Objective To analyze the clinical efficacy of compound 18 norgestrel combined with estrogen in treatment of dysfunctional uterine bleeding. Methods 78 cases of patients with dysfunctional uterine bleeding in Beijing Ji Shui Tan Hospital and Dongguan city people's hospital of guangdong Province were divided into control group (n=39)and observation group (n=39)by using randomized single-blind allocation. The control group was only given estrogen,the observation group was used compound 18 norgestrel combined with estrogen. The clinical efficacy of the two groups was compared. Results 31 cases were cured and 7 cases were valid of the study group,the total effective rate was 97.4%,significantly higher than the control group's total efficiency of 71.8%,the difference was statistically significant (P<0.05). Each index of observation group and the control group were improved after treatment,the difference was statistically significant (P<0.05 );After treatment,the menstrual cycle in observation group was (29.7 ±7.1)d,the menstrual period was (5.6 ±0.5)d,hemoglobin content was (135.5 ±21.7)g/L,endometrial thickness was (0.63 ±0.15)mm, significant changes than the control group,the difference was statistically significant (P<0.05 ). Conclusion Compound 18 levonorgestrel combined with estrogen has a better effect in patients with dysfunctional uterine bleeding and it can significantly improve patients'hemoglobin,the menstrual cycle and the uterus film thickness and other indicators which is worth promoting in clinical.

Objective To discuss the efficacy and relative factors that affect the sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure.Methods We analyzed the clinical data of the patient who was hospitalized in Respiratory Department of the Sixth Hospital of Luohe on 3th February 2008.Results The patient received invasive mechanical ventilation for 4 days,then changed to mask non-invasive positive pressure ventilation for 10 days,while receiving comprehensive treatment of anti-infection and bronchial expansion,etc.Then the patient was recovered.Conclusion The sequential therapy of invasive and non-invasive mechanical ventilation in treating severe respiratory failure is effective.The efficacy depends on the optimum converting time between invasive and non-invasive mechanical ventilation,the choice of ventilator and the patient′s compliance.

Objective To analyse the clinical features,imaging characteristics diversity of deep cerebral veins thrombosis (DCVT).Methods From 2004 to 2013,6 patients diagnosed as DCVT were recorded and a retrospective review of the cases were undertaken for the purpose of this analysis.Results Among the 6 patients with DCVT,4 were male and 2 were female,aged from 28 to 69 years old.The disease duration of 4 cases ranged from 2 to 7 days,remnants were 20 days and 3 months respectively.The first symptoms of 4 cases were headache,1 was feeblemindedness,and the other was hemiplegia.The secondary symptoms were disturbance of consciousness,apathy,diplopia and non-infectious fever.Non-contrast computed tomography showed low signal in the bilateral thalamus in four patients,high signal in the transverse sinus and straight sinus in one patient and high signal in torcular in one patient.Abnormal signal was found in bilateral thalamus on magnetic resonance imaging in all patients and some of them had abnormal signal in the mesencephalon or basal ganglia.The patients were definitely diagnosed as DCVT by magnetic resonance venography (MRV) or digital subtraction angiography (DSA).Among them,2 patients were confirmed by brain biopsy.Four patients were followed up with good outcome and 2 were lost to follow-up.Conclusions The clinical manifestations of DCVT are not specific.For acute-onset DCVT patients,the first symptoms are always headache and vomiting,while the main symptoms are declined cognition and slow reaction for chronic-onset ones.Along with the progress,the main symptoms of DCVT are disturbance of consciousness,psychiatric symptoms and intracranial hypertension.Changes in the bilateral thalamus and basal ganglia are especially main characteristics which are easily misdiagnosed as brain tumor according to the images.DCVT can be definitely diagnosed by no signal of deep cerebral veins on MRV or DSA.

This study was aimed to investigate Baishile Capsule on behavior, memory and expression of SYN I and SYNA in hippocampal CA3 region of depression model rats. SD rats were randomly divided into six groups, which were the control group, depression model group, fluoxetine hydrochloride group, and the Baishile Capsule group (2.88 g·kg-1, 1.44 g·kg-1, 0.72 g·kg-1). The chronic stress depression model rats were established by chronic and mild unpredictable stressors as described in the literature. In the model group, medicine was intragastricly administered once per day and continued for 21 days. In the control group and model group, same volume of distilled water was intragastricly administered. The open-field test, preference for 1% sucrose solution, Morris water maze, and rate of weight were carried out and observed. Immunohistochemistry and in situ hybridization were used in the observation of the expression of SYN I and SYNA in each group of model rats. The results showed that high-dosage Baishile Capsule can significantly increase the horizontal and vertical activities of score after two-week treatment (P< 0.01). The middle-dosage Baishile Capsule can significantly increase the horizontal activity of score after three-week treatment (P< 0.05). The rat's preference for sucrose solution was obviously increased in the high-dosage group after one-week treatment and in the middle-dosage group after three-week treatment (P< 0.01, or P< 0.05). The rate of weight of rats was obviously increased in the high-dosage group after two-week treatment and in the middle-dosage group after three-week treatment (P< 0.01, or P< 0.05). The high-dosage and middle-dosage Baishile Capsule can shorten EL, and significantly increase the number of target quadrant. The high-dosage Baishile Capsule can obviously shorten the target quadrant latency (P< 0.05). Compared with the model group, the immunohistochemistry and in situ hybridization showed high-dosage Baishile can significantly promote the expression of SYN I and SYNA in hippocampal CA3 region; and the middle-dosage group can enhance the expression of SYNA (P < 0.05, or P <0.01). It was concluded that Baishile Capsule can obviously improve the behavior and the expression of SYN I and SYNA in hippocampal CA3 region of depression model rats.

