Objective To evaluate the feasibility and efficacy of laparoscopic tubal anastomosis after tubal sterilization.Methods A total of 27 cases of fallopian tube anastomosis with tubal anastomosis were performed under laparoscopy.After removing the sterilized scar in the tubes the hydrotubation was carried out using Methylene Blue to detect whether the tube was patent.By using 6/0 absorbable thread,we sutured the mesosalpinx with 2 or 3 stitches to close the both ends of the fallopian tube.And then,isthmus-isthmus(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the serous layer of the 8 and 4 o'clock respectively)ampulla-ampulla(1 whole-layer stitch at the 12 o'clock,and then 1-stitch sutures at the whole layers of the 9,7,5,and 3 o'clock respectively),or isthmus-ampulla(same method as the ampulla-ampulla anastomosis but more closed sutures)was performed.The patients received hydrotubation at the first day after the operation and then 3 to 5 days after the first menstruation.They were followed up for every 6 months till pregnancy.Results In the 27 patients(54 tubes),the rate of patency was 88.9%(48/54).The patent rate in the patients received isthmus-isthmus or ampulla-ampulla anastomosis was 86.5%(32/37)and 100%(15/15)respectively.In the 2 cases of isthmus-ampulla anastomosis,one was patent after the operation,and in the other,the Methylene Blue test showed anastomotic leakage.The hydrotubation performed at the first day after the treatment showed a rate of patent in 25 cases(2.6%,25/27),only two patient showed obstruction of the tube(7.4%,2/27).Follow-up was available in 26 of the patients up to over 6 months,19 of them had intrauterine pregnancy(73.1%,19/26)in 24 months after the procedure,among which 89.5%(17/19)occurred in 12 months;one(3.8%,1/26)patient developed ectopic pregnancy.Conclusions Laparoscopic tubal anastomosis is safe and effective for patients who desire reversal after sterilization.

Objective To investigate the association of the gene polymorphism of endothelial nitric-oxide synthase(eNOS) with pregnancy induced hypertension(PIH). Methods Sixty-six gravidas with PIH and 91 normal pregnant women(control) in the third trimester were investigated. The G894T mutation at exon 7 of the endothelial nitric-oxide synthase gene was studied by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results The frequencies of eNOS GG, GT and TT genotypes were 62.1%, 34.8% and 3.1% in PIH group and (79.1%,) 20.9% and 0.0% in control group, respectively (P0.05). Conclusions The variant (G-T) of 894 polymorphism site of eNOS is associated with the genesis of PIH, but not related to the severity of PIH. T allele may be a susceptible gene to PIH.

Objective To investigate clinical biologic characteristics and factors that impact prognosis of patients with follicular thyroid carcinoma(FTC).Method Clinical data of 105 FTC patients treated surgically in the Department of Head& Neck,Tianjin Cancer Hospital from 1970 to 1990 was analyzed retrospectively.Results The overall 5-year,10-year and 15-year survival rates of these patients were 85.3％,76.7％ and 72.9％ respectively.The overall 15-year survival rates of patients ≥45 years and those ＜ 45 years were 45.9％,89.8％ respectively.The overall 15-year survival rates of patients with unilateral and bilateral carcinoma was 50.0％,76.2％ respectively.The overall 15-year survival rates of patients with neck lymph node metastasis and without were 54.2％,79.2％ respectively.The overall 15-year survival rates of patients at stage Ⅰ,stage Ⅱ,stageⅢ and stageⅣ were 89.3％,70.0％,45.5％ and 35.3％respectively.During the follow-up period,11 patients were diagnosed with distant metastasis from 1 year to 33 years after surgical treatment and 9 died of cancer within 5 years after diagnosis.Seventeen patients had local recurrence from 3 months to 34 years after surgery and 10 of these patients died of local recurrence.Conclusions The factors influencing prognosis of patients with FTC were age,clinical stage,bilateral carcinoma and neck lymph node metastasis,therefore early treatment and close following-up are essential to improve the prognosis of patients with FTC.

