Objective To explore the feasibility of clinical applications of the transvaginal cavity mirrors operation on treating ectopic intra-uterine device (IUD) in uterus.Methods The clinical information was collected about 2 patients who suffered from ectopic IUD in pelvic and underwent transvaginal laparoscopic surgery.Results Ectopic devices were taken out by transvaginal laparoscopy operation in all two cases.The operation time was short and quick recovery was quickly.Conclusion Transvaginal laparoscopy operation was proved as a minimally invasive method for ectopic IUD in uterus.

Objective To evaluate the risk factors for surgical site infection(SSI)following limb fracture surgery, and provide basis for making prevention and control measures.Methods Clinical data of 1 453 patients undergoing limb fracture surgery in 16 hospitals between January 1,2014 and June 30,2014 were collected,risk factors for SSI were analyzed by univariate and multivariate logistic regression analysis.Results Among 1 453 patients undergoing limb fracture surgery,12 developed SSI(0.83%).Univariate analysis showed that risk factors for SSI following limb fracture surgery were infection at the other sites 7 days before operation,time from injury to operation,opera-tion opportunity, duration of operation,open fracture, wound type, and anesthesia type ( all P < 0.05 ). Multivariate logistic regression analysis showed that independent risk factors were wound type,anesthesia type, open fracture,time from injury to operation,and duration of operation,OR(95% CI)were 12.47(2.78-15.88), 11.55(2.84 - 17.02),10.79 (2.72 - 11.13 ),2.35 (2.12 - 6.81 ),and 3.07 (1.88 - 4.13 )respectively. Conclusion Risk factors for SSI following limb fracture surgery are multiple,the key to the prevention and control of SSI are identifying risk factors and strengthening the management of key points.

Early recognition and treatment of pediatric septic shock is key strategy to improve prognosis and reduce the mortality,yet controversy still surrounds the current fluid therapy approach.Recently,the results of the Fluid Expansion as Supportive Therapy (FEAST) trial in African children with severe febrile and hypoperfusion illnesses challenge many established principles about pediatric fluid resuscitation,and lead to intense discussion.This review is to describe the current fluid supportive therapy and possible potential mechanisms of increased death associated with bolus resuscitation.

Objective:To explore whether CD36 deficiency promotes insulin resistancein the C57BL/6 mice.Methods:Micewerefedwith a high-fat die(tn=7)for 14 weeks.Intravenous glucose tolerance tests,insulin release and tolerance tests were performed.Triglyceride and free fat acid levels in serum were measured.Results:Compared with the C57BL/6 mice,blood levels of glucose,insulin,triglyceride and free fatty acid were increased in the CD36 knockout mice.Conclusion:The CD36 deficiency indeed promotes insulin resistance in the C57BL/6 mice.

Objective To investigate the levels and clinical significance of serum adiponectin(ADPN),high sensitive C-reactive protein(hs-CRP)and cystatin C(CysC)in type 2 diabetic nephropathy.Methods 75 outpatients and the inpatients with type 2 dia-betes mellitus(T2DM)in our hospital from February 2013 to May 2013 were selected and divided into three groups according to the urinary albumin excretion rate (UAER),normal-albuminuria group(UAER<30 mg/d,30 cases),micro-albuminuria group (UAER 30-300 mg/d,22 cases)and macro-albuminuria(UAER>300 mg/d,23 cases).30 subjects of healthy physical examination were selected as the control group.Urine microalbumin was measured by the immune turbidimetric method,UAER was calculated ac-cording to the 24 h urine volume,CysC and hs-CRP were measured by the immune turbidimetric method,and ADPN was measured by the enzyme linked immunosorbent assay(ELISA).The ADPN,hs-CRP and CysC levels were compared among groups.Results The ADPN level in 3 type 2 diabetic nephropathy groups was lower than that in the control group,the difference was statistically significant (P <0.05 ).With increase of UAER,serum ADPN,hs-CRP and CysC levels in 3 type 2 diabetic nephropathy groups were increased,the difference among the groups was statistically significant (P <0.05 ).The levels of serum ADPN,hs-CRP and CysC in type 2 diabetic nephropathy were positively correlated with UAER(r=0.715 6,0.476 3,0.741 3,P <0.05).Conclusion The combined detection of serum ADPN,hs-CRP and CysC has important reference value for the diagnosis and disease course of early renal damage in T2DM.

