The present paper has reviewed and researched on 112 gynecological records from volume 17 ofZhang-Yuqing’s medical records, and has found that there were 9 common methods of treating gynecological diseases, namely dredging and regulatingqi and blood, adjusting qi to nourish ying, soothing the liver wood, harmonizing the liver and spleen (stomach), tonifying spleen and kidney, nourishing liver and kidney, regulating vital and conception vessels, eliminating dampness and phlegm, and nourishing Yin and clearing away heat.The treatment of gynecological diseases reflects the holistic concept and dialectical concept, and the valuable experience still has a high theoretical value, as well as clinical value, which is worth exploring and discussing.

Objecive To evaluate the causes of 60 cases for clinical failure in post crown.Methods Sixty cases with failure in post crown cure were entered the study.The causes of failure were analyzed.Results Among the 60 cases with failure in post crown cure,38 cases were due to the crown'loosing or broken away,12 cases with the broken dental crown,10 cases with periapical periodontitis,6 cases with broken root.Conclusions It was the loosing or broken away of post crown,periapical periodontitis,dental crown and root broken consist of the main causes for clinical failure in post crown.

Objective To investigate the effects of hippocampal neurogenesis in spatial learning and memory,especially in spatial long-term memory.Methods Totally 24 wistar rats were randomly divided into two groups:normal control group (NC group,n =12) and irradiation group (IRR group,n =12).We use low-dose irradiation at subgranular zone to inhibit adult hippocampal neurogenesis and new neurons were investigated by 5-Bromo-2-deoxyUridine/neuron specific nuclear protein double-labeling.Four weeks after irradiation,Morris water maze,including navigation test and space exploration assay,was used to detect spatial leaming and memory.Then,in the day 8 and day 15 after the navigation test,space exploration assay was repeated to detect spatial long-term memory.The expression levels of postsynaptic density protein 95 and synaptophysin were evaluated using western blot and real-time quantitative PCR.Results Hippocampal neurogenesis was inhibited by low dose irradiation(2.80 ± 0.44 vs 23.50 ± 1.12,t =20.21,P ＜ 0.01).After the inhibition,the escape latency did not change,while the time spent in target quadrant was significantly declined in the day 2((14.76 ±.2.04) s vs (20.47 ± 1.29) s),day 8((11.95 ± 1.34) s vs (19.52±1.43) s)and day 15((11.79 ±1.35) s vs (21.58 ±1.07) s) after the navigation test (t=2.45,P＜0.05; t =3.76,P＜0.01; t =5.39,P＜0.01).The postsynaptic density protein 95 and synaptophysin expressions were significantly decreased in IRR group.As to the RNA levels,there was also a significant difference between the two groups.Conclusion Hippocampal neurogenesis in the dentate gyrus plays an important role for the formation of spatial long-term memory.

Objective To investigate the ultrasound imaging findings of anatomical relationship between femoral artery and vein in children of different ages.Methods Sixty-five children aged 4 months-7 years were enrolled in this study.The children were divided into 3 age groups: group Ⅰ＜ 1 yr;group Ⅱ 1-3 yr and group Ⅲ＞ 3,≤ 7 yr.A protable ultrasound machine was used.The probe was placed at the level of inguinal ligament and 2 and 4 cm below inguinal ligament.The children were placed in supine position.The legs were placed in 2 positions:(1)extended and in standard anatomical position and(2)flexed and 45° abducted and 45° laterally rotated.Results The examination showed that at the level of inguinal ligament,the femoral vein lay behind and lateral to femoral artery in 91% of children.At the level of 4 cm below inguinal ligament,the femoral vein lay posterior and lateral to the femoral artery in all children.When the leg was placed in abducted and laterally rotated,the depth of femoral vein was reduced and the vein was less overlapped by artery in all children,especially in preschool children.Conclusion At the level of 4 cm below inguinal ligament,the femoral vein lies posterior and lateral to the femoral artery in children.When the leg is placed in abducted and laterally rotated,the depth of femoral vein is reduced and the vein is less overlapped by artery.It is indicated that femoral vein puncture should be performed at the level of 4 cm below inguinal ligament with the leg flexed and abducted in all children,especially in preschool children.

