Objective To evaluate the effects of different laparoscopic approaches for hysteromyomectomy. Methods Hysteromyomectomy was performed on 126 patients who required surgical treatment and preservation of the uterus from August 2000 to December 2002 with different laparoscopic approaches. A follow-up for 2-28 months was conducted in all patients. Results There were 70 cases of subserous fibroids, 53 cases intramural fibroids, and 3 broad ligament fibroids in those 126 patients. The average diameter of the fibroids was 6.1 cm (3-12 cm). The diameter of the fibroids less than 5 cm was found in 33 patients (26.2%), but equal to or larger than 5 cm in 93 patients (73.8%). A single myoma was found in 57 patients (45.2%), but numerous myomas in 69 patients (54.8%). Hysteromyomectomy, hysteromyomectomy and uterine artery blockage, and hysteromyomectomy and temporary uterine artery blockage were performed on 26, 70, and 30 patients, respectively. Operations were successful in all patients. There were no intra- and post-operative complications. Conclusion Different laparoscopic approaches for hysteromyomectomy can result in satisfactory clinical outcomes when different case properties and different requirements of patients are taken into consideration.

Objective To examine whether activation of nuclear factor-?B (NF-?B) exists in skin lesions of patients with systemic lupus erythematosus (SLE ) and its association with disease activity. Methods The skin lesions were inves tigated histopathologically in patients with SLE, and NF-?B activation was ass essed by immunohistochemical analysis semi quantitatively. Results Expression o f NF-?B was found on skin lesions in 14 of 15 patients with SLE, including 8 s trong positive (), 3 moderate positive (), and 3 mild positive (+). Brown-coloured particles were mainly distributed in keratinocytes, especially in prick le cells and granular layer cells, as well as in mononuclear cells of dermis. Th ere was no correlation between NF-?B activation and disease activity. However, NF-?B was not detected in skin lesions of all patients with non-SLE and heal thy controls. Conclusions NF-?B activation may be associated with the developm ent of skin lesions in patients with SLE,and not with disease activity.

Objective To develop a reliable scale for evaluating medication compliance among patients with chronic diseases in China.Methods An initial item pool was generated by literature review,based on the definition of compliance generally accepted in China.The items were then subjected to item selections by using item answer distribution and other four methods,which resulted in a primary scale with 16 items.The reliability and validity of this scale was examined.Results Common factors extracted by factor analysis were well explained,there being a close correspondence between the scale construction and the theoretical construction. Convergent validity with the patients' self-ratings on medication compliance ranged from 0.55 to 0.59,and the correlation coefficient with the score of Morisky questionnaire was 0.58.The Cronbach ?,0 and ? coefficients were 0.717,0.751,0.893 respectively,and test-retest reliability was 0.95.Conclusion The newly developed scale appears reliable and may be a useful tool for measuring drug compliance among patients with chronic diseases,but there are still areas where further improvements may be needed.

Patient-reported outcomes (PROs) provide clinical researchers with a good means to assess patient-based outcomes. Yet there are still some problems to pay attention to while using PROs as an effectiveness assessment index, including the selection of an appropriate scale of PRO, quality control in PRO data collection, and the interpretations and application ranges of the PRO results.
Outcome Assessment (Health Care) ; methods ; Patient Satisfaction ; Psychometrics ; Quality Control

Purpose To investigate the value of real-time three-dimensional contrast-enhanced ultrasound (RT3D-CEUS) for the evaluation of blunt renal trauma hemorrhage. Materials and Methods Nine healthy New Zealand white rabbits were randomly divided into three groups, and after heparinization, the models of ongoing hemorrhage of blunt renal trauma were developed by self-made minitype striker in the three groups with different force levels:77.2 N (group A), 106.2 N (group B), 135.1 N (group C). All rabbits were performed ultrasonography (US), color Doppler flow imaging (CDFI) and RT3D-CEUS before and after strike (within 20 minutes). The results achieved by US, CDFI, 2D-CEUS (A-plane results in RT3D-CEUS) and RT3D-CEUS were compared with each other, and further compared with the pathological results of the executed animals after blood pressure decreased lower than 40 mmHg. Results All rabbits showed traumatic renal lesions and it proved that the bigger the force the heavier the injury (group A: 1 case of levelⅠ, 2 cases of levelⅡ;group B:3 cases of levelⅢ;group C:1 case of levelⅢ, 2 cases of level Ⅳ ). After strike, US identified the presence of increasing hematoma under the capsule but could not detect active bleeding. In CDFI, only 1 case was detected ongoing hemorrhage. 2D-CEUS clearly presented the bleeding in all cases. RT3D-CEUS presented a vivid real-time and stereoscopical image of active hemorrhage in all cases and also showed that the wider the bleeding area was shorter than the shock duration time. Conclusion RT3D-CEUS can present a real-time dynamic bleeding and locate headstream of blood in renal trauma vividly and stereoscopically, and can be used to preliminarily evaluate the degree of ongoing hemorrhage in traumatic kidney.

