One hundred and eighty five cases of patent ductus arteriosus treated with surgery in the past thirty years are reported.The discussion centers on the surgical approach. The method of avoiding recurrent laryngeal nerve injury and the key-points in ductus ligation.lt is our opinion that the use of a dacron roll under the ligature, safe for ductus obliteration and avoidance of ductus rupture, is the surgical method of choice.when the ductus is associated with intracardiac anomaly, it may be managed simultaneously under extracorporeal circulation in open-heart surgery

The aim of informed consent is to regard patients as the centre of medical service.Physician-patient communication is an effective way to improve the construction of a harmonious physician-patient in medical practice,so more attention should be paid to the communication.

Objective To evaluate the clinical value of hysteroscopy before in vitro fertilization and embryo transfer(IVF-ET).Methods From December 2003 to May 2005,130 patients received hysteroscopy in our hospital because of IVF-ET failure.Their intrauterine diseases were treated by hysteroscopy,and the abnormal tissues were examined pathologically.Results Among the 130 cases,87 had intrauterine diseases(87/130,66.9%) including endometritis in 40(40/130,30.8%),endometrial polyps in 23(23/130,17.7%),intrauterine adhesion in 20(20/130,15.4%),and submucous leiomyoma in 4(4/130,3.1%).In these patients,67 underwent IVF/ICSI or frozen embryo transfer within one year after the hysteroscopy,of which 20 patients achieved pregnancy.The clinical pregnancy rate was about 30%.The other 20 cases did not repeat IVF-ET in 10-20 months after the hysteroscopy,and had no pregnancy without contraception.Conclusion Pre-transfer hysteroscopy is helpful to avoid IVF-ET failure owing to intrauterine diseases.

Objective To compare clinical effects between percutaneous and open reduction by using tension band wiring for the treatment of transverse patella fractures. Methods A prospective study was carried out. A series of 62 cases of transverse patella fracture from 1997 to 2003 were divided into two groups: the Percutaneous Group (n=27) and the Open Group (n=35). The Percutaneous Group received percutaneous reduction with tension band fixation, including 23 cases of internal fixation by Kirschner-wire techniques and 4 cases of fixation through cannulated cancellous bone screws. The Open Group received open reduction with Kirschner wiring tension band fixation. The time to bone union, the reduction condition, the movement range and the function of the knee were compared between the two groups. Results All the cases were followed for 6~48 months. The bone union was achieved in both of groups. The rate of “good” or “excellent” knee functions was 88.9% in the Percutaneous Group (24/27) and 88.6% in the Open Group (31/35), respectively, without significant difference (?2=0.000,P=1.000). The time to bone union was earlier in the Percutaneous Group than in the Open Group (?2=6.581,P=0.037). Conclusions Percutaneous reduction with tension band fixation can offer good anatomic reduction and enough fixation strength to meet the requirements for bone union and function recovery in the treatment of transverse patella fractures, with minimal invasion, quick union and excellent clinical outcomes.

This study was aimed to explore the clinical efficacy of Shen-Kang Injection (SKI) combined with hemodialysis in the treatment of chronic renal failure (CRF) patients. A total of 41 end-stage CRF patients under the hemodialysis treatment were randomly divided into the SKI treatment group of 19 cases and a control group of 22 cases. Both groups were treated with standard dialysis and the hemodialysis was maintained in the same symp-tomatic treatment conditions. Patients in the control group underwent three hemodialysis treatments in one week, while those in the treatment group were given hemodialysis twice a week based on the symptomatic treatment. And SKI was given after each time of hemodialysis in the treatment group. Indexes and changes in serum creati-nine (Scr), blood urea nitrogen (BUN) level, dialysis adequacy, nutrition status, traditional Chinese medicine ( TCM ) syndrome and other aspects of both groups were observed . The results showed that in the treatment group and control group, there were no significant differences in the renal function, dialysis adequacy, nutrition indica-tors and electrolyte ( P > 0 . 05 ) . In the treatment group , the total efficiency of TCM syndrome was 84 . 21%. And the total efficiency of TCM syndrome in the control group was 45.45%. The treatment group was better than the control group (P < 0.05). Symptoms such as scaly dry skin, numbness of the four limbs and dry stool were not obviously improved . And there was no statistical significance ( P > 0 . 05 ) . Symptoms such as fatigue , shortness of breath, poor appetite, dizziness, headache, lower back pain and spontaneous sweating were improved significantly. And there was statistical significance ( P < 0 . 05 ) . The treatment group was better than the control group . There were no abnormalities in the routine tests of blood, urine and stool, electrocardiogram, liver function, renal func-tion and electrolyte. In the treatment group, there was no significant adverse reactions during patients received SKI. The SKI has good safety. It was concluded that SKI combined with hemodialysis in the treatment of CRF is able to improve the clinical symptoms of patients and improve the patients' quality of life. When patient received adequate dialysis, SKI may reduce the dialysis frequency per week.

