Objective To explore the efficacy of hysteroscopy combined with laparoscopy in the diagnosis and treatment of Herlyn-Werner-Wunderlich syndrome (HWWS).Methods The clinical data of 23 patients with HWWS from January 2009 to December 2015 treated with combination of laparoscopy and hysteroscopy were retrospectively analyzed.The patients had different degrees of dysmenorrhea (17 cases),abnormal vaginal discharge (17 cases),and infertility (4 cases) before surgery.During followup,we observed the symptom and pregnancy outcomes after surgery.Results The patients were followed up for 3-36 months (average,24 months).The vaginal irregular bleeding and abnormal secretions disappeared in 17 patients;dysmenorrhea relieved partly in 17 cases;4 patients who had fertility requirements gave birth to babies.Conclusion Combination of hysteroscopy and laparoscopy sufficiently clears genital malformation of HWWS and solves the lower genital tract obstruction.

[Summary] There are a variety of treatment methods for stress urinary incontinence ( SUI) .Surgery is effective but has high risks, only to adapt to the limited population .Conservative treatment has a high recurrence rate and poor long-term results.Local injection of stem cell has been proposed as a new minimally invasive therapy of SUI .Stem cells, with the ability to transform into muscle cell , secrete various growth factors , promote local nerve and muscle tissue regeneration , and repair sphincter dysfunction .This article reviewed on therapy of skeletal muscle-derived stem cells and the associated risks of treatment .

To explore the anti-atherosclerotic mechanism of estrogen and especially observe the effect of estradiol on the content of cholesterol in J774a.1 mouse mononuclear/macrophage-derived foam cells which were incubated with oxidized low-density lipoproteins (ox-LDL). J774a.1 mouse mononuclear/macrophages were incubated with ox-LDL or with both ox-LDL and estradiol (1, 0.1 or 0.01 micromol x L(-1)). Oil red O staining was used to observe the formation of foam cells, and cholesterol oxidase fluorometric was used to determine the content of cellular cholesterol content. Western blotting and RTFQ-PCR were used to observe the expressions of scavenger receptor class B type I (SR-B I ) in J774a.1 foam cells. Compared with the control cells, J774a.1 mouse mononuclear/macrophage-derived foam cells showed significantly increased contents of total cholesterol and cholesterol ester (P < 0.001) and decreased SR-B I mRNA expression (P < 0.01). Estradiol treatment significantly lowered the contents of total cholesterol and cholesterol ester (P < 0.05), and increased SR-B I protein and mRNA expression (P < 0.01) in the foam cells in a dose-dependent manner. Estradiol can inhibit the formation of mononuclear/macrophage-derived foam cells by decreasing the contents of total cholesterol and cholesterol ester and up-regulating the expression of SR-B I in the foam cells.

Review and analysis of the medical service provision for Beijing Olympic Games by Peking Union Medical College Hospital has contributed to the following experiences: Building of a general coordination center, emphasis to key persons, key timing, and key steps, development and implementation of contingency plans, and hardware preparations in advance among others. These experiences will be highly inspirational for provision of international medical services and large medical assurance tasks.

Objective To study the compliance of examinees,and effectiveness of colorectal distension with partially automated and individualized insufflation of air for dual-energy CT colonography.Methods Forty-six healthy adult volunteers without history of conditions affecting gastrointestinal motor function were enrolled in this study.One day before CT examination,volunteers were asked to orally administered 60 mL 4% diatrizoate meglumine five times for fecal tagging.Air was insufflated by using an inflator in a partially automated and individualized manner.The volunteers were initially asked to assume the right lateral decubitus position,then slowly turn to the supine position.Insufflation rate began at 1.5 L/min,and decreased to 0.5 L/min at later stage.The necessity and volume of air insufflation were decided according to effectiveness of colorectal distension on CT scout images,self-reported sensation of volunteers,and intestinal pressure.Dual-energy CT scanning was performed,and dual-energy blended images were acquired.Compliance of volunteers was statistically analyzed.The effectiveness of colorectal segments distension was statistically analyzed by using Kruskal-Wallis H test.Results No abdominal pain,bloating,nausea or vomiting were noted in the 46 volunteers.All volunteers easily accepted colorectal insufflation of air,with grade 1 compliance.The effectiveness of colorectal distension of grades 1,2,3 and 4 were 0%,2.1%,5.1% and 92.8%,respectively.The difference of effectiveness of colorectal segments distension had no statistical significance(χ2=6.19,P=0.288).The effectiveness of insufflation was poor in 6 colorectal segments,including 2 in sigmoid colon and 2 in rectum.Effectiveness of insufflation was suboptimal in 14 colorectal segments,including 4 in descending colon,4 in sigmoid colon,and 3 in rectum.Conclusion Compliance of examinees with partially automated and individualized insufflation of air for dual-energy CT colonography is excellent,with good effectiveness of colorectal distension.

Good self-management behaviors can control symptoms of the patients with osteoarthritis, improve the patients' joint function and quality of life. Patients' self-management behaviors have been impacted by disease knowledge, self-effcacy, emotional state, and social support. All the above factors should been taken into full consideration when intervening. Self-management program is an intervention mode which can improve patient self-management behaviors and promote patient health.

