Objective To explore clinical effect of dinoprostone in premature rupture of the membranes at term cervical ripening.Methods 42 cases with premature rupture of the membranes at term cervical ripening were selected.All patients were randomly divided into two groups.The dinoprostone group had 21 cases,which applied the treatment of dinoprostone belt the posterior fornix of vagina medicine induced abortion.The oxytocin group had 21 cases,which applied the treatment of intravenous drip oxytocin.The time of induction labor,6h,12h cervical Bishop score after using the medication,drugs acting time,labor conditions and perinatal situation,pregnancy outcome and some other index were observed.Results It taken (6.18 ± 4.48 ) h until parturient and ( 12.62 ± 8.03 ) h until the cervical mouth full open in the dinoprostone group,which were shorter than the oxytocin group,that taken( 10.21 ±5.42) h,( 18.87 ± 9.14) h.( t =2.62,2.35,all P ＜ 0.05 ).There was no significant difference about cervical Bishop score before using the medication.It's(7.52 ± 2.44 ) point 6h after using the medication and( 9.03 ± 1.96 ) point 12h after in the dinoprostone group.They were better than the oxytocin group,which were(5.97 ± 1.95 )point,(7.13 ±2.12 )point.It was significantly different( t =2.27,3.02,all P ＜0.05 ).The average incubation period of dinoprostone group wss (9.91 ± 1.73 )h.It's longger than the oxytocin group,which was( 8.72 ± 1.34)h.The active period of dinoprostone group was(4.36 ± 0.66 ) h.It's shortter than the oxytocin group,which was( 5.84 ± 1.02 ) h.The difference was significant( t =2.49,5.58,all P ＜ 0.05 ).There was no significant difference in the second and third stage of laber between the two groups( t =0.56,0.33,all P ＞ 0.05 ).There was also no significant difference about intrauterine distress,amniotic fluid contamination,cesarean section,intestinal bleeding,the Apgar score of newborns and some other index in the two groups ( x2 =0.00,0.00,0.52,t =0.84,1.04,all P ＞ 0.05 ).Conclusion Dinoprostone had good promoting effect on cervical ripening for preterm premature rupture of membranes pregnant woman.Its effect was better than oxytocin and it was safe to use.

Objective To explore the influencing factors and timing of acute cholecystitis laparoscopic surgery.Methods One hundred and sixty acute cholecystitis patients treated with laparoscopic surgery were divided into group A (56 cases,performed treatment within 24 h),group B (42 cases,performed treatment at 24 -48 h),group C ( 40 cases,performed treatment at 49 -72 h),group D (22 cases,performed treatment after 72 h).The operation time,rate of conversion to laparotomy,length of stay and average costs were compared among four groups and analyzed the impact of laparoscopic surgery conversion to laparotomy.Results The rate of conversion to laparotomy of group D [ 59.09％(13/22) ] was significantly higher than that in group A [ 19.64％(11/56) ] (P ＜ 0.01 ).The operation time of group A was the shortest and group D was the longest.The length of stay of group D was significantly longer than other groups (P ＜ 0.05 ).The costs of the four groups had no significant difference(P ＞ 0.05 ).Single factor analysis showed that white blood cell (WBC) count,body temperature,timing of surgery,gallbladder neck calculi incarceration were correlated with conversion to laparotomy(P ＜ 0.05 ).Multifactor analysis showed that WBC count,timing of surgery were independent risk factors of conversion to laparotomy (P ＜ 0.05 ).Conclusions WBC count,body temperature,timing of surgery,gallbladder neck calculi incarceration are correlated with acute cholecystitis laparoscopic surgery conversion to laparotomy.While WBC count and timing of surgery are independent risk factors.The best time of laparoscopic surgery is within 72 h and WBC count ＜ 15 x 109/L.

