Objective To explore the application of hysteroscopy in assisted reproduction. Methods A retrospective analysis was made on results of routine hysteroscopy in 150 cases of infertile women scheduled for assisted reproduction.Results Among the 150 cases,abnormal hysteroscopic findings were identified in 47 cases(31%),including endometrial polyps in 18 cases(12%),endometrial hyperplasia in 17 cases(11%),uterine deformity in 7 cases(5%),uterine adhesion and stenosis in 3 cases(2%),endometrial tuberculosis in 1 case(0.7%),and submucous myoma or adenomyoma in 1 case(0.7%).To think of hysteroscopic findings as the standard,the sensitivity,specificity,positive predicted rate,negative predicted rate,and accuracy were 66%(31/47),98%(101/103),94%(31/33),86%(101/117),and 88%(132/150) for transvaginal ultrasonography,respectively,and were 26%(12/47),100%(95/95),100%(12/12),73%(95/130),and 75%(107/142) for uterophotography,respectively.Conclusions Hysteroscopy is a simple and reliable way to explore the uterine cavity.It may be selected as a routine examination before assisted reproduction.

Objective To analyze the related factors of influencing deep vein indwelling catheter dysfunction in hemodialysis patients.Methods A total of 37 cases with deep vein indwelling catheter in hemodialysis patients were selected.They were divided into patent group and blocked group according to the appearance of catheter dysfunction (hemodialysis blood flow less than three times 180 ml/min,adjustment of body position,inversion of tube connection during hemodialysis,requirement of thrombolytic therapy and so on) in 5 months.The common data and biochemical indicator were compared between two groups.Results Patent group had 28 cases,and blocked group had 9 cases.There was no significant difference in age,diabetes mellitus ratio,platelet,low density lipoprotein cholesterol and albumin between two groups (P ＞0.05).Hemoglobin in patent group was lower than that in blocked group [(90.1 ± 13.8) g/L vs.(108.3 ± 11.6) g/L],and there was significant difference(P＜ 0.05).Conclusion Hemoglobin is the correlated factor that effects deep vein indwelling catheter dysfunction after hemodialysis.

Objective To measure the angular velocity and perpendicular ground reaction force of the ankle joint under different heights with half-squat jumping in parachute training simulation,providing a reliable experiment basis for the preventing of ankle injury.Methods A total of 18 volunteers participated in this study.The experimental group included 9 male with experience of parachute landing,while the other 9 male without experience of parachute landing were assigned to the control group.Each subject was instructed to jump off a platform with a height of 30 cm and 60 cm and land on a hard surface in a half-squat posture.The dynamic landing process was recorded with a high speed camera and the biomechanical data was collected and analyzed,including perpendicular ground reaction force,angular displacement,velocity and acting time.Results From 30 cm's height,the ankle angular displacement of the control group was significantly larger than the experimental group (25.73°± 8.13° vs 20.05°± 12.27°,P ＜ 0.05).The perpendicular ground reaction force of the control group was significantly smaller than the experimental group (3 372.4±748.6 N vs 5 181.5±1 726.2 N,P ＜ 0.05).The acting time of the control group was significantly longer than the ex perimental group (0.049±0.015 s vs 0.012±0.004 s,P ＜ 0.05).The buffer time of the control group was significantly shorter than the experimental group (1.397±0.746 s vs 1.737±0.451 s,P ＜ 0.05).From 60 cm's height,the ankle angular velocity of the control group was significantly higher than the experimental group (25.45± 15.01 °/s vs 16.51 ±4.18 °/s,P ＜ 0.05).The perpendicular ground reaction force of the control group was significantly smaller than the experimental group (4 616.0±1 124.7 N vs 7 119.5±2 307.4 N,P ＜ 0.05).The acting time of the control group was significantly longer than the experimental group (0.048±0.013 s vs 0.015±0.006 s,P ＜ 0.05).The buffer time of the control group was significantly shorter than the experimental group (0.922±0.347 s vs 1.617±0.547 s,P ＜ 0.05).Conclusion Jumping from different heights,the experinental group was larger in perpendicular ground reaction force but smaller in the angular velocity and displacement than the control group.There was a shorter acting time and a longer buffer time in the experimental group than the control group.

Objective To explore the effect of health education through different postoperative follow-up method, including telephone、Email and QQ, on patients with indwelling D-J stents. Methods 319patients with indwelling D-J stents were divided into the control group(88 cases), the telephone group(89 cases), the Email group (70 cases) and the QQ group (72 cases). M1 patients received rourine health education during hospitalization and before discharge, the latter three groups received follow-up by telephone、Email and QQ after discharge respectively. The rehabilitation effect was observed in the four groups. Results The complication rates of the telephone group, the Email group and the QQ group was significantly less and the mastering of knowledge about prevention and handling of complication was better than the control group during the follow-up. Conclusions Different types of follow-up can be selected by patients according to their actual status. Decreasing complication rate, favorable social benefit and approval of the patients family members will be seen due to involvement of the patients family in health education.

