Objective To detect serum concentration of folate receptor alpha and to investigate its significance in the clinical application of patients with endometrial carcinoma. Methods Thirty-seven patients with endometrial carcinoma, 33 patients with endometrial hyperplasia and 10 healthy women were enrolled in this study. Sera were used to detect the the folate receptor alpha using an Enzyme-linked Immunosorbent Assay (ELISA) technique.The expression level of serum folate receptor alpha in different groups was analyzed. The correlation between the expression level of serum folate receptor alpha and age of patients, menopause, tumor morphology, myometrial invasion and clinical stage was was also analyzed in patients with endometrial carcinoma. Results Level of folate receptor alpha was successfully detected in serum of healthy women and patients with endometrial diseases. Level of folate receptor alpha in patients with endometrial carcinoma was much higher than that in patients with endometrial hyperplasia. Level of folate receptor alpha in patients with endometrial hyperplasia was also higher than that in the healthy controls, with significant difference (P < 0.05). In the endometrial carcinoma group,the levle of folate receptor alpha in serum was correlated with the clinical stage and myometrial invasion (P < 0.05), however, Level of folate receptor alpha was not correlated with the age of patients, menopause andtumor morphology(P > 0.05). Conclusion The Serum level of folate receptor alpha can be detected, and its expression will contribute to the diagnosis, treatment and predicting the prognosis of patients with endometrial carcinoma.

Objective To assess the clinical efficacy of levonorgestrel-releasing intrauterine system(LNG-IUS) in the treatment of adenomyosis. Methods Forty-two patients with adenomyosis diagnosed by clinical symptoms, MRI, laparoscopy and/or chromatic colour type-B ultrasound were treated with LNG-IUS, and the menstrual blood volume, severity of dysmenorrhea and uterine volume were observed three months later. Results After 3 month treatment of LNG-IUS, the menstrual blood volume reduced significantly to (27?11)% of that before treatment. The uterine volume was decreased from (143?33) cm 3 to (115?22) cm 3( P

Objective To explore the expression and significance of hsa-miR-181a (miR-181a) in can-ceration progression of endometrial carcinoma. Methods A total of 75 formalin-fixed paraffin-embedded tissue specimens were studied in this study , of which , 13 were normal endometrium , 18 were endometrial hyperplasia , 44 were endometrial carcinoma. After total RNA had been extracted , real-time PCR was applied to detect the ex-pression level of miR-181a in endometrial tissue in each group. Results miR-181a expression in formalin-fixed paraffin-embedded tissue specimens can be detected. Expression of miR-181a in endometrial carcinoma was high-er than that in endometrial hyperplasia , its expression in endometrial hyperplasia was also higher than that in normal endometrium, and the difference was statistically significant (P < 0.05). The expression of miR-181a in endometrial carcinoma was associated with FIGO stages (P < 0.05). Conclusion The up-regulation of miR-181a expression in women with endometrial carcinoma may play the role of oncogenes. Abnormal expression of miR-181a is probably associated with the occurrence and development of endometrial carcinoma.

Objective To determine the random spot albuminuria to creatinine ratio (ACR) of normal pregnant women , to track the pregnancy outcome , and to discuss the predictive value of ACR in women with hy-pertensive disorders complicating pregnancy (HDCP). Methods Except for 87 pregnant women suffering from HDCP, 2 038 pregnant women were enrolled in this study. ACR, routine examinations of blood and urine, blood biochemical, 24-hr urinary protein were determined. Results ACR, but not 24-hr urinary protein level,was sig-nificantly higher in women with HDCP. There was positive correlation between the ACR and 24-hr urinary protein quantitation. Age, gestational weeks, ACR, red blood cells, fasting plasma glucose, serum creatinine, total pro-tein were the independent risk factors for HDCP. The sensitivity , specificity and optimal cut off value of ACR for predicting HDCP were 0.78, 0.63, 1.46 mg/mmol. Conclusions There was positive correlation between ACR and 24-hr urinary protein quantitation , and ACR provided a more sensitive pathway for early predictionof HDCP.

Objective To establish a short-term scenario simulation training campus in senior med-ical students before graduation for the sake of a smooth transformation from medical students to residents. Methods There were 101 participants involved in the study . All the participants attended emergency medicine traditional teaching, including 51 fourth-year medical students and 50 fifth-year medical students. The 48 students who took the emergency scenario simulation training course were classified as training camp group while the other 53 students were classified as control group. The control group only participated in the emergency medicine traditional teaching, and the training camp group participated in the emergency sce-nario simulation training course on the basis of control group's routine teaching, including advanced cardiac life support and team collaboration, sepsis and doctor-patient communication, polypnea and crisis manage-ment, disorder of consciousness and interdisciplinary teamwork, multiple injuries and emergency plans, and comprehensive case evaluation. The training camp group was divided into groups and received evaluation of performance on treating emergency simulated case (clinical skills, teamwork, doctor-patient communication) before and after class. The training camp group was received questionnaire survey after class. SAS 9.2 was used to do the t test and descriptive analysis. Results There were no statistically significant differences (P>0.05) between the scores of the performance on clinical skills, teamwork, doctor-patient communication of training camp group and control group before class. The scores of training camp group after class were sig-nificantly better than those of control group (P<0.05). In addition, the course had a high recognition by students. 92% (44/48) students thought the course was contributed to improving the ability of crisis man-agement and clinical practice and were in favor of developing similar courses for senior medical students. Conclusion Scenario simulation training campus can strengthen the cultivation of medical students' com-prehensive thinking, independent clinical decision making, practice skills and communication ability in the final stage of medical education as well as enhancing their self-confidence so as to help them to adapt to the real clinical work.

