Objective To assess the effect of dilute pituitrin solution (0.05 U/ml) on blood loss and distention fluid intravasation during hysteroscopy. Methods From January 2003 to June 2004, 68 women with abnormal uterine hemorrhage undergoing hysteroscopic endometrial resection were randomly divided into treatment and control groups (34 cases in each). In the treatment group, dilute pituitrin solution (0.05 U/ml) was injected into the cervix before dilation of the cervix in preparation for hysteroscopy, while the patients in the control received no pituitrin injection. Results The mean operation time in the treatment group was significantly shorter than that in the control [(32.2?6.0) min vs (35.9?6.8) min; t=-2.379, P=0.020]. The amount of distention fluid infusion in the treatment group was significantly less than that of the control [(2982.1?880.5) ml vs (3461.2?795.8) ml; t=-2.354, P=0.022]. The volume of distention fluid intravasation in the treatment group was significantly less than that of the control [(225.3?81.1) ml vs (319.4?89.2) ml; t=-4.551, P=0.000]. The rate of fluid intravasation was (7.5?1.1)% in the treatment group that was significantly lower than that in the control [(9.2?1.1)%, t=-6.372, P=0.000]. The mean blood loss in the treatment group was significantly less than that of the control [(15.1?4.1) ml vs (24.7?6.6) ml; t=-7.204, P=0.000]. Conclusions Intraoperative administration of dilute pituitrin solution can reduce blood loss, operation time, and the amount of distention fluid infusion and intravasation. As a result, it is useful to avoid post-hysteroscopy complications including TURP syndrome.

Objective To evaluate the outcome of posterolateral approach to the fibula for trimalleolar fractures,especially the fracture in posterior malleolus.Methods Thirty-two patients with trimalleolar fractures treated via posterolateral transmalleolar approach from July 2006 to July 2011 were analyzed retrospectively.All underwent open reduction and internal fixation,including 22 Lauge-Hansen grade Ⅳ supination-external rotation ankle fractures and 10 Lauge-Hansen grade Ⅳ pronation-extemal rotation ankle fractures.Results All fractures had bone union after the follow-up of average 15.5 months (range,12-18 months).Average American Orthopedic Foot & Ankle Society (AOFAS) score was 90.75points,suggesting an excellent result.Kellgren grading system for posttraumatic arthritis severity was grade 0 in eight patients,grade Ⅰ in 18,grade Ⅱ in five,and grade Ⅲ in one,which turned out to be satisfactory.Conclusions Posterolateral approach to the fibula for trimalleolar fractures allows direct reduction and fixation of posterior malleolus fragment in treatment of trimalleolar factures and the clinical outcome is satisfactory.Moreover,the approach deserves clinical practice.

Atlanto-Axial Joint ; injuries ; Child ; Humans ; Joint Dislocations ; etiology ; Male ; Tympanoplasty ; adverse effects

Objective To introduce a simple and reliable way for atrial septal puncture. Methods Atrial septal puncture had been carried out in 627 patients with various underlying heart diseases, and the patients aged between 4-78 years old. Three protocols for precise location of atrial septal puncture points were recommended, 1) Site of atrial septal puncture point in cranial-caudal direction was determined under posterior-anterior projection, which was confined to the cranial side of the inferior margin of left atrium silhouette at a distance of 1 cone body height along the midline of spine. If the inferior margin of left atrium silhouette was unclear, angiogram of pulmonary artery to display left atrium and placement of coronary sinus electrodes could be done to verify it. 2) Under right anterior oblique 45 degree view, the puncture point was located between one cone body height anterior to posterior margin of left atrium silhouette and the isometric line between the posterior margin of left atrium silhouette and atria-ventricular suculus. 3) The arch feature of puncture needle and distal part of sheath turned into a straight line under 45 degree of right anterior oblique view. Results The success rate of atrial septal puncture was 99.8% (626/627), and that with only one try was 71.93% (451/627), the rate of tamponade was 0.32% (2/627). No death occurred. Conclusion Simple, reliable and safe, atrial septal puncture under 45 degree of right anterior oblique view is an easily-mastered approach.

Objective To compare the effect of high negative pressure drainage system and the traditional suction drainage system applied in thyroid surgery.Methods Eligible patients were selected randomly and divided into high negative pressure drainage group(30 cases) and traditional suction drainage group(30 cases).The draining rate within 24 hours after operation,delayed extubation rate,postoperative bleeding,rates of recurrent laryngeal nerve Injury,postoperative infection rate,degree of extubation pain and the incidence of severe pain of both groups were observed and difference of incidence of incision adhesions 1 month after operation were observed.Results The average drainage within 24 hours after operation in experimental group was (19.00 ± 6.79) ml,while (28.53 ± 14.74) ml in control group (P ＜ 0.05).Delayed extubation rate in experimental group was 3.33 ％,while 26.67％ in control group (x2 =4.71,P ＜ 0.05).Incidence of hematoma and bleeding after operation in experimental group was 0％,while 10％ in control group(x2 =1.40,P ＞ 0.05).No recurrent laryngeal nerve injury was found in either group,Incidence was 0％.The incidence of infection in experimental group was 0％,while 10％ in control group (x2 =1.40,P ＞0.05).The incidence of severe pain when extubation in experimental group was 0％,while 100％ in control group (x2 =60.00,P ＜ 0.05).Incidence of incision adhesions in experimental group was 0.33 ％,while 30％ in control group (x2 =6.14,P ＜ 0.05).Conclusion Draining rate,delayed extubation rate and incidence of incision adhesions could be reduced with high negative pressure drainage system applied in thyroid surgery,which is worthy of clinical.