ObjectiveTo investigate the value of a digital three-dimensional reconstruction technique in the treatment of hepatic alveolar echinococcosis (HAE).MethodsThe computed tomography scan data for 13 patients with HAE who were admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2011 to October 2011 were reconstructed and analyzed by a three-dimensional reconstruction system to assess resectability,and to facilitate surgical planning and individualized virtual surgery.The results of preoperative analysis were compared with the results of actual operations.ResultsThe three-dimensional models of the liver were reconstructed successfully,and intrahepatie lesions and vessels were clearly displayed.One patient received an autologous liver transplantation,10 underwent hepatectomy,and 2 received percutaneous transhepatic cholangial drainage.Virtual operation planning was carried out for 11 patients using the three-dimensional reconstruction system.The mean volume of the liver to be resected was predicted to be 920 ml (range,339-2678 ml),and the mean percentage of liver to be resected to the total liver volume was predicted to be 45％ ( range,23％ -68％ ).The mean volume o[ the actual liver resection was 834 ml (range,315-2250 m[),and the mean percentage of actual liver resected to the total liver volume was 42％ (range,22％ -70％ ),which was consistent with the results of preoperative three-dimensional reconstruction.All patients were followed up for 2-8 months,and no severe complications such as liver failure,hemorrhage and bile leakage were detected.ConclusionDigital three-dimen-sional reconstruction is helpful in the diagnosis and treatment of HAE and effectively reduces surgical risks.

OBJECTIVETo evaluate the preliminary curative effect of interspinous injections for the diagnosis and treatment of back pain caused by lumbar kissing spine (Baastrup's disease) under fluoroscopically guiding.

METHODSFrom November 2011 to March 2013,17 patients with back pain caused by Baastrup's disease were treated with fluoroscopically-guided interspinous injections, including 7 males and 10 females with an average age of 49.6 years old ranging from 40 to 71 years old; the duration of the disease ranged from 2 to 5 years with a mean of 3.7 years. The visual analogue scale (VAS) and the lumbar segments range of motion (ROM) was analyzed at pre-operation, 2 days, 3 months and final followed-up after operation, the effects were evaluated with modified Macnab standard.

RESULTSAll patients were follow-up from 6 to 10 months with an average of 7.6 months. The pre-operative VAS was 6.41 +/- 0.94, the postoperative VAS at different time points improved significantly comparing with pre-operation,and the differences were statistically significant (P < 0.01). There was no significant difference in VAS at different time points after operation (P > 0.05). The ROM of operated segment and adjacent segment was (4.88 +/- 0.86) degrees and (6.82 +/- 0.73) degrees respectively at pre-operation. The postoperative operated segment ROM at different time points improved significantly comparing with pre-operation, and the differences were statistically significant (P < 0.05). Compared with pre-operation, there was no significant difference in adjacent segment ROM at different time points after operation (P > 0.05). According to modified Macnab, the result was excellent in 6 cases, good in 7 cases, fair in 3 cases and poor in 1 case.

CONCLUSIONFluoroscopically-guided interspinous injections is an effective method for the diagnosis and treatment of Baastrup's disease. The method has advantages of simple operation, minimal invasion and safety, satisfactory short-term and medium-term therapeutic effect; it can also effectively lessen the pain of lumbar and back.

Adult ; Aged ; Anesthetics, Local ; administration & dosage ; Female ; Humans ; Low Back Pain ; diagnosis ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; diagnostic imaging ; drug effects ; Male ; Middle Aged ; Nerve Block ; Spinal Diseases ; diagnosis ; diagnostic imaging ; drug therapy ; Tomography, X-Ray Computed

