Objective To investigate the clinical value of vaginal myomectomy. Methods From March 2005 to May 2008,78 women with abnormal uterine bleeding were diagnosed with submucous myoma by hysteroscopy combined with ultrasonography. All the myomas were located in the lower uterine segment,and the diameter of the tumor ranged from 30 mm to 63 mm. The patients were divided into two groups to underwent vaginal myomectomy (vaginal group,36 cases) or abdominal electrotomy (open group,42 cases). The operation time,intraoperative blood loss,postoperative hospital stay and recovery of the two groups were compared. Results The vaginal operation was accomplished in all of the 36 cases. Compared with the open group,the vaginal group had significantly shorter operation time [(64.7?10.4) min vs (71.1?11.3) min,t=-2.599,P=0.011],less intraoperative blood loss [(200.0?38.4) ml vs (253.6?47.6) ml,t=-5.412,P=0.000],quicker recovery of bowel movement [(18.5?4.3) h vs (30.9?4.7) h,t=-12.078,P=0.000],and shorter postoperative hospital stay [(4.9?1.2) d vs (7.0?1.3) d,t=-7.368,P=0.000]. Follow-up was available in all of the 78 cases for 3 to 40 months (mean,28 months),during which no relapse occurred,and no statistical differences in pregnancy rate between the two groups was revealed [2.8% (1/36) vs 4.8% (2/42),?2=0.000,P=1.000]. The operation satisfaction rates in both of the two groups were up to 100%. Conclusions Vaginal myomectomy has advantages in less hemorrhage,fast recovery,short postoperative hospital stay,and low complication rate. For the tumors located in the lower uterine segment or those larger than 30 mm in diameter,vaginal myomectomy is an alternative to hysteroscopic electrotomy.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Pain Management ; Young Adult

[Summary] Autophagy is an intracellular degradation process by which the damaged organelles and macromolecules are lysosomal dependently degraded by auto‐phagocyte under the control of autophagy‐related genes. The autophagy level in hypothalamus and adipose tissue changes in obese individuals.Autophagy participates in the regulation of food intake and energy balance ,and associates with adipocyte differentiation and adipogenesis. More and more attention has been paid to the relationship between autophagy and obesity w hich may guide the new research direction of pathogenesis study and therapy of obesity.

Objective To explore the treatment methods and clinical result with the flap combining peroneus longus muscle supplying with the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect.Methods After anatomic investigating,Analyzing 6 cases.Excising peroneus lon- gus muscle combining with the foot external flap,supplying with the pediele of the nutrient vessels of sural nerve to repaire the chronic achilles tendon rupture with skin defect,among them,the size of flap was about 6.0 cm?5.5 cm～16.5 cm?11.0 cm,the defect length of achilles tendon 2.0～7.5 cm.Results All ca- ses observed 4 to 16 months,all eases skin and achilles tendon were survived completely,the flap skin appear- ence was good,none ulcer.1 cases part necrosis,1 eases rerupture,Both healed after changed dressings.Ac- cording to Arner-Lindholm criteria to test the efficacy the result were excellent in 3 patients,good in 2,poor in 1.Conclusion It is an ideal way using the flap combining peroneus logus muscle with the nutrient vessels of sural nerve repairing the chronic achilles tendon rupture with skin defect.The advantage is operting conven- iently,transferred adjaeently,repairing the skin and tendon defect simultaneously,healing fastly and anti-bac- teria strongly,biomeehanies property and function is similar to the heel,it can fit the heel and skin for repai- ring.

Objective To develop a sensitive,quick and convenient comet assay with Viciafaba root cells,so as to provide the reference for biomonitoring in situ.Methods The K_2CrO_7 and H_2O_2 were used as the positive control,the Viciafaba root cells isolated with mechanical and enzyme treatment respectively were exposed to the different concentrations of K_2CrO_7(1 nmol/L,10 nmol/L,100 nmol/L,1000 nmol/L)and H202(25 ? mol/L,50 ? mol/L,100 ?mol/L,200 ?mol/L).The effect of DNA damage was detected by using comet assay.Results The yield of Viciafaba root cells isolated from enzyme treatment were much higher than that from mechanical treatment.K_2CrO_7and H_2O_2 could cause DNA damage in Viciafaba root cells,there was significant difference between exposure group and control group(P

Objective:To investigate the effect of activation of proteinase activated receptor(PAR)2 on mediator release from mast cells.Methods:P815 cells(a mast cell line) were challenged with various concentrations of PAR-2 agonist peptide,trypsin,tryptase or elasetase with or without PAR-2 antagonist peptide.The supernatants were collected and analyzed by enzyme-linked immunosorbent assay(ELISA) to detect the quantity of released IL-4,IL-6 and histamine.Results:PAR-2 agonist peptide,trypsin or tryptase induced a concentration-dependent IL-4,but not histamine release from P815 mast cells.Trypsin and tryptase induced IL-4 release from the mast cells was blocked by addition of PAR-2 antagonist peptide.No IL-4,IL-6 and histamine release was observed when P815 cells were incubated with elasetase.Conclusion:Induction of IL-4 release from mast cells by trypsin and tryptase through activation of PAR-2 added some novel information on the hypothesis of self-amplification mechanism of mast cell activation.

