0.05). The pathological findings indicated benign lesions in 63 patients(73%) and malignant lesions in 25 patients(27%)in group 1. All the lesions were found benign in group 2. There was significant difference between the two groups(P=0.0033). Conclusion Noninvasive and painless transvaginal two-dimensional ultrasonograpy and color Doppler ultrasonography may have important clinical application value in diagnosis of intrauterine anomaly in post-menopausal women.

ObjectiveTo determine the effects of perioperative hemodynamic goal directed therapy (GDT) on postoperative infection rates. MethodsWe conducted a systematic review and Meta-analysis.MEDLINE,the Cochrane Library,EMBASE,CNKI and other sources were searched until March 2011.All randomized controlled trials (RCTs) on adult major surgical patients managed with perioperative GDT or according to routine haemodynamic practice were included.Primary outcome measure was specific for type of infection. Two authors independently extracted data and assessed study quality using standardized instruments; Consensus was reached by conference.The Cochrance Collaboration's software RevMan 5.0 was used for data analysis. ResultsSixteen studies were included in the final analysis,providing a sample of 3309 patients. Perioperative GDT significantly reduced surgical site infections (SSI)(OR =0.60; 95％CI0.46-0.74; P ＜0.0001),pneumonia (OR =0.69; 95％CI 0.53 -0.90;P =0.007),and urinary tract infections (UTIs) (OR =0.44; 95％ CI 0.22 -0.88; P =0.02),and there was no heterogeneity between studies (P ＞ 0.1,I2 ＜ 50％ ).A significant decrease in total infection episodes was observed (OR=0.37; 95％CI0.22-0.61; P＜0.00001). ConclusionsA flow-directed hemodynamic therapy protects the high-risk surgical patients against postoperative hospital-acquired infections.

Objective To propose a MR scoring methods for spatium perilymphaticum gadolinium opacification and explore the value of their diagnosis of Meniere' s disease. Methods Fifty-one asymptomatic and 65 symptomatic patients with Meniere's disease were enrolled in this study.MR imaging ofspatium perilymphaticum after intratypanic gadolinium injection were analyzed with following scoring method.　( 1 ) Semicircular canal not visualized equal to score 0 ; some visualized equal score 1 ; full visualized equal　score 2.(2)There were high-signal and low-signal in the vestibule,low-signal areas above the lateral　semicircular canal plane equal score 6 ; low signal areas down to lateral semicircular canal plane equal score　3 ; no higher signal in the vestibule area equal score 0.( 3 ) Basal turn of cochlea:full visualized equal score　3; part visualized equal score 2; scala vestibule of basal turn smaller than scala tympani equal score　1 regardless of full or visualized in basal turn; no visualized equal score 0. Medial turn of cochlea:full　visualized equal score 2 ; part visualized equal score 1 ; no visualized equal score 0.Apical turn of cochlea:　visualized equal score 1 ; no visualized equal score 0. One radiologist scored all cases with double blind.　SPSS 17.0 software was used to conduct multiple independent-samples nonparametric tests,multivariate　Logistic regression, and ROC curve analysis. Evaluate the sensitivity and specificity for diagnosis of　Meniere's disease with the scoring system. Results ( 1 ) Meniere's disease summation score 0 to 12,median 9 (quarter spacing 4.5 ) ; no symptoms group summation score 15 to 18,median 17 (quarter spacing 3),two group differences has statistics significance (Wilcoxon rank and inspection U =-9.118,P =0.00).(2)Based on summation score for the diagnosis of Meniere's disease,tangent point was 14.5,Youden index 0.969,specificity 100.0％,sensitivity 96.9％.( 3 ) Let cochlear,vestibular,semicircular canal scoring for association variable,Logistic regression model:LogitP =61.216 - 7.381 × vestibular -3.056 × canal,based on the P value of ROC curves,diagnostic cut-off point 0.651 (vestibular ≤ 3 or semicircular canals ≤ 4 points ),Youden index 96.9％,specifisity 100.0％, sensitivity 96.9％.Conclusions Perilymphatic space of gadolinium contrast MR score in distinguishing Meniere's disease have practical value,any case meet one of following point could be diagnostic:( 1 ) Perilymphatic space of gadolinium contrast MRI total less than 14.5 ; (2) Vestibular low signal areas down more than lateral semicircular canal plane,namely vestibular score value ≤3;( 3 )Semicircular Canal scoring value ≤4.

