Objective To study the effect of using improved loop electrosurgical excision procedure for diagnosis and treatment of cervical diseases. Methods The clinical data of 70 cases of cervical intraepithelial neoplasia or carcinoma in situ from January 2006 to Decemder 2008 in our hospital was collected.The operation time, the mean volume of blooding, days of blooding, relationship between the mean blood and areas of pyramid area of pyramid was compared between study group and control group. Improved loop electrosurgical excision procedure was executed on 21 cases of study group ( CIN Ⅰ 4 cases, CIN Ⅱ 10 cases,CIN Ⅲ4 cases, CIS3 cases ) and loop electrosurgical excision procedure was used on 49 cases in control group (CIN Ⅰ7 cases,CIN Ⅱ21 cases, CIN Ⅲ 16 cases, CIS5 cases). Results Blood loss [(16.57 ±17. 47 ) ml], operative time [( 9.07 ± 3.34 ) min] and postoperative bleeding time [(9.10 ± 2.23) d] in study group were lower than that in control group [( 39.80 ± 37.43 ) ml, ( 12. 19 ± 5.34 ) min, ( 10. 49 ±2. 76)d], and the differences were statistically significant ( P < 0. 05 ). Cervical cone volume [( 14. 70 ±13. 35 ) mm3] and blood loss [(32. 83 ± 14. 32 ) ml] were positively correlated ( r = 0. 430, P < 0. 05 ). No significant difference between prognosis of two groups was found( P >0. 05 ). Conclusion There was positive relationship between the averge blood loss in surgery and areas of pyramid excision. It'd be better to stitch the ramus descendents of uterine artery at three and nine o'clock of the cervix uteri, when the patients were expected to have large pyramid areas and abundant blood flow who may bleed more than normal. which can reduce the blood loss after surgery and reduce the time of surgery.

Objective To observe the changes of retinal nerve fiber layer (RNFL) thickness and its correlation with visual field mean defects(MD)in Parkinson's disease (PD). Methods Fifteen eyes of 15 PD patients in early stage and 18 eyes of 18 normal controls undertook RNFL examination by Stratus OCT-3. Circular scans (diameter is 3. 46 mm) were taken around the optic nerve head including eight quadrants (superior, inferior, temporal, nasal, temporal-superior, temporal-inferior, nasal-superior and nasalinferior). The RNFL thickness in different quadrants in the two groups was analyzed. The visual field of PD patients was measured by central 30-2 program of Humphery750 visual field analyzer, and the MD was recorded. The correlation between RNFL thickness and MD was analyzed by linear correlation and regression analysis. Results RNFL thicknesses of superior, inferior, temporal, nasal, temporal-superior, temporal-inferior, nasal-superior, nasal-inferior and average RNFL thickness in the control group were (132.7±17.4), (141. 5±15. 3),(83. 2±17. 5), (83.7±22.3) ,(120.8±21.2), (117. 9±24.5) ,(109.6±20. 6),(110.2±27.7), and(109. 9±8. 5) μm respectively, while in the PD group they were (128.1±25.3),(128. 6±13. 2),(68. 7±13. 5),(76. 5±17. 8),(102. 6±23. 7), (103.3±14.1) ,(101.2±20.9),(96.6±15.0),(102.3±11.9) μm . Compared with each other, the differences of RNFL thickness of inferior, temporal, temporal-superior, temporal-inferior and average RNFL thickness were statistically significant (t = 2. 595, 2. 700, 2. 330, 2. 153,2. 131;P = 0. 014, 0. 011, 0. 026, 0. 040, 0. 041). There was a close negative relationship between average RNFL thickness and MD in PD patients (r= -0. 933, P<0. 0001). Conclusions RNFL thickness was significantly thinner in PD patients than that in the normal controls. There was a negative relationship between RNFL thickness and MD in PD patients.

The article gives a brief account of the application of clinical observation to the evaluation of medical students' core competence. It expounds the key points in the assessment about their professional values,attitudes and behavior, emphasizing the application scope, working principle and advantages and disadvantages in the rank evaluation as well as the methods to enhance the effectiveness of evaluation.

