[Summary] A more conservative approach for endometrial cancer ( EC ) is desirable in women who have requirement to preserve fertility, without compromising their survival .In this article, we tried to formulate clinical recommendations of preserving fertility based on suggestions of European Society of Gynaecological Oncology ( ESGO) in 2015 and relevant research progress .

Objective To explore the short-and mid-term curative effect and influence factors of hepaticojejunostomy(Kasai operation) for biliary atresia.Methods The clinical data of 66 children with biliary atresia treated with Kasai operation were analyzed retrospectively.The jaundice fading rate,2-year survival rate and influence factors of prognostic were analyzed.Results The jaundice fading rate of 62 cases was 58.1％ after Kasai operatiou.The patients also had a 2-year native liver survival rate of 53.2％.The jaundice fading rate,2-year survival rate of type Ⅰ,Ⅱ and Ⅲ had no significant differences (χ2 =1.91,0.76,all P ＞ 0.05).The 2-year survival rate of children underwent Kasai operation as younger than 60 days was higher rate than that of the children as 61 to 90 days and older than 90 days(χ2 =4.72,P ＜ 0.05).The 2-year survival rate of children with cytoinegalovirus infection and postoperative cholangitis were 43.6％,39.5％,respectively,which were lower than those of children without cytomegalovirus infection and postoperative cholangitis (69.6％.75.0％) (χ2 =3.92,7.46,all P ＜ 0.05).Conclusion Kasai operation is still the preferred method for the treatinent of biliary atresia.Type of the disease was not related with the short-and mid-term effects of Kasai operation.Age at operation was the main factor affecting the prognosis.Therefore,it is very important to make early surgery,enhance the anti-viral treatment and prevent postoperative cholangitis.

Objective To investigate the nursing aides' working experience of private pension institutions,and provide advances of decision-making on targeted pension institution development strategy.Methods 12 nursing aides for the aged were surveyed by using deep half-structural interviews and were recorded,noted during the whole interviews.Data were analyzed by coding step by step.Results The primary feelings of the participants including vocational responsibility was gradually enhanced in the interaction with the elderly,multiple service consciousness was built up during the process of meeting diverse demands of the elderly,standardized training demands formed from servicing in pension institutions.Conclusion Understanding and care are the key factors for the pension caregivers whose multiple service ability should be ascended,and their training should be further standardized.

Objective To describe the status of publication papers on nursing of 47 grade three and first-class hospitals in Henan province from the year of 1991 to 2014 and provide valuable reference basis for the relevant departments to make policy. Methods The methods of literature metrology was used to analyze the amount, journals, key words distribution and other information of the 12 422 articles with the keyword 'nursing', which were included by China National Knowledge Infrastructure (CNKI) and Wanfang data, VIP database. Results The number of published articles of the investigated units was in the upward trend on the whole. But the number of annual published articles on the core periodicals was significantly lower than the total. The articles were mainly distributed on 3 nursing core journals, 5 non-nursing journals of Henan province, which were mostly for regional academic exchanges. 11 key words of nursing articles of Henan were the same as the nation but different for the sequence. Conclusions The grade three and first-class hospitals in Henan are in urgent need of the construction of systematic and standardized scientific research training system. The channel for the exchange of nursing academic needs to be widen. Clinical nursing research should be paid more attention to the characteristic field.

