Objective To investigate the clinical effect of uterine arterial embolization combined with hysteroscopes in the treatment of cesarean scar pregnancy(CSP).Methods Seventy CSP patients were divided by willingness of patients and their familiality into treatment group and control group with 35 cases each.The treatment group was treated with uterine arterial embolization combined with hysteroscopes,while the control group was treated with uterine curettage after crug therapy.The intraoperative and postoperative situations of two groups were observed.Results The intraoperative blood loss,erythrocyte suspension transfusion,plasma transfusion,preparation time before curettage,hospital stay and pestoperative serum β- human chorionic gonadotropin in treatment group were all obviously lower than those in control group [(420.7 ± 18.9) ml vs.(1893.9 +39.8) ml,(2.1 + 1.3) U vs.(11.1 ±1.4) U,(400.2 ±23.6) ml vs.(1700.3 ± 31.4) ml,(3.9 ± 2.3) d vs.( 18.8 ± 6.7) d,( 14.32 ± 3.89) d vs.(37.83 ± 8.98) d,(312 ± 54) U/L vs.(532 ± 85) U/L,P＜ 0.01].There was 1 case with massive hemorhage in treatment group,while 3 cases in control group.Conclusions Uterine artery embolization combined with hysteroscopes is a safe and effective treatment with less trauma for CSP.It is worthy of clinical promotion and application.

Objective To study the effects of lidocaine on inflammatory mediators and myocardial enzymes in patients undergoing off-pump coronary artery bypass grafting (OPCAB).Methods Twenty patients underging OPCAB were randomly divided into 2 groups of L and C with 10 cases each. After anesthesia induction, group L was given a bolus of lidocaine 2 mg/kg, which was followed by an infusion of lidocaine 2 mg·kg~(-1)·h~(-1) till the end of operation. Group C was given normal saline instead of lidocaine as the control. Blood samples were taken for the measurements of TNF-a, IL-8, SOD, MDA, cTnⅠ, CK-MB and MYO. The hemodynamics, early postoperative clinical informations and ICU and hospital stay were recorded. Results The increases of TNF-α and IL-8 were significiently less in group L than those in group C(P<0.01 or P<0.05). MDA at 24 h after operation was higher in group C than that in group L(P<0.05). The increases of CK-MB and cTnⅠ at 24 h and 48 h after operation were significiently less in group L than those in group C(P<0. 01 or P <0. 05). The ICU and hospital stays were shorter in group L than those in group C(P<0. 05). Conclusion Continuous infusion of lidocaine during OPCAB can decrease the inflammatory mediators and myocardial enzymes and protect the myocardium.

Objective To identify the Candida species isolated from recurrent vulvovaginal candidiasis( RVVC) pa-tients, and provide etiologic datum of RVVC. Methods All Candida isolates, including those from vulvovaginal candidiasis ( VVC) and RVVC patients, were identified by using CHROMagar chromogenic medium and VITEK2 yeast identification kits. Results The proportions of nonalbicans species from nonpregnant RVVC relapse patients and pregnant VVC patients were both significantly higher than those from nonpregnant VVC patients ( P<0. 05 ) . Among pregnant patients, the percentage of C. albicans isolated from RVVC relapse was couer, but there was no significant difference of C. albicans species percentage between RVVC and VVC patients. Conclusion RVVC may be related to the recurrence of same Candia species and the reinfection of different Candia species. Pregnant women may be more inclinable to suffer from disorder caused by nonalbicans species.

Drug addiction is a chronic relapsing brain disease that is characterized by compulsive drug use and persistence of drug craving. Drug abuse can lead to changes in the neuron structure and function of plasticity,alterations in molecules and cells,and ultimately to individual abnormal behavior. Current studies have found that epigenetic changes leading to the sustainability of gene expression is an important mechanism of drug addiction. In this review,we will systematically summarize the latest advances in epigenetic mechanisms of drug addiction. This review is expected to provide robust evidence that repeated exposure to drugs of abuse induces changes within the brain′s reward regions in three major modes of epigenetic regulation-histone modifications such as acetylation and methylation , DNA methylation,and non-coding RNAs. It promises a new perspective from which to gain insights into the genetic and epigenetic mechanisms of drug addiction and a new area for epigenetic research on clinical drug addiction treatment.

Objective To observe the influence of sowing time and planting density on seed germination percentage and growth of Desmodium styracifolium(Osb.) Merr..Methods After quality inspection of the seed,the seeds planting test for Desmodium styracifolium(Osb.) Merr.was carried out from March to October,and the influences of sowing time and planting density on the seed germination percentage and growth were observed.Results On the planting base of Pingyuan county in Guangdong province,the seeds of Desmodium styracifolium(Osb.) Merr.planted from March to October had a high germination percentage and the seedling grew well.With the increase of planting density,the seed germination percentage decreased,but was up to 80% when the planting density was 0.5～1.0 g /m2.Conclusion The optimum planting time for Desmodium styracifolium(Osb.) Merr.is in autumn and the optimum planting density is 0.5～1.0 g /m2.

AIM: To analyse the variety of the alkaloid and volatile oil from Herba Ephedrae after mix-fring with honey. METHODS: The volatile oil was analysed by GC-MS and the total alkaloids were determined by method of Chp. RESULTS: The volatile oil changed distinctly. The contents of Isolineole、p-Cymene、D-limonene、Evcalyptol、?-Terpinen increased evidently, but the contents of Benzaldehyde、Tetramethylpyrazine、p-Vinylanisole、?-Terpineol、?-Terpineol decreased and the contents of the total alkaloids decrease as well. CONCLUSION: The study provides a new experimental basis for the process theory of Herba Ephedrae.