Objective To find out the incidence tendency and characteristics of bladder tumors during the past 28 yesrs in our institution. Methods The data from 1980 to 2007 were divided into three stages:1980-1989,1990-1999和2000-2007.Microsoft excel and SPSSl3.O were used to analyze the sex,age and histological types. Results There were 2350 cases of bladder tumors in 28 years.There were 92(66 males,26 females)cases of benign tumors and 2258(1788 males,470 females)malignant tumors,the incidence in male was 3.8 times higher than that in female.The cases of bladder malignant tumors increased,and the female increased faster than male.The peak age of incidence changed from 50-69 in 1980-1989 to 60-79 in 2000-2007.The average age of squamous cell carcinomas was 68 years,which was the oldest;and the average of paraganglioma was 35,which was the youngest.The age of urinary bladder carcinoma in 1980-1989,1990-1999 and 2000-2007 were significantly different(male:57.5±11. 7,62.6±12.3,65.9±11.3;female:58.7±13.6,60.75±12.1,65.85±12.0,respectively,P<0.05).In male,the age of squamous cell carcinomas was significantly different from the age of urothelial cell carcinomas and adenocarnomas(68.0±9.7 vs 59.85±14.1 and 63.4±9.9,respectively,P<0.05).Inverted papillomas were the most common bladder benign tumors;urothelial cell carcinomas were the most common bladder malignant tumors,and adenocarcinomas were the second,squamous cell carcinomas were the third. Conclusion The incidence of bladder malignant carcinomas in our institution increased and the female increased more quickly than male.

Objective To explore the effect of the self-made pelvic bag on patients with unstable pelvic fracture.Methods Toally 24 patients with unstable pelvic fracture from January 2013 to June 2014 were set as control group and used conventional nursing.Toally 30 patients from July 2014 to December 2015 were set as observation group.The self-made pelvic bag was used in the observation group for pelvic fixation and suspension traction.The degree of pain was compared between the pre-and post-use of the bag.Result The pains after using pelvic bag in the observation group were significantly lower than that of the control group (P＜0.001).Conclusions The self-made pelvic bag can be effective for the pelvic fixation and suspension for the patients with pelvic traction.At the same time it can relieve the pain.

Objective:To explore the impact of clinical pharmacists involved in the treatment team on the reasonable drug use rate in medical orders. Methods:Totally 782 medical records including hypertension and 1-3 kinds of hypertension associated diseases in our hospital from January 2011 to December 2011 were used as the pre-intervention group, and 1 061 ones with the same conditions from September 2012 to August 2013 were used as the post-intervention group. The patients of the two groups were divided into 8 dis-ease subgroups, clinical pharmacists performed timely intervention on the medical orders in the post-intervention group, and the rational drug use rate between the two groups was compared. Results:In hypertension, hypertension associated coronary heart disease, hyper-tension with heart failure and hypertension with diabetes subgroups,the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 01), in hypertension with coronary heart disease and heart failure, hypertension associ-ated coronary heart disease and diabetes, hypertension with heart failure and diabetes subgroup, the difference in the rational drug use proportion before and after the intervention was statistically significant(P<0. 05), while in hypertension with coronary heart disease, heart failure and diabetes subgroups, the difference was not statistically significant(P>0. 05). After the medical records in the 8 sub-groups were aggregated, the difference in the rational drug use proportion before and after the intervention was statistically significant( P<0. 01). Conclusion:Clinical pharmacists should involve in the clinical treatment to intervene irrational drug use,which can signifi-cantly improve the medical record rationality, avoid the health risks as much as possible and ensure the medication safety and treatment effectiveness for patients.

