Objective To approach the feasibility of the development and routinely carrying out of gynecological analgesia. Methods A total of 286 pregnant women, 58 were primiparae with full-term fetus and 228 were for mid-term delivery or induced abortion, were enrolled in present study. The combined lumbar-epidural analgesia (CLEA) and the patient-controlled epidural analgesia (PCEA) were given to the primiparae and the ones for mid-term delivery, and the intravenous anesthesia was given to those for induced abortion. Results Among the primiparae and the ones for mid-term delivery, VAS scores were rapidly reduced from 87.7?12.5 and 51.1?14.1 to 8.7?8.8 and 10.6?6.2, respectively, within 3 minutes by CLEA, the effective rates of analgesia were 94% and 100%, respectively. For all of them the Bromage evaluation was in 0 degree. After the induction of labor, no algesia memory existed in the women for induced abortion, the operative time was 15.28?2.57 minutes, the dosage of propoful was 162.9?39.8 mg (about 3mg/kg), and the dosage of fentanyl was 0.05 mg. The incidence of hypotension after intravenous anesthesia was 5.8%. Conclusions Intravenous anesthesia with propoful may remit the panic and fearful sense of pregnant women to induced abortion, and reduce the pain during operation. It is suggested to develop widely and carry out routinely the intravenous anesthesia as an effective and safe technique in gynecological analgesia.

Ninety eight transvaginal hysterectomies were performed for non prolapse and enlarged myomatous uteri or adenomyosis , with the size equivalent to 6～18 gestational weeks or 138～741g . Bisection , enucleation, morcellation , coring and combination thereof were used to facilitate the operation by reducing the uterine volume. The results showed that, out of 98, 93 cases of vaginal hysterectomy were performed successfully . The average weight of the uterus for the 98 cases were 376g (ranging from 138 to 741g), the mean time for the operation was 99 minutes (ranging from 40 to 135 minutes), the average quantity of blood loss was 245 ml (range 50 to 600ml). The morbidity rate was as low as 3.1% and the average postoperative hospital stay was 5.4 days (range 4 to 9 days). These data suggest that non prolapse and enlarged uterus can be safely removed transvaginally through reduction of the uteriune volume . Not only the size , but also the shape and the mobility of the uterus should be considered when indication for transvaginal hysterectomy existed . The successful operation was closely related to the operator’s skill and experiences .

Objective To study the expression of ARHI mRNA,an imprinted suppressor gene,in ovarian serous carcinoma and the methylation status of its three CpG islands,and to determine the possible role of aberrant methylation of ARHI gene in pathogenesis of ovarian serous carcinoma.Methods Twenty normal ovarian specimens and 20 ovarian serous carcinoma specimens were analyzed.Total RNA was extracted and semi-quantitative RT-PCR was employed to detect the mRNA expression of ARHI gene.Methylation status of three CpG islands were examined by DNA bisulfite treatment,PCR amplification and methylation specific restriction enzymes,TagI for CpG I and III,BstUI for CpG II.Results The average of ARHI/G3PDH was 0.73?0.09 in normal ovarian specimens,and it was 0.43?0.37 in ovarian carcinoma specimens(P

Objective To study the impact of vaginal mesh exposure on quality of life in patients undergoing transvaginal reconstructive pelvic surgery (RPS) with polypropylene mesh.Methods From May 2004 to March 2011,114 patients with severe pelvic organ prolapse(POP) undergoing transvaginal RPS with polypropylene mesh were enrolled in this study,which were divided into exposure and non-exposure group according to appearing vaginal mesh exposure at 2 months,6 months and 1 year after operation.At the same time,pelvic floor distress inventory short form 20 ( PFD1-20 ) and pelvic floor impact questionnaire short form 7 ( PFIQ-7 ) were completed in those patients.Results At 2 months after operation,96 patients were followed up,including 19 patients in exposure group and 77 patients in non-exposure group,and the rate of exposure was 19.8c (19/96); At 6 months after operation,85 patients were followed up,including 13 patients in exposure group and 72 patients in non-exposure group,and the rate of exposure was 15.3％( 13/85 ) ; At 1 vear after operation,77 patients were followed up,including 6 patients in exposure group and 71 patients in non-exposure group,and the rate of exposure was 7.8％ (6/77).Mean score of PFDI-20 and PFIQ-7 in exposure group before operation was 39.6 and 57.1,which was statistically improved to 8.3 and 9.5 at 2 months after operation,8.3 and 9.5 at 6 months after operation,2.1 and 0 in I year after operation (P ＜0.01 ). Mean score of PFDI-20 and PFIQ-7 of non-exposure group before operation was 54.2 and 66.7,which was improved to 8.3 and 4.8 at 2 months after operation,0 at 6 months and 1 vear after operation,but there was no significant difference in mean score of PFDI-20 and PFIQ-7 between the two groups (P ＞ 0.05 ).Conclusion Vaginal mesh exposure was common after transvaginal RPS with polypropylene mesh,however,most of them were moderate,and there was no significant impact on patients'qualifies of life.

