Objective To estimate abortion ways and announcements of early-staged gestation termination in lactation scarred uterus. Methods A retrospective analysis was made on clinical date of 312 early-staged gestation termination cases in lactation scarred uterus. These cases were divided into three groups based on abortion ways: induced abortion group (group A,92 cases), drugs abortion group (group B,98 cases), misoprostol combined uterine aspiration group (group C,122 cases). The abortive efficiency,operation time, operative bleeding, colporrhagia time, postoperative infection and drug adverse reaction were observed and compared. Results Complete abortion rates in group A (97.8%,90/92) and group C(99.2%,121/122) were significantly higher than that in group B (77.6% ,76/98),colporrhagia times in group A [(5.9 ± 1.1) d] and group C [(5.6 ± 1.2) d] were significantly lower than that in group B [(12.4 ± 1.8) d],postoperative infection and drug adverse reaction rate were lower in group A and group C, with significant difference compared to group B (P ＜ 0.05). The operation time was shorter, bleeding was less,third-grade pain rate was lower in group C, there was significant difference between group A and group C (P ＜ 0.05).Conclusions Misoprostol combined uterine aspiration terminated early-staged gestation in lactation scarred uterus is effective and safe, makes the operation easy and simple, decreases the blood loss. The influence to mother and infant is smaller, it is the best abortion style.

Objective To investigate the correlation between serum lipoprotein associated phospholipase A2 (Lp‐PLA2) level and severity of coronary artery stenosis in the patients with coronary heart disease(CHD) and its clinical significance .Methods A total of 243 cases of CHD and suspected CHD were divided into the high‐risk group(at least 1 coronary artery vessel stenosis >50% ,n=102) and low‐risk group(single coronary artery vessel stenosis≤50% ,n=141) according to the coronary angiography re‐sults .The clinical data were collected and Lp‐PLA2 level was detected by ELISA .Results The serum Lp‐PLA2 level in the high‐risk group was significantly higher than that in the low‐risk group ,and the difference was statistically significant(P<0 .01) ,the sensitivity of Lp‐PLA2 for judging the high‐risk patients with CHD was 86 .3% ,the specificity was 96 .6% ,and the overall diagno‐sis accuracy was 98 .0% .Conclusion Lp‐PLA2 can better assess the risk of CHD patients and the serum Lp‐PLA2 level can reflect the severity of coronary artery lesion .

Objective To observe the expression of thioredoxin (Trx) and thioredoxin-interacting protein (Txnip) in the kidney of type 2 diabetic rats induced by streptozotocin and the effect of probucol treatment on thioredoxin system. Methods Thirty male SD rats were divided into control group( C, n = 10), diabetes group ( D, n =10), and probucol treated diabetic group ( P, n = 10). After eight weeks of probucol treatment, the expressions of Trx and Txnip in the kidney of three groups were measured by RT-PCR, Western blot, and immunohistochemistry. Body weight,24 h microalbuminuria( ALB), fasting plasma glucose( FPG), fasting insulin( HNS), blood urea nitrogen (BUN), creatinine (Cr), malondialdehyde ( MDA ), superoxide dismutase ( SOD ), and catalase (CAT) were determined. Results Compared with group C, Trx was markedly decreased in group P (0. 162 ±0. 008 vs 0. 239 ±0. 006, P＜0.05 ), while Txnip was significantly increased (0. 159±0.003 vs 0. 091 ±0.016, P＜0.05 ). Trx in group P was increased as compared with group D (0. 162 ±0. 008 vs 0. 108 ± 0. 013, P ＜ 0. 05 ), while Txnip was lowered (0. 159±0.003 vs 0. 236±0.009 ,P＜0.05 ). FPG, 24 h ALB, BUN, Cr,and MDA levels in group D were markedly increased as compared with group C (P＜0. 05), while the activity of SOD, CAT, and FINS levels were decreased apparently (P＜0.05). The above markers except for FPG in group P were ameliorated (P＜0. 05 ).Conclusions Probucol attenuated oxidative stress by means of partially restoring Trx function and reducing Txnip expression, and thus played a major role in renoprotection of type 2 diabetic nephropathy.