Objective To explore the changes and clinical significance of iron metabolism indexes such as serum ferritin (sFn),serum transferritin (sTf),serum transferritin receptor (sTfR) in patients with hematologic malignant disease before and after treatment.Methods Fifty-nine patients with hematologic malignant disease were enrolled.We measured the blood routine,bone marrow routine and iron bound of bone marrow cells and sFn、sTf、sTfR before and after treatment.The control group was 43 healthy Volunteers.Result Before treatment the level of patients sFn increased obviously,which was higher than that of control significantly (P ＜ 0.05).After chemotherapy,the level of sFn in remission group decreased obviously,which was still higher than that of normal control.sFn expression in non-remission group was not different from that before therapy or normal control (P ＞ 0.05).The level of sTf was lower than that of control significantly pretreatment and aftertreatment (P ＜ 0.05).While there was no different between remission group and nonremission group after chemotherapy (P ＞ 0.05).The level of sTfR in non-remission group after chemotherapy was higher than that of control.Correlation analysis showed that there was positive correlation between the serum level of sFn and the original and naive bone marrow cells (r =0.347).And there was negative correlation between sFn and hemoglobin (r =-0.207).But there was no significant correlation between sFn and bone marrow iron.Conclusions It is possible to predict treatment response and prognosis in hematologic malignant disease by the decrease of sFn after chemotherapy.But sTf and sTfR are not good indexes to predict treatment response in a short time.Prevalence of anemia among patients with tumor was not only because of iron deficiency.So iron supplementation should be cautious.

The effect of inducers on leukemia cell line K562 was studied in liquid culture system in vitro. Our experimental results showed that hemin induced cells only to produce hemoglobin without suppressing the growth of cells; Butyric sodium inhibited only the growth of cells without induction of hemoglobin; Cytosine arabinoside and harring-tonine could induce the hemoglobin of cells in their toxicant quantification.The results suggest that hemin and butyric sodium may have not be a therapeutic effect on leukemia patient; The effect of induced differentiation and cell toxicity of cytosine arabin- oside and harringtonine may be closely interconnected. Clinically, there is still the possibility of cell toxicity in treatment of leukemia patients with small dosage of those drugs, and the effect of those drugs may be the combination of cell toxicity, induced differentiation and cell sensitivity.

Penicillin Acylase from B. megaterium was immobilized on the porous bead carriers based on methacrylate, N,N-methelene-bis-methacrymide, glycidyl methacrylate, Allyl ether copolymers (Eupergit-c) either directly or after chemical modification with 1.6-deaminohexane and L-Lysine. Directly binding with oxirane groups, the most efficient immobilization results were achieved. The immobilization yield was markedly influenced by the ratio of amount of free enzyme to the weight of the carrier. The specific activities of 89 up to 475IU/g (wet) and binding protein of 6.9 to 112 mg/g (dry) were obtained when the free enzyme added to the immobilization solution was from 323IU/g (dry) up to 6250IU/g (dry). The residual activity of immobilized PGA in a recycling system at the 20th was about 92.5% of the initial value.

Objective: To study the relationship between the activation of hepatic stellate cell(HSC) and the early stage of liver fibrosis in experimental diabetic tree shrews.Methods: Tree shrews were divided randomly into normal control group and streptozocin(STZ)-treated group.STZ-treated animals were then divided into diabetic group and STZ control group.ALT,AST,Type Ⅳ collagen(Ⅳ-C),Laminin(LN) and Hyaluronic acid(HA) were detected respectively before and after modelling.Liver biopsy was performed at the end of the experiment(8th week).All of the liver specimens were observed in light microscope and transmission electron microscope.?-smooth muscle actin(?-SMA) was detected by immunohistochemistry and computer image analysis system.Results: Early fibrosis of the liver in diabetic tree shrews can be found by both light and electron microscope.There were some ?-SMA positive HSCs,namely,activated HSCs could be observed in the liver of diabetic group but not in other two groups.The expression of ?-SMA increased significantly in the liver of diabetic group as compared with that of other two groups.In addition,the level of expression of ?-SMA was positively correlated with the collagen area density in diabetic group.Conclusion HSC may play an important role in the development and aggravation of liver fibrosis in diabetic tree shrews.

Medical science is both scientific and humanistic,and medical humanities education is an ever-lasting theme.To enhance residents'health,a new health service reform is being carried out by the government to promote the transformation towards the bio-psycho-social medical model.Social reality,mental environment and social factors have significant effects upon health.To impart medical humanities knowledge and cultivate quality of humanities are the missions of higher education.Based upon the practice of medical humanities education in Sun Yat-sen University and the experience of developed countries and regions,and by elaborating the theory to deepen understanding of medical humanities the author is to deal with the real needs and to enhance educational effectiveness of countermeasures.