ObjectiveTo investigate the clinical efficacy of bidirectional Glenn shunt with noncardiopulmonary bypass(CPB) for treating congenital heart disease.MethodsThe clinical data of forty-four patients receiving bidirectional Glenn shunt from August 2005 to August 2011 were analyzedretrospectively,twenty-three cases of which were treated by bidirectional Glenn shunt with non-CPB (non-CPB group) and twenty-one with CPB (CPB group).The duration of ventilator-assisted breathing,chest drainage volume,amount of blood product usage,postoperative hospital stay and pulse oxygen saturation (SpO2) before leaving the hospital were compared and analyzed between two groups.ResultsForty-four patients were all cured.The duration of ventilator-assisted breathing,chest drainage volume and the amount of blood product usage of non-CPB group were less than those of CPB group [ (4.5 ± 1.3 ) h vs.(6.7 ± 1.5 ) h,(4.6 ± 1.4 ) ml/kg vs.(7.7 ± 3.1 ) ml/kg,( 221.8 ± 97.6 ) ml vs.( 423.4 ± 149.7 ) ml,P ＜ 0.05 ].There was no significant difference of the postoperative hospital stay and SpO2 before leaving the hospital between non-CPB group and CPB group[ (7.4 ± 2.3 ) d vs.(7.8 ± 1.9) d,0.91 ± 0.05 vs.0.88 ± 0.39,P ＞ 0.05 ].Conclusion Bidirectional Glenn shunt with non-CPB is a safe and feasible surgical approach,which is worthy of promotion.

Objective To assess the curative effect of different therapeutic regimen in perimenopausal and postmenopausal pa-tients with depressive disorder ,in order to guide clinical work .Methods Relevant literatures were collect by retrieving a number of online database ,,screen documents independent ,the randomized controlled trial(RCT) and cohort study were included ,and carried on the quality evaluation and data extractione ,then completed the Meta analysis .Results 19 papers were inclouded (2 312 cases) , including 10 RCT papers and 9 cohort papers .There was no statistically significant difference for cure rate (RR=1 .15 ,P=0 .07) , the difference of effective rate had statistically significant (RR=1 .17 ,P=0 .005) .Hormone in combination with antidepressants compared with hormone replacement therapy :the difference of cure ratio (RR=1 .73 ,P=0 .003) and effective rate (RR=1 .52 , P<0 .01) all had statistically significant .The difference of effective rate between antidepressants and hormone replacement therapy had statistically significant (RR=1 .37 ,P=0 .003) .Hormone replacement therapy compared with placebo :the difference of cure rate had statistically significant(RR=2 .17 ,P=0 .03) ,the difference of effective rate had no statistically significant (RR= 0 .78 ,P=0 .15) .Conclusion Although the hormone replacement therapy has a positive effect on the mood ,it′s promoting effect on the anti-depressant of perimenopausal and postmenopausal women is uncertain .

ObjectiveTo investigate the influence on efficacy and quality of life of amisulpride in schizophrenia with predominantly negative symptoms.MethodsSeventy cases of schizophrenia with predominantly negative symptoms were randomly assigned to amisulpride group and clozapine group for 12weeks.The clinical efficacy and side effects were evaluated with SANS,BPRS and TESS before and 1,2,4,8,12 weeks after treatment respectively. GQOLI-74 were used to evaluate the patients' quality of life before and after drug administration.ResultsFor the last assessment,the score of BPRS decrease to 30.68 ±4.62 in amisulpride group,was significantly lower than the beginning(P＜0.01 ) ; the score of BPRS decrease to 31.31 ±4.78 in clozapine group,was significantly lower than the beginning (P ＜ 0.01 ).Two groups showed similar effects,with no significance.12weeks after treatment,the scores of emotional dull,poverty of thought,volition abulia,interest-social lack,attention dysfunction in amisulpride group were 12.31 ± 4.43,9.66 ± 3.07,8.91 ± 2.56,10.29 ± 2.68,5.58 ± 1.43 ; and the scores of emotional dull,poverty of thought,volition abulia,interest-social lack,attention dysfunction in clozapine group were 14.62 ± 4.27,9.32 ± 2.81,8.22 ± 2.60,9.54 ± 2.67,6.62 ± 1.59,and the efficacy of amisulpride in emotional dull and attention dysfunction were better than those of clozapine.And the scores of material life,physical function,psychological function,social function in amisulpride group were not higher than those in clozapine group(P＞ 0.05).And the scores of four domains in GQOLI-74 had been improved significantly in two groups(P＜0.01).The domains of physical function,psychological function,and social function in amisulpride was superior to clozapine(P＜0.01).The side effects were more in clozapine group than those in amisulpride group.ConclusionAmisulpride is as effective as clozapine for the treatment of schizophrenia with predominantly negative symptoms,but it has more advantage than clozapine to improve emotional dull,attention dysfunction and quality of life in schizophrenia with predominantly negative symptoms.

