Objective To discuss the safety and efficacy of laparoscopic modified ventrifixation for women with uterine prolapse.Methods Thirty-seven women with Ⅱ-Ⅳ degree uterine prolapse were undergent laparoscopic modified ventrifixation in the the First Hospital of Qinhuangdao and Anzhen Hospital of Beijing from January 2008 to June 2012.The midpart of a noabsorble PROLENE soft mesh was sutured to the anterior cervical fascia.Two back ends of the mesh were passed through extraperitoneal channels through ligamentum latum uteri and sutured to the abdorminal wall to fix uterus.The effect and complications were observed.Results The objective and subjective success rate were 100％ and 91.9％ respcetively at 6 months after operation.All patients were followed up for 6 to 48 months.Prolapse recurrence rate was 10.8％ (4/37).Conclusion Laparoscopic modified ventrifixation is effective,safe and mini-invasive in the treatment of uterine prolapse.The surgery may be a satisfactory procedure for women with uterine prolapse hoping for uterine preservation.

Objective To study the clinical manifestation of preeclampsia complicated with placental abrup-tion and its treatment measures.Methods 160 patients with placenta abruption were selected,and the patients with preeclampsia complicated with placental abruption were selected as the study group(70 cases),and the patients with non preeclampsia complicated with placental abruption were selected as the control group(90 cases).The clinical manifestations,infant outcome and treatment measures of the two groups were compared.Results When the disease attack of the study group often accompanied with vaginal bleeding,but few had symptoms of abdominal pain,the main symptoms of the control group was vaginal bleeding and abdominal pain.The occurrence rate of abdominal pain of the two groups had statistically significant difference(4.3%vs 92.2%,χ2 =11.032,P<0.05);The placental abruption of the study group wasⅡdegree andⅢdegree(81.4%)while the control group wasⅠdegree(62.2%),with signif-icant difference between the two groups(χ2 =10.973,P<0.05);The incidence of fetal distress of the two groups had no statistical significant difference(95.7% vs 93.3%,P>0.05);The incidence of neonatal asphyxia of the two groups had no significant difference(56.6%vs 55.6%,P>0.05);The perinatal mortality of the two groups had sta-tistically significant difference(31.7%vs 11.1%,P<0.05);1 case of patient′s cervix was fully opened in the study group when at 28 weeks gestational,and been given the vaginal delivery,all others were given operation to terminate the pregnancy,3 cases in the control group used the vaginal delivery,there was no significant differences between the two groups(P>0.05).Conclusion The clinical manifestation of preeclampsia was not typical,with a greater harm to the fetus and perinatal infant,operation to termination of pregnancy is the main method for treatment of preeclamp-sia complicated with placenta abruption.

Objective:To investigate the clinicopathological and immunohistochemical features, histogenesis and biologic behaviors of choroids plexus tumors of the cerebellopontine(CP) angle. Methods:Four cases of choroids plexus tumors of the CP angle were studied by histopathological analysis, immunohistochemical staining and electron microscopic examination. The literatures were review emphasising the diagnostic criteria, differential diagnosis and histogenesis. Results:The histopathologic features of choroid plexus tumors of the CP angle were identical to that in the ventricular system. Immunohistochemical analysis showed that S-100, vimentin and CK of the tumor cells express positive. Choroid plexus papilloma expressed GFAP. The carcinoma of choroid plexus expressed CEA as well. Conclusion:Choroid plexus tumors arising in and occupying the CP angle are rare. The final diagnosis can be made by pathologic examination. The histogenesis may be the small choroid tuft protruding from the foramen of Luschka into the CP angle.

Objective To develop a scale for measuring CHD patients' health belief and to rectify its reliability and validity.Methods The primary items were obtained through reviewing literature and semi-structured interviewing with CHD patients.After team discussion and experts evaluation,the pretesting scale was developed.Two hundred and sixty subjects were recruited in the first study to finish the questionnaire by convenience sampling.The reliability and validity of this scale were tested by exploratory factor analysis,reliability analysis and correlation analysis.Results It was found that eight common factors extracted by exploratory factor analysis.Factor loading of each item ranged between 0.489 and 0.850.The 8 factors explained for 60.698％ of total variance.The correlations between the subscales and the total scale were ranging from 0.811 to 0.876.The correlations between the subscales of the scale were ranging from 0.330 to 0.732.The Cronbach's α coefficients of the total scale was 0.802,and the subscales Cronbach's α coefficients were ranging from 0.684 to 0.834.Test-retest reliability was 0.880,and that of subscales were 0.673～0.841.Conclusions The newly developed coronary artery disease health belief scale has showed acceptable reliability and validity,which can be used as a useful tool for the assessment and intervention of patients' health belief.

Objective To offer the theoretical evidence for clinical application,we observed the changes of angiographic appearances and local pathological changes before and after embolizing the left gastric artery with mitomycin C gelatin microspheres (MMC-MS).Methods Catheter was delivered into the left gastric arteries via femoral artery and then infused MMC-MS.The angiographic appearances and local pathological changes were observed immediately,and then with follow up of 6～8h,24h,72h,1w,2w and 4w. Results The minute arterioles of tunia mucosa and tela submucosa were mainly embolized inducing edema and focal necrosis.With the degradation of MMC-MS,the damage of gastric tissue was alleviated but turned normal after 4 weeks.The results of DSA showed that no recanalization of the embolized vessels occurred after one week of emboliatdion but revealed one recanalization after two weeks and two in four weeks.Conclusions The damage of tissue induced by embolizing the left gastric artery with MMC-MS can be recovered.The application of the MMC-MS is feasible.

