Objective To explore the clinical value of laparoscopic-assisted vaginal hysterectomy(LAVH)in large uterus.Methods Retrospective analysis was conducted on clinical data of 94 patients(whose uterus were as big as 10-18 gestational weeks)who received hysterectomy from January 2005 to March 2007,in which 56 cases were performed laparoscopic-assisted vaginal hysterectomy(LAVH group)and 38 cases vaginal hysterectomy(VH group).The operation time,blood loss,postoperative hospital stay,and the incidence of postoperative complications were compared between the two groups.Results Compared with VH group,there were a lower chance of abdominal hysterectomy(0/56 vs 5/38,?2=5.389,P=0.020),a shorter operation time [(149?11)min vs(179?14)min,t=-11.610,P=0.000] and a shorter postoperative hospital stay [(5.8?1.4)d vs(7.3?3.6)d,t=-2.825,P=0.006] in the LAVH group.There were no significant differences in blood loss,morbidity and time to first flatus between the two groups.Conclusions The LAVH extends the indications of VH,ensuring the safety of VH for the uterus bigger than 10 gestational weeks,therefore it is an operative procedure to be recommended.

Aim To study the effect of sibutramine hydrochloride on hypothalamus orexin system gene in high-fat dietary obesity rats.Methods SD rats were fed with high-fat diet to induce obesity model.Then,the rats were divided into two groups,the treatment group with sibutramine(8 mg?kg-1,ig)and control group with NaCl(ig)for 4 weeks.All rats' weight,blood fat and glucose were measured,prepro-orexin and its receptors mRNA expression in the hypothalamus were assessed by semi-quantity RT-PCR.Results Sibutramine not only decreased the obesity rats' weight and the level of serum lipid and glucose,but also increased the level of prepro-orexin mRNA expression in obesity rats.There was no difference in mRNA expression of both orexin receptors in each group.Conclusions Sibutramine hydrochlorid has an anti-obesity effect in high-fat obesity rats,which may be related to the increase of prepro-orexin gene mRNA expression level.

ive] To evaluate the therapeutic effect of Jiakang Ling (JL) for hyperthyroidism (HT) by ultrasonography. [Methods] Seventy-four cases of HT were randomly allocated to Group B ( n = 40, treated with JL) and Group C ( n = 34, treated with tabazol). And 20 healthy volunteers served as con trol (Group A). Ultrasonic parameters were observed in the three groups. [Results] Ultrasonic parame ters after treatment in 74 cases of HT were similar to those in 20 healthy volunteers. The differences of ul trasonic parameters between Group A and Group B were significant (P

Fasting blood ghrelin level was decreased,and postprandial ghrelin descent was suppressed in high-fat diet induced obese rats.Fasting ghrelin concentration,but not postprandial ghrelin concentration,was negatively correlated with body weight,insulin resistance index,and glucose level.

OBJECTIVE To investigate the postoperative morbility of deep fungal infections and the source and composition of the pathogenic fungi.METHODS Clinical data of 816 patients with post-operative deep fungal infections from Jul 2006 to Jun 2008 were reviewed and analyzed retrospectively.RESULTS The detectable rate of post-operative deep fungal infections was 24.82%,among which Candida albicans was the most common(65.69%),followed by C.tropicalis(10.57%);the rate of broad-spectrum antibiotic application in peri-operation was 96.45%;the infection site in the descending order was cardio-thorax,gastrointestinal tract,urinary tract,female reproductive system,blood and skeleton.CONCLUSIONS Operative trauma is an important factor that causes deep fungal infections in hospital,and is closely related to broad-spectrum antibiotic application.Positive prevention,timely diagnosis and effective treatment should be highly emphasized when dealing with post-operative deep fungal infections.

