OBJECTIVE:To evaluate the quality of Bifonazole Gel from different manufacturers. METHODS:HPLC was per-formed on the column of Diamonsil C18 with mobile phase of methanol- water- tetrahydrofuran(75∶24∶1,V/V/V)at a flow rate of 1.0 ml/min,detection wavelength was 254 nm,column temperature was 23 ℃,and the injection volume was 10 μl. RESULTS:The linear range of bifonazole was 50-600 μg/ml (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 1%;recovery was 97.71%-101.68%(RSD=1.16%,n=9). The contents of Bifonazole gel samples from 3 manufacturers were more than 10 mg/g,with little difference. CONCLUSIONS:The method is simple and accurate with good separation and re-producibility,and suitable for the content determination of Bifonazole gel. The investigated contents of products from different man-ufactures conform to relevant standards.

Objective To evaluate the relationship of biological status of HPV 16 and expression of L1 protein with the degree of cervical tumorigenesis.Methods Sixty-one patients with cervical lessions were enrolled and divided into five groups according to pathology of cervical lesions,including chronic cervicitis(n = 27),cervical intraepithelial neoplasia(CIN) Ⅰ-Ⅱ(n = 10),carcinoma in situ(n = 8),early-stage(n =7)and mid/late-stage(n = 9)of cervical carcinoma.HPV type and its biological status were detected by PCR amplification,and L1 protein in HPV 16 positive tissues was detected by Western blot.Kruskal-Wallis was used to compare between the groups,and Pearson correlation analysis was used to evaluate the relationship of HPV biological status and L1 protain expression with cervical lesions.ResultsFifty-three out of 61 patients with cervical lesions were detected with HPV positive(86.9%).All 25 patients with chronic cervicitis were in HPV free mode; in CIN Ⅰ-Ⅱ group,6 patients were in free and 2 in integral mode; in carcinoma in situ group,1 patient in free,3 in mixed and 3 in integral mode; in the early-stage cervical cancer group,2 patients in mixed and 4 in integral mode; in mid/late-stage cancer group,1 patient in mixed and 6 in integral mode.A strong positive correlation was found between the HPV in integral mode and the severity of cervical lesions(r = 0.705,P ＜0.01).The expression of L1 protein was negatively correlated with the aggravation of cervical lesions in HPV 16-positive patients(r = -0.755,P ＜0.01).Conclusion The integral mode of HPV16 and low expression of L1 protein may have predictive value for the severity of cervical lesions.

Objective: To investigate the trends in incidence of stroke in Jindong District, Jinhua City, Zhejiang Province from 2016 to 2022, so as to provide to the evidence for improving the stroke control strategy. Methods: The incidence of stroke in Jindong District from 2016 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The gender-, age- and subtype-specific incidence of stroke was calculated, and the trends in stroke incidence were investigated with average annual percent change (AAPC). Results: A total of 9 159 stroke cases were reported in Jindong District from 2016 to 2022, with crude incidence of 386.52/105 and standardized incidence of 276.75/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=3.704%, 95%CI: 0.792%-6.700%, P<0.05), while the standardized incidence showed no significant changing patterns (P>0.05). The crude incidence of stroke was significantly higher among men than among women (438.69/105 vs. 334.66/105; χ2=14.028, P<0.05), and the standardized incidence of stroke was significantly higher among men than among women (316.58/105 vs. 237.31/105; χ2=6.985, P<0.05). The crude incidence of stroke appeared a tendency towards a rise with age（χ2=5 290.180, P<0.05), and the crude incidence of stroke appeared a tendency towards a decline with age among residents at ages of 45 to 64 years (AAPC=-9.135%, 95%CI: -15.003% to -2.861%, P<0.05), while no significant changing patterns were found in the crude incidence of stroke among residents at other age groups (P>0.05). The crude incidence of ischemic stroke was significantly higher than that of hemorrhagic stroke (306.08/105 vs. 76.89/105; χ2=137.184, P<0.05). Conclusions The incidence of stroke appeared a tendency towards a rise in Jindong District from 2016 to 2022, with ischemic stroke as the predominant subtype. Male and middle-aged and elderly populations should be given a high priority for stroke control.

