Objective To investigate the incidence,etiology,diagnosis,treatment and outcome of uterus rupture.Methods From January 1999 to May 2013,clinical data of 67 cases with uterine rupture in Woman's Hospital,School of Medicine,Zhejiang University were studied retrospectively.Results A total of 67 cases of uterine rupture with 21 +2--39 +2 gestational weeks out of 128 599 deliveries were recorded giving an incidence of uterine rupture was 0.052 1 ％ (67/128 599).Cesarean scar rupture were found in 59 cases (88％,59/67) and noncesarean scar rupture were found in 8 cases (12％,8/67).The causes of uterine rupture include 60 cases of scar uterus (59 cesarean scar cases and 1 myomyectomy scar case),2 cases of assisted delivery operation trauma,2 cases of malformed uterus,3 cases of unknown causes (all with artificial abortion history).Non obstructive dystocia and improper oxytocin use were found to be related with uterine rupture.Fifty-two cases of cesarean scar spontaneous incomplete rupture were found and repaired during repeated cesarean delivery without maternal and fetal complications.The remaining 15 cases need emergency rescue operation for fetal distress or dead fetus,severe acute abdomen,prepartum or postpartum vaginal bleeding even maternal hypovolemia; 6/15 uterine rupture cases were diagnosed with the history,clinical symptoms and signs,3/15 cases with ultrasonic found dead fetus in the peritoneal cavity before exploratory laparotomy and 6 cases were diagnosed just during laparotomy.Hysterectomy was done in 10/15 cases and uterine repair in 5/15 cases; there was no maternal death and 12 perinatal fetal death (5 cases of mid-late pregnancy termination for deformed fetus) of the 15 uterine rupture cases.One case with hysterectomy was complicated with stress pancreatitis and dysfunction of liver and kidney and discharged 20 days after operation,the remaining 14 cases were discharged 5-7 days postpartum.One case with repaired malformed uterus got pregnancy 4 years later and delivered a 2 000 g healthy baby by cesarean section at gestational age of 33 +4 weeks.Conclusion Uterine scar caused by caesarean section or other operations became the leading cause of uterine rupture,assisted delivery operations,history of intrauterine manipulation and uterine malformations were the predisposing risk factors of uterine rupture.

BACKGROUND:Human umbilical cord blood-derived mesenchymal stem cels are able to repair and regenerate the injured myocardium, which is a new therapy for myocardial infarctionvia transplantation. OBJECTIVE:To explore the therapeutic efficacy of intracoronary injection of human umbilical cord blood-derived mesenchymal stem cels on acute myocardial infarction in rats. METHODS:Thirty-two rats were selected to make animal models of ligation of the left anterior descending coronary, and then model rats were randomized equaly to transplantation group and model group. Human umbilical cord blood-derived mesenchymal stem cels were isolated and prepared into cel suspension. Rats in the transplantation group were subjected to transplantation of human umbilical cord blood-derived mesenchymal stem cels. RESULTS AND CONCLUSION: Human umbilical cord blood-derived mesenchymal stem cels were successfuly isolated and cultured in vitro. Compared with the model group, the microvessel density, left ventricular end-systolic pressure and ±dp/dtmax were significantly increased in the transplantation group (P < 0.05), while the left ventricular end-diastolic pressure was decreased dramaticaly (P < 0.05). Electrocardiography findings showed that the heart function of rats in the transplantation group was improved slightly. These findings indicate that human umbilical cord blood-derived mesenchymal stem cels can promote myocardial angiogenesis and improve heart function of rats with myocardial infarction.

BACKGROUND:A large amount of inflammatory mediators from myocardial cels are secreted in response to myocardial injury after myocardial ischemia. Moreover, inflammatory cytokines in infarction and ischemia regions contribute to myocardial tissue repair and adaptation.
OBJECTIVE:To investigate the effect of tumor necrosis factor-α (TNF-α) pretreatment on cardiac function of myocardial infarction rabbits undergoing umbilical cord blood mesenchymal stem cel transplantation.
METHODS: Thirty-six white rabbits were equally randomized into sham, model, non-TNF-α, and TNF-αgroups. Animal models of myocardial infarction were made in the latter three groups. Twenty-four hours after modeling, PBS, umbilical cord blood mesenchymal stem cells pretreated with or without TNF-α were injected at infarct center and border, respectively, in the model, TNF-α and non-TNF-α groups.
RESULTS AND CONCLUSION: Model rabbits in the TNF-α and non-TNF-α groups showed better cardiac function and lower size of myocardial infarction and fibrosis than those in the model group. Compared with the non-TNF-α group, moreover, the TNF-α group showed better outcomes in these indicators. These findings indicate that TNF-α pretreatment canmarkedly improve the therapeutic efficacy of umbilical cord blood mesenchymal stem cel transplantation on myocardial infarction.

