Objective To explore the clinical value of real-time contrast-enhanced ultrasonography and ultrasonography in the diagnosis and staging of cervical cancer.Methods 80 cervical cancer patients were selected as the research subjects,they were randomly divided into two groups.40 patients in the observation group received real time contrast-enhanced ultrasound,40 cases of the control group received conventional ultrasonography.The detection rate,diagnosis of cervical cancer,cervical cancer tissue and normal tissue parameters were compared between the two groups.Results 35 patients were detected in the observation group,the detection rate was 87.5%,23 patients were detected in the control group,the detection rate was 57.5%,the detection rate of the observation group was significantly higher than the control group (x2=9.028,P=0.002).In the observation group,7 patients in stage Ⅰ(17.5%),1 case in the control group (2.5%),there was significant difference between the two groups (x2=5.000,P=0.025),the differences in phase Ⅱ,Ⅲ and Ⅳ were not statistically significant(P>0.05).In observation group,the peak intensity of cervical cancer was (65.43±10.55)%,and the peak time was (22.09±2.82)min,the peak intensity of normal tissue was (58.21±14.12)%,peak time was (28.27±3.01)min,the peak intensity of cervical cancer was higher than normal tissue,the peak time was shorter than normal tissues,the differences were statistically significant(t=2.590,9.476,all P<0.05).The differences of the area under the curve and the average transit time between normal tissue and cervical cancer tissue were not statistically significant(P>0.05).Conclusion Compared with conventional ultrasonography,the contrast-enhanced ultrasonography can clearly show the range of tumor,quantitative analysis of time intensity curve parameters,can better reflect the characteristics of cervical cancer lesions,can improve the diagnostic rate and clear clinical stage.

Objective The purpose of this article was to investigate the internal tunnel position during anterior cruciate ligament (ACL) reconstruction with single-bundle ACL. Methods MRI were performed in 10 knees form 10 volunteers at full extension and at 30°, 60°, 90°, and 120° flexion position. All the images obtained were exported into Mimics 10.01. Three-dimensional models were established with Mimics in a computer. All the mark points were confirmed on femur and tibia. The distance between the femoral mark point and tibial mark point was measured. The isometric point was determined as the change in the distance was shorter than 3mm during knee flexion-extension. Results Ten three-dimensional models were established successfully and the isometric points of A0-X, A15-X, A30-X, A45-X, B0-Y, B15-Y, B30-Y, B45-Y, C0-Z, C15-Z, C30-Z, C45-Z, and C60-Z were identified. Conclusion There was no absolute anatomical isometric point, whereas the physiological isometric point did exist. Therefore, determination of tibial point should be considered synthetically. B45-Y was recommended for tunnel position.

Objective To evaluate the safety and efficacy of three types of anesthesia methods in elderly patients with coronary heart disease undergoing unilateral lower extremity surgery.Methods Totally 65 patients with coronary heart disease of cardiac function Ⅰ-Ⅱ (NYHA),scheduled for undergoing unilateral lower limb surgery were randomly divided into three groups:local nerve block anesthesia of lumbar plexus plus the sciatic nerve (21 cases),general anesthesia (19 cases),epidural anesthesia (25 cases).Systolic blood pressure (SBP),heart rate (HR),pulse rate and blood oxygen saturation (SPO2) at 0 min,10 min,20 min,30 min,40 min after surgery at the end of the surgery were observed and recorded.The change of troponin Ⅰ (cTnI) at 3 day after surgery was observed.Visual analoguc scales (VAS) scores.movement reaction,the infortnation of muscle relax and corresponding management were recorded in order to detect anesthesia efficacy.Results The excellent and satisfactory rate of anesthesia efficacy of three groups were 17 cases (81.0％) and 4 cases (19.0％),17 eases (89.5％) and 2 cases (10.5％),22 cases (88.0％) and 3 cases (12.0％) (all P＞0.05).In epiduralgroup compared with other groups,SBP were decreased (both P＜0.05).cTnI in nerve stimulator group was decreased (all P＜0.05) at 1 and 3 day after surgery compared with general anesthesia group,and at 3 day after surgery,cTnI level in nerve stimulator group was lower than other two groups(all P＜0.05).Conclusions The nerve stimulator guided nerve block is the most safe method among general anesthesia and epidural anesthesia in elderly patients with coronary heart disease scheduled for lower extremity surgery.

