Objective To evaluate the impact of uterine artery embolization (UAE) tor uterine fibroids on ovarian function in young woman. Methods From 50 young patients with symptomatic leiomyomas managed with UAE, completed follow-up 24-36 months of clinical symptomatic, ovarian function continue and pregnancy outcome. All patients participants ranged in age from 24 to 40 years, divided into lower 35 years group (30 cases)and over 35 years group (20 cases). Results There was no significant difference in serum FSH, LH and E2 levels between two groups before UAE and 3-6, 12, 24-36 months after UAE(P > 0.05).The comparison of serum FSH, LH and E2 levels between two groups at the same time points before and after UAE were no significant difference (P> 0.05). Menstrual blood loss reduced and duration of flow shorted after UAE in two groups, the differences were significant (P < 0.05). Cycle interval in over 35 years group was longer in 3-6 months after UAE than that before UAE, the difference was significant (P <0.05). There were 2 patients occurred transient secondary amenorrhea after UAE in lower 35 years group, 3 patients occurred in over 35 years group. One patient had menopausal syndrome in 37 months after UAE, and serum FSH and LH levels were found to heighten obviously, 47% pregnancies and 30% deliveries in lower 35 years group, 45% pregnancies and 20% deliveries in over 35 years group. Conclusion Transient secondary amenorrhea would have been occurred in young patients with uterine fibroid performed UAE, no prematureo varian failure and premature menopause.

Objective To explore the clinical application of non - invasive sonography in the determination of detrusor thickness in bladder outlet obstruction. Methods Admitted from January 2012 to January 2014, 116 pa?tients with bladder outlet obstruction were selected as observed group, while another 88 patients without bladder outlet obstruction at the same period were selected as control group. The detrusor thickness determined by sonography in the two groups was comparatively analyzed. Results There were significant differences between the two groups in DWT, residual urine volume, urine output, Qmax, PdetQmax and Pdetmax and other indicators (p <0.05). Conclusion Ultrasonic determination of anterior bladder detrusor thickness is reliable to diagnose bladder outlet obstruction, with a high clinical promotional and diagnosis value.

BACKGROUND: Pathogenesis and pathophysiological changes of chronic compressive cervical myelopathy havenotbeen completely clarified.OBJECTIVE: To establish an animal model of experimental chronic compressive cervical myelopathy for the exploration of the pathological and electrophysiological changes after chronic spinal compression.DESIGN: A randomized and controlled observatory study using experimental animals as subjects.SETTING: An Animal Experimental Center of a University and an Orthopaedic Laboratory of Affiliated Hospital of a Military Medical University MATERIALS: The study was conducted in the Animal Experimental Center of Nantong Medical University and the Orthopaedic Laboratory of Shanghai Changzheng Hospital from June 2002 to April 2003. Sixty 12-week healthy Chinese rabbits of either gender with a bodymass between 2.5 kg and 3.0 kg were randomly divided into control group( n = 6) and study group( n = 54).METHODS: Titanic metal screw was put into C5 vertebra through cervical anterior approach for progressive compression to establish chronic cervical myelopathy model.MAIN OUTCOME MEASURES:Principal consequences: ①histological examination ;②electrophysiological examination. Secondary consequence:neural function evaluation.RESULTS: Totally 48 rabbits entered into result analysis, in which 6 rabbits from control group and 42 rabbits from study group. Modified Tarlov's motor function evaluation was 3 in 31 rabbits with compression signs, and 4 in 11rabbits without compression signs. The latency of N1 wave in cortical somatosensory evoked potentials (CSEP) was (9.11 ± 1.61 ), ( 11.36 ± 2.17)and (17.55 ± 3.73) ms respectively in animals of control group, animals of study group without compression signs and animals of study group with compression signs. The lantency of CSEP N1 wave was significantly longer in animals of study group with compression signs than that of the animals in the control group and study group without compression signs (P＜0.05).CONCLUSION: This animal model can simulate clinical invasion process of chronic compressive cervical myelopathy. The severer the spinal compression is, the more often the compression signs appear, the longer the lantency of CSEP N1 wave is, and the more serious the spinal pathological damages are.

