Objective To study the value of hysteroscopy and laparoscopy in the diagnosis and treatment of the complication of intrauterine device (IUD). Methods 55 patients with IUD complications who had previous (1～12) times of unsuccessful operations were performed by hysteroscopy and laparoscopy. The results were retrospectively analyzed. Results 45 abnormal IUD of deformed or broken or remained in uterus were successfully taken out under hysteroscope, and 1 case converted into open operation. 9 ectopic IUD in abdominal and pelvic cavity were successfully taken out under laparoscope. No operative complication occurred. Conclusions Hysteroscopic and laparoscopic operations have the advantages of clear diagnosis, higher successful rate and minimal invasion for the diagnosis and treatment of IUD complications. Abnormal IUD and ectopic IUD out of uterine cavity had better choose hysteroscopic and laparoscopic operations.

Objective To evaluate the short-term and long-term efficacy of conservative laparoscopic surgery combine with goserelin in treatment of severe ovarian endometriosis.Methods From January 2004 to December 2008,206 patients with severe ovarian endometriosis underwent laparoscopy surgery in Nanjing Drum Tower Hospital,Affiliated Nanjing University Medical School were enrolled in this retrospective study.According to the revised classification American Fertility Society (r-AFS), 123( 123/206,59.7％ ) cases were at stage Ⅲ and 83 ( 83/206,40.3％ ) patients were at stage Ⅳ.Among 138 cases presented pelvic pain.All the patients underwent laparoscopic cystectomy,of which 117 patients with childbearing preserving underwent hysteroscopy and hydrotubation examination,including 7 cases with bilateral salpingectomy,2 cases with bilateral tubal obstruction and 108 cases with normal reproduction.After surgery,all cases were administered by goserelin treatment at dose of 3.6 mg per 28 days for 3 to 6 months.At 1 to 5 years following up,pelvic pain,pregnancy and recurrence were observed,those factors associated with pregnancy rate and endometriosis recurrence were analyzed.Results (1)Pelvic pain:complete remission rate of pelvic pain was 76.1％ ( 105/138 ) at 1 to 5 years after surgery.(2) Pregnancy:total pregnancy rate was 70.4％ (76/108),spontaneous pregnancy rate was 68.8％ (66/96) and pregnant rate of in vitro fertilization and embryo transfer (IVF-ET) was 10/12.Pregnancy rate at 1 year was 57.3％( 55/96 ) and accounting for 83.3％ ( 55/66 ) in all pregnant womon.Live birth rates of spontaneous pregnant and IVF-ET were 86.4％ ( 57/66 ) and 9/10,respectively.( 3 ) Recurrence:the total recurrence rate was 8.3％ ( 17/206 ) at 1 to 5 years.The recurrence rates and the cumulative recurrence rates were 3.9％(8/206) and 3.9％ (8/206) at the first year after operation,2.0％ (3/149)and 6.7％ ( 10/149 )at the second year,1.0％ (1/99) and 8.0％ (8/99) at the third year,10.9％ (5/46)and 17.4％ (8/46) at the fourth year,0 and 2/18 at the fifth year,respectively.Conclusion It was suggested that conservative laparoscopic surgery combined with goserelin in treatment of stage Ⅲ or Ⅳ ovarian endometriosis could reduce the recurrence risk of severe ovarian endometriosis and improve the pregnant rate of endometriosisassociated infertility.

【Objective】To analyze the structure of N-linked glycans in salivary glycoproteins and amylase of chronic gastritis(CG)patients with spleen deficiency after stimulation of acid,and to explore the relationship of N-linked glycans structure with salivary amylase activity and splenic hypofunction.【Methods】Iodine-spectrophotometry was used to detect the amylase activity in 47 CG patients with spleen deficiency,15 CG patients with dampness-heat in the spleen and stomach,and 12 healthy volunteers before and after acid stimulation.Method of concanacalin A(ConA) affinity chromatography was used to separate total salivary glycoproteins and amylase and to analyze N-linked glycans structure in 27 CG patients with spleen deficiency,14 CG patients with dampnessheat in the spleen and stomach,and 5 healthy volunteers after acid stimulation.ConA affinity reversed-phase two-dimension chromatography was applied to separate total salivary glycoproteins and to analyze the constitute and distribution of total salivary glycoproteins with different N-linked glycans in 13 CG patients with spleen deficiency,6 CG patients with dampness-heat in the spleen and stomach,and 5 healthy volunteers after acid stimulation.【Results】After acid stimulation,salivary amylase activity in CG with spleen deficiency decreased as compared with that before acid stimulation(P

