Objective To observe oral mifepristone and vaginal misoprostol combination (medical induction labor)for 16-28 weeks termination of pregnancy and compare the effectiveness with intrannmiotic instillation of ethacridine lactate (EL) in this setting. Methods 16-28 weeks gestation, total 100 pregnant women from February 2006 to June 2007 were elected. Two groups were divided randomly: group A (intraamniotic injection of ethacridine lactate)and group B(mifepristone and misoprostol combination). Main outcome measures: success rate, induction-delivery interval, intrapartum hemorrhage, length of stay complications. Results Termination of pregnancy was successful in 38 cases (76%), induction-delivery interval was (42.0±5.8) h, length of stay was (96±6) h and intrapartum hemorrhage was (110.6±6.5) ml in group A. The matched pair analysis revealed termination of pregnancy was successful in 49 cases (98%), there were significantly shorter induction-delivery interval (12.5±4.5) h, length of stay (72±4) h and lower intrapartum hemorrhage (46.3±5.6)ml in group B (P<0.05). Conclusions Compared to intraamniotic instillation of ethacridine lactate, oral mifepristone and vaginal misoprostol combination for 16-28 weeks termination of pregnancy had higher successful rate, shorter induction-delivery interval, length of stay and lower intrapartum hemorrhage.

Objective The purpose of this study was to develop the mechanism of vacuolar H+-ATPase regulation of vaginal microenvironment.Methods In this research,53 women were divided into three groups.Their age,serum estradiol (E2),serum follicle stimulating hormone (FSH),vaginal pH value,and mRNA expression of vacuolar H +-ATPase (VHA) on the ectocervical-vaginal epithelial cells were analyzed.Results (1) As serum E2 levels decreased,the vaginal pH values increased and VHA mRNA declined (P ＜ 0.01).(2) Immunohistochemistry scores decreased in the three groups.VHA expression decreased in human ectocervical-vaginal epithelial tissues except basal cells.(3) The expression of VHA was positive correlated with estradiol,while negative correlated with age and vaginal pH value (P ＜ 0.01).Conclusions Estradiol could regulate the genetic transcription and synthetic of VHA protein under vaginal microenvironment.

Perimenopausal syndrome （MPS）， a common endocrine system disease， is one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in endocrinology， gynecology， and interdisciplinary fields of both Western and Chinese medicine to discuss the advantages and challenges of diagnosing and treating MPS with Western medicine， TCM， and integrative medicine. Experts at the conference believe that MPS is initiated by estrogen decline and rooted in deficiency， with the pathogenesis being imbalance between Yin and Yang in the kidney. The hormone replacement therapy in Western medicine for menopause can rapidly alleviate related symptoms by quickly restoring the estrogen level and timely detect and delay complications of menopause， whereas such a therapy has certain risks， necessitating close monitoring of adverse reactions. Moreover， the various contraindications and precautions limit the clinical application of the hormone replacement therapy. TCM has advantages in synergistically alleviating symptoms such as hot flashes， sweating， sleep disorders， and emotional abnormalities of MPS without causing obvious adverse reactions. However， its efficacy is slower than the hormone replacement therapy， and the TCM evidence for preventing and treating complications of menopause remains unclear. Three suggestions were proposed for the future development of both Western and TCM for ameliorating MPS. First， an integrated diagnosis and treatment system for MPS with both Western and Chinese medicine should be established. Second， high-quality evidence-based interventions for MPS should be developed with TCM alone or in combination with Western medicine. Third， efforts should be made to promote the new TCM drug development and the interdisciplinary cooperation for treating MPS.