Objective: Medical therapy to prevent persistent ectopic pregnancy (PEP) after conservative laparoscopic operation was investigated. Methods:236 patients with ectopic pregnancy were divided into three groups according to the time of hospitalization. 83 cases were in group A, hyperosmolar glucose was injected into the fallopian tube lumen after laparoscopic salpingostomy. 81 cases were in group B, MTX was injected in the same way, 72 cases were in group C as control group. Serum β-HCG was tested for four times, before the operation, the first, third and a week after the operation respectively. Results:There were 6 patients of PEP in this study. One patient in group A, one patient in group B, the rest four patients in group C. The incidence of PEP was not statistically significant between group A and B( P>0. 05), while the difference was significant between group A and C ( P<0. 05). Serum β-HCG in three groups descended significantly in the first 24 hours after operation, but there were no differences among these groups. As for the descending of β-HCG in day 3 and 7, there was no difference between group A and B, but the difference was magnificent between group A and C( P < 0.05). Conclusions: Compared with the MTX, hyperosmolar glucose is an effective and safer method to prevent PEP.

Objective To evaluate the preoperative nutritional status of patients with colorectal carcinoma by using the nutritional risk screening 2002 (NRS2002) score and its prediction for postoperative outcomes.Methods Retrospectively evaluated the nutritional risk of 259 colorectal cancer patients with NRS2002 score in terms of different sexes,ages,tumor location,pathology and differentiation,Dukes stages.The relationship between different NRS2002 score and postoperative complications and hospital stay were also observed.Results NRS2002 score was applicable in 243 cases,≥ 3 scores of 80 cases,＜ 3 scores of 163 cases.Gender,histological differentiation and before surgery NRS2002 score unrelated (P ＞ 0.05).Ages,tumor location,and Dukes stages related NRS2002 score (P ＜ 0.01).No case of perioperative death,hospital stay 10-101 (21.6 ± 9.7) d.The incidence of complications in ≥ 3 scores patients was significantly higher than that in ＜ 3 scores patients [30.0％ (24/80) vs.17.2 ％ (28/163),P ＜ 0.05],hospital stay in ≥ 3 scores patients was significantly shorter than that in ＜ 3 scores patients[(20.5 ± 8.2) d vs.(23.9 ± 11.9) d,P＜ 0.05].Multiple Logistic regression analysis showed that gender,age,tumor location,histological differentiation,Dukes stages,surgical and colorectal cancer complications unrelated (P ＞ 0.05),NRS2002 score associated with colorectal cancer complications (P ＜ 0.05).Pearson correlation analysis showed that hospital stay correlated with NRS2002 score (P ＜ 0.01).Conclusions NRS2002 score is applicable in Chinese colorectal cancer patients.The youth and the elderly,the proximal part of colon,and Dukes D stage patients are more liable to develop preoperative nutritional risk than those of middle age,the distal part of colon,or other Dukes stages.≥ 3 scores predicts higher postoperative complications and longer hospital stay.Preoperative nutritional support is necessary in patients with ≥ 3 scores.

BACKGROUND:Colagen hydrogel provides good matrix support for hepatocyte growth and tissue reconstruction, and the colagen-based engineered tissue is easy to merge the growth and form integrated tissue. OBJECTIVE:To improve the thickness of engineered hepatic tissue by dissociating hepatocytes/colagen hydrogel composite into smal hepatic units that accumulate in the subcutaneous cavity. METHODS:Freshly isolated hepatocytes from rats were mixed with colagen hydrogel to establish hepatocytes/colagen hydrogel composite. The hepatocytes/colagen hydrogel composite was dissociated into smal hepatic units after being cured. The undissociated hepatocytes/colagen hydrogel composite was taken as a control. Six Spraque-Dawley rats were enroled. Three of them were subjected to a two-thirds partial hepatectomy to induce liver regeneration. Dissociated and undissociated hepatocytes/colagen hydrogel composites were implanted into the bilateral inguinal subcutaneous cavity. Dissociated and undissociated hepatocytes/colagen hydrogel composites were implanted into the bilateral inguinal subcutaneous cavity of the other three rats. At the 7th day after transplantation, engineered hepatic tissue formation was evaluated using hematoxylin-eosin staining, immunohistochemical staining and India ink perfusion methods. RESULTS AND CONCLUSION:The grafts in these two groups al formed vascular engineered hepatic tissue in the subcutaneous cavity, but after the smal hepatic units merged, a large piece of vascular engineered hepatic tissue formed. The hepatic tissue thickness was up to 4 mm. The whole piece of implanted liver grafts only formed smal pieces of hepatic tissues, with only several layers of cels. Immunohistochemistry staining confirmed that the hepatocytes in vascular engineered hepatic tissue had the characteristics and functions of natural hepatocytes. Partial hepatectomy experiment showed that engineered hepatic tissue had the ability to respond to regenerative stimulus of partial hepatectomy. These results show that dissociating the hepatocytes/colagen hydrogel grafts into smal units that accumlate in the subcutaneous cavity can increase the thickness of the engineered hepatic tissue.