BACKGROUND: Neuron-specific enolase, γtype isoenzyme that is specially present in the cytoplasm of neurons and neuroendocrine cells, is considered as a sensitive predictor for neuronal damage.OBJECTIVE: To observe the changes of serum neuron-specific enolase in patients with transient brain ischemic attack, so as to explore its relationship with the degree of neuronal damage.DESIGN: Case-control observation.SETTING: Department of Neurology, Jinan No. 4 People's Hospital.PARTICIPANTS: A total of 29 patients who were hospitalized in the Department of Neurology, Jinan No. 4 People's Hospital, due to transient brain ischemic attack (all called for emergent medical treatment within the onset of 6 hours) between March 2002 and May 2004 were enrolled in this study. There were 18 males and 11 females with the average age of(60.36t11.67) years. According to the duration of neural functional deficits, all subjects were divided into two groups, namely, transient-symptom group (≤ 6 hours) of 19 cases and lasting-symptom group (＞ 6 hours)of 10 cases. At the same time, 25 healthy controls, 15 males and 10 females with the average age of (62.34±9.65) years, rere selected from those who came for routine health examination.METHODS: Fasting elbow venous blood of 1 mL was collected only once from the subjects in control group; the same amount of blood was collected from the patients in transient ischemic attack group immediately after hospitalization, and at days 2, 3, 4 and 5. Roche Elecsys 2010 automatic analyzer was used to detect serum neuron-specific enolase. Neuronal damage was assessed with neurological deficit scale (defined as practical recovery if scores were reduced by 90%-100%; remarkable improvement if scores were reduced by 46%-89%; improvement if scores were reduced by 18%-45%; ineffective if scores were reduced by less than 17% or even the disease aggravated).MAIN OUTCOME MEASURES: The daily changes of serum neuronspecific enolase.RESULTS: All the54 subjects remained in the final result analysis. [1]Comparison of neuron-specific enolase density: It was significantly higher in transient brain ischemic attack group than in control group [(23.53±12.35) vs(14.29±6.83) μg/L, t=2.678, P ＜ 0.01]. [2] Curve of neuron-specific enolase changes during the acute stage: It began to increase at the early stage,reached the peak level on the next day, and gradually declined to the normal level in 4-5 days. [3] The level of serum neuron-specific enolase in the two groups with various durations of neurological deficit symptoms: It was obviously higher in transient-symptom group than in control group [(19.24±8.95)vs (14.29±6.83) μg/L, t=1.893, P ＜ 0.05], and higher in lasting-symptom group than in control group [(28.87±13.15) vs (14.29±6.83) μg/L, t=4.367,P ＜ 0.001]. [4] The level of neuron-specific enolase was positively correlated with the duration of neuronal damage (r=0.815, P＜0.01).CONCLUSION: Serum neuron-specific enolase increases within a short term after transient brain ischemic attack and reaches the peak level at around 24-36 hours, suggesting that the detection of serum neuron-specific enolase has a guiding value in assessing the severity of transient brain ischemic attack.

