Objective To investigate the clinical characteristics of endometrial carcinoma in young women,especially the normal weight women.Methods Seventy and five cases of endometrial carcinoma aged ≤ 40 years were treated in Obstetrics and Gynecology Hospital affiliated to Fudan University from January 2008 to December 2011.Among them,there are 68 cases of normal weight and obesity,who were divided into normal weight group (group A,32 cases) and obesity group(group B,36 cases) for comparisons and analysis.Results About 81.2％ of the patients were menstrual disorders in group A and 83.3％ in group B(P =0.822);The merge infertility accounted for 31.2％ and 19.4％ (P =0.279) respectively,and the oligomenorrhea accounted for 21.9％ and 30.6％ (P =0.418) respectively,the patients combined diabetes,high blood pressure or PCOS were 6.2％ and 44.4％ (P =0.001) respectively.According to International Federation of Gynecology and Ostetrics(FIGO) surgery-pathologic stage,two groups of stage Ⅰ were 68.8％ and 83.3％ (P =0.157),respectively.Stage Ⅱ-Ⅳ were 31.2％ and 16.7％ (P =0.157),respectively.Pathological type:8 (25.0％) cases were high-risk of pathology classification in group A,and Five cases (13.8％) in group B,others were endometrial adenocarcinoma.Operations were the main treatments.Five cases were progestogen therapied.After treatments,2 cases were full term pregnant,1 case is now pregnant.Conclusion The clinical manifestations of endometrial carcinoma in young women were mainly menstrual disorders.There were higher percentage infertilities and lower percentage diabetes,high blood pressure and PCOS in normal body weight patients.In normal body weight patients,pathology classification for middle-late of high-risk pattern was increasing.For patients in early stage,if have birth requirement,could be treated with the trial progesterone conservative.

MircoRNAs (miRNAs) are widely existing inorganisms, non-coding small RNA. MircoR-NAs play important role in cell proliferation, apoptosis, stress resistance and fat metabolism. In vitro studies indicate that miRNAs are important factors in platinum resistance of ovarian cancer cell lines. However, the pathway of platinum resistance of ovarian cancers is complex. Studies find miRNA expression play important roles in the sensitivity of platinum resistance of ovarian cancer cell lines , and can be used as an early alert for platinum resistance. Changing the expression of miRNA even can reverse the platinum resistance . But the regular role of miRNAs in target genes network is still unconfirmed. Thus, more studies about miRNA in vivo and animal tumor models are needed to identify the function of miRNAs in platinum resistance of ovarian cancer.

Aberrant microRNA(miRNA) expression has been found in most of human cancers.miRNA-related regulation pathways,including the interaction between miRNA and protein-coding gene and the interaction between miRNA and IncRNA,have been shown correlated with the initiation and progression of human cancers.miRNA might be a therapeutic target in the treatment of malignancies.

Ezrin protein plays an important role in morphogenesis,motility,adhesion.Moreover,Ezrin protein participates in multiple steps of the process of tumor invasion and metastasis.In the progress of tumor metastasis,Ezrin protein is related to several signaling pathways such as Rho mediated signaling pathways,hepatocyte growth factor (HGF) pathways,Fas mediated cell apoptosis signaling pathways,phosphatidyl inositol 3-kinase (PI3K)-Akt pathways,and in which it plays different regulatory role.

Serum tumor biomarkers are significant for the early diagnosis and treatment,preoperative evaluation,prognosis prediction and relapse surveillance of endometrial carcinoma.Recently,serum CA125 and human epididymal secretory protein 4 are widely recognized as closely related with staging,metastasis and prognosis of endometrial cancer.In addition,the serum miRNAs are characterized by their features of high stability and specificity.Omics studies will be helpful for the general assessment of the initiation and progression of endometrial cancer.Insights into these two aspects will facilitate the identifications of new biomarkers with higher sensitivity and specificity for endometrial carcinoma.

It is generally known that postoperative pain can cause many adverse clinical effects on the patients of orthopaedic surgery such as lack of exercises of the involved limb,atrophy of the related muscles,anchylosis,osteoparosis,et al,which will ultimately affect the patient's final recovery and living quality.This paper introduces some recent advanced theories about the orthopaedic postoperative pain diagnosis,evaluation and various kinds of treatments hoping to achieve more effective perioperative analgesia in orthopaedic surgery.