Background The biomeasurement and imageology of retinal nerve fiber layer(RNFL) thickness showed the damage of retinal structure in the early and middle stage of glaucomatous eye,however,the subtle functional damage of glaucoma can not be timely reflected only with automatic static perimeter.Microperimetry is a method of quantitatively assessing mean sensitivity (MS) of macular zone.Objective This study was to evaluate and compare the macular functional change in early and middle stage of primary open angle glaucoma (POAG) and chronic angle-closure glaucoma (CACG) with MP-1 microperimeter.Metbods This trail protocol was approved by Ethic Committee of Peiking University Third Hospital,and written informed consent was obtained from each subject prior to entering the study group.A cross-sectional and case-controlled study was designed.A total of 126 eyes from 126 subjects were enrolled in the trail,including 53 eyes of 53 normal subjects,50 eyes of POAG patients and 23 eyes of CACG patients.A macular 10° program was set with MP-1 microperimetry to record the MS of various subareas.The macula was zoned into central 2°,6°,and 10° visual fields and 4 quadrants in each ring.The MS of different rings and subareas was detected and compared among POAG patients,CACG patients and normal controls.Results The MS values of central 2°,6°,10° and whole macular area were (15.09 ± 3.03),(15.72 ± 3.22),(13.99 ± 3.63) and (14.91±3.07)dB in the POAG group,which were significantly lower than those of (17.29±1.59),(18.05±1.24),(16.76±1.89) and (17.37±1.46)dB in the normal control group (all at P=0.000).The MS values of central 2°,6°,10° and whole macular area was (16.00±2.39),(15.83±2.63),(14.45±3.15) and (15.42±2.54) dB in the CACG group,and the reduced MSs were seen at the 6°,10° rings and whole macular area in the CACG group compared with the normal control group (P =0.004,0.013,0.011).Within the 6° ring,the MS values in the inferotemporal quadrant were declined in the POAG group and CACG group compared with the normal control group (P =0.000,0.022),but the difference was not statistically significant between the POAG group and the CACG group (P =0.311).In addition,the MS value in the inferonasal quadrant was significantly lower than that of the normal control group (P =0.005); while that in the CACG group was not significantly different in comparison with the normal control group (P=0.119).In the POAG group,the MS value of the inferotemporal quadrant was significantly lower than that of the superonasal or superotemopral quadrant (P =0.043,0.016),but no significant differences were found among the 4 quadrants in the CACG group (all at P＞0.05).Conclusions The mild damage of retinal function appears in the early and middle stage of POAG and CACG.More serious MS reducing occurs in the inferotemporal and inferonasal quadrants of POAG.