Objective To evaluate the application of a puncture guidance supporter in CT guided biopsy and interventional therapy. Methods Totally 468 patients underwent CT interventional biopsy (n=110) or treatment (n=358) using a puncture guidance supporter. The size of lesions was 2-15 cm. CT scanning was performed to determine the entry point, data of bi-directional needle angle α, θ and depth d before operation. After local anesthesia, the needle was punctured into skin through the puncture guidance supporter, the needle overlap CT positioning laser line in tilt angle (α) was adjusted and the puncture direction at angle θ. After CT scanning confirmed the needle aiming at target lesion, punctures were performed with the needle into the depth to hit the target. Results The total puncture hit rate was 100%, and one step hit rate was 96.79%. The average time from location scanning to hit the target was 8.4 min. The incidence of pneumothorax occurred in thorax management was 1.56%. Conclusion The application of puncture guidance supporter in CT interventional diagnosis and treatment makes operation more accurate, safe and convenient.

Objective To study an effective treatment of severe thoracic and abdominal injury accompanied with acute respiratory distress syndromes (ARDS).Methods Emergency treatments of 32 patients with severe thoracic and abdominal trauma accompanied with ARDS were retrospectively analyzed.Results All of the 32 patients had severe thoracic and abdominal injury,ribs fracture or pulmonary contuson.Anti-shock treatment,reasonable supplemental blood volume,rational mechanical ventilation and emergency operation were performed.Twenty-six patients were cured,and 6 died,with mortality 18.75%.Conclusions Early diagnosis,timely anti-shock treatment,early treatment for thoracic and abdominal injury and correct mechanical ventilation are essential for treating thoracic and abdominal trauma accompanied by ARDS,and is also an effective method for reducing mortality.

Aim To find out the relationship between muscarinic receptor and reactive oxygen species (ROS) and the probable differences between the four muscarinic receptor subtypes. Methods We transfected the plasmid encoding muscarinic receptor (including subtypes: M_1, M_2, M_3 and M_4) into PC12 cells. Then PC12 cells were exposed to hydrogen peroxide (H_2O_2), carbachol and other inhibitors such as atropine, LY294002 and PD98059. Results The results showed that activation of muscarinic receptor by carbachol protected PC12-M_1, PC12-M_2,PC12-M_3 and PC12-M_4 cells from apoptosis induced by H_2O_2. There was no statistical difference in the protective effect between these four muscarinic receptor subtypes. By using the inhibitors, we found that atropine and LY294002 blocked the protective effect of activation of muscarinic receptor on apoptosis induced by H_2O_2. Conclusion Activation of muscarinic receptor retarded the apoptosis induced by H_2O_2. There was no difference between the four muscarinic receptor subtypes. The protective effect was mainly mediated by the activation of muscarinic receptor and phosphatidylinositol-3 kinase (PI3K).

Objective To review the three-dimensional characteristics and configuration of cranial base arteries of patients with intracranial berry aneurysms. Methods All the 70 patients with intracranial berry aneurysms (83 cases)were admitted from January to December in 2007. Their images of spiral computer angiography (CT) were presented and analyzed retrospectively. The site, size and figures of aneurysms were recorded, especially the variations of cranial base arteries were analyzed. Results Cerebral anterior communicating artery (ACoA) was the frequent site where aneurysms located. Incidence of ACoA aneurysms was 43.37%(36/83), that of posterior communicating artery (PCoA) was 28.92%(24/83), that of internal carotid artery was 9.64% (8/83), that of middle cerebral artery was 6.02% (5/83), that of A1-A3 was 3.61% (3/83), that of basilar artery was 3.61% (3/83), that of posterior cerebral artery was 2.41% (2/83), that of posterior inferior cerebellar artery was 1.20% (1/83),that of anterior choroidal artery was 1.20% (1/83).The shape of many berry aneurysms was regular. Mutational rate of cranial base arteries among aneurysms were 56.63% (47/83) and ACoA ancurysms with A1 dysplasia rate was 72.22% (26/36). Conclusions The solid shape and vascular variation of intracranial berry aneuryams can be optimally identified by spiral computer angiography. The occurrence of berry aneurysms might be associated with variation of cranial base arteries.

