Objective To improve the level of diagnosis and treatment of uterine scar pregnancy after cesarean section,and has a very important relationship with the quality of life of the patients.At present,the purpose of reducing the rate of cesarean section and improving the level of diagnosis and treatment is to improve the quality of life of patients.Methodsthe drug contact ultrasound,analysis of surgical instrument for gynaecology and obstetrics usage of cesarean section to the hospital,and the diagnosis and treatment of uterine incision scar pregnancy patients were selected from 12 patients were investigated.Drugs containing methotrexate combined with mifepristone and mifepristone combined with trichosanthin etc.The diagnosis and treatment process,given daily doses of methotrexate intramuscular injection depth,mifepristone 50mg,two times a day,and then a B-knowledge,in the monitoring,found after a drug combined with gynaecology and obstetric operation type-B ultrasonic monitoring instrument in diagnosis and treatment of cesarean scar pregnancy after mass occurred in the bain line,and the surrounding the blood supply appeared to reduce and disappear.Blood B-HCG levels decreased.The operation of the instrument and the monitoring of the Qing Dynasty under ultrasound monitoring,after abdominal and vaginal B ultrasound monitoring,to avoid the abortion operation of obstetric and gynecological surgical guide device complications,reduce the occurrence of medical disputes.It also realizes the real-time digital recording and storage of the image during the diagnosis and treatment process.Resultsthe drug treatment and application,strengthen the guidance and application of ultrasound in obstetrics and gynecology surgical instrument,reduce the bleeding of uterine scar after cesarean section pregnancy,reduced complications.Conclusionthrough the follow-up of patient records,and proved that this method to reduce the risk,improve the patients quality of life etc.on the safe and effective.

Objective To study the value of serum intestinal fatty acid binding protein(I-FABP) and calcium levels for evaluating the effect of emergency surgical on the treatment of severe acute pancreatitis(SAP). Methods A total of 68 firstly diagnosed as SAP from June 2014 to October 2016 were collected into this study. The arrest time was less than 72 h and they were underwent emergency endoscopic or laparoscopic surgery. The serum I-FABP and calcium levels were detected 12 hours after surgery and analyze the values of serum I-FABP and calcium levels in evaluating the clinical effects by receiver operating characteristic curve(ROC). Results There were 33 cases with excellence, 21 cases with availability and other 14 cases with no-effect, the total efficacy rate was 79.4%. The gender, age, arrest time, APACHE Ⅱ score, derum amylase, blood glucose and total cholesterol levels were no statistical differences in effective group and no-effect group.The serum I-FABP levels 12 hours after surgery in effective group were lower and calcium levels were higher than no-effect group(P<0.05).The evaluating accuracy was 0.856, sensibility was 86.5%,specificity was 92.2%,cut-off value was 368 ng/mL of serum I-FABP by ROC analysis. And they were 0.844,83.5%,86.7% and 1.96 mmol/L of serum calcium level by ROC analysis. Conclusion Serum I-FABP combined with calcium can be used for evaluating the effects of emergency surgical on the treatment of the patients with SAP.

Objective To investigate the role of clinical pharmacist in medical therapy for a patient with cerebrovascular disease and epilepsy.Methods One patient was hospitalized due to headache and twitch.Clinical diagnosis was cerebral venous sinus thrombosis and epilepsy.During the treatment,the clinical pharmacist gave suggestion on drug selection of anti-infection and anti-epileptic therapy,assessed drug interaction between omeprazole-escitalopram and mannitoldexamethasone,monitored the adverse drug reaction of valproate,and provided medication education to the patient.Results Physician adopted clinical pharmacist's suggestion.The patient discharged with stable condition.Conclusion The participation of clinical pharmacists in the medication therapy of patients with cerebrovascular disease can reduce the risk of drug use and promote the efficacy and safety of medication.

