Objective To evaluate the middle-term effect of laparoscopic uterine artery occlusion combined with ascendant myomectomy (LUAO-M) for multiple uterine myomas. Methods The uterine artery was isolated and occluded with Kleppinger bipolar forceps (Sabre 2400,ASPEN LABS USA) or PK forceps (Gyrus Medical Limited Inc UK) under a laparoscope. Then dissection was performed on the surface of pseudo capsule with Kleppinger unipolar needle (Sabre 2400,ASPEN LABS USA) or PK needle (Gyrus Medical Limited Inc UK),and the target myoma was stripped out of the tumor bed with the Separate-Scoop device. Afterwards,repair of the incision was carried out in one layer with interrupted single stitch by Absorbable VICRYL suture (Johnson VICRYL ETHICON USA). Results The mean operation time was (102?36) min and mean blood loss was (88.7?58.4) ml. The mean hospital stay after the operation was (7.9?0.2) d,and febrile morbidity was 5.1% (5/98). Complications included two cases of subcutaneous emphysema and one case of ileus;no other severe complications occurred. Of the patients,98 cases were followed-up for 21 to 52 months (mean,36.3 months),during the period they were visited by a mean of 3.6 times,which showed a correction rate of menstruation abnormality of 95.9% (4/98),rate of uterine volume reduction of 57.7%,and rate of recurrent myoma of 3.1% (3/98). Conclusion LUAO-M shows a good clinical outcome and middle-term effect for multiple uterine myomas.

Objective To establish a biotin-streptavidin ELISA method to measure CTGF,and evaluate the clinical value of CTGF for the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients.Methods Biotinylated anti-CTGF polyclonal antibody and monoclonal antibodies were prepared for the establishment of this biotin-streptavidin ELISA method.Two hundreds and sixty-four CHB patients were subjected into non-or mild liver fibrosis group (S0-S1,108 cases) and severe liver fibrosis group (S2-S4,156 cases),according to the liver biopsy pathological diagnosis.The CTGF assay's diagnostic capacity for CHB was assessed by comparing the area under ROC (AUC) with that of a panel of hepatic fibrosis markers ( HA,PC Ⅲ,C Ⅳ,LN and APRI).Analysis of variance and rank sum test were performed to carry out comparisons between multiple groups.Student's t-test and Mann-Whitney U test were performed for the pairwise comparison between multiple samples.Spearman rank correlation test was performed to analyze the correlation between different hepatic fibrosis stages.Results The minimum detectable dose and detection rang of the ELISA was 0.2 μg/L and 0-64 μg/L respectively.The intra-assay and inter-assay CV at high and low level were 4.5％,9.8％ and 10.1％,12.8％ respectively.Serum CTGF concentrations in S0-S1 group and S2-S4 group were 6.7(3.1 - 10.1 ) μg/L and 16.1 ( 11.8 -27.2) μg/L,with a statistically significant difference (U =1 217,P ＜0.001 ).There was a significant correlation between the levels of serum CTGF and fibrosis stages ( r =0.689,P ＜ 0.001 ),AUC of CTGF was 0.841 (95％ CI:0.762 - 0.920) in distinguishing mild fibrosis from significant fibrosis.When the cut-off value of CTGF was 10.3 μg/L,the sensitivity and specification was 70.5％ and 82.4％ respectively.The sensitivity of parallel combination test of CTGF and APRI was 96.1％,which was higher than that of HA (75.6％),PC Ⅲ (70.5％ ),C Ⅳ(63.6％),LN(79.5％ ),APRI(86.3％ ).The specificity of the combination test was 65.5％,which was lower than of above liver fibrosis markers [HA ( 72.5％ ),PC Ⅲ ( 76.5％ ),C Ⅳ ( 78.4％ )].The specificity of serial combination test of CTGF and PC Ⅲ was 95.9％,which was higher than that of HA,PC Ⅲ,CⅣ,LN(64.7％ ),APRI(66.1％ ),however,the sensitivity of the combination test was 67.7％,which was lower than that of above HA,PC Ⅲ,and APRI.Conclusions The biotin-streptavidin ELISA method measuring serum CTGF has a high minimu detectable dose sensitivity,and specificity.Serum CTGF level is significantly correlated with fibrosis stage,and CTGF maybe a valuable marker for liver fibrosis assessment.The paralledl combination of CTGF and APRI could be used as screening for significant liver fibrosis markers.The serial combination of CTGF and PC Ⅲ may be considered as a confirmatory diagnostic marker for liver fibrosis.