Objective To evaluate the role of transvaginal color Doppler ultrasound measurements of endometrial thickness,endometrium and subendometrial blood distribution patterns and flow index in predicting endometrial receptivity and pregnancy outcome of freezing embryo transfer(FET).Methods 468 cycles FET were analysed retrospectively.Endometrial thickness,endometrium and subendometrial blood distribution patterns,pulsatility index (PI),resistance index (RI),systolic /diastolic ratio (S/D) of endometrial and subendometrial blood flows with transvaginal ultrasonography were measured on the day of progesterone initiation.Based on the clinical pregnancy or not,patients were divided into two groups.The comparison of these indicators were carried out between pregnant group and non pregnant group.Results The endometrium and subendometrial blood distribution patterns had statistical difference between the two groups(P ＜0.05),the clinical pregnancy rate of Ⅰ,Ⅱ,Ⅲ blood distribution patterns were 31.0％,62.5％,79.0％ respectively.In the pregnancy group,the S/D,PI,and RI of endometrium were significantly lower than those in the nonpregnant group (P ＜ 0.05),and there was no significant difference between the pregnant group and nonpregnant group in endometrial thickness(P ＞0.05).Conclusions Endometrium and subendometrial blood distribution patterns and flow index measured with transvaginal color Doppler ultrasound could assess endometrial receptivity and guide the time selecting of FET transplantation.

Objective To study the prognostic value of procalcitonin(PCT) and C?reactive protein ( CRP ) in critically ill patients with ventilator?associated pneumonia ( VAP )?Methods A single?center prospective observational study was conducted?A total of 67 cases patients with VAP admitted into intensive care unit(ICU) from November 2013 to October 2015 were enrolled and grouped as survivors(43 cases) and non?survivors(24 cases)?Blood samples for PCT and CRP were collected on the day of the pneumonia diagnosis,and the 4th and 8th day after the diagnosis?Results There were 24 cases(35?8 %) died among the 28 days after the pneumonia diagnosis?There was no significant difference between the survivor and non?survivor groups in terms of PCT on the day of the pneumonia diagnosis( P>0?05) ,or CRP on the day of the pneumonia diagnosis, and the 4th and 8th day after the diagnosis ( P>0?05)?But the PCT values on the 4th and 8th day were significantly higher in the non?survivor group than the survivor group(4 d:0?4(0?3,1?1) μg/L vs?4?7(2?3, 10?8) μg/L,P<0?05;8 d:0?2(0?1,1?7) μg/L vs?3?9(3?2,14?8) μg/L,P<0?05)?PCT levels decreased significantly from the day of the pneumonia diagnosis(0?7(0?4,4?2) μg/L) to the 8th day after the diagnosis (0?2(0?1,1?7) μg/L,P<0?05) in the survivor group?The PCT level above 1 μg/L on the 4th day after the diagnosis was the strongest predictor of mortality,with an odds ratio of 23?Conclusion PCT is found to be a more important prognostic marker compared to CRP in terms of predicting mortality in critically ill patients with VAP?The PCT level on the 4th day after the diagnosis is the strongest predictor of mortality in VAP.

Basic surgical skills tralning which belongs to the basic course of surgery, is clini-cal basis for the medical students. The teaching practice of basic surgical skills tralning was explored by the Affiliated Hospital of Inner Mongolia Medical University, the theoretical teaching was combined with skills tralning practice, three kinds of means which contalned the model, animal tissues and or-gans in vitro and animal experiment were used to carry out systemic and standardized tralning. Finally, the basic surgical skills of postgraduate in surgery were improved, and the expected alm of teaching was achieved.

Objective:This study aims at exploring the impact of the health resources allocation on healthcare seeking behavior of inpatients with different income in China. Methods:Data at individual level were collected from China National Health Service Surveys conducted in 2008 and 2013 , interlinked with the data of health resources in county level. Multilevel zero-inflated negative binomial regression and multilevel multinomial logit model were respec-tively used to examine the impact of the health resources allocation on inpatient visits and the influence of the choice of healthcare providers by inpatients. Results: The results show that the increase of the number of beds in primary health centers ( PHCs) and physicians in county hospitals increased inpatient visits within counties. The investments in health resources in PHCs had greater impact on improving the likelihood of inpatient visits within counties for the low-income populations than that for the high-income populations. Conclusion: Investments in health resources in PHCs are vital to improve the healthcare seeking behaviors of the low-income populations in China.

Objective To investigate sedation of dexmedetomidine versus midazolam on me-chanically ventilated patients.Methods Seventy-six mechanically ventilated patients were randomly divided into midazolam group (group M)and dexmedetomidine group (group D).The loading dose and maintenance dose of midazolam was 0.06 mg/kg and 0.04-0.2 mg·kg-1 ·h-1 ,and 1 μg/kg and 0.2-0.7 μg·kg-1 ·h-1 for dexmedetomidine.The drug dose was adjusted according to Ramsay score scale.Time when Ramsay reach 2-4 score,the length of ICU stay,mechanical ventilation time,drug adverse reactions,the levels of inflammation factors were recorded and compared between two groups.Results The length of ICU stay and arousing time in group D was significantly lower than that of group M (P <0.05).The levels of TNF-α,hs-CRP in group D were lower after 24 hr treat-ment than that of group M(P <0.05).The levels of hs-CRP in group D were lower after 48 hr treat-ment than that of group M (P <0.01).Conclusion Dexmedetomidine treatment reduced the lengh of ICU stay and levels of inflammatory factors of mechanical ventilated patients.