Objective To analyze the clinical efficacy and safety of laparoscopic and open uterine myomectomy.Methods 160 cases of uterine fibroids diagnosed by our hospital from April 2012 to April 2016 were selected as study cases.The patients were divided into two groups according to the order of treatment.80 patients in the control group received open uterine myoma rejection.80 patients in the observation group received laparoscopic myomectomy.The clinical treatment effect and complication were analyzed.Results The operation time,amount of intraoperative blood loss and the incision size of the observation group were (78.46 ± 10.31)min,(86.24 ±7.65) mL,(25.36 ± 1.28) mm,respectively,which were significantly less than those in the control group,the differences were statistically significant (t =6.57,6.81,7.66,all P ＜ 0.05).The time of postoperative body temperature recovery,time of anal exhaust,time of bedtime and the hospitalization time of the observation group were (24.16 ±3.81)h,(18.29 ± 4.36)h,(11.38± 2.06)h,(4.63 ± 1.51)d,respectively,which were significantly shorter than those in the control group (t =6.25,7.38,7.70,6.27,all P ＜ 0.05).The operative rate and postoperative analgesia rate of the observation group were 6.25％ and 11.25％,respectively,which were significantly lower than those of the control group (x2 =8.33,9.07,all P ＜ 0.05).The incidence rate of postoperative complications was 6.25％ in the observation group,which was significantly lower than 25.00％ in the control group,the difference was statistically significant (x2 =8.65,P ＜ 0.05).Conclusion Laparoscopic myomectomy has the advantages of less trauma,less bleeding,quick recovery and less complication,and high safety.It is the ideal technique for the treatment of uterine fibroids,which is worthy of promotion and application.

Objective To investigate the distribution and synaptic connectivity of neuropeptide Y (NPY)-like immunoreactivity (IR) in Bullfrog retina, Rana Calesbeiana, especially in the inner plexiform layer. Methods Light microscopy immunofluorescence and post-embedding colloidal gold labeling electron microscopy techniques were employed in this study. Results NPY immunoreactivity was associated with a small population of amacrine cell bodies in the inner nuclear layer and cell processes, ramified with 3 distinct bands, in the inner plexiform layer. As for ultrastructure, quantitative analysis showed that NPY-IR amacrine cell processes were most often presynaptic to NPY negative amacrine cell processes (49.7%) and ganglion cell dendrites (49.3%). NPY-IR amacrine cells predominantly received synaptic input from bipolar cell axon terminals (86%), while a few input from other amacrine cell processes (14%). Conclusion NPY-IR in Bullfrog retina is mainly distributed in the inner part and predominately receives excitatory glutamate modulation from bipolar cells.

OBJECTIVE To investigate the feature of nosocomial infections of our hospital inpatients,and analyze the correlative factors,based on which effective methods are taken.METHODS An analysis was made on the basis of the survey,the data came from 58 324 hospitalized cases from 2003 to 2006.RESULTS Of them 2 509 cases were infected,the incidence was 4.30%.The lower respiratory tract ranked the first place (26.66%)and the highest infected rate was in Hematology Department(7.79%).The species were predominated by Gram-negatives(58.04%).CONCLUSIONS Strengthening the nosocomial infection management,the infection rate could be decreased after taking prevention measures according to various correlative factors.

Objective:To observe influence of preinfarction angina pectoris (PAP)on primary ST elevation acute my-ocardial infarction (AMI).Methods:A total of 280 patients with primary ST elevation AMI received coronary angi-ography (CAG)within 24h after symptoms occurred,and they received ECG and QRS scoring on hospitalization. According to PAP or not,patients were divided into PAP group (n=102)and non PAP group (n=178).According to attack to CAG time,patients were divided into early stage group (<2h,n=60),mid-term group (2~6h,n=150)and advanced stage group (6~24h,n=70).Results:QRS score of PAP patients [(2.4±2.4)scores]was sig-nificantly lower than that of non PAP patients [(3.2±3.0)scores],percentage of high QRS score in PAP group (8.0%)was also significantly lower than that of non PAP group (18.4%),P<0.05 both.In early stage group, there was no significant difference in QRS score [(2.0±1.8)scores vs.(2.6±2.8)scores,P=0.35]between PAP and non PAP patients;The QRS score of PAP patients [(2.0±2.1)scores]was significantly lower than that of non PAP group [(3.0 ±3.0)scores]in mid-term group,P=0.03;in advanced stage group,the QRS score all signifi-cantly rose in PAP patients [(4.1 ±3.3)scores]and non PAP patients [(5.5±2.9)scores],P=0.13;QRS score gradually rose along with onset time prolonged in non PAP group.Conclusion:Preinfarction angina pectoris can de-lay progress of acute myocardial infarction and expand therapeutic window of reperfusion.

Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver ; drug therapy ; Humans ; Phytotherapy

OBJECTIVE: A series of Bobath concept, Bobath theoretical hypothesis and clinical practice were summarized, to proVide a better understanding of Bobath concept involved in nervous tissues repairing and functional reconstruction. METHODS: Articles concerning the Bobath treatment for stroke-related literature were retrieved in Highwire press, MEDLINE, and Google from 2001 to 2009, using the key words of "Bobath concept, stroke physical therapy". Data of each study were extracted and analyzed following retrieval. Inclusion criteria:①Bobath concept and its theoretical hypothesis. ②New development of Bobath concept in clinical practice. Exclusion criteria: Repetitive studies. The results of retrieved literatura were analyzed. RESULTS: The theoretical basis of Bobath concept is based on present-day knowledge of motor control, motor learning, neural and muscle plasticity, and biomechanics. The latest theories and viewpoints are rasourced from International Bobath Instructors Training Association and the British Bobath Tutors Association. They expounded on the Bobath concept from linking participation, activities and underlying impairments, organization of human behavior and motor control, the consequences of injury and dysfunction in the execution of movement, neural and muscle plasticity, motor learning and so. This article also discusses several important questions which meet in clinical practice. CONCLUSION: Bobath therapy, as a traditional method for stroke rehabilitation, is constantly absorbing the research results from current neuroscience, psychology and other disciplines, and blended with other treatments to promote the development of neuro-rehabilitation medicine.

Objective To investigate the optimal surgical timing for rib internal fixation.Methods The clinical data of 143 patients with rib fracture were retrospectively analyzed.The patients were divided into early phase fixation group (62 cases) and late phase fixation group (81 cases) according to the time from trauma to internal fixation.The ratio blood lose and body surface area,pulmonary complications and the changes of C reactive protein level before and 5 days after operation were recorded and compared.Results All the patients were healing.The median C reactive protein before operation in late phase fixation group was 45 mg/L,in early phase fixation group was 23 mg/L,there was statistical difference (P ＜ 0.01).The ratio blood lose and body surface area in early phase fixation group was (334.19 ± 37.53) ml/m2,the rate of pulmonary complications was 22.6％(14/61),in late phase fixation group was (438.99 ± 55.24) ml/m2 and 38.3％ (31/81),there were statistical differences (P ＜ 0.01 or ＜ 0.05).The median C reactive protein 5 days after operation in early phase fixation group was 189 mg/L,in late phase fixation group was 258 mg/L,there was statistical difference (P ＜ 0.05).Conclusion Early phase (72 hours) rib internal fixation is expected to reduce patient trauma of systemic reactions,reduce the incidence of bleeding and pulmonary complications.

Version 2015 of the National Comprehensive Cancer Network (NCCN) Guidelines for Uterine Neoplasms uses the 2009 International Federation of Gynecology and Obstetrics (FIGO) staging system.These NCCN guidelines divide pure endnmetrioid cancers into three categories to delineate treatment:(1) disease limited to the uterus;(2) cervical involvement;(3) extrauterinc disease.Surgery is recommended for medically operable patients.Continuous progestin-based therapy may be considered for highly selected patients with stage IA disease who wish to preserve their fertility.Preoperative chemotherapy can be considered if extrauterine disease is suspected.Factors that may influence the decision regarding adjuvant therapy include lymph vascular space invasion (LVSI),patient age,tumor volume,and lower uterine segment or surface cervical glandular involvement.When administering adjuvant radiotherapy,it should be initiated as soon as the vaginal cuff has healed,no later than 12 weeks after surgery.

Burns ; complications ; Humans ; Multiple Organ Failure ; etiology ; prevention & control

BACKGROUND:Cartilage scaffold plays an important role in articular cartilage injury, but it is stil restricted in practice, leading to the repair failure using tissue-engineered cartilage. OBJECTIVE:To explore the preparation method of cartilage scaffold with directional structure and its repairing effect in cartilage injury of rabbits. METHODS:Directional cartilage scaffolds were prepared by temperature gradient induced phase separation technique. The cross-linking of cartilage scaffold was completed with genipin. The physical and mechanical properties of scaffolds were determined. Forty-eight white rabbits were modeled into exercised-induced articular cartilage injury and equivalently randomized into two groups, fol owed by implantation of non-directional or directional scaffolds. Samples were col ected at postoperative 6, 12 and 24 weeks to compare the repair effect of two scaffolds on rabbit joint injury. RESULTS AND CONCLUSION:Scanning electron microscope showed that the regular microstructures on the longitudinal section of directional scaffolds were aligned in the same direction, while the longitudinal and transverse planes of the non-directional scaffolds showed porous honeycomb structures. The elastic modulus of the directional scaffold was significantly higher than that of the non-directional scaffold (P<0.05). O’Driscol histological scores in the directional scaffold group were significantly higher than those in the non-directional scaffold group at 6, 12 and 24 weeks postoperatively (P<0.05). At postoperative 24 weeks, in the directional scaffold group, the three-dimensional reconstruction of the rabbit defect region was flat and smooth, and coronal two-dimensional scanning showed the cartilage thickness of the newborn cartilage was very close to that of the normal bone;the cartilage surface in the non-directional rabbits was flat under three-dimensional CT, and coronal two-dimensional scanning showed that the repaired cartilage was almost the same as the normal cartilage. Hematoxylin-eosin staining showed that at 24 weeks postoperatively, the defect site disappeared and the cartilage cel s arranged in the vertical direction in the directional scaffold group. There were typical cartilage lacunae at the defect site in the non-directional scaffold group at 24 weeks postoperatively. Our findings suggest that the directional cartilage scaffold prepared using temperature gradient induced phase separation technique holds good physical and mechanical properties, and its implantation into the rabbit articular cartilage injury induced by exercise can promote the injury repair to obtain ideal mechanical properties.