Objective To compare the safety and effectiveness of three types of intrauterine device (IUD) inserted immediately after artificial abortion.Methods A randomized controlled clinical trial was performed in 4 family planning service stations in Pudong New Area from January to December 2012.Total 1 200 eligible women were randomly assigned to receive three types of IUD:MYCu,TCu380A or G-Cu200 (n =400 in each group) immediately after vacuum aspiration.All subjects were followed up for 12 months.The cumulative rates of termination of three IUD after 12 months were analyzed with WHO LTA 2.0 life table.Results Total 1 199 subjects were followed up for 12 months with a drop-out rate of 0.08％ (1/1 200).No any uterine perforation was found.During the 12 months the pregnancy rates with IUD in situ in MYCu,TCu380A and G-Cu200 groups were 0.26/100 women year,0 and 0.52/100 women year,respectively (x2 =1.951,P ≥ 0.2).The rates of expulsion in three groups were 0.26/100 women year,1.84/100 women year and 2.05/100 women year,respectively(x2 =5.539,P =0.066).The remove rates related to bleeding and paining in three groups were 1.26/100 women year,7.29/100 women year and 2.76/100 women year,respectively (x2 =21.625,P =0.001).The discontinuation rates related to IUD use in there groups were 3.25/100 women year,9.00/100 women year and 5.50/100 women year,respectively(x2 =12.191,P =0.004).The rates of Abnormal position in three groups were 1.51/100 women year,0 and 0.26/100 women year,respectively (x2 =8.649,P =0.014).Conclusion Three IUDs inserted immediately after vacuum aspiration are all effective.Among three IUDs,MYCu shows lower expulsion rate,lower discontinuation rate related to IUD use and higher continuous rate; but the abnormal position rate of MYCu is higher than other two types IUD.

Objective To explore the epidemiological characteristics of adult allergic diseases,looking for risk factors of allergic airway disease in Shiqi District of Zhangshan,and to provide a scientific basis for the development of community health education.Methods The questionnaire which was designed by national respiratory allergic diseases research and epidemiological survey collaboration group was carried out,and the random cluster sampling method was used to extract a total of 2 000 adults from Shiqi District of Zhongshan City,and the questionnaires,physi calexamination,and laboratory tests were taken.Results In Shiqi District of Zhongshan,the incidence rate of adult respiratory allergic disease was 10.4％,including allergic rhinitis,allergic pharyngitis and allergic asthma,accounted for 54.33％,33.65％ and 12.02％.Most common cause is smoking and keeping pets.Among respiratory allergic disease population,smoking accounted for 28％ and keep pets accounted for 17.8％.Common allergens are mites,cockroaches,animal fur and flowers.Leather pilot assassination test positive rate of respiratory allergic disease population was 37.50％,including mites,cockroach accounted for 23.08％,7.21％ of animal fur,flowers accounted for 6.25％.Conclusion In Shiqi District of Zhongshan,adult respiratory allergic disease prevalence is same as the country,the majority is respiratory diseases.The most common cause is smoking and keeping pets.The most common allergens are mites,cockroaches,animal fur and flowers.The incidence maybe related to life behavior and the living environment.

