Objective To discuss the safety and efficacy of hysteroscopy in the diagnosis and treatment of intrauterine adhesions (IUA). Methods Clinical data of 108 patients who had been treated by transcervical resection of adhesions (TCRA) under B-ultrasound and/or laparoscopic monitoring from January 1998 to August 2002 in this center were reviewed. Results Intraoperative B-ultrasound monitoring was used in 59 cases and B-ultrasound combined with laparoscopic monitoring was used in 49 cases. Complications occurred in 7 cases (3 cases of hemorrhage and 4 cases of uterine perforation) and were cured after proper treatment. Follow-up checkups in 84 cases showed a total effective rate of 82.1% (69/84). The effective rate in patients with a menorrhea, hypomenorrhea and irregular menstruation was 87.0% (40/46), in patients with infertility and habitual abortion was 42.9% (6/14), and in patients with abdominal pain and failing to remove IUD was 95.8% (23/24). Conclusions Diagnosis and treatment of IUA by hysteroscopy is microtraumatic and effective. B-ultrasound and/or laparoscopic monitoring is the key to the operation safety and success.

AIM To explore the radioprotective function of Xihuang Capsules (Bovis Calculus artijactus,Moschus,Olibanum,Myrrha) in patients with acute radiation-induced oral mucositis and its mechanisms.METHODS Eighty patients with nasopharyngeal carcinoma undergone radiotherapy were randomized into two groups:treatment group (radiation plus Xihuang Capsules) and control group (radiation alone).The comparison of two groups in the onset and the tolerated dose of mucositis was made according to the acute radiation injury classification standard.The levels of TNF-α and IL-6 in saliva were detected by ELISA.RESULTS After the treatment with Xihuang Capsules,the onset of oral mucositis delayed significantly and the tolerated dose elevated markedly comparing with the control group (t =2.180,12.930,P ＜ 0.05).The morbidity rate of Ⅲ-N-degree of oral mucositis in the treatment group was lower than that of the control group at the dosage of 40 Gy and 70 Gy,respectively (Z =3.661,4.270,P ＜0.01).Furthermore,there was no difference in the levels of TNF-α and IL-6 in the pre-treatment in the two groups (t =1.010,1.469,P ＞ 0.05).With the increase in radiant dose,the levels of TNF-α and IL-6 in the two groups both elevated dramatically,and peaked at the dose of 40 Gy,but both levels in the treatment group were lower than those of the control group (t =8.305,6.069,P ＜ 0.05).When DT =70 Gy,the levels of TNF-α and IL-6 were lower than pre-radiation,and the levels of TNF-α and IL-6 in the treatment group were lower than those in the radiation alone group (t =3.835,2.488,P ＜ 0.05).CONCLUSION Xihuang Capsules can delay and reduce acute radiation-induced oral mucositis and improve radiation tolerated dose,so it may involve the release of TNF-oα and IL-6 in saliva.

Objective: To investigate the stability of icariin, 2,3,5,4'-tetrahydroxy-stilbene-2-O-β-D-glucoside and hyperoside in Huangmai mixture.Methods: TLC was used to identify astrogaloside IV and Morindae officinalis Radix, and HPLC was used to determine the contents of icariin, 2,3,5,4'-retrahydroxy-stilbene-2-O-β-D-glucoside and hyperoside.The stability of Huangmai mixture under the conditions of accelerated testing and long-term testing was assessed.Results: Astrogaloside IV, Morindae officinalis Radix and icariin showed good stability during the accelerated testing and long-term testing.The contents of 2,3,5,4'-tetrahydroxy-stilbene-2-O-β-D-glucoside and hyperoside declined quickly during the stability testing.Conclusion: Hyperoside and 2,3,5,4'-retrahydroxy-stilbene-2-O-β-D-glucoside are unstable in Huangmai mixture.A novel solid dosage form of Huangmai should be developed to obtain better stability.

OBJECTIVE:To establish a method for the quality control of Huangmai granules and provide reference for the qual-ity control. METHODS:TLC was conducted to identify the Leguminosae in Huangmai granules and HPLC was used to determine the contents of icariin,hyperin and stilbene glycoside in Huangmai granules. RESULTS:The spots on TLC plates were clear with good reproducibility. The results of HPLC showed that the linear range was 9.969-319.0 μg/ml(r=0.999 9) for icariin , 12.3-196.8 μg/ml(r=0.999 9)for hyperin and 12.64-202.2 μg/ml(r=0.999 8)for stilbene glycoside;RSDs of precision,stability and reproducibility tests were all no more than 2.92%;the average recoveries were respectively 95.44%(RSD=1.46%,n=6), 101.06%(RSD=1.90%,n=6)and 100.51%(RSD=1.73%,n=6). CONCLUSIONS:The method is simple,reproducible,accu-rate and reliable,and can be used for the quality control of Huangmai granules.

