Objective To investigate the efficacy and safety of oestradiol valerate (E2V) combined with dienogest (DNG) for menorrhagia without organic pathology.Methods Sixty-two menorrhagia without organic pathology patients were randomized divided into observation group (31 cases ) and control group (31cases).E2V combined with DNG were given in observation group while control group with E2V only.Both of the treatment lasted for 3 cycles.The changes in menstrual blood loss was assessed by the pictorial blood loss assessment chart (PBAC).The time of control bleeding,stop bleeding,the level of hemoglobin and adverse reaction were compared.Results The time of control bleeding,stop bleeding in observation group were significantly lower than those in control group[ ( 16.5 ± 2.2) h vs.(23.4 ± 2.9) h,(23.3 ± 8.4) h vs.(40.9 ±4.6) h] (P＜0.01).The level of hemoglobin and PBAC scores between two groups had no significant difference before treatment (P＞0.05).After treatment for 3 cycles,the level of hemoglobin in observation group was higher than that in control group,but had no significant difference (P＞0.05 ),the PBAC scores in observation group was lower than that in control group after treatment for 1,2,3 cycles(P＜0.01 ).Both of the rate of adverse reaction in two groups was 12.9％ (4/31 ).No severe adverse reaction happened in two groups.Conclusions E2V combined with DNG is more rapid and effective in reducing menstrual blood loss.It does not increase the rate of adverse reaction and worthy of clinical application.

With the deeply thought of military hospital reform and medical support system,the analysis and suggestions for present situation are put forward.

Objective To reproduce a pulmonary carcinoma model by injecting VX2 tumor tissue block suspension into rabbits' lung,and to compare the result with that of injecting VX2 tumor cells suspension.Methods A total of 50 New Zealand white rabbits were divided into two groups randomly with 25 in each.The VX2 tumor tissue block suspension and cell suspension were injected respectively into the right lower lung of each rabbit in two groups.The growth and metastasis of tumor in the thorax were observed with CT scan.The general condition of the animals was observed as well.Results The pathological pictures of the VX2 tumors were the same in two groups.The ratio of successful transplantation was 100% in the tissue block suspension group,while it was 48% in the cells suspension group,a remarkable difference in the success rate of tumor transplantation was found between the two methods(P

Objective To evaluate the effect of dexmedetomidine on quality of wake-up test in the patients undergoing posterior osteotomy correction surgery.Methods Ninety-seven patients of both sexes,aged 17-59 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index 18.5-25.0 kg/m2 and global kyphosis angle＞60°,scheduled for elective posterior osteotomy correction surgery under general anesthesia,were randomly divided into 2 groups using a random number table:control group C (n=46) and group D (n =51).In group D,dexmedetomidine 1.0 μg/kg was infused over 15 min before induction of anesthesia,and group C received the equal volume of normal saline instead.Anesthesia was induced with iv midazolam,propofol,fentanyl,vecuronium and dexamethasone in C and D groups.Mechanical ventilation was performed after tracheal intubation.Anesthesia was maintained with infusion of cisstracurium,propofol and remifentanil.Dexmedetomidine 0.3 μg · kg-1 · h-1 was infused throughout the surgery in group D,and meanwhile normal saline was given throughout the surgery in group C.The anesthetic drugs for maintenance except dexmedetomidine were discontinued at the beginning of the wake-up test.The wake-up time was recorded and the wake-up quality was assessed.Ramsay sedation scores and Riker sedation-agitation scale scores were also recorded when all the patients were successfully awakened.The development of cardiovascular events during wake-up test and intraoperative awareness was recorded.Results The wake-up quality was significantly higher,Riker sedation-agitation scale scores were lower,Ramsay sedation scores were higher,the incidence of nausea and vomiting was lower,and no significant change was found in wake-up time in group D.No intraoperative awareness was observed in the two groups.Conclusion Dexmedetomidine can raise wake-up quality without prolonging wake-up time and with stable hemodynamics and fewer side effects in the patients undergoing posterior osteotomy correction surgery.

Objective To determine the reliability and validity of the Chinese edition of the Amster-dam preoperative anxiety and information scale ( APAIS) for the assessment of preoperative anxiety of Chi-nese patients.Methods The APAIS was translated into Chinese version.One hundred and thirty patients undergoing elective surgery were enrolled to complete the APAIS,STAI-S,VAS-A at the day before surgery, and thirty subjects received a re-test of APAIS at the day of surgery.Results The average score of Chinese version of APAIS anxiety scale and information scale were (7.37±3.51) and (3.67±1.94),respectively. Cronbachαfor the anxiety scale was 0.84 and information scale was 0.78,respectively.Test-retest reliability were r=0.746(P<0.01) and r=0.655(P<0.01) ,respectively.Factor analysis showed anxiety and the desire for information were found,which explained 73.82%of variance.The anxiety scale of APAIS significantly corre-lated with STAI-S and VAS-A,Correlation Coefficient were r=0.720(P<0.01) and r=0.641(P<0.01) ,respec-tively.Conclusion The Chinese version of the APAIS has good reliability and validity to quick measure the preoperative anxiety and desire for information of patients.

