AIM: To evaluate the therapeutic efficacy and failure factors in single dose methotrexate intramusculr injection in treatment of ectopic pregnancy. METHODS: The clinical data of 70 successfully treated cases and 10 failed cases were analyzed comparatively,including the duration of menoschesis,serum ?-HCG level,diameter of adnexa mass and abdominal pain before treatment as well as the decline rate of serum ?-HCG level and change of mass diameter after 3 d of treatment. RESULTS: In succeeded group,the average duration of menoschesis,the mean level of serum ?-HCG and average diameter of adnexa mass were 53?5 d ( 14.3 % of patients≥60 d),1483?216 IU?L -1 ( 11.4 % of patients≥4000 IU?L -1 ) and 2.9 ? 0.9 cm( 7.9 % of patients showed increase of mass diameter≥25%),respectively;whereas in failed group,these corresponding figures were 62?6. d( 40.0 %),6661?126 IU?L -1 ( 80.0 %), 4.1 ? 0.6 cm ( 40.0 %),respectively. After 3 d of treatment, 14.3 % of patients in succeeded group revealed a decline rate of serum ?-HCG level≤15%,while 60.0 % of patients in failed group revealed a similar decline rate. CONCLUSION: Methotrexate is an effective drug for treating ectopic pregnancy in its early stage. The serum ?-HCG level before treatment,its decline rate and the change of adnexa mass diameter after 3 d of treatment are closely related to the therapy failure. Presence of fetus heart beating is not a contraindication for drug treatment of ectopic pregnancy.

Objective: To evaluate differences in dental arch forms between the subjects with Angle II division 1(AngleⅡ1 ) and those with normal occlusion. Methods:60 AngleⅡ1 patients and 60 normal occlusion subjects aged 13-17 years old were selected. Fourteen landmarks, corresponding to the cusp tips and incisor edges, were identified on the upper and lower dental casts of all subjects by YM-21115 three dimension measuring machine. Arch form differences between AngleⅡ1 and normal occlusion subjects were assessed by Euclidean distance matrix analysis (EDMA). Results:(1) In both sexes, the upper arch of AngleⅡ1 subjects was larger than that of normal occlusion (1.8% for females and 2.7% for males); and arch shape difference was also significantly different(P

AIM: To observe the clinical effect of phacoemulsification and posterior chamber intraocular lens ( IOL) implantation in the treatment of unilateral high myopia combined with age-related cataract.
METHODS: A retrospective clinical study was carried out in a single ophthalmology center. All patients diagnosed of unilateral high myopia with age- related cataract were performed phacoemulsification and posterior chamber IOL implantation. The axial length of operation eye was ≥27mm, and the axial length of unoperated fellow eye was≤25mm. Visual acuity and complications were followed up for 1, 7d, 1, 3mo postoperative.
RESULTS:Thirty-three patients with average age 68. 8±9. 26 (41-87) y were enrolled in this study, 7 cases were men, 26 cases were women. The mean axial length of operation eyes was 29. 44±1. 80(27. 1-32. 71) mm and the mean axial length of unoperated fellow eyes was 23. 39±0.92 ( 21. 72 - 24. 90 ) mm. The average axial length difference of binocular eyes was 6. 06±1. 97(2. 78-9. 92) mm. The best corrected visual acuity ( BCVA ) increased from 0. 02±0. 02(light perception~0. 12) preoperatively to 0. 20±0. 20 ( 0. 02 - 0. 8 ) at 3mo postoperatively. There was statistically significant difference (t= -5. 278, P<0. 05). Among the 10 patients whose axial length difference of binocular eyes was 2. 01 - 5. 00mm, 60% of their postoperative BCVA were >0. 3. Among the 13 patients with binocular axial length difference of 5. 01-7. 00mm, 46.2% of BCVA were >0. 3,46.2% achieved 0. 05-0. 25. Another 10 patients of binocular axial length difference between 7. 01-9. 99mm, 90% of BCVA were <0. 3, of which 40% were<0. 05. No complications occurred during operative and postoperative .
CONCLUSION: Phacoemulsification and posterior chamber IOL implantation can effectively improve the postoperative visual acuity and it is safe for unilateral high myopic patients combined with age-related cataract. The recovery of visual acuity is related with binocular axial length difference.

Objective To discuss the perioperative nursing experience of patients with primary venous reflux disease(PVRD)of lower extremity undergoing external valvuloplasty of superficial femoral vein.Methods Patients(146 cases)with PVRD of lower extremity were given psychological nursing,observation of postoperative complications and rehabilitation exercise instruction.Results Five limbs appeared short lymphatic seepage and other limbs recovered completely.No thrombus Was seen.Venous claudication,swelling and pain disappeared in 90.4% patients.Limbs symptom alleviated in 9.6% patients.All varicos evein disappeared.The function of deep vein valve recovered in 92% patients by color doppler ultra sonoscope re-examination.Conclusions General evaluation before operation,good perioperative psycho logical nursing and attention to the complication and rehabilitation exercise instruction are significant for reduction of postoperative complication and improvement of success rate of operation.

