Objective To study the incidence of pelvic adhesions in endometriosis(EM) and the relationship between pelvic adhesions and pain symptoms. Methods The incidence of pelvic adhesions, dysmenorrhea, chronic pelvic pain, dyspareunia, dyschizia in 480 patients with EM were studied retrospectively to evaluate the correlation between pelvic adhesions and the degree of pain symptoms. In accordance with the revised American Fertility Society classification (r-AFS), it was observed that 155 cases were in Stage Ⅰ,33 cases were in stage Ⅱ,108 cases were in stage Ⅲ and 184 were cases in stage Ⅳ. Results (1) Among 480 cases with EM, 72.3% (347/480) of patients have pelvic adhesions simultaneously, of which 25.2% (39/155) patients were in Stage Ⅰ, 78.8% (26/33) patients were in Stage Ⅱ, 90.7% (98/108) patients were in Stage Ⅲ and 100.0% (184/184) patients were in Stage Ⅳ. It was found that positive correlation existed between the degree of pelvic adhesions and clinical staging of EM(rs=0.870,P<0.01).(2) 61.0%(293/480) of patients presented dysmenorrhoea, of which the percentages of mild, moderate and severe dysmenorrhea were 52.2%(153/293), 26.6%(78/293), 21.2% (62/293), respectively. The rate of patients presenting chronic pelvic pain (CPP), dyspareunia and dyschezia were 23.8% (114/480), 15.4% (74/480) and 7.1% (34/480), respectively. (3) Ovarian adhesions was positively correlated with dysmenorrhea and CPP(rs=0.367 and 0.267,P<0.01). Adhesion of the bottom and posterior wall of uterus was positively correlated with dysmenorrhea and CPP (rs=0.336, 0.164,P<0.01); adhesions of fallopian tubes were positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.283, 0.225 and 0.159, P<0.01). Adhesions of rectum was positively correlated with dysmenorrhea (rs=0.101,P<0.05). In addition to dyspareunia, the degree of pelvic adhesions was positively correlated with dysmenorrhea, CPP and dyschezia (rs=0.470, 0.273, 0.132, P<0.01). Conclusion Pelvic adhesions are characteristic lesions of endometriosis, the site and degree pelvic adhesions are closely correlated with pain symptoms.

Objective To develop the Chinese version of multidimensional measure for recurrent ab-dominal pain scale(MM-RAP) and test the reliability and validity of it. Methods The Chinese version of MM-RAP was translated and revised and 100 children with recurrent abdominal pain and their parents were surveyed by it. Then the reliability and validity of the scale was tested. Results The teat-retest reliability coefficient of MM-RAP was 0.86. The total Cronbach's coefficient α of the scale was 0.80. Cronbach's coef-ficient α of each dimensions was above 0.70. The results of correlation analysis showed that there was higher correlation between items and its belonged dimensions than that with other dimensions. The results of confir-matory factor analysis indicated the factor structure was similar with the theoretical construction of the in-strument. Conclusions The Chinese version of MM-RAP demonstrated good reliability and validity and was an effective assessment instrument for measuring recurrent abdominal pain of Chinese children.

Put forward opinions and suggestions about characteristics of the new era of medical disputes pre -vention treatment through the analysis of a hospital in the past five years occurred in 44 medical disputes .We must fo-cus on innovation and long -term mechanism to prevent medical malpractice , medical malpractice to further improve the prevention, comprehensive mechanism , and continuously improve the effectiveness of medical dispute processing services.

Objective To establish practical cell model of HCV infection, and investigate the susceptibility of a human liver cell line HepG2 to hepatitis C virus in vitro. Methods A human liver cell line HepG2 was incubated with serum from a chronic hepatitis C patient for 6～8 hours. Both the plus and minus strands of HCV RNA in infected cells or supernatant were examined by reverse transcription polymerase chain reaction (RT PCR). The HCV NS 3,NS 5 antigens in infected cells were respectively detected with the monoclonal antibodies to antigens of their own by immunohistochemical assay. The minus strand of HCV RNA in infected cells were localized by in situ hybridization. Results The intracellular plus or minus stands of HCV RNA were first detected on day 3 post incubation and then could be intermittently detected until day 35 post incubation in cells or supernatant. The positive signals of NS 3,NS 5 antigens could be expressed within cytoplasm of infected cells. The minus strand of HCV RNA was located within cytoplasm by in situ hybridization. Conclustions These results show that a human liver cell line HepG2 is not only susceptible to HCV but also able to support its long time replication in vitro.

