Objective To evaluate therapeutic effect and safety of hysteroscope operation in treating hysteromyoma. Methods 146 patients were subjected to transcervical resection of myoma (TCRM), curative effects were evaluated as satisfaction or dis-satisfaction according to the degree of bleeding control, the rate of growth of myoma and the need of subsequent surgery. Results The total satisfactory rate is 95%. and satisfactory rate of type 0 and Ⅰ reached 100%. There was no complication in all patients. Conclusion TCRM is the best choice in treating submucous myoma. The results of surgery were satisfactory to intramural myoma if gasp the indictions. Selecting proper indications for operation, B ultrasonic monitoring severity are important for ensuring the operation effect and safety.

Objective To explore the clinical significance of the three indicators combined detection that plasma endotoxin,pro-calcitonin (PCT)and (1,3)-β-D-glucan(BG)in pulmonary tuberculosis patients complicated with bacterial,fungal infection.Methods Retrospective investigation was conducted in 240 pulmonary tuberculosis patients,who were divided into gram negative bacteria (G- )group(39cases),gram positive bacteria (G+ )group(45 cases)including fungal,germ-free group(156 cases).Other 45 healthy people were selected into control group.The levels of plasma endotoxin,PCT and BG in the four groups were compared.Results The levels of plasma endotoxin(0.682±0.418)EU/mL,PCT(2.93±0.87)μg/L in the G- group were significant higher than those of the G+ group (0.063±0.034)EU/mL,(0.85±0.52)μg/L,the difference was significant (P <0.05).The levels of the plasma endotoxin,PCT in the G- group were higher than those of the germ-free group.The levels of plasma endotoxin,PCT and BG in the control group had no significant difference with those of the germ-free group.Conclusion The combined detection of plasma endo-toxin,PCT and BG have some clinical value on the early diagnosis of the patients with pulmonary tuberculosis complicated with G-fungal infection for the advantages of fast and sensitiveness.

ObjectiveTo explore the relationship between the expression of Dishevelled2 and Vangl2 and the embryonic neural tube defects (NTDs) induced by all-trans retinoic acid (RA)in Kunming mouse. Methods Fifty pregnant mice were randomly divided into control and RA-treated groups.RA-treated mice were fed with 30mg/kg RA dissolved with peanut oil on embryo 7.75 days, while the mice of control group were administrated with an equal volume of peanut oil on the same time. Then all the embryos were sampled from pregnant mice at the 4th, 18th, 42nd, 66th and 90th hour after treatment. In situ hybridization and immunohistochemical staining technique were used to detect the expression of Dishevelled2 and Vangl2 in embryonic neural tube. Results The two proteins both existed in the epithelial tissue of the mouse embryonic neural tube and displayed different expression modes at various developmental stages.Compared with the control group, the RA treated group showed a significant decrease (P≤0.05) at the 18th and 42nd hour and a significant increase (P≤0.05) at the 66th hour in Dishevelled2 protein after maternal treatment, and no significant difference was found at the 90th hour. Compared with the control group, the Vangl2 mRNA expression in the RA treated group displayed a significant decrease (P≤0.05) at the 4th and 18th hour and a significant increase (P≤0.05) at the 66th hour after RA treatment, and no difference was found at the 42nd hour. Compared with the control group, the expression of Vangl2 protein in the RA treated group decreased (P≤0.05) at the 18th and 42nd hour, and increased (P≤0.05) at the 90th hour after RA treatment, no difference was found at the 66th hour. Conclusion Excessive RA may interfere with the normal embryonic neural tube closure by regulating the expression of Dishevelled2 and Vangl2.

Objective To study the association between paternal CD3, CD4 and CD8 antigenecity to their pregnant spouses and the development of pregnancy induced hypertension (PIH). Methods Maternal serum from 15 women with PIH in the third trimester and 82 in normal pregnancies (16 in the first, 32 in the second and 34 in the third trimester) were incubated with paternal T lymphocytes. Monoclonal CD3, CD4 and CD8 fluorescent conjugated antibodies were then added and the percentage of paternal T cell differentiation antigen CD3, CD4 and CD8 were measured by flow cytometry. Results During normal pregnancy, the levels of maternal serum blocking antibodies on paternal CD3, CD4 and CD8 were (4.14?1.02, 2.02 ?0.24, 2.37?1.05)% in first trimester, (-0.29?0.13, 1.03?0.27, 0.65?0.23)% in the second trimester and (-1.33?1.47,0.15?0.01, -1.04? 0.37)% in the third trimester. There were significant difference between them( P

