Objective To discuss the treatment of cervical cancer in different stages.Methods The treat- ment of 42 cases of cervical cancer in this hospital from January 2000 to December 2005 was analysed,and clinical treatment modalities were analysed too.Results(1)A total of 6 cases of uterine carcinoma in situ received hysterec- tomy plus bilateral salpingo-oophorectomy.(2)A total of 26 cases was inⅠb-Ⅱa stage,of which 15 cases with cer- vical cancer were treated with a simple radical hysterectomy;6 cases of cervical cancer were radiotherapied after radi- cal hysterectomy;7 cases of cervical cancer received radical hysterectomy plus radiotherapy.(3)A total of 10ⅡbⅣstage eases selected radiotherapy and chemotherapy.Conclusion Different treatment should be applied in differ- ent stages of cervical cancer,and the choice for treatment is important for patients' quality of life after treatment. Comprehensive treatment can improve the survival of patients with cervical carcinoma.

Objective To propose a new classification scheme of otitis media (OM). Methods By reviewing current internat ional classification systems of OM, we analyzed their disadvantages and the prog ress made in histopathologic studies of OM, then worked out a new classification scheme to apply it to clinic. Results In current internati onal classification systems of OM, those apparent clinical signs are regarded as main standards of classification. Their main disadvantage is that these signs c annot very well indicate the condition of pathologic and functional changes of i mportant hearing structure areas. We proposed a “Three-stage Scheme” of OM cl assification and applied in 1 160 cases of OM. The accuracy rate of diagnosis w as 82.4% in 348 cases of early-stage OM, 98.4% in 696 cases of chronic OM, and 95.2% in 116 cases of OM sequela. Conclusion The “Three-s tage Scheme” system is scientific, simple and practical. Its accuracy rate of d iagnosis is very high. It plays a guiding role in diagnosis and treatment of OM.

Selective COX-2 inhibitors can promote the apoptosis of tumor cells and block the growth of new blood vessels through the inhibition of ring oxidase,vascular endothelial growth factor,microvessel and so on. Research shows that COX-2 is overexpressed in vascular and endothelial cells of lung cancer,select COX-2 inhibitors to adjuvant chemotherapy,not only can directly inhibit the tumor proliferation,but also can reduce the adverse reaction of chemotherapy drugs,and enhance the curative effect. To investigate the effects of selec-tive COX-2 inhibitors and cisplatin in lung cancer angiogenesis and its mechanism,will be a hope for the clini-cal treatment of tumor.

COX-2 is the inducible form of cyclooxygenase,which is overexpressed in non-small cell lung cancer,especially in the adenocarcinoma,and is involved in the production of lung cancer drug resistance, reducing the sensitivities of tumor cells to chemotherapy drugs. COX-2 inhibitors have the effects of antitumor and prevention of tumor formation. Therefore,in order to reverse the drug resistance of tumor cells,improve the sur-vival rate and the prognosis of patients with tumor,the application of COX-2 inhibitors as adjuvant chemotherapy and combined with chemotherapy drugs has become a new direction in the treatment of lung cancer.

Objective To investigate and analyze the relative factors in elderly men with type 2 diabetes mellitus(T2DM)complicated with osteoporosis(OP),thus to provide guidance for prevention of OP complicated with T2DM in elderly men.Methods Dual X -ray absorptiometry determination of bone mineral density (BMD)of 67 cases of elderly men with diabetes,men were divided into OP group (n =32),NOP group (n =35).Then,we compared differences in body mass index(BMI),diabetes duration,fasting plasma glucose (FPG),glycosylated hemo-globin(HbA1c),patients'age,fasting insulin(FINS),insulin sensitivity index(ISI),quantitative of urinary albumin (ALb),quantitative of urinary protein in 24 hours and alkaliphosphatase level(ALP),low density lipoprotein choles-terin(LDL -C),triglyceride(TG),and made correlation analysis.Results Compared with those in NOP group,pa-tients in OP group had older age,longer disease course,smaller baric index,lower BMD,higher ALP,lower FINS,low-er ISI,higher HbA1c,higher quantitative of urinary protein in 24 hours and urinary albumin,higher LDL -C,which were significantly different (P <0.05);BMD of elderly men with T2DM was negatively correlated to patients'age, disease course,HbA1c,quantitative of urinary protein in 24 hours,ALb,ALP and LDL -C,but positively correlated to BMI,FINS and ISI.Conclusion Many factors,such as elderly,low body weight,long duration of the disease,high level of blood sugar,insulin dysfunction,low insulin sensitivity,high level of blood suger,insulin dysfunction,low insulin sensitivity,high serum alkalinephosphatase,high LDL -C and diabetic nephropathy,contribute to osteoporosis in elderly men with T2DM.

Objective To investigate the genetic homology in clinical isolates of extensively drug-resistant Acinetobacter baumannii (XDRAB),so as to provide evidence for better controlling hospital infections.Methods The genotypes of 28 clinical XDRAB isolates were determined by Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR).PCR was conducted to analyze 9 types of β-lactamase genes (blaKPC,blaIMP,blaVIM,blaNDM-1,blaOXA-23,blaOXA-24,blaOXA-48, blaOXA-51 and blaOXA-58),the outer membrane porin gene (CarO)and insertion sequence (IS)ISAba1.We also carried out linkage analysis for ISAba1-OXA23 and ISAba1-OXA58.Results Most of the above 28 XDRAB strains were isolated from respiratory tract specimens from intensive care patients.The result of ERIC-PCR showed that there was high homology between all the strains,suggesting that they might derive from the same clone.The genes blaOXA-23,blaOXA-51,CarO and the IS ISAba1 except Class Bβ-lactamase genes,blaOXA-24,blaOXA-48,blaOXA-58,ISAba1-OXA23 and ISAba1-OXA58 were detected in all the clinical strains by PCR.Conclusions All the XDRAB isolates belong to the same clone and carry the same drug-resistant genes,indicating that there was clone spread among XDRAB isolates.

