Objective To discuss the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) in ovarian endometriosis after laparoscopic operation.Methods One hundred and fifty patients with ovarian endometriosis were treated by placement of LNG-IUS after laparoscopic operation (study group).The therapeutic effect and adverse reaction were observed.Fifty patients with ovarian endometriosis only treated by orally gestrinone were as control group.The rate of recurrence was compared.Results After placement of LNG-IUS for 3,6,12 months,the thickness of endometrium in study group was significantly thinner [(6.02 ± 1.84),(5.68 ± 1.38),(4.04 ± 1.24) mm vs.(7.85 ± 1.62) mm],the amount of menorrhea and the scores of visual analogue scale (VAS) was significantly decreased [(48.29 ± 7.04),(32.64 ± 6.09),(19.74 ± 4.78) ml vs.(65.63 ± 7.83) ml,(35.74 ± 16.34),(20.54 ± 12.29),(13.79 ± 10.38) scores vs.(78.13 ± 15.69) scores],there was significantly difference compared with that before treatment (P ＜ 0.05).After placement of LNG-IUS for 3 months,the menstrual period in study group was significandy longer than that before treatment [(9.42 ± 3.75) d vs.(6.69 ± 2.83) d],and after placement of LNG-IUS for 12 months,the menstrual period in study group [(4.53 ± 1.37) d] was significantly shorter than that before eatment (P ＜ 0.05).In study group,the menstrual cycle had no significant difference among different time point (P ＞0.05).In follow-up period,the adverse reaction in study group was mainly intermenstrual bleeding,and the rate of intermenstrual bleeding was gradually decreased (P ＜ 0.05).Others adverse reaction was rare,and the incidence rate was gradually decreased.The rate of recurrence in study group was significandy lower than that in control group [14.7％(22/150) vs.30.0％(15/50)](P＜0.05).Conclusion Placement of LNG-IUS after laparoscopic operation can reduce symptoms and signs,and can play important role in preventing recurrence.

AIM:To identify intragenic mutation loci of the BEST-1 gene with congenital vitelliform macular dystrophy by molecular genetic analysis at one family in Northeast China.
METHODS: Genomic DNA was extracted from peripheral leukocyte of 2 patients and 5 healthy members in the family with vitelliform macular dystrophy and 100 normal controls. Ten exon sequences of BEST - 1 amplified by polymerase chain reaction ( PCR ) were made direct DNA sequencing to define the gene mutation loci and compared with gene screening performed on 100 normal controls.
RESULTS: After the direct DNA sequencing, no mutation loci was found in all the patients of this family with vitelliform macular dystrophy.
CONCLUSION:There is no mutation in the exons of BEST-1 gene causing disease genes in this family.

Objective To investigate the effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome(NSTE -ACS).Methods 195 patients with NSTE -ACS were divided into ST segment elevation in lead aVR group(n =54 cases)and non -ST segment elevation in lead aVR group(n =141 ) according to ST segment elevation in lead on admission;clinical data,laboratory index and coronary artery lesion were recorded,and major adverse cardiac (MACE)in hospitalization time were also recorded.Results Compared with non -ST segment elevation in the lead aVR group,the heart rate of ST segment elevation in the lead aVR group was faster[(85.4 ±12.0)beats per minute vs.(79.3 ±13.2)beats per minute,t =2.959,P <0.05],systolic blood pressure and diastolic blood pressure were higher[(145.0 ±20.3)mmHg vs.(136.0 ±19.4)mmHg,t =2.874,P <0.05];NT -proBNP[(743.9 ±125.8)pg/mL vs.(416.4 ±95.3)pg/mL,t =19.625,P <0.05],cTnI[(3.4 ± 1.0)ng/mL vs.(1.2 ±0.4)ng/mL,t =21.994,P <0.05],CK -MB[(31.5 ±9.8)ng/mL vs.(19.8 ±6.5)ng/mL, t =9.682,P <0.05]were higher (P <0.05);LVEF were lower[(50.1 ±5.2)% vs.(53.8 ±5.7)%,t =4.153, P <0.05];the rate and amplitude of low ST segment in outside lead aVR also was higher[(9.5 ±3.8)mm vs. (7.4 ±2.8)mm,t =4.224,P <0.05];the rate of left main and three -vessel disease in ST segment elevation in lead aVR group were higher (P <0.05).Compared with non -MECE group,proportion of ST segment elevation in lead AVR on admission was higher (P <0.05).Logistic regression analysis showed that heart rate(OR =1.472),NT -proBNP(OR =1.732),cTnI(OR =1.893),left main coronary artery(OR =2.478)and three -vessel disease (OR =2.310)were risk for ST segment elevation in lead AVR(P <0.05).Logistic regression analysis also showed that ST segment elevation in lead AVR were risk for MACE(OR =1.474).Conclusion ST segment elevation in lead AVR has close relationship with large area of myocardial ischemia,and patients prognosis is poorer,which may be independ-ent risk factor for the recent outcomes of patients with NSTE -ACS.Early record of the change in the case of aVR lead ECG ST segment NSTE -ACS patients is of important value in evaluation of the condition and prognosis.

