Objective To discuss the efficacy of Baofukang combined with clindamycin injection in treatment of chronic cervicitis patients with high-risk human papilloma virus infection (hr-HPV).Methods Totally 100 patients who had chronic cervicitis with hr-HPV were selected and divided into two groups randomly.The patients in control group (49 cases) were given Baofukang.The patients in observation group (51 cases) were given Baofukang combined with clindamycin injection.The efficacy of Baofukang combined with clindamycin injection in treatment of chronic cervicitis patients with hr-HPV was evaluated by efficacy,HPV negative rate,inflammatory factors before and after treatment and adverse reaction during treatment.Results After treatment,the effective rate of observation group was 92.1％,and the effective rate of control group was 75.5％,the effective rate of observation group was higher than that of control group (P ＜ 0.05).After treatment,the HPV negative rate in observation group was 90.2％,the control group was 59.2％,the HPV negative rate of observation group was higher than that of control group (P ＜ 0.05).Before treatment,there was no statistical significance on hs-CRP,IL-6,and TNF-α between two groups.After treatment,the hs-CRP,IL-6,and TNF-α were decreased in two groups (P ＜ 0.05).The hs-CRP,IL-6,and TNF-α of observation group were lower than those of control group (P ＜ 0.05).There was no statistical significance on adverse reaction between two groups.Conclusion Baofukang combined with clindamycin injection had a good therapeutic effect on chronic cervicitis with hr-HPV.It could inhibit HPV and inflammatory factors well.It was safe and worthy of clinical use.

Young women affected by education and career delay the childbearing period,which results in reduced fertility.With the two-child policy completely opening,more and more elderly women have demands for pregnancy and the need of assisted reproductive technology (ART) increases day by day.However,the ART treatment faces with a series of medical and ethical problems.For example,the pregnancy rate of aged women is low but the abortion rate is high;and the incidence of pregnancy complications and fetal chromosomal abnormality increases significantly.In this regard,it can solve these problems through limiting the women's age,choosing the donated eggs,strengthening the counseling for elderly infertile women before ART treatment,paying attention to the psychological problems and applying the genetic screening technology before implantation.

Objective:To analyze the pros and cons of the US strategic national stockpile ( SNS) from the per-spective of the supply chain and to put forward suitable recommendations for China’s national emergency medicine system. Methods:Literature review and a comprehensive analysis have been utilized to understand the SNS supply chain model and its differences from the Chinese model. Results:From the perspective of the supply chain, the Unit-ed State’s storage of emergency medicine consists of the forward placement of push packages, managed inventory and purchase contracts. The deployment of logistics for emergency medicine must gain approval from the federal government’s “local-state-nation” system, and be conducted at a different time. To transmit information, a large da-tabase, simulation software, and a technical advisory response unit have been established to manage information flow to distribute medicine accurately and promptly. Conclusion:Given the experiences of supply chain management in the US SNS system, it is critical for China to improve the supply chain system of emergency medicine, define the institu-tions and responsibilities within the supply chain, establish disaster relief reserve of emergency medicine and adopt fourth-party logistics for emergency medicine in order to make the China’s emergency preparedness more systemized, standardized, and information-based.

Objective To investigate the effects of valsartan on insulin resistance of type 2 diabetes in patients with Ⅰ hypertension.Methods Newly diagnosed 152 patients of type 2 diabetes with Ⅰ hypertension were randomly divided into treatment group and control group.The treatment group and control group undergone lifestyle changes( diet and adequate exercise) for two weeks.After that,the control group were given Diltiazem,while the treatment group were given valsartan,an angiotensin receptor blocker(ARB) drugs.Both groups were treated for 8 weeks.Fasting plasma glucose (FPG) and fasting plasma insulin (FINS) before and after treatment in both groups were determined.Homeostasis model assessment evaluation of insulin resistance index(HOMA-IR) and insulin sensitivity index (IAI) were carried out and compared between the two groups.Results After 8 weeks of treatment,HOMA-IR in the treatment group was significantly decreased compared with the control group ( P ＜ 0.01 ),while IAI was significantly increased( P ＜ 0.01 ).Conclusion Application of valsartan in type 2 diabetes mellitus with Ⅰ hypertension can significantly improve the level of insulin resistance.

The steroidal enzyme cytochrome P45017alpha catalyzes the conversion of progesterone and pregnenolone into androgens, androstenedione and dehydroepiandrosterone, respectively, the direct precursors of estrogens and testosterone. Dihydrotestosterone is the principal active androgen in the prostate, testosterone is also an active stimulant of the growth of prostatic cancer tissue. Inhibition of this enzyme as a mechanism for inhibiting androgen biosynthesis could be a worthwhile therapeutic strategy for the treatment of PCA. In this paper, four categories of steroidal inhibitors of cytochrome P45017alpha will be reviewed, a diverse range of steroidal inhibitors had been synthesized and shown to be potent inhibitors of P45017alpha.

