Objective To study the therapeutic effect of ultrasonic guidance MTX local injection combined with mifepristone in the treatment of unruptured tubal pregnancy. Methods From January 2013 to February 2014,a total of 120 cases of unruptured tubal pregnancy were given injection of MTX 1 mg /kg in the capsule under ultrasonic guidance and oral administration of mifepristone 75 mg twice a day for 4 days. Results Ultrasound-guided puncture was successfully completed at first time in 1 12 cases and at second time in 8 cases.Four days after treatment,the β-hCG decreased by more than 15% in 80 cases (66.7%),had no significant change in 10 cases (8.3%),and increased by less than 15% in 30 cases (25.0%).The β-hCG decreased by more than 15% at the seventh day in 105 cases (87.5%),and had a further decline at the 14th day,and dropped to normal after a month,with abdominal pain relieved,vaginal bleeding stopped,and abdominal mass shrunk or disappeared.The treatment successful rate was 87.5%(105 /120).The hospitalization costs was 1208.5 -2722.6 yuan,with an average of 1859.4 yuan. Conclusion Under ultrasonic guidance,MTX local injection combined with mifepristone in the treatment of unruptured tubal pregnancy is a simple and safe method.

To investigate the clinical risk factors of cardiac diastolic dysfunction in type 2 DM, Doppler echocardiographic examinations were performed on 63 male patients.With a routine 2 dimensional echocardiograph, mitral and pulmonary venous flow velocity were recorded. The patients were classified into DM, IGT and NGT based on well standardized criteria of WHO. All analyses were performed by the SPSS/PC or Windows Release 9.0 Statistical Package. The risk factors of impairment of diastolic function were analyzed by regression. Results showed that the levels of blood glucose and insulin were independent risk factors for diabetic cardiac diastolic dysfunction.

ObjectiveTo find out the electroencephalogram(EEG)change of the children with language retardation.MethodsThe EEG change and prognosis of 78 cases of language retardation children were analysed and compared with normal ones.ResultsThe EEG abnormal rate of language retardation was 69.3%,while that of the normal children was 10%(P<0.001).Conclusions The EEG is helpful to understand the developmental status of brain functions.

Objective: To observe the effect of acupoint massage plus Vitalstim electrical stimulation on deglutition function and surface electromyography (SEMG) of deglutition muscle groups. Methods: A total of 60 patients with deglutition disorder after stroke were selected and divided into an electrical stimulation group, a massage group and an integrated group according to the random number table method, with 20 cases in each group. Patients in these three groups were given the same routine rehabilitation training for deglutition. In addition, patients in the electrical stimulation group were given extra Vitalstim electrical stimulation, patients in the massage group were given extra acupoint massage on the head, face and neck, and patients in the integrated group were given extra acupoint massage plus Vitalstim electrical stimulation. Fujishima Ichiro food intake level scale (FILS) was scored before and after treatment. The swallowing duration and maximal amplitude of masseter muscle in SEMG were evaluated before and after treatment. Results: After treatment, the FILS score and the maximal amplitude of recruitment potential generated by muscular contraction of masseter muscle group in the three groups were higher than those before treatment (all P<0.05), and the swallowing duration of masseter muscle group was shortened compared with that in the same group before treatment (all P<0.05). After treatment, the FILS score in the integrated group was higher than that in the electrical stimulation group and the massage group (both P<0.05). The swallowing duration of masseter muscle group measured by SEMG was lower than that in the electrical stimulation group and the massage group (both P<0.05), while the maximal amplitude was higher than that of the electrical stimulation group and the massage group (P<0.05). After treatment, there were no significant differences in the FILS score, swallowing duration and maximal amplitude of masseter muscle group between the electrical stimulation group and the massage group (all P>0.05). Conclusion: Both acupoint massage and electrical stimulation can improve the deglutition function in patients with deglutition disorder after stroke, and improve the coordination and flexibility of masseter muscle. The integration of the two is more effective.

Objective To analyze the epidemiological features and influencing factors of human brucellosis in Qinghai province,and to provide scientific basis for prevention and control of brucellosis.Methods From 2006 to 2010,select the high incidence areas of brucellosis in Qinghai province and five counties(Henan,Dari,Tianjun,Ping'an and Haiyan counties) included in the “Central Subsidies to Local Public Health Special Fund Human Brucellosis Prevention and Control Projects” for the survey point,as well as high-risk employees from Qinghai Biological Pharmaceutical Factory were investigated.Combined with epidemiological questionnaire investigation [done according to the “National Human Brucellosis Surveillance Program(Trial)”],clinical symptoms and signs,confirmed human brucellosis patient were tested by intradermal allergy test,rose bengal plate agglutination test(RBPT) and standard tube agglutination test (SAT),in accordance with “Diagnostic Criteria and Principles of Management of Brucellosis” (GB 15988-1995) and“Diagnostic Criteria for Brucellosis” (WS 269-2007).Results Of 8368 serum samples detected,347 were RBPT positive,and the positive rate was 4.15％;5346 serum samples were tested by SAT,180 were positive,and the positive rate was 3.37％.In June 2009,112 employees in Qinghai Biological Pharmaceutical Factory were investigated on a follow-up survey,83 were RBPT positive,the positive rate was 74.11％; 58 were SAT positive,the positive rate was 51.79％.Eight of them were new cases and 4 were chronic brucellosis.Twenty five new cases were reported between 2006 and 2010.The peak incidence was from March to July.Most of the cases were herdsmen.ConclusionStrengthening animal quarantine,strengthening public education,and improving protection awareness,can effectively control the disease brucellosis.

BACKGROUNDSymbrachydactyly is defined as a combination of short fingers with syndactyly. There are few published reports estimating the incidence of symbrachydactyly. The aim of this study was to investigate the clinical features and the outcome of surgical treatment for congenital symbrachydactyly.

