Objective:The short term results of laparoscopic radical hysterectomy and pelvic lymph nodes dissection for early uterine malignancy were investigated.Methods:70 patients with eady malignant uterine tumor who underwent a laparoscopic radical hysterectomy and pelvic lymph nodes dissection(TLRH+LPL)were retrospectively reviewed.At the samt time,48 patients were recruited to be the control group who had laparotomy radical hysterectomy and pelvic lymph nodes dissection(ARH+APL).Intraoperative and postoperative situations and complications between these two groups were analyzed.Results:70 patients underwent laparoscopic operation,but two cases changed to laparotomy(transfer rate 2.9%).The mean operation time,blood loss,number of dissected pelvic lymph nodes and postoperative temperature recovery time of TLRH+LPL group was significantly different from ARH+APL group(P<0.01),while there were no difference between these two groups on bladder function recovery time and occurance of postoperative complications.Conclusions:TLRH+LPL has the same feasibility and safety with ARH+APL,less invasive to the tissue,thus offers a good option of microinvasive therapy for female malignant tumor.

Purpose：To determine the treatments and prognostic predictors of malignant melanoma of the head and neck. Methods：Surgical treatment and outcome was analyzed for 28 patients with malignant melanoma of the head and neck at department of the head and neck of our hospital (1984-1994). Results：23 patients underwent local excised as the first treatment, and local recurrence was demonstrated in 8 (34.8%). Margin of resection of primary melanoma was divided into narrow excision (≤2 cm) and wide excision (＞2 cm), and 5-year survival was 58% and 40%(P＜0.01). According to surgical methods, 5-year survival of WE, WE/END and WE/TLND were 80%, 80% and 39%. Conclusions：An excision with 2 cm margin is safe procedure for primary tumor of malignant melanoma of the head and neck. Neck dissection may not be practiced until neck lymph node is positive. Neck dissections differ from the positions of the primary tumors, and the flaps must be raised preferably superficial to the platysma.

Objective To observe the feasibility of phase-rectified signal averaging applied for the evaluation of automatic nervous system activity in general anesthesia.Methods Forty-seven fe-males and 63 males aged 18-65 years,ASA falling into category Ⅰ or Ⅱ,scheduled for oral maxillo-facial surgery under general anesthesia were selected.The heart rate variability(HRV)signal was re-corded by Powerlab throughout the operation,and then it was sectioned into three segments with 5 minutes:pre-anesthesia(T0 ),means the waking state before the operation;intra-anesthesia(T1 ),the period of operation in 25-30 min;post-anesthesia(T2 ),the consciousness recovery state in the end of the operation.All indicators of HRV analysis was calculated in the time domain.SpO 2 ,MAP and BIS were recorded synchronously in the three periods.Results Compared with T0 ,DC, RMSSD, SDNN,SD1,SD2,logTP,logLF,logHF were significantly lower at T1 and T2 (P <0.05).In con-trast to T1 ,HR,MAP and BIS were significantly higher at T2 (P <0.05 ),DC,RMSSD,SDNN, SD1,SD2,logTP,logLF,logHF were significantly increased at T2 (P <0.05 ).There was positive relation between DC and RMSSD,SD1,logHF (r =0.905,0.909,0.932,respectively,P <0.01). Conclusion As 5 min-DC could indicate the character of PRSA,especially its specificity in showing vagus nerves activities,it is feasible that DC is used to observe the autonomic nerve activity intra op-eration.

Department ofPediatrics,the Maternal and Child Health Hospital ofHuzhou,Huzhou,Zhejiang 313000,China(Shen ZZ)Objective To observe the effect of phentolamine in the treatment of severe hand foot and mouth disease with acute pulmonary edema.Methods 90 children with severe hand foot and mouth disease and acute pul-monary edema from January 2014 to December 2015 in our hospital were selected as the research subjects.All the children were randomly divided into 45 case of the observation group and 45 case of the control group.They were given conventional drug therapy and positive pressure ventilation,the control group was given milrinone,5μg/kg,the obser-vation group was given phentolamine,5μg/kg.The myocardial enzymes and cardiac troponin were detected before intervention and after 72h intervention,the blood gases index and ventilator parameter were analyzed,and the time of ventilator support and hospital stay were compared.Results (1)The CK -MB,CK,troponin of the observation group and the control group after treatment were (17.52 ±1.33)U /L and (28.23 ±3.89)U /L,(120.42 ±6.21)U /L and (150.86 ±8.67)U /L,(0.46 ±0.07)μg/L and (0.96 ±0.06)μg/L,which were significantly higher than before treatment (t =5.024 and 8.455,9.353 and 14.757,6.356 and 9.505,all P <0.01),but the CK -MB,CK,troponin of the observation group after treatment were significantly lower than the control group (t =5.601,7.426,5.829,all P <0.01 ).(2)The PaO2 and PaCO2 of the intervention group and the control group after 72h intervention were (80.24 ±14.35)mmHg and (62.30 ±5.68)mmHg,(39.38 ±6.08)mmHg and (46.10 ±3.42)mmHg respectively, which were significantly improved than before treatment,the differences were statistically significant (t =11.352 and 7.204,7.827 and 5.287,all P <0.01),there were statistically significant differences between the two groups after the intervention (t =7.426,5.829,all P <0.01).The FiO2 ,PIP,PEEP of the two groups after treatment were significantly lower than before treatment,the differences were statistically significant (t =8.446 and 6.905,9.705 and 7.832, 8.605 and 6.889,all P <0.01),there were statistically significant differences between the two groups after the inter-vention (t =3.461,5.165,4.532,P <0.05 or P <0.01).(3)The time of mechanical ventilation and hospitalization in the observation group and the control group were (3.42 ±1.61)d and (5.06 ±2.15)d,(15.40 ±3.62)d and (18.62 ±3.81)d,the differences were statistically significant(t =3.513,3.734,all P <0.05).Conclusion Phent-olamine has better effect than milrinone in the treatment of severe hand foot and mouth disease with acute pulmonary edema,it can control the disease progression and improve clinical outcomes and has better clinical value.