Objective To evaluate the factors influencing early diagnosis and prognosis in patients with pancreatic carcinoma.Methods The clinical data of 280 patients who had complete follow-up data with pancreatic carcinoma treated from January 2002 to January 2007 were reviewed retrospectively.The medical history and follow-up data were collected from all patients.Survival rate was calculated by the life table method and the Kaplan-Meier estimation.Log-rank test was used for univariate prognostic analysis and Cox regression was used for multivariate prognostic analysis.Results 91.8%of the patients were more than 40 years old and the peak age was 50～73 years old;the major presentations were abdominal pain and jaundice.Major imaging tests included B-ultrasound and CT,the sensitivity was 70.6%,95.3%,respectively;89.3%of patients had combined B-ultrasound and CT examination.The sensitivity of CA19-9 was 81.1%.The median survival time was(7.0±0.5)months.Overall survival rates at 1～5 year survival rates were 28%,9%,6%,2%,and 1%.Univariate analysis suggested that age＞65 years old,CA19-9＞mean value,TNM Ⅲ or Ⅳ stage,lymph nodes invasion,vascular invasion,and metastasis of two or more organs,non-surgical treatment,KPS score＜60 points,weight loss≥5 kg were poor prognostic factors;Cox multivariate analysis showed that treatment modalities,age,TNM stage,KPS score and ascites were independent risk factors for dismal prognosis.Conclusions The age,ascites,tumor stage and treatment modalities affected the prognosis of patients with pancreatic cancer.Early diagnosis and treatment was important to improve the survival time of patients with pancreatic cancer.

Heteroclitin D (H.D) was successfully isolated from Kadsurae Caulis by using flash chromatography and recrystallized by methanol, 10.2 mg of H.D was obtained from 4.86 g of crude extract, and the purity determined by HPLC was 99.4%. The structure was identified by UV, IR, MS, and NMR analysis. The fast, simple and efficient method can be applied to the preparation of reference substance of H. D.

Objective To explore the effects of low-dose X-ray irradiation effects on ischemic flap survival and its possible mechanism.Methods From June, 2014 to December, 2014, 80 SD rats were include in the study, the rats were randomly divided into 2 groups: the experimental group A and control group B.There were 40 rats in each group.The ischemic flaps with the size of 9 cm × 3 cm were designed on the back of the rats.The pedicle of the flaps was near to the tail.A sterile biological isolating membrane was placed under the flap to block the blood supply between muscular layer and flaps.The flaps were intermittently sutured into their original position.The group A was immediately received single and local irradiation of 0.2 Gy after surgery, The group B was not treated.On days 1 to 14 after operation,general observation,HE staining and the western blot of the flaps were performed to calculate the survival vate of the flaps, observe neovascularization and determin the content of VEGF and MMP-9, respectively.Results On the third, seventh and fourteenth days, survival rates of the flaps in the experimental group [(66.46 ± 4.37)％, (44.30 ± 3.86)％, (32.20 ± 4.22)％, respectively] were higher than the control group [(43.15 ± 5.03)％, (27.71 ± 3.20)％, (16.40 ± 5.34)％, respectively] after inspection, there were statistically significant differences between these indices (P ＜ 0.01), HE staining of the flaps in the experimental group were seen in the fibroblast infiltration and neovascularization were higher than that of control group, and experimental group within the lumen of blood vessels were arranged in order, the groups were visible tissue edema obviously control, neovascularization in small numbers, the lumen was irregular.On the third and seventh days, MVD rates of the flaps in the experimental group (85.54 ± 6.12, 44.32 ± 3.56, respectively) were higher than the control group (49.35 ± 4.75,18.75 ± 2.89,respectively) after inspection, there were statistically significant differences between these indices (P ＜ 0.01).VEGF and MMP-9 protein content in the flap for the seventh day in the experimental group were significantly higher than that of the control group.Conclusion Low-dose X-ray irradiation can promote the survival rate of ischemic flap, the mechanism may be related to the expression of VEGF and MMP-9 increased and promoted angiogenesis of the flaps after low-dose X-ray irradiation.