Objective To study the characteristics and clinical significance of the coronary plaques in patients with benign prostatic hyperplasia (BPH).Methods A total of 91 patients undergoing coronary artery angiography (CAG) were selected and divided into two groups according to with or without BPH,56 cases in BPH group,46 cases in control group.The qualitative and quantitative characteristics of 102 lesions area were analyzed by intravascular ultrosound (IVUS),including external elastic membrane-cross-sectional area (EEM-CSA),minimal lumen area (MLA),plaques area (PA),plaques burden (PB),reference external elastic membrane-cross-sectional area (REEM-CSA),reference minimal lumen area (RMAL),reference plaques area (RPA) and reference plaques burden (RPB).Results IVUS showed a higher rate of area stenosis than did the CAG [(58.2± 7.1)％ vs.(55.9 ± 5.2)％,P＜0.01].BPH group had more soft plaques,eccentric plaques,positive remodeling and less calcified than did the control group (P＜0.05).The MLA and RMAL of BPH group were smaller than those of control group:MAL [(5.61±0.96) mm2 vs.(6.06±0.75) mm2,P＜0.05],RMAL[(9.26±1.05) mm2 vs.(10.02±1.10) mm2,P＜0.05]； while the EEM-CSA,PA,PB,RPA,RPB were larger than those of control group:EEM-CSA[(14.51±1.10)mm2 vs.(13.37±1.02)mm2],PA[(8.90±1.24) mm2 vs.(7.31±1.04) mm2],PB[(61.26±6.53)％ vs.(54.53±5.69)％],RPA[(4.26±1.15) mm2 vs.(3.73±1.33) mm2],RPB [(31.30±8.37) ％ vs.(26.81±8.75) ％,P＜0.05].Conclusions IVUS has a higher value on evaluation of mild to moderate coronary artery stenosis.Evidence of myocardial ischemia in patients with BPH needs further excludeing coronary heart disease.

Objectives: To evaluate the clinical significance of nuclear matrix protein 22 (NMP 22) in the detection of bladder transitional cell carcinoma (BTCC) and compare with voided urine cytology(VUC). Methods: A total of 69 cases with voided urine samples for NMP 22 and VUC test were included in this study. Thirty of them were BTCC patients(BTCC group) and twenty nine suffered from other urological diseases (nonbladder cancer group, NBC group). Ten were healthy volunteers (control group). Results: The NMP 22 values for BTCC group (67.3 U/ml) were significantly higher than that of NBC group(7.4 U/ml) and control group (4.3 U/ml)( P 0.05). NMP 22 was more sensitive than VUC in low grade BTCC(Ⅰ,Ⅱ)(62.50% vs 12.50%,P 0.05). Conclusions:Urinary NMP 22 is a useful marker for the early diagnosis of BTCC. It is more sensitive than VUC in low stage and grade BTCC.

[ABSTRACT]OBJECTIVETo evaluate the short-term efficacy of Eustachian tube balloon dilation (ETBD) in the treatment of symptomatic Eustachian tube dysfunction (SETD) by subjective and objective analysis.METHODS Forty patients who underwent ETBD were included. Subjects’ inclusion criteria were as followed: symptoms of ETD (aural fullness predominantly, with or without otalgia, muffle hearing and tinnitus), normal tympanic membrane, type A or C tympanograms, and without a history of any middle ear diseases. Main outcomes including subjective improvement, otoscopy, pure-tone audiometry, impedance audiometry, R-value in tubomanometry (TMM) and Eustachian Tube Score (ETS) were assessed 1 week and 6 months postoperatively.RESULTSAll cases were dilated successfully. A significant effect of treatment was documented when measuring subjective improvement, impedance audiometry, R-value in TMM and ETS 1 week and 6 month postoperatively. Subjective symptoms were not relieved only in one patient. The overall success rate for all patients was 98%.CONCLUSIONETBD can provide short-term benefits to those who are diagnosed with SETD and refractory to medical management. SETD might be an optimal indication for ETBD in the treatment of ETD.

Objective To investigate the role of erythropoietin(EPO)in relieving the injury of human renal tubular cells (HK-2) induced by postasphyxial-serum of neonates.Methods Human renal proximal tubular cell(HK-2) was used as the target cell.The experiment was designed as control group, asphyxia group,and group of pretreatment with EPO. The attacking concentration of serum was 200 mL/L,then the changes of morphology were observed under inverted microscope,and the cell viability was measured by 3-(4,5-dimethy lthiazcl-2-yl)-2,5-diphenyl-tetazolium bromide(MTT) methods,and the leakage rate of lactate dehydrogenase(LDH) was determined by biochemical methods.Results Compared with control group,the change in morphology of HK-2 was most serious and obvious,and the leakage rate of LDH increased significantly,and the cell viability decreased obviously in asphyxia group.But compared with asphyxia group,the change in morphology of HK-2 was obviously improved,and the leakage rate of LDH decreased and the cell viability increased in group of pretreatment with EPO in a dose-dependent manner except the group of 1 IU/mL.Conclusion EPO can play the role in relieving the injury of renal tubular cells induced by postasphyxial-serum in neonates.

Objective To explore the significance of nuclear factor-?B(NF-?B)activation in peripheral blood mononuclear cells(PBMC)during acute Kawasaki disease(KD).Methods Peripheral blood was collected from children with acute KD(n=30)and healthy age-matched children(n=20).PBMC were cultured in vitro and divided into 3 groups:naturally cultured blank control group,protein kinase C(PKC)activator stimulated phorbol 12-myristate 13-acetate(PMA)group and PMA plus NF-?B inhibitor treated PMA plus pyrrolidine dithiocarbamate(PDTC)group.Percentages of NF-?B activation were detected by immunohistochemistry.Results Under natural culturing,the percentage of cells with activated NF-?B was significantly higher in acute KD blank control group than that in healthy blank control group.The percentage of cells with activated NF-?B was significantly higher in acute KD PMA group than that in acute KD blank group and that in normal control PMA group,respectively(Pa0.05).Conclusions NF-?B activation in PBMC during acute KD is markedly increased,which suggests that NF-?B activation plays an important role in the formation of vasulitis and CAL in this disease.NF-?B activation in PBMCs in children with KD is regulated by the PKC signaling pathway and PDTC obviously inhibits the activation of NF-?B.J Appl Clin Pediatr,2009,24(1):35-37