Acupuncture Therapy ; history ; instrumentation ; methods ; China ; History, Ancient ; Humans ; Medicine in Literature ; Needles ; history

Medical service system integration follows the logic of system innovation and development.Case studies of the UK,the USA and Australia found that medical delivery system integration is the product of a series of mixed factors.Health care financing and payment mechanism reform,physician team building,stair-cased movement to grassroots of healthcare service,shared clinical norms utilization as well as its gradual development constitute the general logic of such an integration.In the evolution process,the check and balance between the government and market,equity and efficiency have been affecting the integration process all the way.In light of these logics,China should speed up its transform of the integration concept,improve the integration elements,and strengthen the guidance of integration principles during its integration of the medical service integration.

Objective: To assess the clinical efficacy of Xuebijing injection in the prevention of postoperative systemic inflammatory response syndrome (SIRS) in the patients with ureteral stones and urinary tract infection during the perioperative period of ureteroscopy.Methods: Totally 64 cases with ureteral stones complicated with urinary tract infection treated with ureteroscopy were selected as the subjects and divided into two groups according to the digital method.The 32 cases in the control group were given the conventional antibiotics during the perioperative period for preventing the incidence of SIRS, and the observation group was given 500ml Xuebijing added to 100ml normal saline for intravenous drip additionally.The incidence of SIRS and the laboratory indicators after the operation were observed and compared between the groups.Results: The incidence of postoperative SIRS of the observation group was 9.38% , which was lower than that of the control group (34.38% , P <0.05);the incidence of sepsis of the observation group was 0%, while there was no statisticcally difference bettween the two groups(P＞0.05).The C-reactive protein (CRP), procalcitonin (PCT), leucocyte count and endotoxin in the observation group on the 2nd, 4th and 6th day after the operation were better than those in the control group, and the difference was statistically significant (P＜0.05).Conclusion: Xuebijing injection combined with antibiotics has significant clinical effect on the incidence of SIRS after ureteroscopy in the patients with ureteral stones and urinary tract infection, which can effectively improve the clinical indicators and reduce the incidence of sepsis, and is worthy of clinical promoted application.

Objective To evaluate the effects of probioties on inflammation,intestinal flora and mucosal tumor necrosis factor alpha(TNF-?)expression in experimental colitis rats.Methods Thirty Wistar rats were randomly divided into normal control group(NC),model control group(UC),and pro- biotics treatment group(PC).The experimental colitis were induced by trinitrobenzene sulfonie acid (TNBS)/ethanol enema.Rats in PC group were fed with Bifico[live probiotics of combined bifidobacte- rium(Bif),lactobacillus (Lac) and enterococcus]by 2.2?10~9 colony-forming unit (CFU)/d for 4 weeks.Inflammatory scores and mucosal morphological changes under light microscopy were studied. Plasma endotoxin levels,expressions of TNF-?and interleukin-6 (IL-6) in mueosa were measured. Enteric microorganisms in cecum were fostered with standard methods.Results Inflammatory scores in PC group decreased compared with those in UC group(7.94?0.85 vs 10.25?1.36,P＜0.05),but still higher than those in NC group(7.94?0.85 vs 4.35?0.88,P＜0.01).There was a significant alteration in the enteric microbial flora,Bif and Lac were decreased significantly in UC group,Bifico supplement ameliorated this imbalance.Plasma endotoxin and mucosal TNF-?levels in PC were lower than those in UC group[endotoxin:(93.33?21.22)pg/ml vs (121.25?39.07)pg/ml;TNF-?:67.51?14.63 vs 85.99?18.17,P＜0.05],but higher than those in NC group[endotoxin:(93.33?21.22) pg/ml vs(35.20?15.12)pg/ml;TNF+?:67.51?14.63 vs 43.28 4?19.98,P＜0.01].There was no statistically significant difference in mucosal IL-6 levels between PC group and UC group,though its level in PC group was lower than that in UC group(155.22?34.01 vs 184.09?29.11,P＞0.05),but higher than that in NC group(155.22?34.01 vs 108.73?37.35,P＜0.01).Conclusions Probiotics can attenuate inflammation of experimental colitis of rats through reinstituting gut flora bal- anee.Improving gut flora imbalance,reducing endotoxin and pro-inflammatory cytokines may be the effects of probiotics.