Objective To select the ultrasonic appearances which effect the benign and malignant of thyroid lesions,and to explore the establishment and applications of supersonic evaluation system for thyroid imaging reporting and data system (TI-RADS) classification.Methods The ultrasound images of 1 080 thyroid nodule cases were retrospectively analyzed by Logistic equation,and the ultrasonic appearances were screened to identify benign and malignant of thyroid lesions.All appearances were obtained weights.The TI-RADS classification analysis software was assigned,which was used to analyze 332 patients with thyroid diseases and to verify the diagnostic performance of the TI-RADS classification system.Results Five ultrasonic features were selected into the regression model,including aspect ratio (odds ratio [OR]=3.61),margins (OR=3.83),composition (OR=11.46),echogenicity (OR=14.12),microcalcification foci (OR =48.82).Using objective evaluation system for TI-RADS classification in ultrasound in diagnosing 332 cases,the area under the ROC curve was 0.91 (P＜0.05).Conclusion Relatively the weight and formation of malignant indicators should be more concern than the number of ultrasonic malignant thyroid lesions indicators.The objective evaluation system for TI-RADS classification in ultrasound has relatively high diagnosis capability which established by the methods of Logistic equation.

Objective To analysis the development tendency and research focus of long-term care of chronic disease between China and abroad and guide the research and application of long-term care of chronic disease in China. Methods The PubMed database and China National Knowledge Infrastructure (CNKI) database were searched and co-word clustering analysis and multidimensional scaling analysis with Bicomb and SPSS 21.00 software were used. Results Foreign hot spots are summarized as follows:oxygen inhalation therapy; mental disorder patients; the needs and demands of long term care. And the following domestic hot spots: long term care for the aged; long term care insurance and social support. Conclusions Long-term care researches in China is still in the exploratory stage and combining with domestic and foreign research hot spots, proposal of long term care in China are summarized as follows:expand the study population of the domestic long-term care, such as the disabled and the mental disorder;enrich domestic long-term care research topics, such as long-term care model, caregivers, care quality, etc.

Objective To study the stability of alkaline and degraded products of curcumin by high performance liquid chromatography(HPLC) and HPLC-mass spectrometry (MS) for the optimization of alkaline-dissolved process parameters of the Jianghuang Qingzhi Tablets and for the quality control of the tablets.Methods HPLC was performed for the determination of the alkaline-dissolved stability of curcumin with acetonitrile-acetic acid at volume coefficient of 4％ (48 ∶ 52) as mobile phase,the detection wavelength being 430 nm.The alkalinedegraded products were tested by HPLC-MS assembling with electron spray ionization (ESI) and quadrupole timeof-flight (Q-TOF) in the scan range of 100-2 000 m/z.Results The degradation of curcumin in the alkaline solution was increased with the temperature.When the temperature was below 20 ℃,the degradation slowed down,while when the temperature reached to 80 ℃,curcumin was degraded completely within 2 h.The probable degradation products in the alkaline solution were p-hydroxy benzaldehyde,vanillin,p-coumaric acid,ferulic acid,et al.Conclusion Curcmin compounds are instable in aqueous alkali.To obtain the high-quality of Jianghuang Qingzhi Tablets with high content of curcumin and less degraded products,the alkaline-solution temperature should be controlled below 20 ℃.

Objective To analyze and summarize the clinical effect of peripherally inserted central catheters (PICC) guided by B-ultrasound,and to discuss the catheterization skills of PICC guided by B ultrasound.Methods Retrospectively analyzed the clinical data of 102 patients recieved PICC guided by ultrasound in neurosurgery department of Chongqing emergency medical center from January 2016 to May 2017.The success rate of one-time puncture, the success rate of one-time catheter delivery and the number of complications were analyzed, and the causes and treatment methods of complications were analyzed.Results Of the 102 cases,94 cases were successfully punctured in one time,6 cases were punctured twice,and 2 cases were punctured more than 2 times.The one-time puncture success rate was 92.16%.Catheter misplacement occurred in 5 patients,and postoperative complications occurred in 2 patients.Conclusion Mastering the related angiotomy and imaging knowledge of PICC and using the B-ultrasound guidance system to insert the catheter can improve the success rate of catheterization and reduce the postoperative complications.

Based on the characteristics of medicinal chemistry and the training objectives of experimental teaching,to explore the teaching reform of comprehensive experiments in medicinal chemistry.This paper discussed the time of biginning comprehensive experiments,the choice of experimental article,the demands on teachers in comprehensive experimental teaching,and attention points of teaching management.