Objective To analyze the mechanical stimulation to the endometrium on the clinical pregnancy rate and embryo implantation rate in the frozen thawed embryo transfer of hormone replacement therapy.Methods There were 193 patients undergoing the frozen thawed embryo transfer of hormone replacement therapy.According to the endometrial condition on the second or third day of the menstrual cycle,they were divided into three groups.Group A,54 patients whose endometrial thickness was no less than 0.6 cm or abnormal endometrium were operated the mechanical stimulation.Group B,55 patients whose endometrial thickness was no less than 0.6 cm or abnormal endometrial were not operated the mechanical stimulation.Group C,84 patients whose endometrial thickness was less than 0.6 cm and normal endometrium.Each group was divided into blastomere transplantation and blastula transplantation.Group A was 23,31 patients,group B was 24,31 patients,group C was 39,45 patients.The age,number of embryo,level of estradiol when injecting chorionic gonadotrophin,clinical pregnancy rate and embryo implantation rate were compared.Results (1) The clinical feature of blastula transplantation.The age,number of embryo,embryo implantation rate among three groups had no significant difference (P ＞ 0.05).The clinical pregnancy rate in group A and group C was significantly higher than that in group B [73.91％ (17/23),69.23％ (27/39)vs.37.50％(9/24)] (P ＜ 0.05),and there was no significant difference between group A and group C (P ＞ 0.05).The level of estradiol when injecting chorionic gonadotrophin in group C was significantly higher than that in group B [(841.56 ± 802.73) μ g/L vs.(293.34 ± 69.14) μ g/L] (P ＜ 0.05).There was no significant difference between group A and group B,group A and group C (P ＞0.05).(2)The clinical feature of blastomere transplantation.The age,number of embryo,level of estradiol when injecting chorionic gonadotrophin,embryo implantation rate and clinical pregnancy rate among three groups had no significant difference (P ＞ 0.05).Conclusions Mechanical stimulation to the endometrium can significantly improve the clinical pregnancy rate of blastula transplantation.It has no improvement for embryo implantation rate and clinical pregnancy rate of blastomere transplantation.

Objective To analyze the clinical distribution and antimicrobial resistance of Pseudomonas aeruginosa (PA) so as to guide the reasonable clinical use of antibiotics .Methods The results of drug susceptibility testing of PA strains isolated from pa‐tients in the Hongqiao Hospital from Jan .2010 to Dec .2013 and distribution of specimens were retrospectively analyzed .The WHO‐NET5 .5 software was used for data statistic analysis .Results A total of 752 PA strains were isolated and were most isolated from sputum(accounted for 86 .8% ) ,followed with secretions(accounted for 5 .7% ) .The drug resistance rates of PA to imipenem ,mero‐penem and cefoperazone‐sulbactam were 1 .6% ,2 .9% and 1 .9% ,respectively ;while the drug resistance rates to ciprofloxacin ,levo‐floxacin ,amikacin ,gentamicin ,tobramycin ,cefepime and piperacillin‐tazobactam were 11 .3% ,12 .5% ,14 .0% ,16 .5% ,15 .0% , 11 .6% and 14 .1% ,respectively ;the drug resistance rates to other antibiotics were higher than 20 .0% .The drug resistance rate to sulfamethoxazole‐trimethoprim was the highest(81 .4% ) .Conclusion PA may mainly induce respiratory tract infections ,and the drug resistance rates of PA to the commonly used antibiotics are relatively low .The clinicians should reasonably use antibiotics so as to reduce the resistant strains .

on the basis of systematic examination to the policy system of private medical institutions, this paper summarize the current situation and main problems of the policy system, including basic concepts, related issues a-bout the non-state owned enterprise management, important policies about the non-profit medical institutions, the ab-sence of some main policies. To solve these problems, this paper puts forward specific suggestions, such as to speed up the legislation, to make standards of non-profit medical institutions judging and qualification of exempt from tax in details, to construct the reasonable return system for the investors, to extend the tax holidays for the profit-making medical institutions, to make sure private medical institutions have equitable access to qualification in pilot hospital of healthcare insurance, to improve the transformation mechanism between Non-profit and profit-making institutions, to formulate specific measures.