Objective To investigate the effect of suberoylanilide hydroxamic acid (SAHA) on sufentanil postconditioning-induced cardioprotection in rats with type 2 diabetes mellitus (T2DM).Methods Male SPF Sprague-Dawley rats,weighing 250-300 g,aged 5-6 weeks,were used in the study.T2DM was induced by high-fat diet (4 weeks) and intraperitoneal 1％ streptozotocin 35 mg/kg,and confirmed by fasting blood glucose level≥ 16.7 mmol/L.Forty rats with T2DM were divided into 5 groups (n=8 each) using a random number table:sham operation group (grou T2DM-S);ischemia-reperfusion group (group T2DM-I/R);sufentanil postconditioning group (group T2DM-SP);SAHA group (group T2DM-SA);SAHA plus sufentanil postconditioning group (group T2DM-SASP).In T2DM-SA and T2DM-SASP groups,SAHA 25 mg/kg was injected intraperitoneally once a day for 5 consecutive days before operation.Their hearts were excised and retrogradely perfused in a Langendorff apparatus.The hearts were subjected to 30 min of global ischemia followed by 120 min of reperfusion to establish the model of ischemia/reperfusion injury.At 30 min of equilibration and 30,60 and 120 min of reperfusion,the left ventricular systolic pressure (LVSP),heart rate (HR),and the maximum rate of increase and decrease of ventricular pressure (±dp/dtmax) were recorded.At 120 min of reperfusion,the left ventricular mass (LVM) and infarct size (IS) were measured,and IS/LVM ratio was calculated.The expression of glycogen synthesis kinase 3β (GSK-3β) and phosphorylated GSK-3β (p-GSK-3β) in the myocardium was detected by Western blot.Results Compared with group T2DM-S,the LVSP,HR and ±dp/dtmax were significantly decreased,the IS and IS/LVM ratio were significantly increased,and the expression of myocardial p-GSK-3β was significantly down-regulated in group T2DM-I/R (P＜0.05).Compared with group T2DM-I/R,the ±dp/dtmax was significantly increased,the IS and IS/LVM ratio were significantly decreased,and the expression of myocardial p-GSK-3β was significantly up-regulated in group T2DM-SASP (P＜0.05),and no significant change was found in the parameters mentioned above in T2DM-SA and T2DM-SP groups (P＞0.05).Compared with group T2DM-SP,the ±dp/dt was significantly increased,the 1S and IS/LVM ratio were significantly decreased,and the expression of myocardial p-GSK-3β was significantly upregulated in group T2DM-SASP (P＜0.05).Conclusion SAHA can improve cardioprotection induced by sufentanil postconditioning to some extent in the rats with T2DM.

Objective To evaluate the effect of sufentanil postconditioning on acetylated histon H3 (Ac-H3) expression during myocardial ischemia-reperfusion (I/R) in rats.Methods Thirty-six adult male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 3 groups (n =12 each) using a random number table:sham operation group (S group),I/R group,and sufentanil postconditioning group (SP group).Myocardial I/R was induced by 30 min occlusion of the left anterior descending branch of the coronary artery followed by 120 min reperfusion in anesthetized rats.Sufentanil 1 μg/kg was injected through the femoral vein at 5 min before reperfusion in group SP,while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 120 min of reperfusion,and the myocardial specimens were obtained from the anterior wall of the left ventricle for determination of myocardial infarct size and cell apoptosis (by TUNEL),and myocardial specimens were obtained from the apex for detection of Ac-H3 expression (using Western blot).Apoptotic index was calculated.Results Compared with S group,the myocardial infarct size and apoptotic index were significantly increased,and Ac-H3 expression was down-regulated in I/R and SP groups (P＜0.05).Compared with I/R group,the myocardial infarct size and apoptotic index were significantly decreased,and Ac-H3 expression was up-regulated in SP group (P＜ 0.05).Conclusion Sufentanil postconditioning attenuates myocardial I/R injury through up-regulating AcH3 expression and restoring histone acetylation in rats.

Objective It has been known that hepatopulmonary syndrome(HPS) is related to the imbalance between vasoconstrictors and vasodilators. The aim of the study is to examine the levels of plasma calcitonin gene related peptide (CGRP) and endothelin(ET) in patients with HPS for exploring their roles in HPS formation. Methods The levels of CGRP and ET were measured by radioimmunoassay in 16 cases of HPS, 30 cases of liver cirrhosis without HPS and 15 normal controls. Results The levels of plasma CGRP ((65?15)pg/ml) and ET((78?21)pg/ml) in 16 cases of HPS were significantly higher than those in liver cirrhosis (CGRP (51?15) pg/ml, ET (60?14) pg/ml) and in healthy controls (CGRP (32?12) pg/ml, ET (36?11) pg/ml) ( P 0.05). Conclusions The increase of plasma CGRP and ET is closely associated with the intrapulmonar vascular dilation of HPS and hypoxemia. The levels of plasma CGRP and ET in liver cirrhosis were significantly higher than those in healthy controls ( P

The application of real-time three-dimensional echocardiography (RT 3DE) in the diagnosis of double orifice mitral valve (DOMV) was explored. Five cases of DOMV were examined by using 2-dimensional echocardiography (2DE) and RT 3DE. The spatial morphology of malformed mitral valve and its change in hemodynamics were observed. DOMV associated with partial atrioventricular septal defect was found in 3 cases (in which 2 cases had cleft mitral valve) and isolated DOMV in 2 cases; and moderate to severe mitral regurgitation was detected in 3 cases, and mild mitral regurgitation in 1, and no regurgitation in 1 case; 1 case had complicated rhumatic heart disease. Three cases were preoperatively discovered by 2DE, while 2 missed (1 case was discovered postoperatively). Four cases were diagnosed by RT 3DE preoperatively, and 1 case was diagnosed postoperatively (not examined by RT 3DE preoperatively). It was suggested that RT 3DE is a reliable technique in the diagnosis of DOMV; it permitted comprehensive and noninvasive assessment of mitral valve and may supplement 2D TTE in the assessment of DOMV.

