Objective To investigate the efficacy of metholrexate combined with rmifepristone and laparoscopic surgery for treating ectopic pregnancy.Methods 85 patient with ectopic pregnancy were selected.41 cases treated with methotrexate and mifeprisione were considered as the control group,while 44 cases with laparoscopic surgery were considered as the observalion group on the voluntary basis.The clinical efficacy,serum β-HCG value and recovery time after 7d were compared between the two groups.Results After the treatment,the cure rate in the observation group was 100％ which was significantly higher than 90％ of the control group ( P ＜ 0.05 ),the serum β-HCG value of the observation group was lower and the restoration normal time was shorter than the control group ( P ＜0.05).Conclusions Laparoscopic surgery and conservative treatment of methotrexate combined with mifepristone are effective in the treatment of ectopic pregnancy.However,the clinical efficacy of the laparoscopic surgery is better and it has rapid recovery time,and it can completely cure the patients.

Objective To assess the curative effect and safety of endoscopic therapy at duodenum elevated lesions. Methods We retrospectively studied the clinical data including general data, the procedure of performance, the lesions pathological characters, complications and recurrence after the treatment of patients who underwent endoscopic treatment. Results 111 patients of 112 patients were treated by endoscopic treatment successfully, 1 case was treated by surgery. 49 lesions were treated by electrocoagulation, 36 lesions were treated by polypectomy or endoscopic mucosal resection (EMR), 27 by endoscopic submucosal dissection (ESD). Complication rate was 16.96%(19/112), 1 case of active bleeding was treated by surgery in hemostasis difficulty. 6 cases of perforation, 2 cases of delayed bleeding, 2 cases of transient increase in amylase level and 1 case of delayed perforation. All the patients were successfully performed. Post-operation follow-up period was 1~12 months. Conclusion Endoscopic treatment holds advantages of minimally invasive, quick recovery, low cost, and less risk which may be play an important role in duodenal elevated lesions.

Objective·To investigate and compare the curative effect of rubber ring and dental floss combined with hemoclipping assisted endoscopic submucosal dissection(ESD) on gastrointestinal tumors.Methods·A total of 54 patients with gastrointestinal tumors were collected.Twenty-seven patients in rubber ring group accepted ESD assisted by rubber ring with hemoclipping,and the other 27 patients in dental floss group accepted ESD assisted by dental floss.with hemoclipping.Duration of the operation,installation time of the traction device,detachment frequency of hemoclipping,injury of mucosa,one-time complete resection rate,and complication rate were analyzed as key indicators.Results·The detachment frequency of hemoclipping in rubber ring group was significantly less than that in dental floss group (t=4.418,P＜0.05).There was no injury of mucosa in rubber ring group,while,three patients had mucosa injury in dental floss group.There was no statistically significant difference on duration of operation,installation time of traction device,one-time complete resection rate,and complication rate between two groups.After 2 ～ 12 months of follow-up,the wound healed well in all patients in rubber ring group.No evidence of tumor recurrence was noted.Conclusion·Compared with dental floss,rubber ring combined with hemoclipping is superior in assisted ESD,especially in the right half colon.It is an effective assist device with little trauma and adjustable direction.

OBJECTIVE:To investigate the effect of different processing methods on 4 kinds of flavonoids contents in salt-pro-cessed Cuscuta chinensis. METHODS:Salt-processed C. chinensis piece was processed with different baking temperature (70 ℃, 100℃,130℃,160℃,190℃and 210℃),baking time(10 min,15 min,30 min,45 min,60 min and 75 min)and moisten-ing time(0.5 h,1 h,2 h,4 h and 6 h). HPLC was adopted for contents determination of hyperoside,rutin,quercetin and kaemp-ferol:the column was Synergi 4u Hydro-Rp 80A with mobile phase of methanol- 0.1% phosphoric acid (gradient elution) at a flow rate of 1.0 ml/min,the detection wavelength was 360 nm,and column temperature was 35 ℃. RESULTS:The linear range was 0.416-12.48 μg for hyperoside (r=0.999 9),0.14-4.2 μg for rutin (r=0.999 9),0.185-5.55 μg for quercetin (r=0.999 9) and 0.078-2.34 μg (r=0.999 8);RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 95.55%-99.74%(RSD=2.12%,n=6),95.96%-101.42%(RSD=2.01%,n=6),95.76%-102.75%(RSD=2.77%,n=6), 99.42%-104.93%(RSD=2.02%,n=6). The flavonoids in salt-processed C. chinensis showed highest contents when baking tem-perature was 160℃,baking time was 60 min and moistening time was 2 h. CONCLUSIONS:Different processing methods have certain effects on flavonoids contents in salt-processed C. chinensis.

