ObjectiveTo explore the changes of the frequency and cytokine production of CD19 + CD5 + B cells in Endometriosis before and after treatment.MethodsFlow cytometry and quantitative PCR were used to assess the frequency,cytokine expression of CD19 + CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies of 35 patients with Endometriosis and 29 patients with myoma of uterus (control subjects).Changes in the CD19+ CD5+ B cell compartment in the peripheral blood were compared before and after treatment.ResultsAll 35 endometriosis patients had higher frequencies(all P ＜0.01 ) of CD19+ CD5 + B cells in the peripheral blood,peritoneal fluids and endometrium biopsies [ (13.1 ± 1.9)％,(12.1 ±2.0)％,(11.7 ± 1.7)％] than 29 control subjects[ (2.9 ±0.8)％,(2.6 ±0.9)％,(2.8 ±1.1 )％ ].CD19 + CD5+ B cells from endometriosis patients expressed higher IFN-γ[ (7.2 ± 1.0) × 103,(7.9±1.3) ×103,(7.4±1.1) ×103 copies] than control subjects [ (1.9±0.7)×103,(2.2±0.8)×103,(2.0 ±0.5) × 103 copies).The endometriosis patients also had higher IL-10 production of CD19 + CD5 + B cells [ (6.4 ±0.9) × 103,(6.8 ± 1.2) × 103,(6.1 ±0.8) × 103 copies] than control subjects [ ( 1.7 ±0.5) × 103,(2.1 ±0.9) × 103,( 1.6 ±0.4) × 103 copies].Compared with control subjects,the endometriosis patients had a clinical response to treatment demomtrated a significant decrease in CD19 + CD5 + B cells in the peripheral blood[ ( 13.1 ± 1.9)％ vs (7.3 ± 1.2)％ ],expressed lower IFN-γ [ (7.2 ± 1.0)×103 copies vs (3.3 ±0.6) × 103 copies],produced less IL-10 [(6.4 ±0.9) × 103 copies vs (3.2 ±0.7) × 103 copies].ConclusionsCD19+ CD5 + B cells might play an important role in the pathogenesis of endometriosis through higher IFN-γand IL-10 expression.

Aim To investigate the role of Xuefuzhuyu decoction ( XFZYD ) combined with EPC in repairing damaged vascular endothelium using traditional Chi-nese medicine way of blood circulation combined with cell therapy. Methods The repaired situation of inju-ried endothelium was observed and the effect of XFZYD on EPC was analysed after the endothelial in-juried rats were gavaged XFZYD and vena caudalis in-jected EPC. Results Compared with EPC group and XFZYD group, the XFZYD joint EPC group ’ s endo-thelial thickness was reduced significantly(P<0. 05). And there appeared more significant role in lowering triglycerides, total cholesterol and increasing HDL lev-els( P<0. 05 ) , the calcium was decreased more sig-nificantly( P <0. 05 ); vascular eNOS protein expres-sion increased significantly(P<0. 05); vascular SDF-1 expression was significantly increased. Conclusion XFZYD can promote EPC repairing damaged endotheli-um, and the mechanism may be relevant to improving the environment and promoting the EPC homing.

OBJECTIVETo observe the effect differences on post-stroke dysphagia among acupoint injection combined with neural electrical stimulation, acupoint injection, neural electrical stimulation, and swallowing training respectively, so eligible intervention can be applied to this kind of disease.

METHODSOne hundred and eight-three patients of post-stroke dysphagia were randomized into a comprehensive treatment group (42 cases), an acupoint injection group (44 cases), a neural electrical stimulation group (49 cases) and a swallow training group (48 cases) and were treated with the comprehensive therapy of acupoint injection and neural electrical stimulation, acupoint injection, neural electrical stimulation and swallowing training separately. The treatments for 10 days made one session. There were 3 days at the interval among treatment sessions and 3 sessions were required totally. The cases in those treatment groups were blankly controlled with the other 47 patients of post-stroke dysphagia. All the patients received basic rehabilitation treatment. The modified water swallowing test was conducted to assess the efficacy before treatment, 10 days after treatment and 30 days after treatment in each group separately. The clinical efficacy, score of water swallowing test and improvement in water swallow test were compared among the groups.