Objectives:To evaluate the effect of different teeth arrangement methods on the masticatory efficiency of complete dentures.Methods: Three complete dentures for each of ten edentulous patients were made respectively by using maxillary teeth arrangement,mandibular teeth arrangement and comprehensive teeth arrangement methods.After three months of wearing,the masticatory efficiency of the three complete dentures was tested by light absorption method,and was compared to that of dentulous subjects.Results:The masticatory stroke and masticatory efficiency in denture wearing group were fewer and weaker than those in dentulous group in either bilateral mastication or unilateral mastication. Good masticatory efficiency was gained after three months of wearing the complete dentures made by the three different teeth arrangement methods.There were no significant difference in the masticatory stroke and masticatory efficiency of complete dentures made by mandibular teeth arrangement and comprehensive teeth arrangement methods,but they were both higher than those made by maxillary teeth arrangement method.Conclusions:The complete dentures made by mandibular teeth arrangement method and comprehensive teeth arrangement method are feasible for restoration of masticatory efficiency of endentulous patients.

Objective To investigate the effects of propofol on the spontaneous transient outward K+ currents in mouse cerebral arterial smooth muscle cells.Methods Kunming mice of both sexes,weighing 18-22 g,were used in this study.Vascular smooth muscle cells were freshly isolated from cerebral arteries in two steps.Five cells were chosen and studied.When holding potential was - 30 mV,spontaneous transient outward K+ currents were recorded before and after the application of 56 μmol/L propofol by perforated whole-cell patch-clamp technique.The amplitude,frequency,area under the curve and half time width of spontaneous transient outward K+ currents were analyzed.Results Propofol 56 μmol/L significantly increased the amplitude,frequency and area under the curve of spontaneous transient outward K+ currents.There was no significant change in the half time width of spontaneous transient outward K+ currents after administration,Conclusion Propofol can activate spontaneous transient outward K+ currents in mouse cerebral arterial smooth muscle cells,and thus induces vascular smooth muscle relaxation.

Aim To study the growth inhibitory effect of the conjugate ( ovarian cancer specific targeting peptide and cisplatin, OSTP-DDP ) that targeting ovarian cancer cells A2780. Methods Using chemical method to syn-thesize OSTP-DDP, ovarian cancer cells A2780 were cul-tured in vitro, using CCK-8 method ( Cell Counting Kit-8) to detect the growth inhibitory effect of ovarian cancer A2780 cells, which were disposed by OSTP-DDP and DDP. Annexin V-FITC was used to detect the cycle and apoptosis effect of ovarian cancer A2780 cells which were disposed by OSTP-DDP and DDP. Results According to the mass spectrometry and the high performance liquid chromatography ( HPLC ) analysis, OSTP-DDP was proved to synthesize successfully. CCK-8 assay showed that both OSTP-DDP and DDP could play the growth in-hibitory effect and showed a concentration-dependent manner when cells were treated in different concentrations (10,20,40,80,160,320μmol·L-1 ) respectively after 24 h, 48 h, 72 h. And the effect of OSTP-DDP was stronger than DDP (P<0. 05), indicated OSTP-DDP had targeted cytostatic effect. The result of the flow cytometry showed that cell cycle was mostly arrested in G1 phase after 72h treated by OSTP-DDP and DDP, the inhibitory effect of OSTP-DDP was stronger than DDP (P<0. 05). The apop-tosis effect of OSTP-DDP was stronger than DDP ( P <0. 01),suggested that OSTP-DDP had a stronger targeting apoptosis-inducing effect. Conclusion OSTP-DDP has the targeting growth inhibitory effect on the ovarian cancer cell A2780, OSTP as a chemotherapeutic drug targeting vector has a great prospect to treat ovarian cancer.

