Objective To compare the clinic value of uterine artery embolism (UAE) and total hysterectomy (TH) for intractable postpartum hemorrhage. Methods 15 cases of intractable postpartum hemorrhage were performed UAE and other 17 cases of intractable postpartum hemorrhage were performed HE in our hospital during 10 years. Two groups' preoperative preparation time, operation time and the hospitalization time were compared. Results The preoperative preparation time (26.2±1.6) min of UAE was significantly longer than TH group (13.5±1.4) min (P<0.01; the former group's average operation time was (47.8±16.2) min, and the latter group's was (100.6±18.7) min (P<0.01); the hospitalization time of UAE (6.1±0.1) days was significantly shorter than TH group (8.8±0.5) days)(P<0.01). Conclusion With short operation time, low morbidity rate and possibility of preserving reproductive function, UAE is proved to be very effective in the treatment of intractable postpartum hemorrhage, but in some cases, UAE can't replace TH yet.

Objective To approach the treatment value of endoscopic sphincterotomy for the dysfunction of Oddi sphincter in postcholecystectomy syndrome.Methods Endoscopic sphincterotomy was undergone in 28 cases with ultimate diagnosis of Oddi sphincter dysfunction after BUS, ERCP , basal sphincter pressure examination and ruled out the patients with retained or recurrent stones,stricture or carcinoma in the bile duct having postcholecystectomy syndrome.Results Symptoms disappeared completely after the treatment in 18 cases,alleviated apparently in 5 cases and other 2 cases after the second treatment,without alleviation in 3 cases,the effective rate is 89.3%(25/28).No severe complication happened.Conclusion It is assumed that endoscopic sphincterotomy is a micro-traumatic,safe and effective treatment for the dysfuction of Oddi sphincter in postcholecystectomy syndrome.

Objective To investigate the correlations of serum total bilirubin level with infarct volume,severity and etiological typing in patients with acute ischemic stroke.Methods Patients with acute ischemic stroke admitted to hospital from January 2012 to January 2014 were used as subjects of study.Their clinical and imaging data were collected,and serum total bilirubin levels were detected.The correlations of the serum total bilirubin levels with the infarct volume,severity and etiological typing were analyzed.Results A total of 290 patients with acute ischemic stroke were enrolled in the study.The patients were divided into either a large infarction group (≥1.8 cm3,n =145) or a small infarction group (＜ 1.8 cm3;n =145)according to the median cerebral infarction volume.The total bilirubin level of the large infarction group was significantly higher than that of the small infarction group (16.896± 7.761 μmol/L vs.13.039±4.477 μmol/L;t =5.185,P ＜ 0.001).Multivariate logistic regression analysis showed that the bilirubin highest quantile group (＞ 17.893 μmol/L) was an independent risk factor for large infarction (odds ratio [OR] 2.754,95％ confidence interval [CI] 1.028-7.375;P =0.044).According to the National Institutes of Health Stroke Scale (NIHSS) score,the patients were divided into a mild stroke group (NIHSS score ＜8;n =210) and a moderate to severe stroke group (NIHSS score≥ 8,n =80).The total bilirubin level of the moderate to severe stroke group was significantly higher than that of the mild stroke group (16.861 ±7.689)μmol/L vs.14.246 ± 6.019 μmol/L;t =3.052,P =0.002).Multivariate logistic regression analysis showed that the total bilirubin level was not an independent risk factor for moderate to severe stroke.Small artery occlusive stroke,large artery atherosclerotic stroke,and other definite causes of stroke were combined into non-cardioembolic stroke group (n =244).The total bilirubin level in the cardioembolic stroke group (n=46) was significantly higher than that in the non-cardioembolic stroke group (19.639±8.409 μmol/L vs.14.087 ±5.831 μmol/L;t =5.479,P＜0.001).Multivariate logistic regression analysis showed that the bilirubin highest quartile group (＞ 17.893 μmol/L) was an independent risk factor for cardioembolic stroke (OR 8.405,95％ CI 1.719-41.106,P =0.009).Conclusions The increased serum total bilirubin level is an independent risk factor for larger infarction and cardioembolic stroke.As an oxidative stress index,serum total bilirubin in acute stage can provide help for early identification of infarct volume and etiological subtype in patients with ischemic stroke.

This study was aimed to optimize the extraction technology of Shu-Feng Ding-Chuan(SFDC) granules in the Huang-Qin(HQ)group by Box-Behnken response surface methodology(RSM).With three major characteristic components (baicalin,praeruptorin A and solid content in extraction liquid),the effects of four factors,such as the concentration of ethanol,the dosage of ethanol,the duration of extraction and the extraction times,were investigated by the single factor experiment.Then,the range of parameters of key factors was further studied and explored by Box-Behnken RSM.The results of single factor experiment and Box-Behnken design showed that the optimum preparation conditionswere 8-fold 70% ethanol,extracted for 2 times,with 1.0 h per each time.Under these conditions,the transfer rates of baicalin and praeruptor in A were 89.57% and 87.90%,respectively.And the transfer rateof solid content was 32.35%.It was concluded that the single factor experiment combined with RSM can be used in theoptimization of extraction technology for SFDC granules in the HQ group.This technique wasstable and feasible,which provided scientific evidences for the industrial production.