We wished to undertake molecular characterization of the reverse transcriptase (RT) gene and overlapping surface (S) gene in lamivudine-treated patients with chronic infection with the hepatitis B virus (HBV). Sequencing analyses of the HBV RT/S gene of isolates from 25 chronic hepatitis B (CHB) patients with the YMDD mutation and 30 treatment-naïve CHB patients were undertaken. In patients with the YMDD mutation, rtM2041 was the major type of mutation (20/25, 80%). rtL80I was present in most of the patients with rtM204I (14/20, 70%). rtL180M coexisted with rtM204V (5/5, 100%). Patients with the YMDD mutation had a significantly higher prevalence of mutation of the RT gene than treatment-naïve CHB patients (P < 0.05). Classical primary resistance and secondary/compensatory mutations were detected at only five sites (rtL80, rtV173, rtL180, rtM204, rtM250) in CHB patients with the YMDD mutation. The frequency of nucleos(t)ide analog resistance (NAr) mutation within the RT gene in patients with the YMDD mutation was significantly higher than that in treatment-naïve patients (P < 0.05). Amino-acid mutations within the RT gene were also associated with other types of NAr in patients with the YMDD mutation. The rate of amino-acid variants within the S gene region was significantly higher in patients with the YMDD mutation than that in treatment-naïve patients (P < 0.05). sM133L and sG145R variants were also present in patients with the YMDD mutation. These observations suggest that CHB patients with the YMDD mutation also have NAr mutations related to other NA drugs, which might lead to cross-resistance in CHB patients. Variants present in the S gene region could cause changes in the antigenicity of HBsAg, which could result in a false-negative diagnosis of HBsAg and immune in escape of the HBV.
Adolescent ; Adult ; Antigens, Surface ; genetics ; Antigens, Viral ; genetics ; DNA Mutational Analysis ; Female ; Genetic Variation ; Hepatitis B, Chronic ; drug therapy ; genetics ; Humans ; Lamivudine ; pharmacology ; therapeutic use ; Male ; Middle Aged ; RNA-Directed DNA Polymerase ; genetics ; Young Adult

Objective To study the characteristics and regularities of somatotype growth of Yugu adolescents.Methods The somato-type growth of 989 Yugu adolescents(male:512,female:477)in Sunan was evaluated by the Heath-Carter method.Results The average somatotype of YuGu adolescents in males was mesomorphic ectomorph(3.0-3.6-3.7),and in females,the average somatotype was ectomorphic endomorph(3.8-2.9-3.6).The somatotypes develop from central,endomorphic ectomorph to mesomorphic ectomorph in the male,however,in the female from central,ectomorphic endomorph,endomorphic ectomorph,to mesomorphic endomorph.Conclusion The somatotypes of Yugu adolescents are very different between males and females.In the male group,the somatotypes of the 7-12 year-old group of Yugu adolescents are similar to the Mongolia,Han ethnic,Zhuang ethnic and Hungary.The somatotypes of 13-17 year-old group are similar to Tibetan,Zhuang ethnic,Han ethnic and Daur.However for the female group,the somatotypes of the 7-9 year-old group are similar to Hungary,and the 10-17 year-old group are similar to Tibetan,Zhuang ethnic,Han ethnic and Finn.

On the basis of the summarization about some MPH education experience in Sun Yat-sen University,we make the assumption concerning construction of MPH training quality assurance system ,expound the content and operating mode of this training quality system,and then offer reference for improvement of MPH training quality.

Objective To summarize the clinical outcome of direct trans-scleral drainage by puncture with 25G needles in the external-route surgeries for primary retinal detachment. Methods Fifty-four consecutive cases of primary retinal detachment were treated by external-route surgeries. The subretinal fluid of 23 cases was drained by direct scleral puncture with 25G needles (25GND group), the other 31 cases underwent the conventional scleral incision and drainage(CD group). Postoperative complications, the single-operation retinal reattachment rate and functional outcome were recorded.Results Subretinal fluid was adequately drained in all cases. there was no significant difference in the single-operation retinal reattachment rate between 25GND and CD groups. In comparision to CD, 25GND significantly decreased postoperative complication rate (?2=4.729,P

Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. It is mostly caused by bleeding from bronchial circulation. Bronchial artery embolization is now considered to be the treatment of choice for acute massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. So knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, efficacy, safety and possible complications of BAE and with the characteristics of the various embolic agents. Bronchial arterial catheterisation in human via a percutaneous approach has been practiced for 32 years (1973) in the world and 20 years (1986) in China, initially for direct chemotherapy treatment for bronchial malignancies and then for the embolization of patients with massive haemoptysis. A review of clinical experience to evaluate technique,embolic materials,outcome and complications of BAE is presented.

