Objective To investigate the clinical effect of laparoscopic operation and laparotomy in the treat-ment of uterine fibroids.Methods A retrospective analysis of uterine fibroids and requests to retain the clinical data of 380 cases of uterine of patients,according to treatment methods,they were divided into laparoscopic myomectomy group (group A)and cesarean section uterine fibroids removed surgery group (B group),there were 190 cases,two groups of patients,surgery,clinical effect were analyzed.Results In group A,operation time,postoperative exhaust time,postoperative ambulation time,postoperative VAS score,duration of hospitalization,injection of analgesics appli-cation proportion were (96 ±35)min,(24 ±8.5)h,(12 ±4)h,(2.0 ±1.5),(4.0 ±1.2)d,17.8%,patients in the group B respectively (98 ±28)min,(40 ±12)h,(20 ±8)h,(6.0 ±1.3),(8 ±2)d,84.6% there was a significant differences between the two groups (t=-2.558,33.96,45.810,50.571,34.120,χ2 =169.89,all P<0.05);group A and group B,the amount of bleeding were (186 ±78)mL and (175 ±85)mL,with no significant difference between the two groups (t=1.911,P>0.05);group A,the complication rate was 7.34%,lower than the 12.6%in the group B,there was significant difference between the two groups (χ2 =3.923,P<0.05).Conclusion Laparoscopic myo-mectomy in treatment of uterine fibroids,good effect,less trauma,quicker recovery,shorter hospitalization time of patients,should be further popularized in clinic.

As originated from hematopoietic stem cell clonal diseases,bcr-abl-negative chronic myeloproliferative neoplasms (MPN) include polycythemia vera (PV),essential thrombocythemia (ET) and primary myelofibrosis (PMF).With the discovery of JAK2 mutations,many new mutations have been identified.With the in-depth study of gene mutation,the pathogenesis of MPN has been gradually uncovered.Novel drugs have been developed accordingly.

Objective To evaluate the 7th edition American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumor node metastasis (TNM) staging system for gastric carcinoma with the 6th edition in Chinese population.Methods A total of 401 gastric cancer patients undergoing surgical resection was staged using the 6th and 7th edition AJCC TNM staging system,respectively.Homogeneity,discriminatory ability,and monotonicity of gradients of two systems were compared using linear trend x2 test,likelihood ratio x2 statistics,and akaike information criterion (AIC) calculations.To compare the accuracy of prognostic evaluation between the 6th and the 7th edition TNM staging system for gastric cancer.Results Significant difference in 5 years survival rate were observed according to the T/N classification using the 6th edition staging system,and there were similar survival curves between T1a and T1b according to the 7th T classification.There was not significant difference between the area under the curve (AUC) of the 6th and the 7th edition staging systems.Conclusions T staging and N classification according to the 7th edition showed better performance,but the 72 TNM staging system was not better in predictive accuracy.

Objective To investigate the allergens and study the clinical significance of detecting serum levels of TNF-α,IL-4, IL-6 and IL-8 in patients with bronchial asthma.Methods 62 cases of patients with bronchial asthma were selected from August 2011 to August 2013 in Baoji Central Hospital,enzyme-linked immunosorbent assay were carried out in patients u-sing standardized allergens.62 cases of healthy people were selected as control group,and detected serum levels of TNF-α, IL-4,IL-6 and IL-8 of the two groups.Results Dust mites were the most important and the strongest allergens.The levels of TNF-α,IL-4,IL-6 and IL-8 in observation group was significantly higher than those in control group (230.87±27.82 ng/ml vs 152.14± 23.27 ng/ml;25.32 ± 12.04 ng/L vs 8.57 ± 3.64 ng/L;152.45 ± 24.56 μg/L vs 98.56 ± 18.63 μg/L;218.79±32.91μg/L vs 142.68±23.76μg/L,P<0.05).Conclusion TNF-α,IL-4,IL-6 and IL-8 levels in patients with bronchial asthma j udgment can be used as an important predictor,and it is worthy of clinical application.

Chemotherapy, molecular targeted therapy, and hormonal therapy are essential components of medical oncology. Al-though cancer patients significantly benefit from the emergence of various new anticancer drugs, none of these treatments can directly address drug resistance. Radiation therapy is one of the three conventional cancer treatment methods. Nearly two-thirds of cancer pa-tients accept radiation therapy during treatment. However, radiation resistance is a significant barrier affecting the therapeutic effect of this procedure. Epithelial–mesenchymal transition (EMT) is a biologic process that enables a polarized epithelial cell to undergo multi-ple biochemical changes. These changes enable the cell to assume the functions of a mesenchymal cell phenotype. These functions have been extensively studied and are related to embryogenesis, tumor invasiveness, and metastasis. In recent years, increasing evidence sug-gests that EMT is closely linked with tumor treatment resistance. The study of the relation between EMT and tumor treatment resistance is expected to contribute to the prevention of drug resistance and radiation resistance and thus improve treatment efficacy to provide benefit to cancer patients. This article explores this issue.

