Objective To study hysteroscopy plus laparoscopy on stress response and pregnancy in patients with tubal infertility.Methods According to the digital table,80 patients with tubal infertility were randomly divided into two groups,the control group(n =40 cases) and the observation group(n =40 cases).The control group were operated through hysteroscopy,while the observation group were operated through hysteroscopy plus laparoscopy.Operative time,blood loss and hospital stay were observed.Serum cortisol (Cor) and hsCRP were measured before and after surgery.Results In the observation group,operative time,blood loss and hospitalization stay were less than those of the control group(t =3.268,4.928,2.728,all P ＜ 0.05).Postoperative serum Cor and hs-CRP were significantly higher,but the observation group were lower than the control group,there were a significant differences between the two groups(t =3.165,2.147,all P ＜ 0.05).In the observation group,intrauterine pregnancy was significantly higher and ectopic pregnancy was significantly lower than those of the control group(x2 =4.78,4.16,both P ＜ 0.05).Conclusion Hysteroscopy plus laparoscopy can improve pregnancy and decrease stress response in patients with tubal infertility.

This paper has made a distinction between the materialist concept of qi on the medical philosophical level and its substantial existence, and illustrated the materiality and multiplicity of qi. Materiality refers to the objective reality, a summation of various things or phenomena related to human beings; while multiplicity refers to diversity of specific substances, each holding its individual essence. Based on two essential conceptions "xiang" and "xiangji", and combining the theories of traditional Chinese medicine and Western medicine, this paper has also made a preliminary study on the substantial existence of qi at macro- and micro-levels, and on physiological (normal) and pathological (abnormal) aspects. It is the author's argument that studies of the substantial existence of qi from different aspects, micro-dimension in particular, will push the syndrome differentiation of traditional Chinese medicine to a more subtle sphere.

Over the past few decades,the curative effect of leukemia has been improved significantly.But the effect of refractory acute lymphoblastic leukemia and about 50％ of acute myeloid leukemia has not been improved.At present,targeted therapy,which is unique to the incidence of leukemia,has become a hotspot,such as the antibody drugs targeted cell surface molecules or kinases.At the same time,many drugs have been applied into clinical treatment because of their better clinical results,such as imatinib,bortezomib.

Objective To study the effect and safety of spinal-epidural anesthesia(CSEA) and epidural anesthesia(EA) in the surgery of the elderly patients over age of 75.Methods 96 elderly patients over the age of 75 with lower limb surgery and the ASA Ⅱ ～ Ⅲ grade were randomly divided into two groups according to the anesthesia method.The study group(48 cases) was treated with CSEA and the control group(48 cases) was given EA.The heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP),oxygen saturation (SpO2) before anesthesia (T0),after anesthesia(T1),after the beginning of surgery(T2) and the end of the surgery(T3) were recorded.And the onset time,block perfect time,anesthetic effect and adverse reaction were observed.Results The HR,SBP,DBP,and SpO2 between the two groups and within the two groups had no statistically significant differences (P ＞ 0.05) ;the onset time and complete block time of anesthesia of the study group were significantly shorter than the control group (P ＜ 0.05),the anesthetic effect of the study group was significantly better than the control group (P ＜ 0.05).The incidence rate of adverse reactions had no statistically significant difference between the two groups (P ＞ 0.05).Conclusion CSEA has rapid onset of anesthetic and the anesthetic effect is good,it has few adverse reactions for elderly patients with lower limb surgery,and it is safe and effective,which is worth to be promoted and popularized in clinical.

Through analyzing the present situation of applying software in the daily operation in hospitals, to build a set of management process for applying software to manage intangible assets, discuss the accounting methods. The purpose is to standardize the application software to manage intangible assets, in order to reflect the status of the hospital intangible assets better.

With the continuous improvement of drag for stroke prevention, ipsilateral stroke risk in patients with asymptomatic carotid stenosis has been equal to or lower than that in the revascularization group in randomized controlled trials. Under this condition, is the asymptomatic severe carotid stenosis an indication for revascularization? This article introduces the views of different researchers.

Neuroimaging studies show that transient ischemic attacks of middle cerebral artery occlusion are not uncommon.Whether these patients should be treated with tissue plasminogen activator remains to be controversial.This article introduces the different views around this debate.

There are many controversies for how to treat the occurrence of ischemic stroke on the basis of infective endocarditis would be more reasonable,especially there is no consensus on whether to treat with anticoagulants.The article discusses about this.

Post-examination quality management is an important part in clinical microbiology,which includes systematic review,standardized result reporting format and interpretation,protection of private infomation in accordance with the medical ethics system,consulting services,and proper storage of clinical microbial specimens in course of post-examination procedures.Only in this way,the clinical microbiology laboratory could play greater roles in guiding doctors to rational antibacterial drug usage and preventing the produce of drug-resistaut strains.

ObjectiveTo explore clinical manifestations and CT performance characteristics of amalgamative AIDS tuberculosis. MethodsThe clinical data and CT manifestations of 28 patients who were already diagnosed with AIDS amalgamative tuberculosis were analyzed. ResultsThe common clinical manifestations of AIDS amalgamative tuberculosis: were cough, sputum, fever, night sweats, angular, difficult breathing, diarrhea, superficial lymph node enlargement,etc. The CT manifestations:were diffuse com grain of venereal change, the spot piece infiltrating kitchen,lung door ormediastinumlymphnodeenlargement, pleuraleffusion. Emptyandcalciticationwererare.ConclusionThe clinical manifestations and CT performance characteristics of amalgamative AIDS tuberculosis were not typical,whose performance was related with the body's immune state. When AIDS patients appoare diffuse lung in corn grain, spot piece infiltration sex pathological change focal, lung door or mediastinum lymph node enlargement, the possibility of amalgamative tuberculosis pleural effusion should first be diagnosed.