Objective To retrospectively review the history and development of radiotherapy quality assurance ( QA) in the Affiliated Cancer Hospital of Fudan University, and to report the primary experience and evolvement of an entire QA workflow management. Methods The multidisciplinary QA team has implemented an entire QA workflow management process in the Radiotherapy Center using the failure modes and effects analysis ( FMEA) and plan?do?check?act ( PDCA) tool since April 2015. Treatment data of approximately 6000 patients before and after implementation were compared. Results The error rate was reduced from 17% to 09% after using the entire QA workflow management. Conclusions Entire QA workflow management effectively improves the accuracy and safety of radiotherapy.

Objective To investigate the effects of granulocyte-macrophage colony-stimulating factor (GM-CSF) on the generation of human myeloid derived suppressor cells (MDSCs) relied on peripheral blood monocytes,and to establish efficient induction system in vitro of MDSCs.Methods Kidney transplantation recipients between January and March 2017 were included in this study.Purified CD14 + cells isolated from peripheral blood were cultured in the presence of GM-CSF with different concentrations for 7 days.Phenotypes and immunosuppressive abilities of induced MDSCs (iMDSCs) were investigated with FACS analyses.Inducible nitric oxide synthase (iNOS) mRNA expression was detected by qRT-PCR to determine the influence of iNOS-pathway on the immunosuppressive abilities of iMDSCs.Results A total of 11 recipients were included in this study.HLA-DR expression decreased sharply after the culture with GM-CSF.iMDSCs showed the similar phenotype characteristics with monocytic-MDSCs (M-MDSCs) as well as significant ability to suppress T cells proliferation and cytokines production.iMDSCs expressed higher levels of iNOS than monocytes,and the inhibitor effects of iMDSCs were significantly reduced after treatment with L-NMMA (1 mmol/L).The variations of phenotype and suppressive ability were concentrationdependent,and more significant changes could be revealed in the group of 10 μg/L GM-CSF.Conclusion GM-CSF-treated peripheral blood monocytes can be efficiently transformed to M-MDSCs,and suppress T cells proliferation and cytokines secretion via iNOS-dependent pathway.These results may contribute to establish MDSCs induction system,which would provide a basis for the clinical application of MDSCs.

Objective To approach the clinical presentation,treatment and diagnosis of primary seminal vesicle carcinoma.Methods The records of 4 patients who diagnosed seminal vesicle carcinoma were retrospectively reviewed,including the symptoms signs and examination results as well as operation program,postoperative therapy.Considered to the literature reports.Bilateral seminal vesicles,bladder, prostate and rectum were totally removed in one case.Seminal vosiculectomy and partial cystoprostotectomy were performed in 2 cases,and the another one,bilateral lower ureterectomy and ileum substitute bladder was be done.Results Followed up for 3 months to 5 years,and no recurrence had been observed so far, one died of colon cancer after 2 years.Conclusions Early symptoms of primary seminal vesicle carcinoma are unobvious,so that early diagnosis of seminal vesicle carcinoma is difficult and the misdiagnosis is so usually.Thus,accurate recognition is important for early diagnosis.Radical surgery appears to offer the best chance and different approaches can be selected according to tumor stage and invasive condition of the circumambient organ.Comprehensive treatment like hormonal therapy,along with the 5-fluorouracil,paclitaxel,and oxaliplatin chemotherapy regimen appears to be effective against adenocarcinoma.

