Objective To observe clinical efficacy of laparoscopy combined with gonadotropin-releasing hormone agonist (GnRH-a ) in the treatment of endometriosis (EMs).Methods 158 patients who underwent laparoscopic surgery and were diagnosed endometriosis in our hospital during Sep.2010 to Dec.2010 were chosen and divided into three groups:control group were treated with pure laparoscopic surgery,group A were treated with laparoscopic surgery and follow-up GnRH-a medication,and group B were treated with laparoscopic surgery,follow-up GnTH-a medication and add-back therapy.The total effective rates,recurrence rates,the changes of hormone levels before and after the treatment and adverse reaction rates after treatment were compared and analyzed to evaluate the efficacy of different treatments.Results The total effective rates of group A and group B (84.6%,86.2%) were significantly higher than that of control group (58.3%),and the difference was statistically significant (P=0.032,P=0.032).The recurrence rates of group A and group B (15.4%,13.8%)were significantly reduced compared with that of control group (41.6%)(P=0.012,P=0.012).The hormone levels decreased dramatically after treatment in three groups.The adverse reaction rate of group B was apparently reduced compared with that of group A,and the difference was statistically significant (P=0.001 ).Conclusion Laparoscopy combined with GnRH-a medication was a safe and effective treatment for endometriosis.The application of GnRH-a after laparoscopy can significantly increase the total effective rate of the operation and reduce the postoperative recurrence rate.For the patients who need to take long-term GnRH-a treatment,add-back therapy need to be given to decrease its adverse reaction and recurrence rate,or to delay its recurrence,thus could improve patients' living qualities significantly.

Objective To establish a method for the determination of berberine hydrochloride in Weichangning granules.Methods RP-HPLC method was set up,using Merck-LiChrospher RP-18 column(4 mm ? 250 mm,5?m);the mobile phase was methnd-water(including 0.18 % phosphoric acid and 0.22 % sodium laurylsulfonate)(68 ∶ 32),flow rate being 1.0 mL / min;column temperature was 35 ℃ and the detection wavelength was 345nm.Results A good linearity was obtained in the range of 0.30 ~ 1.80 ?g(r = 0.9995).The average recovery was 98.32 %,with RSD 0.83 %.Conclusion The method is simple,rapid and with good reproducibility for the determination of berberine hydrochloride in Weichangning granules.

Objective To investigate the expression levels of TAK1 and p38 genes among different subtypes of acute myeloid leukemia (AML) patients,and to analyze the clinical characteristics of patients with different expression levels of TAK1 and p38 genes.Methods GAPDH was made as an internal reference,14 healthy people as control group.The quantitative real-time PCR was used to detect the expression of TAK1 and p38 in bone marrow samples of 87 AML patients,and the results were analyzed statistically.Results The expression levels of TAK1 and p38 in experiment group were higher than those in control group (0.194± 0.125 vs 0.015±0.008,0.233±0.140 vs 0.010±0.005,P ＜ 0.001).TAK1 expression in M4 was higher than that in M2,M3 and M5 (P =0.005,0.000,0.002),TAK1 expression in M3 was lower than that in M2 (P =0.022).p38 expression in M4 was higher than that in M1,M2,M3 and M5 (P =0.013,0.035,0.000,0.045),as it was higher in M2 and M5 than that in M3 (P =0.001,0.012).The CD56 positive rate cells and the number of peripheral blood leukocytes of the TAK1 high expression group were higher than those of the TAK1 low expression group,the CD19 positive rate of the p38 low expression group was higher than that of the p38 high expression group.Conclusion The expression levels of TAK1 and p38 genes are elevated in AML patients,and the up-regulation may play an important role in the pathogenesis of AML.