Objective To explore imaging features of the lateral atlanto-dental interval (LADI) of atlanto-axial joint and its value in the diagnosis of atlanto-axial joint dislocation/subluxation. Methods Two hurdred and forty healthy volunteers without atlanto-axial joint dysfunction and 32 patients with torticollis and/or functional impairment at atlanto-axial joint were enrolled into this study. All subjects were examined with multi-slice CT in both neutral and max rotation positions to the left/right. Clinical endpoints including VBLADI, variance range of the VBLADI and asymmetric conditions were evaluated. x2 test is used to evaluate the variance of incidence of bilateral LADI asymmetry in different age groups, Pearson-test(2-tailed) is used to evaluate the correlation between VBLADI and rotary function of atlanto-axial joint,precise test of fourfold table is used to compare normal group with patient groups. Results ( 1 ) In the normal control group: asymmetry of bilateral LADI were observed in 204 among 240 (85.00%) healthy volunteers including 60 youngsters( ＜ 15 years) and 180 adults( ≥ 15 years). The median and P95% of |VBLADI| were 0.850 mm,2.450 mm in the young ( ＜ 15 years) and 0.700 mm,2.051 mm in the adult(≥15 years),there were 2 and 10 volunteers whose |VBLADI| ≥P95% in the young and in the adult respectively. There was no correlation between VBLADI( -2.146 to 2.114 mm,Median 0.000 mm) and LA(22.949° to 44.649°, Median 34.500°), RA (25.284° to 45.334°, Median 35.300° ), VLRA ( - 11.643°to 8.623 °, median 0.000 ° ) respectively in normal people ( r = - 0.030, - 0.005,0.026, P ＞ 0.05 ). ( 2 ) In the study with 32 patients including 25 youngsters( ＜ 15 years) and 7 adults( ≥ 15 years). Seventeen of 32 had atlanto-axial lateral subdislocation (AALSD),in 16 youngsters( ＜ 15 years), the median of the |VBLADI| was 3.350 mm and 14 cases |VBLADI| ≥2.450 mm;1 adult patient(≥ 15 years) had |VBLADI| ≥ 2.051 mm; 7 of 32 patients had atlanto-axial rotatory dislocation (AARD) including 4 youngsters |VBLADI| ＜2.450 mm,median 1.200 mm,3 adults |VBLADI| ＜2.051 mm,all of the 7 patients with AARD had unilateral parasol LADI in neutral position;8 of 32 patients had atlanto-axial complicated dislocation(AACD) including 5 youngsters |VBLADI| ≥2.450 mm,3 adults |VBLADI| ≥2.051 mm. There are more cases whose |VBLADI| ≥P95% in group AALSD and group AACD than in abnormal group( P<0.01 ), but there is no difference between group AARD and normal group( P = 0.738 ).Conclusion The imaging finding of "asymmetry of bilateral LADI" may be either a physiological variation or a pathological condition, clinical manifestations and other imaging findings should be evaluated to make a diagnosis.

Objective To explore the possible mechanism of the apoptosis of hepatoma cell line HepG2 induced by the combination use of GNRs@SiO2-FA and 125I seeds and to discuss its relationship with Bcl-2 and Bax protein expressions so as to provide theoretical basis for clinical treatment of hepatic cancer with interstitial brachytherapy by using 125I seeds. Methods In vitro cultured HepG2 cells were randomly divided into 4 groups: blank control group (not treated), simple GNRs@SiO2-FA group, simple 125I seeds group, and combination group (GNRs@SiO2-FA plus 125I seeds). The apoptosis of HepG2 cells was determined by flow cytometry. The expression of Bax mRNA and Bcl-2 mRNA of HepG2 cells were tested by RT-PCR. The apoptosis-related genes (Bax and Bcl-2) and the tumor proliferation cell nuclear antigen (Ki67) proteins expression on HepG2 cells were examined with immunohistochemistry method. Results The flow cytometry examination showed that the apoptosis rate of HepG2 cells in the simple GNRs@SiO2-FA group and simple 125I seeds group was higher than that in blank control group (P<0.05), and the apoptosis rate of the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group (P< 0.05). The expression level of Bax mRNA in the combination group was higher than that in the simple GNRs@SiO2-FA group and simple 125I seeds group, while the expression level of Bcl-2 mRNA in the combination group was obviously lower than that in the simple GNRs@SiO2-FA group and simple 125I seeds group. Bax protein was expressed on cytoplasm, Bcl-2 protein was expressed on cytoplasm and cell membrane, while Ki67 protein was expressed on nucleus. All of them presented as brown finely granular precipitations. Statistically significant differences in the amount of Bax, Bcl-2 and Ki67 protein expression existed between each other among the four groups (P< 0.05). The positive expression rate of Bax protein in the combination group was significantly higher than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, while the positive expression rate of Bcl-2 and Ki67 protein was significantly lower than that of the simple GNRs@SiO2-FA group and the simple 125I seeds group, and the differences were statistically significant (P < 0.05). Conclusion The combination use of GNRs@SiO2-FA and 125I seeds can more effectively induce the apoptosis of HepG2 cells. This effect may be accomplished through increasing the expression of Bax protein and inhibiting the expression of Bcl-2 and Ki67 proteins.

OBJECTIVE To evaluate the clinical efficacy of piperacillin/tazobactam for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) with pulmonary encephalopathy.METHODS Seventy three cases of AECOPD with pulmonary encephalopathy were randomized into piperacillin/tazobactam group and ceftazidime group,and sputum culture was underwent for each case before and after treatment.RESULTS The total efficacy rates and bacterial clean rates in piperacillin/tazobactam group and ceftazidime group were 91.67% and 88.89%,75.68% and 57.89%,respectively,and the differences between the two groups were statistically significant.CONCLUSIONS It suggested that piperacillin/tazobactam be a more effective drug for AECOPD with pulmonary encephalopathy.

