Objective To evaluate the safety and feasibility of hysteroscopy in the treatment of endogenous type cesarean section scar pregnancy (CSP). Methods Clinical data of 58 cases of CSP from August 2012 to February 2014 in our hospital were analyzed retrospectively.Thirty-one cases were treated by hysteroscopy,while 27 cases were treated by laparoscopy.The intraoperative blood loss,operation time,postoperative hospital stay,postoperative drainage of uterine cavity,β-hCG level resolution time and time to menstruous restoration were compared between the two groups. Results The intraoperative blood loss,operation time,length of hospitalization after operation,and time to menstruous restoration were statistically lower in the hysteroscopy group than those in the laparoscopy group [(109 ±59)ml vs.(143 ±63)ml,t =-2.121 ,P =0.038;(43.7 ±17.5)min vs.(100.8 ±18.8)min,t =-1 1 .974,P =0.000;(3.8 ±0.7)d vs.(4.5 ±0.6)d,t =-4.057,P =0.000;(43.8 ±3.9)d vs.(45.9 ±3.8)d,t =-2.070,P =0.043].There were no significant differences in postoperative drainage of uterine cavity and β-hCG level resolution time between the two groups [(22.1 ±2.8)ml vs.(23.6 ±3.2)ml,t =-1 .904,P =0.062;(20.5 ±7.7)d vs.(22.9 ±9.3)d,t =-1 .075,P =0.287]. Conclusion Hysteroscopy has advantages of less intraoperative blood loss,shorter hospitalization time and quicker recovery in the treatment of endogenous type CSP.

Anesthesia ; methods ; Child ; Child, Preschool ; Female ; Foreign Bodies ; surgery ; Humans ; Infant ; Male ; Muscle Relaxants, Central ; therapeutic use ; Respiratory System

Objective To explore the therapeutic effects of Ni-Ti memory alloy embracing fixator on the multiple fracture of ribs and flail chest. Method From January 2006 to December 2009, the effects of operation and long-term follow-up after internal fixation operation with memory alloy embracing fixator in patients with multiple fracture of ribs and flail chest were observed. Results The hospital stay of patients treated with memory alloy embracing fixator was 10.31 ± 3.14 days and pain was significantly reheved after treatment ( P= 0.02) .The rate of post-operative complications was 17.65% such as atelectasis, pulmonary infection, etc. There were fewer longterm complications and less influence to daily activity of life. Conclusions It is a advanced and practical method for patients with the multiple fracture of ribs by using Ni-Ti memory alloy embracing fixator with slighter trauma,simple, safe, reliable, good histocompatibility and fewer post-operative complications.

Objective:To clone the RC-RNase gene and prepare its recombinant prokaryotic construct, and then to express RC-RNase protein using Escherichia coli system. Methods: RC-RNase cDNA was obtained by RT-PCR from liver of Rana catesbeiana, and cloned into pUCm-T plasmid for nucleotide sequencing. Its expression construct was prepared using the 6?His vector pRSET-A, and induced to express by IPTG in Escherichia coli BL21(DE3). Western blotting identified the expression product. Results: A 380 bp long cDNA was obtained from liver of Rana catesbeiana, restriction sites and sequence being consistent to those reported for RC-RNase. After introducing the gene into Escherichia coli and through the induction by IPTG, it was observed a new peptide at the expected position (Mr 16000) on SDS-PAGE gel. This product was proved to be the target protein via Western blotting. It existed in a form of inclusion body and its efficiency reached 12.5% of total bacterial proteins. Conclusion: RC-RNase gene was cloned and expressed in Escherichia coli. The protein could be used for characterizing the biological activities and function of RC-RNase.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