Objective To compare sensitivity and specificity of the acute physiology,age,and chronic health evaluation system Ⅱ (APACHE Ⅱ),the acute physiology,age,and chronic health evaluation system Ⅲ (APACHE Ⅲ) system in predicting prognosis after cardiac operation.Methods A prospective study of 1 180 consecutive patients entering in a single cardiac postoperative intensive care unit of Anzhen hospital was assigned between November 2013 to January 2014.APACHE Ⅱ and APACHE Ⅲscore was calculated daily at least three days or until death,then compared the calibration and discrimination of the two different system using Hosmer-Lemeshow goodness-of-fit and receiver operating characteristic(ROC) curve.Results In discrimination analysis,ROC value of the first day after operation was(APACHE Ⅱ 0.699 、APACHE Ⅲ 0.734),ROC of the maximum(APACHE Ⅱ 0.836,APACHE Ⅲ 0.862),ROC of the maximum during the first 3 days(APACHE Ⅱ 0.814、APACHE Ⅲ 0.855),ROC of the change between the third day and the first day(APACHE Ⅱ 0.524 、APACHE Ⅲ 0.549).In calibration analysis,we compared the x2 value and overall corrected percentage of the first day value,the maximum value,the maximum value during the first 3 days,the change value between the third day and the first day of the three different system.x2 value of APACHE Ⅱ was(15.688,10.132,8.061,42.253),x2 value ofAPACHE Ⅲ was(13.608,11.196,19.310,47.576).Conclusion APACHE Ⅲ was better than APACHE Ⅱ in prediction of death risk after cardiac surgery.

Objective To investigate the effect and safety of long-term use of atorvastatin on carotid atherosclerosis in advanced elderly patients.Methods Totally 61 elderly patients with carotid atherosclerosis were permitted into study.They were treated with atorvastatin (20 mg/d) and followed-up for five years.The carotid atherosclerosis parameter and the serum levels of TC,TG,LDL-C,HDL-C,fasting blood glucose (FBG),ALT,AST,STB,CB,Bun,Cr and creatine kinase (CK) were measured before and 5 years after treatment.Results During fellow-up,2 patients died of severe pneumonia and 1 patient died of operation complications of intestinal obstruction,with mortality rate of 4.9％.2 patients (3.4％) gave up treatment because of muscle-related side-effect.Data was collected in 56 patients achieving study end.There was significant decrease in LDL-C (P＜0.05) and increase in HDL-C (P＜0.05),but there was no change in serum levels of TC,TG,FBG,ALT,AST,STB,CB,BUN,Cr and CK (P＜0.05) after 5 years.The total area of carotid atherosclerosis plaque was reduced [(0.63±0.41)cm2 vs.(1.07±0.67)cm2,P＜0.05] and echo of carotid atherosclerosis plaque was enhanced (2.67±0.52 vs.1.53±0.44,P＜0.01),but carotid intima-media thickness(IMT) appeared no change after five years.Conclusions Atorvastatin is safe in the treatment of advanced elderly patients,it can make carotid atherosclerosis plaque smaller and stable after long-term treatment.