Objective To assess the long-term outcome of unilateral adrenaletomy in patients with adrenocorticotropic hormone independent macronodular adrenal hyperplasia (AIMAH).Methods The data from 82 cases of AIMAH were reviewed and summarized including clinical manifestations, endocrinological data, imaging findings and postoperative follow-up.Fouty-nine males and thirty-three females with a mean age of fifty years composed our series.Among the 82 cases, 41 demonstrated Cushing syndrome (CS), 74 presented with hypertension, 38 manifested diabetes mellitus, 35 complicated of osteoporosis and 11 of them with bone fracture, 39 complained of edema.Laboratory tests showed low ACTH plasma levels (＜ 2.2 pmol/L) in 62 of 79 cases.High level of 24-hour urinay free cortisol excretion(＞ 284.2nmol/L) was found in 67 of 79 cases.Elevated serum cortisol with loss of the circadian rhythm was presented in 55 of 60 cases.Failed to suppress cortisol secretion was observed in 61 of 63 conducted with low-dose dexamethasone suppression tests and in 47 of 53 implemented with high-dose dexamethasone suppression tests.Bilateral massively enlarged multinodular adrenal glands were found in all cases with CT or MR imaging.Unilateral adrenalectomy was performed in the larger side of adrenal gland in all 82 cases.All adrenalectomies were carried out including 47 in right sides and 35 in left sides, with 77 by retroperitoneoscopic approach and 5 by open retroperitoneal approach.Results Histopathological examination confirmed nodular hyperplasia of the adrenal cortex for all specimens.After a mean duration of 48.5 months, 80 of 82 patients were available for follow-up.Most clinical symptoms resolved within 6 months after operation.Cushingoid features disappeared in 58.5％ (24/41)of patients who initially presented with typical signs of Cushing Syndrome.Weight loss was seen in 56.3％ (45/80).Improvement of hypertension and diabetes was observed in 63.5％ (47/74) and 76.3％ (29/38) respectively.All the eyelids swelling and edema of the limbs subsided within 3 months.In long-term follow-up (more than 6 months), 82.9％ (63/76) had clinical and biochemical recurrence within a mean time of 14.6 months and 46.0％ (29/63) received contralateral adrenal surgery.Two patients died, one died from heart attack and another one died from pulmonary infection, 2 years and 7 years after unilateral adrenalectomy, respectively.Conclusions Unilateral adrenalectomy just has transient efficiency for AIMAH.Most patients will experience clinical and biochemical recurrence for a long period,and have to receive another operation for the contralateral hyperplastic adrenal gland.

Objective To discuss related factors of perioperative pulmonary complications in infants with congenital heart disease and provide a scientific basis to improve the quality of intensive care in in-fants with congenital heart disease after surgery. Methods Tracking survey was carried out in 225 cases of infants with congenital heart disease in our city to observe the perioperative lung condition from March 2005 to May 2007. Every process that might occur pulmonary complications,such as preoperative care of children,anesthesia and cardiopulmonary bypass surgery (CPB) management and postoperative monitoring was closely observed. Statistical analysis was conducted according to emerging problems and summarized the relevant factors and nursing methods. Results 225 infant patients passed the operation with no seri-ous complications.Conclusions Effective treatment and nursing during every process of perioperation was the key factor to reduce pulmonary complications.

Bacillus subtilis B6-1 was used as an original strain for mutagenic treatment and a defined medium was used as the selective medium. A mutant named B. subtilis W003 was isolated after three serial ultraviolet (UV) irradiations and one diethyl sulfate (DES) treatment. The ?-PGA yield on a rotary shaker was enhanced from 10.9 g/L in parental strain to 20.5 g/L in the mutant. It was illustrated by single factor experiments that the optimal carbon and nitrogen sources were glucose and (NH4)2SO4 respectively. The optimal fermentation medium was achieved by orthogonal test. In the optimal medium, a ?-PGA yield of 45.3 g/L was obtained after 36 h cultivation.

Objective To study the clinical significance of cell factors in plasma samples of hand?foot?mouth disease. Methods Sixty?nine cases hand?foot?mouth diseases children who were treated in Fifth People’ s Hospital of Wuxi from July to December 2014 were selected as research objects,and divided into normal hand?foot?mouth disease group with 48 cases and severe hand?foot?mouth disease group with 21 cases. Twenty healthy children were selected as healthy control group. Serum samples were collected from 3 groups of subjects. The lev?el of IgA,IgG and IgM were detected by immune turbidity method. The level of IFN?γ, IL?10, IL?13 and IL?2 were detected by flow cytometry. Results The level of serum IgG,IgA of severe hand?foot?mouth disease group patients were (12. 33±8. 58) g/L,(0. 78±0. 55) g/L,significantly lower than control group((7. 09±6. 36) g/L,(0. 61±0. 36) g/L) and the normal hand?foot?mouth disease group((7. 41±5. 07) g/L,(0. 57±0. 41) g/L),the differences were significant(P<0. 05),while there was no significant difference between normal hand?foot?mouth disease group and control group( P>0. 05) ,and there was no significant difference in term of the level of IgM among the three groups( P>0. 05) . The level of serum IFN?γ,IL?2,IL?13 of severe hand?foot?mouth dis?ease group were (0. 95±0. 67) ng/L,(1. 07±0. 64) ng/L,(1. 25±0. 46) ng/L,significantly lower than normal hand?foot?mouth disease group((2. 72±1. 15) ng/L,(2. 07±1. 53) ng/L,(2. 31±1. 35 ) ng/L) and the control group((1. 83±1. 12 ) ng/L,(1. 61±1. 37) ng/L,(1. 99±0. 75) ng/L),the differences were significant(P<0. 05). The level of serum IL?10 of normal hand?foot?mouth disease group was (2. 69±1. 33) ng/L,significant?ly higher than severe hand?foot?mouth disease group ( ( 1. 54 ± 1. 23 ) ng/L ) and control group ( ( 1. 35 ± 1. 12 ) ng/L) ,the differences were significant( P<0. 05) . Conclusion The level of serum cytokines can reflect the ge?netic profile status,understand the development trend of the disease,provide a reliable index for early clinical in?tervention.