Pulmonary fibrosis is a common pathological change in many chronic lung diseases, and its pathogenesis and characteristics are mainly caused by repeated lung alveolar injury leading to abnormal activation of fibroblasts and the accumulation of large amounts of extracellular matrix (ECM) deposition. Fibroblasts are not only responsible for constituting the interstitial structure of the lung but are also involved in the post-injury repairment in healthy lung tissue. In contrast, fibroblasts show a typical pro-fibrotic metabolic phenotype after differentiation into myofibroblasts during the development of pulmonary fibrosis. To synthesis large amount of collagen, the myofibroblasts have a strong metabolism characteristic of serine/glycine, glutamine, proline, and arginine. At the same time, the myofibroblast get the ability to resist cell apoptosis. As an important cell type for collagen degradation, fibroblasts reuse the amino acids of collagen to maintain cell metabolism. However, the myofibroblasts cannot degrade the ECM due to the suppression of autophagy activity, thus accelerating the progression of pulmonary fibrosis. This review attempts to summarize how amino acid metabolism of fibroblasts influence the pulmonary fibrosis.

Objective To explore the contrast perilymphatic MRI characteristics of inner ears with sudden hearing loss with vertigo.Methods Forty three patients with sudden hearing loss with vertigo and 35 patients with unilateral tinnitus diagnosed by the department of Otolaryngology-Head and Neck Surgery were retrospectively included.Forty eight ears (38 ears with unilateral sudden hearing loss and 10 ears in 5 cases with bilateral sudden hearing loss) were regarded as sudden hearing loss group,35 asymptomatic ears (the opposite ears of the unilateral tinnitus ears) as control group.Thirty eight opposite ears of the 38 unilateral sudden hearing loss ears and 35 ears of the control group showed normal in the pure tone audiometry exam.One hundred and twenty one ears (48 hearing loss ears,38 opposite ears of the 38 unilateral sudden hearing loss ears and the 35 control group's ears) underwent contrast perilymphatic MR exams,0.4 to 0.5 ml gadolinium hydrate diluted with saline was injected through the tympanic membrane,twenty four hours later,three-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence was performed using a 3.0 T MRI scanner.After the contrast perilymphatic MR exam,success in the exam was judged through the raw image.The signal intensity ratio (SIR) of cochlea basal turn and homolateral brain stem was quantitatively calculated.The SIR difference of 48 ears with sudden hearing loss and 35 asymptomatic ears in control group was analyzed by t test.The SIR difference of the 38 unilateral sudden hearing loss ears and the contralateral asymptomatic ears was also analyzed.The presence of endolymphatic hydrops was judged.Results The contrast perilymphatic MRI of 121 inner ears with intratympanic gadolinium injection were all successful.Endolymphatic hydrops were observed in 12 sudden hearing loss ears with the occurrence rate of 25％(12/48).The SIR of basal turn and homolateral brain stem of the sudden hearing loss ears (2.062±0.907) were lower than the SIR of the control groups' asymptomatic ears (2.703± 0.640) with significant difference between them (t=3.619,P=0.001),the SIR of basal turn and homolateral brain stem of the unilateral sudden hearing loss ears (1.941 ±0.860) were also lower than the SIR of the contralateral asymptomatic ears (2.411±0.670) with statistical difference between them (t =3.270,P=0.002).Conclusions Endolymphatic hydrops were observed in sudden hearing loss with vertigo.The SIR of the cochlea in sudden hearing loss ears were lower than that of the asymptomatic ears,indicating the abnormal permeability of the round window membrane.

