Objective:To study the clinical and pathological features of small cell carcinoma of cervix.(SCCC).Methods:Clinical data,pathological changes and immunohistochimical findings were reviewed in 7 cases of small cell cervical carcinoma(SCCC),and immunohistochemical staining was performed for VEGF in 4 cases of SCCC.Results:The average age was 37 years in 7 patients,and the main symtoms were vaginal bleeding.Under microscope,tumor cells showed oat or intermediate cell type,Three tumors were associated with other forms of carcinoma: squamous cell carcinoma,endometrial carcinoma,poor-differentiated adenocarcinoma.Immunohistochemical staining showed neuroendocrine differentiation and VEGF.Their FIGO staging was stage Ⅰ_b in 2 cases,stage Ⅱ in 2 cases,stage Ⅲ in 2 cases.In the 5 patients with follow-up data,4 were dead and 1 was in following up.Conclusion:Small cell carcinoma of the cervix has stated an extremely aggressive biological behavior with minimal survival chances and a rapid and fatal clinical course.

Objective To investigate the analgesic effect of epidural labor analgesia with contin-uous background infusion and its impact on obstetric outcome.Methods This was a retrospective co-hort study.In the two months of march 2014 and march 201 5,503 nulliparas women who had re-ceived epidural analgesia for labor were enrolled and assigned to two different study groups according to their analgesic protocol.Two hundred and fifty-eight nulliparas in group C received only patient-controlled analgesia while two hundred and forty-five nulliparas in group P received patient-controlled analgesia with continuous background infusion.The basic and perinatal data of all enrolled nulliparas women were collected and analyzed to compare the analgesic effect and the impact on obstetric risk of two different analgesic protocol.Results The NRS pain score during the second labor stage was lower in group P [3 (3-4)scores vs.5 (4-5)scores](P <0.001).The second stage prolonged [50 (29-82) min vs.38 (24-62)min](P =0.001)and intrapartum hemorrhage increased [200 (100-250)ml vs. 1 50 (100-200)ml](P =0.003)in group P.There were no significant differences between the two groups with regard to the delivery mode (P =0.656)and the morbidity of postpartum hemorrhage (9.8% vs.10.9%,P =0.697).Analgesic protocol with background infusion was not associated with postpartum hemorrhage,instrumental delivery risk and cesarean risk.Conclusion Epidural labor an-algesia with continuous background infusion provided more effective analgesia in nulliparas,without additional obstetric risk.

Objective To investigate the efficacy of intermittent epidural bolus ( IEB) for patient?controlled epidural analgesia ( PCEA) during delivery. Methods Eighty?five parturients requesting epi?dural analgesia, who were at full term ( 37-42 weeks of gestation) with a singleton fetus in vertex presenta?tion, of American Society of Anesthesiologists physical statusⅠorⅡ, with body mass index< 35 kg∕m2 , were divided into either IEB group ( n=42) or continuous epidural infusion ( CEI) group ( n=43) using a random number table. The analgesia solution contained 0.08% ropivacaine and 0.4μg∕ml sufentanil in both groups . IEB settings were a 6 ml bolus every hour at the rate of 400 ml∕h with a bolus dose 6 ml and lockout interval 30 min. CEI settings were background infusion 6 ml∕h with a bolus dose 6 ml and lockout interval 30 min. Numeric rating scale score was maintained≤5, and if the efficacy was not satisfactory, a bolus of pump solution 5-10 ml was added. The consumption of analgesics per hour, initial PCA time, and occur?rence of lower extremity numbness, motor block, nausea and vomiting, and pruritus were recorded. Pa?tients′satisfaction with analgesia was scored, and the duration of labor and mode of delivery were recorded. Results Compared with group CEI, the initial PCA time was significantly prolonged, the satisfaction score was significantly increased, the incidence of lower extremity numbness was significantly decreased ( P<0.05) , and no significant change was found in the consumption of analgesics per hour, incidence of motor block, nausea and vomiting, and pruritus, constituent ratio of mode of delivery, and duration of la?bor in group IEB ( P>0.05) . Conclusion IEB can be safely and effectively used for PCEA during deliver?y, and the efficacy is better than that of CEI in the parturients.