AIM: To confirm the effects of capillary endothelium injury in the lung with ischemia reperfusion. METHODS: The rabbits pulmonary models of ischemia reperfusion (I-R)injury were established. Plasma nitric oxide and endothelin levels, arterial oxygen tension and wet/dry weight ratios were determined in different periods in control and I-R groups, and the pulmonary ultrastructure abnormities were analyzed under electromicroscope. RESULTS: The plasma levels of NO and ET-1 in I-R animals increased significantly ,compared with those in sham treated control groups. The level of ET-1 had significantly negative correlation with PaO 2 and positive correlation with the value of the wet/dry weight ratios. The swelling and karyopyknosis of capillary endothelium in the lung with I-R groups were observed in ischemia periods. The injuries of endotheliums and typeⅠandⅡ alveolar cells in 0 5 h of reperfusion were more severe than those in ischemia time, and the injuries began to repair in 2 h of reperfusion time. CONCLUSION: In the I-R group, pulmonary capillary endothelium have been injuried, which may play a prominent role in I-R injury and dysfunction of the lung.

Objective To estimate blood lead level of children in Jinchang city of Gansu province.Methods According to relevant request,256 children(male 133,female 123) aged 2-7 years from some kindergartens in Jinchang city were randornly selected from Oct. 2004 to Jun. 2005. Blood lead level was measured by atom-absorbing graphiteingle method.Results The average blood lead level of 256 children was(126.30?52.98)?g/L.The lowest blood lead level was 28.3 ?g/L while the highest was 268.0 ?g/L.And 160 children(62.54%) were found with a blood lead level ≥100 ?g/L(the diagnostic level of lead poisoning in children).The blood lead level became higher with the increase of children′s age,as groups aged 2-3 years group were lower than aged 5-6 years and 6-7 years groups,of which the differenes had statistical significance(P0.05).Conclusion Blood lead levels of children in Jinchang city and prevalence of lead poisoning are both relatively higher,to which enough attention shall be paid.

Objective To evaluate the efficacy and safety of endoscopic retrograde cholangiopancre-atography (ERCP)by using a duodenoscope in patients with prior Billroth Ⅱ gastrectomy.Methods Data of 98 patients(including 7 who underwent Billroth Ⅱand Braun)with prior Billroth Ⅱ gastrectomy who un-derwent ERCP from January 2008 to May 2014 at Endoscopy Center of Ruijin Hospital were retrospectively studied.Results A total of 98 patients accepted 111 ERCP procedures,the overall success rate was 75.7%(84 /111).The success rate of accessing Vater′s papilla was 82.0%(91 /111)and the selective can-nulations success rate was 92.3%(84 /91).In the cases of successful access,therapeutic procedures were achieved in 100.0%(84 /84)of all patients.The overall rate of complications was 4.5%(5 /111),with mild post-procedure pancreatitis occurring in 3 cases,cholangitis in 2 cases,respectively.Conclusion ERCP u-sing a duodenoscope can be safely and effectively performed in patients with prior Billroth Ⅱ gastrectomy with high cannulation and treatment success rates.

Objective To investigate the effect of mycophenolic acid on the proliferation of smooth muscle cells (SMCs) in rats' pulmonary arterial at cellular level. Methods Growth curve, MTT tests, and flow cytometry were used to detect the number of proliferative cells, the A-value of living cells and the DNA content of the control and drugs groups respectively and the number of cells in G1-phase, S-phase, G2M- phase and the proliferation index were calculated. Results Compared with the control group, the number of living cells in the mycopbenolic acid groups (with the concentration of 1, 10, 100 μmol/L) decreased, except the lowest dosage group (100 nmol/L). The difference was statistically significant (P<0.01). The living cells measured by MTT dose-dependently reduced in the mycophenolic acid groups. In the mycophenolic acid groups, the fraction of living cells in the S-phase and G2M-phase decreased respectively while that in G1- phase increased, and the proliferation index decreased. All these responses presented with a dose-dependent manner. Conclusion Mycophenolic acid can effectively inhibit the proliferation of rats' pulmonary arterial SMCs. This process happens mainly in ONA synthesis phase, and is dose dependent. In addition, these effective concentrations are all in the available range for clinical application.