Objective: To investigate the effects of Nd:YAG laser in the treatment of dentine hypersensitivity. Methods:270 teeth in 153 patients were equally divided into two groups at random. The teeth in the experimental group were treated with Nd:YAG laser at 265.5 J/cm 2 (0.75 W and 10 Hz for 2 min) for 3 times with the interval of 1 week, those in the control group were treated with Gluma desensitizer for 3 times with the interval of 2 d. Results:The effective rate of the experimental and control groups was 92.59% and 49.62% respectively (P

BACKGROUND:Stem cels have multi-directional differentiation and self-replication abilities, under certain conditions, which can differentiate into myocardial cels to repair the damaged myocardium. OBJECTIVE: To investigate the effects of transplantation of umbilical cord mesenchymal stem cels derived at different gestational weeks on infarct size and angiogenesis in the infarct region of experimental rabbits with myocardial infarction. METHODS: Ten ful-term umbilical cord samples and 10 umbilical cord samples of aborted fetuses at 10-12 gestation weeks were selected to in vitro isolate umbilical cord mesenchymal stem cels that were subjected to BrdU labeling. HLA-G expression was detected in the cels. Thirty white rabbits were selected to make myocardial infarction models, and 2 weeks after modeling, the model rabbits were randomized into aborted cel transplantation group, ful-term cel transplantation group and control group (n=10 per group). Then, BrdU-labeled cels were injected correspondingly into the infarct region of rabbits in the two cel transplantation groups. Rabbits in the control group were subjected to an equal volume of serum-free. Four weeks after transplantation, heart function of rabbits was monitored using electrocardiogram, and myocardial tissues were taken to measure infarct size and blood capilary density. RESULTS AND CONCLUSION: HLA-G expression was different in different sources of umbilical cord mesenchymal stem cels: high HLA-G expression was found in the aborted umbilical cord mesenchymal stem cels, and meanwhile, low HLA-G expression was found in the ful-term umbilical cord mesenchymal stem cels. Compared with the control group, the left ventricular end-diastolic volume and left ventricular ejection fraction of aborted and ful-term cel transplantation groups were significantly improved, especialy in the aborted cel transplantation group (P < 0.05). BrdU-positive cels were found in the infarct site in both transplantation groups. Compared with the control group, the infarct size and capilary density were improved most significantly in the aborted cel transplantation group folowed by the ful-term cel transplantation group (P < 0.05). Electrocardiogram findings showed significant improvement in both cel transplantation groups compared with the control group (P < 0.05), especialy in the aborted cel transplantation group. These findings indicate that umbilical cord mesenchymal stem cels derived at low gestational weeks improve the heart function more significantly than the ful-term umbilical cord mesenchymal stem cels, which have the potential to become a better source of cardiomyocytes for transplantation.

Objective To explore the prognosis of mild hypothermia treatment in cases of severe traumatic brain injuries(sTBI),improve the knowledge of mild hypothermia treatment on brain injuries.Methods Cases were divided into 2 groups:mild hypothermia treatment group and control group.Mild hypothermia was applied to the cases of sTBI in mild hypothermia group.The prognosis was divided into five grades such as good recovery(GR),moderate disability(MD),severe disability(SD),persisted vegetative state(PVS)and death(D).Results In mild hypothermia group,there were 20 GR cases,5 MD,2 SD and 3 D cases,while in control group,there were 14 GR cases,9 MD,4 SD and 3 D cases.Conclusion Mild hypothermia treatment can improve the prognosis of sTBI.

