Objective To investigate the clinical efficacy of levonorgestrel- releasing intrauterine system (LNG-IUS) in the treatment of adenomyosis and the influence of ovarian function. Methods Eighty patients with adenomyosis were followed up for 0, 1, 3, 6, 12 months after treating with LNG-IUS. The menstrual blood volume, dysmenorrheal, size of uteri, CA125 and EMAb level, hepatic function, serum glucose and serum lipids were observed and evaluated. Serum- levels of FSH and LH were tested before insertion and followed up for 6, 12 months after insertion, respectively. Results After inserting LNG-IUS,dysmenorrhea was obviously alleviated, and it was significantly decreased after 6 months. The menstrual blood volume was (200. 0 ±60)ml, (40. 0 ± 15)ml and (28 ±7)ml in 0, 6, 12 months after the insertion.Serum CA125 and positive rate of EMAb also significantly reduced [CA125: (50. 69 ± 10. 00) IU/L vs (18. 60 ±3.55)IU/L;EMAb:80. 0% vs 3. 8%, P ＜0. 05]. The volume of uterus reduced without significant changed (P ＞0. 05). There were little changes in the levels of hepatic function, serum glycosum, serum lipids, FSH and LH at 6 and 12 months after LNG-IUS(P ＞ 0. 05). Conclusions LUG-IUS is an effective and safe therapy for adenomyosis with dysmenorrheal and menorrhagia, and it has no significant effects on ovarian function.

Objective To investigate the role of C-Jun N-terminal kinase (JNK) in epithelial mesenchymal transition (EMT) induced by transforming growth factor β1 (TGF-β1) in rat peritoneal mesothelial cells(RPMCs). Methods RPMCs were harvested from the peritoneum of male Sprague-Dawley rats, then cultured in DMEM/F12 medium with 15% (V/V) FBS. After stimulation with TGF-β1, the expression of a-smooth muscle actin (α-SMA), E-cadherin and collagen I were detected in RPMCs. In some groups, the ceils were pretreated with SP600125, a specific inhibitor of JNK, for 4 hours before incubation with TGF-β1. The protein expression of phosphorylated JNK was detected by Western blotting. The mRNA and protein expression ofα-SMA, E-cadherin and collagen I were examined with RT-PCR and Western blotting, respectively.The intracellular distribution and expression of α-SMA was determined by indirect immunofluorescence. Results TGF-β1 could significantly increase the expression of α-SMA and collagen I, and decrease the expression of E-cadherin in RPMCs. TGF-α1 could stimulate the expression of phosphorylated JNK at 5 minutes with the peak at 10 minutes (P<0.01). The addition of SP600125 effectively inhibited TGF-β1-induced high expression of α-SMA and collagen I (P<0.05), and prevented TGF-β1-induced down-regulation of E-cadherin expression in RPMCs (P<0.05). The indirect immunofluorescence showed that the expression of intracellular α-SMA in RPMCs stimulated by TGF-β1 for 48 h increased significantly, which could be inhibited by SP600125. Conclusions JNK regulates epithelial mesenchymal transition induced by TGF-β1 in rat peritoneal mesothelial cells. JNK inhibitor may be used as a novel therapeutic agent for peritoneal fibrosis.

Objective To study the quality of life of patients with lower extremity artery disease (LEAD) and explore the effect of demographic and clinical factors on their quality of life. Method A self-designed demographic and clinical data questionnaire and the MOS 36 items short form health survey were used to investigate the life quality of 90 LEAD patients. Results The scores on the dimensions of life quality of the LEAD patients were significantly lower than those of common population (P<0.001). The marriage status and education affected patients′physical function, general health and social health;the longer the course of disease, the worse the general health;the complications, exercise and kind of disease affected patients'physical responsibility, physical function and emotion;the kind of disease affected patients'vitality; patients with exercise had higher general health (all P<0.05). Conclusions The life quality of LEAD patients is in general lower. The life quality of patients with different demographic and clinical data factors is varied. Therefore, doctors and nurses should correctly assess the life quality of LEAD patients and instruct those with problems so as to improve their quality of life.

Objectives To explore the relationship between illness perceptions and health behavior in the subjects. Methods Revised illness perception questionnaire and health promoting lifestyle profileⅡ (HPLPⅡ) were used to measure 101 patients′illness perception and health behavior between the groups. Results The HPLPⅡscore of LEAD was(2.17 ± 0.29) with the score of dimension. The course of disease, prognosis and perception of emotion were negatively related to health behaviour; personal control and primaty congtion of drsease were postively related to health behaviour (all P<0.01). Conclusion Medical personnel should pay attention to the relationship between illness perceptions and health behavior in patients with LEAD and effective measures should be taken to improve the patients′illness perceptions, promote their choices and persistence in health behavior and improve the quality of life.

