Objective To discuss and validate which method is more effectiveness for central placenta previa through analysing the clinical outcomes of the management of hemorrhage between uterine packing and stitching hemo-stasis during cesarean section.Methods 48 pregnant women with central placenta previa was conducted in this ret-rospective study,which were all cesarean section delivery.These patients were divided into two groups.24 patients with uterine packing with gauze in the control of massive hemorrhage during cesarean section were indetified,other-wise,the other 24 patients were conducted with sewing and ligation uterine.And then,the effectiveness and outcomes were compared.Results These all patients were alive and keep the uterus.The average estimated blood loss of the stiching group was (554 ±327)mL,obviously less than the uterine packing group,which was (828 ±584)mL,and the difference was statisatically significant (t =6.689,P<0.01 ).The rate of blood transfusion during operation was 8.33% (2/24)in the group of stiching,and was 50.0%(12/24)in the uterine packing group(P<0.05).Similar-ly,the operation time of the stiching hemostasis group,which was (48.9 ±10.0)min,was evidently shorter than (68.3 ±13.3)min of the other group(t=8.126,P<0.01).The two groups had no significant difference in therate of primary healing of incision,postoperative fever and admission time(P>0.05).Conclusion The uterine stiching is an effective,rapid and simple technique in the control of hemorrhage of central placenta previa.

OBJECTIVE:To observe the influence of capecitabine combined with radiotherapy on postoperative survival rate, relapse rate and survival quality of elderly patients with rectal cancer at Ⅱ-Ⅲ stage. METHODS:110 patients with rectal cancer atⅡ-Ⅲ stage were selected and randomly divided into control group and observation group with 55 cases in each group. Both group received radical resection of rectal carcinoma. Control group was given three dimensional conformal radiation therapy(3DCRT)af-ter operation;observation group was additionally given capecitabine 1 500 mg/m2,d1-14,qd,on the basis of control group. A treatment course lasted for 21 d,and both groups received 2 courses of treatment and followed up for 3 years. The survival rate and metastasis and recurrence rate of 2 groups were compared as well as KPS score before and after treatment. Toxic reaction of 2 groups was also observed. RESULTS:The follow-up total survival rate and disease-free survival rate of observation group were 89.09%and 76.36%,which were significantly higher than 74.55%and 54.55%of control group;the distant metastasis rate and lo-cal recurrence rate were 12.73% and 5.45%,which were significantly lower than 30.91% and 21.82%,with statistical significance (P<0.05). KPS score of 2 groups were increased significantly,between 2 groups before and after treatment ,with statistical signifi-cance(P<0.05);Comparison between groups(P>0.05). There was no statistical significance in the incidence of nausea and vom-iting,diarrhea and urinary tract reaction between 2 groups (P>0.05);but the incidence of bone marrow arrest in observation group was significantly higher than control group(P<0.05). CONCLUSIONS:Capecitabine combined with 3DCRT can effectively improve postoperative distant survival rate of patients with rectal cancer at Ⅱ-Ⅲ stage,and reduce the metastasis and recurrence risk;do not lower life quality and induce serious adverse reactions.

Objective To analysis the varying degrees of the M protein staining after immunofixation electrophoresis(IFE)and study its applications in clinical diagnosis.Methods 196 cases of clinical serum samples were tested by using IFE,we analyzed the positive electrophoretic bands of M protein and performed statistical analysis by using SPSS17.0.The M proteins were analyzed ret-rospectively.Results 103 patients were diagnosed with monoclonal gammopathy in 196 patients with positive M protein bands,in-cluding 96 cases of multiple myeloma(MM)and 7 cases of other monoclonal gammopathy;93 patients were non-monoclonal gam-mopathy.By analyzing the M band staining in different clinical groups,we found that M bands were mainly with dense and thick staining in monoclonal immunoglobulin group,the dense staining rate of MM was 90.6%,and the difference between MM and the other monoclonal gammopathy was not significant(P >0.05).In contrast,M bands were in light and narrow staining in non-mono-clonal immunoglobulin group,the rate of which was 25.8%,the difference between non-monoclonal immunoglobulin group and monoclonal immunoglobulin group was statistically significant(P <0.01).The proportion of allelic band in MM,other monoclonal gammopathy,non-monoclonal gammopathy were 39.6%,28.6% and 2.2% respectively,the differences were statistically significant (P <0.01).Conclusion The M band,accompanied by allelic band in IFE staining,is helpful in the diagnosis of monoclonal gam-mopathy,especially MM.The appearance of M protein provides early warning of monoclonal gammopathy.