Objective The objectives of this study were to investigate the relationship between DKK1 protein expression and lymph node invasion,and prognosis in patients with intrahepatic cholangiocarcinoma.Methods From January 2005 to December 2012,78 patients with intrahepatic cholangiocarcinoma were treated with endoscopic resection.Tissue microarray of intrahepatic cholangiocarcinoma and adjacent tissues were done and biochemical indexes were measured before operation.The patients were recruited every 3 months after operation.The Kaplan-Meier method was used to analyze the recurrence-free survival curve and the overall survival curve.The Cox proportional hazards regression model was used to analyze the multivariate analysis and to determine the factors that affect the disease-free survival(RFS)and overall survival(OS).Results There were significant differences in the expression of GGT,hepatic portal lymph node invasion,Child-Pugh grade,MMP9 and DKK1 protein in the negative and positive expression of intrahepatic cholangiocarcinoma(P ＜ 0.05).The positive expression rate of DKK1 protein in intrahepatic cholangiocarcinoma was 35.90％ (28/78),and the positive expression rate of DKK1 protein in hilar cholangiocarcinoma was 14.10％ (11/78).RFS and OS in 78 cases of intrahepatic cholangiocarcinoma were 51.28％ (40/78) and 50.00％ (38/78),41.03 ％ (32/78) and 38.46％ (30/ 78),25.64％ (20/78) and 23.08％ (18/78) after surgery for 1,3 and 5 years,respectively.The results from univariate and multivariate analysis showed that GGT,CA19-9,CEA,tumor size,DKK1 and hilar lymph node invasion were the prognostic factors of OS in patients with intrahepatic cholangiocarcinoma.CEA,tumor size,DKK1 and hilar lymph node involvement were prognostic factors for RFS in patients with intrahepatic cholangiocarcinoma.DKK1 protein expression positive and negative OS curve or RFS curve showed that 5 years after intrahepatic cholangiocarcinoma patients DKK1 protein expression positive and negative OS were 28.20％ and 20.51％;RFS were 24.36％ and 21.79％.Conclusion The expression of DKK1 protein is closely related to lymph node invasion in patients with intrahepatic cholangiocarcinoma.The expression of DKK1 protein is the prognostic factor of OS and RFS in patients with intrahepatic cholangiocarcinoma.

Objective To investigate aberrant methylation in the promoter area of p16 gene and p16 protein expression in human pancreatic carcinoma and in the corresponding tumor-adjacent tissues,and evaluate their role in the carcinogenesis and progression of tumor and its clinical significance.Methods Immunohistochemistry and MSP(methylation-specific PCR)were performed on 46 samples of pancreatic carcinoma and their corresponding tumor-adjacent tissue specimens for p16 and its methylation.Results Expression rate of p16 protein was 41.3%(19/46)in pancreatic carcinomas,95.7%(44/46)in corresponding tumor-adiucent tissues.Through MSP,the methylation rate in pancreatic carcinomas was 39.1%.No gene methylation was found in 19 cases expressing p16 protein.p16 gene methylation was closely related to p16 protein expression in pancreatic carcinoma(P0.05);but were significantly related to the PTNM staging,histological differentiation,distant metastasis and lymph node metastasis(P

Objective To compare the efficacy of two doses of ambroxol in the treatment of the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods A hundred and ten cases of the elderly patients with an acute exacerbation of COPD were divided into low-dose group and high-dose group.Low-dose group (56 cases) were given Ambroxol 30 mg,2 times per day for 10 day and high-dose group (54 cases) were given Ambroxol 60 mg,2 times per day for 10 days.Results The effective rate in high-dose group was significantly higher than that in low-dose group.Conclusion High-dose ambroxol has significant effect in the treatment of acute exacerbation of chronic obstructive pulmonary disease.

Objective To observe the feasibility, safety and efficacy of percutaneous coronary intervention (PCI) for treatment of chronic total occlusions (CTO)by only the guidewire versus by the guidewire dependent on balloon. Methods The 108 patients with CTO confirmed by coronary angiography and treated with PCI from March 2009 to March 2011 were enrolled in this study, including 59 cases with old myocardial infarction, 22 unstable angina cases and 27 stable angina cases. The clinical data, outcomes of PCI, perioperative complications and incidence of major adverse cardiac events (MACEs) during follow-up were retrospectively analyzed between group A (only by the guide wire) and group B (by guide wire dependent on balloon). Results The 88 of 108 patients (81.5%) got successful operations. The success rate of CTO was a little higher in group B than in group A [80.0%(52/65) vs. 83.7%(36/43), P＞0.05]. The rate of total complications was more in group A than in group B [10.8%(7/65) vs. 2.3%(1/43), P＜0.05]. No death occurred during operation, no MACE occurred after operation in hospital and no patients underwent emergency coronary artery bypass graft (CABG) in the two groups. Conclusions The PCI for treatment of CTO used by the guidewire dependent on balloon shows a safety and effecary.