This paper introduced the importance of the air medicine system,and features and advantages of its development in the USA,Switzerland and Germany,and China's status quo.In view of the slow development of air medicine,imbalanced development and different operation models of air medicine systems in localities,and different models of emergency medicine services in the country,the paper proposed to build a model of government guidance and business operation as support for air medicine against emergency events,providing air ambulance service; to build an air medicine system featuring both public welfare and business operation,reasonable layout,timely response,and efficient operation,which will enhance the overall capacity of air medicine.

Objective To analyze the demand for home care service and its influential factors among elderly in Tianjin city.Methods A total of 254 residents aged 60 and above from Tianjin city were investigated with a self-designed questionnaireDemand for Home Care Service,Katz index of independence in Activities of Daily Living(ADL) and Lawton Instrumental Activities of Daily Living (IADL) scale.Results The mean score for home care service has been revealed (2.40±0.67),as the ranking demonstrated:public welfare (3.61±1.04),social participation (2.69±1.32),medical service (2.56±0.90),rights safeguard by law (2.37±1.54),mental need (2.26±0.99),and need for daily life care (1.73±0.69).Multiple linear regression analysis showed that income,education level,activity of daily living and the convenience degree of seeking treatment were major factors affecting demand for home care service among elderly,which explained 16.3％ of the variance.Conclusions Oriented by demand,further progress shall be achieved multidimensionally,under which circumstances,individualized service ought to be de-livered.Simultaneously,the vulnerable elderly groups require more attention.

OBJECTIVE: To investigate the pathogenic factors of severe acute pancreatitis (SAP) complicated by hepatic insufficiency, the prognosis and the effective preventive and therapeutic interventions. METHODS: One hundred and fifty-two patients with SAP (from January 2003 to June 2004) were divided into 2 groups, SAP with hepatic insufficiency group and SAP without hepatic insufficiency group. The related factors such as causes of disease, serum biochemical criteria, complications, mortality and course of disease were observed. RESULTS: The concentrations of serum amylase, creatinine and lactate dehydrogenase were all much higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). The incidences of complications such as acute renal failure, heart failure, gastrointestinal hemorrhage and infection were also higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). There was no significant difference in mortality between these two groups, but the course of disease in SAP with hepatic insufficiency group was longer than that in the other group (P<0.05). CONCLUSION: The causes of SAP complicated by hepatic insufficiency are related to the imbalance of internal environment and the characteristics of the liver function. To control the biliary tract diseases, intervene with traditional Chinese medicine, recover the intestinal function in time, reduce the damage of pancreatic enzyme, maintain the stability of internal environment and avoid using drugs that can induce liver injury are all important aspects of reducing the incidence of hepatic insufficiency.

Objective To observe the clinical features and treatment outcomes of presumed tubercular retinal vasculitis.Methods This is a retrospective non-comparative interventional clinical research.A total of nine patients (11 eyes) with major presentation of retinal vasculitis were included in this study.Patients first consulted the eye clinic and were diagnosed presumed tubercular retinal vasculitis.The patients,seven males and two females,aged from 19 to 66 years,with an average of 43.89 years.The time interval from symptoms to diagnosis ranged from two weeks to six months with an average of 76.27 days.Visual acuity,slit lamp ophthalmoscopy,fundus fluorescein angiography (FFA),optical coherence tomography (OCT),hematological and tuberculosis related investigations were examined and analyzed.All patients had standard anti-tuberculosis treatment.Treatment outcomes were followed for six to 37 months with an average of 14.11 months.Results Baseline visual acuity ranged from hand movement to 0.8 with an average of 0.28.Among 11 eyes,six presented mild to moderate vitritis,five presented as retinal vein occlusion with no obvious vitirits.Fundus examination showed six cases with retinal hemorrhage,four cases with macular edema,two with macular epiretinal membrane,and two with vitreous hemorrhage.FFA revealed 11 cases with leakage of vessels,11 with nonperfusion area,four with macular edema,three with retinal neovascularization,and two with choroidal lesions.OCT of nine eyes suggested six eyes with retinal edema,three with macular edema,three with macular epiretinal membrane.TST of seven patients were all strong positive.T-SPOT.TB of four patients were all positive.Three of eight patients who had chest X-ray or chest CT were suggested tuberculosis infection.Four to six weeks after the start of anti-tuberculosis treatment,vitritis,exudates,retinal and macular edema subsided.During follow up,inflammation was stable with no recurrence observed.The visual acuity of last follow-up ranged from 0.15 to 0.8 with an average of 0.51.Conclusions The main presentations of presumed tubercular retinal vasculitis are vitritis,retinal vein occlusion,and retinal hemorrhage.Standard anti-tuberculosis treatment can improve inflammation and retinal hemorrhage.