Objective: To explore the value of combined detection of serum cystatin C (CysC), urinary β2-microglobulin (β2-MG), and liver type fatty acid binding protein (L-FABP) in early diagnosis of acute renal injury after cardiac surgery. Methods: 126 patients undergoing cardiac surgery in our hospital from April 2015 to August 2016 were selected as the subjects, according to the occurrence of acute renal injury after operation, 48 cases were divided into acute renal injury (AKI) group and 78 cases into non-acute renal injury (non AKI) group, the levels of serum CysC, urine β2-MG, and L-FABP were detected in the two groups. Receiver operating characteristic (ROC) curve was used to analyze the effects of serum CysC, urine β2-MG, L-FABP in the early diagnosis of acute renal injury after cardiac surgery. Results: The incidence of AKI after cardiac surgery was 38.10% (48/126); the serum CysC level in group AKI was significantly higher than that in non AKI group (P<0.05); the levels of urine β2-MG and L-FABP were significantly higher than those in non AKI group (P<0.05); the area under curve (AUC) of serum CysC for AKI diagnosis after cardiac surgery was 0.874 (P<0.05), with diagnostic sensitivity 85.7%, and specificity 76.5%; the AUC area of urinary β2-MG for AKI diagnosis after cardiac surgery was 0.754 (P<0.05), with diagnostic sensitivity 92.9%, and specificity 73.5%, respectively; the AUC area of urinary L-FABP for AKI diagnosis after cardiac surgery was 0.834 (P<0.05), with diagnostic sensitivity 92.9%, and specificity 74.1%. The AUC area of combined diagnosis of the three was 0.914 (P<0.05), with the diagnostic sensitivity 92.1%, and specificity 82.4%. Conclusions Serum Cys C, urine β 2-MG and L-FABP levels were significantly increased in patients with AKI. The diagnosis of the three alone has a certain reference value, which is lower than the combined diagnosis. The combined diagnosis of the three can provide an important reference for screening acute renal injury after heart surgery.

OBJECTIVETo observe analgesic effect of electroacupuncture ( EA) on rats with chronic inflammatory pain and its regulatory mechanism on ispilateral dorsal root ganglion (DRG) and spinal dorsal horn (SDH) Mas-related G protein-coupled C receptor (MrgprC).

METHODSTotally 40 healthy male SD rats were divided into 4 groups according to random number table, i.e., the normal (N) group, the model (M) group, the acupuncture (Acu) group, the EA group, 10 rats in each group. The model of chronic inflammatory pain was established by subcutaneous injecting 0. 1 mL complete Freund's adjuvant (CFA) into right hind paw. Paw withdrawal thresholds (PWTs) were measured before modeling, at day 1, 3, 5, 7, and after CFA injection, respectively. Expression levels of MrgprC in ispilateral DRG and SDH were detected by Western blot. The content of bovine adrenal medulla 22 (BAM22) in SDH was detected by immunohistochemical assay.

RESULTSCompared with N group at each time point, PWTs significantly decreased in M group (P <0. 01). Compared with M group, PWTs significantly increased at day 5 of EA and after EA in EA group (P < 0.05, P < 0.01). Compared with Acu group at each time point, post-EA PWTs significantly increased in the EA group (P < 0.05). Compared with N group, expression of MrgprC in ispilateral DRG and ratio of BAM22 positive cells in ispilateral SDH increased in M group (P < 0.01). Compared with M group, expression of MrgprC in ispilateral DRG and ratio of BAM22 positive cells in ispilateral SDH increased in the EA group (P < 0.05).

CONCLUSIONEA had favorable analgesic effect on chronic inflammatory pain induced by CFA, and its mechanism might be possibly associated with up-regulating MrgprC expression in ispilateral DRG and BAM22 content in ispilateral SDH.

Analgesia ; Animals ; Electroacupuncture ; Enkephalins ; metabolism ; Freund's Adjuvant ; Ganglia, Spinal ; drug effects ; Inflammation ; chemically induced ; drug therapy ; Male ; Pain Management ; methods ; Peptide Fragments ; metabolism ; Posterior Horn Cells ; drug effects ; Random Allocation ; Rats ; Rats, Sprague-Dawley