Background　Culture of retinal pigment epithelium(RPE) cells is very important for establishment of proliferative vitreoretinopathy (PVR) model,prevention and treatment of PVR as well as RPE cell transplantation.Isolation of animal RPE cells by trypsinization is a critical step.ObjectiveThe present study is to establish the methods of isolation and culture of retinal pigment epithelium (RPE) cells in rabbit and comparied with that of pig RPE culture.MethodsRPE cells were isolated by trypsinization in pigmented rabbit and pig and cultured in DMEM containing 20% fetal bovine serum.Cultured RPE cells were identified by immunochemistry.The fourth generations of cells were used in this experiment.Morphology and characteristics of cultured RPE cells from rabbit and pig were examined and compared under the light microscope.ResultsIsolated RPE cells from pig were obtained by once trypsin digestion,but two times of trypsinization were needed in rabbit RPE cells isolation.The differentiation in response to trypsinization was related to anatomic difference between the two types of cells .The adherence time of pig RPE cells was 24 hours ,however,the rabbit RPE needed 48-72 hours after culture.Proliferation and vitality of cultured cells were gradually attenuated and melanin decreased after several times subculture.The morphology of culture RPE cells was obviously different between rabbit and pig because species difference.Immunohistochemistry demonstrated the positive response of RPE cells for keratin.ConclusionRPE cells can be acquired from both rabbit and pig by trypsinization and culture.The culture process of RPE cells of pig is simpler than that of rabbit.Cells within the fourth generations are suitable for experimental application.

Objective To summarize the observation points and nursing experience after minimally invasive ventriculo-atrial shunt. Methods 45 patients after minimally invasive ventficulo-atrial shunt were given preoperative psychological care and preparations, postoperative observation of vital signs, con-sciousness, pupil, with or without intracranial hypertension, inadequate shunt or transitional symptoms, in-fectious symptoms, specific and basic care, awareness of postoperative complications and detailed guidance for discharge and follow-up jobs. Results Half month after shunt 28 cases regained consciousness, 9 cases with alleviated consciousness dysfunction, 8 cases with unchanged consciousness dysfunction, 5 cases with shunt blockage; 3 cases with over-shunt; 5 cases with inadequate shunt, 1 case with blood-borne in-fection, 1 case with shunt exposed, no intracranial infection, air embolism, complications such as endocardi-tis took place. Conclusions Adequate preoperative preparation and close postoperative observation, ef-fective specific care and basic care can increase success rate of ventriculo-atrial shunt and improve the quality of life of patients.

Objective To establish reverse transcriptase-polymerase chain reaction(RT-PCR) with primers specific for CEA gene and CK20 gene to detect circulating tumor cells in peripheral blood of esophageal cancer pa-tients,and try to find the relationship between the mRNA expression and micrometastasis. Methods The expressions of CEA,CK20 were analyzed by RT-PCR in 53 cases of esophageal tumor tissue and in peripheral blood,compared with 10 patients with benign esophageal disease and 20 healthy volunteers. Results The expressions of CEA-mRNA, CK20-mRNA were 96.23% (51/53), 100% ( 53/53 ) in 53 esophageal tumor tissue and were 52.83% (28/53), 49.06% (26/53) in peripheral blood of 53 esophageal cancer patients. In control group,there was only one expression of CEA-mRNA in peripheral blood of 10 patients with benign esophageal disease,as well as in 20 healthy volunteers. There was no expression of CK20-mRNA in peripheral blood of 10 patients with benign esophageal disease and 20 healthy volunteers. Conclusion CEA-mRNA, CK20-mRNA might be specific and sensitive markers to detect circu-lating tumor cells in peripheral blood and their expression was closely related to TNM stages of the esophageal cancer patients.

Objective To understand biochemistry study situation in clinical medicine undergraduates and to improve biochemistry teaching quality.Methods Totally 120 clinical medicine undergraduates were enrolled randomly to receive investigation on problems related to biochemistry.Corresponding statistic analysis was made using softwares of Excel and SPSS 16.0 in view of the main problems.Results One hundred and twenty copies of survey questionnaires were finished.There were 114 effective copies and the effective rate was 95％ after checking on these questionnaires.61.4％ of the students neither liked nor disliked biochemistry course; 56.1％ of the students thought that learning biochemistry was difficult; students thought that chapter 4 sugar metabolism,chapter 5 lipid metabolism and chapter 6 biological oxidation to be very difficult.Only 11％ of the students did preview,further analysis found positive relation between preview and understanding (rj =0.288,P ＜ 0.01 ).Conclusion Clinical medicine undergraduates like biochemistry insufficiently with few doing preview.It suggests that teachers should pay attention to the cultivation and stimulation of students' interest in biochemistry course,improve teaching method for the difficult sections,strengthen experiment teaching and try combination and separation teaching mode.

Objective To investigate the efficiency and application value of CT-guided percutaneous puncture biopsy in the diagnosis of lung disease.Methods The clinical and imaging data of 60 patients with CT-guided percutaneous lung biopsy were analyzed retrospectively.Results Among all the 60 patients, 57 had finally to be proved by pathological diagnosis, including 47 primary lung cancer (21 squamous cell carcinoma, 18 adenocarcinoma, 3 small cell lung cancer and 5 bronchioloalveolar carcinoma), 7 metastatic lung cancer and 3 tuberculosis.In addition, 3 cases were chronic inflammation and did not make a definite diagnosis, in which 2 were proved to be caseous pneumonia and 1 was proved to be fungus infection by postoperative pathology.The successful rate of punctures,the diagnostic accuracy and the total complications rate of lung puncture biopsy in 60 cases was 100%, 95.0% and 21.7% [11.7% pneumothorax (7/60), 8.3% hemoptysis (5/60) and 1.7% needle bleeding(1/60)].Conclusion CT-guided percutaneous puncture biopsy is a safe, accurate and significant clinical method in the diagnosis and differential diagnosis of lung lesions.