Objective To investigate pathogenic genes related to the phenotype of fetus with severely short limbs in the first and second trimester by whole exome sequencing (WES). Methods Thirteen fetuses with severely short limbs detected by ultrasonography in the first and second trimester admitted in Chinese PLA General Hospital from September 2016 to June 2018 were collected. All cases were performed induced abortion, 6 of which were carried out karyotype analysis of amniotic fluid at the same time. WES and copy number variations (CNV) were performed on specimens from fetal tissues after labor induction. The suspected pathogenic mutations were validated by Sanger sequencing reactions. Results No abnormal karyotypes or pathological CNV were found. In 10 fetuses, pathogenic or possibly pathogenic mutations were detected in the following genes: COL2A1, FGFR3, COL1A1, COL1A2, DYNC2LI1 and TRIP11, all of which were essential to skeletal development. The diagnostic yield of WES in the fetuses with severe short limbs was 10/13. Conclusions In the first and second trimester, most of the fetuses with extremely short limbs suffer from monogenic diseases. WES is likely to be a valuable diagnostic testing option for the fetuses with severe short limbs.

Objective:To explore the effect of mind mapping teaching of gastroenterology in the standardized training for general practitioners, and provide new ideas for general practice education.Methods:A total of 65 physicians who were enrolled in the standardized training of general practice from January to December 2017 were collected as the control group, and the traditional teaching method was adopted; another 58 physicians from January to December 2018 were selected as the experimental group, and the mind mapping was adopted based on the traditional teaching method. The learning effect (theoretical and operational results) and the satisfaction questionnaire of trainees and teachers were used as evaluation indicators. SPSS 21.0 was used for t test and chi-square test. Results:The theory exam and clinical skills examination results of experimental group (80.80±5.30, 82.66±5.90) were significantly higher than those of the control group (71.60±5.20, 75.72±4.57), and the difference was statistically significant ( P<0.05). Compared with the control group, the experimental group had better understanding of knowledge points of this discipline, clinical thinking ability, higher learning interest, teamwork ability, innovation ability and teacher satisfaction, with statistical significance ( P<0.05). Conclusion:The mind mapping has more advantages than traditional teaching methods in the standardized training for general practitioners, which can be further extended.