Objective:To investigate the clinicopathological characteristics of extraskeletal myxoid chondrosarcoma(EMC).Methods:Nine cases of extraskeletal myxoid chondrosarcoma were studied.Immunohistochemical analysis was performed in all cases and ultrastructural studies were done in 2 extraskeletal myxoid chondrosarcomas.Follow-up information was available for seven patients.Results:There were 7 males and 2 females whose ages ranged from 31 to 69 years(median 52.78 years).Local pain or tenderness and the presence of a palpable mass were the main complaints of the patients.The tumors were located mainly in the lower extremities(66.7%).Most tumors were deep-seated.They usually had a distinct multinodular configuration delineated by fibrous connective tissue.The tumor cells were arranged in delicate intersecting strands,rings,and garlands for the most part.The myxoid matrix was abundant in most cases.Immunohistochemical analysis was performed in all cases and ultrastructural studies were done in 2 extraskeletal myxoid chondrosarcomas.EMC expressed vimentin(100%,9/9),neuron-specific enolase(77.8%,7/9),S-100 protein(66.7%,6/9),synaptop hysin and chromogranin A(22.2%,2/9),None of the tumors expressed EMA and desmin.Ultrastructurally,EMC was characterized by distinct cords of cells immersed in a glycosaminoglycan rich matrix.The cells were rich in mitochondria,had well-developed Golgi apparatus and there were numerous smooth vesicles.In many cells,there were also prominent glycogen deposits and lipid droplets.Some tumor cells had intracisternal microtubules.In one of 2 extraskeletal myxoid chondrosarcomas there were 140～180 nm diameter membrane-bound dense-core secretory granules in cell bodies.Conclusion:Extraskeletal myxoid chondrosarcoma is a rare soft tissue sarcoma characterized by distinctive morphological and cytogenetical features.It was believed to represent a variant of soft-tissue chondrosarcoma owing to its histological resemblance to chondroblastic tissue in the early stages of cartilage development or chondroid tumors such as skeletal chondrosarcoma.However,the chondroid nature has been a subject of controversy,and its line of differentiation remains to be determined.A substantial proportion of EMC show immunophenotypic and/or ultrastructural evidence of neuroendocrine differentiation.EMC has high potential of local recurrence and metastasis,and a high disease-associated death rate.

Superoxide dismutase was prepared from human crythrocytes. The sample was purified using a DEAE-cellulose column and chromatography on Sephadex G-75. During purification the produce determined the protein peak and SOD active peak at the same time to decide the SOD was present. The enzyme exhibited an ultraviolet absorption spectra with a maximum at 270-275 nm. Polyacrylamide disc gel electrophoresis revealed three bands which were in dose agreement with the active bands by reduction of NBT. The molecular weight was 41687, 31623 and 15136. The specific activity of human SOD possessed 3300 units per mg It contained 2 eq of Cu, Zn per mole of enzyme, respectively.

Objective To evaluate the clinical efficacy of compound Danshen and Cerebrolysin Vial combination therapy in treating cases of neonatal hypoxic ischemic encephalopathy(HIE).Methods 90 cases of neonatal HIE hospitalized form May 2005 to September 2006 were randomly separated into an experiment group and a control group.On the basis of conventional trigeminal supporting treatment,the experiment group was treated with additional compound Danshen and Cerebrolysin Vial combination therapy.At the end of therapeutic courses,overall effective rate was evaluated.Results The overall effective rate of the experiment group was 95.56%,comparing with a 77.78% overall effective rate in the control group.The overall effective rate of the experiment group was significantly different from the control group (P＜0.05).Conclusions Compound Danshen and Cerebrolysin Vial combination therapy was significantly effective in treating neonatal hypoxic ischemic encephalopathy.This therapy is recommendable in daily clinical treatment of HIE.