Objective To investigate the high risk factors of chlamydia (CT) infection in female.Methods Enzyme linked immunosorbent assay was used to detect 120 cases of gynecological clinic,including 60 cases asymptomatic patients before abortion and 60 cases patients with symptoms of mild genital itching,vaginal secretions slight increased.CT antigen in uterine cervix were detected,and the relationship between its symptoms,age,birth time,contraception,cervical condition,the number of sexual partners,mycoplasma and CT infection were analyzed.Results Among 120 cases,there were 28 cases of CT positive,positive rate was 23.3％ (28/120).CT infection rate of symptomatic and asymptomatic patients was 16.7％,30.0％ respectively,the difference was not significant(P＞0.05).The CT infection rate of patients' age younger than 30 years was 27.8％,higher than older than 30 years (10.0％),the difference was significant(x2=3.975,P＞0.05).The CT infection rate of patients had multiple sexual partners in nearly lyear was 62.5％,higher than that had one sexual partner(9.0％),the difference was significant(x2=37.42,P＞0.05).The CT infection rate of patients didn't use contraceptive tools was 29.1％,higher than that used contraceptive tools(12.2％),the difference was significant(x2=4.319,P＜0.05).Conclusion The symptoms of CT infection are no specificity,should be targeted at screening for patients have high-risk factors,such as age less than 30 years old,have multiple sexual partners nearly 1 year and don' t use contraceptive tools.

? amyloid protein(A?) including A?40 and A?42 are the important bioactive substances in vivo.Their toxic and beneficial attributes in the body depend on its concentration.The brain A? level is maintained by two balances under the physiological condition.The first balance is the generation involved in ?-secretase and ?-secretase and the degradation involved in neprilysin(NEP) and insulin-degrading enzyme(IDE) of A?. The second one is the balance between the receptor for advanced end glycation products(RAGE)-mediated influx and low-density lipoprotein receptor related protein 1(LRP1)-mediated efflux of A? across the blood-brain barrier(BBB).Breakdowning any one of the two balances would result in the aggregation and precipitation of A? in the brain,which is a crucial event in the pathogenesis of Alzheimer's disease(AD).This paper reviews the regulation of brain A? level under the physiological condition and the reducing strategies on the level of brain A? under the pathological condition for developing new drugs in the treatment of AD.

OBJECTIVETo establish social stress induced depression-like model in mice of C57BL/6 strain, and to assess its reliability using differenf behavioral methods.

METHODSTotally 20 male mice of C57BL/6 strain were divided into the normal group and the stress model group by random digit table,10 in each group. Another 10 CD1 mice were subjected to social stress. Mice in the normal control group received no stress, while those in the model group received social stress for 10 successive days. Behavioral assessment was performed using social interaction test (SIT), the elevated plus-maze (EPM) test, tail suspension test (TST), respectively. Serum cortisol level was detected by ELISA to assess the reliability of the model.

RESULTSIn the social interaction test when the social target (CDI mice) was inexistent, mice in the normal control group spent longer time in the social interaction zone and less time in the corner zone (P < 0.05); mice in the model group spent less time in the social interaction zone and more time in the corner zone (P < 0.05). Compared with the normal group when CDI mice existed, mice in the model group spent less time in the social interaction zone and more time in the corner zone (P < 0.05). Compared with the normal control group, the total times for entry into open arms, close arms, and the maze were obviously reduced (P < 0.05), and the proportion of entering open arms was significantly reduced (P < 0.05) in the model group. In TST, the motionless time within the last 4 mm was prolonged in the model group (P < 0.05). The serum cortisol level in the model group was obviously elevated (P < 0.01).

CONCLUSIONSocial stress induced depression-like animal model in mice of C57BL/6 straineasquite reliable and possibly suitable to be used in integrative medicine research of combination of disease and syndrome model.

Animals ; Behavior, Animal ; Depression ; physiopathology ; Disease Models, Animal ; Hydrocortisone ; blood ; Male ; Mice ; Mice, Inbred C57BL ; Social Behavior ; Stress, Psychological

Humans ; Hyperthyroidism ; Infant, Newborn

OBJECTIVETo explore the clinical effects of minor bone anchors and palmaris longus tendon graft in treating chronic mallet fingers deformity.