BACKGROUND: The mitofusin 2 (Mfn2) may affects vascular smooth muscle cell Ras protein and suppress cellular proliferation through inhibition of extracellular signal-regulated protein kinase signaling pathway, which plays an important role in pathogenesis of vascular disorders such as hypertension, atherosclerosis and post-angioplasty restenosis. Mfn-2 gene amino acid sequence of the first 442 serine serves as protein kinase A (PKA) phosphorylation site, which is closely related to its phosphorylation status and may be involved in its functional regulation.OBJECTIVE: To investigate the effect of Mfn2 gene with PKA phosphorylation site deletion[Mfn2-PKA (△)] on inhibiting the proliferation of vascular smooth muscle cells and related signaling pathway.METHODS: Vascular smooth muscle cells of rats infected by recombinational adenovirus carrying green fluorescent protein,Mfn2 gane and Mfn2-PKA (△), were subcultured for 3-10 passages and randomly divided into 4 groups: ① Control group without intervention. ② Control group infected with adenovirus carrying green fluorescent protein. ③ Experiment group infected with adenovirus carrying Mfn-2 gene.④ Experiment group infected with adenovirus carrying Mfn2-PKA (△). Laser confocal microscopy was used to observe the locations of Mfn2 gene with and without PKA in cells. The expressions of extracallular signal-regulated protein kinase, Mfn2 gone and Mfn2-PKA (△) were determined by Western blot analysis. The growth curve of the vascular smooth muscle cells was explored by MTT.RESULTS AND CONCLUSION: The Mfn-2 and Mfn2-PKA (△) both expressed protein-specific bands in vascular smooth muscle cells. Two kinds of gone expression products were mainly located at the out membrane of mitochondria. Compared with the control group and adenovirus carrying green fluorescent protein group, the absorbance values at 3, 4, 5, 6 days were significantly reduced in adenovirus carrying Mfn2 group (P ＜ 0.01), and no obvious changes were observed in adenovirus carrying Mfn2-PKA (△) group. Compared with the control group and adenovirus carrying green fluorescent protein group, the extracellular signal-regulated protein kinase expression was significantly reduced in adenovirus carrying Mfn2 group (P ＜ 0.01), and no obvious changes were observed in adenovirus carrying Mfn2-PKA (△) group. Mfn2-PKA (△) located at the out membrane of mitochondria, has no effect on suppressing the proliferation of vascular smooth muscle cells, and no inhibition effect on extracellular signal-regulated protein kinase signaling pathway.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.

[Objective] To study the factors relative to the delayed diagnosis of spontaneous dual arteriovenous fistulas (DAVF) and its influence on the prognosis.[Methods] We included 102 continuous patients diagnosed DAVF in the First Affiliated Hospital of Sun Yat-sen University,and analyzed the correlative factors and impact on outcome of diagnostic delay.Outcome was whether symptoms were non-improvement,improvement or restoration at discharge.[Results] Median delay from onset to diagnosis was 3 months (interquartile range,1 to 6).Compared with patients diagnosed carlier(diagnose time≤3 months),patients diagnosed later (diagnose time ＞ 3 months) had a lower frequency of headache (P =0.012),ptosis (P =0.035) and parenchymal lesions (P =0.001),a higher frequency of conjunctival congestion (P =0.004),tinnitus (P =0.021),visual dysfunction (P ＜ 0.001),isolated visual dysfunction (P =0.007) and delayed imaging scan (P ＜ 0.001),a higher frequency of endovascular treatment,and a lower frequency of improvement or restoration at discharge (P =0.033),in which patients with visual dysfunction had a lower frequency of improvement or restoration than those without visual dysfunction (P =0.023).Compared to those with visual dysfunction and other symptoms,patients with isolated visual dysfunction had a higher frequency of onset with paroxysmal blurring or blinding (P ＜ 0.001),two eyes involved (P ＜ 0.001) and more severe visual loss (P =0.057),a higher frequency of draining into transversesigmoid sinus (P ＜ 0.001) instead of cavernous sinus (P ＜ 0.001),and suffered intracranial hypertension all (median intracranial pressure,405 mmH2O;interquartile range,370 ～ 512 mmH2O).However,no statistically significant differences were found in the frequency of improvement or restoration at discharge between two groups (P =0.739).[Conclusion] Diagnostic delay was considerable in this cohort and was associated with outcome,especially in patients with visual dysfunction.

Objective To analyze the clinical characteristics and treatment Methods of severe com?plications after percutaneous tracheotomy( PDT) in neurosurgery patients,and to provide reference for the treat?ment and rescue of these patients. Methods A retrospective analysis of 578 cases after PDT was performed in Neurosurgery Intensive Care Unit ( NSICU ) of Xuanwu Hospital of Capital Medical University from 2005 to 2015. The types of complications,treatment method and prognosis were analyzed. Follow?up was 3 months to 1 year. Results Eighteen cases with severe complications,including bleeding,wound infection,asphyxia caused by tracheal mucosa suffocation,airway stenosis caused by granulation tissue,subcutaneous emphysema and neu?momediastinum,etc. After treatment and active rescue,most patients recovered,no patients die directly associated with surgery. Conclusion PDT plays an important role in the treatment of patients in NSICU,but it is still pos?sible to have serious complications,so physicians must understand and be prepared for complications,and pay more attention to prevent poor prognosis.