2 000 mIU/ml,combined use of mifepristone(100 mg,twice daily,for 3 days) was employed. Results The treatment succeeded in 28 patients,with a success rate of 87.5%.Acute lower abdominal pain occurred in 4 patients and laparoscopic salpingectomies were carried out.The serum ?-hCG levels decreased by 23%~35% at 3 days after injection,by 38%~62% at 1 week,and to normal levels(≤6.1 mIU/ml) at 2~4 weeks.The mass completed subsided at 30～55 days after injection. Conclusions Transvaginal ultrasound guided methotrexate injection for the management of unruptured early tubal pregnancy is simple,safe, and effective.Further investigations should be carried out in respect of the recovery of tubal anatomy and physiological functions.

Objective To establish a RP-HPLC method for determination of the concentrations of dextromethorphan and its metabolites dextrorphan in human urine.Methods Phenacetine was used as internal standard,and the urine sample was hydrolyzed by enzyme,alkalified and extracted with hexane-butanol(91).The separation was carried out on DiamonsilTM C18 column(250 mm?4.6 mm,5 ?m) with mobile phase of acetonitrile-1% triethylamine buffer solution(pH adjusted to 2.2 with H3PO4).Gradient elution was done for 0-15 min(20%-35% A).The flow rate was 1.0 ml/min.The detection wavelength was set at 280 nm and the column temperature was 40℃.Results The linear ranges of dextromethorphan and dextrorphan were 0.05-2.0 ?g/ml(r=0.999 9,n=5) and 0.5-20.0 ?g/ml(r=0.999 9,n=5),respectively,and their lowest detecting concentrations were 0.04 ?g/ml and 0.4 ?g/ml,respectively.The intra-day and inter-day precision were both less than 10%.The low,middle and high extraction recoveries were between 94%-108%.Conclusion Our method is accurate and sensitive,and is suitable for the CYP2D6 phenotype analysis and pharmacokinetic studies of dextromethorphan and its metabolites in human.

Aged ; Antigens, CD ; metabolism ; Antigens, Differentiation, Myelomonocytic ; metabolism ; Carcinoma, Signet Ring Cell ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Gastrectomy ; methods ; Histiocytic Sarcoma ; metabolism ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Male ; Phosphoglucomutase ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; surgery

Objective To observe the characteristics of cognitive impairment in patients with primary hypothyroidism.Methods A total of 90 primary hypothyroidism patients untreated with thyroid hormone were selected.All the 90 patients were divided into subclinical hypothyroidism group,mild or moderate hypothyroidism group and serious hypothyroidism group,and 30 patients in each group.The other 30 healthy volunteers were selected as controls.Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used for the testing their orientation,immediate memory,attention and calculation,delayed recalling,linguistic competence,visual space and execution,naming ability and abstracting power.One-way analysis of variance was performed to determine significant differences among four groups.Results The MMSE scores in subclinical hypothyroidism group,mild or moderate hypothyroidism group and serious hypothyroidism group((27.53 ± 2.16),(26.90±1.88) and (24.80 ± 2.10) respectively) were lower than those of the control (28.23 ± 1.33).The MoCA scores of the above hypothyroidism groups ((23.57 ± 3.33),(2 1.60 ± 2.81) and (20.53 ± 3.03) respectively) were also lower than that of the control (26.63 ± 2.31) (P ＜ 0.05).Except for orientation and immediate memory,statistical significances of the other cognitive function were existed between hypothyroidism groups and the healthy controls (P＜ 0.05).With the increase in severity of hypothyroidism,the abnormality of attention,calculation,linguistic competence,visual space and executive ability,naming ability and abstracting power were appearing gradually in hypothyroidism groups (P ＜ 0.05),and the scores were low(P＜ 0.05).Conclusion Defects of attention and calculation,delayed recalling,linguistic competence,visual space and execution,naming ability and abstracting power are existed in primary hypothyroidism patients.

ObjectiveTo determine endometrial thickness, endometrial volumeand, endometrial and subendometrial blood flows, by using transvaginal two-dimensional (2D) and three-dimensional (3D) ultrasound examination and to compare the value of all the parameters in the prediction of endometrial receptivity during in vitro fertilization-embryo transfer (IVF-ET) cycles.MethodsOne hundred and twenty patients undergoing IVF cycles were recruited for this study. Transvaginal 2D and 3D ultrasound examination was performed to determine endometrial thickness, endometrial volume, pulsatility index (PI), resisitance index (RI) , systolic/diastolic ratio (S/D) of endometrial, subendometrial blood flows , vascularization index (VI), flow index (FI) and vascularization flow index (VFI) of endometrial and subendometrial regions by experienced sonographers on the day of human chorionic gonadotropin (HCG) injection. Statistical comparison was carried out by Mann-Whitney test. The receiver operator characteristic (ROC) curve analysis was applied and the area under the curve (AUC) was calculated. Statistic analyses were performed using SPSS 13.0. The two-tailed value of was considered statistically significant.ResultsThere were no significant differences between the pregnant group and non-pregnant group in endometrial thickness, endometrial volume (P>0.05). Patients in the pregnant group had lower PI, RI and S/D of endometrial and subendometrial blood flows than those in the non-pregnant group (Z=-3.811,-3.097,-2.071, P=0.001, 0.001, 0.038), with statisticalsignificant difference. Patients in the pregnant group had higher VI, FI and VFI of endometrial and subendometrial regions than those in the non-pregnant group (Z=-1.970,-2.698,-1.981, P=0.490, 0.007, 0.048;Z=-2.098,-2.090,-2.115,P=0.036, 0.037, 0.034), with statistical significant difference. ConclusionsEndometrial and subendometria blood flows measured by transvaginal 2D and 3D ultrasound can be as a reliable indicator to assess endometrial receptivity and predict the pregnancy outcome. Among all the endometrial and subendometrial blood flow parameters, VI of endometrial and subendometrial are better predicators.