Objective Excision repair cross-complementing gene-1(ERCC1) are key regulatory enzymes whose expression patterns are associated with overall survival(OS) in several malignancies.Their expression patterns and prognostic value in resected gastric adenocarcinoma(GAC) are not known and need to investigate.Methods A total of 109 patients who underwent resection for GAC in Liu′an People′s Hospital from January 2010 to June 2013 had tissue available for analysis.The primary objective was to assess for the differential expression of ERCC1 using by immunohistochemistry.The secondary objective was to assess for the association between OS and the expression of ERCC1.Results The median follow-up was 21.2 months,and the median OS was 28.8 months.Resected GAC exhibited differential expression of ERCC1(high expression,n=25(23%)).ERCC1 expression was not associated with OS(18.9 months vs.27.7 months,P=0.72).In a subset analysis of patients who received chemotherapy(n=73),high ERCC1 expression was associated with decreased OS(16.7 months vs.53.8 months,P=0.03).After controlling for known adverse pathologic features,high ERCC1 expression persisted as a negative prognostic factor in multivariate Cox regression analysis(HR=2.22,95% CI1.05-4.98,P<0.05).Conversely,in patients who underwent resection only(n=35),high ERCC1 expression demonstrated a trend toward improved OS(40.4 months vs.12.7 months,P=0.10).A positive prognostic influence also was present on multivariate analysis(HR=0.20,95% CI0.05-0.84,P=0.03).Conclusion Resected GAC exhibited differential expression of ERCC1.Among all patients,ERCC1 expression levels were not associated with OS.High ERCC1 tumor expression is associated with decreased OS in the patients who received chemotherapy but is associated with increased OS in those who underwent surgery alone.ERCC1 expression have prognostic value in resected gastric cancer,and further investigation is needed.

Background Experimental data have shown tnat polymorpnisms in tne angiotensm-converting en- zyme 2(ACE2)gene are related to echocardiographically determined parameters of left ventricular mass,structure or function in the general population whether ACE2 genotype influences the effect of angi0tensin Ⅱ receptor blocker which improve left ventricular remodeling and function is unknown.Objective To investigate the association be- tween ACE2 gene G9570A polymorphism and the effect of irbesartan on left ventricular structure and function in hy- pertensive patients.Methods Two hundred and five male patients and 190 female patients who were preliminaryly diagnosised with mild and moderate essential hypertension were treated with irbesartan for 48 weeks with initial dose of 150 mg/d and titrated to 300 mg/d to reach the targed BP.Gene polymorphisms of ACE2 G9570A were detected by PCR-RFLP methods.The association between changes in the SBP,DBP,parameters of left ventricular struc- ture and function and genotypes of the ACE2 gene locus were analyzed.Results Irbesartan reducted in blood pres- sure in all patients(P

Objective To investigate the expressions of KLF2 mRNA and KLF4 mRNA in the acute lung injury (ALl) rats induced by lipopolysaccharide (LPS),and to analyze the correlation between KLF2,KLF4 and ALI.Methods A total of 100 SD rats were randomly divided into 2 groups:normal control group and LPS treated group,then the latter group was randomly further divided into 3 subgroups as per the serum and lung tissue samples taken separately at 2,4 and 24h after modeling.The ALI model was made by injecting 5mg/kg LPS into tail vein.The pathological changes of lung tissue were observed in each group,and the expressions of KLF2,KLF4 mRNA in serum and lung tissue were detected by RT-PCR.The data of laboratory findings were analyzed with SPSS 17.0 software for statistical analysis.Results The histopathological changes showed the most obvious damage of lung tissue occurred at 4 hours after modeling.The expressions of KLF2 mRNA and KLF4 mRNA in the lung tissue and serum of control group were significantly higher compared to LPS treated subgroups (P ＜0.01).The expression of KLF2 mRNA in LPS treated subgroup at 2 hours was lower than that in LPS subgroups at 4 hours and 24 hours (P ＜ 0.01),while the expression of KLF4 mRNA in LPS treated subgroup at 4 hours was lower than that in LPS treated subgroups at 2 hours and 24 hours (P ＜ 0.01).Conclusions The expression of KLF2 mRNA was occurred earlier than the pathological changes in acute lung injury,while the expression of KLF4 was emerged synchronously,and both KLF2 and KLF4 could be used as candidates of predictive and diagnostics molecular markers of ALI.