OBJECTIVE:To evaluate the effects of different doses of flurbiprofen axetil on analgesia effects of patients after laparoscopic cholecystectomy. METHODS:120 patients undergoing laparoscopic cholecystectomy were selected and randomly divid-ed into group A,B and C,with 40 cases in each group. Group A,B and C were given the mixture 100 ml of flurbiprofen axetil 100,150 and 200 mg combined with tramadol 600 mg and ondansetron 4 mg respectively and 0.9% Sodium chloride injection for patient controlled intravenous analgesia(PCIA)at the end of operation. Mean arterial pressure(MAP),heart rate(HR)and static and dynamic visual analogue scale(VAS)scores were observed in 3 groups at the end of operation,4,8,24 and 36 h after sur-gery. The incidence of incision pain,neck-shoulder pain and hypochondrium,the occurrence of ADR were recorded 36 h after oper-ation. RESULTS:After operation,There was no statistical significance in comparison of 3 groups with MAP,HR,static and dynam-ic VAS(P>0.05),4,8,24,and 36 h after operation,MAP,HR,static and dynamic VAS score of group B and C decreased sig-nificantly,there was statistical significance,compared with group A(P<0.05);there was no statistical significance in above indi-cators between group B and group C(P>0.05). After operation,the incidence of incision pain,neck-shoulder pain and hypochon-drium in group A were significantly higher than group B and C,with statistical significance(P<0.05),but there was no statistical significance between group B and group C(P>0.05). After operation,the incidence of ADR in group A and B were significantly lower than in group C,with statistical significance(P<0.05),but there was no statistical significance between group A and group B(P>0.05). CONCLUSIONS:Flurbiprofen axetil 150 mg combined with tramadol 600 mg and ondansetron 4 mg can improve he-modynamics and patient controlled intravenous analgesia in patients underwent laparoscopic cholecystectomy with lower incidence of ADR.

Objective For Genistein has been reported to inhibit many tumors ,we investigate the role of autophagy in the proliferation inhibition to Hela cells by Genistein and the machanism of autophagy plays in this process.Methods Human cervical cancer Hela cells were divided into control group,Genistein group and 3-MA+Genistein group,the control group were cultured in RPMI 1640 medium supplemented with 10% fetal bovine serum(FBS),Genistein group were cultured in various concentrations Genistein(25,50,100μmol/L),3-MA+Genistein group were treated with 5mmol/L 3-MA for 1h before cultured in 100μmol/L Genistein.The proliferation inhibitory rate of Hela cells was detected by MTT method.The ultrastructure changes of Hela cells was observed under transmission electronic microscope(TEM).The levels of autophagy-associated protein P62 and Beclin-1 were detected by Western blotting analysis.The expressions of autophagy-associated proteins LC3A/B in Hela cells were determined by fluorescent staining to analyse the autophagy induced by Genistein in Hela cells.Results Compared with control group ,the proliferation inhibitory rate of Hela cells was 20.9%±1.3%,33.5%±1.6% and 46.5%±3.2% when cultured in 25,50,100μmol/L Genistein(P<0.01).After treated with various concentrations Genistein for 48h, we observed a dose-dependent increase in the expression of Beclin-1 and decrease of P62.Confocal laser scanning microscopy confirmed the fluorescent density of LC3A/B expression in Hela cells treated with 100μmol/L Genistein increased significantly as compared with control group.TEM showed there are many vacuoles and double-membrane autophagosomes which involved cytoplasmic components in Hela cells treated with 100μmol/L Genistein.The proliferation inhibitory rate of Hela cells of Genistein group is decreased as compared with those in 3-MA+Genistein group[(46.5±3.2)% vs (58.2±2.2)%,P<0.01].Conclusion Genistein could inhibit Hela cells proliferation and induce autophagy.

Lifitegrast is a novel inhibitor of integrin,which can take effect by blocking the binding of intercellular adhesion molecule 1 and integrin lymphocyte function associated antigen 1.In July 2016,the U.S.Food and Drug Administration (FDA) officially approved the application of lifitegrast ophthalmic solution 5％ (commodity name XiidraTM).Clinical trials of the drug include a 12-week phase II clinical trial and three 12-week phase III clinical trials for dry eye disease patients.The results of clinical trials have demonstrated the efficacy and safety of the drug.Lifitegrast is the first FDA approved drug to improve and treat dry eye symptoms,and other similar drug is only cyclosporine.It is believed that in the near future clinical application of lifitegrast will be more extensive.

Objective To explore the diagnostic value of whole?body bone scan combined with SPECT/CT imaging for osteofibrous dysplasia( OFD) . Methods A total of 30 patients ( 14 males, 16 fe?males, age range 10-48 ( average age 29.2) years) with OFD confirmed by pathology from June 2007 to De?cember 2014 were included. The images of whole?body bone scan and SPECT/CT imaging were retrospec?tively analyzed. Results Nineteen patients (63.3%, 19/30) showed monostotic OFD, which mainly in?volved extremities (n=18), especially the femur. Eleven patients(36.7%, 11/30) showed polyostotic OFD, which frequently be seen unilaterally (n=7). Highly or obviously abnormal uptakes of radiotracer were shown in most lesions (95.3%, 81/85) on whole?body bone planar images, the ribs and extremities showed abnormal uptake along the backbone orientation, while the cranium, pelvis and spine showed irregu?lar bulky uptake of radioactivity. On SPECT/CT images, the lesions of high or obvious abnormal uptake of radiotracer mainly showed cystic expansion growth, ground glass, vegetable sponge and mixed appearance;and the higher the radioactive aggregation degree was, the more the morphological changes were. The density and morphological changes on CT were not obvious for lesions with moderately and mildly abnormal uptake of radiotracer. Conclusion The whole?body bone scan combined with SPECT/CT imaging is an effective diag?nostic method for OFD.