Objective To investigate the effect of hydrogen-rich water on cerebral edema and aquaporin 1 (AQP1) expression in rats with traumatic brain injury (TBI).Methods Ninety male Sprague-Dawley (SD) rats were randomly divided into sham operation group,TBI model group,hydrogen-rich water treatment group (H group),with 30 rats in each group.TBI model was reproduced by weight dropping method.The skulls of rats in sham operation group underwent only craniotomy without direct hit and with bone wax sealed suture.5 mL/kg of hydrogen-rich water injection was given intraperitoneally after model reproduction in H group,and equal amount of normal saline was given in sham and TBI groups,once a day for both groups for 5 days.Six rats from each group were sacrificed at 6,12,24,48 hours and 5 days after evaluating neurological severity scores (NSS).The cerebral cortex was harvested,and the pathological changes in morphology of brain tissue were observed with light microscope.The positive expression of AQP1 in cerebral cortex was observed with immunohistochemistry by light microscopy,the AQP1 mRNA expression in cerebral cortex was determined by real-time fluorescent quantization reverse transcription-polymerase chain reaction (RT-PCR),and the AQP1 protein expression in cerebral cortex was determined by Western Blot.Results ① All rats in sham operation group had a NSS of zero at each time point.NSS of TBI group was obviously raised with time prolongation,and peaked at 24 hours followed by a lower tendency,while the score in H group was significantly lower than that of TBI group,and the difference was the most obvious at 24 hours as compared with TBI group (9.83 ± 2.78 vs.13.50± 2.42,P ＜ 0.05).② It was shown by light microscope that in the TBI group there were pathological changes in cerebral cortex,including obvious irregular arrangement of nerve cells,cerebral edema,obvious bleeding,especially at 24 hours,then the cerebral edema became vanished gradually;and the positive expression of AQP1 in the pia mater at all the time points in the TBI group was significantly increased,and it was most obvious at 24 hours.Compared with TBI group,the pathological changes at time points of 12 hours to 5 days in H group was significantly lessened,and the positive expression of AQP1 in the cerebral pia mater was reduced obviously.③ Compared with sham operation group,the mRNA and protein expressions of AQP1 in cerebral cortex in TBI group were significantly elevated,peaked at 24 hours [AQP1 mRNA (2-△△Ct):7.50±0.26 vs.1,AQP1 protein (gray value):1.986±0.110 vs.0.336±0.034,both P ＜ 0.05],then they gradually declined.The mRNA and protein expressions of AQP1 in cerebral cortex were significantly decreased after hydrogen-rich water treatment [24-hour AQP1 mRNA (2-△△Ct):5.40±0.21 vs.7.50±0.26,24-hour AQP1 protein (gray value):1.246±0.137 vs.1.986±0.110,both P ＜ 0.05].Conclusions The up-regulation of AQP1 mRNA and protein in ratst cerebral cortex after TBI perhaps participates in edema formation which might be involved in the pathophysiology of cerebral edema in TBI.Early treatment with an intraperitoneally injection of hydrogen-rich water is capable of attenuating the extent of TBI-induced up-regulation of AQP1 mRNA and protein,alleviating cerebral edema,and achieving its protective effects.

Objective To investigate the influence of prepubertal exposure to estradiol benzoate (EB)in the male reproductive system of the rats and the natural process of tissue repair,and to clarify the possible mechanism of the reproductive toxicity of exogenous estrogen.Methods Ninety 2 1-day-old male Wistar rats were randomly divided into 2 experimental groups (low dose of EB group and high dose of EB group,n=30)and control group (n=30). The rats in the experimental groups were injected with EB dissolved in peanut oil at 15(low dose of EB group)and 15 000μg·kg-1 (high dose of EB group)respectively,the rats in control group received equal vehicle injection only,once every other day for two weeks from postnatal day(PND)21 to 34.All of them were normally fed after the drug usage was stopped.The testes were harvested at the stages of PND 60 and PND 125(n=15 at each stage).The serum levels testosterone of (T),follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin (PRL)and estradiol(E2)of the rats in various groups were detected with radioimmunology method and the weights of the rats in various groups were recorded;the histological changes of the testes tissue were observed with light microscope.Results On PND60,compared with control group,the T levels in low dose of EB group and high dose of EB group were decreased(P<0.05 or P<0.01);the FSH,LH and E2 levels were increased (P<0.05 or P<0.01),and the PRL levels had no change(P>0.05);the weights of testes were decreased(P<0.01);the histological changes of the testes of the rats in experimental groups included seminiferous tubules maldevelopment, decreased cell number of seminiferous epithelia.Compared with low dose of EB group,the T and FSH levels in high dose of EB group were decreased (P<0.05 or P<0.01),the E2 and LH levels were increased(P<0.01),the PRL level had no change (P>0.05 ), and the weight of testes was decreased (P<0.01 );the diameters of seminiferous tubules were smaller,there was no sperm in high dose of EB group while there were a few sperms in low dose of EB group.On PND125,compared with control group,the T,FSH and PRL levels in low dose of EB group and high dose of EB group were decreased(P<0.01),the E2 levels were increased (P<0.01);the LH level in low dose of EB group was increased(P<0.05),the LH level in high dose of EB group was decreased(P<0.01), and the weights of testes in high dose of EB group were decreased(P<0.01);the diameters of seminiferous tubules and the cell number of seminiferous epithelia were increased but not apparent change.Compared with low dose of EB group,the T,LH levels in high dose of EB group were decreased (P<0.01),the E2 and FSH levels were increased(P<0.01),the PRL level had no change(P>0.05),and the weight of testes was decreased(P<0.01);there was still no sperm in high dose of EB group, the number of sperms was increased in low dose of EB group, but it was still lower than that in control group.Conclusion EB is harmful to the reproductive system and can change the normal serum sex hormone levels,even induces the irreversible injury.