Objective: To study the relationships between the expressions of E-cadherin and ki-67 in the tissues of heatocellular carcinoma(HCC)and the prognosis of HCC patients after hepatectomy as well as their clinical pathology. Methods: We examine the expressions of E-cadherin and ki-67 in 255 HCC tissues by tissue microarray and PV-6000 two-step method of immunohistochemistry and analyze the correlations between their expressions and clinical pathological data, 1-year recurrent rate and overall survival time after hepatectomy. Results: The expression of E-cadherin correlated with the tumor size and the 1-year recurrent rate of positive group was higher than that of the negative group. The expression of ki-67 correlated with vascular invasion and differentiation of the tumor, the positive group showed a higher 1-year recurrent rate and a shorter overall survival time. Multivariate Cox regression analysis indicated that the expression of ki-67 was an independent risky factor. Conclusions: The negative expression of E-cadherin and the positive expression of ki-67 predict a higher recurrent rate of early stage. The expression of ki-67 is an independent risky factor which can be used to evaluate the prognosis of patients with HCC after hepatectomy.

Objective:To obtain the normal values of the facial soft tissue measurements of the attractive Uygur females in Xinjiang by photogrammetric analysis,and to study the relationship between the facial feature of attractive Uygur females and the neoclassical canons. Methods:31 attractive Uygur women were selected, standardized and referenced frontal photographs of faces were taken,and 14 standard anthropometric marks were determined,then measurements were performed by photoshopCS software.Results:Intercanthal width was rather smaller than nose width and larger than eye fissure width;nose width occupied more than 1/4 of face width or 2/3 of mouth width.The chin occupied 2/3 of the entire mandibular height.There was positive correlation among many horizontal and vertical facial soft tissue measurements.Conclusion:The facial features of the attractive Uygur females in Xinjiang fit the classical facial canons to some extent. There is pertinence in attractive facial form and features.

CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P ＜ 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P＜ 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression ＞ simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression ＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compression= concave distraction after convex compression＞ simple concave bracing.Simple concave distraction could not produce obvious corrective effects on kyphosis rather than lead to worsened kyphosis to some extent.Simple convex compression could not produce obvious corrective effects on scoliosis rather than result in aggravated scoliosis to some extent.

ObjectiveTo analyze the prognosis of the new occurred proximal thoracic(PT) curve after posterior correction surgery in adolescent idiopathic scoliosis (AIS) patients.MethodsThe radiographs of 21 AIS patients,who had a primary main thoracic (MT) curve and suffered from a new PT curve after posterior correction surgery,were retrospectively reviewed.All patients were followed up for an average of 19.8 months.Imaging parameters including coronal Cobb angle,T1 tilt and radiographic shoulder height,were measured and analyzed.ResultsThe average coronal Cobb angle of the MT curve was 54.3° preoperatively,14.1° at the final follow-up,with an average correction rate of 74.6％.Before operation,5 patients had negative T1 tilt and 16 without T1 tilt.After operation,all the 21 patients had positive T1 tilt and new PT curves;the average T1 tilt was 6.0° and the average coronal Cobb angle of the PT curve was 16.0°.At the final follow-up,the average T1 tilt and coronal Cobb angle of the PT curve were 4.0° and 13.2°,respectively; eighteen patients still had positive T1 tilt and 17 patients still had PT curves larger than 10°.As for the radiographic shoulder height,5 patients had equal shoulders and 16 patients had right shoulder elevation before operation; after operation,19 patients had left shoulder elevation and 6 patients had unbalanced shoulders; at the final follow-up,14 patients still had left shoulder elevation and 5 patients had unbalanced shoulders.At the final follow-up,T1 tilt and coronal Cobb angle of the PT curve were better than those postoperatively immediately,while the incidences of the new PT curve,left shoulder elevation,unbalanced shoulders were all not significantly different from those postoperatively immediately.ConclusionThe new occurred PT curves after posterior correction surgery in AIS patients are difficult to be compensated and could cause shoulder imbalance,thus great attention should be paid to prevent the occurrence of the PT curve.