Objective To summarize the SPECT/CT manifestation of spondylitis caused by Brucells infection and to evaluate the diagnostic value.Methods From June 2012 to October 2015,a total of 28 patients (14 males,14 females,average age 46.4 years) with Brucellosis spondylitis confirmed by laboratory test and pathology were included.The images of whole-body bone scan and SPECT/CT fusion imaging were retrospectively analyzed.According to the pathological and serologic test results,the diagnostic efficacy of imaging was calculated.x2 test was used.Results Most of the Brucellosis spondylitis happened in the lumbar(76.7％,43/56),and the most common locations were L3,L4,L5 (72.1％,31/43).Two or more involved consecutive vertebra were found in 71.4％ (20/28) of the patients.Moderate radioactive distribution was showed in 89.2％ (50/56) of lesions,high radioactive distribution was showed in 5.4％ (3/56) of lesions,and mild radioactive distribution was showed in the rest 3 lesions.Thirty-three lesions(58.9％,33/56) had diffuse increased radioactivity uptake in the affected vertebra,and 32.1％(18/56) showed diffuse increased radioactivity at the superior and inferior margin of the vertebra;only 8.9％ (5/56) of lesions were on one side of the vertebral bodies.The SPECT/CT results were as follows:(1) Bone destruction was showed in 80.4％ (45/56) of lesions,and the edge of the lesion was clear.(2) For 66.7％ (30/45) of lesions,bone hyperplasia was seen along with bone destruction and moderate radioactivity concentration on the edge of destruction area.(3) The damage of the intervertebral disc was mild,and the vertebral abscess was relatively rare (5.4％,3/56).The diagnostic accuracy of SPECT/CT was statistically higher than that of whole-body bone scan:67.8％(38/56) vs 96.2％(54/56);x2=13.1,P＜0.05.Conclusion SPECT/CT imaging has a higher diagnostic efficiency than whole-body bone scan in Brucellosis spondylitis.

Objective To investigate the perinatal outcome of fetus with increased nuchal translucency (NT) at first trimester.Methods The thickness of NT above 95th percentile of the fetuses with same crown-rump length (CRL) was set as the criteria of increased NT.The outcomes of fetuses with increased NT during early pregnancy from Jan.2008 to Dec.2009 in Guangzhou Women and Children's Medical Center were followed up.The information of ultrasound at second trimester,pregnant complications and delivery outcome were collected.All infants were followed up for 3 months after birth and were divided into four groups according to their different thickness of NT.The relationship between NT thickness and perinatal outcome were analyzed with single factor analysis of variance and multiple comparison method.Results Among the 178 cases we followed up,there were 2 spontaneous fetal losses and 19 terminations whose reasons were Down syndrome (n=6),severe a thalassemia (n =5),fetal malformations (n =7) and social factor (n =1).Among the 157newborns delivered,one was found with congenital heart disease.The rate of abnormal infants was 11.8％ (21/178) and the detection rate of abnormal infants was 9 5.2％ (20/21).Healthy living rate of fetus with NT thickness between 95th percentile and 2.9 mm was 96.1％ (122/127); 82.4％ (28/34) for those with NT thickness between 3.0 mm and 3.9 mm; and 35.3％ (6/17) when NT≥ 4.0 mm.Conclusions Increased NT might have close relationship with poor pregnant outcome.The thicker the NT,the lower the healthy living rate of the fetus.The pregnant outcome is very poor if NT≤4.0 mm.

Objective To analyze the clinical features of takayasu's arteritis in elderly patients for improving their general management.Methods Twenty-six patients,aged over 60 years,with takayasu's arteritis were enrolled.The clinical manifestations and medical records were collected in detail and analyzed retrospectively.Results The mean age of the patients in our study was 64.0±3.8 years,four males and twenty-two females.Of all patients,nine were accompanied by coronary heart disease,seven by primary hypertension,four by diabetes mellitus,two by arrhythmia and one by subacute infective endocarditis.The frequent clinical manifestations were hypertension (n = 21,81%),dizzy (n=12.46%),chest pain (n=9,35%),pulselessness or weak pulse (n=7,27%).The clinical classification of this group showed brachiocephalic artery type (n = 8,30%),abdominal aorta type (n=4,15%),extensive type (n=11,58%) and pulmonary artery type (n=3,12%).Ten patients had elevated ESR level,six had elevated CRP level and fourteen had elevated ASO level.Two patients with diabetes mellitus died of serious complications.Conclusions Takayasu's arteritis in the elderly is usually accompanied by other cardiovascular diseases and risk factors.It is important to enhance the comprehensive treatment of these patients.