BACKGROUND: The urinary fistula rates following kidney transplantation are varying in each center, which lack of unified classification criteria and treatment standard. OBJECTIVE: To explore optimal treatments for urinary fistula following kidney transplantation by retrospective analyzing the characteristics, etiological factors and therapeutic efficacy of urinary fistula. METHODS: Totally 68 patients with urinary fistula were collected, including 42 males and 26 females, aged 21-57 years. The urinary fistula occurred at days 1-17 after operation. According to the location of urinary fistula, patients were divided into stomas fistula and ureter fistula groups. The location of fistula was determined by cystography, magnetic resonance hydrography (MRH) or operation research. In both groups, conservative treatment was first adopted, namely, placing a negative pressure drainage tube draining the wounds and placing a double-J catheter or a urinary canal in, however, if invalid, a surgical repair was performed. There were 45 patients underwent surgery. The location, onset period, therapeutic efficacies of urinary fistula was analyzed. RESULTS AND CONCLUSION: Among the 68 cases of fistula, 20(29.4%) were stomas fistula and 48 (70.6%) were ureter fistula. The onset period was (5.1±2.5) and (8.8±5.5) days after transplantation, respectively (P < 0.05). Fifteen of 20 stomas fistula (75.0%) were cured successfully by conservative treatment. Whereas, for the remaining 5 cases (25.0%), we attempted open surgery, among which 4 were cured, free of recurrence, and 1 case underwent nephrectomy because of acute rejection. For the 48 cases of ureter fisula, only 8 (16.7%) were cured by conservative treatment, but the other 40 (83.3%) must accept further open surgery, among which 35 were cured (including 6 cases of recurrent fistula). Three cases underwent nephrectomy failure of repair owing to acute rejection, besides 2 died of pulmonary infection. The achievement ratio of conservative treatment in lower fistulae was significantly higher than that of upper fistulae (P < 0.01). It is necessary to determine the location of urinary fistula following kidney transplantation. Compared to ureter fistula, stomas fistula occurred earlier with great leaked volume. Conservative treatment can first selected for stomas fistula, only if it is invalid can we resort to open surgery. However, for. ureter fistula, it is wise to adopt open surgery as soon as possible.

Objective To observe the efficacy of cumulative dose of polyethylene glycol-interferon (Peg-IFN)α-2a combined with ribavirin in patients with decompensated hepatitis C virus (HCV)-related liver cirrhosis , and to evaluate the effects of anti-virus therapy on the progress of the disease . Methods From January 2005 to March 2009 ,patients with decompensated HCV-related liver cirrhosis were enrolled ,also included patients received partial splenic embolization .Peg-IFNα-2a combined with ribavirin therapy was given to patients whose blood cell met interferon (IFN) therapy standards .The dosage of Peg-IFNα-2a and ribavirin was adjusted according to the tolerance of the patients .After the treatment ,the patients were followed-up for 24 weeks .The patients whose blood cell did not meet IFN therapy standards and the patients unwilling to receive anti-virus therapy were assigned to control group and were followed-up for 96 weeks .The total amount of medication was calculated according to cumulative exposure dose . Sustained virological response (SVR ) , recurrence rate , liver function and disease progression were observed .The t test or Chi-square test was performed for comparison between groups and rate of disease progression was analyzed with Kaplan Meier curve .Results After anti-virus therapy , SVRs of patients with cumulative dose of Peg-IFNα-2a and ribavirin over 60% (include 60% ) were 27 .3%(12/44) and 27 .7% (13/47) ,respectively ;the recurrence rates were 7/19 and 35 .0% (7/20) ,respectively . In patients with cumulative dose less than 60% ,SVRs were 1/7 and 1/4 ,respectively ,and the recurrence rates were both 1/2 ;the differences of different doses was not statistically significant (all P>0 .05) .At the 24th week of follow-up after therapy ,the Child-Pugh score of combined therapy group was 7 .9 ± 1 .4 , which was lower than that before treatment (8 .5 ± 1 .2) ,and the difference was statistically significant (t=2 .33 ,P=0 .02) .At the 96th week of follow-up ,the Child-Pugh score of control group was 10 .0 ± 1 .6 ,which was higher than that before treatment (8 .5 ± 1 .4) ,and the difference was statistically significant (t=5 .82 , P<0 .01) .The disease progression rate of combined therapy group was 15 .7% , which was lower than that of control group (32 .4% ) ,and the difference was statistically significant (χ2=4 .34 ,P= 0 .04) .Conclusion The application of non-standard dosage of Peg-IFNα-2a combined with ribavirin in the patients with decompensated HCV-related liver cirrhosis can achieve virological response once the cumulative dose reached certain standards ,improve Child-Pugh scores of patients and slow disease progression .