Silver nanoparticles ( AgNP) , the metallic silver par-ticles with the diameter of 1 ~100 nm are now widely used in many fields. Many researches show that the smaller size of Ag-NP, the stronger toxicity it shows. Generally speaking, AgNP with 20 nm shows strongest toxicity. After entering the body, they are distributed in different organs in the body, and the dis-tribution in the kidney shows a certain gender difference. They also produce some toxic effects after entering body organs. AgNP often exhibit dose effect on the toxicity in vitro cells,while in vivo experiments, their toxic effects change with the different objects and ways of acting. In addition, AgNP can produce toxic effects on reproduction, and may cause parental reproductive activity to deteriorate, and pass the toxic effects to offspring through the placenta to exert a negative influence on the growth and develop-ment of the offspring. The toxicity mechanisms of AgNP are oxi-dative stress injury caused by producing free radicals;metabolic disorders caused by reducing of drug metabolic enzyme activity;and also related gene expression defects and certain molecules, such as transcription factor NF-E2-related factor 2(Nrf2) prote-ase caused by abnormal expression. In short, AgNP can be toxic to organisms, and we must evaluate their biological safety when we use it, to minimize or even avoid the danger it brings about.

Objecive To investigate the prevalence of NDM-type carbapenemases in the carbapenem-resistant Escherichia coli strains collected from Ruijin Hospital, Shanghai Jiaotong University School of Medicine. The epidemiological characteristics of NDM-type carbapenemase-producing isolates were analyzed.Methods Eighteen strains were collected from November 2013 to January 2015 in the clinical microbiology laboratory of Ruijin Hospital. All of them were resistant to imipenem or meropenem (inhibition zone diameter≤19 mm). The blaNDM gene was detected by PCR. The amplified products were subjected to sequencing analysis. Conjugation experiment was carried out to verify the transferability of plasmids. Multilocus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were performed to analyze the molecular epidemiology.Results The blaNDM gene was identified in 6 strains, 4 of which had blaNDM-1-type and 2 had blaNDM-5-type carbapenemase gene. Three strains were positive in the conjugation experiment. MLST analysis showed that 6 NDM carbapenemase-producing isolates belonged to ifve sequence types, corresponding to five PFGE-DNA patterns (A-E). Two of these isolates shared the identical sequence type (ST5018) and nearly the same PFGE-DNA patterns (A1, A2).Conclusions NDM-type carbapenemase-producing E. coli is identified in this study. Most blaNDM-positive cases were sporadic. Plasmid might play an important role in the spread of blaNDM inE. coli. The blaNDM-5 type carbapenemase gene was first identified in Shanghai, to which more attention should be paid.

Aim To investigate the influence of gly-cyrrhizic acid( GA) on cell proliferation and cell cycle and secretion of extracellular matrix ( ECM) , the level of fibronection ( FN) , type Ⅳ collagen ( C-Ⅳ) in the rats′ glomerular mesangial cells ( HBZY-1 ) cultured with advanced glycation endproducts ( AGEs ) . Meth-ods HBZY-1 were incubated in culture medium con-taining AGEs in the presence of GA and treated for 48 h. At the same time, the normal and control groups were established. Methylthiazoletetrazolium ( MTT) as-say was used to measure cell proliferation;cell cycle a-nalysis was performed using a flow cytometry; FN and C-Ⅳwere analyzed by enzyme-linked immunosorbent assay ( ELISA ) . Results Cell counts increased markedly in AGEs group. Cell cycle analysis showed that cell percentage of S phase increased, G1 reduced and PI increased from 35. 01% ± 4. 21% to 44. 93%± 0. 25% ( P <0. 05 ) . FN and C-Ⅳ secretion in-creased ( P <0. 05 ) . Whereas GA was added, cell counts decreased, and the percentage of S phase also decreased and G1 increased, PI decreased from 44. 93% ± 0. 25% to 42. 16% ± 1. 04% ( P<0. 05 ) . In addition, the secretion of FN and C-Ⅳ decreased ( P<0. 05 ) . Conclusion GA could prevent AGEs-induced HBZY-1 . GA may protect HBZY-1 from in-hibiting the abnormal cell proliferation, changing the cell cycle. GA can reduce the synthesis of FN and C-Ⅳ.

OBJECTIVETo investigate the method for uncertainty evaluation of determination of tin and its compounds in the air of workplace by flame atomic absorption spectrometry.