Objective To evaluate the mid-term effect of total hip arthroplasty (THA) after failed internal fixation of intertrochanteric fracture.Methods Twenty-one patients treated with THA due to failed internal fixation of intertrochanteric fracture from January 2007 to December 2010 were studied retrospectively.There were 10 males and 11 females,at mean age of 71.7 years (range,66-79 years).Sixteen patients were treated with dynamic hip screws/dynamic condyle screws (DHS/DCS),3 proximal femoral nails,2 hollow screws.Mean interval from internal fixation to THA was 29 months (range,10-79 months).Causes for the failed internal fixation were loosening,cutting,and breakage of screws which generated fracture displacement or nonunion in 19 patients and femoral head necrosis in 2 patients.All patients received THA with uncemented acetabulum cups and proximally long-stemmed,porous-coated titanium femoral components including AML stems for 5 patients and Solution stems for 16 patients.Moreover,greater trochanteric fracture was fixed by Luke wire.Harris hip score were measured before operation and at final follow-up.Radiographs were performed before operation,at 3,6 and 12 months after operation,and at final follow-up to assess the fracture restoration,healing,prosthesis initial fixation,and mid-term survival condition.Results One patient was died due to pulmonary infection 1.5 years after operation.Two patients were lost to follow-up and 18 patients were followed up for 3-5 years (mean,3.9 years).At final follow-up,13 patients regained the ability to walk independently,4 needed support of a cane,1 needed assistance of a walker.There were no signs of loosening,subsidence or rupture of the prosthesis.Mean Harris hip score increased from 25.3 points preoperatively to 80.6 points at final follow-up; the score was excellent in 11 patients,good in 6,good in 1,with the excellent and good rate of 94％.Conclusion THA can improve hip function,patients' quality of life and midterm outcome in salvage of failed internal fixation of intertrochanteric fractures.

Objective To evaluate the clinical effects of open reduction plate screw nail internal fixed and minimally invasive elastic intramedullary nail internal fixation combined with neck strap suspension for treating adult humeral shaft fracture . Methods A retrospective analysis was made on the clinical data of 65 patients with humeral shaft fracture in our hospital from March 2012 to March 2014 ,including 38 cases of open reduction plate screw internal fixation (plate screw nail fixation group) and 27 cases of limited open or closed reduction elastic intramedullary nail internal fixation combined with neck strap suspension (elastic intramedullary nail group) .The operation time ,intraoperative blood loss amount ,iatrogenic radial nerve injury ,occurrence rate of incision infection ,postoperative fracture reduction degree ,fracture recovery time and elbow joint function score were compared be‐tween the two groups .Results The operation time and intraoperative bleeding volume in the elastic intramedullary nail group were less than those in the plate screw nail fixation group ,the differences were statistically significant (P<0 .05);the postoperative frac‐ture healing rate had no statistically significant difference between the two groups (P>0 .05) ,the postoperative shoulder and elbow joint function scores in the plate screw nail group were significantly higher than those in the elastic intramedullary nail group ,the difference was statistically significant (P<0 .05) .No serious nerve damage ,incision infection and other postoperative complications occurred in the two groups .Conclusion Both the open reduction plate screw nail internal fixation and elastic intramedullary nail in‐ternal fixation are effective method for treating adult humeral shaft fracture ,the latter has shorter operation time ,less intraoperative bleeding ,but shoulder elbow pain and limitation of motion are more serious than the former .