Objective:To analyze circRNAs specifically differentially expressed in esophageal squamous cell carcinoma (ESCC) based on high-throughput sequencing data.Methods:Six patients with pathologically confirmed ESCC in Tangdu Hospital of Air Force Medical University from March 2018 to March 2019 were selected as the research subjects, among which 3 were stage Ⅰ ESCC and 3 were stage Ⅲ ESCC. High-throughput sequencing technology was used to analyze the difference in the expression of circRNA in cancer tissues and adjacent tissues of patients. GO enrichment analysis, KEGG enrichment analysis and Venn analysis were performed on differentially expressed genes. The circRNA-miRNA-mRNA network was constructed using Cytoscape software. The most significantly differentially expressed genes in cancer tissues were verified in cells and tissues, and the relationships between circRNAs and clinical pathological indicators of patients were analyzed.Results:A total of 553 differentially expressed circRNAs were screened in paracancerous tissues and cancer tissues of 3 stage Ⅰ ESCC patients, of which 413 were up-regulated and 140 were down-regulated in cancer tissues; A total of 425 differentially expressed circRNAs were screened in paracancerous tissues and cancer tissues of 3 stage Ⅲ ESCC patients, of which 276 were up-regulated and 149 were down-regulated in cancer tissues. GO enrichment analysis showed that the host genes of differential circRNAs in patients with stage Ⅰ ESCC were mainly enriched in cell cycle-related biological processes such as mitotic G 2/M transition. The host genes of differential circRNAs in patients with stage Ⅲ ESCC were mainly enriched in biological processes related to cell division and tumor development, such as mitotic spindle checkpoint and cell matrix adhesion. KEGG enrichment analysis showed that the differential circRNAs in cancer tissues of stage Ⅰ and stage Ⅲ ESCC patients were mainly enriched in cancer-related biological pathways such as cell adhesion. The results of Venn analysis showed that in stage Ⅰ ESCC patients and stage Ⅲ ESCC patients, 2 and 8 circRNAs that were only specifically expressed in paracancerous tissues and had significant differences were screened out respectively, and were only specifically expressed in cancer tissues with significant differences were 11 and 14 respectively. The circRNA-miRNA-mRNA network showed that the cancer tissue-related circRNA-miRNA-mRNA network in stage Ⅰ ESCC patients consisted of 7 circRNA nodes, 10 miRNA nodes and 28 mRNA nodes, and the cancer tissue-related circRNA-miRNA-mRNA network in stage Ⅲ ESCC patients consisted of 7 circRNA nodes, 9 miRNA nodes and 49 mRNA nodes. The most significantly differentially expressed hsa-circ-0060927 and hsa-circ-0109301 in cancer tissues of patients with stage Ⅰ ESCC and stage Ⅲ ESCC were selected for cytological and histological verification. The results showed that the relative expression levels of hsa-circ-0060927 in ESCC cell lines TE1, TE13, KYSE30, KYSE170, and human normal esophageal epithelial cell line HEEC were 7.82±1.96, 12.69±2.68, 12.78±2.74, 7.53±1.75, and 2.43±0.17, respectively, with a statistically significant difference ( F=4.68, P=0.004). The relative expression levels of hsa-circ-0060927 in ESCC cell lines TE1, TE13, KYSE30, and KYSE170 were higher than that in human normal esophageal epithelial cell line HEEC, with statistically significant differences ( P=0.009; P=0.003; P=0.003; P=0.007). The relative expression levels of hsa-circ-0109301 in ESCC cell lines TE1, TE13, KYSE30, KYSE170, and human normal esophageal epithelial cell line HEEC were 5.16±1.32, 6.28±1.57, 4.89±1.13, 8.92±2.12, and 22.56±4.13, respectively, with a statistically significant difference ( F=4.31, P=0.022). The relative expression levels of hsa-circ-0109301 in ESCC cell lines TE1, TE13, KYSE30, and KYSE170 were lower than that in human normal esophageal epithelial cell line HEEC, with statistically significant differences ( P=0.027; P=0.015; P=0.024; P=0.008). The expression level of hsa-circ-0060927 in cancer tissues of 13 early ESCC patients was 12.89±2.67, significantly higher than 5.73±1.18 in paracancerous tissue, and there was a statistically significant difference ( t=15.02, P<0.001) ; the expression level of hsa-circ-0109301 in cancer tissues of 19 patients with advanced ESCC was 7.78±2.17, significantly lower than 16.32±3.15 in paracancerous tissue, and there was a statistically significant difference ( t=9.73, P<0.001). The expression of hsa-circ-0109301 was related to the degree of tumor differentiation in advanced ESCC patients ( P=0.023) . Conclusion:One circRNA (hsa-circ-0060927 and hsa-circ-0109301) with the most significanty differential expression is selected in early and advanced ESCC patients respectively, in which hsa-circ-0060927 is highly expressed in ESCC cancer tissues and hsa-circ-0109301 is lowly expressed in ESCC cancer tissues, and the expression of hsa-circ-0109301 is correlated with the degree of tumor differentiation.

The application of real-time three-dimensional echocardiography (RT 3DE) in the diagnosis of double orifice mitral valve (DOMV) was explored. Five cases of DOMV were examined by using 2-dimensional echocardiography (2DE) and RT 3DE. The spatial morphology of malformed mitral valve and its change in hemodynamics were observed. DOMV associated with partial atrioventricular septal defect was found in 3 cases (in which 2 cases had cleft mitral valve) and isolated DOMV in 2 cases; and moderate to severe mitral regurgitation was detected in 3 cases, and mild mitral regurgitation in 1, and no regurgitation in 1 case; 1 case had complicated rhumatic heart disease.Three cases were preoperatively discovered by 2DE, while 2 missed (1 case was discovered postoperatively). Four cases were diagnosed by RT 3DE preoperatively, and 1 case was diagnosed postoperatively (not examined by RT 3DE preoperatively). It was suggested that RT 3DE is a reliable technique in the diagnosis of DOMV; it permitted comprehensive and noninvasive assessment of mitral valve and may supplement 2D TTE in the assessment of DOMV.