Objective To discuss the construction and application of computer system in the radiology department of medium and small hospitals.Methods Through the local area network,the self-invented Radiological Information System(RIS) was linked to the Hospital Information System(HIS) and Wandong DR equipment software in coordination with the Neusoft CT software and the digital stomach and intestines software.Results A simple extraordinary and practical radiological information system was established,which possessed functions of PACS.Conclusion The management level in radiology department is enhanced and the working efficiency is increased.

Objective: To screen the active fraction with anti-inflammatory effect of Hosta plantaginea and study the chemical constituents of the active fraction. Methods: Different polar fractions were prepared by extraction with organic solvents. Their anti-inflammatory effects were evaluated by mice models treated by acetic acid-induced celiac capillary permeability and cotton pellets-induced granuloma. The constituents of active fraction were purified by chromatographic methods and identified by physicochemical properties and spectral data. Results: The ethyl acetate fraction could significantly inhibit the reinforce of celiac capillary permeability and the cotton pellets granuloma. Ten compounds were isolated from the ethyl acetate fraction and identified as docosanol (1), β-sitosterol (2), stigmasterol (3), (25R)-2α,3β-dihydroxy- 5α-spirostane-9(11)-en-12-one (4), daucosterol (5), (25R)-2α, 3β-dihydroxy-5α-spirostane-9(11)-en-12-one-3-O-{O-β-D- glucopyranosyl-(1→2)-O-[β-D-xylopyranosyl-(1→3)] -O-β-D-glucopyranosyl-(1→4)-β-D-galactopyranoside} (6), kaempferol 3-O-(2″-O-β-D-glucopyranosyl)-β-D-rutinoside (7), kaempferol 3-O-β-D-rutinoside-7-O-β-D-glucopyranoside (8), (25R)-2α,3β,12β-trihydroxy-5α-spirostane 3-O-{O-α-L-rhamnopyranosyl-(1→2)-β-D-galactopyranoside} (9), and (25R)-2β, 3β-dihydroxy-5α-spirostane 3-O-{O-β-D- glucopyranosyl-(1→4)-β-D-galactopyranoside} (10). Conclusion: The ethyl acetate extract was the anti-inflammatory fraction of H, plantaginea. Compounds 1-10 were isolated from H. plantaginea for the first time, and compound 10 is a new natural product.

Objective To explore the effects of subchronic arsenic exposure through drinking water on glutamate-glutamine cycle in the brain of mice. Methods The female Kunming mice were exposed to arsenite ( iAsⅢ ) by drinking water at the levels of 25, 50 and 100 mg/L respectively for 6 consecutive weeks. The blood and brain were taken, the concentration of inorganic arsenic (iAs), monomethylarsenic acid (MMA), dimethylarsenic acid (DMA) and the activity of glutamine synthetase (GS), phosphate activated glutaminase (PAG), superoxide dimutase (SOD) and the concentrations of glutamate (Glu), lipidperoxide(LPO) were determined. Results The concentrations of iAs, MMA and DMA in the blood and brains increased as the iAsⅢ concentrations in drinking water increased. The activity of GS, PAG and the concentrations of Glu in the arsenic exposed mice increased compared with the control. The activity of GS in 50 mg/L group, the activity of PAG in 25 and 50 mg/L groups, the concentration of Glu in 100 mg/L group showed a significant difference compared with the control. The activity of PAG in 25 mg/L group was significantly higher than that in 100 mg/L group. The activity of SOD in exposed groups was higher than that in the control, the concentration of LPO in exposed groups did not show a significant difference compared with the control. Conclusion Arsenic can enter the brain and organic arsenic is dominant both in the blood and brain, however, the composition of arsenic speciation is different in the blood and brain. DMA, as a main arsenide, distributed in the brain. Arsenic exposure can change the activity of GS and PAG which can influence the concentration of Glu. Moreover, arsenic exposure can increase the superoxide anion and make the activity of SOD increase compensatively.

