ObjectiveTo investigate the clinical value of intrafascial hysterectomy with intact ascending uterine artery.MethodsA total of 78 cases of simple hysterectomy patients were divided into group A (underwent intrafascial hysterectomy with intact ascending uterine artery) and group B(underwent modified intrafascial hysterectomy) with 39 cases each by random digits table.The operation time,the amount of hemorrhage,the postoperative complications,the ovarian function and the quality of sexuality were studied and compared.ResultsThree cases were lost in group B.There were no statistical differences in operation time,the amount of hemorrhage,postoperative hemorrhage,postoperative pyrexia,the quality of sexuality between two groups(P ＞0.05).There were significant differences in follicule-stimulating hormone and estradiol level in group B compared with those before operation (P＜ 0.05).There was significant difference in climacteric symptom between two groups [ 5.13％ (2/39) vs.22.22％ (8/36) ](P ＜ 0.01 ).The ascending uterine arteries and the ovarian branch of both sides were showed 100％ in group A.ConclusionsIntrafascial hysterectomy with intact ascending uterine artery has less influences on the blood flow of the ascending uterine arteries and the ovarian branch,there is slight influence on ovarian function and has no obvious influence on the quality of sexuality.The forward clinical effects should be studied further.

BACKGROUND:So far there are many studies about the uses of nano-carbon tracers in the diagnosis and treatment of malignancies. However, little has been reported on the mechanism underlying protective effect of nano-carbon tracers on the parathyroid glands during thyroid cancer surgery. OBJECTIVE:To study the protective effect of nano-carbon tracers on the parathyroid in thyroid cancer surgery. METHODS:180 cases of thyroid cancer were randomly divided into nano-carbon and control groups (n=90 per group):patients in the nano-carbon group were injected with nano-carbon tracers into the thyroid before surgery, and those in the control group underwent routine thyroid cancer surgery. Then comparisons of the operating time, incision length, blood loss, postoperative hospital stay, number of lymph node dissection, lymph node metastasis as wel as hypoparathyroidism rate were performed between two groups. Besides, levels of serum calcium and parathyroid hormone in the two groups were detected at 3 days after surgery. RESULTS AND CONCLUSION:There were no significant differences in the operating time, incision length, blood loss, postoperative hospital stay and lymph node metastasis between the two groups (P>0.05). The number of dissected lymph nodes of nano-carbon group was significantly higher than that of control group (P<0.05);the mis-resection rate of parathyroid and hypoparathyroidism of nano-carbon group were significantly lower than those of control group (P<0.05). Furthermore, the incidences of hypocalcemia and low parathyroid hormone of nano-carbon group were significantly lower than those of control group (P<0.05). These results suggest that the nano-carbon tracer plays a protective role on the parathyroid glands in thyroid cancer surgery, which can reduce the mis-resection rate of parathyroid, as wel as the incidences of hypoparathyroidism, hypocalcemia and low-level parathyroid hormone.

Objective To investigate the effects of two infusion fittings on obstruction of double-lumen PICCs. Methods About 100 patients with double-lumen PICCs treated in the department of oncology in our hospital from 2013 to 2015 were randomized according to simple data table into observation group and control group, with 50 cases in each group:in the observation group Kolafu needleless infusion connector (MC100) was used and in the control group high voltage double-lumen PICCs were connected to the end of the diaphragm closed transfusion needleless joint (Q-syte). The incidence rate of catheter obstruction between the two groups were compared. Result The incidence of obstruction in the observation group was significantly lower than that in the control group (P<0.001). Conclusion Kolafu needleless infusion connector (MC100) can reduce the obstruction rate of the connectors, worthy of promotion.

The discussion method adequately applied to the teaching module of new medical teaching mode may promote the study of medical professional knowledge and cultivate the medical students' moral and cultural quality in the course of medical education,thus further optimizing the new medical teaching mode on a certain extent.

Objective To observe the effect of Compound Fuling Gancao Decoction(CFGD) on transforming growth factor ?1(TGF-?1) in pulmonary artery of rats with pulmonary hypertension(PH),and to explore its therapeutic mechanism for PH and pulmonary vascular remodeling.Methods Thirty SD male rats were randomized into the normal control group,model group,and CFGD(5.46g?kg-1?d-1) group.PH rats models were induced by intraperitoneal injection of monocrotaline(50mg/kg).The mean pulmonary artery pressure(MPAP) in rats was detected with the method of right cardiac catheterization,right ventricular hypertrophy index was calculated,histological changes of lung small artery were analyzed with pathological image analysis,and TGF-?1 expression in pulmonary artery was detected by immunohistochemical method.Results MPAP and right ventricular hypertrophy index were enhanced obviously,the number of muscular arteries and partially-muscular arteries was increased,ratio of media area and luminal thickness in the muscular arteries became bigger,and TGF-?1 expression in pulmonary artery of the model group was increased.The above indexes were improved in CFGD group.Conclusion CFGD is effective on decreasing pulmonary pressure and improving pulmonary vascular remodeling,and its mechanism is probably related with the inhibition of TGF-?1 expression in pulmonary artery.

Objective To improve the detection of G6PD heterozygotes in female patients by the optimum experimental factors of G6PD/6PGD specific value assay.Methods (1)Identifying the mutations of G6PD gene with the use of amplified refractory mutation system (ARMS).(2)Measuring the G6PD/6PGD specific value.Results According to the data analysed by statistics and ROC curve, the optimum experimental factors included that the incubation temperature was 37℃,the substrate concentrations were 0.78 mmol/L G6PNa2 and 0.195mmol/L NADP+, the reaction time was 10min.Conclusion The optimum experimental factors of G6PD/6PGD specific value assay may be used to improve the detection rate of G6PD heterozygotes in female patients.

