Objective To evaluate the clinical effect of uterine arterial embolization (UAE) as a treatment of symptomatic uterine fibroids(UF).Methods Twenty-six patients with clinic symptoms(menorrhagia, pelvic pain, bulk-related symptoms and anemia)caused by uterine fibroids underwent UAE.The embolization with a single catheter using the single-femoral artery approach to bilateral uterine artery was performed, injection of PVA 355～500 ?m and silk particles were used in 20 and 6 cases respectively.Results All cases were followed up for 6 to 18 months after treatment.The symptoma were noticeable improvement in 24 cases but 2 cases whom with injection silk particles.The tumors were marked diminution in size(45%～75%) sonographically after 2～6 months in 13 cases.No severe complication were discovered in all cases.Conclusion Uterine artery embolization is a safe and effective method for the management of symptomatic UF.Longer follow up is needed to evaluate the long term effects.

Objective To explore the effect of age on the fracture healing through bioinformatical analysis of gene ex?pression data in GEO, and to screen critical molecular targets and pathways involved in this process. Methods Through R programming language, we identified different expressed genes between 26/52 week old rats and 6 week old rats in every time points of the experiment (No fracture;3 days, 1 week, 2 weeks, 4 weeks and 6 weeks after fracture). By comparison of these different expressed genes, those genes that may contribute to fracture healing were identified. Function annotation was conducted based on DAVID database and PPI network that was constructed via STRING database. Results Compared with 6 week old rat, 52 week old rat show more different genes at 2, 4 and 6 weeks after fracture as well as more than intact rats. At the time point of 6 weeks after fracture, 26 week old rat present 4 different genes while 52 week old rat present 99 differ?ent genes compared with 6 week old rat. We totally found 99 genes that might play important roles in the process of fracture healing. These genes involved in biological process related to bone healing, immune, inflammatory and etc. Also, two screened gene enriched KEGG pathways were identified: ECM-receptor interaction and Arachidonic acid metabolism. Through the analysis of PPI network, Pcna, Fn1, Casp3 and etc, who present high density connectivity in PPI network, were screened out. Conclusion Pcna, Casp3 and Fn1 and etc might play important roles in fracture healing through affecting ECM-receptor interaction and Arachidonic acid metabolism.

Occupational chromium rhinopathy is chronic nasal damage caused by chromic anhydride, chromate and dichromate 6-valent chromium compounds. In 2016, 700 people who were exposed to chromium slag in steel plant were checked out. 24 people were found to have nasal injuries. The expert group confirmed 1 case of occupational severe chromium rhinosis and 23 cases of occupational mild chromium rhinosis.There was no significant difference in the incidence, type of work and duration of injury among 24 patients (P>0.05) . Active measures should be taken to prevent chromium rhinopathy and the technological process should be reformed. Occupational health education and occupational health monitoring should be strengthened to avoid exposure of chromium and its compounds through nose and respiratory tract, and to reduce or eliminate the occurrence of chromium rhinosis.

Objective:To investigate the relationship between Tei index and right heart function in patients with pneumoconiosis complicated with pulmonary heart disease (PHD).Methods:108 cases of pneumoconiosis patients with PHD in our hospital from January 2018 to January 2020 were randomly selected and divided into three groups according to the X-ray diagnostic criteria of pneumoconiosis, including 50 cases in stage Ⅰ group, 25 cases in stage Ⅱ group and 33 cases in stage Ⅲ group. All patients were examined by ultrasonic cardiography (UCG); the right ventricular Tei index and brain natriuretic peptide (BNP) levels, right ventricular outflow tract (ROVT) diameter, main pulmonary artery (MPA) diameter, right ventricular anterior wall thickness (RVAW), right ventricular diameter (RV), right atrial diameter (RA), pulmonary artery pressure (PASP), Tei index were compared in groups; Pearson correlation analysis was used to analyze the correlation between UCG index and BNP level; multiple linear regression analysis was used to analyze the influencing factors of BNP.Results:The levels of RV, Tei index and BNP in Ⅰ stage group were significantly lower than those in Ⅱ stage group, and the levels of RV, Tei index and BNP in Ⅱ stage group were significantly lower than those in Ⅲ stage group ( P<0.05). There was no difference in ROVT, MPA, RVAW, RA, PASP in the three groups ( P>0.05). Pearson correlation analysis showed that ROVT, RV, Tei index in UCG indicators and BNP level were positively correlated ( P<0.05); multiple linear regression analysis showed that RVAW and Tei indexes were the main influencing factors of BNP levels ( P<0.05). Conclusions:The right heart Tei index of patients with pneumoconiosis and PHD has a good correlation with BNP level, and is the main influencing factor of BNP level, which can make up for BNP deficiency and effectively evaluate the right heart function of patients.