Bile reflux gastritis (BRG)has been recognized as a chemical gastropathy due to excessive duodenogastric reflux (DGR).Abnormalities in pyloric anatomic structure,as well as antropyloric and duodenal dysmotility are considered to be implicated in the occurrence of pathologic DGR.Bile acid may induce apoptosis of gastric mucosal cells,and high concentration of bile acid plays a crucial role in the induction of intestinal metaplasia in stomach.In this review article, advances in study on BRG,including the mechanisms of DGR,the pathogenic effect of bile acid on gastric mucosa,and the diagnosis and treatment of BRG were summarized.

Perioperative nutrition support may be required when the synthesis and utilization of nutrients become disordered due to gastrointestinal abnormalities and trauma anesthesia. Proper nutrition support can reduce or prevent malnutrition, and thus facilitate the recovery and lower complications and case-fatality rate.

Objective: To study on in vitro release of tetanus toxoid contained in polylactide microsp heres and the influence of additives on the drug release. Methods: Some parameters affecting the rate of release were asse ssed during the in vitro experiments lasted 84 days: (1)the molecular mass of the poly mers , (2)the protein loading of the microspheres, (3)the particle sizes, (4)co-enca p sulation of additives. Results: The polylactide microspheres con taining tetanus toxoid presented considerable sustained release effect. Release kinetics of the microspheres fitted in with zero order equations. The rate of release was shown to dep end on the four parameters mentioned above. Conclusion: The poly lactide microsph eres investigated may be prospective for the development of controlled release v accines.

Objective To assess the psychometric properties of the Chinese version of Family Man-agement Measure (FaMM). Methods FaMM was translated into Chinese and distributed to 330 caregivers whose children had chronic diseases to fill the questionnaire. Results Cronhach's alpha coefficient for the subscales ranged from 0.52 to 0.86, indicating acceptable internal consistency. The content validity index was 0.84. Construct validity was supported by significant correlation between FaMM and FAD and CBCL,Pearson correlation coefficient ranged from 0.11 to 0.38. The relationship among them accorded with the expected trends of Family Management Style Framework. The result of factor analysis indicated 9 factors explaining 60.08% variance. Conclusions The psychometric property of the Chinese version of FaMM was acceptable and it could be regarded as a reliable and valid instrument to measure the family response of Chinese families whose children had chronic diseases.

The paper analyzed the problems of preparing before class,exerting teaching methods,applying multimedia and summarizing after class in neurology teaching and brought forward some solving countermeasures.

Objective To investigate the clinical efficacy of joint-corresponding point selection plus exercise acupuncture in treating acute ankle sprain.Method Enrolled 70 patients with acute ankle sprain were randomly allocated to two groups.The treatment group received joint-corresponding point selection plus exercise acupuncture and the control group,elastic bandage fixation.Both groups were given ice compress,mobilizationand elevation as auxiliary measures.Treatment was provided seven days as one coursefor a total of two courses.The pain, tenderness, swelling andrange of activitieswere scored in the two groups of patients before and after treatment.Thetherapeutic effects were compared.Result The total efficacy rate was 88.6% in the treatment groupand54.3% in the control group.The therapeutic effect was significantly better in the treatment group than in the control group (P<0.01). Joint pain, tenderness, swelling and activity scores decreased in the two groups after treatment (P<0.01). Joint tenderness and activity scores were lower in the treatment group than in the control group after treatment (P<0.01).Conclusion Joint-corresponding point selection plus exercise acupuncture has clinically a marked therapeutic effect on acute ankle sprain.