METHODSFrom January 2008 to June 2013, 26 patients with chronic mallet fingers deformity were treated with minor bone anchors and palmaris longus tendon graft. There were 18 males and 8 females, aged from 18 to 52 years old with an average of (32.0±1.3) years. Among them, 8 cases caused by machine injury, 6 cases by fall injury, 6 cases by sprain from fight, 4 cases by tendon spontaneous rupture, 2 cases by knife trauma. There was no tendon attachment of extensor tendon check in 16 cases, and with 0.3 to 0.5 cm tendon attachment in 10 cases. All patients had the flexion deformity and the disability of dorsiflexion activity. During operation, the distal interphalangeal joint was fixed in 10° to 20° dorsiflexion by a Kirshner wire, the minor bone anchor was used to reconstruct the extensor tendon insertion, the palmaris longus tendon slice was transplanted the decayed area of extensor tendon insertion. Four weeks postoperatively, the Kirshner wire was removed and the plaster external fixation was used, and the patient began function exercises. Postoperative complications were observed and fingers functions were assessed according to Dargan standard.

RESULTSThe patients were followed up from 6 to 14 months with an average of (5.0±0.3) months. Wound superficial infection occurred in 2 cases, the skin pressure ulcer in 2 cases, joint activities disability in 1 case; these symptoms got improvement after symptomatic treatment. Traumatic arthritis occurred in 2 cases, 1 case was improved after treatment, and 1 case had chronic pain for a long time. No internal fixation loosening or breakage and tendon rupture were found. According to Dargan standard to evaluate the finger function, 17 cases got excellent results, 8 good, and 1 poor.

CONCLUSIONIt is an effective way to treat the chronic mallet finger deformity using minor bone anchors and palmaris longus tendon graft, and the method has advantages of reliable fixation, easy operation, satisfactory effect and less complication.

Adolescent ; Adult ; Female ; Finger Injuries ; surgery ; Fracture Fixation, Internal ; Hand Deformities, Acquired ; surgery ; Humans ; Male ; Middle Aged ; Suture Anchors ; Tendon Transfer

Aged ; Animals ; Diabetes Complications ; Diagnosis, Differential ; Female ; Humans ; Ophthalmoplegia ; diagnosis ; etiology ; Tolosa-Hunt Syndrome ; diagnosis

Objective To compare the results of the three grades pictures affiliated With the Synotophore and to choose the opti- mal pictures for the clinician.Design Retrospective case series.Participants 41 normal persons and 44 cases of intermittent exotropia. Methods All participants were separately examined the three grades function with different kinds and degrees pictures affiliated with the Synotophore.The average radian measured with four sorts of pictures of the first grade function and the average measured with the three sorts of pictures of the second grade function were analysed,the stereoacuity of third grade function was measured with qualitative picture and random dot quantitative picture.Comparison was made between two groups of the people who possessed with stereoacuity. Main Outcome Measures Radians and seconds gained from the pictures affiliated with the Synotophone,Results Synotophore of the superposition of the first grade function:the outcome of using four sorts of pictures to examine the normal persons were 1.47+1.68, 1.21?1.21,1.68?1.60,1.32?1.27,F=0.595,P=0.619;the intermittent exotropias were 8.41?4.30,8.73?4.26,8.45?3.86,8.73?4.28,F= 0.070,P=0.987;the difference was not prominent.The fusion range of the second grade of Synotophore,using three different pictures to examine the normal persons were 26.03?6.17,21.11?6.87,17.21?5.40,F=17.260,P=0.000,the result of the fusion range has direct proportion with the degrees of the pictures,the bigger the picture was,the larger the fusion range,the difference was statistically signif- icant.And there was no significant differences for the intermittent exotropias when examined with the same pictures(21.74?7.43,21.31?7.82,20.32?7.53),F=0.590,P=0.556.The stereoaeuity of the third grade of Synotophore,in the normal person group 85.4% and 100%, X~2=4.877,P=0.027,the results were statistically significant between the qualitative picture and the random dot quantitative picture. About the intermittent exotropia group,no statistically significant differences were detected(72.73% and 59.10%),X~2=1.821,P=0.177. Condusion Choose pictures randomly when examine the first grade function of Synotophore;for the second grade function of Syno- tophore in both groups may choose intergraded degree pictures;the stereoacuity of the third grade of Synotophore,normal group should choose quantitative pictures,while strabismic patients may choose both of them.(Ophthalmol CHN,2008,17:120-122)