Objective To explore distally-based the interal ankle perforator saphenou neuro-veno-fasciocutaneous flap has been universally adopted for the repairment of the foot and the ankle soft-tissue defects.Methods Lay a foundation of anatomic studying,using the interal ankle perforator saphenous neuro-venofasciocutaneous flap 10 cases, the flap axis point was 1-3 cm above the pink of the interal ankle, average 2 cm. The scope of the flap were 4.0 cm× 3.0 cm-8.0 cm× 6.0 cm. Results All the perforator saphenous neuro-veno-fasciocutaneous flap were lively. About all, 2 cases had the small distant part necrosis, 1 case accompanying with subcutaneous tissue heels after change dressings, another heels after skin grating. All case can walk as usual, the flap had wear-resisting and keenly feel. Conclusion Distally-based the interal ankle perforator saphenous neuro-veno-fasciocutaneous flap, near ankle, donner area exiting fine, utlizing scope large, skin nice, grating easy, no hurting important blood vessle, alive rate high, it is an good donner area in repairing the foot and the ankle soft-tissue defects.

Objective To investigate the resting?state functional alteration in posterior cingulate cortex ( PCC) in Type 2 diabetes ( T2DM) patients with cognitive impairment and to determine the relation?ship of rs?fMRI changes with cognitive decline. Methods Resting?state functional magnetic resonance ima?ging was performed T2DM patients with impaired cognition ( n=19) and healthy control subjects ( n=20) . The amplitude of low frequency fluctuations ( ALFF) and regional homogeneity ( ReHo) values were calcu?lated in left PCC to represent the spontaneous brain activity. Using left PCC as a seed region,the functional connectivity of the whole brain was mapped. In addition,correlation analysis was conducted among ALFF,Re?Ho,and neuropsychological test scores. Results The ALFF values of left PCC (0.72±0.37) was decreased compared with the control group(1.09±0.46),but the ReHo value(1.12±0.10)was not significantly changed compared with control group (1.14±0.11). The functional connectivity was decreased with the left medial temporal lobe,left superior and middle temporal gyrus,right superior frontal gyrus,and right supplementary motor area ( SMA) ,while it was increased with the left middle frontal gyrus,inferior frontal gyrus and right cerebella. MoCA scores were positively correlated with the ALFF values of left PCC. Conclusion In resting state,the spontaneous activity and functional connectivity of PCC is altered in T2DM patients with cognitive impairement;and the function of PCC contributes to the cognitive decline associated with T2DM.The decrease of ALFF value of PCC may help to detect the cognitive decline of T2DM.

Objective To explore the role of hypoxia inducible factor 1α(HIF-1α)-mediated signaling pathway in angiotensin Ⅱ(Ang Ⅱ)induced renal interstitial fibrosis. Methods Renal tubular epithelial cells were cultured and treated with different concentrations (10-9-10-6 mol/L)of Ang Ⅱ for 24 h and 48 h.Real-time quantitative PCR and Western blotting were preformed to detect the mRNA and protein expressions of HIF-1α,prolyl hydroxylase 2 (PHD2)and tissue inhibitor of metalloproteinase 1 (TIMP-1)in renal tubular epithelial cells. Results HIF-1αmRNA level was increased with Ang Ⅱ treatment in a concentration dependent manner.When cells were treated with Ang Ⅱ concentration at 10-7mol/L for 24 h,the mRNA level was markedly increased by 166%.Furthermore,by real-time quantitative PCR and Western blotting,compared with the control group,Ang Ⅱincreased the mRNA and protein levels of HIF-1α and TIMP-1 (P<0.05,respectively),while the mRNA and protein levels of PHD2 were decreased markedly (P<0.05,respectively)in renal tubular epithelial cells.Conclusion Ang Ⅱ reduces HIF-1αdegradation in renal tubular epithelial cells probably by reducing the expression of PHD2,which increases the expressions of HIF-1α and TIMP-1 involved in renal interstitial fibrosis.

Objective To survey the CT radiation dose to cancer patients,and to compare it with diagnostic reference level (DRL) provided by newly issued national standard.Methods Computed tomography dose index weighted (CTDIw) of 5 CT equipments was measured by the standard phantom with typical scanning protocol and radiation dose parameters including average computed tomography dose index volume (CTDIvol),dose length product (DLP),75％ DLP with 900 adult and 300 pediatric cancer patients were collected.According to age stage,effective dose was estimated.Results The measured CTDIw for head scanning was on the same level with DRL,while lumbar vertebra and abdominal scanning were lower than DRL.To adults,DLP of cerebrovascular enhanced scanning and effective dose of abdominal enhanced scanning were the highest.To pediatric patients,there was no significant difference in DLP among different ages.Conclusion CTDI only reflects the dose contribution from a slice,but do not reflect the cumulative dose.For the patients need multiphase scanning,because they may be exposed to high dose,national standard should provide DLP value as the diagnostic reference level.Using individual scanning protocol is an effective method to reduce radiation dose of pediatric patient.