Tigecycline is a new broad-spectrum antibiotic,which is the first glycyclines antibiotic used in clinic. Tigecycline is ac-tive against Gram-positive/negative bacteria and anaerobicbacteria, especially multidrug-resistant (MDR) pathogens. In this review, the literatures associated with tigecycline-induced coagulopathy published after 2005 were searched in Pubmed and the clinical charac-teristics as well as the research progress were summarized. The mechanism of tigecycline-induced coagulopathy was also explored. Cli-nicians should observe coagulation markers of patients during the treatment with tigecycline. If coagulation disorders or active bleeding occurs,tigecycline treatment should be stopped and symptomatic and supportive treatment should be given immediately.

OBJECTIVE: To explore whether laryngopharyngeal simulator teaching can improve the quality of clinical operation compared with traditional preclinical teaching program. METHOD: Sixty-five surgical interns were randomly divided into two groups. Experimental group was given traditional clinical practice together with simulator for laryngopharyngeal training, while control group received traditional clinical practice only. The teaching effect were compared through the operation assessment. RESULT: After simulation training, the performance of experimental group was superior to that of the control group, and the difference was statistically significant (P < 0.05). CONCLUSION Simulator can improve the quality of teaching. It is recommended for teaching hospital and doctor's training base and deserves further promotion.
Educational Technology ; instrumentation ; methods ; General Surgery ; education ; Humans ; Pharynx ; anatomy & histology

Objective To explore the feasibility of hybrid procedure of percutaneous puncture for residual shunt after ventricular septal defect(VSD) repair.Methods From March 2015,we did percutaneous punctured transcatheter device closure of residual shunt after VSD repair for four patients.The patients included 2 males and 2 females with age from 4 years 9 months to 11 years 7 months and weight from 18 kg to44 kg.Four patients are diagnosed for4 years after VSD repair,3 years after tetralogy of Fallot (TOF),3 years after coarctation of aorta(CoA) combined with VSD,and 1 year after VSD repair,respectively.The withsize of residual shunt from 4.8 mm to 6.8 mm.Residual shunt are perimembranous,conoventricular and intracristal.Punctured directly through the right ventricular surface into the right ventricle in the 4-th or 5th intercostal space of the left sternal border.Next,extracted the guide wire after inserting a conveyor tube.Subsequently,7-10 mm VSD closure device were delivered via the conveyor tube.Results All the four operations were succeeded.A total of four closure devices were placed.Two of them are equilateral devices,and two are decentered devices,with size from 7mm to 9mm.Echocardiographyexamination revealed no significant pericardial effusion.Post-operative ultrasonic cardiogram showed the VSD closure device on site,with no pericardia1 effusion and no obvious morphological abnormalities of the valve.For one-year follow-up,the cardiac functionsof all patients were well.Conclusion Percutaneous punctured transcatheter device closure is a new,efficient and reliable method of treatment for children withresidual shunt after VSD repair.This method also can extend and offer a new avenue for valvular prosthesis and Perimembranous VSD.

Objective To explore the feasibility of percutaneous puncture for ventricular septal defect(VSD).Methods From March 2015,we did percutaneous punctured transcatheter device closure of VSD for 22 patients.The patients included 15 males and 7 females with age from 2 years 6 months to 11 years 7 months, weight from 13.5 kg to 44.0 kg.Among 22 pa-tients,6 were diagnosed with residual shunt after VSD repair, with size of residual shunt from 4.8 mm to 7.0 mm.Residual shunts are perimembranous, conoventricular and intracristal.The other 16 patients were diagnosed with isolated VSD,with de-fect size from 3.5 to 5.1 mm.For all patients,we punctured directly through the right ventricular surface into the right ventri-cle in the 3th or 4th intercostal space of the left sternal border.Next, we succeeded to extract the guide wire after inserting a conveyor tube for 21 patients.Subsequently,7-10 mm VSD closure device were delivered via the conveyor tube.Only one patient was changed to perform occlusion of VSD through chest small incision due to improper selection of punctured position. Results A total of 21 closure devices were placed for 21 patients.18 of them are equilateral device,and 3 are decentered de-vice,with size from 5 mm to 10 mm.There were small amount of pericardial effusion in 4 patients using TEE examination,and no future treat was performed after observation.For one-year follow-up, all patients have recovered very well.Conclusion Percutaneous punctured transcatheter device closure fits for treatment for children with residual shunt after VSD repair and isola-ted VSD.It has a good recent result.