BACKGROUND: Rapid development of tissue engineering is the new hope of repairing bone defect so as to obtain complete bone regeneration,and rapid proliferation of seed cells is one of the important factors in it.OBJECTIVE: To evaluate the proliferation and osteogenic differentiation of human mesenchymal stem cells (MSCs) plated at different cell density during subculturing period.DESIGN: Repetitive measurement.PARTICIPANTS: The experiment was conducted in the Trauma, Burn and Combined Injury Laboratory of the Third Military Medical University of Chinese PLA between January 2003 and March 2004. MSCs were obtained from iliac bone bone marrow of the 5 healthy male volunteers by separation and proliferation.METHODS: The MSCs of second generation were inoculated at 8×103/cm2,3×103/cm2, and 8×102/cm2, respectively, and then the growth curve was drawn and analyzed. After 18 days of proliferation and culture, the increased amount of MSCs was recorded to analyze the post-proliferation growth curve and osteogenic ability.MAIN OUTCOME MEASURES: ①Growth curve of cells plated at different cell density; ②Results of alkaline phosphatase(ALP) staining and immunohistochemical staining of osteocalcin.RESULTS: Human MSCs from bone marrow were CD34 negative and expressed low level of ALP. Population doubling time was 40 hours after MSCs were plated at 8×103/cm2 and the number of the cells was expanded (51±13) times after 18 days. MSCs were expanded (28±6) times 18 days after plated at 3×103/cm2. While plated at 8×102/cm2, the number of the cells was only expanded (5±3) times. Proliferative ability of cells cultured at a low density was stronger that that at a high density. MSCs could be induced to differentiate into the osteocytic lineages after plated at not only 8×103/cm2 but also 8×102/cm2.CONCLUSION: Cell density plays an evident role in the proliferation of MSCs. Cell density of 8×103/cm2 is proper to the rapid proliferation of MSCs as seed cells in bone tissue engineering.

OBJECTIVE To investigate the antimicrobial-resistant genes in meticillin-resistant Staphylococcus aureus(MRSA).METHODS Forty strains of MRSA were clinically isolated.Nine kinds of antimicrobial-resistant genes were analyzed by polymerase chain reaction(PCR).RESULTS The positive rates of mecA,aac(6′)/aph(2′)and tetM were all 100.0%.The positive rates of ermA/B/C,aph(3′)-Ⅲ,qacA/B,PVL and ant(4′,4″) were 82.5%,67.5%,45.0%,10.0% and 2.5%,respectively.CONCLUSIONS There are higher positive percentages of relevant resistance genes in MRSA isolates clinically.MRSA can induce clone transmition in hospital which should pay,and attention to the disinfection and isolation.

Objective To observe the biological behavior of chondrocytes in chitosan based hydrogel in vitro and to evaluate the possibility of chitosan and glycerophosphate mixed gel using as injectable scaffolds in tissue engineering.Methods A novel injectable thermosetting gel was made of chitosan and glycerophosphate mixture.Chondrocytes isolated by enzymic digestion from the articular cartilage of the young rabbits aged 3-4 weeks were cultured in monolayer system.After primary culture and subculturing,the cells were seeded in chitosan based gel in concentration of 5?10~7/ml in vitro.Characteristics of chondrocytes during 4-week culture were observed with invert microscope.MTT was used to detect the seed growth after one-week culture.In 4th week,after haematoxylin eosine and toluidine blue staining,the artifical cartilage was performed type Ⅱ collagen immunohistochemistry and observed by scanning electron microscope.Results Chondrocytes retained their round morphology,multiplied,and produced matrix in chitosan and glycerophosphate mixture gels.The results of immunohistochemistry were strongly positive.Conclusion That most chondrocytes appeared to occupy large areas of rough chitosan based gels,guarantees a suitable environment where chondrocytes secrete matrix macromolecules and preserve their round morphology in vitro.Chitosan and glycerophosphate mixture gel may be a vehicle for injectable tissue-engineered cartilage.

Objective To investigate the clinical characters and therapy of primitive neuroectodermal tumor(PNET).Methods A retrospective analysis was conducted.A 36-year-old female patient was showed pain and numbness of the right upper limb and back for 6 months.The cervical spine MRI showed a spindleshaped intradural mass right ventrolateral of spinal cord at C5-7 with in homogeneously enhancing.Surgery and pathologic examination confirmed that was PNET.Combiled with a series of literatures to analyse the clinical characters Results Surgery was performed to remove the tumor and decompression combined with radiotherapy.The pathologic examination and immunohistochemical analysis revealed that it was PNET.MRI identified local recurrence in spinal canal at 3 month later after surgery.Conclusion Spinal PNET is an uncommon intraspinal tumor with poor prognosis.Histopathology is the evidence of diagnosis.Optimal therapy has not yet been found.Surgical resection with the combination of chemo-radiotherapy or radiotherapy might get the better outcomes.Multidisciplinary treatment should be further clinical required.

