Objective To detect whether there is neurotropism following end-to-side neurorrhaphy by means of the neuron retrograde tracing technique. Methods Forty female Sprague-Dawley rats were randomly divided into 4 groups: tracing main branch of musculcutaneous nerve(MC) of end-to-side group, tracing MC main branch of normal group, tracing MC motor branch of end-to-side group and tracing MC motor branch of normal group.In two end-to-side groups, the MC was transeeted, then an 1 mm epineukral window was created on the ulnar nerve. Distal end of MC nerve was sutured to the windowed ulnar nerve by means of end-to-side neurorrhaphy.In two normal control groups, MC and ulnar nerves were just exposed. Five months post operation, by means of retrograde Fluoro-Gold neuron tracing technique,the number of C5～ T1 anterior horn motoneurons and dorsal root ganglion sensory neurons of all groups were counted. Results In two tracing MC main branch groups: the motor neuron counts in end-to-side group was 245.2 ± 93.8, the motor neuron counts in normal group was 846.7 ± 264.8, and counts of end-to-side group was 30.0% of the normal control group (P＜ 0.01). The sensory neuron counts in end-to-side was 434.7 ± 160.4, the sensory neuron counts in normal group was 1545.2 ± 287.4, and counts of end-to-side group was 28.1% of the normal control group (P ＜ 0.01). The per-centage of motor neuron in end-to-side group was 0.36 ± 0.09, there was no difference between end-to-side group and normal control group(P＞ 0.05). In two tracing MC motor branch groups: the motor neuron counts in end-to-side group was 72.3 ± 35.3, the motor neuron counts in normal group was 189.7 ± 57.0, and counts of end-to-side group was 38.1% of the normal control group (P ＜ 0.01). The sensory neuron counts in end-to-side was 110.8 ± 52.5, the sensory neuron counts in normal group was 157.9 ± 50.0, and counts of end-to-side group was 70.2% of the normal control group (P ＞ 0.05). The percentage of motor neuron in end-to-side group was 0.40 ± 0.14, the difference between end-to-side group and normal control group was signifieant(P ＜ 0.01 ). Conclusion Neurotropism in collateral spouting after end-to-side neurorrhaphy is not significant.

Objective To analyse the effective rate and adverse effect of only levetiracetam (LEV) versus LEV plus other drugs in the treatment of middle and old aged patients with partial seizures (PS) and secondary generalized tonic-clonic seizure (SGTCS).Methods The self-control study was used and 59 elderly patients with PS and SGTCS were treated with LEV single or plus drug (therapeutic dose was 1000-2000 mg/d,bid).The effective rate and the side effects of LEV were observed and compared between LEV single and plus drug or between the patients with only epilepsy versus epilepsy plus other diseases,respectively.Results The effective ratios at the end of 3,6,9and 12 months after LEV treatment were 76.2％,70.6％,64.3％ and 66.7％,respectively and there were no significant difference among above time points (x2=1.911,P＞0.05).A chi-square test showed that the differences in effective ratios were not statistically significant (P＞ 0.05) between single and combination of drugs (x2 =1.437) and between two groups of patients at the end of 12 months.Clinical effect of LEV showed no remarkable difference between different types of epilepsy at the end of 6 months (x2 =1.315,P＞0.05)and 12 months(x2 =2.700,P＞0.05).The control ratio of epileptic attack was higher in single LEV than in combination drugs (x2 =10.83,P＜0.05).The total side effects were 13.6％,including somnolence,weakness,anorexia,headache,irritability and forgetfulness.Conclusions The curative effects of levetiracetam single or in combination are definite,stable and continuous for PS and SGTCS,especially in combination with other diseases.

Objective To discuss the characteristics and management of pregnancy on cesarean section scar. Methods Five women with pregnancy on cesarean section scar were reviewed from Apr. 2000 to Mar. 2003. Results All of the five patients had cesarean section before and suffered from painless,irregular vaginal bleeding after 6～8 weeks of amenorrhea. The pregnancy could be misdiagnosed as invasive mole or cervical pregnancy. All had better outcome by uterine suction under ultrasound monitoring without massive bleeding or hysterectomy. Conclusions Women who had cesarean section before are in the risk of pregnancy on the old scar. Clear diagnosis should be made before any treatment. Ultrasound monitoring,local MTX injection and packing can be utilized to prevent perforation during suction. Patients should be monitored continuously after operation with serum hCG level and ultrasound. The principle prevention of pregnancy on cesarean section scar is to reduce the cesarean section rate and effective contraception.

