Objective To explore the clinical characteristics and management of urinary tract injuries incidental in gynecologic surgery. Methods Urinary tract injuries in gynecologic surgery during the past 10 years were reviewed retrospectively.The clinical features of initial operations including the types of disease,operative procedures and the methods of diagnosis and treatment was studied. Results 21 urological injuries were incurred during the performance of 6075 gynecologic surgical procedures,an incidence of 0.35% including of 10 ureter injuries and 11 bladder injuries with incidence of 0.16% and 0.18% respectively. The time of diagnosis from 0 to 23 days postoperatively.As for operation way,Laparoscopic surgery 10 cases(48%),radical surgery for cancer 7 cases(33%),other surgery 4 cases.injury of urinary tract was found intraoperatively in 15 patients(67%) and postoperatively in 7 patients(33%).Urinary fistulae occurred in 6 patients(29%).Urinary tract injuries were mainly diagnosed methylene blue infusion,via excretory urogram(IVP),CTU.An appropriate repair during operation,putting the doubleJ-catheter and catheterization was useful. Conclusion The rate of urinary tract injury is increased as more patients received laparoscopic surgery.Most of urinary tract injuries in gynecologic surgery had optimal results when they were diagnosed early and managed correctly.

Objective To observe the effect of estrogen on BBB permeability,occludin expression after ischemia-reperfusion in rats,and to make a further investigation on the role of estrogen in cerebral ischemia. Methods Ovariectomized rats were randomly divided into sham-operated group,model group,and estrogen pretreatment group. 4 h,24 h,3 d after ischemia-reperfusion were selected as different observation points,and changes of edema,occluding expression,and blood-brain barrier permeability of the 3 points in time were observed. BBB ultra-structure electron microscope observation was made at 24 h and 3 d after ischemia-reperfusion. Changes in cerebral edema were measured by brain water content percentage;protein expressions were measured by Western blot;and BBB permeability was measured by Evans blue as-say. Results Compared with the sham group,brain tissue water content and EB content in model group both increased 4 h after ischemia-reperfusion (P<0. 05),and they keep increasing as time goes by and finally reaching the peak (P<0. 01). Compared with the model group at the same time point,brain tissue water content and EB content in estrogen pretreatment group decreased in different degrees (P<0. 05 or P<0. 01),and it was most significant at the time point of 24 h after ischemia-reperfusion (P<0. 01). Compared with model group,through electron microscope observation,ia was displayed that BBB TJ's open was reduced in estrogen pretreatment group,astrocyte foot process and capillary tube edema were lighter,and it was significant at the time point of 3 d after ischemia-reperfusion. Western blot detection of occludin protein expression found that it was lower in the model group compared with the sham group at 4 h after ischemia-reperfusion,but there was no significant difference (P>0. 05). 24 h after ischemia-reperfusion,the occludin expression were weaker than that in the sham surgery group with a significant difference (P<0. 05),and it keep weakening with a significant difference 3 d after ischemia-reperfusion (P<0. 01). In estrogen group,there was no significant difference compared with the model group in terms of occludin expression at 4 h after ischemia-reper-fusion (P>0. 05). In estrogen group,there was significant difference in occludin protein expression at 24 h and 3 d after ischemia-reperfusion compared with model group at the same time point (P<0. 05). Conclusion BBB ultrastructure disclose TJ was broke and vesicles within EC was increased and astrocyte cell foot process was swelling in MCAO model,it might be the vasogenic brain edema pathological basis for MCAO. In MCAO animal model,with ischemia-reperfusion time increasing,TJ protein occludin expression significantly decreased,it suggests that occludin plays an important role in the regulation of TJ permeability. Estrogen increases has a very close relationship with occludin ex-pression,and it may be one of the mechanisms of protecting BBB integrity and lessening cerebral edema.

Considering the modern features and requirement of our medical education, we tried some exploration and reforms of the clinical practice training on students of clinical medicine major(7-year program). By strengthening the training of clinical practice while learning subjects, we came to the conclusion that students got their study’s aim much more positively and actively in their study, and the teaching goals are more direct and the teaching effects are better.

Object To compare the hupzine A (Hup A) in Huperzia serrata (Thunb.) Trev. obtained by different extracting methods and investigate the amount of alkaloids and the content of Hup A from different parts of the plants and from different places. Methods Using HPLC for the determination of Hup A. Results The content of Hup A in the stem and leaf is richer than that in the root. The content of Hup A from Guizhou, Guangdong and Anhui Provinces is 0.018%, 0.021% and 0.020% repectively; The difference of extract method of Hup A is no prominence. Conclusion The content of Hup A in the ground is richer than that of underground, and there are some difference in the content of Hup A obtained from different places.

0.05).In the patients with 4G/4G polymorphism of PAI1 gene,the GMP-140,vWF,FⅦa,D-D and PAI-1 levels in plasma were significantly increased at immediate postoperative period(P0.05).In the patients with 4G/5G and 5G/5G genotypes,all indexes mentioned above were significantly increased at immediate postoperative period(P0.05).In the patients with 4G/4G genotype,the PAI-1 level in plasma was significantly higher than those in the patients with 4G/5G and 5G/5G genotypes 24 h after PCI(P