Objective To provide the hardware system of EIT with an excellent direct current(DC) power source. Methods The spectrums of the outputs of DC power source and the driving source were analyzed by means of Spectrum Analyzer- E4408B when EIT system was respectively powered by battery, linear power source and switching power source. Based on the numbers and power levels of the spurs of the three power sources and the numbers and power levels of the interferences within the driving source, the influence of the three power sources on the error of measuring was estimated. Meanwhile the EIT system did data acquisition, the overall signal-to-noise-ratio(SNR) of the three power sources at the 18 frequencies were calculated and the influence of the three power sources on the error of measuring was judged. Results With respect to the numbers and power levels of the interferences within the driving source when EIT was powered respectively by the three power sources, the battery output 6 interferences, the highest power of which achieved -78.25 dBm; the linear power source output 6 interferences, the highest power of which achieved -67.11 dBm; the switching power source output 15 interferences, the highest power of which achieved -35.83 dBm. The overall SNRs of the battery at the 18 driving frequencies were higher than that of the linear power source, and the overall SNRs of the linear power source were higher than that of the switching power source. Conclusion The power mode of battery is the best for the hardware of EIT among the three power sources.

Objective To explore the insertion of the teaching contents of nursing in rural doctors'higher education,so as to increase their understanding of medical knowledge and improve their medical skills.Method 90 rural doctors of Grade 2014 were chosen as the research object,and according to their willingness to participate,they were divided into control group and observation group.The students in the control group were mainly taught by the relevant knowledge of clinical medicine,while nursing teaching content was inserted in the teaching of observation group.In the teaching process,firstly,the teaching contents of nursing were reorganized,and then the teaching content of clinical medicine was taken as the main line,according to the development of teaching content,flexibly inserting nursing teaching part.The results of the final examination of the internal medicine of the two groups were compared and the specific learning experience of rural doctors was investigated.SPSS 20.0 was used to analyze the data,the count data was expressed as percentage,and chi square test was performed.Results The number of students in the control group and the observation group whose subjective score was more than 40 was 17.65％ and 48.72％ respectively.The number of students scoring ＜30 points accounted for 23.53％ and 5.13％ of the total number of students,and there was a statistically significant difference between the two groups(P＜0.05).The observation group had a better learning experience,and had little influence on the learning of clinical medical knowledge.Conclusion In the stage of education for rural doctors,inserting the teaching contents of nursing can improve the teaching effect.

Discoidin domain receptor 2 (DDR2), a tyrosine kinase receptor belonging to DDRs family, is associated with progression of various cancers. Studies have indicated that DDR2 expression is upregulated in various cancer tissues, which could promote tumors proliferation, invasion, and metastases. Furthermore, patients with high DDR2 expression showed poor 5-year overall survival rate. In addition, DDR2 point mutation can enhance the sensitivity of tumor cells to small molecule tyrosine kinase inhibitor dasatinib, which suggests that DDR2 mutation may be a promising target for cancer therapy.

Objective To discuss methods and clinical efficacy of patients treated with arthrolysis for posttraumatic elbow stiffness with heterotopic ossification.Methods The study involved 16 patients with posttraumatic elbow stiffness combined with heterotopic ossification treated by arthrolysis between June 2007 and June 2011.There were 11 males and 5 females,at average age of 29.6 years (range,18-53 years).Time from injury to surgery averaged 10.7 months (range,8-14 months).Other than medial approach for only one patient,the rest adopted medial to lateral approaches to have a complete clearance of periarticular heterotopic ossification tissue and hyperplastic tissue as well as partial resection of articular capsules and ligaments.Besides,seven patients were fixed using hinged external fixators.After surgery,three weeks of oral celecoxib was given for the patients.Rehabilitation was started immediately after operation.Range of motion (ROM) of the elbow and Mayo elbow pcrformance score (MEPS) were used to determine clinical results.Results All patients were followed up for 8-17 months (mean 13.4 months).ROM of the elbow (extension lag,flexion,pronation and supination)showed an improvement from (45.2-3.5)° to (27.2 ±8.4)°,(68.1-11.8)° to (106.8 ± 16.4)°,(55.8 ± 8.2) ° to (80.5 ± 3.3) °,and (53.7 ± 6.3) ° to (83.1 ± 5.3) ° respectively (P ＜ 0.01).MEPS increased from (46.8 ±7.0) points to (83.2 ±9.4) points after operation (P ＜0.01).According to MEPS criterion,the results were excellent in seven patients,good in five and fair in four.Conclusion With respect to posttraumatic elbow stiffness with heterotopic ossification,satisfactory therapeutic results can be achieved by thorough preoperative evaluation,strict control of surgical indications,appropriate selection of intraoperative techniques and early systematic rehabilitation.

Objective To observe the expression of cysteine rich-protein 61 (Cyr61) on renal tubular cells,to explore its effects against hypoxic induced kidney injury and the underlying mechanisms.Methods A stably Cyr61 expressed tubular cell line Cyr61-HK2 was established based on HK2 cells and recombinant Cyr61-lentivirus.BrdU incorporation assay was used for cell proliferation.The apoptosis of cells was analyzed by flow cytometry with Annexin V and propidiumiodide staining.Western bloting was used to detect the protein expression of BAD,Akt and ERK.Results (1) Cyr61-HK2 cells displayed more proliferation ability than HK2 cells.(2) Under hypoxia condition,the apoptosis of both HK2 and Cyr61-HK2 cells increased,but the apoptosis of Cyr61-HK2 cells was lesser than HK2 cells.(3) The expression of Cyr61 led to the phosphorylation of BAD,Akt and ERK on 0 h,0.5 h,1 h (all P ＜ 0.05).Conclusion The expression of Cyr61 can promote cell proliferation and dampen cell apoptosis induced by hypoxia,which may be involved in the Akt/ERK signal pathway.