[Objective]To discuss the application of the short reconstruction intramedullary nail in treating intertrochanteric fracture.[Method]From Jan 2000 to Aug 2004,35 patients(14 males and 21 females)with femoral intertrochanteric fracture were treated by short reconstruction intramedullary nail.Various data were analyzed for evaluating the characteristics and curative effect.[Result]The mean incision length was 3.5 cm,the average duration of operation and intraoperative X-ray fluoroscopy was 65 min and 0.16 min,respectively.The mean blood loss was 50 ml.None of the complications occurred postoperatively,including nonunion,deep venous thrombosis or infection of the incision etc.except only 1 malunion due to inappropriate surgical skill.Internal fixation loosening didn't appear in 97% of the patients.[Conclusion]Using short reconstruction intramedullary nail to treat intertrochanteric fracture can obtain satisfing outcomes of different concerns,such as time-saving,small incision,few complications,quick recovery and so on,which indicates that it should be the first choice for the treatment of femoral intertrochanteric fracture.

The occurrence rate of DTC in children and adolescents is not high.However,DTC in these patients has some distinct characteristics different from those in adult,such as larger tumor volume at diagnosis,early invasion of neck lymph nodes and early distant metastases,high NIS expression,high recurrence but higher overall survival rate.131 I ablation is still one of the important treatment methods after surgery.Currently,there are 3 major dosage regimens adopted for 131I treatment: prescribed dose without causing bone marrow suppression/toxicity,dose aiming at tumor ablation,and empirically fixed dose.

Objective To compare the difference between intermittent epidural bolus(IEB) combined with patient controlled epidural analgesia(PCEA)and continuous epidural infusion(CEI)combined with PCEA mode in labor analgesia. Methods It was a retrospective cohort study ,which subjects were assigned to CEI+PCEA and IEB + PCEA group. Correlated data were collected to compare the effect of the two analgesic mode on perinatal events. Results There were less consumption of ropivacaine and sufentanil per hour ,less PCEA request and actual bolus in IEB + PCEA group. There were no significant difference between the delivery mode and the percentage of low Apgar score in neonates. Conclusion IEB+PCEA mode has better analgesic effect ,meanwhile doesn't disturb the delivery mode has no effect on the neonate outcome.

Objective To investigate the effect of the different phases of menstrual cycle on the incidence of post-operative nausea and vomiting (PONV)after laparoscopic gynecological surger-ies.Methods A total of 228 women undergoing laparoscopic gynecological surgeries were enrolled from Mar 2016 to Feb 2017 in our hospital.They were classified into three groups according to the different phases of menstrual cycle at the time of surgeries:group follicular phase (n =98),group o-vulatory phase (n =79),and group luteal phase (n =59).The incidence of PONV and the use of res-cue antiemetic drugs were recorded within 0-2 h,0-24 h periods after surgeries.Multivariate Logistic regression analysis was applied to identify independent risk factors of PONV.Results The incidence of 0-2 h PONV and 0-24 h PONV were 23.2% (53/228)and 54.8% (125/228)respectively.Univa-riate analysis showed that the incidence of PONV in the different phases of menstrual cycle was not statistically significant,as well as 0-24 h.Multivariate logistic regression analysis showed that the risk of 0-2 h PONV in group luteal phase might be higher than that in group follicular phase,however, the difference was not statistically significant (OR =2.289,95%CI 0.979-5.355,P =0.056).And two independent risk factors of 0-2 h PONV were identified:duration of operation > 1 h (OR =3.176,95% CI 1.567-6.436,P = 0.001 )and history of PONV (OR = 5.711,95% CI 1.710-19.080,P =0.005).Three independent risk factors of 0-24 h PONV were identified:duration of op-eration>1 h (OR = 2.714,95%CI 1.525-4.829,P = 0.001 ),postoperative PCA (OR = 2.717, 95%CI 1.233-5.986,P = 0.013 )and application of metronidazole (OR = 3.926,95%CI 1.808-8.527,P =0.001).Conclusion There was no significant effect of different phases of menstrual cycle on the incidence of nausea and vomiting after gynecologic laparoscopic surgeries.