Objective To investigate the efficacy and safety of ERCP for biliary stricture with duct stone after liver transplantation.Methods Clinical data of 60 patients undergoing ERCP for biliary stricture with duct stone after liver transplantation between January 2013 and June 2014 were retrospectively analyzed.Results ERCP was successfully performed 78 times in 60 patients.Bile duct stenosis was cured in 24 cases (40％),improvement was observed in 27 cases (45％) and was not obvious in 9 cases (15％).Bile duct stones were successfully removed in 39 patients (65％).Incidence of post-ERCP complications was 13％ (8/60),including mild pancreatitis in 1 case,hyperamylasemia in 5 cases,biliary tract infection in 2 cases,which were all resolved after conservative treatment.Conclusion ERCP is a safe and effective treatment for biliary stricture with duct stone following liver transplantation.

Objective To study curative efficacy of granisetron in treatment of postoperative severe vomiting after posterior scleral reinforcement . Methods 84 patients of posterior scleral reinforcement who received therapy from January 2012 to December 2014 in our hospital were selected as research objects.According to random number table,those patients were divided into the control group (n=100) and the observation group (n=100), the control group were treated with ondansetron hydrochloride at the end of surgery, while the observation group were treated with granisetron at the end of surgery.Then postoperative sedation, analgesia, nausea, vomiting and so on.were compared.Results There were no significant differences in anesthesia time, operation time and remifentanil dosage between the two groups.The Ramsay scores of the observation group were (2.49 ±0.31), (2.23 ±0.34) and (2.10 ±0.28) points at 30 min, 1h and 2h after operation, respectively.In the control group, Ramsay scores were (3.02 ±0.42), (2.84 ±0.37), (2.45 ±0.34) at 30 min, 1h and 2h after operation, lower than the control group.The incidence of nausea and vomiting in the observation group were 9.52% ( 4/32 ) , 11.90% ( 5/42 ) respectively, and there was no significant difference between the two groups in the postoperative analgesia The total incidence of postoperative nausea and vomiting was 30.95% (13/42) and 30.95% (13/42) respectively, which were lower than the control group (P <0.05).Conclusion Granisetron is well for postoperative posterior scleral reinforcement, which can reduce the incidence of postoperative severe vomiting, it’s worthy of application and promotion.

Objective To assess the current status of knowledge, attitude and practice (KAP) towards antibiotic use among community residents in Hangzhou, and to explore the correlations among them. Methods A total of 449 permanent residents in Hangzhou were randomly selected using a multistage stratified random sampling method. Self-reported data on basic demographic factors, and relevant KAP information were collected by the questionnaire survey. Differences in KAP scores according to each demographic factor were assessed by the t test or ANOVA test, and AMOS 21.0 was used for the path analysis. Results Scores for knowledge, attitude and practice regarding antibiotic use were (6.17±2.45), (6.45±0.99) and (6.21±1.02) respectively. Results of the path analysis showed that education level and age had effects on the knowledge (coefficients: 0.57 and -0.38 respectively) . Age, gender and knowledge had effects on the attitude (coefficients: -0.27, 0.12 和 0.02 respectively), and attitudes, gender, monthly income and the level of education had effects on the practice (coefficients: 0.48、 0.37、 0.06 and 0.02 respectively) . Conclusion Community residents in Hangzhou lack relevant knowledge, and there are some irrational attitudes and practices regarding antibiotic use. There is a correlation between knowledge and attitudes, as well as between attitudes and practices, but the knowledge and practices are not correlated.