METHODSThe national occupational health standards, GBZ/T160.28-2004 and JJF1059-1999, were used to build a mathematical model of determination of tin and its compounds in the air of workplace and to calculate the components of uncertainty.

RESULTSIn determination of tin and its compounds in the air of workplace using flame atomic absorption spectrometry, the uncertainty for the concentration of the standard solution, atomic absorption spectrophotometer, sample digestion, parallel determination, least square fitting of the calibration curve, and sample collection was 0.436%, 0.13%, 1.07%, 1.65%, 3.05%, and 2.89%, respectively. The combined uncertainty was 9.3%.The concentration of tin in the test sample was 0.132 mg/m³, and the expanded uncertainty for the measurement was 0.012 mg/m³ (K=2).

CONCLUSIONThe dominant uncertainty for determination of tin and its compounds in the air of workplace comes from least squares fitting of the calibration curve and sample collection. Quality control should be improved in the process of calibration curve fitting and sample collection.

Objective To identify the clinical profile and neuro-imaging findings of the right temporal lobe variant of semantic dementia (RTLV),and to understand the relationship between anatomic and function by comparison to the left temporal lobe atrophy.Methods Of 70 patients with diagnosis of frontotemporal dementia in our memory clinic,three patients with right temporal lobe atrophy were identified based on the MRI scans.We obtained the profile of cognitive function,behavior and personality changes in these 3 patients and compared them with those in 5 semantic dementia (SD) patients with predominant leftsided temporal lobe atrophy.We also underwent 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) with statistical parametric mapping analysis in these 3 patients.Results In RTLV patients,the most prominent cognitive deficits were impairment of prosopagnosia,and getting lost.Variety behavioral symptoms including apathy,social disinhibition,stereotypy,compulsive behaviors were more prevalent in early course for patients with RTLV,which were different from SD patients with semantic loss began with anomia or single-word comprehension.18F-FDG-PET scan showed decreased metabolism mainly in right temporal lobe and in other brain regions with varying degrees.Conclusions The RTLV is clinical heterogeneous.Prosopagnosia,behavioral changes and getting lost are the main features in the early course.It therefore,might be proposed a separate clinical entity.

10.3969/j.issn.2095-4344.2013.24.018

Objective To analyze the factors affecting the efficacy of postoperative radiotherapy (PORT) in node-positive non-small cell lung cancer (NSCLC). Methods 480 patients with stage N_1-N_2 NSCLC after radical surgery were retrospectively reviewed. Of them, 267 patients received adjuvant chemotherapy and 121 received PORT. All patients were grouped based on the N stage, tumor size and lymph node positive ratio (the percentage of positive lymph nodes from the detected lymph nodes, LNPR). Group 1 included patients with tumor size ≤3 cm and LNPR ≤33%, group 2 was tumor size > 3 cm or LNPR > 33%, and group 3 was tumor size > 3 cm and LNPR > 33%. The endpoints were the local recurrence free survival (LRFS) and overall survival (OS). Kaplan-Meier method and Cox's proportional hazards regression model were used for the statistic analyses. Results PORT improved the overall survival only in patients with N_2 disease. Both tumor size and LNPR significantly influenced the efficacy of PORT. The 5-year LRFS for patients with vs. without PORT in the group 1, 2 and 3 were 55% vs. 60% (χ~2 = 0.03,P-0.869), 42% vs. 50% (χ~2 =0.31,P=0.547),and 62% vs. 52% (χ~2=4.25,P=0.036), respectively;and the corresponding OS were 22% vs. 50% (χ~2 = 1.65 ,P =0. 199), 26% vs. 22% (χ~2= 0. 13,P=0.786) and 42% vs. 16% (χ~2= 15.33,P=0.000), respectively. Conclusions Tumor size and LNPR significantly impact the efficacy of PORT . For patients with stage N_2 NSCLC , PORT could improve local recurrence free survival and overall survival when tumor size > 3 cm and LNPR >33%.