Objective:To investigate the causes,preventions and treatments of vaginal bleeding of pregnancy.Methods:From April 2001 to October 2004,1180 cases of vaginal bleeding of pregnancy in outpatient service of our hospital excluded placenta previa and placenta abruption by type B ultrasonography were diagnosed by the gynecological examination and then analyzed between.Results:The cases of vaginal bleeding of pregnancy were diagnosed.256 cases were threatened abortion(22.34%).153 cases were preterm labor(15.34%).278 cases were vaginitis(23.34%).14 cases were cervical erosion(9.61%).324 case were cervical polypus(27.31%).2 cases were cervical cancer(0.17%).16 cases were urethritis(1.35%).4 cases were anal fissure and hemorrhoid(0.34%).Conclusion:Vaginal bleeding of pregnancy was often in the conditions of cervicitis and vaginitis.The effective treatment methods were treatment before pregnancy and causal treatment.

OBJECTIVE: To analyze the effects of social and psychological factors on rehabilitation status of end stage renal disease (ESRD) patients under peritoneal dialysis. METHODS: From August in 2005 to March in 2007, 171 patients experienced peritoneal dialysis were diagnosed at the Center of Peritoneal Dialysis, Department of Nephrology, First Hospital, Peking University, including 66 males and 105 females, aged (60±13) years, with an average dialysis time of 22.8 months. They were studied with questionnaires and interview. Rehabilitation status was investigated from two aspects of activity and participation by Karnofsky activity index, Social Dysfunction Screening Scale. Hamilton depression and anxiety scales, Medical Coping Modes Questionnaire and Social Supporting Rating Scale were used to investigate social and psychological factors.RESULTS: A total of 200 questionnaires were handed out and 171 (85.5%) of them were drawn in. 134 patient had normal activity status, 78.4% of them had Dysfunction and 129 patients (75.4%) had normal social function status. Forty-two (24.5%) of patients had the symptom of anxiety, 15 (8.2%) had depression. The score of "Acceptance-Resignation" was significantly higher in this group than patients with other chronic diseases. There were no significant differences in scores of "Confrontation" and "Avoidance". Activity of rehabilitation outcome and participation index served as dependent variable, whereas depression and anxiety, coping mode and social supporting as independent variable. Using multiple stepwise regression analysis, factors that affected patient rehabilitation were found, including depression, utilization of social support and the facing coping mode. CONCLUSION: Depression, utilization of social support and the facing coping mode have important effects on patient rehabilitation.

Objective:CⅡTA is a transcriptional factor for transactivation of HLA expression.The aim of the study is to investigate the regulation of prednisone on inducible expression of CⅡTA in native PBMCs.Methods:Normal PBMC was stimulated with combination of IFN-? and PHA with or without the presense of prednisone.CⅡTA mRNA in the cells was amplified by RT-PCR,for analyzing transcriptive level in three designed groups of native PBMCs,activated PBMCs using the biomodulators and the triggered PBMCs in presense of prednisoloen.Results:Normal human PBMCs constitutively expressed CⅡTA,which was increased by stimulation of PHA and IFN-?.Prednisone significantly inhibited the inducible pattern of CⅡTA expression.Conclusion:Prednisone has showed inhibition effect on the expression of PBMC CⅡTA by descending transcription of the specialized transcriptional factor in activated PBMCs,whereby to downregulate the expression of HLA in PBMCs.

Objective:To explore the preoperative risk factors of laparoscopic cholecystectomy(LC)combined with laparoscopic common bile duct exploration(LCBDE) in the treatment of cholecystolithiasis combined with choledocholithiasis, and establish a nomogram model to predict the transition to laparotomy.Methods:A retrospective analysis of the clinical data of 309 patients undergoing surgery in Cangzhou People′s Hospital from January 1, 2015 to December 31, 2019, were divided into 290 cases in non-laparotomy group and 19 cases in laparotomy group whether they were transferred to laparotomy. Obtained independent predictors of transition to laparotomy through univariate analysis and multivariate logistic regression analysis, and used RStudio to establish a nomogram model to verify it.Results:The results of univariate analysis showed that the history of abdominal surgery, BMI, white blood cell, neutrophil ratio, ALP, serum total bilirubin, gallbladder wall thickness, common bile duct diameter, and lower common bile duct stone incarceration were relative risk factors of LC combined with LCBDE for conversion to laparotomy ( OR=0.195, 0.369, 0.287, 0.241, 0.237, 0.082, 0.166, 0.198, 0.190; 95% CI: 0.073-0.517, 0.114-1.195, 0.096-0.859, 0.085-0.682, 0.092-0.613, 0.023-0.287, 0.058-0.475, 0.073-0.537, 0.056-0.649). Multivariate logistic regression analysis showed that white blood cells>10×10 9/L, alkaline phosphatase>150 U/L, serum total bilirubin>17.1 umol/L, gallbladder Wall thickness> 4 mm, common bile duct diameter>12 mm, and lower common bile duct stone incarceration were independent predictors of LC combined with LCBDE for conversion to laparotomy ( OR=6.498, 3.656, 22.160, 5.762, 4.849, 7.916; 95% CI: 1.434-29.442, 1.095-12.203, 4.485-109.496, 1.491-22.262, 1.384-16.988, 1.366-45.884). The nomogram model was established based on independent predictors, and then bootstrap repeated sampling was used to internally verify the predictive model. The calibration curve found that the model was in good agreement, with a C-index of 0.924(95% CI: 0.857-0.990) and the area under the receiver operating characteristics curve was 0.924(95% CI: 0.855-0.992), indicating the high accuracy of the model. Conclusion:The nomogram model established based on the factors of lower common bile duct stone incarceration, gallbladder wall thickness, common bile duct diameter, common bile duct diameter, white blood cells, alkaline phosphatase, and serum total bilirubin has good ability to predict conversion to laparotomy of LC combined with LCBDE, and has high clinical application value.

