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 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 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 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 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.

Objective The measurement of normal tibia was aimed to obtain the value of the posterior slope angle of the medial tibial plateau in Chinese adult and its related parameters in order to improve the design of knee prosthesis more suitable for Chinese people, and also provide an essential features of tibia for resecting tibial plateau in total knee arthroplasty. Methods 450 knees of 428 persons which were healthy Chinese adult long living in North China, were 252 male knees and 198 female knees with an average age of 43.9 years ranging from 18 to 79 years. The criteria of the subjects were no tibial deformity, no genu varum and valgum, abnormal changes of articular surface, and had sustained ever any tibial trauma. Depending on the age of subjects, they were divided into three groups, group A was between 18 and 39 years, group B between 40 to 59 years, and group C more than 60 years. Moreover, 6 tibias harvested from healthy Chinese corpses were measured as well. Computer radiography was used to take standard lateral aspect of X-ray film. The imagines were stored into computer by scanning the films, and so the measurement was taken in computer using Danzig method. The data were analyzed statistically. Results By two factors analysis, the sex and age had no significant influence of the posterior slope angle of the tibia; furthermore, the angle was not different between the left and right tibia. In male adult, the average degrees of left posterior slope angle of the medial tibial plateau were 13.2??4.4?, the right 10.5??5.1?, and the average degrees of posterior slope angle of both sides were 11.7??4.9?. In female adult, the average degrees of left posterior slope angle of the medial tibial plateau were 11.2??3.5?, the right 10.6??4.4?, and the average degrees of posterior slope angle of both sides were 10.8??4.0?. The average degree of group A were 11.7??4.4?, group B 10.4??4.7?, group C 12.3??4.4?. In summary, there was no significant difference of posterior slope angle of the medial tibial plateau between sex, side and age. Conclusion The average degrees of posterior slope angle of the medial tibial plateau in North China adult were 11.3??4.5? ranging from 0??21? to 9?-13?, and were larger than that of the Westerns.

Objective To explore the clinical results of internal fixation of patellar transverse body fracture by comparing figure-of-eight tension band wiring combined with cannulated compression screws technique with traditional modified tension band (AO technique). Methods There were 14 cases in the cannulated screws combined with tension band wire group, it involved 9 males and 5 females, the average age was 46 years. The patients were followed up for an average of 30 weeks with a range from 16 to 48 weeks. Another 20 cases were in the modified tension band group, it involved 13 males and 7 females, the average age was 42 years. The patients were followed up for an average of 42 weeks with a range from 36 to 72 weeks. The t test was used to compare the clinical results between two groups, including the mean knee flexion at the 2nd and 4th week, the mean clinical union time and the mean flexion loss at the 24th week postoperatively. Results In the cannulated screws combined with tension band wire group, the mean knee flexion at the 2nd week and 4th week postoperatively was 59??14.8? and 98??15.1? respectively. The mean clinical union time was (10?3.0) weeks and the mean flexion loss at the 24th week postoperatively was 11??6.3? without any complication. In the traditional modified tension band group, the mean knee flexion at the 2nd week and 4th week was 31??13.3? and 63??13.7? respectively. The mean clinical union time was (13?3.8) weeks and the mean flexion at the 24th week postoperatively was 18??6.2?. In this group, 2 cases failed because loosening of the tension band with the pin pulled out. One was managed with the plaster brace, the other underwent re-operation. Conclusion With stable construct, the internal fixation of transverse patellar body fracture with figure-of-eight tension band wiring combined with cannulated compression screws is less invasive to local soft tissue, optimal on knee functional recovery and fracture union. No complication has occurred, but the long-term clinical result and complication should be followed up for longer time.

Objective To explore three dimensional relationships of commonly used bony marks of the distal femur, and to investigate its clinical application of distal femur rotational alignment. Methods One hundred and fifteen normal distal femurs of 62 volunteers were studied. With MR sagittal imaging and three dimensional reconstruction, correlative parameters, including PCA (posterior condylar angle), angle between surgical transepicondylar axis (STEA) and posterior condylar line (PCL); CTA(condylar twist angle), angle between clinical transepicondylar axis (CTEA) and PCL; APA, angle between the perpendicular of antero-posterior line (APL) and PCL; ATA, angle between the perpendicular lines of APL and STEA; CSA, angle between CTEA and STEA. All these angles were measured. The parameters of the two groups both in males and females, as well as in right and left knees were analysed. Results PCA: 3.44??1.08? (range, 0.62? to 6.75?); CTA: 6.03??0.86? (range, 2.93? to 8.92?); APA: 4.31??0.64? (range, 1.92? to 7.05?); ATA: 0.87??0.78? (range, -1.72? to 3.84?); CSA: 2.58??0.57? (range, 0.22? to 4.51?). There was no significant difference between left and right knee in terms of all the above mentioned parameters, yet there was significant difference between male and female groups in terms of PCA, CTA and ATA. PCA and CTA were larger in male groups than that of female group, while ATA in female group was larger than that of male group. Conclusion Three dimensional reconstruction based on imagings of MR is a reliable method to study the distal femur rotational alignment. In the normal knees, there is constant relationship between these parameters. Operators should use distal femur rotational alignment according to practical conditions in performing the total knee arthroplasty.