Objective: To analyze the incidence, etiological factors, clinical characteristic, diagnosis, treatment method and the prevention measures of recurrent ectopic pregnancies in our hospital from January 2001 to June 2004. Methods:19 cases of recurrent ectopic pregnancy were analyzed retrospectively. Results: There were 19 recurrences in 353 cases of ectopic pregnancy with a incidence rate of 1∶ 18.6( 19/353). The average age was 31.7 years old. 17 were operated with lesions involving the contralateral oviduct in 16 cases and the homolateral oviduct in 1 case. Pathological examination revealed additional chronic salpingitis in 13 cases. The shortest interval between the recurrent ectopic pregnancies were 2 months to 6 years,with an average of 33 months. Among them, 10 patients recurred within 36 months. There was one patients suffering from 3 times of ectopic pregnancies. The misdiagnosis rate was 5.26%. And the disease of misdiagnosis was miscarriage of early pregnancy. Surgical treatment can be the first choice of treatment of recurrent ectopic pregnancy. Conclusion: Pelvic adhensions, inflamed salpinx and conservative treatment are risk factors of recurrent ectopic pregnancy. Effective treatment of pelvic inflammation and avoiding of the first heterotopic pregnancy are the important measures for prevention of recurrent ectopic pregnancy.

Objective: To analyze the pathogenesis,diagnosis,treatment and prognosis of severe hypertensive disorder complicating pregnancy(HDCP) and hypoproteinaemia(HP).Methods: We reviewed 25 cases of HDCP and HP treated in our hospital and compared and analyzed the perinatal and maternal outcomes,including pregnancy edema,serum albumin,delivery methods and the weight of newborns.Results: Severe HP was the main cause of pregnancy complications in severe PIH.Prompt correction of HP benefited both the neonate and the mother.Conclusion: Severe HDCP is usually complicated with severe HP.Prenatal correction and treatment of HP will be helpful for both severe HDCP mothers and the newborns.

Objective To observe the safety and feasibility of autologous peripheral blood stem cell (PBSC) transplantation by intracoronory infusion in patients with acute myocardial infarction (AMI).Methods Totally 27 patients with AMI were randomly allocated to receive either inclusive type granulocyte colony-stimulating factor (G-CSF),or excretory type G-CSF to mobilize the stem cells.They received the dose of G-CSF 300-600?g/d by hypodermic injection for 5 days.On the sixth day,PBSCs were separated by Baxter CS 3000 blood cell separator into 50ml suspending liquid.The suspending liquid without treatment was infused into the infarct-related artery (IRA)by occluding the over-the-wire balloon and infusing artery through balloon center lumen.During PBSC mobilization,the following side-effects should be paid attention to,such as bone pain,lethargy,tetter,fever,gastrointestinal effects (nausea,vomiting,constipation),angina or deteriorated heart failure,as well as some rare complications (spontaneous spleen rupture,severe purulent infection, hypercoagulable state,and autoimmune diseases).When the PBSCs were being separated and collected,some complications were observed,for example,low calcium effects (mouth numbness and spasm),pale and dizziness due to vagus reflect,pale and dizziness owing to low blood volume,deterioration of angina or heart failure.The complications should also be observed during the PBSC transplantation by intracoronary infusion:arrhythmia including bradycardia (because of balloon occlusion),sinus arrest or the third degree of atrial ventricular block (because of coronary spasm due to balloon stimulating stent), ventricular fibrillation or hypotension,etc.Results There were 22 cases with complications during the mobilization,separation,collection, and infusion of PBSCs.The incidence of complications during mobilization was 44.4%(12/27),during separation and collection is 25.9%(7/27),and during PBSC transplantation by intracoronary infusion 11.1%(3/27).Conclusion In patients with AMI,Intracoronary infusion of PBSC is feasible and safe.