Objective To find out a new treatment method for advanced pancreatic carcinoma. Methods Twenty-nine patients with advanced pancreatic carcinoma and liver metastases were randomly divided into 2 groups.Group A (n=11) underwent bilio-enterostomy and/or gastro-enterostomy combined with systemic chemotherapy after operation;Group B(n=18) underwent bilio-enterostomy and/or gastro-enterostomy combined with peripancreatic arterial ligation and arterial infusion regional chemotherapy.The alleviation of clinical symptom,the change of carcinoma volume by BUS and CT scan,survival period and serum CEA were observed in two groups. Results The symptoms were alleviated apparently in most cases in Group B;BUS and CT scan showed that the tumor volume decreased apparently in Group B;The response rate was 67.7% in Group B,and 18.2% in Group A,respectively(P＜0.01);the mean survival period was (4.8±0.6) months in Group A,and (12.5±1.2) months in Group B,respectively(P＜0.01),there was significant difference between the two groups.The decrease of serum CEA was 54% in Group A and 60% in Group B,but the difference was not significant(P＞0.05). Conclusion Peripancreatic arterial ligation combined with arterial infusion regional chmotherapy is believed to be effective against both pancreatic carcinoma and liver metastases,and it can alleviate the clinical symptoms,postpone the growth speed of tumor,and prolong the survival period.

Aim To identify chemical constituents of supercritical extract from Pteridium aquilinum (Linn.) Kuhn (SFEPA) and investigate its antiadipogenic effect and underlying mechanism. Methods The chemical constituents of SFEPA were identified by GCMS. The differentiation of 3T3L1 preadipocytes was induced to establish cell model. MTT assay was employed to detect cell viability. Oil Red 0 staining was used to analyze the effect of SFEPA on the differentiation of 3T3L1 preadipocytes. qRTPCR was performed to examine the expression of genes related with adipogenesis and lipogenesis. Results Ten compounds of SFEPA were identified. The major constituents were 4, 4, 5, 7, 8pentamethyldihydrocoumarin (36. 0 7 %), ßsitosterol (25. 6 6 %), 4amino7diethylaminochromen2one (8 . 2 6 %) and palmitic acid (5. 0 5 %). SFEPA suppressed 3T3L1 adipocyte differentiation and reduced fat accumulation in a dosedependent manner. Treatment of SFEPA significantly downregulated the mRNA expression of PPARy, C/ EBPa, SREBPlc, as well as FAS and ACC. Conclusions SFEPA can inhibit the adipogenesis and differentiation of 3T3L1 cells, and its mechanism may be closed related to its inhibition of genes expression regulating adipogenesis and lipogenesis. Phenols and alcohols might be potential bioactive components.

Based on the experiences in Quyang Community Health Service Center,and through focus group discussions and literature research,the home-based rehabilitation mode for stroke patients in community was developed.With the principles of safety and effectiveness,rehabilitation physicians and family physicians are responsible for rehabilitation program,while rehabilitation therapists and community nurses implement the rehabilitation program.The rehabilitation services are provided for patients and their families at home with the community service resources,including counseling services,rehabilitation aids and other cares according to their needs and demands.The definition and contents of the mode provide a basis for further clarification and operation of home-based rehabilitation for stroke patients in community.

To explore the effect of icariside ? on osteoprotegerin(OPG) expression in osteoblasts, primary osteoblasts were cultured with different concentration of icariside ? and 17?estradiol. As a major metabolite of icarrin in vivo, icariside ? exerted a better effect on OPG expression which plays a key role in osteoporosis. 20 ng/dl icariside ? also exerted better effect on OPG secretion than that of positive control group. Consequently, icariside ?could be a candidate for osteoporosis treatment.

Objective To investigate the risk factors of electrocoagulation syndrome after endoscopic submucosal dissection (ESD) in patients with colorectal lesions.Methods Clinical data of 145 patients with colorectal mucosal lesions undergoing ESD in People's Hospital of Wuhan University between September 2010 and September 2015 were retrospectively studied.Results Among 45 patients,post endoscopic submucosal dissection electrocoagulation syndrome (PEECS) was developed in 32 cases (22％).The median age in PEECS group was higher (t =-5.783,P =0.000),the median lesion size was larger(t =-5.590,P =0.000),the median length of hospital stay was longer (t =-6.841,P =0.000) than those in non-PEECS group.Univariate regression analysis showed PEECS was associated with the age,lesion size,lesion location,length of hospital stay,malignant tumor,polyps type,resection modality.Multivariable logistic regression analysis showed that the independent risk factors for the development of electrocoagulation syndrome were age ＞65 year (OR =1.123,95％ CI:1.013-1.244,P =0.027),lesion size ＞ 3.5 cm (OR =1.173,95％ CI:1.015-1.357,P =0.031),malignant tumor (OR =3.498,95 ％ CI:1.460-8.379,P =0.005),hospital stay ＞ 10 d (OR =2.480,95％ CI:1.346-4.569,P =0.004),non-rectal lesions (OR =12.612,95％ CI:3.446-46.157,P =0.000).Conclusion Attention should be paid for colorectal lesion patients with high risk of PEECS,when endoscopic submucosal dissection is performed.