,2.18 μg/L and 18.86 μg/L in the group without metastasis,respectively.The median levels of tPSA,fPSA,and cPSA were 410.05 μg/L,51.50 μ.g/L and 290.40 μg/L in the group with metastasis,respectively.Significant differences of those results could be found in two groups (P＜0.05).fPSA/tPSA was 0.07 and cPSA/tPSA was 0.79 in the group without metastasis.fPSA/tPSA was 0.08 and cPSA/tPSA was 0.80 in the group of metastasis.fPSA/tPSA (P=0.77),cPSA/tPSA (P=0.64) in patients with metastasis were not greater than in those without metastasis (P＞0.05).The area under the curve of tPSA and cPSA were 0.83 (95％ CI 0.73-0.93) and 0.82 (95％CI 0.73-0.92) respectively.Analysis of ROC curves showed that the AUC for cPSA is not significant different from tPSA (Z=1.64,P=0.10).The specificity of cPSA was 22.2％ which is higher than that of tPSA (19.4％) at a sensitivity of 92.1％ in predicting metastasis comparing with the patients without metastasis.The sensitivity could reach to 90.0％ when the cut off value of tPSA was 9μg/L or the cut off value of cPSA was 7 μg/L.Conclusions In our study,a preliminary validation that cPSA is useful for predicting the metastasis in patients with prostate cancer was made.

Objective Toexploretheclinicalefficacyandtoxicityofintensitymodulatedradiationtherapy(IMRT)combined with high intensity focused ultrasound(HIFU) for inoperatable recurrent hepatic carcinoma after operation and TACE .Methods Total 60 patients with inoperatable recurrent hepatic carcinoma after operation and TACE were randomly divided into two group ,30 patients in observation group received IMRT and HIFU ,while 30 patients in control group received only IMRT .For both groups , the same radiotherapy technic was given with IMRT in 6 MV X‐ray ,the total dose was 54 -70 Gy/6 -7 weeks .In observation group ,HIFU was carried out concurrently with IMRT (5 days/week ,6-7 weeks) .Results The difference of the short‐term effi‐cacy between the observation group and the control group was statistically significant (P<0 .05) ,there was no significant difference in acute radioactive toxicity between the two groups (P>0 .05) .The one and two year overall survival rate 89 .9% ,78 .9% in obser‐vation group ,while 72 .8% ,36 .2% in control group ,the differnces were statistically significant (P<0 .05);the one and two year progression‐free survival rate were 85 .9% and 50 .9% in observation group ,while 64 .3% and 28 .1% in control group ,the differ‐ences between two groups were statistically significant (P<0 .05) .The medium survival time was 36 months in observation group , and 24 months in control group;the medium progression‐free survival was 27 months in observation group ,and 17 months in control group .Conclusion For recurrent unresectable or reject surgery after TACE in patients with primary hepatic carcinoma ,the efficacy of IMRT combined with HIFU treatment is effective ,the toxicity can be tolerated ,and has certain application value .