Female ; Granulomatosis with Polyangiitis ; complications ; diagnosis ; Humans ; Otitis Media ; diagnosis ; etiology ; Young Adult

Objective To accurately understand multi-spot medical practice in China and evaluate its effect.Methods Operation data of 2008 and 2009 were gathered from all medical institutions in Kunming to analyze the effect of the practice trial using the fixed effect model.Results Under control of such factors as the scale and type of the hospitals,clinic visits of the second certified hospital benefited by the practice increased by 14％than before,whereas the medical revenue of the institution increased by 29％.The effect proves more significant in terms of total clinic visits and medical revenues at level-1 and level-2 medical institutions.Conclusion Multi-spot medical practice in Kunming proves successful as it increased medical service supply and medical revenue,especially for level-1 and level-2 medical institutions.This effect possibly results from releasing high-level physicians down to lower-level institutions,helping these institutions to attract patients.

OBJECTIVETo compare the differences in pain reaction, hemodynamics and clinical efficacy between extracorporeal shock wave lithotripsy (ESWL) after injection with flurphen mixture (mixture of droperidol and fentanyl citrate) at Shenshu (BL 23) and simple ESWL in the patients.

METHODSSixty-four cases of urinary calculi with ESWL were randomized into an observation group and a control group, 32 cases in each one. In the observation group, 15 to 20 min before ESWL, flurphen mixture (droperidol injection 1.25 mg and fentanyl citrate injection 0.05 mg were diluted to 6 mL with 0.9% sodium chloride solution 4.5 mL) was injected at bilateral Shenshu (BL 23). In the control group, no any adjuvant therapy and medication were used before ESWL. The changes in blood pressure and heart rate, visual analogue scale (VAS) score, lithotripsy frequency till calculi complete removal and the rate of calculi complete removal after the first lithotripsy were observed in the two groups.

RESULTSIn the control group, blood pressure and heart rate were higher during lithotripsy than those before lithotripsy (both P<0.05). In the observation group, the differences in blood pressure and heart rate were not significant statistically as compared with those before lithotripsy (both P>0.05). The blood pressure and heart rate during lithotripsy in the observation group were apparently lower than those in the control group (both P<0.05). VAS scores during lithotripsy in the observation group were lower apparently than those in the control group (both P<0.05). The lithotripsy frequency in the observation group was less than that in the control group. The rate of calculi complete removal in 1 week after the first lithotripsy in the observation group was higher than that in the control group [75.0% (24/32) vs 50.0% (16/32), P<0.05].

CONCLUSIONThe flurphen mixture at Shenshu (BL 23) significantly alleviates pain reaction in patients undergoing ESWL, avoids the fluctuation of hemodynamics and improves the clinical effect of lithotripsy.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Analgesics ; administration & dosage ; Female ; Hemodynamics ; Humans ; Kidney Calculi ; therapy ; Lithotripsy ; adverse effects ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; Young Adult

OBJECTIVE:To investigate the effects of hydrophilic polymers on the stability of self-microemulsifying drug deliv-ery systems (SMEDDS). METHODS:Taking felodipine (FDP) as model drug,the content of FDP was determined by HPLC method. The effects of pure water,0.5% Kollidon VA64,HPMC E5,HPMC K100LV,HPMC K4M,PVP K30 solution,while 0.1%,0.5% and 1.0% HPMC E5 and Kollidon VA64 on residual content of dissolved FDP were determined in SMEDDS. RE-SULTS:The residual contents of dissolved FDP in SMEDDS placed in Kollidon VA64,HPMC E5,HPMC K100LV,PVP K30, HPMC K4M and pure water for 1 h were 92.7%,63.6%,50.2%,46.2%,36.0%and 24.0%,respectively. The order of maintain-ing the supersaturation state was Kollidon VA64>HPMC E5>HPMC K100LV>PVP K30>HPMC K4M>pure water. The residu-al contents of dissolved FDP in SMEDDS placed in 0.1%,0.5%,1% Kollidon VA64 and HPMC E5 and pure water for 1 h were 93.2%,95.1%,96.0% and 48.4%,62.1%,75.1%. CONCLUSIONS:Kollidon VA64 and HPMC E5 can significantly inhibit drug release in SMEDDS and be used as stabilizer of SMEDDS,wherein Kollidon VA64 was better.

