Background and purpose:High frequency loop electrosurgical excision procedure(LEEP)has been widely used in the treatment of cervical intraepithelial neoplasia. The purpose of this study was to explore the value of loop electrosurgical excision procedure in the diagnosis and management of CINⅢ and stage ⅠAl cervical carcinoma.Methods:A retrospective analysis was carried out in 396 cases of CINⅢ and cervical carcinoma with stage ⅠAl undergoing operation and loop electrosurgical excision procedure between January 2003 and October 2006 at Obstetrics and Gynecology Hospital of Fudan University.Results:The coincidence rate of the multiple biopsies before the procedures compared with the conization ones was 88.6 % (351/395). The incidence of residual disease was 10.2%(6/59) and 7.7 % (6/78), respectively in patients with positive margins and negative margins.Conclusions:Loop electrosurgical excision procedure can improve both the diagnosis and treatment of CINⅢ and cervical carcinoma stage ⅠAl. We should offer further treatment properly to the cases with positive margin because of the persistent lesions.

Background and purpose:Fallopian tube carcinosarcoma is a rare malignant tumor that is prone to metastasis and recurrence. Patients with the malignancy often have poor prognosis. This paper retrospectively analyzed the clinical manifestation, pathology, treatment and prognosis of fallopian tube carcinosarcoma.Methods:The clinical manifestations, pathological features, treatment and survival time of 7 cases of fallopian tube carcinosarcoma were retrospectively analyzed.Results:The most common symptoms of 7 cases of fallopian tube carcinosarcoma were irregular vaginal bleeding (4/7, 57.1%). Among 7 cases, one case was stageⅠa, 1 stageⅡa, 1 stageⅡb, 1 stageⅢb, and 3 stageⅢc. Four cases (57.1%) were heterologous and found to have cartilage components whereas 3 cases (42.9%) were homologous. Seven cases were performed with tumor volume reduction surgery, and 6 cases with chemotherapy, while no one received radiotherapy. Five patients survived and 2 were dead. The survival time of 3 patients was more than 5 years. The longest survival time to the end of the follow-up was 114 months.Conclusion:The pathological examination is the diagnostic means of fallopian tube carcinosarcoma. The prognosis of the patients with the pathological characteristics of the homologous is better than that of the heterologous. Satisfactory reduction of tumor, postoperative chemotherapy with adequate TP regimen, combined with systemic chemotherapy and intraperitoneal chemotherapy may be an effective treatment for fallopian tube carcinosarcoma.

AIM: To understand whether native and oxidized low density and very low density lipoprotein (n-LDL, n-VLDL, ox-LDL, ox-VLDL) enhance the expression of macrophage inflammatory protein (MIP)1? mRNA in cultured aortic smooth muscle cells (SMCs). METHODS: Native low density and very low density lipoprotein were isolated from normal blood donors by density gradient ultracentrifugation, and were oxidatively modified by adding CuCl 2. After a 24 h-exposure of the cultured SMCs to n-LDL, n-VLDL, ox-LDL and ox-VLDL, respectively, the expression of MIP-1? mRNA was determined by in situ hybridization and RT-PCR. RESULTS: Cultured aortic SMCs expressed MIP-1? mRNA at low level. N-LDL, n-VLDL, ox-LDL and ox-VLDL enhanced the expression of MIP-1? mRNA in SMCs, ox-LDL and ox-VLDL showed stronger effect than n-LDL and n-VLDL, respectively. The effect of ox-VLDL was most striking. There was a significant difference between groups ( P

PurposeTo exploit the relationship between the history of abortion and the infection of viral hepatitis C in the pregnant women.MethodsRisk factors for hepatitis C virus(HCV) infection were analyzed by Chi-square and a multiple logistic regression analysis in 2 783 pregnant women from Shanghai Punan hospital in 1995- 1998.ResultsThe results showed that the following factors associated significandy with anti-HCV seropositive rate:number of abortion,anti-HCV positive of spouse. In the logistic regression analysis the prevalence rate of HCV in pregnant women who were laid-off their work was 7.37 %, which was higher than that of other occupational pregnant women. There was no relationship between the HCV infection and age,marital status,history of injection, operation, hospitalization and the drug abuse.ConclusionsAbortion is a risk factor of HCV infection in pregnant women. The positive rate of anti-HCV is increased with the number of abortion. Strengthening thesterilization and disinfection of instruments during the abortion operation is necessary.