Objective To explore the application of furosemide/hydrochlorothiazide load test in clinical classification of Bartter syndrome and Gitelman syndrome and the significance of selecting target genes. Method The clinical features, biomarkers, the furosemide/hydrochlorothiazide load test, and gene detection in 5 patients with Bartter syndrome and Gitelman syndrome were retrospectively analyzed during 2012 to 2014. Results All of those 5 patients were manifested low potassium and metabolic acidosis; basis of renin, angiotensin II, and aldosterone were elevated. The blood pressures were normal. Most of the patients suffered from polydipsia, diuresis, and different degrees of growth retardation. The gene analysis of these 5 patients made the same diagnoses as furosemide/hydrochlorothiazide load test did. Conclusions Furosemide/hydrochlorothiazide load test can make a differentiation of Bartter syndrome from Gitelman syndrome and thus it can guide the selection of targeted gene detection.

Objective To study the immune system regulatory effects of CD8+CD28-regulatory T lymphocytes in an experimental bone marrow mesenchymal stem cell treatment of autoimmune encephalomyelitis.Methods A model of autoimmune encephalomyelitis (EAE) was established in twenty-eight C57BL/6 female mice,6 to 8 weeks old weighing 16 to 20 g using myelinoligodendrocyte glycoprotein 35-55 amino acid peptide (MOG35-55).The mice were randomly divided into a phosphate-buffered solution (PBS) group (n =7),an MSCs-Low group [n =7 which received an injection of 2× 105 mesenchymal stem cells (MSCs)],an MSCs-Med group (n=7,1× 106 MSCs),and an MSCs-High group (n=7,5×106 MSCs).Their clinical condition was then evaluated daily.On the 15th day after the MOG35-55 immunization,the different MSC doses were administered intravenously via the tail.On the 30th day the mice were sacrificed to observe any neuropathology of the spinal cord.At the same time,FACS flow cytometry was used to assay CD8+CD28-T cells in the spleen.Results Compared with the PBS control group,the MSC treatment effectively alleviated illness among the mice by the 15th day after the immunization.The maximum and average disease scores and clinical illness scores had all improved significantly.The medium dosage worked best.Neuropathological analysis showed that the MSC treatment could significantly reduce the invasion of inflammatory cells and minimize demyelination in the spinal cord.Furthermore,the CD8+ CD28-regulatory T cells in the spleens of the MSCtreated animals increased compared with the PBS control group,though the secreted levels of IL-10 showed no obvious difference.Conclusions Treatment with MCSs can promote the recovery of neural function in autoimmune encephalomyelitis,at least in mice.CD8+CD28-regulatory T cells may not be the main effector cells,playing only a synergistic therapeutic role.

OBJECTIVE To investigate the correlation of S-phase kinase associated protein 2 (Skp2) and p27 expression with the clinical factors and prognosis of patients with laryngeal squamou cell carcinoma (LSCC). METHODS The expressio of Skp2 and p27 in 79 specimens of LSCC and 1 specimens of adjacent normal laryngeal mucos tissues were evaluated by SP immunohistochemist methods. RESULTS The overexpression rate Skp2 was significantly higher in LSCC(53.16 %) tha in adjacent normal laryngeal mucosa tissue (0 % (P