Objective To assess the clinical value of pentraxin-3 (PTX-3) in diagnosis and survey of therapeutic effect for lung cancer.Methods The serum level of PTX-3,carcinoembryonic antigen (CEA),cytokeratin 19 fragment (CYFRA 21-1) were measured in 802 patients with lung cancer,462 with benign lung diseases and 522 healthy controls from multiple research centers,using ELISA and electrochemiluminescent assays.The clinical value of PTX-3 was assessed by comparing the area under receiver characteristic curves (AUC) with CEA and CYFRA21-1.The optimum cutoff value for diagnosis of lung cancer was investigated by maximizing the sum of sensitivity and specificity.By following-up,the serum level of PTX-3 was measured at 3 day,7 day,and 14 day in 61 lung cancer patients after surgical resection of lung cancer.Results In test group and validation,the serum levels of PTX-3 (g/L) are significantly higher in lung cancer group [9.21 (6.13-12.80),10.4(5.54-13.11)] than in benign lung diseases [5.28 (3.42-8.53),6.52 (3.84-7.89)] and in healthy controls [2.18 (0.54-5.44),2.44 (0.67-5.87)],[Z =8.161,14.118,(test group,all P ＜ 0.05) ;Z =9.832,17.595 (validation group,all P ＜0.05)].ROC curve showed the optimal cut-off values for PTX-3 was 8.03 g/L [AUC of 0.831,with a sensitivity of 76.1％ and specificity of 75.2％ in the test cohort; 0.828,71.3％,89.2％ in the validation cohort].Similar results were noted for early-stage lung cancer [0.764,79.1％,and 62.2％ in the test cohort; 0.744,71.3％,and 69.6％ in the validation].In the diagnosis of early-stage lung,the AUC and sensitivity and specificity of PTX-3 were 79.1％,0.764,71.3％ (test group),and 75.2％,89.2％,0.824 (validation group) significantly higher in these patients than CEA and CYFRA21-1.In small cell lung cancer,PTX-3 and NSE shared similar AUC differentiating LC from benign lung diseases and health controls.In following-up 61 lung cancer patients,PTX-3 levels before surgical resection of tumours [11.12(9.12-12.59)] was significant high than following 3 day after surgery(Z =4.32,P ＜0.01),and 14 day (5.12 ±2.54) vs.7 day (7.13 ±3.42) (t =2.143,P =0.023).The correlation between PTX-3 and CRP in LC,benign lung diseases,health control was 0.364,0.592,0.512 (all P ＜ 0.05).Conclusion Serum PTX-3 is a valuable biomarker of lung cancer and early-stage lung cancer with high sensitivity and specificity and improved identification of patients with lung cancer from those with non-malignant chronic lung diseases.

OBJECTIVE: To analyze the correlation of the tympanic injection of triamcinolone acetonide, middle ear pressure (MEP) and radioactive secretory otitis media (RSOM) with nasopharyngeal carcinoma (NPC) after radiotherapy. METHOD: Fifty-two patients suffering NPC without otitis media before radiotherapy were randomly divided into three groups. 17 cases with 34 ears were distributed into treatment group I, and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-7 weeks 1 times a week. Treatment group I had 17 cases with 34 ears,and radiotherapy 1 hour before the start of each side of the tympanic cavity injection of triamcinolone acetonide injection, 1-12 weeks 1 times a week. And control group consisted of 18 cases with 36 ears who didn't accept such treatment. In all 104 ears, MEP was tested at the begin of radiotherapy and the end of 1st, 2nd, 3rd month after radiotherapy. RESULT: From the beginning of radiotherapy to the end of th 1st, 2nd, 3rd month after radiotherapy, the morbidity of RSOM gradually increased and MEP decreased in the treatment group I , II and the control group, in which treatment group II showed the lowest morbidity of RSOM and MEP was maximum (P < 0.01), and the treatment group I showed the lower morbidity of RSOM and MEP was greater (P < 0. 05), while the control group showed the highest morbidity of RSOM and MEP was minimum (P > 0.05). CONCLUSION Tympanic injection of triamcinolone acetonide could reduce radiation injury, and medication time was positively correlated with the MEP, and a negative correlation with RSOM morbidity, and the longer treatment, the more significant the effect is. The difference is most obvious at the end of 3rd month after radiotherapy. It may be due to the more active repairation after radiation damage in middle ears, but long-term efficacy must continue to observe.
Anti-Inflammatory Agents ; administration & dosage ; Carcinoma ; Ear, Middle ; Humans ; Injections ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; Otitis Media with Effusion ; drug therapy ; Radiation Injuries ; Triamcinolone Acetonide ; administration & dosage

Objective To explore differentiation in vitro of rat adipose-derived stem cells into photoreceptor cells and RPE cells.Methods The ADSCs were cultured by adhering to the flask surface and purified by continual passaging.Surface antigens including CD45、CD90、CD49d、CD106 were indentified by flow cytometry.ADSCs were induced to differentiate by EGF,activin A,taurine,retinoic acid(RA) and extracted liquid of retina respectively.Meanwhile,ADSCs were induced by EGF+taurine,EGF+RA,taurine + RA,EGF+taurine+RA respectively.Immunofluorescence was used for detecting the expression of rhodopsin,CK and S-100,and flow cytometry was used for quantification.Results For primary culture,the phenotypes of ADSCs were: CD45,CD90,CD49d and CD106,with a positive percentage of 1.6%,71.3%,7.8% and 3.5%,respectively.From passage 1 to 5,these phenotypes were: CD45(0.8%～9.3%),CD90(84.7%～94.8%),CD49d(16.8%～31.0%)and CD106(8.3%～22.2%).There was a higher CD49d percentage than CD106 in all the passages.The induction efficacy of ADSCs was 17.5%～46.0% for rhodopsin,19.7%～79.3% for CK and 27.3%～50.7% for S-100.Conclusion It is suggested that ADSC has potential to differentiate into photoceptors and RPE cells as evidenced by thepresence of the specific markers of photoceptors(rhodopsin) and RPE markers(CK and S-100).