Objective To investigate the clinical effects of different urinary diversion regimens after minimally invasive resection of bladder cancer. Methods 127 patients with muscular infiltrating bladder cancer from January 2010 to June 2015 were enrolled in this study. According to the patients' condition, they were divided into orthotopic ileal cystectomy group (58 cases), Bricker bladder surgery group (33 cases), ureteral skin ostomy group (36 cases), then compare the clinical data, postoperative complications and quality of life of the three groups. Results There was no significant difference in the ratio of sex, the distribution of age and tumor staging among the three groups. The operation time and postoperative hospital stay in orthotopic ileal cystectomy group were longer than those in the other two groups. The operation time and postoperative hospital stay of the Bricker bladder surgery group were longer than that in ureteral skin ostomy group, the difference was statistically significant; the bleeding in orthotopic ileal cystectomy group was more than the other two groups, and in Bricker bladder surgery group was more than ureteral skin ostomy group, the difference was statistically significant. There was no significant difference in the recovery time of intestinal function among the three groups. The recovery time of intestinal function in ureteral skin ostomy group was shorter than that in the other two groups, the difference was statistically significant. There was no significant difference in the incidence of short-term complications of the three groups of patients. The incidence of long-term complications of orthotopic ileal cystectomy group was significantly higher than the other two groups, the difference was statistically significant. The social function scores, and overall health score of orthotopic ileal cystectomy group were higher than the other two groups, the difference was statistically significance. Conclusion Without external device, closer to the characteristics of physiological urination, orthotopic ileal cystectomy holds higher postoperative quality of life, and higher incidence of long-term complications. With advantages of quick recovery and less complications, ureteral skin ostomy is best for patients who can not stand for long time surgery. It should choose the appropriate surgical approach for patients according to individuals' conditions.

BACKGROUND:The cryopreservation of single tissue has achieved great advancement and is gradual y applied in clinics. However, the cryopreservation of complex tissue is rarely reported.
OBJECTIVE:To investigate the morphological change in rabbit limb tissue after replantation through different rewarming methods, find the best rewarming methods of compound textured blood vessels, and provide theoretical basis for the feasibility of limb replantation after long-term cryopreservation.
METHODS:Thirty New Zealand white rabbits were randomly divided into control group, slow freezing-slow thawing group, and slow freezing-rapid thawing group. The right posterior limbs of al the rabbits were cut off 1 cm above the knee joint. Except control group, the latter two groups were given limb replantation after thawing, and then the right posterior limb was again cut off after the replanted limbs were survived for 6 hours. For al groups, the histological changes and gross observation in aorta tissue were observed by light microscopy and transmission electron microscope, and the results were analyzed with statistical methods.
RESULTS AND CONCLUSION:In the slow freezing-slow thawing, slow freezing-rapid thawing groups, the pathological changes (gross specimen, light microscope, electron microscope) of rabbit limbs 6 hours after replantation were worse than those in control group. Compared with slow freezing-rapid thawing group, better integrity of endothelial cells and less damage of the organel es were found in slow freezing-slow thawing group. Through deep cryogenic freezing-thawing process, rabbit limb blood vessels can maintain the structural integrity after replantation and survived at 6 hours. Slow freezing-slow thawing is better than slow freezing-rapid thawing for the preservation of severed limbs, providing evidences for the long-term survival fol owing a deep cry ogenic treatment after the severed limb replantation.

The out-patient and emergency department is the window of a hospital open to the society,also is the most direct social image of the hospital.So,we must insist on the moral principle of the "ten needs" in the work of the out-patient and emergency department in order to establish a healthy and harmonious physician-patient relationship.The "Ten needs" includes a proper attitude,a sincere communication,a quick response,a correct diagnosis,a flexible treatment,a reasonable prescription,a steady action to the emergency,a well nursing,complex skills and a standard management.

Objective To explore the expression and the pathomechanism of folate receptor alpha(FRα) and CA125 in the development and progression of endometrial carcinoma.Methods Sixty samples of endometrial carcinoma tissues,46 samples of endometrial hyperplasia tissues and 10 normal endometrial tissues were collected in the study.Immunohistochemical methods were used to detect the expression of Frαand CA125 in all tissues.The expressions of FRα and CA125 and their correlation with clinicopathological characteristics were analyzed.Results FRα was positively expressed in 93.9％ of the endometrial carcinoma tissues,with a strongly positive rate of 65.0％,which was significantly higher than that in endometrial hyperplasia tissues and normal endometrial tissues (P ＜ 0.05).The highly expressed FRαin endometrial carcinoma tissues was associated with age,FIGO stage and histologic types (P ＜ 0.05),while no statistical significance was found between the high expression of FRαand myometrial invasion.The expression of FRα in endometrial atypical hyperplasia was higher than that in other hyperplasia subgroups.The expression of CA125 in endometrial carcinoma tissues and endometrial hyperplasia tissues were both higher than that in normal endometrial tissues (P ＜ 0.05).Conclusion FRα may play an important role in the carcinogenesis and progression of endometrial carcinoma,and act as a target of therapy and a kind of assessment for prognosis in endometrial carcinoma.CA125 may be involved in the development of endometrial lesions and further researches are needed to confirm a physiological mechanism between FRA and CA125 in carcinogenesis of endometrial carcinoma.