Objective To investigate the value of global longitudinal strain (GLS) in detecting severe coronary artery stenosis (SCAS) in patients with coronary artery disease. Methods Fourty-two patients with SCAS confirmed with coronary arteriongraphy (CAG) underwent two-dimensional strain echocardiography. GLS, wall motion score index (WMSI) and left ventricular ejection fraction (LVEF) were obtained. Taking CAG as gold standard, the sensitivity, specificity and areas under the ROC curve (AUC) of definition of SCAS with GLS, WMSI and LVEF were calculated, respectively. Fifteen healthy volunteers were recruited as control. Results ①Definition of one or more branches with severe stenosis: The sensitivity and specificity was 77.51% and 100% with GLS of -17.50% as a cutoff value, 70.01% and 100% with WMSI of 1.00, and 57.51% and 100% with LVEF of 59.21%. ②Definition of two or more than two branches with severe stenosis: The sensitivity and specificity was 62.52% and 80.81% with GLS of -11.05% as a cutoff value, 56.22% and 65.31% with WMSI of 1.60 and 56.21% and 65.42% with LVEF of 54.31%. ③The correlation coefficient was 0.78 between GLS and LVEF, and -0.82 between WMSI and LVEF. The AUC of detecting one or more branch with severe stenosis with GLS, WMIS and LVEF was 0.87, 0.80 and 0.78, respectively, and AUC of GLS was more than that of LVEF (P＜0.01). AUC of detecting two or more than two branches with severe stenosis with GLS, WMIS and LVEF was 0.76, 0.64 and 0.64, AUC of GLS was more than that of LVEF and WMSI (all P＜0.01). Conclusion GLS can be used in detecting SCAS, and the value of GLS is better than that of WMIS and LVEF.

Objective To investigate the related factors of clinical incidence and the ultrasound diagnostic value of endometrial polyps (EMP).Methods A total of 278 patients with clinical abnormal vaginal bleeding,menorrhagia,infertility,cervical polyps or physical examination showing EMP received vaginal ultrasound and hysteroscopy.The related clinical factors were recorded and single factors and multivariate unconditional Logistic regression analysis were carried.Results The univariate analysis showed that the number of pregnancy,menopause,placing intrauterine device,oral comtraceptives,history of hormone therapy,chronic endometritis,cervical polyp,merger endometriosis and obesity were the statistically significant factors of EMP incidence (P ＜ 0.05 or ＜ 0.01),which were used as dependent variables for multivariate Logistic regression analysis,indicating that menopause,chronic endometritis,history of hormone therapy and cervical polyp significantly affecting EMP incidence (P ＜ 0.05),with OR values of 4.068,4.122,3.770 and 3.983 respectively.Conclusion Menopause,chronic endometritis,history of hormone therapy,cervical polyps are the related risk factors of EMP.

Objective To investigate the epidemiological characteristics of mycoplasma pneumoniae (MP),Epstein-Barr virus (EB virus) and cytomegalovirus (CMV) infection in children with acute upper respiratory tract infections in Hangzhou.Methods Throat swabs and sputum samples were collected from 5942 children with acute upper respiratory tract infections in Hangzhou First People's Hospital during January 2011 and December 2012.MP,EB virus and CMV were detected using quantitative PCR.The distribution and seasonal changes of the above pathogens in children of different ages were analyzed using Chi-square tests.Results MP,EB virus and CMV were positive in 29.91％ (1777/5942),22.92％ (1362/5942) and 8.55％ (508/5942) children,respectively.Mixed infections were found in 556 (9.36％) children.The positive rates of MP varied among different age groups (x2 =113,P =0.000),and the highest one was detected in children ＞ 6-year old (448/1012,44.36％).EB virus infection was rare in age group 0-1 year,and the positive rate was of statistical difference from those in other age groups (x2 =167,181 and 187,P =0.000).The highest positive rate of CMV (23.78％) was found in children aged 0-1 year old.The positive rates of MP varied in different months of the year (x2 =208 and 211,P =0.000),and the highest positive rate was found in July and August.Conclusion The predominant pathogen of acute upper respiratory tract infection in children is MP in Hangzhou,and MP plus EB virus infection is common,particularly in older children;while CMV infection more likely occures in 0-1 year old babies,and usually in summer.

Objective To prepare an occupation well-being scale for nurses, and test its reliability and validity. Methods After literature review and semi-structured interviews, the item pool of the occupation well-being scale for nurses was created based on theory of structure of the subjective well-being. After group discussion, and evaluation by the specialists, a pilot scale was obtained. A total of 350 clinical nurses were selected by using stratified sampling method, and their occupation well-being were surveyed by the scale. The data were used to assess the reliability and validity of the scale. Results The occupation well-being scale for nurses had 3 dimensions, including 8 exploring factors. The values of Cronbach Alpha and the split half reliability coefficient of the total scale, endogenous exogenous satisfaction, satisfaction of nurses occupation happiness were all larger than 0.9, which meaned the internal consistency was good. In the emotion dimension, the value of Cronbach Alpha and the split half reliability coefficient were less than 0.7, which meant the internal consistency was not so good. The reliability coefficient of repeated measurement of the whole scale and each dimension were greater than 0.7, suggesting the external consistency of the scale was good. The content validity index of 3 dimensions were all larger than 0.9,and the cumulative ex-planatory variables were all larger than 55%. Conclusion The occupation well-being scale for nurses proposed in this study has good reliability and validity, and can be used to evaluate the occupation well-being of the nurses.