Objective To study clinical efficacy on cesarean scar pregnancy (CSP) treated by transvaginal surgery.Methods From Jan.2008 to Mar.2011,31 cases with CSP were managed by transvaginal surgery in Anshan Women and Children Hospital.Based on ultrasonograpy examination and intraoperative exposure of lesion,variable surgical options were executed.Fifteen cases in group A were treated by debridement resection and vaginal repair of uterine wall,7 cases in group B were treated by transvaginal uterine artery ligation and curettage,9 cases were treated by cutting the anterior wall in the lower uterine segment and repairing uterine.The intraoperative blood loss,operation time,hospital stay,hCG fluctuation at postoperative period and complications were analyzed among those groups.Results Allcases in 3 groups were cured well in one time.( 1 ) The intraoperative blood loss were (41 ±21 ) ml in group A,(27 ±7) ml in group B and ( 148 ± 132) ml in group C.There was no statistically different blood loss between group A and group B ( P ＞ 0.05 ),however,the amount blood loss in group C was significantly more than those in group A and group B ( P ＜ 0.05 ).( 2 ) The average surgical time,the mean hospital stay,postoperative recovery time of blood hCG were (40 ± 11 ) minutes,(4.7 ± 0.8 ) days and ( 2.7 ± 1.0) weeks in group A,(44 ± 5 ) minutes,(4.0 ± 0.8) days and (2.9 ± 1.0) weeks in group B,(40 ± 12) minutes,(4.9 ± 1.0) days and (2.8 ±0.9) weeks in group C.Those clinical index were no statistically different among those 3 groups(P ＞0.05).(3) No bladder injury and other complications were observed in those groups.Conclusions Transvaginal surgery is efficacy,easy to operate,to keep the uterus,safe and economy in treatment of CSP.Surgery in group A is suitable to treat early and exogenous lesions; surgery in group B is suitable to treat endogenous lesions; surgery in group C is suitable to treat failure cases in group A and B,however,the injury is greater than those in group A and B.

Objective: To investigate the effects of crystalline silica with different exposure patterns on lung fibrosis in rats. Methods: A total of 20 adult male Wistar rats were randomly divided into 4 groups consisting of five animals each and received intratracheal instillation of sterile saline or silica suspension in different patterns: saline once at day 0, saline once/week, crystalline silica 50 mg at day 0, crystalline silica 6.25 mg/week. The rats were sacrificed at 8 weeks. The lung tissues were collected for pathological analyses, and determining mRNA and protein levels of related fibrogenic molecules. Results: The collagen deposition induced by crystalline silica in lung tissues were increased. The mRNA levels of IL-1β and Col I in group c were significantly elevated than those in group saline once at day 0 (all P<0.05). Compared with group saline once/week, the mRNA levels of IL-1β, TGF-β, Col I, Col III and CTGF were significantly increased in group crystalline silica 6.25 mg/week (P<0.05) . The mRNA levels of Col I and CTGF were significantly increased in group crystalline silica 6.25 mg/week in comparison with those in group crystalline silica 50 mg at day 0 (P<0.05) . Conclusion Given the same cumulative dose of crystalline silica, multiple exposures were likely to induce more severe lung fibrosis.

Objective: To evaluate the relationship between the offset of a laser-assisted flap using the WaveLight FS200 femtosecond laser and the clinical results after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). Methods: In this prospective cohort study, 125 patients who underwent FS-LASIK for myopia by WaveLight FS200 femtosecond laser from June 2017 to July 2018 at the Tungwah Ophthalmic Center were divided into two groups according to the offset of the corneal flap from the pupil center: the no-offset group (57 eyes) and the certain-offset group (68 eyes); the baseline data, including age, sex, uncorrected visual acuity(UCVA), spherical degree, and central corneal thickness were matched in the two groups.UCVA, residual astigmatism, spherical degree, corneal curvature and aberration were observed 1 week and 1 month after surgery.The study protocol was approved by the Ethics Committee of Tungwah Hospital of Sun Yat-Sen University (No.2017DHLL004). Written informed consent was obtained from each subject prior to entering the study cohort. Results: UCVA, corneal curvature, spherical degree, spherical and corneal aberration between the two groups were not significantly different (all at P>0.05). One week after surgery, the residual astigmatism was ≤-0.50 D in 50 eyes (87.7%, 50/57)and >-0.50 D in 7 eyes (12.3%, 7/57) in the no-offset group; the residual astigmatism was ≤-0.50 D in 50 eyes (73.5%, 50/68) and >-0.50 D in 18 eyes (26.5%, 18/68) in the no-offset group.The residual astigmatism between the two groups 1 week after surgery was significantly different (χ²=3.902, P=0.048), and there was no significant difference in residual astigmatism 1 month after surgery (χ²=2.031, P=0.068). The trefoil of the no-offset group was statistically less than of the certain-offset group at 1 week and 1 month after surgery (0.05[0.04, 0.08]vs.0.06[0.04, 0.10]; 0.05[0.03, 0.07]vs.0.06[0.05, 0.09])(Z=-2.245, P=0.022; Z=-2.370, P=0.018). The spherical aberration and coma were not significantly different between the two groups at 1 week and 1 month after surgery (both at P>0.05). Conclusions The offset from femtosecond laser-assisted flap by WaveLight FS200 has no effect on long-term visual acuity or residual astigmatism.Some patients may have different visual experiences because of the residual astigmatism and higher order aberration during the early postoperative stage.