Cervical cancer poses a major threat to public health worldwide, early diagnosis of cervical cancer can improve the survival rate of patients. The detection rate of the existing cervical cancer screening methods is not very stable, and there is no reliable non-invasive index to predict the recurrence, metastasis and prognosis of cervical cancer. We searched literaruture for cervical cancer-related diagnostic and prognostic indicators and included 20 related literature, confirming that liquid biopsy is expected to replace and supplement the existing methods of screening and testing. Circulating nucleotides are an important part of liquid bioassays, including circulating cell-free DNA (cfDNA) and circulating cell-free RNA (cfRNA), among which cfRNA is a potentially rich source of tumor biomarkers, especially in the early diagnosis of cervical cancer. It has unique specificity and great potential value in the early diagnosis.

Objective To explore the reason for remedy radical operation after endoscopic submucosal dissection (ESD) for early gastric cancer.Methods The clinical data of 26 early gastric cancer cases who received remedy radical gastrectomy after ESD between January 2012 to March 2015 in Nanjing Drum Tower Hospital were analyzed retrospectively.Results All cases were followed up and mid follow-up was 25 months.There was no death nor tumor reccurence cases during the follow-up.Three cases suffered from complications in radical surgery for gastric cancer including afferent jejunal loop obstruction,adhesive intestinal obstruction,stomach paralysis respectively,all were cured by conservative therapy.Postoperative pathology found lymph node metastasis in 3 cases.Conclusions En bloc resection and negative resection margin,as well as free lymphatic metastasis are two important factors determing the survival of early gastric cancer patients undergoing ESD treatment.

OBJECTIVETo observe the effects of electroacupuncture (EA) with branch-foundation acupoint combination on the indices regarding pituitary-target gland axis in aging rats with yang deficiency, so as to explore its regulating mechanism on aging rats with yang deficiency.

METHODSForty healthy Sprague-Dawley female rats were randomly divided into a normal control group, a model group, an EA group and an EA control group, 10 rats in each group. Except the normal control group, the rats in the rest 3 groups were all treated with subcutaneous injection of D-galactose for 40 d, followed by intramuscular injection of hydrocortisone for 7 d to establish aging model with yang deficiency. After the successful establishment of model, the EA group was treated with EA at "Guanyuan" (CV 4), "Housanli" (ST 36) and "Baihui "(GV 20) while the EA control group was treated with EA at "Zhongji" (CV 3) "Yinlingquan" (SP 9) and "Yintang" (GV 29); the rats in the normal control group and model group were immobilized and fixed during the same time period. The treatments were given 6 times per week totally for 4 weeks. With radiation immunity analysis method, the 8 biological indices of pituitary-target gland axis, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine-4 (T4), adrenocorticotropic hormone (ACTH), corticosterone (CORT), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were detected to observe the changes of their content.

RESULTSCompared with the normal control group, the serum level of TSH, T3, T4 and E2 were reduced in the model group (P<0.05, P< 0.01) while those of ACTH, CORT, FSH and LH were increased (P<0.05, P<0.01). Compared with the model group, the serum level of TSH, T3, T4 and E2 were increased in the EA group (P<0.05, P<0.01) while those of ACTH, CORT, FSH and LH were significantly reduced (P<0.05, P<0.01). Compared with the EA control group, the content of TSH was increased in the EA group without statistical significance (P>0.05), that of T3, T4 and E2 was increased (all P<0.05) and that of ACTH, CORT, FSH and LH was significantly reduced (all P<0.05).

CONCLUSIONThe electroacupuncture with branch-foundation acupoint combination has benign regulating effects on the key hormones of pituitary-target gland axis, which could effectively improve the dysfunction of pituitary-target gland axis that is caused by aging with yang deficiency; the efficacy of electroacupuncture with branch-foundation acupoint combination is superior to that of adjacent control acupoint combination.

Acupuncture Points ; Adrenocorticotropic Hormone ; blood ; secretion ; Aging ; blood ; metabolism ; Animals ; Disease Models, Animal ; Electroacupuncture ; Estradiol ; blood ; secretion ; Female ; Follicle Stimulating Hormone ; blood ; secretion ; Humans ; Pituitary Gland ; secretion ; Rats ; Rats, Sprague-Dawley ; Thyroid Hormones ; blood ; secretion ; Yang Deficiency ; blood ; metabolism ; therapy