To obtain and analyze the sequence of the nucleocapsid gene from bovine coronavirus, and to produce the fusion protein of the N gene in E.coli in order to use this recombinant protein for the study of bovine coronavirus. The N gene of BCV-DQ strain was amplified by RT-PCR, in which the primers were designed on the basis of N gene sequence of BCV-Mebus strain. The PCR products of 1 347 bp in length were cloned and sequenced, and then inserted into the prokaryotic vector pET30a. The recombinant plasmids were then transformed into Escherichia coli BL21 and identified by SDS-PAGE and Western blot assay. ELISA assay was optimized of N protein as the coating antigen to detect the viruses in the clinical samples. In comparison with 6 BCV strains in GenBank, the sequence identity was proved to be more than 98.3%. Result in SDS-PAGE showed that the fusion protein had a molecular weight of 60 ku, and could be specifically recognized by mouse serum against BCV. The indirect ELISA was used to test 256 serum samples collected from Heilongjiang province and 65.23% samples were positive. On testing field samples, an overall agreement of 95.31% was generated between the the neutralization test of viruses (VN) and indirect ELISA. It is apparent that the N gene was highly conservative and is expressed in E. coli in high level,also the prokaryotic expression products of this gene show a fine reactiongenicity in immune responses. It was also suggested that the N protein may be a useful antigen for sero-diagnosis and epidemiological investigation of BCV.

Objective To investigate the effective ways of improving medical students' clinical competence during the process of internship. Methods Totally 398 students of clinical medicine from 2006 and 2007 grade in Soochow University were enrolled as research objects. Forty objects distribut-ed to the First Affiliated Hospital were taken as experiment group while 358 objects distributed to other hospital as control group. In experiment group, objective structured clinical examination (OSCE) was introduced during regular internship, innovation was made on test on completion of a course and autonomous learning and clinical practice was advocated and enhanced. Traditional practice and ex-amination method was used in control group. SPSS 19.0 was used to do statistical analysis on the test scores of students. Paired sample t test and independent sample t test were employed. Measurement data is expressed as x±s and P<0.05 signifies statistically significant differences. Results Clinical practice ability of students in experiment group was enhanced to various degrees after internship com-pared with that before internship. ECG interpretation, heart and lung auscultation, interrogation tech-nique, medical and surgical operation performances of students in experiment group were promoted significantly (P<0.05). Students' overall competence in the final graduation skill test was better in ex-periment group than in control group (P<0.05). Conclusions OSCE-test on completion of a course not only make intern management more effective, but also make students' aim more definite, therefore it is conducive to enhancing clinical competence.

The purpose of tumor staging is to guide treatment, and the treatment for a certain stage should be adjusted based on the changes in disease condition, in order to facilitate better control of tumor. Therefore, the treatment of liver cancer requires follow-up and re-staging to develop better treatment regimens for patients, especially the opportunity for cure. Surgical resection is not suitable for large hepatocellular carcinoma confined to the liver, and after embolization chemotherapy combined with radiotherapy for tumor regression and downstaging, some patients may undergo surgical resection, and the incurable tumor can thus be cured. For liver cancer patients with portal vein tumor thrombus, surgical resection can be performed after tumor thrombus is reduced by neoadjuvant radiotherapy, and the patients undergoing neoadjuvant radiotherapy have a significant increase in survival time than those not undergoing neoadjuvant radiotherapy. Large hepatocellular carcinoma can be downstaged to small hepatocellular carcinoma after multimodality therapy, and then stereotactic radiotherapy or radiofrequency ablation can help to achieve radical treatment. There is an increasing number of clinical reports of radiotherapy for liver cancer downstaging, with a gradual increase in evidence-based level, and thus it holds promise for clinical application.

AIM: To examine T-lymphocyte rDNA transcription activity in peripheral blood of patients with gastrointestinal maliganant tumor and to clarify its clinical significance.METHODS: T-lymphocyte rDNA transcription activity in peripheral blood of 48 cases of patients with stomach-intestine tract malignant tumor were measured.RESULTS: Before surgery, the T-lymphocyte rDNA transcviption activity was obviously lower than that after surgery, also lower than that of the normal control( P

Objective To compare the accuracy of blood volume perfusion imaging (perfusion CT)with contrast enhanced 64-slice spiral computed tomography (CECT) in the evaluation of gross tumor volume (GTV) and clinical target volume (CTV) using rabbits with VX2 brain tumor. Methods Perfusion CT and CECT were performed in 20 rabbits with VX2 brain tumor. The GTV and CTV calculated with the maximal and minimal diameter of each tumor in the blood volume (BV) maps and CECT were measured and compared to those in pathological specimens. Results The mean value of the maximal and minimal diameter of GTV was (8.19 ± 2. 29) mm and (4.83 ± 1.31) mm in pathological specimens, (11.98 ±3.29) mmand (7.03±1.82) mm in BV maps, while (6.36±3.85) mm and (3.17±1.93) mm in CECT images, which were significantly different (pathological specimen vs. BV map, t = 7. 17,P =0. 000;pathological specimen vs. CECT, t = 8.37, P = 0. 000, respectively). The mean value of the maximal and minimal diameter of CTV in pathologic specimens was (12.87 ± 3.74) mm and (7.71 ± 2. 15) mm, which was significantly different from that of GTV and CTV in CECT (t = - 3. 18, P = 0. 005 and t = - 4. 24, P =0. 000;t= -11.59,P=0.000 and t= -9.39,P=0.000), while similar with that of GTV in BV maps (t = - 1.95,P = 0. 067; t = - 2. 06, P = 0. 054). For CECT, the margin from GTV to CTV was 81.83% ±40.33% for the maximal diameter and 276.73% ± 131.46% for the minimal. While for BV maps, the margin was 7.93% ± 17. 84% and 12.52% ± 27. 83%, which was significant different from that for CECT images (t=7.36,P=0. 000 and t= -8.78,P=0.000). Conclusions Compared with CECT, the BV map from 64-slice spiral CT peffusion imaging might have higher accuracy in target volume delineation for brain tumor.