Objective To explore the feasibility of coronary computed tomographic angiography (CCTA) for obese patients with lower tube voltage (100 kV) and lower contrast media concentration (270 mgI/ml) using iterative reconstruction.Methods A total of 48 patients with body mass index greater than 30 kg/m2 were included and randomly divided into 2 groups according to random number table method.The images of the control group were obtained using iodine 370 mgI/ml, a tube voltage of 120 kV, and traditional filtered back projection (FBP) image reconstruction.Patients in the test group were injected with isotonic low concentration contrast media (270 mgI/ml), scanned with a lower tube voltage (100 kV), and adaptive iterative noise reduction image reconstruction algorithm (AIDR-3D) was used.Two experienced physicians scored the image quality in a double-blind way.Independent sample t-test was used to compare the effective dose (E), average CT values, signal to noise ratio (SNR), contrast to noise ratio (CNR), the figure of merit (FOM), image quality scores and the total iodine intake.Side effect was also evaluated.Results The subjective scores for control group and test group were not significantly different (P ＞ 0.05).The scores of two physicians were consistency (Kappa =0.88, P ＜ 0.05).The average CT values, SNR and CNR for the two groups were not significantly different (P ＞ 0.05), but the FOM of the test group was significantly higher than that of the control group (t =-9.250,-8.604,-9.158,-5.341, P ＜ 0.05).Effective dose in the test group was (1.61 ± 0.41) mSv, lower than that of the control group (t =8.373, P ＜ 0.01).The total iodine and iodine injection rate in the test group were both lower than in the control group (t =7.628, 8.480, P ＜ 0.01).The incidence of contrast mediarelated discomfort in the test group was lower than control group (x2 =18.70, 6.25, P ＜ 0.05).Conclusions For obese patients, isotonic low concentration of contrast media and low-dose CCTA could be feasible, which substantially reduce the radiation dose and iodine intake without sacrificing image quality.Trial registration Chinese clinical trial registry, ChiCTR-DPD-15007510.

Objective To study the effect on body mass index ( BMI ) caused by treatment with Gonadotropin-releasing hormone analogs ( GnRHa) in girls with central precocious puberty ( CPP) or early and fast puberty ( EFP ) . Methods The BMI in 318 girls ( 227 CPP and 91 EFP ) treated with GnRHa alone was analyzed. Among them 89 were followed up to their final adult height. Results Before GnRHa treatment was started, thegirlswithCPPandEFPhadameanBMIstandarddeviationscore(SDS)forchronologicalage(BMISDSCA)of0.39 ±0.84andforboneage(BMISDSBA)of-0.11±0.69. Attheendoftreatment,themeanBMISDSCAwas0.59±1.01 and BMISDSBA was 0. 24 ± 0. 89, both were significantly higher than those at initiation. The increment in BMISDSBA (0.38±0.50)wasgreaterthanthatinBMISDSCA(0.21±0.56). Moreover,theratioofoverweight(BMI>85%)was significantly elevated. BMISDSCA of 89 girls who were visited at their final adult height was 0. 17 ± 1. 15, which was similar with BMISDS at initiation and in normal population. Conclusion The mean BMISDSCA of CPP and EFP was significantly higher than the general population, while BMISDSBA was significantly lower. During GnRHa treatment, BMISDS tended to be elevated. But it was reversible, for the mean BMISDS was back to normal at final adult height.

Objective To assess the effect of early menarche and treatment with gonadotropin-releasing hormone analogs ( GnRHa ) in girls with central precocious puberty ( CPP ) or early and fast puberty ( EFP ) on menstrual regularity. Methods Six hundred and ten healthy girls were recruited and their menarche age and menstrual cycle were recorded. 169 CPP or EFP girls treated with GnRHa were followed up, and their menarche age and menstrual cycle were also recorded. Results There were 129 girls with irregular menstruation among 610 healthy girls(21. 1%), with 10 in 44 early menarche girls(22. 7%) and 11 in 44 late menarche girls(25. 0%). Compared with normal menarche girls(17. 2%), no significant difference was found in the incidences of irregular menstruation in early and late menarche girls. The incidences of dysmenorrhea were 41. 1% in normal girls and 50. 0% in early menarche girls, without significant difference. There was a higher incidence of irregular menstruation in 113 CPP girls and 56 EFP girls treated with GnRHa compared with healthy girls (31. 4% vs 21. 1%, P<0. 05), but without difference compared with early menarche girls(P>0. 05). Fifty-seven cases treated with GnRHa(33. 7%) suffered from dysmenorrhea, and there was no significant difference as compared with healthy girls and girls with early menarche. Conclusion The incidence of irregular menstruation was similar in early menarche girls and normal girls. CPP and EFP girls with GnRHa treatment had a significantly higher incidence of irregular menstruation than normal girls, but no difference was found as compared with girls with early menarche. Early menarche and GnRHa treatment did not affect the incidence of dysmenorrhea.