Objective To investigate the effect of long-term proton pump inhibitor on osteoporosis in elderly patients.Methods A total of 150 patients with peptic ulcer treated in our hospital from January 2011 to January 2015 were selected as the observation group.150 healthy subjects were selected as the control group.The age,height,body weight and PPI time of the two groups were recorded.The changes of bone mineral density before and after treatment were measured by bone mineral density analyzer,ineluding lumbar L1-4,radial density and ulna density.The changes of bone mineral density were observed and recorded in the observation group before treatment,six months,1 year and 2 years after treatment.Results After treatment,the levels of gastrin were significantly increased in the observation group,and the serum calcium concentration and bone mineral density were significantly decreased (P＜0.05).The density of lumbar vertebrae,radius and ulna was significantly lower in observation group than those of control group (P＜0.05).With the prolongation of PPIs,lumbar vertebrae,radius and ulna density in observation group showed a decreasing trend.Conclusion Long-term application of proton pump inhibitors in elderly patients can cause bone loss.

Objective To observe the effects of balance visual feedback training on balance function and walking capacity in patients with hemiplegia. Methods40 patients with hemiplegia were divided into the visual feedback group (n=20) and balance board training group (n=20). They were assessed with the Berg Balance Scale (BBS) and the Holden Walking Classification before and 5 weeks after treatment. ResultsThere was no significant difference between groups before treatment in both BBS and Holden Walking Classification (P>0.05). The visual feedback group improved more than the balance board training group (P<0.01). ConclusionThe balancer visual feedback training is more effective on balance function and walking ability in stroke patients with hemiplegia.

Objective To investigate the related risk factors in patients with atrial fibrillation in order to prevent and delay the occurrence of atrial fibrillation.Methods Five hundred and fifty-eight inpatients with atrial fibrillation were retrospectively analyzed from June 2005 to June 2008.They were divided into several groups according to the age and the characteristics of the elder patients with atrial fibrillation were analyzed.Results In the 558 cases with atrial fibrillation, there were 298 males (53.4%) and 260 females (46.6%) aged from 21 to 97 years.The average age was (72.8 ±10.1) years.There were 57 cases aged 21-59 years(10.2 %)and 501 cases aged 60-97 years(89.8 %).The total number of inpatients in our hospital was 11 869, and there were 4049 cases aged<60 years, 2527 cases aged 60-69 years, 3971 cases aged 70-79 years, 1244 cases aged 80-89 years and 78 cases aged>90 years.The proportions of the inpatients with atrial fibrillation in the above five age groups of inpatients were 1.4%(57 cases), 4.2%(107 cases), 6.6% (262 cases), 9.5%(118 cases)and 17.9% (14 cases), respectively.In 558 cases with atrial fibrillation, there were 230 cases (41.2%) with paroxysmal atrial fibrillation, 44 cases (7.9%) with persistent atrial fibrillation and 284 cases (50.9%) with permanent atrial fibrillation.The most common underlying disease was hypertension in the 558 cases, followed by coronary heart disease, heart failure, diabetes, rheumatic heart disease and so on.Conclusions The prevalence of atrial fibrillation is increased with aging.Hypertension, coronary heart disease, rheumatic heart disease, heart failure, hyperthyroidism,diabetes, chronic pulmonary disease and renal failure are all the risk factors for atrial fibrillation.