Objective To investigate the effect and necessity of hysteroscopy combined with laparoscopy in the diagnosis and treatment of refractory polycystic ovarian syndrome complicated with infertility.Methods 80 cases of patients with polycystic ovary syndrome (PCOS)combined with infertility were randomly divided into two groups with 40 cases in each group.The testing group used hysteroscopy combined with laparoscopy in diagnosis and treatment while the laparoscopy was only used in the control group.The changes of ovary,ovarian follicles and serum hormone level of the two groups which before and after operation were compared,and the data of postoperative normal ovulation rate,pregnancy rate and abortion rate of the two groups were recorded.Results The follicle number and ovarian volume of the testing group were significantly decreased than that before treatment,and were significantly lower than that of the control group,with statistical difference (t =3.82,3.80,3.74,3.75,all P <0.05).The serum T,LH and LH/FSH of the testing group were significantly decreased than the data before surgery,and were significantly lower compared to the control group with statistical difference (t =9.32,4.06,3.80,all P <0.05).The normal ovulation rate,pregnancy rate and abortion rate of the testing group were significantly higher compared to the control group (90.0%,62.5% and 7.5% vs.72.5%,50% and 15%)χ2 =4.02,4.10,3.90,all P <0.05).Conclusion Hyste-roscopy combined with laparoscopy has an obvious curative effect in the diagnosis and treatment of polycystic ovary syndrome combined with infertility,which can effectively improve ovulation rate and pregnancy rate and reduce the abortion rate,is worthy of clinical application.

OBJECTIVE:To observe the effect of room temperature and low temperature storage on the chronergy of domes-tic cisatracurium. METHODS:90 patients undergoing elective surgery under general anesthesia were randomly divided into low tem-perature group,room temperature A group and room temperature B group,with 30 cases in each groups. Through single supramaxi-mal electrical stimulation of the adductor pollicis muscle,TOF-Watch SX muscle relaxation monitor was used to observe the degree of muscle relaxation. After induction of anesthesia and lost consciousness,the patients was given intravenous injection of cisatracu-rium 0.2 mg/kg;when muscle twitch decreased to the maximum inhibition degree,the patient received endotracheal intubation. The cisatracurium of low temperature group was stored in refrigerator at 2 to 5℃;that of room temperature A group and room tempera-ture B group was stored in incubator for 15 days or 30 days. The onset time,maximum inhibition degree of muscle twitch,clini-cal duration,recovery index and total chronergy were recorded in 3 groups. RESULTS:The maximal inhibition degree of muscle twitch reached 0 under the action of cisatracurium. There was no statistical significance in onset time and clinical duration between room temperature A group,room temperature B group and low temperature group(P>0.05);the recovery index and total chroner-gy of room temperature A group and room temperature B group were or longer than low temperature group,with statistical signifi-cance(P<0.05). CONCLUSIONS:Domestic cisatracurium stored at low temperature shows weaker effect on muscle relaxation.

Antineoplastic Agents ; therapeutic use ; Clinical Trials as Topic ; Humans

Pancreatic neoplasm is one of the most commonly-appeared digestive tumors and has been well-recognized as the poor diseases which have the difficulties in diagnosis,treatment and prognosis estimation.Recently,the detection of circulating tumor cells (CTCs) has been a pretty highlight of the research on detecting tumor cells in peripheral blood,and furthermore,the clinical value in the diagnosis,treatment and prognosis prediction has already been verified through a large amount of samples analyses in various kinds of tumor diseases.This paper aims to review and conclude the techniques of CTCs enrichment,detection and clinical implications in pancreatic neoplasms.In addition,the existing papers have been summarized and prospect of application of CTCs is also presented.

Gastroenteropancreatic neuroendocrine neoplasms are a group of heterogeneous tumors originated from the gastrointestinal peptidergic neurons and neuroendocrine cells.Rectum is one of the major sites of gastroenteropancreatic neuroendocrine neoplasms.Although the progression of rectal neuroendocine neoplasms (rNENs) is relatively slow,metastasis could occurs and liver is the major target organ invaded by distant metastatic rNENs.Surgical operation can be used as the preferred method for the treatment of rNENs and its metastasis at present.If the clinical situations of tumors are not eligible for the operation,interventional treatment can be considered as an alternative treatment.The chemotherapies and molecule-targeted drugs for rNENs are primarily in the light of therapeutic methods for pancreatic neuroendocrine neoplasms,it may help patients achieve partial response or stable disease,and prolong patients survival time.However,there has been few clinical researches directed toward rNENs and no an extensive consensus for treatment of rNENs up to now,and more evidences of evidence-based medicine should be necessitated.This paper has discussed and summarized treatment progression of rNENs and its metastasis.

A method based on in situ formed ionic liquids microextraction-ultra performance liquid chromatography(ISFILM-UPLC) was established for the determination of vancomycin in human serum.The samples were pretreated by vortex and centrifugation.[C6MIM] [Br] and NaPF6 were applied as the extracting agent,and Metronidazole as the internal standard.Methanol was applied to redissolve the precipitate.The separation was carried out on a BEH C18 column,and the mobile phase consisted of methanol and 0.05 mol/L monopotassium phosphate solution.The flow rate was 0.2 mL/min,the injection volume was 5 μL,and the column temperature was 18 ℃.The key parameters of this method such as the specificity,accuracy and precision were validated.This method showed good correlation with the immunoassay.It shows great potential for the application in clinical practice.