Objective To discuss the influence of hardiness conception utilization on rehabilitation of breast cancer patients. Methods 80 breast cancer patients were involved in this trial, the responsible nurses collected and analyzed the data of patients by interview, observation, and investigation question-naires, then gave patients individual directions of hardiness conception according to stage and primary and secondary of the data to arouse the hardiness characteristic of patients. The application results underwentχ2 test. Results The number of psychical problems decreased and the need of information about breast cancer increased obviously after the direction. Conclusions The utilization of hardiness conception can strengthen patients' confidence, raise their treatment compliance, and promote their rehabilitation.

Aim To explore the effects of inhibitors of glycosphingolipid biosynthesis D-PDMP on the proliferation and differentiation of neural stem cells. Methods Neural stem cells cultured in vitro were treated with different concentration of D-PDMP. The effects of D-PDMP on proliferation and differentiation of neural stem cells were evaluated by counting of neurospheres size and cellular number, MTT assaying and the experiment of inducing differentiation.Results Neurospheres were smaller in size after treated with D-PDMP. The data of cellular counting and MTT assay suggested that D-PDMP could inhibit proliferation of neural stem cells and lead cells death in higher concentration, D-PDMP also reduced the differentiation ability of neural stem cells. Although differentiated cells were fewer, they could be induced into neurons and astrocytes.Conclusion The inhibitors of glycosphingolipid biosynthesis D-PDMP could inhibit the proliferation of neural stem cells, even lead cells death. It also reduced the differentiation ability of neural stem cells.

10.3969/j.issn.1007-3969.2013.04.009

Objective To compare the anthelmintic effect of albendazole with that of triclabendazole against Fasciola giganti-ca. Methods Two patients infected with Fasciola gigantica were investigated,and one was administered with albendazole orally (200 mg,twice per day for 5 days)and another was administered with triclabendazole[10 mg/(kg?d)for 2 days]. Their total fe-ces were collected daily during the period of whole therapy,and the eggs of the parasite were collected by using the nylon bag method,and incubated at 28℃. Results The parasite eggs were detected from the first patient’s dejecta on the 1st,2nd and 5th day after the end of the treatment,and no miracidiums hatched out as well as no eggs developed during the period of 25 days of the incubation. Meanwhile,her body temperature fluctuated between 37.4℃and 38.3℃,and she still complained bellyache. For the other invalid,the eggs were not detected on the 2nd and 5th day after the end of the treatment. However,the eggs before and dur-ing the treatment developed the miracidiums of Fasciola gigantica on the 13th day after the incubation,but the eggs collected from the 1st day after the termination of the therapy did not develop and no miracidiums hatched out. At the same time,the signs and symptoms of the patient vanished after the 4th day of the end of the therapy. Conclusions Albendazole has no obvious insecticid-al activity on adult Fasciola gigantica in the short term,but may affect the development of eggs. Triclabendazole has the anthelmin-tic effect on the adults as well as eggs of Fasciola gigantica. In addition,triclabendazole has the characteristics of well curative ef-fect,short course of treatment,and no obvious side effects.

Objective To study the effects of purified rabies vaccine for human use (RV) on specific Th1/Th2 cytokines in human. Methods Twenty cases were injected intramuscularly with 5 full doses of RV. PBMCs were isolated from the blood sample collected at day 0, 14, 45 after the RV inoculation. Neutralizing antibody was determined by ELISA, and the proliferation of lymphocyte by in vitro test. The levels of RV specific IFN-γ, TNF, IL-2,IL-4, IL-5, IL-10 in the culture supernatants were detected by cytometric bead array (CBA). Results The neutralizing antibody was tested positive in 19 cases 45 days after inoculation and 1 case after 60 days, with the positive rate reaching 100%. After stimulation with RV, the lymphocyte transformation index at day 14, 45 in cases were significantly higher than those day of 0 (P< 0.05), and similar results were confirmed with IFN-γ, IL-2, IL-4, IL-5 tested by CBA (P<0.05). Condusion The RV could induce humoral and antigen-specific cellular immune responses in human, tested by showing good protective effect on rabies virus.

The patient was a 38-year woman.Six years prior to presentation,she developed erythema and papules with occasional pruritus in both labium majora,which gradually confluenced into plaques with the formation of superficial erosion and ulcer;extension into the vulva and crissum occurred later.Half a year prior to presentation,a subcutaneous firm nodule measuring about 1.5cm in diameter with intact epidermis,developed on the right submaxilla,associated with mild swelling in the area;the nodule enlarged gradually.A subcutaneous induration measuring 0.5 cm in diameter was observed in the left chin 2 months later.She also reported a 20-year history of dry eye and dry mouth.The patient tested postive for antinuclear antibody cally,there was a focal infiltration of lymphocytes in tissue of minor salivary glands.The pathology of lesions on the right labium majus showed a dense dermal infiltration with S100-and CD1a-positive,irregulady-shaped histiocyte-like cells with abundant eosinophilic cytoplasm and few mitotic figures.Needle biopsy of the right submaxilla area showed tumor cells.A diagnosis of Langerhans cell histiocytosis and Sj(o)gren syndrome was made based on clinical manifestation,laboratory findings and histopathological features.Combination chemotherapy with cyclophosphamide,vincristine,corticosteroids and etoposide resulted in clinical improvement.