Aim To investigate whether DATS induce MGC803 cell apoptosis and the relationship betweenapoptosis and Ca~(2+) disruption. Methods MGC-803 cell growth inhibition was measured by MTT assay. Tunnel and flow cytometry methods were used to determine the induction of apoptosis and Ca2+ homeostasis disruption. Result MTT assay showed that the inhibitory rates on MGC-803 cell growth of different concentrations of DATS 4,8,12,16 and 24 mg?L-1 were 0.231?0.037,0.305?0.036,0.455?0.029,0.607?0.058,0.751?0.019 respectively. Flow cytometry analysis showed that treating MGC803 cell with DATS significantly increased the percentage of apoptosis cells and intracellular Ca2+. Treatment of cells with 1,2-bis(2-aminophenoxye-thane)-N,N,N-tetraacetic acid tetrakis acetoxymethyl ester (BAPTA-AM), cellular Ca2+ chelator, resulted in abolishment of the elevation of intracellular Ca~(2+) and blockage of DATS induced apoptotic of MGC-803. Conclusoin DATS could induce apoptosis of MGC-803 cells through the mechanism of Ca~(2+) homeostasis disruption.

Objective To develop a core competence evaluation index system for preventive medicine undergraduates.Methods Following the scientific,systematic and applicable principles,we proposed evaluation index system of core competence for professional medical prevention and selected 35 experts for three rounds expert consultation on the index system by using Delphi method.The basic situation,the positive and authority degree of experts and all levels of index weight coefficient were analyzed using SPSS 13.0 software.Results The core competence evaluation index system for preventive medicine undergraduates included six dimensionalities,fifteen secondary indicators and forty-nine tertiary indicators.The six dimensionalities included professional value behavior (0.25),professional knowledge and skills (0.28),basic specialized knowledge (0.20),communication (0.13),information management (0.06) and systems thinking (0.08).Conclusion The establishment of the evaluation system can provide a scientific and objective reference for the evaluation of the core competence of medical students.

Objective:To analyze the clinicopathological features of giant ovarian masses(mean diameter≥10 cm)and analyze the clinical characteristics of patients in different age groups.Methods:The clinicopathological characteristics of 311 patients diagnosed with giant ovarian masses by surgery at Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from January 2014 to December 2022 were retrospectively analyzed.Patients were further stratified by age and mass size to compare the differences of clinical and patho-logical features among different age groups and different mass diameter groups.Results:①The median age of thepatients were 44(24,60)years old.The first symptoms were as follows:ovarian mass discovered during physi-cal examination,abdominal pain,bloating,conscious abdominal distension,and symptoms of compression.②The surgical methods were as follows:unilateral oophorectomy(30.5％,95/311),ovarian cystectomy(28.9％,90/311),tumor staging or cytoreductive surgery(28.0％,87/311),total hysterectomy with bilateral adnexectomy(12.5％,39/311).③The pathological types were benign(49.5％,154/311),malignant(31.8％,99/311)and borderline(18.7％,58/311).④ Patients complained abdominal distension in＜20 years old group were signifi-cantly higher than the other two groups(P＜0.05).The ovarian resection rate in the＞50-year-old group was higher than that of the other two groups(P＜0.05),and the rate of unilateral ovarian resection in the＜20-year-old group was still as high as 30.1％(15/49).⑤ The size of the mass correlated with the duration of the disease.When the disease course was between 1 to 6 months,the mass diameter line＞30 cm was the most common(P＜0.05).The incidence of borderline tumors in the＞30 cm group was significantly higher than that in the other two groups,and the difference was statistically significant(P＜0.05).Conclusions:Ovarian mucinous and mucinous borderline tumors are the most common types of giant adnexal masses.The size of the mass tends to increase with the prolongation of the disease course.The incidence of borderline tumors increases with the in-crease of mass.Health education for young people should be strengthened.When abdominal pain,abdominal bloating,especially lower abdominal distension occurs,they should seek medical treatment in time to avoid adnex-ectomy due to borderline tumors.