Objective To investigate the significance of combined detection of homocysteine(Hcy) and ischemia modified albu‐min(IMA) in serum to the diagnosis of acute myocardial infarction(AMI) .Methods The serum levels of Hcy and IMA were detec‐ted in 80 patients with acute myocardial infarction ,60 patients with angina pectoris and 40 healthy subjects(control group) ,and the results were statistically analyzed .Results The concentration of Hcy and IMA in AMI patients was significantly higher than which in the control group ,the difference is statistically significant(P<0 .05);the sensitivity of the Hcy+ IMA combined diagnosis was higher than that of the single project .Hcy and IMA was positively related(P<0 .05) .Conclusion The combined detection of Hcy and IMA levels in patients with acute myocardial infarction has a good effect on early diagnosis and monitoring ,and it is worth popularizing .

Background and purpose:The prognosis in patients with early breast cancer(EBC) was poorly defined by clinical and histopathological features.There were more than 200 genes that might be correlated with development,progression,recurrence and prognosis of breast cancer in the published literature.This study evaluated the prognosis of patients with EBC at molecule level according to the protein expressions of 16 selecting genes(HER2,ER,PR,BCL2,Ki-67,BMYB,Cyclin B1,STK15,MMP11,BAG1,NM23,PTEN,P53,P27,VEGF,PCN A).Methods:The immunohistochemical method was used to detect the protein expressions of these genes in 76 patients with EBC and the statistical analysis was performed by COX proportional hazards model.Results:COX proportional hazard model revealed that BCL2,VEGF and STK15 were independent prognostic factors for patients with EBC.A formula of PI was set up according the three genes.The predictive outcomes with PI were compared with the actual follow-up outcomes in 48 patients with EBC.As a result,the predictive accuracy of good and bad prognosis was 86.67% and 91.67%,respectively.Conclusion:A formula of PI derived from protein expressions of the 16 genes correlated with breast cancer was ultimately set up and might be used to predict the outcomes of the patients with EBC.

Objective To observe the clinical efficacy and safety of ultrapulse CO 2 laser-assisted au-tologous epidermal grafting for the treatment of vitiligo.Methods1605patients with30660skin grafts were treated by CO 2 laser-assisted autologous epidermal grafting.Among them,782patients had localized vi-tiligo,319segmental,226general and278scattered.Epidermal grafts were harvested with negative pressure blistering method from normally pigmented skin,and recipient areas were prepared with a ultrapulse CO 2 laser.The curative effect was evaluated8weeks later.Results79.04%of the lesions were cured complete-ly,and total response rate was92.21%,with better effect in localized and scattered lesions than in other le-sions.The best results were shown in face,while the worst results shown in brow and hairline lesions.Con-clusions The advantage of combined therapy of CO 2 laser with autologous epidermal grafting in vitiligo is of easy performance,convenience,high response rate,which is worthy of large scale application.

Background and purpose: Reports showed that berbefine not only had an effect ofdetoxification and inflammation but also could induce the cell to apoptosis. Berberine may also inhibit the migration and metastasis of tumor. To investigate the effects and mechanism of berberine on migration and metastasis of A549 cells, the proliferation, mobility and adhesion of A549 cells were observed after incubation with berberine. Methods: The proliferation was determined by MTT. Wound healing assay and adhesion test were used to observe the mobility and adhesion rate. The mRNA and protein expressions of MMP2 and MMP9 were assessed by semi-quantitive RT-PCR and gelatin zymography, respectively. Results: Berberine could significantly inhibit the proliferation ofA549 within a certain range of treating time and dose (P<0.05). The mRNA and protein expression of MMP2 and MMP9 gene were decreased slightly by the treatment ofberberine (P<0.05), especially at dose of 100 μg/ml. Conclusion: Berberine can inhibit the migration and adhesion abilities of A549 cells, probably by down-regulating the expression and activation of MMP2 and MMP9.