OBJECTIVE:To study the effects of indometacin on apootosis and proliferation of cervical cancer Hela cell. METH-ODS:Hela cell was cultured in vitro as study object,and cultured with 0(blank control),200,400,600,800 and 1 000 μmol/L indometacin for 24,48 and 72 h. The inhibitory rate of indometacin to the proliferation of Hela cells was detected by MTT assay. After treated with 0(blank control),400,600 and 800 μmol/L indometacin for 24 h,the change of cellular morphology was ob-served by invert microscope;cell cycle phase and apoptosis were analyzed by flow cytometry. RESUITS:Indometacin of 600, 800,1 000μmol/L could inhibit the proliferation of Hela cell,which was positively correlated to drug concentration and time. Com-pared with blank control,indometacin could induce that Hela cell transformed from polygonous to round in appearance,and result-ed in cell apoptosis and necrosis;the proportion of cells at G0/G1 phase increased,while the proportion of cells at S phase reduced;the apoptotic rate of cells raised. CONCLUSIONS:Indometacin could inhibit the proliferation of Hela cell,block cell cycle at G0/G1 phase and induce apoptosis.

Objective To investigate and analyze the application of three steps therapy analgesics in good pain management(GPM)-ward,in order to provide rational analgesics drug application in clinical practice.Methods Through the hospital HIS system,the application data of analgesics in GPM-ward from Jan.2014 to Dec.2015 were collected and analyzed.Results The sum and proportion of the strong opioid drug was lined first.The total DDDs of the three -stage analgesics ranked from high to low was celecoxib >tramadol >oxycontin >morphine >fentanyl trans-dermal.The celecoxib was usually assisted the other;in addition,tramadol's DDDs and expense amount decreased, which was in the line with NCCN guidelines.Moreover,oxycontin's DDDs and expense amount increased.As well as, anesthesia prescription qualified rate was 93.5%,medical record standard rate was 80.5% in 2014,prescription qual-ified rate was rose to 97.5%,medical record standard rate was rose to 91.5% in 2015.Conclusion The application of cancer pain drug was basically rational in GPM-ward,which is in line with the principles of cancer pain relief by the mouth,by the clock,by the ladder and for the individual.

Objective To evaluate the strength of tobacco control at or below county-level governments of Zhejiang Province,to explore the strategies and measures on tobacco control,and promote a smoke-free government.Methods By multistage stratified random sampling method,12 government ageucies were selected in 4 counties.The information of tobacco control strength and smoke-free environment creation was collected by interview and field observation,and the scores were calculated by using the percentage assignment method.An intercept suuvey was carried out in four counties and there were 405 civil servants under investigation.The data were analyzed by frequency statistic and correlation analysis.Results The smoking rate of civil servants was 17.8％,and the secondhand smoking rate was 61.9％;84.7％ of civil servants adnmitted the harm of smoking and 96.8％ admitted the harm of secondhand smoking.Support for forbidding the cigarette advertisements was highest and increasing the cigarette price was the weakest.The scores of smoke-free environment creation of project counties showed that the average score was 50.60,Zhuji and Luqiao got a maximum score of 57.14,Haiyan got a minimum score of 42.86.The scores of tobacco control strength showed that the average score was 82.35,Zhuji got a maximum score of 92.16,followed by Luqiao,Jiande and Haiyan counties,82.35,80.39 and 74.51 respectively.The scores of tobacco control strength,include policy,political will,capacity,and tobacco control efforts were the highest in Zhuji county.The results of correlation analysis showed that the total score of tobacco control strength had significant association with the score of smoke-free environment creation,smoking rate of civil servants,and approval rate of anti smoking in public places (P＜0.05).Conclusion The overall situation of tobacco control strength at or below county-level governments of Zhejiang province is good,but there is a relative shortage of smoke-free environment creation.Civil servants master the knowledge related to tobacco and support tobacco control policy.We should further promote the construction of smoke-free government.More effective smoking control measures should be conducted in order to raise the strength of tobacco control and finally implement the tobacco control legislation.

Objective To understand the prevalence of tobacco use among college students in different populations by sex,age and major,and to provide evidence for smoking control and health decision.Methods A total of 4 638 college students selected in 21 colleges through stratified multi-stage cluster sampling from Zhejiang Province were surveyed by using questionnaire analysis.Indicators such as tried smoking,current smoking,and secondhand smoke exposure,etc.,were calculated by weight on age proportions from the numbers of college students in Zhejiang.Results The prevalence of tried smoking and currcut smoking among college students were 29.72％ and 10.57％,respectively.The prevalence of tried smoking was 46.52％ for men,18.25％ for women;28.57％ for undergraduate,31.53％ for junior college;the prevalence of current smoking was 18.86％ for men,3.86％ for women;8.88％ for undergraduate,13.23％ for junior college students.The snoking rate in college students increased with age,the group of ≥21 Years was the highest (37.87％,16.09％).The lowest level of smoking was medical student (21.76％,2.19％).The prevalence of secondhand smoke exposure in outdoor and indoor places,and dormitory among students were 65.49％,60.33％,and 23.66％,respectively.In the past 30 days,college students have seen tobacco advertisement (47.38％),smoking scenes (60.20％),and got tobacco related gifts (10.40％),free tobacco products (8.93％);college students have seen information about tobacco control (60.50％),cigarette pack warning labels (58.45％),and learned the tobacco knowledge in class in the past 12 months (14.03％).Conclusion Current prevalence of smoking in college students in Zhejiang province remained at a high level,the rate of secondhand smoke exposure is high and in college students there was lack of tobacco control education in class.The results indicated that the policy about tobacco control in school was not enough and the task of health promotion should be taken more arduously.