Objective The incidence rate of acute pancreatitis in pregnancy (APIP) is on the rise, and yet there is no effec-tive method for its prevention and treatment .This study aimed to investigate the high risk factors of APIP and its prognostic evaluation index. Methods We retrospectively analyzed the clinical data of 35 cases of APIP ( group A) and another 35 cases of acute pancre-atitis in non-pregnancy as controls (group B).We compared the etiologic factors of acute pancreatitis , changes of laboratory indexes after onset of the disease , and clinical outcomes between the two groups . Results No statistically significant differences were found in the risk factors between the two groups (χ2 =0.233, P>0.05).Serum cholesterol and triglyceride levels were remarkably higher in group A ([15.69 ±7.71] and [15.54 ±7.82] mol) than in B ([5.07 ±2.95] and [3.82 ±2.58] mol) (P<0.05).There were significant differences between groups A and B in WBC count ([19.00 ±5.31] vs [14.98 ±9.77] 109/L), Hb ([82.77 ±11.77] vs [101.77 ±1.50] g/L), and serum Glu ([8.77 ±2.76] vs [6.23 ±1.99] mol/L)(P<0.05).Multivariate logistic regression a-nalysis showed the predictive value of cholesterol and triglyceride levels for APIP and a correlation of WBC and Hb with the clinical out -comes of the patients.The in-hospital mortality rate was significantly higher in group A than in B (χ2 =3.968, P=0.046), and so was the incidence rate of severe acute pancreatitis (χ2 =5.510, P=0.019). Conclusion Biliary diseases are the main high risk factors of APIP, followed by hyperlipidemia .Triglyceride and cholesterol levels have the predictive value for APIP .The WBC count and Hb level can be used to assess the patients′condition and predict the clinical outcomes .

Objective We Observed the mobilization effects of autologous circulating blood stem cell by G-CSF in old patients(≥70 years old) with acute myocardial infarction (AMI).Methods 10 old patients with AMI were allocated to receive either inclusive type Granulocyte Colony-Stimulating Factor (G-CSF), or excrete type G-CSF to mobilize the stem cell, with either 300?g/day or 600?g/day. The patients received G-CSF by hypodermic injection, and the duration of applying G-CSF was 5 days. In the process of the mobilization of the circulating blood stem cell, the white blood cell (WBC) and CD34 + cell count in the circulating blood should be observed. Results Prior to applying G-CSF and the 3rd、4th、5th、6th、7th after applying G-CSF, the counts of WBC were 6.75?10 9/L、28.16?10 9/L、34.93?10 9/L、34.40?10 9/L、38.93?10 9/L、21.85?10 9/L; the counts of CD34+ cell were 6.25?10 6、51.10?10 6、92.60?10 6、109.65?10 6、134.69?10 6、45.09?10 6 The peak of curve that WBC and CD34 + cell count changed with applying days was at the 6th .The count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood(r=0.940)Conclusion In old patients with AMI, the mobilized peak of WBC and CD34 + cell counts changed with applying days was at the 6th, and the count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood.

BACKGROUND: Most of evidence-based studies include both adult degenerative scoliosis and adult idiopathic scoliosis, which lead to indirectness in the results, and suppress the promotion of the evidence.OBJECTIVE: To systematically analyze the current clinical researches, and to review the curative efficacy of lateral lumbar interbody fusion for adult degenerative scoliosis.METHODS: A computer-based research of Medline, EMBASE, CENTRAL, WanFang and CNKI databases from December 2015 to December 2016, was performed with the key words of lateral lumbar interbody fusion, direct lumbar interbody fusion, extreme lateral interbody fusion, minimal invasive surgery, adult scoliosis. The articles were screened based on the inclusion criteria, and the clinical symptom improvement and radiological changes were analyzed.RESULTS AND CONCLUSION: Totally 13 articles were included. In the treatment of adult degenerative scoliosis, lateral lumbar interbody fusion shows less blood loss, short hospitalization time, significantly improved symptoms, satisfactory correction at the coronal plane, and low incidence of long-term complications. However, it has the poor correction at the sagittal plane and high incidence of short-term postoperative complications. Therefore, intraoperative neurologic monitoring is necessary and the combination with internal fixation has obtained good effectiveness.