Objective To investigate the high risk factors, clinical manifestation and therapy strategy of ovarian hyperstimulation syndrome (OHSS) in assisted reproduction techniques (ART). Methods Clinical data of 136 cycles of OHSS patients after in vitro fertilization-embryo transfer (IVF-ET) from 2005 to 2008 were analyzed retrospectively. Results (1) A large number of follicles stimulated, luteal phase supported with hCG and pregnancy were high risk factors to induce OHSS. (2)Most of OHSS occurred on the 3~(rd) day to 10~(th) day after administration of medicine to induce ovulation. (3) Longer disease process, more severe symptoms and larger amount albumin used for treatment of OHSS were commonly observed in pregnant patients with OHSS compared with non-pregnant ones. (4) Human serum albumin through intravenous dripping was one of the most successful treatment as plasma expanders through restoration of effective blood volume; paracentesis was necessary for critical OHSS patients with severe ascites and hydrothorax. Conclusions OHSS is a serious complication of controlled ovarian hyperstimulation, which deserves proper prevention and treatment.

BACKGROUND: The bone marrow stem cell (MSC) transplant treatment have the obvious superiority to tradition graft treatment for bone nonunion, but how to obtain the concentrated and highly effective bone marrow mesenchymal stem cell, as well as the dose-effect relations to fracture healing need further discussions. OBJECTIVE: To observe the curative effect of bone nonunion by using autologous MSC transplant treatment, and to compare with autologous iliac bone graft.DESIGN, TIME AND SETTING: Randomized controlled analysis was performed from January 1999 to June 2005 in the Affiliated Second Hospital of Hebei Northern College.PARTICIPANTS: The admitting 140 patients with humerus and tibia fracture were divided into 2 groups at random, autologous iliac bone graft group and autologous MSC transplant group, with 70 patients in each group. METHODS: Under aseptic condition, autologous MSC transplant group received puncture through posterior superior iliac spine, extracting bone marrow 10-20 mL from different spots, separating MSC using the density gradient centrifugation method, and counting as 4×10~9 nucleated cells/mL under the microscope for later use. In the autologous iliac bone graft group, bone fracture end was implanted with the suitable amount of iliac bone, while autologous MSC transplant group with the mixture of decalcified bone matrix and MSC, followed by suture. After the transplantation, external fixation may assist for 4-6 weeks according to the fixed degree of internal fixation.MAIN OUTCOME MEASURES: ① Bone callus formation and pain conditions in 2 groups at different time points after transplantation. ② Comparison of bone healing time between 2 groups. ③ Adverse events and side effects.RESULTS: According to intention-treatment analysis, experimental adopted 140 patients of humerus and tibia fractures, who all entered the final analysis. ① Bone callus formation and pain at different time points post-surgery: At 1 month after transplantation, bone callus formation in the fracture end was not obvious in autogenous iliac bone graft group, and could be seen in autologous MSC transplant group, both groups of fractures exhibited tenderness. At 2 months after transplantation, bone callus formation was observed in autogenous iliac bone graft group, fracture tenderness was relieved compared with the previous condition; in autologous MSC transplant group, a large number of bone callus formed, fracture tenderness was not obvious. At 3 months after transplantation, there were a large number of bone callus formations in autogenous iliac bone graft group, with slight fracture tenderness; in the autologous MSC transplant group, continuous bone callus formation appeared, without fracture tenderness. ② Bone healing time: The average healing time of autologous MSC transplant group was significantly shorter than autogenous iliac bone graft group [(5.5±1.5), (8.0±2.0) months, P < 0.05]. ③ Adverse events and side effects: Except 4 patients had iliac bone pain, all patients during the treatment had no infection and other complications, there were no re-fracture occurred at the follow-up of 8 months.CONCLUSION: The autologous MSC transplant treatment of exhibits a short duration and good effect for bone non-union, has obvious advantages over traditional bone graft.

Objective To discuss the blood flow charateristics of normal Couinaud’s hepatic segments by using whole-liver perfu-sion with multi-slice spiral computed tomography (MSCT).Methods 73 patients underwent whole-liver perfusion enhanced CT scans for detection of gastric or pancreas cancer,and some were excluded including metastatic liver tumors in 7,multiple liver cysts (>3 cm in diameter)in 6,cirrhosis in 6,liver operation or splenecormy in 3,intra-hepatic bile duct dilation in 1,and excessive motion artifacts in 4.The final 46 patients with normal liver were included,and the perfusion parameters of liver segments were measured for estimating blood-dynamics condition.Results The hepatic arterial perfusion (HAP)in segment 3 was significantly higher than that in segment 6,7 and 8 (P <0.05),and the HAP in segment 4 was significantly higher than that in segment 7 (P <0.05).The hepatic perfusion index (HPI)in segment 3 was significantly higher than that in segment 7 (P <0.05).All normal liver were classi-fied into two groups (group A:<60 years,group B:≥60 years),and no significant correlation between age groups was found.How-ever,the perfusion parameter values in group A were higher than those in group B.No significant correlation was found between gen-ders.Conclusion Our results suggest that differences exist in normal hepatic parenchyma between liver segments.MSCT whole-liver perfusion imaging can more comprehensively response hemodynamic changes in liver,and provids the imaging basis for clinical evaluation of liver disease.