RESULTSAfter 10-day treatment, the differences in efficacy and score of water swallow test were not significant in each group (all P > 0.05). After 30-day treatment, the effective rate (94.29%, 33/35) in the comprehensive treatment group was apparently better than 68.75% (22/32) in the acupoint injection group, 80.00% (32/40) in the neural electrical stimulation group, 67.50% (27/40) in the swallowing training group and 42.86% (12/28) in the blank group separately. The score in water swallow test in the comprehensive treatment group was lower than that in each of the other groups (1.37 ± 0.60 vs 2.03 ± 1.00, 1.90 ± 0.90, 2.20 ± 0.72, 2.71 ± 0.90, all P < 0.05). The differences in the effective rate and score in water swallow test were not significant among the acupoint injection group, neural electrical stimulation group and swallowing training group (all P > 0.05), which indicated that the improvement in swallowing function in the comprehensive treatment group was significantly superior to the other groups (all P < 0.05).

CONCLUSIONThe comprehensive therapy of acupoint injection and neural electrical stimulation achieves the much better efficacy on post-stroke dysphagia.

Acupuncture Points ; Adult ; Aged ; Combined Modality Therapy ; Deglutition ; Deglutition Disorders ; drug therapy ; etiology ; physiopathology ; therapy ; Electric Stimulation Therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome ; Vitamin B 12 ; administration & dosage ; Young Adult

Objective: To examine the mediating effect of positive coping style on health literacy and lifestyle among medical students, so as to provide the reference for health education and health promotion among medical students in universities. Methods: Medical students of six full-time medical colleges in Guizhou Province were sampled using a multi-stage stratified cluster random sampling method from April to June 2023, and their gender, age and educational level were investigated by questionnaires. The College Students' Healthy Lifestyle Scale, the Health Literacy Questionnaire and the Simplified Coping Style Scale were used to evaluate lifestyle, health literacy and coping style of students. The Process program was used to analyze the mediating effect of positive coping style on health literacy and lifestyle, and Bootstrap method was used to examine the significance of the mediating effect. Results: A total of 9 266 peoples were investigated, including 3 177 males (34.29%) and 6 089 females (65.71%), and had a mean age of (21.06±2.61) years. There were 2 775 junior college students (29.95%), 4 864 undergraduates (52.49%) and 1 627 master students (17.56%). The scores of lifestyle, health literacy and positive coping style among medical students were 118.34±19.06, 54.57±10.81 and 2.81±0.68, respectively. Health literacy had a direct positive effect on lifestyle (effect value=0.286, 95%CI: 0.257-0.316) and a indirect positive effect on lifestyle through positive coping style (effect value=0.215, 95%CI: 0.193-0.236), and the mediating effect contributed 42.91% to the total effect. Conclusion Health literacy could improve lifestyle indirectly through positive coping style among medical students.

Objective To compare the effect between intra-arterial and intra-venous neoadjuvant chemotherapy(NACT)in stage Ⅰb2-Ⅱ b cervical carcinoma.Methods A retrospective analysis Was done on 52 cases of intra-venous NACT and 95 eases of intm-arterial NACT for stage Ⅰ b2-Ⅱ b cervical carcinoma treatad in Peking Union Medical College Hospital from 1999.ResulIs The response rate of intraveHous NACT and intra-arterial NACT was 88%(46/52)and 79%(75/95).and the operative rate after NACT Was 81%(42/52)and 72%(68/95)respectively(P>0.05).There were no significant differences in surgery time,blood loss and pest-operative morbidity between these two groups.Pathological parametrial positive rate after NACT in arterial group(6%)Was significantly lower than that of venous group (50%,P>0.05).The venous group had very similar recurrence rates(13%vs 17%)and death rates (9%VS 12%)when compared with the arterial group(P>0.05).Conclusions The intra-arterial and intra-venous NACT for stage Ⅰ b2-Ⅱb cervical carcinoma show similar response rate.operative rate and surgical difficulties.Arterial NACT shows a better effect on parametrial infiltration.

