Objective To investigate the possibility of interventional treatment of placenta accreta. Methods One patient with placenta accreta was treated with uterine arterial infusion of cef and MTX followed by embolization. Results Her placenta discharged through vagina at the 27th day after uterine aterial embolizayiea. No remnant was found in the uterine by Doppler imaging. The patient uneventfully recovered.Conclusions Intervetional therapy with uterine arterial embolization is a new and reliable method for treatment of placenta accheta.

Grounding impedance measurement is a traditional proficiency testing programs, 2014 proficiency testing program on the basis of original ability to verify, combined with actual detection need, innovation introduced two verification point of the power input socket and metal plane testing. This paper analyzes and discusses the results of the ability verification in 2014, and puts forward the points of attention and the recommended method of metal plane test.
Laboratories ; standards ; Laboratory Proficiency Testing

Objective To investigate the effect of trimetazidine postconditoning on myocardial cell apoptosis in acute ischemia-reperfusion injury in rats.Methods 40 healthy adult Wistar rats were randomly assigned to Sham-operated group,MIRI group(I/R group),trimetazidine group and ischemic postconditioning group(IPOC group).The left anterior descending coronary artery of rat was ligated and the acute myocardial ischemia-reperfusion injury model was established.After that,ultrastructural changes of apoptotic myocardial cells were observed under electron microscope,and apoptotic cells were detected under optical microscope.The expressions of the Bcl-2,caspase-3 apoptosis related proteins were determined.Results ① The degree of ultrastructural injury of apoptotic myocardial cells was mild and basically the same in trimetazidine group versus IPOC group,and had a significant improvement as compared with I/R group.② The degree of myocardial apoptosis was basically the same in trimetazidine versus IPOC group,and lighter than in I/R group.③ Bcl-2 protein expression levels were(61.9 ± 2.9) ％,(21.4 ± 3.2) ％,(46.8 ± 3.5) ％ and (49.7 ± 3.1) ％,and caspase-3 protein expression levels were(38.1±4.5) ％,(72.8±5.7) ％,(47.2±5.1) ％ and(39.8 ±4.6)％ in Sham-operated group,I/R group,trimetazidine group and IPOC group respectively.Compared with I/R group,the expression of Bcl-2 protein was increased obviously,while the expression of easpase-3 protein was decreased in trimetazidine group and IPOC group.But there were no significant differences in the protein levels of Bcl-2 and caspase-3 between trimetazidine group and IPOC group(both P＞0.05).Conclusions Trimetazidine postconditoning can inhibit the myocardial cell apoptosis in acute ischemia-reperfusion injury in rats,and has a protective effect on myocardial cells.

Objective Experimentally to investigate the changes in vasospastic canine basilar arteries. Methods Vasospasm of basilar arteries was induced by double-injecting autologous blood into the brain cisterns. 28 adult mongrel dogs of both genders served as the subjects, of them 20 involved in experimental group and accepted the PTA treatment and the other 8 doges were in negative control group without any treatment. PTA was performed by a single inflation of balloon for 10 seconds at a peak pressure of 2.0 atmospheres. Angiography was re-performed at 30 day, 90 day and 300 day following PTA, respectively. The histologic changes were then evaluated using light and electron microscopy. Results Caliber of basilar arteries of all canines decompressed obviously, from 1.3 mm to 0.8 mm. In test group, PTA succeeded in 15 ones, with caliber of vasospastic basilar arteries enlarged obviously after PTA ( P

Objective To investigate the safety and feasibility of laparoscopic pylorus-preserving pancreaticoduodenectomy.MethodsThe data of 59 patients with laparoscopic pancreaticoduodenectomy in Shangjin hospital of West China hospital of Sichuan University from January 2014 to December 2015 were analyzed retrospectively.The general data,operative time,estimated blood loss,conversion rate,time to liquid diet,postoperative hospital stay and complications were analyzed.Results The laparoscopic pylorus-preserving pancreaticoduodenectomy were successfully performed in 56 cases,the successful rate was 94.9%,the other 3 patients were converted to laparotomy for superior mesenteric vein/portal vein involvement.The operative time was 255~510 minutes,with mean operative time (384±145) minutes,the intraoperatve blood soss was 50~800 mL,with mean estimated blood loss (148±28)mL,the time to liquid diet was 1.0~4.0 days,with average time (3.2±1.1)days,the postoperative hospital stay was 5.0~53.0 days,with average time (10.3±2.6)days.After surgery,16 cases suffered from complication,the rate was 27.1%.The most common complication was pancreatic fistula which occurred in 13 cases including 12 cases of grade A and 1 case of grade pancreatic fistula.No grade C pancreatic fistula occurred in this series.Six patients suffered from delayed gastric emptying.One patient suffered from bile leakage.Conclusion Laparoscopic pylorus-preserving pancreaticoduodenectomy was safe and feasible.Pylorus-preserving does not increase the incidence of delayed gastric emptying.