It is well known that the tumor mainly transfers through the lymphatic vessels of the tumor .The current studies main-ly focus on the mechanism of metastasis , hoping to uncover the lymph node metastasis through investigating generation of lymphatic ves -sels and remodeling of tumor lymphatic vessels .Lymph node metastasis is directly related to and prognosis and the quality of life of cancer patients , and how to block the corresponding signaling pathways to prevent tumor lymphangiogenesis becomes the research fo -cus.This paper reviews the lymphangiogenesis and lymphatic vessel remodeling .

Objective　The conditional hierarchical clustering for 1-dimensional(1-d) ordinal data was discussed.Methods　Because the individuals are ordered in 1-d,the conditional matrix was constructed with all elements in the second-diagonal are 1 and the others are 0.Distance matrix of individuals defined by some particular definition.Then the conditional-distance matrix was made for the hierarchical clustering by connecting the conditional matrix and distance matrix.This method was called 1-dimentsional conditional hierarchical clustering.An example was illustrated by this method and a Monte Carol study showed that method was feasible and robust.Results　Compared with the least-squares partition,this method is easy to understand,easy to practice and easy to compute.It also can give us a stable result.Conclusion　Because of the austere theory,the simple thought and the convenient application,it's a good method for the 1-d ordinal data.

To investigate the efficacy and the clinical value of total laparoscopic radical hysterectomy (TLRH) for the treatment of uterine malignancies, we performed a retrospective review of 87 patients with cervical cancer and 23 patients with endometrial carcinoma who underwent TLRH at Union hospital between June 2008 and September 2009. Data collected included operative time, estimated blood loss, lymph node count, time for the recovery of normal temperature and time to resumption of normal bladder function, intraoperative and postoperative complications. The procedure was completed laparoscopically in 108 patients. Two patients were converted to laparotomy due to common iliac vein injury. The mean overall operative time was 200.6+/-38.6 min; the mean operative blood loss was 280.5+/-128.3 mL; he mean number of pelvic lymph nodes that were resected wa26. 0+/-5.8. The time for recovery of normal temperature and the normal bladder function after the operation was 5.8+/-2.9 d and 15.2+/-4.3 d. There were 2 (1.8%) common iliac vein injuries during the operation and 10 (9.1%) bladder retentions post operation. It was concluded that TLRH is feasible, minimally invasive and provides promise for the treatment of uterine malignancies.

Objective To explore the related factors that affect the incidence of uterine fibroids to provide a theoretical basis for the clinical diagnosis and prevention.Methods Based on the clinical data selected from June 2014 to July 2016 in pathology of our hospital,159 cases of patients were confirmed with uterine fibroids,a comparative study was employed and the single factor test and the logistic regression analysis were both used to analyze the related risk factors that affecting the incidence of uterine fibroids.Results There were all significant level (P ＜ 0.05) between case and control groups in 40 years to 50 years,the number of abortions (≥2) as well as gynecological diseases,which were the independent factors for the incidence of uterine fibroids.In the present,the regression coefficients of former two factors were 0.186 (P ＜ O.05),and 0.584 (P ＜ 0.05),respectively.The corresponding regression coefficients of breast hyperplasia,vaginitis,cervicitis,endometritis and pelvic inflammatory disease,and other gynecological diseases and gynecological diseases were 0.221 (P ＜ 0.05),O.363 (P ＜ 0.05),O.539 (P ＜ 0.05),0.361 (P ＜ 0.05),and 0338 (P ＜ 0.05),respectively.It suggests that these were independent factors affecting the incidence of uterine fibroids.Conclusions The more the increasing age and the number of abortions,kinds of gynecological diseases infected will increase the risk of patients suffering from uterine fibroids.

PPAR? is a kind of nuclear receptors responsible for the regulation of glucose and lipid metabolisim and adipocyte difference,which is related with the pathogenesis of obesity,insulin resistance and type 2 diabetes mellitus.PPAR? agonists as insulin sensitizer have been used in the clinical treatment for type 2 diabetes for more than decades.Recently,with the further research plunging into the PPAR signaling pathway and insulin sensitizer,the recognition of this crucial nuclear receptor has been renewed and developed.The aim of this review is to report the update research outcomes.

OBJECTIVE:To study the postoperative use of anti-infectives inpatients undergoing liver transplantation and its rationality.METHODS:50 inpatients who had undergone liver transplantation were randomly collected from center of organ transplantation for the analysis of the use of anti-infective agents within 1 month after operation in respect of utilization frequency(cases/times),duration of medication,drug utilization index(DUI) as well the conformity between drug combination and etiology so as to derive the rationality of drug use.RESULTS:Among the top 10 anti-infectives in terms of utilization frequency in patients undergone liver transplantation,9 had their DUI less than 1,and 1 had its DUI above 1.The perioperative application rate of anti-infective agents was 100%.In terms of drug combination,2 cases(4%) used one kind of anti-infectives,17(34%) two kinds,21(42%) tree kinds,10(20%) four kinds concomitantly.CONCLUSION:The doses and the proportion of anti-infectives used in combination for inpatients undergoing liver transplantation were on the high side,which should be controlled urgently.