On the basis of drawing on recently published literature on international medical tourism, this paper comprehensively summarizes the effects thereof on driving economic growth, expanding employment and improving in-ternational competitive power, analyzes the main driving forces for the international medical tourism development and the experiences from Thailand, India, Malaysia, Japan, South Korea, etc. According to China’s advantages and dis-advantages and learning from the international experience, this paper proposes suggestions to develop China’s interna-tional medical tourism, including an improvement to the management system, formulating international medical tourism development strategies, building brand characteristics with traditional Chinese medicine, constructing ‘Ex-perimental and Leading Area’ , and promoting international certification for the medical institutions and services.

Objective:To study the relationship between TCM syndrome type of chronic diarrhea, chronic diarrhea and negative colonoscopy terminal ileum lesions by colonoscopy.Methods:104 cases in our hospital underwent colonoscopy patients (each patients colonoscopy pushed to the terminal ileum is more than or equal to 20 cm) were divided into control group and observation group by examination results, each with 52 cases. The patients in the control group had no chronic diarrhea and the observation group had negative chronic diarrhea. The observation group was given the lines of traditional Chinese medicine syndrome differentiation typing, and chronic diarrhea associated with ileum end lesions were given death drop spirit combined micro ecological preparation, and then review the lesions after 15 days.Results: In the observation group, 1 case was TCM sub type of damp heat in spleen and stomach (1.92%), 2 cases were spleen deficient deficiency (3.84%), 3 cases were liver stagnation (5.77%), 4 cases were deficiency of spleen and liver (7.69%), 8 cases were cold-dampness disturbing spleen (15.38%), 9 patients were liver stagnation and spleen deficiency (17.31%), 11 cases were spleen and kidney deficiency (21.15%), and 14 cases were spleen wet trapped (26.92%). There were 37 cases (71.15%) in the observation group of patients with ileal mucosal edema, congestion, erosion and ulceration and 12 cases in the control group (23.08%). The differences between the two groups were statistically significant (x2=24.12,P<0.05). There were 38 cases in the observation group and 7 cases in the control group with ileal follicular hyperplasia. There were 18 cases were mid hyperplasia in the observation group and 8 cases in the control group. The differences were significant(x2=37.64,x2=21.31;P<0.050). The size of patients with hyperplasia was 4.5mm in the observation group and 1.2mm in the control group. The differences between the two groups were statistically significant (Z=13.05,P<0.05). 46 cases of chronic diarrhea symptoms disappeared after treatment and 26 cases of colonoscopy terminal ileum lesions were improved. The differences before and after treatment were statistically significant (70.27%).Conclusion: Patients with chronic diarrhea syndrome are found lesions in terminal ileum. The symptom would disappear or be greatly improved after medicine treatment. It can be promoted as a reference standard of clinical medication.

Objective To study the efficacy arid side effects of postoperative analgesia between Lornoxicam and Buprenorphine. Methods Sixty ASA I-II patients were randomly divided into Lomoxicam group(group A) and Buprenorphine group(group B). Analgesiae were subcutaneously injected via an electronic patients controlled analgesic pump post surgeries. The visual analgesiae sacle( VAS) was used to evaluate the postoperative pain relief,and analgesic response was recorded. Result There were no significant differences between Lomoxicam and Buprenorphine about the analgesic response(P>0. 05),moreover,no stastical differences in the patients demography,analgesic and anesthetic type were associated with the analgestic outcomes. Conclusion Lomoxicam without respiratory distuber-ance was a good alternative to Buprenorphine in PCSA.

Objective To study the efficacy and side effects of tramadol combined with and fentanyl for patient-controlled analgesia(PCA) after pancreatectomy. Methods 30 ASA Ⅰ-Ⅱ patients were randomly divided into tramadol group (group A) and droperidol group ( group B). Results Sedation score in group B at 24 h was significantly higher than that in group A(P ＜0. 05). Side-effects were significantly more in group B than those in group A. Conclusion The analgesia efficacy of tramadol combined with and fentanyl was effective and safe with less side effects than Droperidol