Objective To observe the effects of icarisid Ⅱ (ICS Ⅱ)on cognitive deficits and expression of synaptophysin(SYN)in chronic cerebral hypoperfusion(CCH)rat models.Methods 40 male SD rats were randomly divided into four groups:normal group,sham operation group,model group and ICSⅡgroup.The model was established by permanent bilateral common carotid artery occlusion(BCCAO).ICS Ⅱ group was administered ICS Ⅱ at a dose of 8mg·kg -1 ·d -1 by gavage on 1st day after modeling.Sham group and CCH group were injected double -distilled water.The escape latency(s)and spatial probe times were measured by water maze test.Then,the morphology change and expression of SYN in hippocampal were assayed by HE and immunohistochemistry analysis.Results At the 1st month and 2nd month,the escape latency in the model group[(40.02 ±4.95)s,(42.29 ±5.75)s]were significantly prolonged compared with the sham operation group[(26.43 ±2.68)s,(26.84 ±2.06)s](t =4.89,5.06,all P <0.05).And those in the ICS Ⅱ group[(30.58 ±3.03)s,(29.19 ±4.23)s]were significantly decreased compared with the model group(t =3.63,4.10,all P <0.05).The space probe times in the model group[(2.6 ±0.89)times, (2.40 ±1.14)times]were significantly reduced compared with the sham operation group[(6.00 ±2.16)times, (5.75 ±2.16)times](t =3.23,4.18,P <0.05).And those in the ICS Ⅱ group[(4.40 ±1.34)times,(5.00 ± 1.58)times]were significantly increased compared with the model group (t =2.49,2.98,all P <0.05).The average optical density of SYN in hippocampal in the model group[CA1:(0.121 ±0.009),(0.122 ±0.008);CA3:(0.172 ± 0.028),(0.173 ±0.021 )]were significantly reduced compared with the sham operation group[CA1:(0.131 ± 0.006),(0.136 ±0.007);CA3:(0.218 ±0.035),(0.204 ±0.018)](t =2.43,2.53,3.12,2.34,P <0.05). Those in the ICS Ⅱ group[CA1:(0.131 ±0.006),(0.132 ±0.006);(0.212 ±0.02),(0.208 ±0.022)]were significantly increased compared with model group(t =2.41,2.41,2.31,2.77,all P <0.05).However,there was no statistically significant difference of those index between the normal group and sham operation group(P >0.05 ). Conclusion ICS Ⅱ can improve the cognitive deficits in CCH rat models and this effect may be associated with increased expressions of SYN in hippocampal.

Objective To investigate the diagnostic value of the real-time tissue elastography (RTE)and AST/PLT ratio in-dex (APRI)for the assessment of the early stage liver fibrosis in chronic liver disease patients.Methods Totally 90 patients with chronic liver disease were enrolled in the present study.The RTE score and the area percentage of the blue color (AREA,one of the elastic characteristics),the AST and PLT were recorded.Compared the results among different stages of liver fibrosis reported by biopsy considered as the gold standard for the assessment of liver fibrosis.The accuracy of the diagnosis of liver fibrosis by RTE scores,AREA and APRI were compared.Results RTE scores,AREA and APRI increased with the stage of liver fibrosis. Taking ≥S1 as the diagnosis standard of the early stage liver fibrosis,the area under the curve of ROC for RTE scores,AREA and APRI were 0.88,0.92,0.76 (P <0.05).Conclusion RTE is a new and promising sonography-based noninvasive method for the assessment of hepatic fibrosis in patients with chronic liver disease.Combined RTE with APRI have great clinical significance in di-agnosing the early stage liver fibrosis in chronic liver disease patients.

