Objective To investigate clinical effects of laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy.Methods 160 children with tubal pregnancy were chosen in our hospital in the period and randomly divided into two groups including control group (80 children)with laparoscopic salpingotomy treatment and treatment group (80 children)with pituitrin adjunct treatment before operation on the basis of control group.And the operation time,intraoperative bleeding volume,postoperative body temperature,hospitalization time,the retention rate of fallopian tube,fallopian tube patency rate,persistent ectopic pregnancy rate,intrauterine pregnancy rate and fertility rate of both groups were compared.Results The operation time,intraoperative bleeding volume, postoperative body temperature and hospitalization time of the control group were separately (20.33 ±2.70)min, (52.76 ±7.42)mL,(37.52 ±0.54)℃ and (7.56 ±1.98)d;the operation time,intraoperative bleeding volume, postoperative body temperature and hospitalization time of the treatment group were separately (8.94 ±1.61)min, (16.33 ±2.15)mL,(37.46 ±0.50)℃and (5.91 ±1.42)d;the operation time,intraoperative bleeding volume and hospitalization time of the treatment group were significantly better than those of the control group (t=2.26,2.60, 2.08,all P<0.05 );there was no significant difference in postoperative body temperature between 2 groups (t=1.55,P>0.05).The retention rate of fallopian tube and fallopian tube patency rate of the control group were sepa-rately 75.00% (60/80)and 52.50%(42/80);the retention rate of fallopian tube and fallopian tube patency rate of the control group were separately 93.75% (75/80)and 81.25% (65/80);the retention rate of fallopian tube and fallopian tube patency rate of treatment group were significantly better than those of the control group (χ2 =9.71, 10.14,all P<0.05).The persistent ectopic pregnancy rate,intrauterine pregnancy rate and fertility rate of the control group were separately 17.50%(14/80),31.25%(25/80)and 37.50%(30/80);the persistent ectopic pregnancy rate,intrauterine pregnancy rate and fertility rate of the treatment group were separately 15.00% (12/80),61.25%(49/80)and 16.25% (13/80);there was no significant difference in persistent ectopic pregnancy rate between 2 groups (χ2 =1.33,P>0.05);the intrauterine pregnancy rate and fertility rate of treatment group were significant-ly better than those of the control group (χ2 =11.84,12.52,all P<0.05).Conclusion Laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy can efficiently decrease operation time the amount of bleeding,shorten hospitalization time and be helpful to improve the reproductive outcome.

0.05),the content ratio of glutamate to gamma-aminobutyric acid in the hippocampus of the dependent rats was lower than that in the control group(P

0.05).IGFR-1? expressed in all the 6 cell lines,with the highest expression in SW480(P0.05),but a gefitinib-induced and dose-dependent increase in p-IGFR-1?,not IGFR-1?,expression was observed in HT29 cells(P0.05),but the expression of IGFR-1? was higher in HCT116 than in Lovo and HT29(P

Objective To evaluate the dose distributions with different dose rates, and approach a reference to the dose rate for radiation. Methods Three classic static intensity modulated radiotherapy (IMRT) plans of prostate cancer, lymphoma and nasopharyngeal carcinoma were chosen for the study. For each plan, the dose verification of three different dose rates (100, 300 and 600 MU/min) was performed with the Varian 600CD linear accelarator by using the 2-DICA of I'mRT Matrixx. With the Pinncale planning system, each segment was used as a beam to form another IMRT plan. The OmniPro-I'mRT V1.6 was applied to compare the segments in the two IMRT plans, and then the actual weights were obtained. The simulated plans at different dose rate were designed when setting the weights back into the planning system. Results With the increase of dose rate, the passing ratio of the verification decreased and the D_(max), D_(min), D_(mean) and D_(95) of the planning tumor volume increased. The high dose area expanded significantly in target regions, and the 95% isodose line extended. At the dose rate of 600 MU/min, The D_(95) of GTV_(nd) in nasopharyngeal carcinoma increased by 5.33% than the original plan with the V_(110) up to 19. 38%. The irradiation dose of the organs at risk (OARs) increased. For the case of lymphoma, the V_(20) of the lungs in the original plan and the three simulated plans were 31.77%, 32. 11%, 32.60% and 33.26%, respectively. For the case of nasopharyngeal carcinoma, the V_(30) of the right parotid were 48.75%, 49. 56%, 51.65% and 53.91%, respectively. Conclusions With the increase of dose rate in static IMRT , the actual dose distribution deviates the original plan , and the high dose area and the OARs dose increases. The higher dose rate is suboptimal when the dose of the OARs is proximate to the tolerance limit.