Objective To evaluate the clinical value of the combined detection of serum human epididymis protein 4(HE4) ,carbo‐hydrate antigen125(CA125) ,carbohydrate antigen199(CA199) and carbohydrate antigen724(CA724) in the early diagnosis of ovar‐ian cancer .Methods 40 cases of ovarian cancer verified by pathological examination (ovarian cancer group) ,40 cases of ovarian be‐nign tumor (ovarian benign tumor group) and 40 individuals undergoing the physical examination(healthy control group) were se‐lected .The levels of CA125 ,CA199 and CA724 were measured by the electrochemiluminescence method ,the HE4 level was meas‐ured by the enzyme‐linked immunosorbent assay(ELISA) .The values of single index detection and the combined detection in diag ‐nosing ovarian cancer were analyzed .Results Serum HE4 ,CA125 ,CA199 and CA724 levels and positive rates in the ovarian cancer group were significantly higher than those in the ovarian benign tumor group and the healthy control group (P< 0 .05) .There was no statistical difference between the ovarian benign tumor group and the healthy control group (P> 0 .05) .The positive rate of the combined detection was 92 .5% ,which was significantly higher than the single index detection (P < 0 .05) .In the comparison of HE4 ,CA125 ,CA199 and CA724 single detection ,the sensitivity and specificity of HE4 detection were best .The detection rates of the stage Ⅰ and Ⅱ of ovarian cancer in the combined detection were significantly higher than that in the single index detection (P<0 .05) .Conclusion The combined detection of serum HE4 ,CA125 ,CA199 and CA724 might increase the detection rate of early di‐agnosis of ovarian cancer .

0.05).The blood loss was significantly higher for women who had the abdominal approach(t=3.214,P

Objective To summarize the experiences of ultrasonic liposuction in 204 cases, and to analyze the advantages and disadvantages of this technique. Methods The ultrasonic system (SILBERGEE E.U.A. TM ) and the liposuction equipment (HEROULES TM , American) were applied with the tumescent technique in 204 cases. Results Satisfactory rate was 90.69 %. After operation the highest sucked fat quantity was 6 800 ml, and the fewest quantity 250 ml, with an average of 1 907.6 ml for each case. Average volume of sucked fat in each position was 1 005.5 ml, which exceeded that by the traditional method. Advantages of this technique were larger fat quantity, obvious effect, less bleeding and pain, and safety. Disadvantages and complications were rough and uneven surface, accumulation of the liquid, bilateral asymmetry, slow wound healing, subcutaneous ecchymosis and hardening nodule, and even decreased blood pressure. The corresponding processing technique was recommended after liposuction. Conclusion This method is a simple and convenient, safe and reliable technique. It is suggested that multiple times and less portions of liposuction may be of benefit to patients.

Objective To observe optic nerve axons degenerative disorder and microglial responses by establishing unilateral optic nerve crush model.Methods YFP mouse group with axonal markers and GFP mouse group with microglia markers were divided into surgery and control group,the optic nerve were dissected at 4 hours,1 day,3 days,5 days,10 days after optic nerve crush,and the neuronal degenerative disorder and microglial responses were observed by confocal laser scanning microscope.Rrsults Compared with control group,the optic nerve axons in YFP mouse group were fractured in injury region at postoperative 4 hours;The partial axon became beadlike change at postoperative 1 day;Most of the axons turned into the process of beadlike change at postoperative 3 days;The axons became to debris from beadlike at postoperative 5 days;The axons changed into many debris at postoperative 10 days.Compared with control group,the formation of glial scar and resting microglia in GFP mouse group began to emerge at postoperative 4 hours;The microglia gradually activated and began to cover the injury region at postoperative 1 day;The activated miacroglia basically covered the injury region at postoperative 3 days;The number of microglia roughly remained stable,although the axons continued to deteriorate at postoperative 5 days and 10 days.Conclusion The optic nerve occur irreversible degenerative disorder after being injured,meanwhile with the microglial increase and activation.This phenomenon suggests that microglia is closely associated with optic nerve degeneration.