Objective To investigate the predictive factors of progressive motor deficits (PMD) after isolated pontine infarction. Methods Consecutive patients with isolated pontine infarction admitted to hospital within 48 hours after onset were enroled. They were divided into either a PMD group (increase ≥1 within 7 days) or a non-PMD group according to the clinical course and the changes of motor scores of the National Institutes of Health Stroke Scale (NIHSS). The pontine infarction patterns were classified as basal surface infarction and deep infarction, the sides were divided into left and right, the infarct levels were divided into upper, middle, and lower according to diffusion-weighted imaging. The demographics, baseline clinical data, and imaging features were compared between the two groups. Multivariable logistic regression models were used to analyze the predictive factors of PMD after isolated pontine infarction. Results A total of 101 patients with isolated pontine infarction admitted to hospital within 48 h of onset were enroled, including 16 in the PMD group and 85 in the non-PMD group. The proportions of pontine infarction involving the basal surface (87. 5% vs. 47. 1% , χ2 = 8. 851, P = 0. 003), the infarcts on the middle levels (56. 2% vs. 24. 7% , χ2 = 4. 851, P = 0. 028), and basilar artery stenosis or occlusion (62. 5% vs. 27. 1% ,χ2 = 7. 689, P = 0. 006) of the PMD group were significantly higher than those of the non-PMD group, while the proportions of the infarcts on the left sides (18. 8% vs. 56. 5% , χ2 = 7. 664, P = 0. 006) and the infarcts on the upper levels (37. 5% vs. 72. 9% , χ2 = 7. 689, P = 0. 006) of the PMD group was significantly lower than those of the non-PMD group. Multivariate logistic regression analysis identified that pontine infarction involving the basal surface (odds ratio 5. 650, 95% confidence interval 1. 011 - 31. 580, P = 0. 049) and basilar artery stenosis or occlusion (odds ratio 4. 075, 95% confidence interval 1. 127 - 14. 741, P = 0. 032) were the independent risk factors for PMD after isolated pontine infarction. Conclusions Infarction involving the basal surface and basilar artery stenosis or occlusion may be the predictors for PMD after isolated pontine infarction.

Objective To investigate the correlation between lesion pattern and etiological mechanism in acute isolated pontine infarction.Methods The clinical data in patients with acute isolated pontine infarction were collected retrospectively. Diffusion weighted imaging (DWI) was used to identify the lesion patterns. The correlation between the lesion pattern and etiological subtype was analyzed. Results A total of 146 patients with acute isolated pontine infarction were enrolled in the study, including 136 unilateral infarctions and 8 bilateral infarctions. The DWI lesion pattern analysis showed that there were 98 patients with paranasal infarction, 11 with anterolateral infarction, 18 with tegmentum infarction, and 19 with multiple infarction. Among all the etiological subtypes, basilar artery branch disease (BABD) accounted for the greatest proportion (n = 72, 49.3%), followed by large arterial occlusive disease ( n = 32, 21.9%), small arterial occlusive disease ( n = 25, 17.1%), and other causes/unknown causes ( n = 12, 8.2%). Cardioembolism was minimal (n =5, 3.4%). The distribution patterns of DWI lesions in acute isolated pontine infarction were significantly correlated with the etiological subtypes (C = 0.516, P < 0.001). Among them, 60 patients with paramedian infarction ( χ2 =16.915, P <0.001), 1 with anterolateral infarction ( χ2 =7.701, P = 0.006), 1 with tegmentum infarction ( χ2 =17.401, P <0.001) were closely associated with BABD; 9 patients with paramedian infarction ( χ2 =12.534, P <0.001), 6 with anterolateral infarction ( χ2 =24.365, P <0.001), and 10 with tegmentum infarction ( χ2 =18.312, P < 0.001) were significantly associated with small arterial occlusive disease. Conclusions There are significant correlation between the lesion pattern and etiological mechanism in acute isolated pontine infarction. The cause of acute isolated pontine infarction can be predicted in early stage by DWI revealed infarction distribution characteristics.

Objective To investigate methods and results of endovascular treatment in TASC (Ⅱ) D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases (26 branches) of superficial femoral artery occlusion with endovascular treatment of TASC (Ⅱ) D-type superficial femoral artery occlusion were retrospectively reviewed. The effi-cacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7%(21/26), including 13 branche with stent implantation, 6 branches with Silver-hawk atherectomy and 2 branches with Viabahn stent implantation. All patients were followed up for a mean period of (10.3 ± 1.2)months, primary patency rates at 6 months were 69.2%in stent group, 66.7%in Silverhawk atherectomy group and 100%in Viabahn stent group. Conclusion Endovascular treatment of TASC (Ⅱ) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.