Ulta performance liqiuid chromatography-triple quadrupole tandem mass spectrometry ( UPLC-MS/MS) was used to monitor the relative levels of bufadienolides in toad venom in normal and bensulfuron-polluted groups. Methanol extract of toad venom was separated by UPLC ( ODS-C18 ) using a gradient elution of water contains 0. 1% formic acid and acetonitrile. Mass spectrometry was used in an ESI source operated in positive ion and MRM mode. The parameters in the source were set as follows: capillary voltage 3. 0 kV; sampling cone voltage 30 V; and desolvation temperature 500℃. In this method, external calibrations of 6 standards were typically constructed (R2=0. 9953-0. 9992). The LOD was 0. 42-4. 86 ng/mL. Intra- and inter-day precision was 3. 8%-6. 8% and 4. 0%-8. 8%, respectively. The recovery of standard was evaluated by spiking the standard compound into toad venom. Their average recoveries were 96. 9%-109. 6%, and RSDs were 2. 0%-8. 1%. This method was further employed into monitoring the levels of 36 bufadienolides. The levels of more than 20 bufadienolides were greatly different after bensulfuron pollution, suggesting that the bensulfuron pollution could change the chemical expression pattern of bufadienolides in toad venom.

Objective To comparative study the effect on colorectal cleansing of CT colonography with gulping down 10 mg bisacodyl before or 1 h after oral taking 2 liter polyethylene glycol .Methods Forty participants with informed consent were appor‐tioned to group A ,group B randomly ,20 cases in each group .On the day before CT colonography ,participants in group A oral took 20 mL of 40% W/V barium sulfate prior to 3 mealtime ,and 20 mL of 60% diatrizoate meglumine diluted in 250 mL of water after supper ,then gulped down 10 mg bisacodyl enteric‐coated tablets 1 hour before oral taking 2 liter polyethylene glycol electrolyte so‐lution .Participants in group B were the same as that in group A ,with the exception of gulping down 10 mg bisacodyl enteric‐coated tablets 1 hour after oral taking 2 liter polyethylene glycol electrolyte solution .Cleansing efficacy of stool and fluid ,and attenuation value of remainder fluid between the two groups were analyzed statistically .Results In group A ,score of cleansing efficacy of stool (1 .96 ± 0 .11) was lower than that in group B (2 .01 ± 0 .12) ,segments with good cleansing efficacy of stool (87/120 segments , 72 .50% ) was higher than that in group B (83/120 segments ,69 .17% ) ,the difference was not statistically significant (P>0 .05) .In group A ,score of cleansing efficacy of fluid (1 .50 ± 0 .06) was lower than that in group B (1 .53 ± 0 .06) ,segments with good cleansing efficacy of fluid(113/120 segments ,94 .17% ) was higher than that in group B (111/120 segments ,92 .50% ) ,the differ‐ence was not statistically significant (P>0 .05) .Attenuation value of remainder fluid [(729 ± 29)HU ] in group A was higher than that in group B[(653 ± 25)HU] ,the difference was statistically significant(P<0 .05) .Conclusion Gulping down 10 mg Bisacodyl before or after oral taking 2 liter polyethylene glycol has no effect on cleansing of stool and fluid ,with good cleansing efficacy .The former has better cleansing efficacy of fluid ,is beneficial to detecting polyps for CT colonography .

Clinical data of 349 patients with postmenopausal ovarian cystic and cystic solid tumors undergoing surgical treatment in Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University from May 2013 to May 2017 were retrospectively analyzed.Postoperative pathology confirmed 100 cases of malignant tumor,228 cases of benign tumor,and 21 cases of borderline tumor.The malignant risk index (RMI) score was calculated based on the preoperative pelvic ultrasound and serum CA125 level,and the score＜200 was classified as benign tumors and ≥200 as malignant tumors.The postoperative pathological results were used as gold standard,the sensitivity,specificity,accurate rate of RMI in diagnosis of malignant tumors was 0.840(84/100),0.987 (225/228) and 94.2％ (309/328),respectively.The consistency of RMI with pathological diagnosis was high (Kappa=0.858,P＜0.05).The study suggests that RMI has a high degree of credibility for the evaluation of postmenopausal ovarian cystic and cystic solid tumors.

Objective:To investigate the value of CT radiomics mode in differential diagnosis of benign and malignant thyroid nodules.Methods:The clinical and imaging data of 179 patients with thyroid nodules confirmed by pathology from May 2017 to August 2018 were retrospectively analyzed in the Affiliated Huaian First People′s Hospital of Nanjing Medical University. Among the patients, 89 cases were benign nodules and 90 cases were malignant nodules. All patients underwent unenhanced and enhanced CT scan before operation. The stratified random sampling method was used to divide patients into a training group (143 cases) and a testing group (36 cases) according to a ratio of 8∶2. The A.K software was used to extract 378 imaging omics features based on preoperative CT images, and then Spearman correlation analysis and least absolute shrinkage and selection operator regression analysis were used for feature selection and model construction. The receiver operating characteristic (ROC) curve was used to verify the model in the training group and the testing group, and the efficacy of imaging omics features to predict benign and malignant thyroid nodules was evaluated.Results:After feature screening, 16 radiomics features were used to construct an identification model between benign and malignant thyroid nodules. In the training group, the area under the ROC curve (AUC) was 0.92 [95% confidence interval (CI): 0.88-0.97], the sensitivity and specificity were 88.7%, 82.0%, and the diagnostic accuracy of the model was 91.1%. In the testing group, AUC was 0.90 (95 %CI: 0.81-0.98), sensitivity and specificity were 88.5%, 84.6%, and the diagnostic accuracy of the model was 88.2%. Conclusion:The CT radiomics mode has a good diagnostic performance in the identification of benign and malignant thyroid nodules.