To observe therapeutic effect of levosimendan on acute heart failure (AHF) and its impact on cardiac function ,levels of brain natriuretic peptide (BNP) ,high sensitive C reactive protein (hsCRP) ,tumor necro‐sis factor (TNF)‐α and interleukin (IL)‐6. Methods :A total of 148 AHF patients treated in our hospital from Jan 2016 to Jan 2018 were randomly and equally divided into dobutamine group and levosimendan group ,both groups re‐ceived corresponding medication based on routine treatment for 21d.Cardiac function ,levels of plasma BNP ,serum hsCRP ,TNF‐α and IL‐6 ,6min walking distance (6MWD) before and after treatment ,total effective rate and inci‐dence of adverse reactions were observed and compared between two groups .Results :Total effective rate of levosi‐mendan group was significantly higher than that of dobutamine group (83. 78% vs.68.92%) , P＝0.033. Compared with dobutamine group after treatment , there were significant rise in LVEF [ (49. 98 ± 3. 68 )% vs.(52.17 ± 3.82)%] ,stroke volume [SV ,(67. 52 ± 5. 79) ml vs.(69. 48 ± 5. 83) ml] and 6MWD [ (328.46 ± 31.62) m vs. (396.75 ± 31.89) m] ,and significant reductions in left ventricular end systolic dimension [ (54. 12 ± 8.64) mm vs. (51.31 ± 8.26) mm] ,left ventricular end diastolic dimension [(65.25 ± 8. 86) mm vs.(62.14 ± 8.57) mm] ,levels of plasma BNP [ (572.59 ± 89. 62) mg／ml vs .(351.78 ± 81. 41) mg／ml] ,serum TNF‐α [ (24. 68 ± 5.83) ng／L vs. (21.05 ± 5. 39) ng／L] ,IL‐6 [(21.36 ± 4. 51) ng／L vs.(18.29 ± 4.34) ng／L] and hsCRP [(4. 89 ± 2. 15) ng／L vs. (3. 06 ± 1.47) ng／L] in levosimendan group , P＜0. 05 or ＜0. 01. There was no significant difference in incidence rate of adverse reactions during treatment between two groups , P＝0.690. Conclusion :Compared with dobutamine , levosimendan possesses more significant therapeutic effect on AHF .It can more significantly improve cardiac func‐tion ,exercise capacity and reduce cytokine levels in these patients .

Objective:After the propensity score matching method was used to balance the covariates between groups, the effects of pancreaticoduodenectomy (PD) and total pancreatectomy (TP) on the survival of patients with pancreatic head cancer and related prognostic factors were compared.Methods:The National Cancer Institute Surveillance, Epidemiology and Results (SEER) database were searched and 3 676 patients with pancreatic head cancer from 2010 to 2016 were selected, of whom 3 559 patients underwent PD (PD group) and 117 patients underwent TP (TP group) . Using propensity score matching to balance confounding factors, 117 pairs of cases from PD group and TP group were matched successfully. The Kaplan-Meier curve was used to observe the overall survival rate and cancer-specific survival rate of patients before and after matching. Log-rank test and Cox proportional hazard model were used to analyze and evaluate the impact of different clinicopathological characteristics on the prognosis of patients with pancreatic head cancer.Results:Before matching, the 1, 3, and 5-year cancer-specific survival rates of 3 559 patients in the PD group were 72.8%, 35.1% and 24.9%, and the median survival time was 23.89 months; the 1, 3, and 5-year cancer-specific survival rates of 117 patients in the TP group were 67.9%, 29.4% and 26.1%, and the median survival time was 21.51 months, and all the differences were not statistically significant (all P>0.05). After matching, the 1, 3, and 5-year cancer-specific survival rates of 117 patients in the PD group were 77.8%, 44.5% and 31.8%, and the median survival time was 31.50 months, which was significantly better than that of the TP group, and the differences were statistically significant (all P values <0.05). Cox regression analysis showed that surgical methods, tumor differentiation degree, N staging and pathological types were independent risk factors for overall survival and cancer-specific survival. Conclusions:Surgical methods, tumor differentiation degree, N stage and pathological type were independent risk factors affecting the overall survival rate and cancer-related survival rate. The survival benefit of PD was significantly better than that of TP, and the clinical choice of TP treatment for patients with pancreatic head cancer should be cautious.

Complement is an important element of immune system playing vital roles in immune surveillance and tissue homeostasis. Increasing evidence shows that complement activations not only protect the body, but contribute to the occurrence and development of autoimmune diseases. Inappropriate activations of complement may also lead to or aggravate various neuro-immunological diseases, including neuromyelitis optica spectrum disease, myasthenia gravis and Guillain-Barré syndrome. Several complement-targeted therapeutics have emerged in recent years, established themselves as popular clinical research topics associated with various autoimmune diseases. Following that note, this review introduces mechanisms of complements participating in autoimmune diseases of the nervous system and the latest development of complement-targeted therapeutics, with the view to contributing to the development of this emerging therapeutic field.