Objective To study the independent risk factors of relapse of smoking among current smokers of different ages who underwent percuta?neous coronary intervention(PCI). Methods Totally 197 current smokers who received PCI from January 2007 to December 2009 in the Fourth Affiliated Hospital of China Medical University were enrolled. Information about relapse of smoking was collected through the medical records and the telephone follow?up. Discrepancy of risk factors of smoking resumption was compared in different age groups. Results Totally 112 patients re?sumed smoking after PCI. There were 87 patients in the non?elderly group and 25 in the elderly group. According to the correlation analysis,more than one stents(P=0.025),severe nicotine dependence(P=0.001)and long time for daily passive smoking(P=0.000)were related with relapse in the non?elderly group,and there was a negative correlation between more than one stents and relapse. But in the elderly group,relapse was associ?ated with history of hypertension(P=0.034). According to the logistic regression analysis in different age groups,independent predictors of smoking relapse in the non?elderly group were severe nicotine dependence(OR:3.914,P=0.003)and long time for daily passive smoking(OR:1.352,P=0.000). And in the elderly group,independent risk factors of smoking relapse were male(OR:17.325,P=0.027),history of hypertension(OR:13.185,P=0.005),long time for daily passive smoking(OR:1.273,P=0.045)Conclusion Independent risk factors of smoking relapse were different in the elderly group and the non?elderly group. In the non?elderly group,these factors were severe nicotine dependence and long time for dai?ly passive smoking. And in elderly group,these factors were male,history of hypertension,long time for daily passive smoking.

Objective To access the clinical effectiveness and safety of the home-made coronary artery stent - Jin Xin stent. Methods Ten patients with coronary heart disease,from 39 to 70 years old (averaged 55 2yrs),male 7,female 3,were performed PTCA .Jin Xin stents were implanted in to left anterior descending arteries(2),left circumflex(3)and right coronary arteries (5). Results The stenosis was 80～100% before the stents implantation, and 0 after the implantation. There were no abrupt occlusion and thrombosis during the procedure,and no cardiac events during the 6～8 months follow-up. Conclusion Jin Xin Stent is very good at releasing and standing-support. And it can dilate completely. It is safe and effective as an interventional therapy for coronary heart disease.

Objective To compare the difference in ischemic heart disease (IHD) incidence between left and right breast cancer treated with post-op radiation therapy.Methods We retrospectively reviewed electronic database of breast cancer patients treated in our cancer center from October 2006 to December 2011.Clinical data were recorded including clinical features,radiation fraction,and IHD.Statistical analysis was performed to compare the difference in IHD incidence between left and right breast cancer.Results Age on diagnosis was significantly associated with IHD (P ＜ 0.05).Compare to younger patients (≤60),the increased hazard ratio of IHD in older patients (＞60) was 3.84.The left breast cancer patients had greater incidence of IHD with the increased hazard ratio of 1.57 although this difference did not reach statistical power (P ＞ 0.05).No patients got IHD in the intensity-modulated radiation therapy group.Conclusions Left-side breast cancer patients may have more probability to get IHD after thoracic radiation therapy compared to right-side patients.We recommend that left-side breast cancer patients should be treated with intensity-modulated radiation therapy to spare heart if they receive prophylactic radiation therapy after surgery.

Objective To explore effect of irregular chemotatic factor fractalkine(FKN),phosphatidyl inositol 3 kinase and nuclear factor?κB(NF?κB)on interleukin?6(IL?6)expression in peripheral blood monocytes and the effect of valsartan intervention,so as to research the signal conduc?tive mechanism of FKN impacting on IL?6. Methods Peripheral blood monocytes were isolated from fresh blood of healthy volunteers by the densi?ty gradient centrifugation. The extractive peripheral blood monocytes were divided into seven groups:the control group,the FKN group,the LY294002 group(PI3K inhibitors),the PDTC group(NF?κB inhibitors),the FKN+valsartan group,the FKN+LY294002 group,and the FKN+PDTC group,the latter two were pretreated by LY294002 and PDTC respectively before FKN inducing PBMC cells. The IL?6 expression in cell me?dium was measured in each group by ELISA at 12 hours and 24 hours after PBMC treatment. Results After 12 hours of culture,compared with the control group,the expression of IL?6 in the FKN group was decreased(P<0.05),while LY294002 and PDTC groups had no significant difference (P>0.05). Compared with the FKN group,the expression of IL?6 was decreased in the FKN+valsartan group(P<0.05),increased in the FKN+LY294002 group(P<0.05),and was decreased in the FKN+PDTC group(P<0.05). After 24 hours of culture,the IL?6 expression in each group had no significant difference(P>0.05). Conclusion FKN can adjust the expression of peripheral blood PBMC IL?6 in a two?way pattern, inhibiting the expression of IL?6 by PI3K pathway and promoting the expression of IL?6 by NF?κB pathway,overall,FKN can inhibit the expression of IL?6. Valsartan can increase FKN to inhibit the expression of IL?6.