Objective To study the epidemiological characteristics and influencing factors of hand-foot-mouth dis-ease(HFMD)outbreaks in kindergartens,so as to provide reference for control and prevention of HFMD. Methods Papers published between 2009 and 2015 about HFMD outbreaks in kindergartens were retrieved from Wanfang database and China National Knowledge Infrastructure (CNKI),then collected papers were analyzed. Results Data about 39 cases of HFMD outbreaks were obtained,35 cases occurred in 2008-2012,1 case occurred respectively in 2007,2013,2014,and 2015. 33.34% and 23.08% of outbreaks occurred in May and April. Out-breaks lasted 5-52 days,with a median of 11 days,30.77% of outbreaks lasted more than 2 weeks. The attack rates of the whole kindergartens were 1.90% -39.74% ,attack rates of whole kindergartens were 5% -15% a-mong 65.79% of outbreaks,attack rate of whole kindergartens was >20% among 13.16% of outbreaks. 85.71%of outbreaks involved more than 20% of classes,25.71% of which involved all classes. Both EV71 and CoxA16 caused HFMD outbreaks in kindergartens,two kinds of viruses were both detected in some outbreaks;there were no significant difference in attack rate of whole kindergartens,attack rate of classes with highest incidence,class in-volving rate,and duration of epidemic between EV71 and CoxA16 epidemic groups(all P>0.05).Conclusion Once an HFMD outbreak occurred in a kindergarten,epidemic intensity would be high,both EV71 and CoxA16 can cause HFMD outbreak. There is no obvious correlation between class size and attack rate.

BACKGROUND:The hip is a complicated structure and irregular in shape. It is hard to measure stress distribution and transmission. OBJECTIVE:To establish a three-dimensional finite element model of the hip joint and upper femur, and analyze the stress distribution and transmission characteristics of the acetabulum region under different loads, and explore mechanics mechanism of hip fracture based on CT data. METHODS:The three-dimensional finite element hip and femur model were reconstructed in Mimics 14.0 based on the CT data of a healthy adult man. After dividing mesh, assigning material and transforming into finite element model, the stress distributions of anterior wal , the top, and the posterior wal of the acetabulum, the stress of acetabulum areas and displacement of acetabular unit were calculated with finite element software Ansys 13.0 software under 300, 600, 900 and 1 200 N. RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of the hip and the femur was successful y established, consisting of 284 183 nodes and 160 665 units. (2) The characteristics of the stress distribution of acetabulum region:the maximal stress was concentrated on the posterosuperior part of acetabular crest, fol owed by the posterior wal and the anterior wal in order in upright position under different loads. The stress transmitted by four ways:from acetabular crest to ilium, along linea terminalis of pelvis to sacroiliac joint, in the acetabular sockets, and along the pubic ramus. The stress and the propagation distance were increasing as the loads increased. Acetabular element stress variable was increased. (3) Above results indicated that three-dimensional finite element model of the human hip joint established by Mimics 14.0 based on CT data matches the anatomical structure in a great degree, could be used in the biomechanics analysis under different loads, and has a guiding significance for design of artificial hip prosthesis.

Objective To investigate the mechanism of linezolid resistance in methicillin-resistant Staphylococcus epidermidis ( MRSE) strains isolated in Hangzhou area. Methods Twenty-three linezolid-re-sistant Staphylococcus epidermidis ( LRSE) strains were isolated from the patients with septicaemia, urinary tract infection or infectious pleuritis in several hospitals in Hangzhou area during May, 2013 to April, 2015. The minimal inhibition concentrations ( MICs) of thirteen different antibiotics against the LRSE strains were detected by using E-test. Pulsed-field gel electrophoresis ( PFGE) and cluster analysis were performed for homology analysis. Correlations between linezolid resistance in the LRSE strains and G2576T mutation at theⅤ functional region of 23S rRNA gene or cfr gene were determined by PCR and sequencing analysis. Re-sults The MICs of linezolid to 15 LRSE strains were higher than 256 μg/ml while to the other 8 LRSE strains were 6 or 8 μg/ml. All of the 23 LRSE strains were resistant to both oxacillin and cefoxitin. Among the LRSE strains with high linezolid MICs (MIC>256 μg/ml), LRSE1 and LRSE2, LRSE3-LRSE6 and LRSE9-LRSE12 respectively belonged to the same clone line and came from the same hospital. All of the 23 LRSE strains carried the cfr gene. Moreover, the G2576T mutation at theⅤfunctional region of 23S rRNA gene was detected in the 15 LRSE strains with high linezolid MICs ( MIC>256 μg/ml ) , but not in the 8 strains with lower linezolid MICs ( MIC=6 or 8 μg/ml) . Conclusion There are significant differences in linezolid resistance among LRSE strains isolated in Hangzhou area. The LRSE strains are methicillin-resist-ant coagulase negative Staphylococcus ( MRCNS) strains and widely distributed. The linezolid resistance in LRSE strains is related to the G2576T mutation at theⅤfunctional region of 23S rRNA gene and cfr gene.

