Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

Objective To evaluate the efficacy and safety of holmium laser lithotripsy for the treatment of urinary calculi.Methods A total of 1216 cases of urinary calculi underwent ureteropyeloscopic and cyctocopic holmium laser lithotripsy.There were 1 006 cases of ureteral stones(302 cases of upper ureteral stones,364 cases of middle ureteral stones,and 340 cases of lower ureteral stones) and 210 cases of bladder stones.Results In 1 case of upper ureteral stones,failure to access the ureteral orifice due to enlarged prostate was encountered,and extracorporeal shock wave lithotripsy(ESWL) was employed.In 1006 cases of ureteral stones,the rate of successful fragmentation on single session was 95.5%(961/1 006),with 89.4%(270/302),96.4%(351/364),and 100%(340/340) for upper,middle,and lower ureteral stones,respectively.Ureteral perforation was encountered during lithotripsy in 6 cases.In 210 cases of bladder stones,the rate of successful fragmentation on one session was 100%(210/210).No bleeding or bladder perforation was observed during lithotripsy.Follow-up checkups for 0.5~40 months(mean,18.6 months) in 881 cases of ureteral stones showed that the stone-free rates were 91.1%(224/246),98.5%(318/323),and 100%(312/312) for upper,middle,and lower ureteral stones,respectively.The overall stone-free rate for all levels of ureteral stones achieved 96.9%((854/881)).Ureteral stenosis was found in 6 cases.Follow-up checkups for 0.5~31 months(mean,12.4 months) in 187 cases of bladder stones revealed a stone-free rate of 98.4%(184/187). Conclusions Holmium laser lithotripsy is a highly effective,minimally invasive,and safe therapy for urinary calculi.It is indicated as the first choice of treatment for patients with ureteral stones and bladder stones.

Objective A enzymatic method for measurement of calcium in serum by using urea amidolyase was introduction. Methods Double reagent two-point method.TEA buffer(pH 8.0,200 mmol/L)was used as the buffer solution.The first reagent consisted of sodium bicarbonate 26.0 mmol/L,NADPH 0.4 mmol/L,2-oxoglutaric acid 8.0 mmol/L,urea amidolyase 115 U/L and GLDH 43.0 kU/L.The second reagent contained sodium bicarbonate 26.0 mmol/L and ATP 6.2 mmol/L in the buffer solution.Results The Linearity range was 0.5～5.0 mmol/L.The average rate of recovery was 102.7%.The average within-run and between-run CV were 2.13% and 2.69%.Camparison with OCPC(X1)，showed that Y1=1.02X1-0.021,r=0.981,and with Arsenazo Ⅲ(X2),Y2=0.99X2+0.03,r=0.978.No interference from as much as 300 μmol/L of bilirubin,4 g/L of hemoglobin,2.5 mmol/L of magnesium,2.0 mmol/L of ammonium ion and 8.0 mmol/L of triglyceride.Conclusion This method was simple,accurate and ripid,suitable for automatic analysis of calcium in serum.

Objective To research the quality control of determination of formaldehyde concentration in the indoor air in the newly decorated houses with 4-amino-3-hydrazine-mercapto-1, 2, 4-amilinoazaole spectrophotometry. Methods 35 newly decorated houses in two urban districts of Guiyang were chosen and the air samples were collected from March to December in 2004. Formaldehyde concentration was determined as soon as the air samples were collected, and the laboratory internal quality was controlled by using the standard sample in the determination. Results The formaldehyde concentration range of 35 newly decorated houses was 0.01-1.71 mg/m3, the detection rates was 100%, the rate of exceeding national standard was 77.1% and the median was 0.28 mg/m3. The recovery rates of quality control samples were 90.70%-103.00%. Conclusion The quality control method used in the present paper can make the results of formaldehyde concentration determinated with 4-amino-3-hydrazine-mercapto-1, 2, 4-amilinoazaole spectrophotometry be controlled in the demanded ranges of errors.

ObjectiveTo investigate the language cortex organization characteristics of native Chinese. Methods20 patients who underwent language mapping via intraoperative direct cortical electrical stimulation (ioDCES) under awake anaesthesia for glioma in dominant hemisphere were analyzed retrospectively. Results16 patients were identified at least one language site, 3 patients located in the frontal and 1 patient in the temporal lobe. The language sites mostly located in the perisylvian region. The frontal language sites conformed to traditional Broca's areas, but the superior temporal gyrus contained much more language sites than the middle temporal gyrus.ConclusionHigh individual variability in language organization indicates a need for revision of the classical model of language localization. Because of the samples were too small, our current dates can't fully reflect language cortex organization characteristics of native Chinese.