Objective To observe the effects of massage along meridians based on different stages of Brunnstrom on lower extremity function in patients with convalescent stroke. Methods Ninety patients with convalescent stroke and lower limb dysfunction who were hospitalized in our hospital's brain center from September 2016 to August 2018 were selected. They were randomly assigned to an observation group of 45 patients and a control group of 45 patients. Both groups were given basic rehabilitation therapy. The control group was given conventional exercise therapy, and the observation group was given additional massage based on different stages of Brunnstrom. The two groups were treated for6 weeks, and the FMA-L, MAS and BBS scores before and after treatment were evaluated. Results There were no significant differences in FMA-L, MAS and BBS scores between the two groups (P>0.05). After 6 weeks of treatment, the FMA-L and BBS scores of the two groups were significantly higher than the pre-treatment scores, while the MAS scores were lower than the pre-treatment scores (P<0.05 or P<0.01). Compared with the control group, the improvement of FMA-L and BBS scores and the reduction of MAS score in the observation group was more significant (P<0.05 or P<0.01). Conclusion On the basis of conventional treatment methods, the application of massage therapy based on different stages of Brunnstrom is more helpful to improve the balance function of patients during stroke recovery, reduce muscle tension of lower limbs and to improve functional activities of lower limbs.

Objective: To explore the association between exposure to bedroom night light during sleep and emotional symptoms in children and provide a scientific basis for subsequent effective prevention and intervention. Methods: In December 2021, 1 926 students from grades 4 to 6 were recruited to conduct a student questionnaire survey in two primary schools in Tianchang of Chuzhou City, Anhui Province. The data, including general demographic information, use of night lights and curtains, emotional symptoms, and other information, was collected. Binary Logistic regression analysis was used to examine the correlation between night light use and children s emotional symptoms. Results: The reporting rates of depression symptoms, generalized anxiety symptoms, social phobia, and obsessive compulsive symptoms of the children were 2.5%, 2.6%, 3.4% and 2.5%, respectively. About 12.6% of children often sleep with a night light on, and 22.0% of children did not close the curtains. Binary Logistic regression analysis revealed that frequent sleep with night lights was associated with an increased risk of depression symptoms( OR=2.29, 95%CI = 1.04- 5.03), social phobia ( OR=1.93, 95%CI =1.02-3.64) and obsessivecompulsive symptoms ( OR=3.44, 95%CI =1.72-6.88) in children( P < 0.05). Conclusion There is a positive correlation between bedroom night light exposure during sleep and the detection rate of children s emotional symptoms. The attention should be paid to bedroom light environment of children during sleep to reduce the adverse effects of night light exposure on the mental health.

OBJECTIVETo analyze a child with developmental delay, severe mental retardation, speech delay and muscular hypotonia.

METHODSThe karotypes of the child and her parents were analyzed with G-banding analysis. Their genome DNA was also analyzed with array comparative genomic hybridization (array-CGH).

RESULTSNo karyotypic abnormality was detected at cytogenetic level. However, array-CGH has identified a de novo 4q21.21-q22.1 deletion in the child, which has a size of 12.1 Mb.

CONCLUSIONThe de novo interstitial 4q21.21-q22.1 deletion probably underlies the main clinical manifestation in the child. Array-CGH is useful for diagnosing children with multiple congenital anomalies with unclear etiology.

Child, Preschool ; Chromosomes, Human, Pair 4 ; Comparative Genomic Hybridization ; methods ; Female ; Gene Deletion ; Growth Disorders ; diagnosis ; genetics ; Humans ; Intellectual Disability ; diagnosis ; genetics ; Sequence Deletion