Objective:To develop a Child School Refusal Behavior Rating Scale(SRBQC)and examine its reliabilities and validities. Methods:Based on literature review,interview,and open-ended questionnaire,124 origi-nal items were developed. Totally 573 students were recruited to complete the test version. After item and explorato-ry factor analysis,the formal scale-SRBQC was got. Totally 946 students were tested with formal version for further confirmatory factor analysis,internal consistency reliability and composite reliability. The criterion validity was test-ed with the Social Anxiety Scale for Child (SASC). Totally 41 students were retested for test-retest reliability with 2 weeks interval. Results:The formal version of SRBQC included 19 items. Exploratory factor analysis generated 5 factors which account 59. 793% of the variance in all,the results of confirmatory factor analysis showed that SR-BQC had a good construct validity (χ2 =329. 51,df=142,χ2/df=2. 32,CFI=0. 97,GFI=0. 93,IFI=0. 97,NFI=0. 95,NNFI=0. 96,RMSEA=0. 05,SRMR=0. 05). The SRBQC scores were positively correlated with the SASC scores (r=0. 18-0. 34,Ps<0. 05 ). The Cronbach coefficients were 0. 87 for the total questionnaire and 0. 55 -0. 78 for the 5 factors. The test-retest reliabilities were 0. 84 for the total questionnaire and 0. 66 -0. 78 for the 5 factors. Conclusion:The reliability and validity of the School Refusal Bevior Questionaire for Children(SRBQC) meet the needs of psychometrics.

OBJECTIVE To know the bacterial distribution in the blood of septicemia patients and the characteristics of drug resistance.METHODS To train the blood in BD BACTEC 9050 full-automatic blood training system and to analyze it in the FOUTUNE IMS bacterial identification and hypersusceptibility analysis system of Fuxing Company.RESULTS The Gram-negative bacilli were in superiority with 64.9% of the total isolated bacteria.Then were the Gram-positive cocci,and Staphylococcus were the main.The Enterococcus and fungi were with a certain proportion.The drugs to which had relatively low resistance for the Gram-positive bacilli and the Gram-positive cocci were the carbapenems,the enzyme inhibitors and vancomycin.CONCLUSIONS The Gram-negative bacilli get priority in the blood bacteria in patients with septicemia during the last two years,the enterococci and fungi have a certain proportion.And the pathogenic bacteria have higher resistance clinically to antibacterial drugs.

Objective To study the long-term results of using an autologous vascularized pedicled flap of gastric tissues in the repair of traumatic bile duct strictures.Methods From 2002 to 2016,38 patients with traumatic bile duct strictures underwent repair using an autologous vascularized pedicled flap of stomach tissues.The postoperative morbidity,mortality,long-term clinical results,liver function and the rate of biliary stricture recurrence were studied.Results The overall complication rate was 18.4％ (7/38).A delay in healing of the incision wound occurred in 4 patients,biliary fistula in 2,and ascites in 1.Two patients died of malignant tumor.The median follow-up was 92 (61 ～ 107) months and the follow-up rate was 100％.Excellent results were obtained in 97.2％ (35/36) of patients.Abnormal liver function was detected in 1 patient which improved with treatment using choleretic drugs.The remaining 35 patients had normal liver functions with absence of abdominal pain.Conclusions To repair traumatic bile duct strictures using an autologous vascularized pedicled flap of stomach tissues was safe and reliable,and good long-term outcomes are available.