Objective To assess the relationship between fruit intake and gastric cancer.Methods Articles published during January 2001 and October 2012 that assessed the relationship between fruit intake and gastric cancer were searched on PubMed,Ovid and Willey database.Adjusted relative risk (RR) and 95％ confidence intervals (CI) were calculated by using fixed-effect or random-effect model.Variants of subgroup analysis included living regions,followup duration,and adjusted factors.Results A total of 3679 gastric cancer patients and 1 173 859 subjects from 7 prospective cohorts were included in this metaanalysis,and the pooled RR was 0.89 (95％ CI:0.78-1.01).In the subgroup analysis,the pooled RR in the 10-year followup group was 0.94 (95％ CI:0.85-0.99) before age,cigarette smoking and alcohol drinking were adjusted (RR =0.81,95％ CI:0.54-0.99).Conclusion Fruit intake may prevent the development of gastric cancer.

Objective To evaluate the clinical efficacy of infliximab (IFX) in Crohn′s disease (CD) and its effects on mucosal healing and promoting fistula closure.Methods Between September 2007 and February 2011,relevant clinical data of CD patients treated with IFX in the Department of Gastroenterology,Ruijin Hospital were collected and the efficacy and safety of IFX were retrospectively analyzed.After IFX therapy,the efficacy evaluation included laboratory index,clinical efficacy,efficacy of fistula closure and mucosal healing.The data were analyzed using t test and Wilcoxon signed-rank test.Results A total of 22 patients were enrolled in this study,11 males and 11 females; the mean age was 29.3 years.The dosage of IFX was 5 mg/kg to 10 mg/kg at week 0,2,6to induce remission,and every 8 weeks on maintenance therapy.Of 22 patients,16 patients were active CD.One case dropped out.At week 14,of the remaining 15 cases,11 cases achieved clinical remission,two cases achieved clinically effective and two cases were ineffective.Crohn′s disease activity index (CDAI) (112±80) and ESR [(13±11) mm/1 h] of week 14 decreased compared with that of week 0 [(186±88),(21± 15) mm/1 h,P=0.04 and 0.007].Two cases of 10 patients with fistula dropped out as a result of ineffective,while eight cases had a partial response and six patients sustained response during the maintenance therapy,but no fistula closed and completely disappear.Seven patients reviewed by endoscopy after five times IFX therapy (24 weeks),after therapy the simple endoscopic score for Crohn′ s disease (SES-CD) ( 3.21 ± 2.89 ) decreased compared with that before treatment (5.86±3.02) (Z＝-2.38,P＝0.018).Eleven times of adverse events were found in nine patients,infusion reaction and respiratory tract infection were more common and no severe adverse effect was observed.Conclusions IFX can rapidly improve clinical symptoms and with good safety.The effects in mucosal healing and fistula closure may occur at early medication.

ObjectiveTo investigate the clinical features and the efficacy of medium-and long-term immune suppression in the treatment of Crohn's disease (CD) in Chinese Han nationality.MethodsThe clinical data and diagnosis methods of 178 CD patients between 2003 and 2010 were analyzed.All patients received predinisone and immune suppression (azathioprine) treatment.The patients were followed up every 2 weeks.Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were reviewed every 4 weeks.CD activity index (CDAI) was scored every 3 to 6 months.ResultsThe peak age for onset of CD was between 18 to 30 years old,and the mean time from the appearance of symptoms to diagnosis was (8.3±3.7) months.About 34.8％ (62/178 cases) patients had corresponding complications at time of diagnosis due to the progress of the disease.The average dosage of azathioprine was (1.24±0.16) mg/kg,and the total withdrawal rate due to adverse effect was 15％ (25/167 cases).The surgical intervention rate was 15.1％ (22/146 cases) during long-term follow-up.ESR and CRP of patients decreased obviously and tended to normal after 3 months treatment.The CDAI score significantly decreased after 6 months treatment.Conclusions Most Chinese patients had a good tolerance of immune suppression and achieved better medium- and long-term clinical efficacy at the dosage lower than that recommended by European and United States guidelines.