Objective To evaluate the prognosis and fertility outcomes of patients with early stage of cervical cancer treated by vaginal radical trachelectomy ( VRT ) in combination with laparoscopic pelvic lymphadenectomy.Methods The surgical data , disease recurrences and fertility outcomes were analyzed retrospectively for 51 patients who received VRT in Peking Union Medical College Hospital from Dec.2003 to Nov.2013.Results Forty-eight patients succeeded in preserving fertility.The median age was 29 years.International Federation of Gynecology and Obstetrics ( FIGO ) stage: 5 cases Ⅰa1 with lymph vascular space invasion (LVSI),4 cases Ⅰa2 and 39 cases in stage Ⅰb1.Tumor size: 20 cases with no visible lesion, 20 cases with tumor size ≤2 cm, 8 cases with tumor size >2 cm.Histological type:42 cases with squamous carcinoma , 6 cases with adenocarcinoma or adeno-squamous carcinoma.The mean excised cervical length and parametrial width was ( 2.6 ±0.6 ) cm and ( 1.9 ±0.5 ) cm, respectively.Six recurrences ( 12%) were observed after following up for a mean duration of ( 35 ±21 ) months.The recurrent rate in patients with tumor size >2 cm was 3/8, which was significantly higher than that of the
patients with tumor size ≤2 cm (8%, 3/40;P<0.01).Of the 35 patients who desired to conceive after the surgery, 13 women had 17 pregnancies and the pregnant rate was 37% (13/35).Nine women obtained 10 healthy live birth babies.The fertility rate was 26%( 9/35 ).Conclusions VRT in combination with laparoscopic pelvic lymphadenectomy could preserve the fertility of patients with early stage of cervical cancer with acceptable oncologic and fertility outcomes.Tumor size ≤2 cm should be emphasized as the indication of VRT in considering of the higher recurrent rate in patients with tumor size >2 cm.

Objective This retrospective study is to analysis the special medical conditions that most Chinese secondary hospitals are facing with,and to review the safeguards and pitfalls for arterial switch operations,in order to probe intothe feasibility of this procedure for Chinese secondary hospitals and provide our experiences to help other surgeons to avoid pitfalls on complex procedures.Methods Between January 2006 and December 2011,totally 21 newborns and infants with TGA/VSD and TGA/IVS underwent arterial switch operation.There were 15 males and 6 females.In the TGA/VSD group,there were 16 cases,ranging from 30 days to 1 year at surgeries,and weight from 3.4-8.5 kg with average of (5.33 ± 1.42) kg.In the TGA/IVS group,there were 5 cases,ranging from 13 days to 1 month at surgeries,and weight from 3.1-5.5 kg with average of (3.75 ± 1.17)kg.All patients underwent one stage of arterial switch operation.Routine follow-up checking points are set at discharging,3 months,half year and every year after operation.Results The early death rate is 9.5％ (2/21),and the reexploration rate is 9.5％ (2/21).In the TGA/VSD group,average cardiopulmonary bypass time is (151 ± 33) minuntes with the aortic crossclamp time is (1 19 ± 26) minutes.Ventilator support time is 24-159 hours,and the length of ICU stay is 3-17 days.1 case has residual VSD with the diameter less than 2 mm.The pulmonary flow velocity in 2 cases increase mildly to 2.0 m/s and 2.2 m/s,and another 2 cases increase severely to 3.1 m/s and 3.7 m/s.The aortic flow velocity in 3 cases increase to 2.0m/s.ECG instructs no case has myoinfarction signs.In the TGA/IVS group,average cardiopulmonary bypass time is (170 ± 52) minuntes with the aortic crossclamp time is (137 ± 48) minutes.Ventilator support time is 51-144 hours,and the length of ICU stay is 4-14 days;The pulmonary flow velocity in 2 cases increase mildly to 2.0 m/s.The aortic flow velocity in 1 cases increase to 2.0 m/s.ECG instructs no case has myoinfarction signs.Conclusion Unbalanced medical resources distribution causes significant differences between heart centers and the secondary hospitals in China,especially on the complex congenital heart diseases procedures.However,with relatively solid background on correction of the simple congenital heart diseases,the Chinese secondary hospitals can still perform arterial switch operation with satisfactory mortality and morbidity,and provide more prompt medical services for more population.

Objective To observe the effect of Ningxia aqueous extracts of fruitless lycium sprout (AEFLS) on cardiomyo cyte antioxidation and apoptosis-related protein expression in aging mice.Methods The natural aging C57BL/6J mice with 13 months old were randomly divided into aged control group,AEFLS low dose group (AEFLS1),AEFLS middle dose group (AEFLS2)and AEFLS high dose group(AEFLS3).The AEFLS1,AEFLS2 and AEFLS3 groups were respectively given with 5,10,20 mg/kg AEFLS gavage,while the aged control group was given with the normal saline gavage,for continuous8 weeks.The xan thine oxidase assay and thiobarbituric acid method were used for the determination of SOD and MDA in heart tissues.Western-blot and immunohistochemical method were used to detect the expressions of Bcl-2,Bax and Capase-3 in heart tissue.Results Compared with the aged control group,the MDA level in the AEFLS2 and AEFLS3 groups was decreased,while the SOD activity was increased,the difference was statistically significant (P＜0.01).The Western-blot result showed that compared with the aged control group,the optical density value of Bcl-2 in the AEFLS2 and AEFLS3 groups was increased,but the optical density values of Bax and Capase-3 were decreased (P＜0.01);the immunohistochemical results showed that compared with the aged control group,the immunopositive(IP) expressions of Bcl-2 protein in heart tissues in the AEFLS2 and AEFLS3 groups were increased (P＜0.01),while the IP expressions of Bax and Capase-3 were decreased (P＜0.01).Conclusion Middle and high doses of AEFLS can increase the antioxidative ability of myocardial tissue,up-regulates the Bcl-2 expression,down-regulates the Bax and Capase-3 expressions and plays anti-cardiomyocyte apoptotic role.