Objective To compare the effect of three β-thalassemia prenatal screening strategies in Guangdong province. Methods A total of 13 284 hospital-delivered couples and 13 369 newborns were recruited from 91 hospitals in 21 counties or districts of Guangdong province from June to December 2012. Mean cell volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A2 (Hb A2) were tested for all the couples, and all the couples and newborns were detected by 17 types ofβ-globin gene mutations. The effect of three β-thalassemia prenatal screening strategies were compared as following:(1) MCV/MCH with Hb A2 serial screening(SS):Hb A2 was tested if the woman′s MCV<82 fl and(or)MCH<27 pg. If the woman′s Hb A2>3.5, it meant positive. And if the woman wasβ-thalassemia carrier and her husband′s Hb A2>3.5, it meant couple positive. (2) MCV/MCH with Hb A2 parallel screening(PS):if the woman′s MCV<82 fl and (or) MCH<27 pg and(or) Hb A2>3.5 pg, it meant couple positive. And the husband would be tested forβ-globin gene mutations if the woman was β-thalassemia carrier. (3) MCV/MCH with Hb A2 serial screening for couples(SSC):if one of the couple or both of them had MCV<82 fl and(or) MCH<27 pg, the couple would be tested for Hb A2, and if one of the couple got Hb A2>3.5, it meant couple positive. Results (1) For the SS strategy, the sensitivity was 92.69%(583/629);the specificity was 99.87%(12 638/12 655); the positive predictive value was 97.17%(583/600);and the negative predictive value was 99.64%(12 638/12 684). The results ofβ-globin gene mutations tested showed that the rate ofβ-thalassemia carriers was 4.74%(629/13 284) in the 13 284 pregnant women, and it was 4.29%(570/13 284) in their husbands. (2) The SS strategy detected 27 (0.20%,27/13 284) β-thalassemia carrier couples. For the SS strategy detecting β-thalassemia carrier couples, the missed diagnosis rate was 11.11%(3/27);the sensitivity was 88.89%(24/27);the specificity was 100.00%(27/27); the positive predictive value was 100.00%(24/24); and the negative predictive value was 99.98%(13 257/13 260). (3) When using the SS strategy for 13 369 offsprings, there were 582β-thalassemia carriers (4.35%,582/13 369), including 578 (99.31%,578/582) minorβ-thalassemia, 3 (0.52%,3/582) intermediaβ-thalassemia and 1 (0.17%,1/582) major β-thalassemia. The SS strategy detected 25 fetuses who neededβ-thalassemia prenatal diagnosis. (4) For the PS strategy, the sensitivity was 98.09%(617/629); the specificity was 88.73%(11 229/12 655); the positive predictive value was 30.20%(617/2 043); and the negative predictive value was 99.89%(11 229/11 241). (5) When using the PS strategy for theβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 95.55%(12 667/13 257);the positive predictive value was 4.38%(27/617);and the negative predictive value was 100.0%(12 667/12 667). (6) The PS strategy detected 28 fetuses who needed β-thalassemia prenatal diagnosis in 13 369 offsprings. (7) For the SSC strategy, the sensitivity was 93.80%(590/629); the specificity was 95.75%(12 117/12 655); the positive predictive value was 52.30%(590/1 128); and the negative predictive value was 99.68%(12 117/12 156). When the SSC strategy was used for the husbands, the sensitivity was 92.28%(526/570); the specificity was 95.27%(12 112/12 714);the positive predictive value was 46.63%(526/1 128); and the negative predictive value was 99.64%(12 112/12 156). (8) When the SSC strategy was used inβ-thalassemia carrier couples, the sensitivity was 100.00%(27/27);the specificity was 91.69%(12 156/13 257);the positive predictive value was 2.39%(27/1 128);and the negative predictive value was 100.00%(12 156/12 156). (9) The SSC strategy detected 28 fetuses who neededβ-thalassemia prenatal diagnosis. Conclusions All the three β-thalassemia prenatal screening strategies had good effect in clinical practice and public health. While in the high-prone area of β-thalassemia, MCV/MCH with Hb A2 parallel screening and MCV/MCH with Hb A2 serial screening for couples stratigies were better.