METHODSOne hundred and twenty webs of thirty-four patients of symbrachydactyly were involved in the study. The sex ratio was 21 males/13 females. The age ranged from 1 year to 8 years, average 2.6 years. Four cases had both hands involved and 30 patients had one hand involvement. Release of the syndactylous digits webs were completed by one surgical procedure in 14 cases and more than one surgical procedure in 20 cases; 3 to 6 months between the procedures. In the meantime, some of the associated hand deformities were treated.

RESULTSPostoperative follow-up time was 10 to 18 months, average 12 months. All the fingers involved in this study were separated successfully. However, 6 fingers had scar tissue contracture and 8 had web scar adhesion. All complications needed further surgical treatment. Parents of 94.1% of the patients were satisfied with the overall function of the hand, and 76.5% were satisfied with the cosmetic appearance of hand.

CONCLUSIONSThe combination of syndactyly and brachydactyly is the main clinical feature in symbrachydactyly. Separation of the digital webs can greatly improve the function of the hand. However, more work needs to be done to improve the cosmetic appearance of the hand.

Abnormalities, Multiple ; Brachydactyly ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Syndactyly ; surgery ; Treatment Outcome

Objective To explore the clinical efficacy in bilateral lumbar foraminal stenosis (LFS) after treatment with bilateral facetectomy combined with pedicle screw fixation and interbody fusion.Methods A total of 41 cases of patients with bilateral LFS underwent bilateral facetectomy combined with pedicle screw fixation and interbody fusion from February 2010 to August 2013 in Department of Spine Surgery,the People's Hospital of Tianjin City,were retrospectively analysed.The clinical efficacy was assessed by Oswestry disability index (ODD questionnaire and visual analogue scale (VAS) before and after operation,anterior and posterior disc height and L1-S1 angle were measured as well.Then the ODI and VAS scores,and changes in anterior and posterior disc height and L1-S1 angle were calculated at the time of the last patient follow-up visit.Results All 41 patients were followed up for 12 to 36 months,with an average of (26.2±2.4) months.Compared with preoperation,at the time of the last follow-up visit the back pain VAS score,leg pain VAS score and ODI were decreased,while the anterior and posterior disc height were increased,there were statistically significant differences (P＜0.05).No statistically significant difference was found in L1-S1 angle between preoperation and postoperation (P＞0.05).Conclusion The short-term clinical curative effect of posterior bilateral facetectomy combined with pedicle screw fixation and interbody fusion in the treatment of bilateral LFS is satisfactory.

Objective:To explore CCR7 expression in splenic dendritic cells and its role in migration and activity of splenic dendritic cells in multiple organ dysfunction syndrome (MODS) in mice.Methods:The MODS model of mice was reproduced by Zymosan injection into peritoneal cavity.The mice were randomly divided into groups of normal,3-6 hours,24-48 hours and 10-12 days post zymosan injection.CD11c and CD205 were analysed by immunohistochemistry;The expression of CD86 and CCR7 of DCs were studied by the flow cytometry analysis.Results:In normal mice,many DC were found at the margin between the red and white pulp.In the 3-6 h and 24-48 h groups,CD86 and CCR7 were strongly up-regulated in the DC,and they distributed in T cells areas.In the 10-12 d group,DC distributed at the margin by the immature form.Conclusion:The CCR7 expression level of DC has close correlations with the migration of DC,CCR7 can be used to evaluate the migration and functional activity of DC in MODS.

AIM: To discuss the clinical applications of methods to localize nasal cut ends and the effects of Z-plasty in the surgeries for lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption.
METHODS: From September, 2010 to October, 2013, a total of 37 patients ( 37 eyes ) with lower eyelid longitudinal laceration combined with lower lacrimal canaliculi disruption were operated for anastomosis of lacrimal canaliculi disruption and suture of lower eyelid longitudinal. Different methods to search for the nasal cut ends of lacerated lacrimal canaliculi, such as “under a microscope directly”, “guided by probing needle” and“pigtail curved probe”. Then, to repair lower eyelid longitudinal laceration with Z-plasty transposition flaps. Follow up was 3mo~2a after operation.
RESULTS: All nasal cut ends could be found successfully on 37 patients;Lacrimal duct unobstructed in 31 patients (83. 8%), improved in 5 patients (13. 5%), invalid in 1 patient (2. 7%),the overall successful rate was 97. 3%; the eyelids repair was satisfactory, small scars, the appearance and function was normal.
CONCLUSION: The nasal cut ends can be found successfully by “directly under a microscope”, “guided by probing needle” and“pigtail curved probe”;the effect of silicone drainage tube used as lacrimal canaliculi bracket is satisfactory; most patients gained excellent recovery for both appearance and function after Z-plasty.

Objective To understand the impairment and compensation mechanism of brain function in pa-tients with non-fluent aphasia after ischemic stroke. The fractional amplitude of low frequency fluctuation (fALFF) method was used to analyze the functional magnetic resonance imaging (fMRI) data in the resting state between the aphasia patients and the normal controls. Methods The scans of the resting state of fMRI were performed in 17 aphasia patients and 19 age-, education-, and sex-matched healthy control subjects. The scan sequence was single-shot echo planar image,DPARSF software was used to analyze fALFF data of the aphasia patients and the healthy controls. Results Compared to the control group, the value in right superior temporal gurus, inferior parietal lob-ule, frontal lobe cortex, and postcentral gurus were significantly increased in the aphasia group. The fALFF in bilat-eral cerebellum and right thalamus were also decreased in the aphasia group. Conclusions The fALFF values in some brain region in the aphasia group were abnormal in the resting state , indicating a few pathological change of brain function in patients with non-fluent aphasia after ischemic stroke.