Low frequency sensorineural deafness is a common subtype of idiopathic sudden deafness. Certain patients suffered recurrent attacks without vertigo, much alike Meniere's disease. Few of them developed into definite Meniere's disease during long-term follow-up in many clinical studies. Although the pathophysiology of recurrent low frequency deafness is yet unknown, the desease is considered associated with early state of endolymphatic hydrops or migraine. Otologists shall be aware of its clinical course and careful explanation is necessary at time of initial informed consent.
Endolymphatic Hydrops ; complications ; Hearing Loss, Sensorineural ; complications ; diagnosis ; Hearing Loss, Sudden ; Humans ; Meniere Disease ; complications ; Vertigo

Objective To determine the impact of PEE with different ethanol concentration extract on the activity of tyrosinase in B16 melanoma and to explore the feasibility of PEE used as skin whitening agent make use of a model organism .Methods 30%, 50%, 70%, 95%, different concentration of ethanol reflux got four kinds of PEE alcohol extract, respectively.And selected the most active inhibition to mushroom tyrosinase ( PEE30、PEE50、PEE70、PEE95).The effect of extracts from the selected on B16 cell model was determined by MTS, NaOH splitting decomposition, L-DOPA oxidation progress.The change in protein expression level after ethanol extract of PEE was determined by Western bolt.Results The capacity of inhibition to mushroom tyrosinase in each concentration of PEE extraction, but PEE70 had the most active inhibition.When challenged with B16 cell model, PEE70 showed the capacity of decrease in tyrosinase activities and melanin synthesis (P<0.01) and had a does dependence ;it also decreased Tyrosinase and TRP-1 expression compared with control B16 cells.Conclusion These data support the idea that PEE can restrain melanogenesis, through its inhibitory effect on the activity of tyrosinase.

Objective To observe the effect of a novel pressure controlled water jet used in transurethral resection of bladder tumor. Methods Clinical data of 12 patients who underwent a transurethral resection of bladder tumor by using a novel water jet was retrospectively analyzed. Results All 12 cases were successfully operated. Estimated blood loss during operation was less than 5 ml. Operation time was 20-45 minutes (median was 28 min), time of water injection was 8-15 minutes (median was 12 min). There were no significant complications. All patients were followed up for 4-10 months, and tumor recurrence or progression was not found by cystoscopic examination. Conclusion Transurethral resection of bladder tumor by using a novel pressure controlled water jet is advantageous with favorable safety and feasibility.

Objective To explore the association of Crohn's disease (CD) with T cell immunoglobulin and mucin domain 3 (Tim-3) gene polymorphisms in patients of Zhejiang Han population in China.Methods A total of 308 CD patients and 573 age-and sex-matched healthy controls were enrolled in our study.Two single nucleotide polymorphisms (SNPs) of Tim-3 (rs1036199 and rs10515746) were examined by the improved multiple ligase detection reaction technique (iMLDR).Analyses of linkage disequilibrium and haplotype were also performed by Haploview 4.2 software in all study subjects.Results In general,the allele and genotype frequencies of Tim-3 (rs1036199 and rs10515746) were not statistically different between CD patients and the controls (all P ＞0.05).According to the Montreal Classification,CD patients were divided into different subgroups.The variant allele (C) and genotype (AC + CC) of rs1036199 were more frequent in CD patients with penetrating diseases than in the controls (10.4％ vs 1.7％,P =0.002;20.8％ vs 3.5％,P =0.023).Similar conclusions were also drawn for the variant allele (A) and genotype (CA + AA) of rs10515746 in patients with penetrating diseases when compared with the controls (10.4％ vs 2.2％,P =0.000;20.8％ vs 4.2％,P =0.033,respectively).The two SNPs of Tim-3 were in strong linkage disequilibrium (D'=1.0,r2 =0.928).The haplotype (AC) formed by their wild-type alleles (A) and (C) was decreased in patients with penetrating CD compared with the controls (89.6％ vs 98.3％,P =0.000).However,the haplotype (CA) formed by their variant alleles was more frequent in patients with penetrating CD than in the controls (10.4％ vs 1.6％,P =0.000).Conclusions Tim-3 (rs1036199 and rs10515746) variations might be correlated with the enhanced risk of penetrating diseases in CD patients.Furthermore,the haplotype (AC) and (CA) formed by the two SNPs might be a protective and a risky factor for penetrating CD respectively.

Objective To evaluate the clinical significance of intercellular space diameters (ISD)of squamous epithelium by light microscopy (LM) in lower esophagus of erosive reflux esophagitis (ERD),non-erosive reflux disease ( NERD), Barrett esophagus (BE) and healthy controls. Methods A total of 21 ERD and 21 NERD patients with reflux symptoms and confirmed with 24-hour esophageal pH monitoring, 13 BE patients diagnosed by gastroscopy and biopsy, and 20 other healthy controls were enrolled in the study.Samples of ERD, NERD and control group were collected at 2 cm above dentate line, and made HE slides in the conventional way. Images for measurement of ICS were acquired with oil lens ( × 1000). ICS of squamous epithelium was quantitatively measured by computer-assisted morphometry. Ten cells were taken for each sample, 10 consecutive ISD for each cell, i.e. 100 ISD for each subject. Mean ISD was calculated.Results Mean ISDs by LM in control, BE, ERD, and NERD groups were 0. 59, 0. 99, 1.29 and 1.06 μm, respectively. The mean ISDs in BE, ERD, and NERD group were much greater than that in control (P＜0. 05). The mean, maximal and minimal ISDs of group ERD were greater than those of NERD and BE (P = 0. 000). However, the ISDs of NERD and BE are of no significant difference ( P ＞ 0. 05 ). The cut-off value of mean ISD for diagnosis of gastro-esophageal reflux disease (GERD) was 0. 85 μm. Diagnostic sensitivity and specificity for ERD, NERD and BE were 89. 1% and 100. 0%, with reference to clinical symptoms, endoscopy and ISDs above the cut-off value. Conclusion Larger ISDs in lower esophagus by using LM will be found in all subgroups of GERD, including ERD, NERD and BE. Increased ISDs may be one of the markers for diagnosis of ERD, NERD and BE.

Basic life support ( BLS ) is a very important clinical skill for medical students. However,current BLS education is lack of proper BLS skills evaluation protocol to give educational feedback both to instructors and students. This article is aimed to discuss the necessity of protocol of skills evaluation in basic life support education for medical students prior to their internship.