ObjectiveTo investigate the effect of jin’s three-needle scalp electroacupuncture on Cyt-c and Caspase-3 expressions in the cerebral cortex in Intrauterine distress-induced HIBD rats and reveal the mechanism of its protective action on the brain. MethodThe abdomen was incised in a female SD rat at 21 days of pregnancy. Bilateral uterine horn blood vessels were tightly clamped with a hemostat for five minutes. An infant rat was then taken out by a cesarean section. A rat model of hypoxic-ischemic brain damage was confirmed by the use of a behavior test and braintissue sections. The rats were randomized into model and acupuncture groups. The model group was not needled. Acupuncture groups 1, 2, 3 and 4 began to be needled at 3, 5, 7 and 14 days after birth, respectively. Acupuncture treatment was given for seven consecutive days. The normal control group was naturally delivered, not used to make a model and not needled. All groups of rats were decapitated to take the brain tissue at 21 daysafter birth. Cyt-c and Caspase-3 expressions in the cerebral cortex were detected.ResultCyt-c optical density value decreased somewhat in the four acupuncture groups; there was a statistically significant difference between acupuncture group 1 or 2 and the modelgroup (P<0.05). Caspase-3 expression was significantly down-regulated in acupuncture group 1; there was a statistically significant difference compared with the model group (P<0.05).ConclusionThe protective effect of acupuncture beginning at 3 days after birthon the brain is related to the down-regulation of Cyt-c and Caspase-3 expressions in intrauterine distress-induced HIBD rats.

Objective To investigate the quality of life and sexual function of cervical cancer patients following radical hysterectomy (RH) and vaginal extension.Methods Case-control and questionnaire-based method was employed in this study.Thirty-one patients of early-stage (Ⅰ b1-Ⅰ b2) cervical cancer who had undergone vaginal extension following classic RH in Peking Union Medical College Hospital from December 2008 to September 2012 were included in study group,while 28 patients with matching factors and RH only during the same period were allocated to control group.There was no significant difference between two groups in terms of clinical and demographic variables including age at diagnosis,tumor stage and follow-up time (P＞0.05).Patients were assessed retrospectively by validated selfreported questionnaires the European Organization for Research and Treatment of Cancer Cervix Cancer Module Questionnaire (EORTC QLQ-CX24) mainly for quality of life and sexual function for cervical cancer patients; the Sexual Function and Vaginal Changes Questionnaire (SVQ) further investigates sexual function and vaginal changes of patients with gynecologic malignancy at least 6 months after treatment.Results Vaginal length acquired by pelvic examination by gynecologic oncologists during follow-up visits was (10.0±1.3) cm and (5.9± 1.0) cm in study group and control group respectively (P=0.000).Sixty-eight percent (21/31) of cases in study group and 64％ (18/28) of cases in control group had resumed sexual activity at the time of interview,and the time interval between treatment and regular sexual activity was mean 6 months (range 3-20 months) and mean 5 months (range 1-12 months) in study and control group respectively,in which there was not statistical significance (P＞0.05).No difference was observed regarding pelvic floor symptoms (P＞0.05) while difficulty emptying bladder,incomplete emptying and constipation were most commonly reported.Both group presented with hypoactive sexual desire disorder [88％ (52/59)],orgasm dysfunction [72％(28/39)] and low enjoyment or relaxation after sex [51％(20/39)],which was not statistically significant (P＞0.05).Reduced vagina size and shorter vagina was more prominent in control group (12/18) than that in study group [19％ (4/21)] with statistical significance (P＜0.05),while no difference in sexual desire,vaginal lubrication,dyspareunia and sexual enjoyment (P＞0.05).Conclusions Patients with peritoneovaginoplasty following RH had much longer vagina and less self-perceived short vagina.Vaginal extension following RH does not worsen the pelvic floor symptoms.