Background Intermittent exotropia is a type of strabismus that between latent extropia and manifest extropia.The assessment of fusional convergence/divergence is important for understanding control ability of exodeviation in children with intermittent exotropia.Objective This study was to analyze the correlations between fusional convergence/divergence and control ability of exodeviation in children with intermittent exotropia.Methods Sixty-three children with intermittent exotropia were recruited in Beijing Tongren Eye Centre from July 2013 to February 2014 under the informed consent of children and their parents.Angle of deviation was measured by wearing prism and covering method alternately.The control ability of exodeviation was evaluated and scored by the Revised Newcastle Control Score (RNCS),and fusional convergence and divergence were measured with 1 Δ-40Δ horizonal prisms and regulating targets.The correlations between the measured parameters of fusional convergence/divergence and control scores of exotropia were analyzed by Spearman rank correlation analysis.Results The mean diopter of the right and left eyes was (-1.95 ± 1.63)D and (-2.01 ± 1.73)D,respectively,and the mean deviation angle for distantly and near was (36.67 ± 15.69) Δ and (38.25 ± 14.83) Δ,respectively,without significant differences between them (diopter:t =-0.13,P＞0.05;deviation angle:t =-0.57,P＞0.05).Considerably negative correlations were found between the breakpoints of fusional convergence for distant or near and control scores of exodeviation (rs =-0.41,P=0.03;rs =-0.56,P＜0.01).No significant correlations were found between the breakpoints of fusional divergence for distantly or near and control scores of exodeviation (rs =0.05,P =0.78;rs =0.04,P ＜0.75).In addtion,there was no significant correlation between fusional recovery level and control scores (both at P ＞ 0.05).Conclusions Breakpoints of fusional convergence may be useful in grading the severity of intermittent exotropia in children,and it is probably one of the surgical indications of intermittent exotropia.

Objective:To promote the rational drug use in the patients treated with ambulatory chemotherapy. Methods:A model of integrated pharmaceutical care was established using such service as the real-time prescription examination, configuration standardi-zation, active care and prescription review. Results:The integrated pharmaceutical care could effectively reduce the unreasonable drug use, optimize drug use structure, lower the medical expenses and provide supporting data for clinical decision-making. Conclusion:The development of integrated pharmaceutical care in the patients treated with ambulatory chemotherapy is an important field for phar-macists displaying professional skills, which can promote the rational drug use. The treatment efficacy and life quality of cancer patients can be improved with the cooperation of doctors, nurses and pharmacists.

12E7 Antigen ; Adnexa Uteri ; surgery ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD ; metabolism ; Cell Adhesion Molecules ; metabolism ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Granulosa Cell Tumor ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Hysterectomy ; methods ; Inhibins ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Ovarian Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Survival Rate ; Vimentin ; metabolism

Objective To investigate the effect of intra-articular carboxymethylated ehitosan(CM- CTS)injection on inducible nitric oxide synthase(iNOS)expression in cartilage at the early stage of os- teoarthfitis(OA).Methods Thirty-two white rabbits were underwent unilateral anterior cruciate ligament transection(ACLT)and were randomly divided into 4 groups 5 weeks after transection.Rabbits of group A re- ceived 0.3 ml of 2% high molecular weight CMCTS(H-CMCTS)once every two weeks.Rabbits in group B were treated using 2% low molecular weight(L-CMCTS)CMCTS at:the same intervals.Group C rabbits were injected intra-articularly with 0.3 ml of 1% sodium hyaluronate(Na-HA)once a week.Animals of group D were not injected.At sacrifice,11 weeks following surgery,the expression of iNOS in cartilages was analyzed by immunohistochemistry and reverse transcription-polymerase chain reaction(RT-PCR)methods.Results Both immunohistochemistry and RT-PCR showed that the level of iNOS expression of cartilage in CMCTS in- jection groups was lower than that in Na-HA injection group and the untreated group.There was no significant difference in iNOS expression between the two different molecular weight CMCTS injection groups. No signifi- cant difference of iNOS expression in cartilage was found between Na-HA injection group and the untreated group.Conclusion CMCTS suppresses iNOS expression in cartilage during the early stage of OA.Na-HA treatment has no effect on iNOS expression in cartilage.

Objective To compare the safety and effect of the holmium laser enucleation of the prostate (HoLEP) and transurethral resection of the prostate(TURP) for benign prostatic hyperplasia(BPH).Methods Three hundred and forty-nine cases with benign prostatic hyperplasia were divided into HoLEP group (172 cases) and TURP group(177 cases).All patients were assessed preoperatively,then we recorded hemorrhage volume,operation time,catheter indwelling time and complication rate.Follow-up 3 months,postvoid residual(PVR),maximal urinary flow rate(Qmax),international prostate symptom score(IPSS),quality of life score(QOL) were analyzed.Results Hemorrhage volume,operation time,catheter indwelling time in HoLEP group were significant less than TURP group(P ＜ 0.05),complication rate of HoLEP group was lower than that of TURP group(P ＜ 0.05).After 3 months follow-up,IPSS,Qmax,PVR,QOL were obviously improved in both groups compared with preoperation (P ＜ 0.05).Conclusions HoLEP is safer than TURP on the base of same effectiveness,it is an promising surgical method for BPH patients.