Objective To discuss the treatment of cervical cancer in different stages.Methods The treat- ment of 42 cases of cervical cancer in this hospital from January 2000 to December 2005 was analysed,and clinical treatment modalities were analysed too.Results(1)A total of 6 cases of uterine carcinoma in situ received hysterec- tomy plus bilateral salpingo-oophorectomy.(2)A total of 26 cases was inⅠb-Ⅱa stage,of which 15 cases with cer- vical cancer were treated with a simple radical hysterectomy;6 cases of cervical cancer were radiotherapied after radi- cal hysterectomy;7 cases of cervical cancer received radical hysterectomy plus radiotherapy.(3)A total of 10ⅡbⅣstage eases selected radiotherapy and chemotherapy.Conclusion Different treatment should be applied in differ- ent stages of cervical cancer,and the choice for treatment is important for patients' quality of life after treatment. Comprehensive treatment can improve the survival of patients with cervical carcinoma.

Objective To propose a new classification scheme of otitis media (OM). Methods By reviewing current internat ional classification systems of OM, we analyzed their disadvantages and the prog ress made in histopathologic studies of OM, then worked out a new classification scheme to apply it to clinic. Results In current internati onal classification systems of OM, those apparent clinical signs are regarded as main standards of classification. Their main disadvantage is that these signs c annot very well indicate the condition of pathologic and functional changes of i mportant hearing structure areas. We proposed a “Three-stage Scheme” of OM cl assification and applied in 1 160 cases of OM. The accuracy rate of diagnosis w as 82.4% in 348 cases of early-stage OM, 98.4% in 696 cases of chronic OM, and 95.2% in 116 cases of OM sequela. Conclusion The “Three-s tage Scheme” system is scientific, simple and practical. Its accuracy rate of d iagnosis is very high. It plays a guiding role in diagnosis and treatment of OM.

Objective To explore the change of 25 hydroxyvitamin D level and its correlation with glucose metabolism and bone mineral density in elderly men with type 2 diabetes mellitus(T2DM).Methods Hospitalized 53 elderly male patients with T2DM (T2DM group) and 51 patients without T2DM (NDM group) were chosen.Blood.biochemical indexes and 25 hydroxyvitamin D level were measured.Bone mineral density of lumbar (L2_4),left proximal femur was measured by dual energy X-ray.Results The serum 25 hydroxyvitamin D level in T2DM group was lower than that in NDM group [(12.38 ±5.12)μg/L vs.(17.35 ± 5.52) μ g/L],and there was significant difference(P＜ 0.05).The serum 25 hydroxyvitamin D level was negatively associated with fasting blood glucose level and glycosylated hemoglobin (r =-0.225,-0.499,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with fasting insulin and homeostasis model insulin resistance index (r =-0.050,-0.082,P ＞ 0.05).The incidence of osteoporosis in T2DM group was higher than that in NDM group [30.19％(16/53) vs.11.76％(6/51)],and there was significant difference (P ＜0.05).The serum 25 hydroxyvitamin D level was positively associated with bone mineral density of femur neck,greater trochanter of femur and Ward triangle(r =0.773,0.762,0.812,P ＜ 0.05).The serum 25 hydroxyvitamin D level was not associated with bone mineral density of lumbar (L2_4)(r =0.116,P ＞ 0.05).Conclusions The prevalence of vitamin D deficiency is found in elderly men with T2DM.Vitamin D level can affect blood glucose control and increase the risk of the occurrence of osteoporosis.Therefore,T2DM patients,especially elderly patients,should be routine vitamin D testing.Vitamin D supplementation to the patients of vitamin D insufficiency in time may be beneficial to glucose metabohsm and the prevention and treatment of osteoporosis.

Selective COX-2 inhibitors can promote the apoptosis of tumor cells and block the growth of new blood vessels through the inhibition of ring oxidase,vascular endothelial growth factor,microvessel and so on. Research shows that COX-2 is overexpressed in vascular and endothelial cells of lung cancer,select COX-2 inhibitors to adjuvant chemotherapy,not only can directly inhibit the tumor proliferation,but also can reduce the adverse reaction of chemotherapy drugs,and enhance the curative effect. To investigate the effects of selec-tive COX-2 inhibitors and cisplatin in lung cancer angiogenesis and its mechanism,will be a hope for the clini-cal treatment of tumor.

COX-2 is the inducible form of cyclooxygenase,which is overexpressed in non-small cell lung cancer,especially in the adenocarcinoma,and is involved in the production of lung cancer drug resistance, reducing the sensitivities of tumor cells to chemotherapy drugs. COX-2 inhibitors have the effects of antitumor and prevention of tumor formation. Therefore,in order to reverse the drug resistance of tumor cells,improve the sur-vival rate and the prognosis of patients with tumor,the application of COX-2 inhibitors as adjuvant chemotherapy and combined with chemotherapy drugs has become a new direction in the treatment of lung cancer.