Objective To explore the value of dual-source CT monoenergetic-plus imaging in the diagnosis of early gastric cancer. Methods Imaging data of 2 6 cases with pathologically proven early gastric cancer who underwent dual-energy scanning were analyzed retrospectively.Monoenergetic-plus images with energy levels at 40 keV,50 keV,60 keV and 70 keV were reconstructed by using an advanced monoenergetic software (syngo.via.VA30A,Dual energy Mono+).Contrast-to-noise ratio (CNR)of the lesion,image noise,overall image quality score and lesion conspicuity score were com pared between different monoenergetic-plus images and conventional polychromatic images at 1 2 0 kVp.Results The CNRs (3 .2 4 ± 0 .7 6 ,2 .9 4 ± 0 .9 2 ,2 .4 7 ± 0 .7 9 ,2 .3 7 ± 0.98 and 1.22±0.40 respectively)and image noises [(32.7±1.82)HU,(25.6±2.61)HU,(20.30±2.1 7)HU,(1 7.03±2.1 5)HU and (18.15±2.12)HU respectively]among 40 keV,50 keV,60 keV,70 keV and 120 kVp groups all had statistical differences (F =24.654 and 227.05,P <0.01).The CNR in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups,but similar to that in 40 keV group (P >0.05).The SD value in 50 keV group was lower than that in 40 keV group,but higher than that in other three groups (P <0.05).The overall image quality score (3.08±0.27,3.65±0.49,3.31±0.47,3.23±0.43 and 3.1 5±0.37,respectively) and lesion conspicuity score (4.15±0.67,3.92±0.48,3.27 ±0.45,3.08±0.27 and 3.04±0.20)among the five groups all had statistical differences (Z =25.343 and 70.426,P <0.05).The overall image quality score of 50 keV group was higher than that of the other four groups (P <0.05).Lesion conspicuity score in 50 keV group was higher than that in 60 keV,70 keV and 120 kVp groups and similar to that in 40 keV group (P =0.1 52).Conclusion The 50 keV monoenergetic-plus images can increase the CNR value of early gastric cancer while maintaining the overall image quality.

Objective To observe the inhibitory effect of Gefitinib,a selective oral epidermal growth factor receptor tyrosine kinase inhibitor,on the growth of human colon cancer cells,and investigate the relationship between the sensitivity of colon cancer cells to Gefitinib and PIEN expressions.Methods The inhibitory effects of Gefitinib on 6 kinds of colon cancer cells(Lovo,HCT116,HT29,Lsl74T,SW480 and SW620),the levels of PTEN mRNA in different colon cancer cells.and PTEN protein expressions in colon cancer cells were detected by MTT assay,RT-PCR and Westem blot,respectively.Results The inhibitory effects of Gefitinib on the 6 colon cancer cells in vitro varied a lot.When the concentration of Gefitinib was 1 μmol/L,LoVO cells had the most sensitivity to Gefitinib with an IC50＜10μmol/L;HT29 and SW480 had moderate sensitivity,and the IC50 ranged from 10 μnol/L to 100 μmol/L;HCT116,LS174T and SW620 were insensitive to Gefitinib,and their IC50＞100 μmol/L.All the colon cancer cell lines exhibited PTEN mRNA and protein expressions.Conclusions PTEN mRNA andprotein expressions might not be associated with the inhibitory effects of Gefitinib on the growth of colon cancer cells.The expression of PTEN can not be taken as the indication of the sensitivity of colon cancer cells to Gefitinib.

