Objective To investigate the factors for the difficulty of removing intrauterine devices(IUD)and preventive measures among women in perimenopausal and menopausal period.Methods The IUDs were taken out among 192 women from family planning clinics and the influential factors for the outcome of removing IUD such as age,menopausal years were summarized through the statistical analysis.Results Among 192 cases of IUD removal, 163 cases went smoothly,the percentage was 84.90%,but the process of 29 cases was difficult,the percentage was 15.10%.The age,menopausal years,IUD positioned period,regular physical examination,cervical atrophy degree and intrauterine adhesion were the statistical factors to IUD removal(χ2 =6.740,7.429,11.235,8.443,11.998,9.016, all P <0.05 ).The residence,abortion history and times of pregnancy had no significant influence (P >0.05 ). Conclusion The important way to prevent and solve the difficulty of IUD removal is supervising women to take regular physical examination,learn more knowledge about IUD,remove IUD during half a year after menopause in order to increase the success rate and safety.

Objective To investigate the clinical value of color Doppler ultrasound (CDFI) in the diagnosis of carotid atherosclerosis lesion in patients with acute stroke.Methods Totally 60patients with acute cerebral infarction were examined with CDFI to observe vessel diameter and stenosis degree of common carotid artery,internal carotid artery and external carotid artery and the results were compared with digital subtraction angiography (DSA) test.Results Among 60patients,normal ultrasound diagnosis was in 28 cases,occlusion and stenosis in 32 cases,stenosis in 25 cases; mild,moderate and severe stenosis were in 18,20,12 vessels,occlusion in 7 cases,14vessels.DSA examination results showed normal in 29 cases,stenosis and occlusion in 31 cases,stenosis in 26 cases,mild,moderate and severe stenosis of the 18,16,18 vessels; occlusion in 5 cases,10 vessels.The consistency test results between carotid artery color Doppler ultrasound and DSA were Kappa=0.786,0.667(P＜0.05).All carotid DSA results were considered as gold standard,CDFI diagnosis of moderate to severe stenosis was in high accuracy compared with DSA.Conclusions CDFI in the diagnosis of different degrees of carotid stenosis is in good agreement with DSA diagnosis,and may replace invasive DSA diagnosis of moderate to severe stenosis.

A total number of 2221sera collected from different kinds of subjects , i.e.patients with various stages of schistosomiasis. normal individuals, persons with other parasitic diseases or non-parasitic diseases, were detected with Dot Immunogold Filtration Assay (DIGFA) using anti-SVLBP IgG as capturig antibody. Positive rate of 70 sera from patients with acute schistosomiasis was 100%, and that of 307 sera with chronic schistosomiasis was 68.4% .None of 200 sera from normal individuals showed false positive reaction. No obvious cross reaction was found in sera from other parasitic/non-parasitic diseases except sera from patients with paragonimiasis.2 batches of sera were detected with DIGFA by single-blindness method. Results showed that sensitivities to chronic schistosomiasis were 69.4% and 68.9%, and 100% to acute schistosomiasis while specificities were 98.9%-99% .508 samples from residents in endemic areas were tested with DIGFA and Kato-Katz. Positive rate of circulating arrtigen was 20.9% with DIGFA while 65 samples were positive with stool examination.46 samples were positive both by DIGFA and by Kato-katz.The coincidental rate was 70.8% .These results indicated that DIGFA showed sensitive and specific in the detection of circulating antigen. It will be useful in mass application and vahuable in epidemiological stuvey.

OBJECTIVE To monitor the risk of occupational exposure among medical staffs and give the preventive measures.METHODS The profession high risk factor,element of sharp instrument injury,the risk of evaluation after exposure and preventive medication in 95 blood-borne among medical staffs from Nov.2005 to 2008 were analyzed.RESULTS Among the occupational exposure degree to blood source among medical staffs,the first was nurses(75.79%),the second doctors(16.84%).The sharp instrument injury was the most common type of the occupational exposure to blood source,and common appeared in the pinhead of infusion apparatus,and most appeared at the withdrawal of needles after transfusion completed or bare-handed.No staff got the infection brcause of occupational exposure to three HIV patients.CONCLUSIONS It is the key to cut down the risk of occupational exposure by enhancing the training of medical staffs,specification of procedure,enforcing standard precautions,establishment monitoring system,strengthening the report and effective treatment after exposure.