Objective To assess the safety, tolerability and efficacy of preoperative low dose intravenous amiodarone in the prevention of atrial fibrillation (AF) after off-pump coronary artery bypass grafting (OPCAB). Methods Two hundred patients with coronary atheroselerotic heart disease underwent selected OPCAB and were randomly divided into two groups: control group (100 cases) and experimental group (100 cases). Patients in control group were given conventional medicines and placebo, and patients in experimental group were treated with low dose intravenous amiodarone daily for 4 days before surgery. They were given conventional medicines after surgery. Results After the off-pump coronary artery bypass grafting, the incidence of AF, ventricular rate and the duration of AF in the experimental group were lower than those in control group [15% vs. 41%, χ2=16.766, P=0.000; (126.0±20.8) times/ min vs. (150.0±25.6) times/ min, t=0.478, P =0. 017; (8. 0±8. 6) h vs. (12.0±9.6) h, t=0. 439, P=0. 019]. No significant difference were found in the incidence of side effect between low close amiodarone group and the control group. Conclusions Prophylactic application of low dose intravenous arniodarone before off-pump coronary artery bypass grafting can safely and effectively reduce the postoperative ventricular rate and the incidence of AF, shorten the duration of AF, promote the rehabilitation and slightly improve the clinical symptoms.

Objective To observe the effect of pulsed radiofrequency (PRF) on refractory infraorbital neuralgia. Methods From January, 2012 to December, 2014, 49 patients who received ineffective conservative therapy including medicine and nerve blockade underwent PRF treatment. Postoperative Numeric Rating Scale (NRS)=0 or 50%diminution of NRS was considered effective. NRS, effective rate, addition-al carbamazepine dosage and side effects were recorded on the first day, the first week, the second week, the first month, the third month, the sixth month, the first year, and the second year after operation. Results The effective rate were 67%, 67%, 65%, 59%and 51%on the first month, the third month, the sixth month, the first year, and the second year after operation, respectively. No serious side effect was observed, except that eight patients felt short-term (within one month) mild numbness. Conclusion PRF technique is safe and effective for refractory infraorbital neuralgia, and may become an alternative therapy.

Objective To observe the effect of radiofrequency thermocoagulation on patients with refractory supraorbital neuralgia Methods From February, 2007 to September, 2014, 36 patients with refractory supraorbital neuralgia following ineffective conservative ther-apy including medicine and nerve blockade underwent radiofrequency thermocoagulation. Numeric Rating Scale (NRS), Patient Satisfaction Scale (PSS), onset time, effective rate, recurrence rate, additional carbamazepine dosage and side effects were recorded before, and one day, one month, three months, six months, one year, two years after treatment. NRS=0 or 50%diminution was considered effectively. Results It worked two days on average (zero to seven) after treatment. The NRS score decreased (P<0.05) and the PSS score increased (P<0.05) com-pared with the data before treatment. The effective rate was 100%within six months. The recurrence rate was 11.1%within two years. Sec-ond radiofrequency thermocoagulation treatment still worked for the recurrent patients. No other side effect was observed, except permanent frontal numbness, short-time palpebral edema and ecchymosis. Conclusion Radiofrequency thermocoagulation is effective on refractory su-praorbital neuralgia, and the side effects are tolerable so it is an alternative choice for patients experiencing invalid conservative therapy.

Abstract: Objective　To analyze the drug sensitivity and the carrying of carbapenem resistant gene of Acinetobacter baumannii isolated from clinical patients and clinical objects, and analyze the homology of strains to provide support for the control of nosocomial infection. Methods　A total of 38 strains of Acinetobacter baumannii isolated from patients and clinical objects surface were collected from January 2019 to August 2020. The antimicrobial susceptibility was tested by the minimum inhibitory concentration method. In addition, the resistance related genes were detected by polymerase chain reaction method, and homology analysis was performed by enterobacterial repetitive Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR). Results All 34 strains of Acinetobacter baumannii isolated from Clinical patients and 4 strains isolated from clinical objects carried blaOXA-51 and imp resistance genes, neither of them carried blaVIM gene. 32 Acinetobacter baumannii carrying blaOXA-23 gene, 28 strains carrying blaTEM gene, 7 strains carrying blaOXA-58 gene. After cluster analysis, 38 Acinetobacter baumannii isolates were classified into 7 genotypes (expressed A, B, C, D, E, F, G), and cluster E and cluster G were the main clusters, containing 12 strains (12/38, 31.6%) and 18 strains (18/38, 47.4%), respectively, as the main prevalent clonal strains. Conclusions　Acinetobacter baumannii isolated from different sources have the significant differences in drug resistance and carry different resistance genes. There is no direct correlation between patients and environmental isolates of Acinetobacter baumannii belonging to different clonal strains. Also, there aren’t significant correlation between clinical patients infected with Acinetobacter baumannii.

In MAST (mRNA accessible site tagging),the DNA tags from synthesized library were employed for identifying mRNA accessible sites. A large number of tags were amplified and subcloned for sequencing to verify mRNA binding profiles. A PCR was designed by using one primer which bridges over the tag terminal sequences. In PCR reaction DNA tag fragments were concatemerized by a bridge primer in reaction cycles. The concatemerized tag fragments were subcloned and sequenced. Dozens of the concatemerized sequences contained thousands tags. The PCR was a simple,effective way which for sequencing tags in a high through put manner.