OBJECTIVETo compare differences of clinical therapeutic effect of heat-sensitive moxibustion with different doses for irritable bowel syndrome (IBS).

METHODSSixty cases of IBS were randomly divided into a saturated-dose group (30 cases) and a traditional-dose group (30 cases). Heat-sensitive moxibustion was applied in both groups. The acupoints that had the strongest heat-sensitive feeling were selected and treated by warm and suspended moxibustion with moxa stick. Disappearance of heat-sensitive feeling was taken as the sign of treatment time in the saturated-dose group, while the traditional-dose group was treated for 15 min each time. The treatment in both groups was given twice a day for first 5 days, and from the sixth day it was given once a day for continuous 25 times, totally 30 days. Clinical symptom scores and therapeutic effect before and after treatment in two groups were observed.

RESULTSAfter the treatment, the cured and markedly effective rate was 75.0% (21/28) in the saturated-dose group, which was inferior to 44.4% (12/27) in the traditional-dose group (P < 0.05). The clinical symptom scores, including diarrhea, abdominal distension and pain, were obviously reduced in two groups compared with those before the treatment (all P < 0.05). Compared with the traditional-dose group, the symptom scores of diarrhea and abdominal distension in the saturated-dose group were obviously decreased (0.87 +/- 0.13 vs 1.27 +/- 0.21, P < 0.01; 1.12 +/- 0.41 vs 1.32 +/- 0.26, P < 0.05).

CONCLUSIONThe moxibustion featured with disappearance of heat-sensitive feeling and saturated dose has better therapeutic effect than that with traditional-dose for treatment of IBS. As individual dynamic amount of moxibustion, disappearance of heat-sensitive and quantitation varies from person to person, which is one of the key factors to obtain the best curative effect.

Acupuncture Points ; Adult ; Female ; Humans ; Irritable Bowel Syndrome ; therapy ; Male ; Middle Aged ; Moxibustion ; Treatment Outcome ; Young Adult

The article introduces a new method for three-dimensional reproduction of edentulous dental casts, and wax occlusion rims with jaw relation by using a commercial high-speed line laser scanner and reverse engineering software and evaluates the method's accuracy in vitro. The method comprises three main steps: (i) acquisition of the three-dimensional stereolithography data of maxillary and mandibular edentulous dental casts and wax occlusion rims; (ii) acquisition of the three-dimensional stereolithography data of jaw relations; and (iii) registration of these data with the reverse engineering software and completing reconstruction. To evaluate the accuracy of this method, dental casts and wax occlusion rims of 10 edentulous patients were used. The lengths of eight lines between common anatomic landmarks were measured directly on the casts and occlusion rims by using a vernier caliper and on the three-dimensional computerized images by using the software measurement tool. The direct data were considered as the true values. The paired-samples t-test was used for statistical analysis. The mean differences between the direct and the computerized measurements were mostly less than 0.04 mm and were not significant (P>0.05). Statistical significance among 10 patients was assessed using one-way analysis of variance (P<0.05). The result showed that the 10 patients were considered statistically no significant. Therefore, accurate three-dimensional reproduction of the edentulous dental casts, wax occlusion rims, and jaw relations was achieved. The proposed method enables the visualization of occlusion from different views and would help to meet the demand for the computer-aided design of removable complete dentures.
Analysis of Variance ; Computer-Aided Design ; Dental Models ; Denture Design ; Denture, Complete ; Dimensional Measurement Accuracy ; Humans ; Imaging, Three-Dimensional ; methods ; Jaw Relation Record ; Lasers ; Mouth, Edentulous ; rehabilitation ; Waxes