Objective To investigate the effect of auxiliary heterotopic partial liver transplantation in treating acute ischemic liver failure. Methods Auxiliary heterotopic partial liver transplantation was performed on pigs.The pigs were divided into two groups.Group I: The host′ liver was preserved in situ, liver artery was ligated, portal vein was constricted,and donor patial right liver was transplanted under the right lobe of the liver of the host.Portal venous blood supply was constructed only, and arterial blood supply was not constructed .Group B:Except both arterial blood supply and portal venous blood supply of the donor liver were constructed, and the other operative procedures were as the same as in Group A. The living condition, liver function, blood supply, pathology and bile secretion of the donor liver were observed. Results The survival rates in Group B before and after operation were higher than that in Group A .Serum bilirubin(SB) after the operation was higher than that before the operation in Group A, but showed no change in Group B.After the operation, SB in Group A was higher than that in Group B. In Group A, the donor liver didn't secret bile,and hepatocytes were necrosis.In Group B, the bile secretion and blood supply of donor liver were good,and hepatocyte of the donor liver were alive and proliferating actively.The hosts' liver was necrosis obviously in both groups. Conclusions Hosts' liver artery ligation and portal vein constriction can result in acute ischemic liver failure.Auxiliary heterotopic partial liver transplantation is effective in correcting liver failure.The good arterial blood supply must be constructed in the donor liver to get good donor liver quality.

Objective To investigate the combination of compound anisodine and physical therapy in the treatment of amblyopia,and its possible mechanism.Methods Totally 300 outpatients with amblyopia(3 to 14 years old) were randomly and equally divided into treatment group and control group.In the treatment group,subcutaneous injection of compound anisodine(2 ml,once per day) to the superficial temporal artery of eye was given for a course of 14 d and followed by another course after 5 days'interval.Cover treatment was carried out at the same time.The control group was only treated with physical therapy.Vision,central retinal artery peak systolic velocity(PSV) and diastolic resistance index(RI) were measured during the 3 months' follow-up.Results The 3 to 6-year-old efficiency was 75.0%,7 to 9-year-old efficiency was 69.6%,and 10 to 14-year-old efficiency was 61.1% ;The difference of efficiency between therapy group and control group was very significant(P0.05).Conclusion Compound anisodine plus physical therapy for amblyopia at different ages and varying degrees are effective and safe.The mechanism may be due to enhanced retinal blood supply.

Objective To investigate prevalence and risk factors of urgency urinary incontinence (UUI) among adult women in Beijing.Methods Multiple-stage stratified sampling was used to recruit women equal to and more than 20 years old from 48 communities ( villages and neighborhoods ) in six districts of Beijing,by household interview with a standardized questionnaire to collect information of demographic characteristics,delivery history,health conditions and UUI related clinical data.Data analysis was performed by SPSS software version 16.0.Results Totally,3058 adult women completed the survey,with an overall prevalence of UUI of 1.7 % (52/3058).Distribution of age,cultural background,family income,number of pregnancy,number of abortion,delivery history,history of chronic diseases,general surgery,pelvic surgery,abdominal pain and abdominal distension were found significantly different between UUI participants and non-UUI ones with univariate analysis ( all P ＜ 0.05 ).Results of multivariate logistic regress analysis showed that number of pregnancy ( OR = 1.29,95% CI = 1.06-1.58 ),history of chronic diseases ( OR = 2.53,95% CI = 1.38-4.62 ) and history of abdominal pain ( OR = 2.32,95%CI= 1.10 -4.91 ) all significantly associated with UUI.Conclusions UUI associates with complicated factors and its prevention and intervention at communities is necessary targeting at related factors.

Objective To study reliability and validity of incontinence impact questionnaire short form (IIQ-7) in the Chinese population. Methods IIQ-7 form was translated into Chinese; 74 patients with urinary incontinence completed the IIQ-7 simplified Chinese version and short-form 12-item health survey (SF-12) questionnaires. The urinary incontinence patient also ran a 1 hour pad test. Then, reliability and validity of those forms were analyzed. Results The Cronbach's alpha of IIQ-7 simplified Chinese version was 0. 824 (P <0. 01). The intra-class correlation coefficient of IIQ-7 simplified Chinese version was 0. 749 (P < 0.01) . IIQ-7 simplified Chinese version scores were negatively correlated with SF-12 scores (Spearman correlation coefficient: - 0. 570, P < 0. 01) , IIQ-7 simplified Chinese version scores were positively correlated with 1 hour pad test (Spearman correlation coefficient: 0.461, P < 0. 01) , IIQ-7 simplified Chinese version scores were also positively correlated with the course of disease (Spearman correlation coefficient: 0. 235 , P < 0. 05) . Factor analysis of IIQ-7 simplified Chinese version showed good construct validity. Conclusions The simplified Chinese version of IIQ-7 has higher reliability and validity in the Chinese population. They are highly recommended for clinical treatment and research.