The high mobility group A2 (HMGA2) is a non-histone chromatin protein. It has no transcriptional activity of itself but could alter chromatin structure to regulate the transcription of other genes. HMGA2 gene is weakly expressed or does not express in normal tissues. The expression of HMGA2 is up-regulated during embryogenesis and malignant neoplasias. In several malignant tumors, HMGA2 is used as a diagnostic molecular marker or an independent prognostic indicator. Furthermore, HMGA2 not only elicits epithelial-mesenchymal transition but also maintains the differentiation potential and self-regeneration capability of stem cells. It plays an important role in initiation, proliferation, and metastasis of malignant neoplasias.

ObjectiveTo investigate the clinical efficacies of ultramicro needle knife plus Maitland technique in treating knee osteoarthritis.MethodEighty patients were randomly allocated to observation and control groups, 40 cases each. The observation group received ultramicro needle knifeplus Maitland technique and the control group, Maitland technique alone. The subjects’ symptoms were scored using the Visual Analogue Scale (VAS) and the Lysholm Knee Score Scale (LKSS) before and after four and six weeks of treatment. The clinical therapeutic effects were evaluated in the two groups.ResultAfter four weeks of treatment, the total efficacy rate was 91.9% in the observation group (37patients) and 76.3% in the control group (38 patients); there was a statistically significant difference between the two groups (P<0.01). The VAS score and the LKSS score improved significantly in the two groups compared with before treatment (P<0.01) and improved more in the observation group than in the control group (P<0.01). There were no statistically significant differences in the VAS score and the LKSS score between after six and four weeks of treatment in the observation group (P>0.05). There were statistically significant differences in the VAS score and the LKSS score between after six and four weeks oftreatment in the control group (P<0.05). No adverse reactions occurred during the whole treatment course.ConclusionUltramicro needle knife plus Maitland technique is significantly superior to Maitland technique alone and can markedly relieve the pain and dysfunction in patients with knee osteoarthritis. It is characterized by short time to produce an effect, a lasting therapeutic effect and high safety.

The study was undertaken to determine whether low dose of endotoxin could induce rat brain damage, and its relation to the metabolism of oxygen free radicals. Male Wistar rats were treated with E. Coli endotoxin intraperitoneally (2 mg/kg body wt). Fourteen hours later, the lipoperoxide level was markedly elevated in animals given endotoxin compared with that in the controls (5.0?1.0 vs 3.9?0.7, P

The hospital culture constrction should stick to a human-orientedconcept ,and aim to provide humanitarian brand services.Hospitals should create a favorable hospitalizing condition,and foster a standard treatment,which embodies the feathers of the present time while bearing its own characteristics .It should focus on the in-depth cultural constrction and try to carry out cultural management of the hospital,the leaders of the hospital play a critical role in the cultural constrction

Objective To investigate the pathogenesis of endometriosis by studying endometriosis coexisting with variable genital tract anomalies and analysis the association between obstructive or nonobstructive anomalies with endometriosis.Methods From January 2000 to April 2010,a total of 67 cases of endometriosis coexisting with genital tract anomalies undergoing treatment in Peking Union Medical College Hospital were studied retrospectively.Results According to subtypes of concurrent genital tract anomalies,67 cases were divided into 19 cases in obstructive group and 48 cases in non-obstructive group.(1) Age and symptoms:the mean age were (22 ± 8) years in obstructive group and (32 ± 7) years in non-obstructive group,which reached statistical difference (P ＜ 0.05).The major symptoms were dysmenorrheal or chronic pelvic pain (14/19) and amenorrhea (8/19) in obstructive group.However,in non-obstructive group,the major symptoms were dysmenorrheal or chronic pelvic pain (31％,15/48) and infertility (35％,17/48) and abortion (21％,10/48).(2) Degree and incidence of endometriosis:the moderate or severe endometriosis was 11/19 in obstructive group and 40％ (19/48) in non-obstructive group,which did not show statistical difference (P ＞ 0.05).The incidence of peritoneal endometriosis,ovarian endometriosis,adenomyosis did not show significant difference between two groups (all P ＞ 0.05).The rate of moderate or severe endometriosis coexisting with duplex uterus,uterus bicornis and uterus septus did not show significant difference in non-obstructive group (P ＞ 0.05).Conclusions The severity of endometriosis showed no association with obstructive anomalies.The results implied that there might be other factors involved in pathogenesis of endometriosis.

Objective To investigate the route of minimal invasive sling procedures and evaluate their safety. Methods Tension-free vaginal tape (TVT),TVT-obturator (TVT-O) and posterior intravaginal sling (P-IVS) procedure were performed on five fresh pelvis.4% formaldehyde was used to preserve the cadavers and colored latex was injected into the vessels.An anatomic study and measurements between the trocars and related vessels or organs were carried out.Results There was no complication during all injections.The distance between TVT trocar and pubic vessels,the bladder,external lilac vessels and obturator vessels were 0.6,0.6,4.2 and 4.3 cm,respectively.Out of control of TVT trocar,the axial rotation or lateral diversion of TVT handle could injure these structures.We found during TVT-O operation,the retropubic space was not violated.The right placement of introducer was very important. When the beginning point was too deep into the anterior vaginal wall,2.2 cm proximal to urethral meatus or on a horizontal plane with a 35° angle relative to the urethral sagittal plane,the introducer would enter the retropubic space or perforate the upper posterior zone of the obturator membrane,where the obturator vessels and nerves exit the obturator canal.Based on our study,the diversion of P-IVS trocar would damage the rectum,and the pudendal vessels and nerves were relatively safe.Conclusions The TVT trocar passes the retropubic space and may injure the important vessels or organs.The route of TVT-O inside-out operation is stable and the retropubic space is not violated.The blunt design in the P-IVS trocar tips is helpful to reduce injury.