Primary tracheobronchial amyloidosis (TBA) is a rare pulmonary disease. A systematic review was performed on 64 cases of primary TBA in China and progress in the diagnosis and treatment of this disease is discussed. The Chinese biological and medical databases from 1970 to 2010 were searched and 75 cases of complete clinical and pathological data were identified. The clinical characteristics of the disease were summarized and longitudinal comparisons were made of diagnostic and treatment methods over time. The results showed that the morbidity associated with primary TBA has increased over recent years. The clinical manifestations were non-specific. Progressive dyspnea, cough and sputum were the most common symptoms. The percentage of patients undergoing computed tomography (CT) scan has increased over the years. The bronchoscopy and transbrochial lung biopsy (TBLB) were usually sufficient to establish the diagnosis. Treatment was reported for a total of 44 cases. Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration such as steroids and colchicines were reported to be effective in some patients. It is concluded that the demographic characteristics and clinical manifestations of primary TBA patients in China are largely consistent with findings reported in other countries. Dramatically more cases were reported in recent years, mainly due to the extensive application of bronchoscopy since 1990s. Chest CT scan provides important clues for the diagnosis of the disease. The definite diagnosis was confirmed by bronchoscopic findings and Congo red staining of biopsy specimen. Bronchoscopic Nd:YAG laser irradiation, argon plasma coagulation (APC) and drugs administration, such as steroids and colchicines were reported to be effective in some patients.

Objective To investigate the toxic effect of immunosuppressive drugs on apoptosis of rat pancreatic islet cells in vitro and the protective action of Bcl-2.Methods Islet cells expressing Bcl-2 and the control islet cells were cultured at different concentrations of tacrolimus and the apoptosis rate of islet cells and insulin accumulation in the culture medium were detected after 48h.Results Low and high concentrations of tacrolimus induced the apoptosis of islet cells and decreased insulin secretion.The Bcl-2 inhibited the apoptosis of islet cells induced by tacrolimus and improved the insulin secretion.Conclusion Tacrolimus may directly damage to isolated rat islet cells and the expression of Bcl-2 can protect the cells from the damage of immunosuppressive drugs.

Aim To study the effects of Shenfu soup onthe ISO -induced myocardial ischemia injury model ofrats and the influence of apelin level changes on myocardial ischemia.Methods The myocardial ischemiainjury model of rats was established by the subcutaneous injection of ISO.For 1 5 days,rats in Shenfugroups were given by gavage 3,6 and 1 2 g · kg -1Shenfu soup and rats in SF injection group were given6.67 g·kg -1 Shenfu injection,rats in sham group andmodel group were given the same volume of distilledwater.Rats were subcutaneously multipoint injectedISO for 5 days on the eleventh administrating day.Theeffects of Shenfu soup on myocardial morphology,serum myocardial enzyme levels,apelin mRNA level inserum and apelin protein level in myocardial tissue,and relationship between myocardial enzyme and apelinexpression were evaluated. Results Shenfu soupcould reduce the degree of myocardial tissue necrosisand compared with model group,CK values and LDHvalues of rats in middleand highdose groups were significantly lower (P <0.05 or P <0.01 ).However,the apelin mRNA level in myocardial tissue and apelinprotein level in serum of the rats in middleand highdose groups compared with model group had increased(P <0.05,P <0.01 ).Meanwhile,serum levels ofapelin and the expression of myocardial enzyme CK andLDH were negatively correlated.Conclusion Shenfusoup has a protective effect on myocardial ischemia injury in rats induced by ISO and the mechanism is involved with the promotion of apelin mRNA and proteinexpression,the inhibition of myocardial enzyme production and the improvement of myocardial ischemia.

ObjectiveTo study the effect of negative pressure suction during laser in situ keratomileusis (LASIK) on rabbit retinal structure.Methods32 New Zealand white rabbits were randomly divided into normal control, experimental control, negative suction 45 seconds and negative suction 3 minutes groups. Experimental control groups were treated only using eximer laser. In negative suction groups, rabbit eyes were suction for 45 seconds or 3 minutes by negative pressure generator. The tissues of optic nerve and retina both after negative pressure suction and of normal rabbit eyes were examined with electron and light microscope 0, 7, 14, 28 days after operation. ResultsThere was no change in the tissues of optic nerve and retina between normal control and experimental control. After the negative pressure suction for 45 s, the optic nerve and retinal cells changed lightly at different time point. After the negative pressure suction for 3 min, the optic nerve fibers and retinal cells changed sharply during postoperative instant to 14th days, which can be recovered until 28 days after operation.ConclusionUltrastructural changes of retina and optic nerve may be induced by acute intraocular pressure elevation caused by negative pressure suction during LASIK.

