Objective To evaluate the efficacy of laparoscopic operations in the treatment of ectopic pregnancy.Methods A total of 148 cases of tubal pregnancy from January 2002 to January 2005 were studied.Laparoscopic operations included 106 cases of oviduct-sparing operation(79 cases of oviduct fenestration and 27 cases of lesion clearance),37 cases of salpingectomy,and 5 cases of lesion clearance.Results The diagnosis and operation were laparoscopically completed in all the 148 cases.Persistent ectopic pregnancy occurred in 2 cases.Postoperative monitoring of serum ?-hCG levels showed the shortest recovery time to normal levels after the treatment of salpingectomy(8?1 d),and the longest one after lesion clearance (15?2 d).Regular menstruation resumed at((31?)2 d) after salpingectomy and at(43?3 d) after lesion clearance.Follow-up checkups with uterotubography in 84 cases for 1~3 months(mean,2.3 months) found a patent rate of both oviducts of 82.1%(69/84).Conclusions Laparoscopic operations is a safe and effective option in the treatment of ectopic pregnancy.

0.05).The median survival time was 32 weeks in group A compared to 27 weeks in group B(P

Objective To evaluate the protecting effects of matrine on chemotherapy related hepatic lesion and its possible mechanism.Methods The positive rate and severity of hepatic lesion were compared between pa- tients being treated with or without matrine during chemotherapy processes.Furthermore,the difference of liver pro- tecting effect of this Chinese medicine between hepatitis B virus(HBV)infection chemotherapy patients and disinfec- tion patients were also analyzed.Results Both the rate of hepatic lesion and level of ALT in matrine treated group were much lower than those in untreated group in chemotherapy patients.The rate of hepatic lesion and level of ALT in HBV infection patients were higher than those in HBV disinfection patients in untreated group,while the signifi- cant difference of these two parameters between HBV infection patients and disinfection patients were disappeared in matrine treated group.Conclusion Matrine has hepatic protecting effect in chemotherapy related liver lesion.

Objective To establish and evaluate a gene microarray for determination katG mutations of Mycobacterium tuberculosis isolates associated with resistance to isoniazid(INH).Methods A panel of probes were designed and gene chips were prepared by dotting.Mycobacterium tuberculosis isolates resistance to 5 drugs was determined by proportional dilution methods.Amplicons of Mycobacterium tuberculosis isolates were detected by our chip and sequenced.Results The drug resistance rate of the isolates to at least one of the anti-tuberculosis drugs was 70.8%(97/137).45 strains out 137 Mycobacterium tuberculosis isolates was resistant to INH(32.8%).katG was successfully amplified from 100% of the susceptible strains and 88.9%(40/45)resistant strains.4 of 45 INH resistant isolates' katG were deleted.27 of 40(67.5%) katG has been detected to have katG 315 codon mutations.The mutations were 315 AAC(Asn,13/40), ACC(Thr,6/40),ACA(Thr,4/40),ATC(Ile,2/40),AGC(Arg,2/40).The mutation rate of katG analyzed by gene chips we prepared were identical to katG sequencing.Conclusion The gene microarray techniques we developed for determination of Mycobacterium tuberculosis resistance to INH are specific, sensitive and may be used as an alternative in clinical laboratory.

BACKGROUND:Surgical treatment for pigmented vil onodular synovitis can maximize the excision of synovial lesions and recovery of joint function.
OBJECTIVE:To investigate the knee joint function and relapse rate fol owing treatment of pigmented vil onodular synovitis with total knee replacement and arthroscopic synovectomy.
METHODS:We retrospectively analyzed 34 cases of knee pigmented vil onodular synovitis admitted for surgical treatment in the Department of Orthopedics, Xiangya Hospital of Central South University, China from December 2006 to December 2011. In these cases, 24 patients received arthroscopic synovectomy and 10 patients were subjected to total knee replacement. Adjuvant radiotherapy was conducted according to postoperative patient’s conditions. Lysholm scoring was employed in the arthroscopic synovectomy group, and American Knee Society scoring was used in the total knee replacement group. Knee function in two groups was compared before and after treatment. Fol ow-up observation was performed to compare knee function recovery and relapse rate between two groups.
RESULTS AND CONCLUSION:Thirty-four patients were effectively fol owed up for 12-66 months, mean 41.3 months. Statistical analysis showed that in the arthroscopic synovectomy group, the postoperative Lysholm score was (86.3± 10.3) points, significantly higher than the preoperative score which was (55.5±13.2) points (t=3.81, P=0.016, P<0.05). In the total knee arthroplasty group, the American Knee Society score was increased from (40.7±2.2) points preoperatively to (90.2±1.1) points postoperatively (t=6.27, P<0.01). In the arthroscopic synovectomy group, the American Knee Society score was increased from (34.2±3.9) points preoperatively to (80.8±1.9) points postoperatively (t=16.58, P<0.01). Arthroscopic synovectomy combined with adjuvant radiotherapy can achieve better outcomes in pigmented vil onodular synovitis patients, while the total knee replacement for advanced with advanced knee diffuse pigmented vil onodular synovitis is better to restore knee function and the recurrence rate is low.