Ricin is a plant-derived ribosome-inhibitor which can be easily purified in large quantities from castor beans. It is a potent irreversible inhibitor of protein synthesis. The mode of intoxication could be inhalation, ingestion, intravenous injection.Ricin has been classified as a schedule 1 threat agent by the Chemical Weapons Convention.A fast and sensitive method for the detection of this threat agent is an important tool for preventing or dealing with the consequences of intoxication. An ideal method should be highly sensitve, highly selective, and well capable of identifying ricin in a short assay time. Several methods have been established for ricin detection. This review summaries the development of detection methods for ricin in recent years.

Objective:To explore the influence of radiofrequency ablation (RFA)on P-wave dispersion (difference between maximum and minimum P-wave interval)in patients with paroxysmal atrial fibrillation (PAF).Methods:A total of 95 PAF patients underwent circumferential pulmonary vein isolation.The preoperative and postoperative 12-lead ECG were recorded for 24h,maximum P-wave interval (Pmax)and minimum P-wave interval (Pmin)were measured,and P-wave dispersion was calculated.Since three months after operation,patients received outpatient follow up and dynamic ECG every month for six months.The operation was judged for successful or not according to symptoms of atrial fibrillation and dynamic ECG results,and patients were divided into success group (n=70)and recurrence group (n=25).Results:Compared with before operation,there was significant reduction in P-wave dis-persion [(48.84±4.08)ms vs.(42.22±4.02)ms,P <0.01]in all PAF patients after RFA.Compared with be-fore operation,there was significant reduction in P-wave dispersion [(47.63±3.58)ms vs.(40.67±4.82)ms,P<0.01]in success group;and reduction in P-wave dispersion [(49.51±1.64)ms vs.(48.26±3.48)ms]in recur-rence group,but no significant difference (P =0.346).After circumferential pulmonary vein isolation,P-wave dis-persion in success group was significantly lower than that of recurrence group (P <0.01).Conclusion:Circumferen-tial pulmonary vein ablation can improve P-wave dispersion in patients with atrial fibrillation,and it's more signifi-cant for success group.P-wave dispersion can predict the recurrence of atrial fibrillation after circumferential pulmo-nary vein ablation.

Objective To investigate characteristics of endometriotic lesions clone with various pathological subtypes by analyzing the polymorphism of X chromosome linked human androgen receptor allele (HUMARA). Methods Eight frozen tissues of endometriotic leisons were collected from 6 patients who received laparotomy or laparoscopy surgery in Peking Union Medical College Hospital from Nov. 2008 to Jun. 2009. Fifty specimens of epithelial cells from single endometrial glands were isolated and collected from endometriotic lesions by using laser capture microdissection. HUMARA was applied as the gene marker of clonal analysis. Nested palymerase chain reaction, double-enzyme digestion reaction with two methylationsensitive restriction endonuclease (Hha Ⅰ and Hpa Ⅱ), and the automated gene sequencing technique were utilized in this study to evaluate the characteristics of endometriotic lesions clone. Results Of 50 specimens of isolated glands, 34 were informative for clonal analysis, and all of which showed monoclonality. Of 3 ovarian endometriotic tissues, one tissue of HUMARA showed unuseful information, the other 2 ovarian endometriotic tissues respectively had 4 and 7 informative specimens of gland epithelial cells, and all of the glands from each tissue showed uniform clonal pattern. Two peritoneal endometriotic tissues had 1 and 5 informative specimens from individual glands, respectively; and the clonal patterns in 5 glands from the single lesion were divergent. Two abdominal wall endometriotic tissues had 7 and 6 informative specimens,respectively; and variable clonal patterns were seen in different glands from each lesion. One deep infiltrating endometriotic lesion had 4 informative specimens of isolated glands, and all of them showed unique clonal pattern. The disparate clonal patterns were found in endometriotic lesions with variable pathological subtypes, even arising from the same patient. Conclusions The epithelial cells from individual endometriotic gland showed monoclonality , and different glands from the same endometriotic lesion might show divergent patterns.

Objective To investigate clinical features and management of complicated or rare vulvovaginal anomalies derived from urogenital sinus malformation.Methods Medical documents of 6 cases with vulvovaginal anomalies treated in Department of Obstetrics and Gynecology in Peking Union Medical College Hospital in the past 10 years were reviewed retrospectively.According to embryological and anatomical characteristics,the classification system were established.Results This kind of vulvovngihal anomalies was very rare and not enrolled into current diagnosis and treatment system. All patients had a common clinical features:menstruation bleeding and urine from the same outflow tract;and two orifices on perineum were found by bimannal examination,one orifice located under clitoris,the other orifice Was anus.No vagihal vestibule and vulvar were observed between those two orifices.According to clinical features,those 6 cases were divided into 3 types:type Ⅰ Was persistence of distant urogenital sinus with clinical manifestation of simple labial fusion;type Ⅱ was low communication between vagina and urogenital sinus (infrasphincterie),presenting with distal vaginai atresia and urethrovagihal fistula;type Ⅲ was high communication (suprasphincteric) with distal vagihal atresia and more proximal urethrovavihal fistula.Type Ⅲ was frequently associated with severe rectum and anus anomaly,and other malformation as well.All patients were treated by surgical correction.Basically.the principle of operation wag to reconstruct perineal appearance,release the obstruction,and rear the defect and ultimately recovering the normal function.The alternative surgical methods should be considered individually.Conclusions The vulvovnginal anomalies derived from urogenital sinus malformation were complicated clinically.To establish classification system will be benefit for clinicians to make diagnosis and choose appropriate treatment. The individualized surgery should be performed on those patients to restore the structure and function,in the mean time,the factors associated with esthetics.sex and psychics should be considered.