Objective To evaluate the value of acoustic radiation force impulse (ARFI) elastography in assessment of nonalcoholic fatty liver disease (NAFLD) and hepatic fibrosis in rats.Methods Models with various degrees of NAFLD severity were conducted in 110 rats by feeding high fat emulsion.The right liver lobe of rat models were processed and embedded in a fabricated gelatin solution to measure the shear wave velocity (SWV) by ARFI.And the other liver lobes were used for histologic assessment.Based on NAFLD activity score (NAS),the final pathologic NAFLD diagnosis were considered as normal group (NAS=0),simple steatosis (SS) group (1≤NAS≤2),borderline (3≤NAS≤4) group and nonalcoholic steatohepatitis (NASH) group (NAS≥5).The diagnostic accuracy of the SWV parameters in evaluating NAFLD severity and fibrosis stages was studied using ROC curves.Results The difference of SWV values among normal group,SS group,borderline group and NASH group was statistically significant (F=31.53,P＜0.001).Taking SWV≥ 2.54 m/s as the diagnostic standard to differentiate normal rats from rats with SS,and SWV≥2.90 m/s to differentiate SS from NASH in rats,the area under ROC curve (AUC) was 0.922 (95％CI [0.871,0.973],P＜0.001) and 0.882 (95％ CI [0.807,0.956],P＜0.001) respectively.The sensitivity and specificity were 93.5 ％ and 100 ％ for differentiating normal and SS groups,83.3 ％ and 84.2 ％ for differentiating SS and NASH groups.Taking SWV≥3.48 m/s as cutoff to predict fibrosis (≥F2 stage),the AUC was 0.963 (95％CI [0.909,1.000],P＜0.001),the sensitivity was 92.9％ and the specificity was 97.6％.Taking SWV≥3.61 m/s as cutoff to predict severe fibrosis (≥F3 stage),the AUC was 0.997 (95％CI [0.990,1.000],P＜0.001),sensitivity was 100％ and specificity was 98.9％.The same high validity was maintained as in the prediction of cirrhosis (F4 stage) with the cutoff as SWV≥4.50 m/s,and the AUC was 0.993 (95％CI [0.982,1.000],P＜0.001),the sensitivity was 100 ％ and the specificity was 96.8％.Conclusion ARFI elastography is a promising method for differentiating the different severity of NAFLD and staging the degree of hepatic fibrosis with NAFLD in rat models.

OBJECTIVE: To explore the effect of thrombocytopenia on the prognosis of patients with septic shock and its mechanism in leading to death. METHODS: A retrospective case-control study was conducted. Patients with septic shock admitted to emergency intensive care unit (EICU) and intensive care unit (ICU) in Peking University People's Hospital from April 1, 2015 to January 31, 2023 were enrolled. Patients were divided into the thrombocytopenia group and the non-thrombocytopenia group, according to whether the minimum platelet count was less than 100×10⁹/L within 24 hours after admission to ICU. The outcome index was the mortality during ICU stay. The baseline data, hospitalization information and laboratory test results of the two groups were compared, and the risk factors of in-hospital death were analyzed by Logistic regression, and the mediation effect was performed by Bootstrap method. RESULTS: A total of 301 patients with septic shock were enrolled, of which 172 (57.1%) had thrombocytopenia and 129 (42.9%) did not. There were significant differences between the two groups in age, mortality, disseminated intravascular coagulation (DIC), continuous renal replacement therapy, and level of creatinine, urea nitrogen, total bilirubin, white blood cell count, lymphocyte count, prothrombin time (PT) and activated partial thromboplastin time (APTT). Univariate Logistic regression analysis showed thrombocytopenia [odds ratio (OR) = 4.478], continuous renal replacement therapy (OR = 4.601), DIC (OR = 6.248), serum creatinine (OR = 1.005), urea nitrogen (OR = 1.126), total bilirubin (OR = 1.006) and PT (OR = 1.126) were risk factors of death during hospitalization in patients with septic shock (all P < 0.05). Multivariate Logistic regression analysis showed that thrombocytopenia [OR = 3.338, 95% confidence interval (95%CI) was 1.910-5.834, P = 0.000], continuous renal replacement therapy (OR = 3.175, 95%CI was 1.576-6.395, P = 0.001) and PT (OR = 1.077, 95%CI was 1.011-1.147, P = 0.021) were independent risk factors for in-hospital mortality in patients with septic shock. Mediation analysis showed that 51% of the deaths due to thrombocytopenia in patients with septic shock were due to coagulopathy. CONCLUSIONS Thrombocytopenia is a powerful predictor of death in septic shock patients, and half of all thrombocytopenia-related deaths may be due to abnormal coagulation function.
Humans ; Shock, Septic ; Retrospective Studies ; Case-Control Studies ; Hospital Mortality ; Prognosis ; Thrombocytopenia ; Intensive Care Units ; Bilirubin ; Nitrogen ; Urea ; Sepsis