Objective To understand the incidence and related risk factors of healthcare-associated infection(HAI)in neu-rological patients with cerebrovascular diseases.Methods The occurrence and risk factors of HAI in patients with cerebro-vascular diseases in a hospital between Jan and December 2013 were investigated and analyzed.Results Of 3 573 investiga-ted patients,214 had HAI,the incidence of HAI was 5.99%;the main infection site was respiratory tract (54.67%),fol-lowed by urinary tract (25.23%).Univariate analysis revealed that age,length of hospitalization,disturbance of conscious-ness,chronic obstructive pulmonary disease,diabetes mellitus,invasive procedures,application of antacids,and antimicro-bial prophylaxis were all related to the occurrence of HAI (P<0.05).Multivariate logistic regression analysis revealed that disturbance of consciousness,old age,invasive procedures,chronic obstructive pulmonary disease,and diabetes mellitus were independent risk factors for the occurrence of HAI (all P <0.05).Conclusion The incidence of HAI is high in hospitalized patients of the neurology department,there are multiple risk factors associated with HAI,it is necessary to take corresponding interventions for reducing the incidence of HAI.

Objective To investigate the relationship of plasma homocysteine and the polymorphism of MTHFR gene with ischemic stroke in type 2 diabetes. Methods Serum Hcy ,folic acid and the polymorphism of MTHFR gene were compared among 81 T2DM patients with brain infarction (T2DM+BI) and 325 T2DM patients without brain infarction (T2DM ). Results All the genotypes of T2DM group and T2DM+BI group followed the hardy‐weinberg law. There was no significant difference in the frequency of mutant alleles (T) in site 677 of MTHFR gene and in frequency of TT genotype between the groups of T2DM and T2DM + BI (64.15% vs 60.15% and 42.5% vs 34.5% ,P > 0.05 ). The concentration of Hcy was significantly higher in patients with TT genotype than with CC genotype (14.4 ± 7.86) vs (10.58 ± 3.37)mmol/L(P<0.01). Conclusion There is no correlation between polymorphism of MTHFR gene and stroke in T2DM patients. The mutation of MTHFR C677T is associated with hyperhomocysteinemia.

Objective To compare the treatment effects of catheter directed thrombolysis and thrombetomy for acute ar?terial ischemia of the lower extremity. Methods Patients who visited Tianjin Medical University General Hospital from 2011 to 2013 and were attacked by acute ischemic disease of lower extremities within 3 days (n=66) were investigated. Thrombetomy and thrombolysis treatment had been performed to 32 cases and 34 cases respectively according to patients’ own willingness. Postoperative symptom remission rate, limb salvage rate, fatality rate, reperfusion injury rate (including re?nal inadequacy, heart failure, muscle fascia compartment syndrome), bleeding rate and limb dysfunction rate were compared between these two groups. Results There was no statistical difference on the rate of symptom remission (93.8% vs 94.1%), limb salvage(96.9%vs 100%), case fatality rate(3.1%vs 0), bleeding rate(0 vs 8.8%)and limb dysfunction rate (0 vs 5.9%)between these two groups. However, the incidence of reperfusion injury was higher in the group of thrombectomy (37.5%vs 2.9%, P<0.05)compared to that of the other group. Conclusion Similar effect of treatment and less reperfusion injury, especially renal injury, had been achieved by CDT compared with thrombetomy.

Objective To investigate the etiology of the nosocomial infection and immune function changes anus and anal after operation.Methods 130 patients who needed anus and anal canal surgery were recruited in the study.The clinical data were recor-ded and postoperative nosocomial infection data were observed,including infection type,distribution,pathogenic analysis and im-mune function.Results A total of 67 cases of nosocomial infection occured,the infection rate was 51.5% (67/130),the main types of infection were perineal wound infection,abdominal infections and pelvic infections,urinary tract and vaginal infections were rare. 93 isolates were collected,of which gram-negative bacilli accounted for 67.7% (63/93 ),including bacteroides fragilis (21.5%), Escherichia coli (18.3%),Pseudomonas aeruginosa (10.8%);Gram-positive bacteria accounted for 23.7% (30/93 ),including Staphylococcus aureus(17.2%),Staphylococcus epidermidis(6.5%);5 fungi were isolated accounting for 5.4%,other strains ac-counted for 3.2%.All the immune parameters detected in patients with postoperative nosocomial infection were statistically differ-ent from those before infection(P <0.05)except for IgM(P >0.05).Conclusion The incidence of nosocomial infection was rela-tively high in patients who had anus and anal canal surgery,which could serious affect the patients'outcomes,preventive and control measures should be taken in clinical practice.

ObjectiveTo explore the content of isorhynchophylline in different medicinal parts of Ramulus Uncariae Cum Uncis.MethodsHPLC was adopted to determine 8 batches of different Ramulus Uncariae Cum Uncis of different origin and different medicinal parts. The Waters Symmetry C18 color(4.6 mm×250 mm, 5μm) was used with mobile phase of methanol -0.01 mol/L ammonium acetate buffer(pH 8.0)(60∶40), column temperature of 25℃ , 20μl sample volume, velocity of 1.0 ml/min, and detection wavelength of 246 nm. ResultsIsorhynchophylline can be detected in all 8 batchs of Ramulus Uncariae Cum Uncis in different regions, and different content were found among different origins. The content of isorhynchophylline in different parts of the same origin showed a decreasing sequence of the rhabd, stem with hook, stem without hook, and twig without hook and leaves.ConclusionMost of medicinal part of Ramulus Uncariae Cum Uncis contains isorhynchophylline, which provide a lab basis for exploring medicinal parts of this herbal medicine.