Objective To investigate the relationship between serum surfactant protein-A (SP-A) and -D (SP-D) in patients with systemic lupus erythematosus (SLE) complicated with interstitial lung disease.(SLE-ILD) and its clinical significance.Methods Serum SP-A and SP-D levels of SLE patients and controis were assessed using a sensitive enzyme-linked immunosorbent assay (ELISA).The relationship between SP-A and SP-D and SLE-ILD,the correlation between SP-A and SP-D with age,disease activity index,pulmonary function test and high-resolution computed tomography (HRCT) score were analyzed.Results The level of serum SP-A and SP-D in patients with SLE is higher than that in healthy controls(P＜0.05).The level of serum SP-A and SP-D in patients with SLE complicated with ILD was higher than that in patients without ILD and healthy controls (P＜0.05).The level of serum SP-D in patients with SLE-ILD was correlated positively with HRCT score (r=0.508,P=0.004) and interstitial score (r=0.468,P=0.009),and it correlated inversely with vital capacity (%VC) (r=-0.590,P=0.001 ) and diffusing capacity of carbon monoxide (%DLCO)(r=-0.588,P=0.001 ).There was no correlation between the level of serum SP-A with SLE-ILD and HRCT score,%VC and %DLCO.The level of serum SP-D in patients with SLE-ILD correlated positively with serum IgG (r=0.376,P=0.040),and the level of serum SP-A in patients with SLE-ILD correlated positively with serum C reactive protein (CRP)(r=0.403,P=0.027).There was a positive correlation between the level of serum SP-D in patients with SLE and age (r=0.352,P=O.001 ).Conclusion The levels of serum SP-A and SP-D may be useful markers for ILD in patients with SLE.There is correlation between the level of serum SPD and HRCT score,pulmonary function test,and it is positively correlated with age and disease activity index.

Objective To discuss and analyze the reliability and validity of the application Chinese version of Caregiver Grief Scale (CGS) on caregivers of patients with advanced hepatocarcinoma. Methods To translate the original English scale into Chinese and adapt it to the culture of China, forming a Chinese CGS. Totally 330 patients were selected with advanced hepatocarcinoma who were hospitalized in a gradeⅢ, class A hospital by the convenient sampling method. They were carried out exploratory factor analysis and confirmatory factor analysis respectively. Results For Chinese CGS, the critical value of every purpose has statistical significance (P < 0.05) by comparison. Exploratory factor analysis showed:KMO value was 0.923;Bartlett's sphericity test value was 794.31;cumulative variance contribution rate was 67.532%;four common factors can be extracted. Confirmatory factor analysis showed that the structural model of the scale was good: χ2/d?=1.11<3.0,goodness of fit index=0.995,root mean square error of approximation=0.021,adjusted goodness-of-fit index=0.968,normed fit index=0.973, comparative fit index=0.957,Tucker-Lewis index=0.993,incremental fit index=0.943. Each correlation coefficient of the scale has statistical significance and expert validity is between 0.832 and 0.973. Reliability analysis shows that the total Cronbach'sαof the scale was 0.908;Cronbach'sαcoefficient of every dimension was between 0.896 and 0.913; Guttman's split-half reliability was 0.917; test-retest reliability was 0.831. ROC curve showed that when the total score of the scale ≥24.5, specificity and sensitivity were good. Conclusions Chinese version of CGS has good reliability and validity, which is suitable for preliminary screening grief emotion of caregivers of patients with advanced hepatocarcinoma.

OBJECTIVE:To provide reference for the timely and accurate judgment of drug fever induced by Piperacillin sodi-um and tazobactam sodium for injection and rational drug use in the clinic. METHODS:The medication,clinical manifestations, laboratory examination results and the physician treatment of 30 inpatients with drug fever induced by Piperacillin sodium and tazo-bactam sodium for injection from Sept. 2013 to Sept. 2014 were analyzed retrospectively and statistically. RESULTS:Most of the drug fever induced by Piperacillin sodium and tazobactam sodium for injection occurred in continuous 7 to 14 d medication,and the cumulative dosages were between 1.3 to 2.7 g/kg;73.3% of the 30 patients had fever during the intravenous drip,with body temperature mainly≥38.5 ℃;the elevation of eosinophil and slightly increase of serum C-reactive protein (CRP) and blood cell sedimentation rate (ESR) could be used as observation indexes of drug fever,but the leucocyte reduce could’t be suitable;the body temperature dropped to normal within 24 to 48 hours after stopped using it. CONCLUSIONS:The drug fever induced by Piperacillin sodium and tazobactam sodium for injection has no correlation with the patients’gender or age,and no special diagnos-tic criteria. But it has certain correlation with duration of medication,cumulative days and dosages and it can be used as reference of judgment with the combination of hematological examination index. Clinicians should improve the understanding and attention about drug fever to stop using suspicious drug in time.

Background and purpose:High frequency loop electrosurgical excision procedure(LEEP)has been widely used in the treatment of cervical intraepithelial neoplasia. The purpose of this study was to explore the value of loop electrosurgical excision procedure in the diagnosis and management of CINⅢ and stage ⅠAl cervical carcinoma.Methods:A retrospective analysis was carried out in 396 cases of CINⅢ and cervical carcinoma with stage ⅠAl undergoing operation and loop electrosurgical excision procedure between January 2003 and October 2006 at Obstetrics and Gynecology Hospital of Fudan University.Results:The coincidence rate of the multiple biopsies before the procedures compared with the conization ones was 88.6 % (351/395). The incidence of residual disease was 10.2%(6/59) and 7.7 % (6/78), respectively in patients with positive margins and negative margins.Conclusions:Loop electrosurgical excision procedure can improve both the diagnosis and treatment of CINⅢ and cervical carcinoma stage ⅠAl. We should offer further treatment properly to the cases with positive margin because of the persistent lesions.