A patient with multiple ischemic stroke due to spontaneous bilateral internal carotid artery dissection (ICAD) was reported and the epidemiology, neuroimaging, clinical characteristics and treatment of spontaneous bilateral ICAD were reviewed.Spontaneous bilateral ICAD mostly occurs in young and middle-aged individuals and the clinical manifestations are mainly stroke(71.1%), headache and neck pain(62.2%), Horner's syndrome(15.6%) and cranial nerve palsy(11.1%).Cervical axial T1-weighted fat-suppressed image is an alternative to DSA to make the definite diagnosis.Antithrombotic therapy is regularly used and the general clinical outcome is good.Cervical arterial dissection is one of the most common causes of stroke in young and middle-aged patients.Cervical MRI T1-weighted fat suppressed image is crucial for timely diagnosis and initiation of appropriate clinical intervention.

Objective To explore the clinicopathological features of IgA nephrolpathy associated with malignant hypertension (IgAN-MHT) and to analyze their correlation with renal vascular lesions. Methods Twenty-nine patients of IgAN-MHT were screened from 2000 biopsy-proven eases with primary IgA nephropathy (IgAN) in our department from April 1997 to May 2007. Data of clinicopathology and follow-up of these 29 patients were collected. Semi- quantitative analysis was performed to evaluate the pathological changes. Inner lumen, outer lumen, intimal thickness, tunica media-to-internal lumen ratio of 436 arterioles, 124 interlobular arteries and 5 arcuate arteries were measured. The primary endpeint was the composite of a doubling of serum creatinine level and ESRD. Correlations of renal vascular lesions with clinical manifestation, pathological change and prognosis were examined by Spearman and Cox methods. Results 1.5% of all the IgAN patients presented malignant hypertension. The common clinical features were renal failure (100%), hyperurieacidemia (62.7%) and hypertriglyceridemia (51.7%). The average amount of urine protein excretion was 2.8 g/d. The common pathological changes were moderate mesangial proliferation, severe global sclerosis, severe interstitial inflammation and severe interstitial- tubular fibrosis. The small arteries (arcuate arteries and interlobular arteries) and arterioles (afferent arterioles) were both involved in IgAN-MHT. The characteristic lesions of intrarenal arteries included vascular occlusion, media thickening, proliferative endarteritis (onionskin lesion, musculomucoid intimal hyperplasia), hyaline arteriosclerosis, but mainly vascular occlusion (86.2%). The arteriole lesion was negatively correlated with age and total protein level; vascular occlusion was positively correlated with uric acid level. The average foUow-up period was 21.1 months. Forteen patients reached the endpoint. The arteriole lesion was the main independent risk factor for the progression of IgAN-MHT (RR=10.21, 95%CI=1.16～89.67). Conclusions The main clinical feature of IgAN-MHT is renal failure. The main histological feature of intrarenal vascular lesions is occludes arterioles. Arteriole lesion is the main independent risk factor for the progression of IgAN-MHT.

ostic sensitivity and specificity of EUS are high in distinguishing benign and malignant character of upper digestive tract GIMTs. EUS plays an important role in guiding the clinical management of upper digestive tract GIMTs.

Objective To investigate the changes in plasma microRNA-126 and microRNA-1 in children with asthma exacerbation and its relationship with bronchial asthma.Methods From October 2012 to December 2013,48 children with asthma exacerbation from the Outpatient Department and the Inpatient Department in Houjie Hospital Affiliated to Guangdong Medical College were enrolled in the study (asthma group).Meanwhile,52 healthy children wcre selected as the healthy control group.The expression levels of plasma microRNA-126 and microRNA-1 were detected by real-time quantitative PCR (RT-PCR).The content of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in plasma was measured by enzyme-linked immunosorbent assay (ELISA).The predictive value of microRNA-126 and microRNA-1 in plasma to bronchial asthma was evaluated by receiver operating characteristic (ROC) curve.Results The relative expression levels of plasma microRNA-126 in the asthma group were upregulated compared with those in the healthy control group [7.36 (0.96-41.21) vs 3.68 (0.75-38.91),Z =3.135,P =0.038],and microRNA-1 relative expression levels in the asthma group were lower than those of the healthy control group [2.17 (0.18-26.97) vs 5.83 (0.82-39.62),Z =2.156,P =0.045].The content of IL-4 in asthma group was higher than those of the control group [(109.98 ± 74.58) ng/L vs (78.50 ± 75.82) ng/L,t =2.122,P =0.036],and the IFN-γ level in the asthma group was lower than those of the healthy control group [(70.49 ± 12.03) ng/L vs (77.03 ± 17.16) ng/L,t =2.270,P =0.025].In the plasma of patients with asthma exacerbation,the sensitivity of microRNA-126 and microRNA-1 was 85.42％ (41/48 cases)and 79.17％ (38/48 cases),respectively.The specificity of microRNA-126 and microRNA-1 in healthy controls was 78.85％ (41/52 cases) and 73.08％ (38/52 cases),respectively.The area under ROC curve of microRNA-126 and microRNA-1 was 0.919 (95％ CI 0.866-0.973),0.867 (95％ CI 0.796-0.939).Conclusions MicroRNA-126 is significantly elevated in plasma of children with asthma exacerbation.The plasma levels of microRNA-1 were significantly downregulated.These results suggest that microRNA-126 and microRNA-1 may be potential markers for the diagnosis of bronchial asthma.

CBS(Case Based Study)teaching method is given in a case requiring students to answer a series of questions surrounding the case.In the teaching process,students of small groups are required to find their own solutions.Compared with tradition method,this mothed can improve students'academic performance(P