Objective To assess the clinical characteristics of primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) and its treatment and prognosis. Methods Twenty patients diagnosed with PGI-DLBCL were admitted to hospital between 2003 and 2007. The clinical characteristics and tumor molecular model of PGI-DLBCL as well as therapeutic methods were retrospectively studied. The factors that related to survival and prognosis were statistically analysed.Results The overall survival (OS) time of the patients were from 42 months to 52 months,while the progression-free survival (PFS) time were from 37months to 47 months. The International Prognostic Index (IPI) score (0～2 or ＞2) played a reminding role in prognosis of the disease. Tumor molecular model was no effect on prognosis [that was no significant difference between germinal center B-cell-like (GCB) type and non-GCB type]. The efficacy of Rituximab in combination with CHOP chemotherapy (R-CHOP) in treatment of PGI-DLBCL was similar to CHOP chemotherapy alone, whereas surgical intervention might prolong survival period. Conclusions The biological characteristics of PGI-DLBCL is so particular that the most therapeutic method, which need to be further studied, would be different from DLBCL in other position.

Objective:To compare the therapy effects of chemotherapy and non-chemotherapy groups and to determine the value of chemotherapy for adult diffuse low-grade gliomas. Methods:We reviewed and analyzed 64 patients with adult diffuse low-grade glio-mas admitted to the Beijing Tiantan Hospital from May 2005 to April 2008. Among the patients, 18 received 4 to 12 cycles of temozolo-mide chemotherapy after operation and radiotherapy, whereas the other 46 cases only received radiotherapy. The progression-free survival of the two groups was compared. Results:The median progression-free survival of the chemotherapy and the control groups were 67.8 and 51.3 months, respectively. The results of the comparison implied a significant difference (χ2=8.741, P=0.003). Conclu-sion:Chemotherapy can improve the progression-free survival of the patients with adult diffuse low-grade gliomas, and thus, can be recommended as its effective therapy.

Diverticulum ; diagnosis ; diagnostic imaging ; Heart Defects, Congenital ; diagnosis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Objective:To optimize 3.0T MRI diagnosis indicator in breast cancer and to select the best MRI scan program.
Methods:Totally 45 patients with breast cancers were collected, and another 35 patients with benign breast tumor served as the control group. All patients underwent 3.0T MRI, including T1-weighted imaging (T1WI), fat suppression of the T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), 1H magnetic resonance spectroscopy (1H-MRS) and dynamic contrast enhanced (DCE) sequence. With operation pathology results as the gold standard in the diagnosis of breast diseases, the pathological results of benign and malignant served as dependent variables, and the diagnostic indicators of MRI were taken as independent variables. We put all the indicators of MRI examination under Logistic regression analysis, established the Logistic model, and optimized the diagnosis indicators of MRI examination to further improve MRI scan of breast cancer.
Results:By Logistic regression analysis, some indicators were selected in the equation, including the edge feature of the tumor, the time-signal intensity curve (TIC) type and the apparent diffusion coeffcient (ADC) value when b=500 s/mm2. hTe regression equation was Logit (P)=-21.936+20.478X6+3.267X7+21.488X3.
Conclusion:Valuable indicators in the diagnosis of breast cancer are the edge feature of the tumor, the TIC type and the ADC value when b=500 s/mm2. Combining conventional MRI scan, DWI and dynamic enhanced MRI is a better examination program, while MRS is the complementary program when diagnosis is diffcult.

A consensus remains unsettled yet for basic medical insurance and common protocols on managing patients seeing doctors out of their hometown.This results in such setbacks as difficulty in seeing doctors elsewhere for those covered and in unaffordable financial burden,as well as medical insurance fraud,lack of information sharing among social insurance authorities,and difficulty of supervision.This study described the status quo of seeding doctors elsewhere under China's basic medical insurance system,and analyzed problems found in the management framework.On such basis,authors proposed such recommendations as unified management system for seeding doctors elsewhere,network information sharing for medical insurance information,and networked settlement for medical expenses for basic medical insurance.These measures should be carried out as per general requirements for health reform stage by stage.