Objective To explore the effects of baicalin in the treatment of a preeclampsia (PE) rat model by detecting the expression of X-linked inhibitor of apoptosis protein (XIAP) and cysteine containing aspartate-9 (Caspase-9) and observing the ultrastructure of mitochondria in trophoblast cells.Methods Forty-eight pregnant Wistar rats were randomly divided into two groups:12 in the control group and 36 in the PE model group.The PE model was established with subcutaneous injection of l-nitro arginine methyl ester with 100 mg/kg per day from the 13th day of pregnancy.Beginning from the 16th day of pregnancy,the PE rats were injected with different doses of baicalin till cesarean section,and divided into three groups:non-intervention PE model group treated with saline (NIP group),low-dose baicalin intervention group (IDB group) at 50 mg/kg per day,and high-dose baicalin intervention group (HDB group) at 100 mg/kg per day.The rat tail artery blood pressure and 24-h urine protein level were measured at pregnant day 10,16 and 20.The levels of XIAP and Caspase-9 in placenta were measured by immunohistochemistry.The ultrastructure of mitochondria of trophoblast cells of the rat placenta was observed under electron microscope.T test,F test and LSD-t test were applied for statistical analysis.Results (1) On pregnant day 10,no significant differences were observed in rat tail artery systolic blood pressure,diastolic blood pressure and 24-h urine protein level between the control group and PE model group (all P＞0.05).On pregnant day 16 and 20,the systolic blood pressure,diastolic blood pressure and 24-h urine protein level of NIP,IDB and HDB groups were significantly higher than those of control group [pregnant day 16:systolic blood pressure:(137.74±5.21),(136.15±4.86),(138.28±4.79) and (110.57±3.79) mmHg (1 mmHg=0.133 kPa),diastolic blood pressure:(89.58 ± 5.50),(88.45 ± 8.59),(89.42 ± 6.29) and (80.28 ± 7.36) mmHg,24-h urine protein:(7.78 ± 0.45),(7.53 ± 0.54),(7.86± 0.57) and (6.45 ± 0.56) mg;pregnant day 20:systolic blood pressure:(145.26 ± 4.67),(131.28 ± 4.34),(130.93 ± 5.33) and (110.40 ± 6.92) mmHg,diastolic blood pressure:(89.87±6.55),(85.34±7.33),(84.64±7.36) and (80.19±7.34) mmHg,24-h urine protein:(11.18±0.42),(9.65±0.54),(9.06±0.56) and (6.31 ±0.45) mg] (all P＜0.01).On pregnant day 20,the systolic and diastolic blood pressure and 24-h urine protein level in IDB and HDB groups were significantly lower than in NIP group (all P＜0.05),but showed no significant differences between IDB and HDB groups (allP＞0.05).(2) Compared with NIP group,the expression of XIAP in control group,IDB and HDB groups were significantly increased(210.39±0.78,180.56±0.82,195.36±0.96 and 192.84± 1.06,all P＜0.01).There was no significant difference in the expression of XIAP between IDB and HDB groups (P=0.66).The expression of Caspase-9 in control group,IDB and HDB groups were significantly decreased compared with NIP group (210.36±0.55,195.53±0.96,198.42± 1.01 and 185.25±0.64,all P＜0.01).There was no significant difference in the expression of Caspase-9 between IDB and HDB groups (P=0.65).Ultrastructure of mitochondria in NIP group showed different degrees of damage,matrix swelling,and mitochondrial cristae bresk or disappearance.In IDB group,mitochondrial matrix swelling was not obvious,and mitochondrial cristae were visible.In HDB group,mitochondrial cristae were neat and clear.Conclusions Baicalin may play an important role in the treatment of preeclampsia by reversing the trophoblast apoptosis and improving the ultrastructure of mitochondria through its regulation of XIAP expression and downregulation of Caspase-9 expression.

Contents in orthopaedic are independent relatively and finding out the internal relations during them is helpful to improving the effect of orthopaedic teaching.Transfer theory is important tools for clinical teaching practice,and finding out the common characteristics between the orthopaedic chapters is primary for the theory.This research focuses on the following fields:fractures,nerve injury,infection,tumor and deformity.After the common characteristics between these chapters were analyzed and discussed,we concluded that the transfer theory is helpful in orthopaedic teaching practice,especially for students' comprehension and memory,but still we should avoid some negative effects in teaching process.

Objective To investigate the importance of elements of teaching aesthetic(appearance aesthetics; language aesthetics; emotion aesthetics; PPT aesthetics; blackboard-writing aesthetics and model aesthetics) in clinical orthopaedic teaching,and to analyze the reasons and significance of them.Methods Totally 137 medical students(2005 and 2006 grade) were investigated by the questionnaire in resent 2 years.They were asked to choose the first two important elements of teaching anesthetic from six elements displayed by four teachers.Results The percentage of appearance aesthetics,language aesthetics,emotion aesthetics,PPT aesthetics,blackboard-writing aesthetics and model aesthetics were showed as 97.4％,88.7％,67.1％,58.9％,13.6％ and 1.2％ respectively.Conclusion Teaching aesthetics is an indispensible part of teaching aesthetically and it is helpful to promote the teaching.We should be focus on PPT aesthetics and appearance aesthetics,which show high percentage in our research.