Objective To investigate the protein and mRNA expressions of Toll-like receptor 2 (TLR2) and Toll-like receptor 4 (TLR4) on colons of rats with trinitrobenzene sulfonic acid (TNBS)- induced colitis,and to evaluate the effects of probiotics.Methods Thirty male Wistar rats were randomly divided into normal control group (NC group),model control group(UC group) and probiotics-treated group(PC group).The experimental colitis was induced by TNBS/ethanol enema.Rats in PC group were fed with Bifico [live probiotics of combined hifidobacterium(Bif),lactobaeillus(Lac) and enteroeoccus] by 2.2?10~9 CFU/d for 4 weeks.Inflammatory scores were studied.Expressions of protein and mRNA of TLR2 and TLR4 were measured by Western blot and real-time quantitative polymerase chain reaction (PCR),respectively.Results Inflammatory scores in NC group,UC group and PC group were 4.35?0.88,10.25?1.36 and 7.94?0.85,respectively.The inflammatory scores in PC group were decreased compared with that in UC group (P

ObjectiveTo realize the relevance between hypertension and serum uric acid (SUA) in residents in Baise City.MethodsTwenty one thousand,five hundred and eighty eight Baise residents were examined.The body weight,height,waist circumference,hip circumference,blood pressure(BP) were recorded and blood lipidlevels,blood glucoseand serum uric acid (SUA) were tested.The relevance between hypertension and hyperuricemia (HUA) was analyzed by multi-factor variance analysis,x2 test,t test,linear regression and Logistic regression analysis.ResultsHypertension prevalence rate was 31.5％,the frequency of HUA was 12.0％,and 5.8％ residents had both.For patients with both hypertension and HUA,when compared to those with normal serum uric level,their mean diastolic blood pressure(DBP) was(84±10),(72±6) mm Hg res-pectively,there mean systolic blood pressure (SBP) was(151±12),(127±6) mm Hg respectively,and pulse pressure (PP) was (50±12),(37±8) mm Hg respectively.The average BMI of those two groups was (23.9±2.6),(21.7±2.4) kg/m2 respectively.The average TC level was (6.0±1.3),(5.2±1.1)mmol/L respectively,the average TG level was(2.3±2.2),(1.5±0.7) mmol/L respectively,and the average LDL-C level was(3.4±1.3),(3.0±1.1) mmol/L respectively.All these parameters were higher than those people without hypertension or HUA(P＜0.01).However,the situation of HDL-C[ (1.2±0.4),(1.5±0.5)mmol/L] was the opposite (P＜0.01).Regression analysis had shown that age,BMI,waist-hip ratio,SUA,blood glucose,TC,TG,HDL-C and LDL-C were independent risk factors for hypertension,while people with HUA was 3.1 times more when compared to those without HUA.The prevalence rate of HUA in people with hypertension was 2.6 times higher than that of the control group.ConclusionHypertension and HUA are two public health problems that prevalent in the residents in Baise City.Obesity,high blood glucose level and hyperlipidemia are thebasis for the development of hypertension and HUA.Hypertension can be the cause of HUA and verse versa.They may have mutual interactions.The adverse effect of HUA on-cardiovascular system should be taken into consideration clinically.

ObjectiveTo analyze the characteristics of magnetic resonance diffusion tensor imaging(DTI)and diffusion tensor tractography (DTIT) in patients with cerebral infarction, and explore the diagnosis values and prognosis of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) in patients with cerebral infarction in different stages. Methods58 patients with cerebral infarction in different stages and 25 healthy volunteers were examined by magnetic resonance imaging(MRI), including conventional T1 and T2 weighted imaging, DWI and DTI. Fractional anisotropy (FA) images were reconstructed. The values of FA and apparent diffusion coefficient (ADC) were measured in the infarcted regions, corresponding contralateral normal regions and corresponding normal regions in normal control group. Results①DWI and DTI showed size of infarction focus was more accurate and clearer than that of conventional MRI; ②The FA and ADC values of the infarcted regions during superacute stage, acute stage, subacute stage and chronic stage were (0.24±0.02, 0.31 ±0.11), (0.20±0.02, 0.32±0.12), (0.18±0.02, 0.34±0.11) and (0.16±0.02, 0.37±0.13), respectively, lower than those in the contralateral corresponding regions which were (0.40±0.03, 0.70±0.21), (0.37±0.03, 0.71±0.21), (0.39±0.03, 0.72±0.22) and (0.40:±0.03, 0.72±0.23), respectively. The differences were statistically significant (P＜0.05). The FA and ADC values had no significant differences between the uninjured sides in patients with cerebral infarction and the corresponding regions in the normal control group (P＞0.05); ③The FA and ADC values in brain tissues changed regularly with the time of infarction after cerebral infarction. The FA values in the affected sides had no consistent changes as compared with the contralateral sides in the superacute stage. They increased or decreased slightly, then (during acute stage, subacute stage and chronic stage) decreased irreversibly. The ADC values in the affected sides changed with time regularly, they decreased significantly, gradually returned to normal, and then increased again. Conclusion DTI and DTT examination contribute to the diagnosis of cerebral infarction. The combination of the FA and ADC values may more accurately conduct clinical staging and evaluate the time of the occurrence of cerebral infarction.