Objective To determine the evaluating prognostic value of plasma Nt-proBNP in patients with congestive heart failure.Methods 107 patients with congestive heart failure were included in this study,followed the degree of rehospitalization and mortality rate of the cured patients after left hospital.The plasma concentrations of Nt-proBNP were measured by enzymelinked immunozorbent assay(ELISA).Results Concentrations of Nt-proB-NP of Ⅱ,Ⅲ,Ⅳ classincation were(1129.8±383.2),(5849.7±567.6),(9506.3±492.4)ng/L in NYHA functional classification respectively(P＜0.01);the plasma level of Nt-proBNP had significant positive correlation with NYHA functional classification(r=0.759,P＜0.01).The degree of rehospitalization were(0.85±0.96),(1.98±0.86),(2.58±0.91)respectively(P＜0.01);mortality rate were 8.3%,12.5%,45.2%respectively(P＜0.01).Conclusion Plasma Nt-proBNP level may be the more important clinic value in evaluating prognosis in patients with congestive heart failure.

Objective To investigate the therapeutic effect of stage treatment of severe complicated injuries in palmar forearm and wrist.Methods From March 2008 to Novemler 2011, eleven cases with skin lost combined with fracture and lost of flexor tendon, ulnar radial arteries, median and ulnar nerves,and some of them had fracture of ulnar and radius were treated in the first stage with vacuum sealing drainage after emergency debridement and tissue repair. Secondary microsurgical repair was performed after the VSD was removed. The lost of median and ulnar nerves was repaired with transplantation of sural nerve,and the wound was repaired with free flaps and complex tissue flaps. Results Eleven cases were treated with vacuum sealing drainage for 7 to 10 days.Infections were under control,wound areas reduced and most wound areas were covered by granulation tissues.Flaps and skin grafts were survived.After postoperative follow-up for 3 to 36 months (average 13 months),three cases was received flexor tendolysis.As result,the blood circulation of hand was good, the sensor of injured nerve was higher than S3, and there was a good functional rehabilitation of hand muscles. Conclusion Using vacuum sealing drainage after emergency debridement and tissue repair, there was a good repairing effect of secondary repair with flaps and skin grafts for severe complicated tissue defect in palmar forearm and wrist,and it is an effective choice of operation.

Objective To evaluate the therapeutic effect of ESWL combined with urinary stone decoction and ear acupoint pressure for the patients with renal and ureteral calculi.Methods A total of 110 patients with renal and ureteral calculi were randomly divided into the Chinese medicine (CM) and conventional groups, 55 in each group. Both groups were given ESWL treatment as basic treatment. Chinese medicine group were given the urinary stone decoction and auricular acupressure, and the conventional group used stone granules. Both groups were treated for 2 weeks. According to the photography of ultrasound, the changes of calculi, time of lithagogue, pain relief after operation and the effect rates of pain relief on abdomen and waist, of remission of haematuria, and of urinate pain. ResultsAfter treatment, the successful rates of operation in the CM group was 90.9% (50/55), and conventional group was 76.4% (42/55). There was significant difference between 2 groups (χ2=4.251,P=0.009). The time of stone removal in CM group was significantly shorter than that in the conventional group (7.3 ± 3.8 dvs. 11.2 ± 4.3 d,t=4.032,P<0.001). After 1st, 3rd, 5th, 7th days, the VAS pain scores in the CM group were significantly lower than those in the conventional group (4.1 ± 0.8vs. 5 ± 1.2,t=4.783;4.5 ± 0.9vs. 5.3 ± 1.3,t=4.492; 3.8 ± 0.8vs. 4.5 ± 0.8,t=4.503; 2.2 ± 0.8vs. 2.9 ± 0.9,t=3.691; allP<0.01). After 7th day, the rates of abdominal pain relief was 60% (33/55), pain relief was 79.1% (34/43), the remission of hematuria was 81% (17/21) in the CM group, and the control group were 40% (22/55), 59.6% (28/47), 52% (13/25). There were significant differences between 2 groups on these indices (χ2 values were 4.400, 3.982, 4.217,P values were 0.036, 0.046, 0.040).Conclusions The ESWL combined with urinary stone decoction and ear acupoint pressure could improve the symptoms of patients with kidney ureteral stones.

Standardized rotary residency training is an important part of clinical medical education. Traditional clinical teaching can't meet the rapid development of oncology medicine. In the rotary residency training in oncology department, we put forward the problems encountered in clinical practice, stimulate the interest and initiative of residence, the PBL teaching model is combined with the evidence-based medicine in the teaching process through the relevant training, literature review and discussion. By standardizing the treatment concept the residence's understanding of the basic theory and frontier knowledge of oncology was improved, the thinking innovation and clinical practice ability of the residency doctors were enhanced.