Objective To investigate application of multi-purpose urologic examining table in the lower ureter retrograde urography. Methods The performance of the multi-purpose urologic examining table was described, and 198 cases that applied this table for the lower ureter retrograde urography were reported. Results With 196 cases (99% ) succeed and 2 cases (1% ) defeat, this examining table enhanced achievement ratio of the lower ureter retrograde urography. Conclusion The multi-purpose urologic examining table has great superiority in the lower ureter retrograde urography, and can integrate ureter retrograde catheterization under cystoscope and contrast examination.

Objective To explore the clinical efficacy of modified single-portlaparoscopic radical prostatec-tomy(LRP) by atransperitoneal or extraperitoneal approach, and the impact of either approach on immune function in patients with prostate neoplasms. Methods The clinical data on 39 patients who had undergoneextraperitoneal LRP(group A) and 20 patients who had receivedtranperitoneal LRP (group B) in our department from January 2012 to December 2015 were retrospectivelyanalyzed. The prostate neoplasms were preoperatively diagnosed as cancer by ultrasound, CT or MRI, and pathological examinations. The clinical stage was T1-T2c , N0M0 in all patients.The efficacy was assessed by surgical duration, intraoperative blood loss, timeto intestinal function recovery, and post-operative hospital stay in both groups. The indicators for immune function including prostate specific antigen (TPSA and FPSA), immunoglobulin (IgG, IgA, lgM, C3, and C4) and T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+) in patientswith prostate neoplasms before and after surgery were detected. Results 59 patients were operat-ed successfully, without converting to open approach. The mean surgical duration, blood loss, time to intestinal function recovery, and postoperative hospital stay were (133.8 ± 68.6) min, (75.6 ± 51.3) mL, (2.2 ± 0.7) days, and (14.7 ± 3.6) days in group A, while (159.4 ± 78.1) min, (102.2 ± 70.8) mL, (2.9 ± 1.1) days, and (15.2 ± 4.1) days in group B. There were significant differences between the two groups (P<0.05). After surgery, levels of IgG, IgA, C3, C4, CD3+, CD4+and CD4+/CD8+were significantly higherin group Athan in group B (P < 0.05). There were no significant differences between the two groups in levels of TPSA, FPSA and lgM (P>0.05). Average postoperative follow-up was 15 months (range 3-36) in 36 patients. No recurrence or metastasis was found in all the patients by imaging studies,and no long-term complications were found. Conclusions Extraperitoneal LRP, as compared with tranperitoneal LRP, has clearer vision, fewer effects on abdominal organs, shorter surgical duration, less blood loss, faster postoperative recovery, and better protection of immune function. It is worth popularizing clin-ically.

Vagus nerve reflex is a rare complication of percutaneous renal decompression. It is often induced by excessively rapid decompression of severe hydronephrosis and traction of the main nerves innervating the kidney. The clinical manifestations are irritability, sweating, clammy skin, hiccups, slow heart rate. It is easy to misdiagnose. In this study, 4 patients with vagus nerve excitement after percutaneous renal decompression were treated. After monitoring the patient’s vital signs and giving treatment such as expanding blood volume and raising blood pressure, the symptoms gradually disappeared.

Objective To determine the expression profile of serum microRNAs(miRNAs) in early-onset familial Alzheimer's disease (EO-FAD) patients. methods miRNA microarrays were performed to detect the expression profile of serum miRNAs in 2 cases of EO-FAD patients,2 cases of EO-FAD carriers and 2 cases of normal controls.Preliminary bioinformatic analysis was conducted. Result sIt was found that 21 miRNAs were up-regulated and 22 miRNAs were down-regulated in serum of EO-FAD patients,the differences were statistically significant(P<0.05).miR-5704(P=0.0002),miR-4639-3p(P=0.0195),miR-107(P=0.0204) were markedly up-regulated,miR-5572(P=0.0008),miR-204-3p(P=0.0014),miR-542-5p(P=0.0106) and miR-155-5p(P=0.0240) were markedly down-regulated.Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis suggested that the dysregulated miRNAs may be involved in the mechanism of EO-FAD by affecting neurotrophin signaling pathway.Conclusion miR-5704,miR-4639-3p,miR-107,miR-5572,miR-204-3p,miR-542-5p and miR-155-5p may be used as potential biomarkers of EO-FAD,and involved in the mechanism of EO-FAD by affecting neurotrophin signaling pathway.