Objective:To explore the effects of sitagliptin phosphate combined with metformin on blood glucose control and microinflammation in patients with type 2 diabetes.Methods:One hundred patients with newly diagnosed type 2 diabetes who were treated in the First Affiliated Hospital of Xingtai Medical College from March 2017 to March 2019 were randomly divided into observation group (50 cases) and control group (50 cases). The observation group was treated with sitagliptin phosphate combined with metformin for 8 weeks, while the control group was treated with metformin for 8 weeks. The changes of fasting blood-glucose (FBG) and blood glucose 2 h after meal (2 h-PBG ) in the two groups before and after treatment were observed, and the standard time of FBG and 2 h-PBG in the two groups were statistically analyzed. The levels of interleukin(IL)-1, IL-6 and high-sensitivity C-reactive protein (hS-CRP) were compared between the two groups before and after treatment.Results:After treatment, the levels of FBG and 2 h-PBG in the observation group were significantly lower than those in the control group: (6.32 ± 0.83) mmol/L vs. (7.21 ± 1.03) mmol/L, (8.61 ± 1.26) mmol/L vs. (9.63 ± 1.12) mmol/L, and the standard time of FBG and 2 h-PBG in the observation group were significantly shorter than those in the control group: (3.11 ± 0.86) weeks vs. (4.53 ± 1.31) weeks, (3.26 ± 0.36) weeks vs. (9.63 ± 1.12) weeks, and the differences were statisticlly significant ( P<0.05). After treatment, the serum levels of IL-1, IL-6 and hs-CRP in the observation group were significantly lower than those in the control group: (22.86 ± 4.07) ng/L vs. (35.13 ± 5.92) ng/L, (5.93 ± 0.84) ng/L vs. (9.67 ± 1.11) ng/L, (2.12 ± 0.25) ng/L vs. (3.57 ± 0.48) ng/L, and the differences were statistically significants ( P<0.05). Conclusions:Sitagliptin phosphate combined with metformin in the treatment of type 2 diabetes patients can rapidly and effectively control blood glucose and improve the state of microinflammation in patients.

Objective To improve the diagnostic ability of leukoencephalopathy with cerebral calcifications and cysts (LCC),a rare central nervous system disease.Methods The clinical manifestations,neuroimages and neuropathological features of a 19-year-old male patient were analyzed.A total of 20 cases from 14 literatures were reviewed.Results The patient was admitted with right limb weakness,cognitive decline,headache and blurred eyesight.Head CT scan showed multiple calcifications,cysts formation and leukoencephalopathy.Brain MRI showed several cysts in bilateral hemisphere,basal ganglia,thalamus and paraventricular areas.A mural nodule was noted inside one of the cyst,which was enhanced on the contrasted MRI.The wall of the cysts was partially enhanced,but not with the fluid inside the cysts.The corresponding CT calcifications foci showed on T1 and T2 with either both hyperintensity or both hypointensity,which was also partial enhanced.Extensive leukoencephalopathy was formed around the cysts and the ventricles.But neither Cho nor NAA changed a lot on MRS.Amplitude diagram of SWI series exhibited multiple round small dark signals all over the affected areas with mixed signals showed in the phase diagram,which indicated both calcifications and microbleedings at the lesions.Neuropathological examinations found no tumor cells in the operated cyst,and showed angiomatous small blood cells were dominant in the cyst wall.Hyaline degenerations,microcalcifications and hemosiderin deposition were observed.No obvious demyelination was discovered,while gliosis,numerous Rosenthal fibers and fibrinoid vascular necrosis were found around the lesions.The clinical,neuroimaging and pathological features of this patient were in accordance with the cases reported in the literatures.Conclusions Neuroimaging is the most important method for the diagnosis of LCC.As small vessel lesions are probably closely related to the pathophysiology of LCC,SWI could be recommended to further reveal the etiology of LCC.

Objective To analyze the clinical,imaging and pathological features of cortical vein thrombosis (CoVT).Methods Three cases of cortical vein thrombosis were diagnosed in our hospital from February 2010 to October 2012.We reviewed and summarized their clinical manifestation,radiological feature and pathological characteristics.Results All patients were young with acute onset.The main clinical manifestations included headache,epilepsy or limbs weakness.Two cases had intracranial hypertension.One case had decreased activity of protein S.One had increased plasma homocysteine.Brain computed tomography scan showed hypodensity lesion with some hyperdensity inside.Cranial routine magnetic resonance imaging showed long signal in T1-weighed image and T2-weighed image,with occasional short T1 signal inside.Contrast-enhanced magnetic resonance imaging revealed heterogeneous enhancement.All of 3 cases underwent brain biopsy because of the suspected diagnosis of brain tumor.Brain pathology showed the local necrosis and hemorrhage,dilated small vein with congestion or thrombosis.Neuronal degeneration,hyperplasia of gliocyte,hyperplasia of endotheliocyte in small blood vessels with reaction of histiocytes was also displayed.Duration from initial visit to final diagnosis was from 14 days to 2 months.Conclusions CoVT has various clinical and radiological manifestations and it is easy to misdiagnose as brain tumor.Careful analysis of clinical and imaging data could improve its diagnostic accuracy.Brain biopsy would also be helpful for diagnosis.