Objective To compare the effect and cost of three different α-thalassemia prenatal screening strategies used in Guangdong, China, and to provide evidence for α-thalassemia prevention. Methods In total, 13 284 hospital-delivery couples and 13 369 newborns/fetuses (offspring) from 21 counties or districts of Guangdong Province were included in this study, who were treated from June to December 2012. Mean cell volume (MCV), mean corpuscular hemoglobin (MCH) and hemoglobin A2 (Hb A2) were detected in the couples, and 6 types ofα-globin gene mutations were found in all couples and newborns. The strategies were MCV/MCH and serum Hb A2 (protocolⅠ) or parallel screening based on pregnant women (protocolⅡ), and serum screening based on couples (protocolⅢ). The validity and reliability of the three strategies were then compared using the Chi-square test. Results The sensitivity and the specificity of pregnant women who wereα-thalassemia carriers in protocolⅠwere 74.82%(1 352/1 807) and 74.11%(8 506/11 477), and were 89.82%(1 623/1 807) and 48.60%(5 578/11 477) in protocol Ⅱ , respectively. And 1.67% (221/13 284) couples were bothα-thalassemia carriers by the gene test. The rate of missed diagnosis in bothα-thalassemia carrier couples in protocolsⅠ,ⅡandⅢwas 50.68%(112/221), 11.76%(26/221) and 11.31%(25/221), respectively. In couples who needed prenatal diagnosis, the rates of missed diagnosis, sensitivity, specificity, positive predictive value, and negative predictive value were 17.46%(11/63), 82.54%(52/63),98.35%(13 003/13 221), 19.26%(52/270) and 99.92%(13 003/13 014) in protocolⅠ;4.76%(3/63), 95.24%(60/63), 88.18%(11 658/13 221), 3.70%(60/1 623) and 99.97%(11 658/11 661) in protocolⅡ;and 3.17%(2/63), 96.83%(61/63), 59.31%(7 842/13 221), 1.12%(61/5 440) and 99.97%(7 842/7 844) in protocol Ⅲ , respectively. The diagnosis of severeα-thalassemia was not missed in all three screening strategies. The mean cost of protocols Ⅰ, Ⅱ and Ⅲ for detecting a couple who needed prenatal diagnosis was 37 049.23, 50 836.00 and 40 321.64 RMB, respectively. Conclusions The three screening protocols have good efficiency in screening forα-thalassemia. However, protocolsⅡandⅢare preferred when financial conditions permit.

Objective To investigate the clinical effect of cisplatin and nedaplatin through comparing the effects of synchronous radiotherapy and chemotherapy of cisplatin and nedaplatin on patients with locally advanced cervical cancers.Methods Clinical data of 54 cases of patients with locally advanced cervical cancers received treatment at our hospital from 2009 to 2011 were analyzed retrospectively.Patients were divided into two groups according to the treatment:group DDP (cisplatin) and group NDP (nedaplatin).The general information,short-term effect,long-term curative effect,and adverse reactions were compared between two groups.Results The general information including gender,age,body mass index (BMI),stages,and pathology had no statistically significant difference between two groups.The response rate (RR)of patients in each group was 100％.The complete remission (CR) rate between groups NDP and DDP had no statistically significant difference.Among the patients ≤60 years old,the CR rate,the survival rate of 1,2,and 3 years,and the median progression-free survival (PFS) had no statistically significant difference.Among the patients ＞ 60 years old,the survival rate of 1,2,and 3 years,and the median PFS had no statistically significant difference,but the CR rate had statistically significant difference.In the non-hematological toxicity,the incidence rate of nausea and vomiting,the effect on renal function in group NDP were obviously lower than those in group DDP.There was no significant difference in liver function damage.In the hematological toxicity,there was no statistically significant difference in the incidence rate of anemia and leukopenia.The incidence rate of decrease of platelet in group NDP was higher than that in group DDP,but it was mainly reflected in the Ⅰ and the Ⅱ level.Conclusions Cisplatin had the same efficacy of concurrent chemoradiotherapy with nedaplatin for the treatment of locally advanced cervical carcinoma with a worse tolerance.