OBJECTIVE: To discuss the clinical characteristics of bilateral bronchial foreign body in children, increase the curative rate and reduce the complications. METHOD: The clinical data of 35 cases with bilateral bronchial foreign body in children were retrospectively analysed, including surgery, key surgery points, and postoperative combined therapy. RESULT: The foreign bodies of all cases were removed under intravenous general and tropical anesthesia without complications. CONCLUSION The bilateral bronchial foreign body is a serious case, the timely and effective treatment can lower the mortality rate and postoperative complications. The children lack of oxygen for a long time before and in operation should be give comprehensive therapy, for example: sedation and hyperbaric oxygen.
Anesthesia ; Bronchi ; pathology ; Bronchoscopy ; Child ; Foreign Bodies ; diagnosis ; surgery ; Humans ; Oxygen ; Postoperative Period ; Retrospective Studies ; Treatment Outcome

Objective To study the experiences of severe acute pancreatitis (SAP) treated by combmation of traditional Chinese and western medicine.Methods Two hundred and forty patients with SAP were divided into A and B groups randomly,140 patients of group B were treated by combination of traditional Chinese and western medicine;100 patients of group A were treated by western medicine.Results After treatment in group B, the serum and urine amylase, and c-reactive protein,signiflcantly decreased.The complication rate of group A and group B was 55.00 % and 12.86 %(P

In the era of digital information,internet plus mode provides new opportunities for the development of traditional medical education.This paper introduces the application patterns of internet plus mode in the medical education,including the following aspects,such as the construction of medical quality resources sharing class,the implementing of medical massive open online courses and other kinds of open online courses,making comprehensive construction of textbooks,using social interactive software and some new wearable devices such as Google glass,distance education and so on.And from the construction of autonomy,sharing,dynamic teaching atmosphere and building a new relationship between teachers and students,it explores the application advantage of Internet plus in medical education,emphasizes thatInternet plus mode and traditional medical education should be organically integrated and financed.At the same time,we should improve the evaluation of information quality,study the integrity test,and the application of big data processing,so as to provide some ideas for the sustainable development.

OBJECTIVE ToinvestigatethepossibleprotectiveeffectofTripterygiumwilfordiipolyg-lycoside (TWP ) on experi mental diabetic nephropathy (D N ) rats and its possible mechanis m. METHODS Thediabeticmodelwasinducedbyasingleintraperitonealinjectionofstreptozotocin (STZ)65 mg·kg -1 .Three weeks after modeling,TWP 4.5,9.0 and 1 8.0 mg·kg -1 was ig given to rats,once daily,for 8 consecutive weeks.During the experiment,the changes of body mass,hair, mental health of rats were observed.Two days before the end of the experi ment,the rats were placed into metabolic cages to collect 24 h urine in order to detect 24 h urinary albu min excretion rate (UAER). The rats were given TWP for 8 weeks and anesthetized with 1 0%chloral hydrate.The blood was collect-ed fro m the heart and centrifuged,seru m creatinine and urine creatinine were measured,and creatinine clearance (Clcr)was calculated.Blood urea nitrogen (BUN)and the serum catalase (CAT)activity were tested by optical method while the level of seru m superoxide oxygen anion(O2÷)was tested by col-orimetry.The level of malondialdehyde(MDA)was determined by thiobarbituric acid condensation,and glutathione peroxidase (GSH-Px)activity was tested by colorimetry.The right kidney was HE stained to observepathologicalchanges.RESULTS Comparedwithnormalcontrolgroup,theratsinmodel control group developed polydipsia,polyuria,polyphagia,body mass loss,unresponsiveness,brown hair,pale tail and apathy clammy.Besides,blood glucose,BUN and 24 h UAER were significantly higher (P<0.01 ),but Clcr was lower (P<0.01 ).The activity of serum CAT and GSH-Px in renal tissue was significantly lower(P<0.01 ),while the level of serum O2÷ and MDA in the renal tissue was significantly higher(P<0.01 ).Compared with model control group,TWP 9.0 and 18.0 mg·kg -1 could improve the general condition of rats.BUN and 24 h UAER were obviously reduced(P<0.01 ),Clcr and serum CAT were increased obviously(P<0.01 ),the level of MDA and O2÷ were reduced obviously(P<0.01 ),and GSH-Px level was increased(P<0.01 ).TWP 9.0 and 18.0 mg·kg -1 could significantly im-prove the renal histopathological changes of rats.TWP 4.5 mg·kg -1 had no significant effect on the aboveindicators.CONCLUSION TWPhasprotectiveeffectontherenalfunctionofexperimentalDN rats.The mechanis m may be related to inhibition of the oxidative stress and enhance ment of the body antioxidant capacity.

Objective To explore the diagnostic consistency and correlation between MR discography (MRD) and CT discography (CTD) in diagnosing chronic low back pain. Methods Guided by C - arm fluoroscopy the mixed solution of gadoterate meglumine (GD-DOTA) and Iohexol (GD-DOTA at a dilution of 1 ∶ 400 with Iohexol) was injected into 96 lumbar intervertebral discs of the 36 patients. CT scanning was performed at 15 minutes after the injection of contrast, and axial together with sagittal SE T1WI MR scanning was carried out one hour after the injection. CTD and MRD images were randomly numbered and were independently evaluated by two experienced radiologists according to Dallas discogram scale in order to assess the diagnostic consistency and correlation between (MRD) and (CTD). In addition the diagnostic value of MRD was evaluated. Results The results revealed that in determining disc degeneration grade CTD and MRD were highly consistent with each other(Kappa = 0.836, P < 0.01), and the diagnostic results judged by the two reviewers were essentially in agreement (ICC = 1.00, P < 0.01; r = 0.997, P < 0.01). Higher consistency (Kappa = 0.836, P < 0.01) and correlation(ICC = 0.90, P < 0.01; r = 0.869, P < 0.01; Kappa =0.836, P < 0.01) in determining annulus rupture extent were also obtained. Conclusion MRD is an accurate diagnostic method for the determination of disc degeneration and the severity of annulus rupture, and this technique has greater consistency and correlation with CTD in diagnosing chronic low back pain.