Objective Metabolic syndrome ( MS), a disorder involving multiple metabolic abnormalities such obesity,hypertension, diabetes or abnormal glucose tolerance and dyslipidemia, has been observed in many patients receiving coronary artery bypass procedures. In this study we try to examine the perioperative effects of metabolic syndrome on the off-pump coronary artery bypass (OPCABG). Methods A prospective study was conducted in 1060 consecutive OPCABG patients who were admited to Beijing Anzhen Hospital from July 2009 to March 2010. The patients were grouped as MS group and non-MS group according to the diagnostic criteria for Chinese metabolic syndrome. The outcomes such as mortality, atrial fibrillation,stroke, staying in ICU for more than three days, use of IABP, ECMO, dialysis, multiple organ dysfunction score ( MOOS) ,postoperative score for cardiac surgery (PSCS), PaO2/FiO2 , heart rate x central venous pressure/mean artery pressure(pressure-adjusted heart rate, PAHR) ,renal and liver function, platelets, and the dosage of vasoactive agents were analyzed and compared between the two groups by x2 test or t test. Results Three hundred and eighty-nine cases were diagnosed with MS among 1060 cases with OPCABG. In the MS group, 17 cases stayed in ICU for more than 3 days, 2 cases died, 76 had atrial fibrillation, 3 had stroke, 18 cases were treated with intra-aortic balloon counterpulsation (IABP). In the non-MS group, 47 cases stayed in ICU for more than 3 days, 12 cases died, 148 had atrial fibrillation, 3 had stroke, 48 cases were treated withIABP, 3 cases received ECMO and 4 cases received dialysis. No significant difference between MS group and non-MS group was identified in the aspects of mortality, atrial fibrillation, stroke, duration of more than three days in ICU, the use of IABP,ECMO, dialysis after OPACBG based on the x2 test(P＞0.05). However, on the operative days, the MODS and PSCS in MS group were significantly higher than that in non-MS group (P ＜ 0.05). MODS 2. 57 ± 1. 62 in MS group vs. 2. 15 ± 1.65 in non-MS group, PSCS 4.27 ±2.15 in MS group vs. 3.92 ±2.29 in non-MS group. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (249.23 ± 110.99 vs. 283. 33 ± 114. 35), P ＜ 0. 01. PAHR in MS group was significantly higher than that in non-MS group (9.98 ±3.54 vs. 9.23 ±3. 88), P ＜0.05. On the first postoperative days, the MODS in MS group was also significantly higher than that in non-MS group (3.05 ±1.64 vs. 2.82 ± 1.72), P＜0.05. PaO2/FiO2 in MS group was significantly lower than that in non-MS group (277.11 ±122.99 vs.318.47 ±143.84), P＜0.05. Conclusion MS was not a predictor for death, atrial fibrillation, stroke, duration of more than three days in 1CU, the use of IABP, ECMO, dialysis after OPACBG. However, MS had a temporary adverse effect on the respiratory and circulatory systems on the operative day and the first postoperative day after OPCABG.

Objective To compare the efficacy and complications of the two surgical methods (between type Ⅰ hysterectomy and type Ⅱ hysterectomy),and to explore the feasibility of type Ⅰ hysterectomy in stage ⅠA cervical cancer.Methods The study group,92 cases(48 cases of stage ⅠA1,44 cases of stage ⅠA2) were performed with type Ⅰ hysterectomy plus selective pelvic lymph node dissection;the control group,93 cases (49 cases of stage ⅠA1,44 cases of ⅠA2) were performed with type Ⅱ hysterectomy plus selective pelvic lymph node dissection.Results The survival rate of 5 years and 10 years in study group were 100 ％ (92/92),100 ％ (74/74) and that in control group were 100 ％ (93/93),100 ％(66/66),respectively.There were no signicant difference between the two group (both P ＞ 0.05).When compared with the control group,the urinary tract infection of the study group was significantly reduced (0 versus 13.99 ％,P ＜ 0.05).Moreover,there were a shorter surgical duration [(96.14±17.20) min vs (116.82±16.30) min].The hemorrhage [(117.35±39.61) ml] and blood transfusion (0 ml) in study group was less common than those in control group [(201.74±46.25) ml,(82.07±16.32) ml] (all P ＜ 0.01).Conclusion There are no difference of 5-year and l0-year survival rate in stage ⅠA patients with type Ⅰ or type Ⅱ hysterectomy,however,the rate of the postoperative urinary tract infection in the former is lower than that in the latter,and also there are a shorter surgical duration,less hemorrhage and reduced blood transfusion requirements in study group.Therefore,type Ⅰ hysterectomy can be effective and applicable for the patients of stage ⅠA cervical cancer.

Objective To report the clinical and genetic characteristics of a dentatorubralpallidoluysian atrophy (DRPLA) pedigree with an onset of cognitive impairment.Methods Clinical data of this pedigree was collected.The numbers of CAG repeats in the exon 5 of atrophin-1 (ATN1) gene were analysed in the proband and the other 4 healthy family individuals.The polymerase chain reaction (PCR) products of the proband underwent cloning-sequencing using an original TA cloning kit.Results There were 5 patients in this family,4 with onset in adult and one in childhood.The proband had an onset manifestation of cognitive impairment,while the other 3 adult patients presented with ataxia.The two-year-old child in the pedigree had myoclonic epilepsy.The proband had 61 CAG repeats in the exon 5 of ATN1 gene.After TA cloning-sequencing of the proband ' s PCR products,there were 2 different numbers of CAG repeats,including 61 and 64.Conclusions The clinical manifestations of DRPLA can have obvious heterogeneity in one family.Some patients present with cognitive impairment.It is very important to test the numbers of CAG repeats of ATN1 gen for DRPLA diagnosis.Somatic mosaicism may be also observed in Chinese DRPLA patients.