Objective To explore the measures and methods to cope with the early stage epidemic struck of H7N9 avian influenza,as the head nurses of the department of infectious diseases.Methods The main work focus of the head nurses of the department of infectious diseases were analyzed during the early stage of H7N9 epidemic struck systematically by reference to the domestic literatures.Results At the early stage of H7N9 epidemic struck,the main work focus of the head nurses of the department of infectious diseases was to draw up every emergency plans,prepare necessary protective medical supplies,train medical staff,and be ready to the preview and triage.Conclusions The head nurses of the department of infectious diseases should pay close attention to the progress of H7N9 epidemic struck,and get ready for all related work in order to ensure smooth treatment during early stage of the epidemic struck.

Objective To evaluate the value of PET/CT in preoperative assessment and postoperative monitoring of ovarian cancer. Methods A retrospective analysis was conducted in 45 patients of ovarian neoplasm with clinical records underwent 18F-FDG PET/CT, including 10 patients underwent PET/CT before surgery and 35 patients after surgery. The clinical follow-up time was 6 months at least. The diagnosis based on pathology and clinical follow-up data. Results (1) The sensitivity, specificity and accuracy of PET/CT in detecting ovarian cancer were 94.6%,75.0%and 91.1%, respectively. (2) Ten patients before surgery were all detected tumor by PET/CT, but 2 of them were false positive based on pathologic results. (3) Two patients with non-standard surgery were detected tumor by PET/CT. In 33 patients after standard surgery, 6 patients were no tumor detected by PET/CT. In addition,4 patients with normal CA125 and no signs of recurrence and metastasis were detected tumor by PET/CT. The pathology and clinical follow-up data supported the results. 23 patients with higher CA125 were diagnosed recurrence and metastasis based on pathology and clinical follow-up data, 21 of them were detected tumor by PET/CT. Conclusion 18F-FDG PET/CT plays an important role in preoperative assessment, early diagnosis and accurate positioning of recurrent and metastasis of ovarian cancer. It can be used to guide the clinical treatment.

OBJECTIVE: To investigate the clinical features and therapeutic effects of sudden deafness after radiotherapy combined with chemotherapy in nasopharyngeal carcinoma patients. METHOD: Clinical data of 42 nasopharyngeal carcinoma patients suffered from sudden deafness after radiotherapy combined with chemotherapy were analyzed retrospectively. Among the 42 patients, 2 showed moderate deafness, 4 presented excessive deafness, 30 suffered from severe deafness, and 6 exhibited profound deafness. The audiogram pattern of 33 patients met with the type of high tone frequencies hearing loss, and that of the rest 9 cases showed hearing loss at all frequencies. All patients received medical therapy combined with hyperbaric oxygen therapy. RESULT: Of all the cases with hearing loss, 2 were cured, 2 showed excellent recovery, 9 came out partial recovery, and 29 showed no response to the treatment. The total effective rate was 30.95%. For the accompanied symptoms, none of the 30 cases of tinnitus were relieved, 3 out of 10 cases of aural fullness were cured, and the 5 cases of dizziness or vertigo were all improved. CONCLUSION The sudden deafness after radiotherapy combined with chemotherapy in patients with nasopharyngeal carcinoma is closely related to radiotherapy. The hearing loss is serious, and the therapeutic effects are not satisfactory.
Antineoplastic Agents ; adverse effects ; Carcinoma ; Dizziness ; etiology ; therapy ; Hearing Loss, High-Frequency ; etiology ; therapy ; Hearing Loss, Sudden ; etiology ; therapy ; Hearing Tests ; Humans ; Hyperbaric Oxygenation ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; drug therapy ; radiotherapy ; Radiotherapy ; adverse effects ; Retrospective Studies ; Tinnitus ; etiology ; therapy ; Vertigo ; etiology ; therapy