Objective To compare the effect of application of constant speed injection pump and manual injection on hysterosalpi-nography (HSG).Methods A total of 220 infertile patients were selected and classified into experimental group and control group. Then the patients were scheduled to undergo HSG.The experimental group was undergone constant speed pump injection and control group manual injection.Observe the effectiveness of the two methods on patients in two groups,respectively.Results The excellent rate of the images in experimental group (94.55%)was significantly higher than the control group (85.45%)and the risk of adverse reactions were significantly decreased in the former.There was statistical difference between the two groups.Conclusion Constant speed infusion pump is a convenient,safe and effective method in hysterosalpinography compared with manual injection,which is worthy of application in clinic.

Objective To approach the status of leprosy disabilities in newly detected cases in recent 10 years in China and provide the scientific basis for formulating the preventive strategies. Methods Based upon the individual records from the National Leprosy Recording and Reporting System in National Center for STD and Leprosy Control, 22 437 leprosy cases detected during 1989－ 1998 in China were analyzed in terms of leprosy disability. Results The proportion of disabilities in newly detected leprosy cases in 1989 in whole country was 46.49％ and decreased to 32.31％ in 1998, and the proportions of cases with grade II disabilities were 25.55％ (1989) and 20.23％ (1998). There were 18 provinces where disability rate was more than 40％ . Out of patients with disabilities, those with grades I and II disabilities and with deformities (loss of eyebrow, facial paralysis or saddle nose) accounted for 37.86％ , 60.64％ and 1.5％ , respectively. There were 25 provinces where grade II disabilities accounted for more than 50％ of all patients with disabilities. The disability rates in patients aged under 15 years, 15－ 65 years and over 65 years were 24％ , 39.85％ and 53.33％ . The patients with a delay in detection of 2 years had a disability rate of 29.85％ , and those with a delay of more than 2 years and 5 years had the rates of 48.82％ and 61.17％ , respectively. The disability rate was 52.9％ in patients with leprosy reactions and 46.1％ in patients with a damage of more than 3 nerves. The grade II disability rate in paucibacillary patients(28.99％ ) was significantly higher than that in multibacillary ones (22.04％ ). Conclusion Disability rate of leprosy in newly detected cases is still high although it has decreased in the recent 10 years. The rate is associated with delay in detection, leprosy reaction and leprosy type. It suggests that early detection of leprosy patients, regular treatment with multidrug therapy, and management of leprosy reactions will be the effective measures to prevent disabilities of leprosy.

This study was to investigate the role of urethral catheter balloon dilatation(F16)in the treatment of intrauterine adhesion after hysteroscopic surgery.A total of 523 patients with severe intrauterine adhesion(IUA)following hysteroscopic surgery underwent urethral catheter balloon dilatation during April 2000 and December 2005.During 3～15 months'follow-up,normal menses were seen in 340 patients (65.0％),nearly normal menses in 165 patients(31.5％),and menoschesis in 18 patients(3.4％).302 patients showed normal uterine cavity with no recurrent endometrial adhesion,203 patients(38.8％)were found slight IUA,and only 18 patients(3.4％)still presented with severe adhesion.No operative complication was reposed.and the pregnant rate was 47.6％.In summary.urethral catheter balloon dilatation.based therapeutic strategies is safe.effective and beneficial.

Four hundred and five pregnant women whose husbands had positive HBeAg,HBsAg and anti HBc were recruited in the study.Among them.218 women with positive HBsAb were completely randomized into group A and group B,while 187 cases with negative HBsAb formed group C.Women in group A and group C were injected with hepatitis B immunoglobulin(HBIG)before delivery.All newborn babies in 3 groups received routine HCV vaccination.in addition babies in group A and group C also received HBIG iniection within 24 h after birth.The HBV infeetion rate of newborns was 12.1%in group A,12.8%in group B and 23.0%in group C respectively.

Objective To investigate the clinical value of the combination of hysterescope and laparoecope in the treatment of tubal obstruction infertility.Methods Two hundred and sixty-slx infertile women managed by the combination of hysteroscope and laparoecope from August 2003 to December 2006 were enrolled.The postoperation tubal recapalization extent and pregnancy rate were analyzed.Results The recanalization rate of the umbrella and ampulla portion was higher (86.9%) than that of other sites (interstitial portion was 33.8%,isthmic portion was 35.5% ),and the pregnancy rote of patients with one tubal recavalization was signifieenfly higher than that of patients with bilateral tubal obstruction.The pregnancy rate was 48.0% in 12 months,little higher than 41.0% in 6 months after operation.Conclusion The combination of hysterecope and laparescope in treatment of tubal obstruction infertility has ideal effect and clinical application value.