It is the trend to integrate the curriculum contents and strengthen the ability training in reform of edu-cation model at present .After the abilities to develop and maintain medical informatics-related information sys-tems, to process medical information and to provide medical information service were analyzed, certain suggestions were put forward for the practical teaching reform of medical informatics according to the requirements of ability training and the characteristics of subject knowledge structure .

This paper introduced the importance of the air medicine system,and features and advantages of its development in the USA,Switzerland and Germany,and China's status quo.In view of the slow development of air medicine,imbalanced development and different operation models of air medicine systems in localities,and different models of emergency medicine services in the country,the paper proposed to build a model of government guidance and business operation as support for air medicine against emergency events,providing air ambulance service; to build an air medicine system featuring both public welfare and business operation,reasonable layout,timely response,and efficient operation,which will enhance the overall capacity of air medicine.

Objective To investigate the genetic homology in clinical isolates of extensively drug-resistant Acinetobacter baumannii (XDRAB),so as to provide evidence for better controlling hospital infections.Methods The genotypes of 28 clinical XDRAB isolates were determined by Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR).PCR was conducted to analyze 9 types of β-lactamase genes (blaKPC,blaIMP,blaVIM,blaNDM-1,blaOXA-23,blaOXA-24,blaOXA-48, blaOXA-51 and blaOXA-58),the outer membrane porin gene (CarO)and insertion sequence (IS)ISAba1.We also carried out linkage analysis for ISAba1-OXA23 and ISAba1-OXA58.Results Most of the above 28 XDRAB strains were isolated from respiratory tract specimens from intensive care patients.The result of ERIC-PCR showed that there was high homology between all the strains,suggesting that they might derive from the same clone.The genes blaOXA-23,blaOXA-51,CarO and the IS ISAba1 except Class Bβ-lactamase genes,blaOXA-24,blaOXA-48,blaOXA-58,ISAba1-OXA23 and ISAba1-OXA58 were detected in all the clinical strains by PCR.Conclusions All the XDRAB isolates belong to the same clone and carry the same drug-resistant genes,indicating that there was clone spread among XDRAB isolates.

Objective To analyze the demand for home care service and its influential factors among elderly in Tianjin city.Methods A total of 254 residents aged 60 and above from Tianjin city were investigated with a self-designed questionnaireDemand for Home Care Service,Katz index of independence in Activities of Daily Living(ADL) and Lawton Instrumental Activities of Daily Living (IADL) scale.Results The mean score for home care service has been revealed (2.40±0.67),as the ranking demonstrated:public welfare (3.61±1.04),social participation (2.69±1.32),medical service (2.56±0.90),rights safeguard by law (2.37±1.54),mental need (2.26±0.99),and need for daily life care (1.73±0.69).Multiple linear regression analysis showed that income,education level,activity of daily living and the convenience degree of seeking treatment were major factors affecting demand for home care service among elderly,which explained 16.3％ of the variance.Conclusions Oriented by demand,further progress shall be achieved multidimensionally,under which circumstances,individualized service ought to be de-livered.Simultaneously,the vulnerable elderly groups require more attention.

OBJECTIVE: To investigate the pathogenic factors of severe acute pancreatitis (SAP) complicated by hepatic insufficiency, the prognosis and the effective preventive and therapeutic interventions. METHODS: One hundred and fifty-two patients with SAP (from January 2003 to June 2004) were divided into 2 groups, SAP with hepatic insufficiency group and SAP without hepatic insufficiency group. The related factors such as causes of disease, serum biochemical criteria, complications, mortality and course of disease were observed. RESULTS: The concentrations of serum amylase, creatinine and lactate dehydrogenase were all much higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). The incidences of complications such as acute renal failure, heart failure, gastrointestinal hemorrhage and infection were also higher in the SAP with hepatic insufficiency group than those in the SAP without hepatic insufficiency group (P<0.05). There was no significant difference in mortality between these two groups, but the course of disease in SAP with hepatic insufficiency group was longer than that in the other group (P<0.05). CONCLUSION: The causes of SAP complicated by hepatic insufficiency are related to the imbalance of internal environment and the characteristics of the liver function. To control the biliary tract diseases, intervene with traditional Chinese medicine, recover the intestinal function in time, reduce the damage of pancreatic enzyme, maintain the stability of internal environment and avoid using drugs that can induce liver injury are all important aspects of reducing the incidence of hepatic insufficiency.