Objective To explore of curative effect analysis of mifepristone in treatment of endometriosis and the influence of sex hormone levels isoforms expression.Methods 70 cases of patients with endometriosis were randomly divided into the observation group and the control group with 35 cases in each group.The control group was treated by laparoscopic operation,postoperative unused drug therapy.The observation group was treated with laparoscopic operation,postoperative given mifepristone treatment.Results The complete remission rate of the observation group was 85.71％.It was higher than 62.86％ in the control group(x2 =4.786,P ＜ 0.05).The cumulative recurrence rate was 5.71％ in the observation group and the control group was 20％.It was lower than the control group (x2 =5.062,P ＜ 0.05).The level of estradiol (E2) and progesterone (P) after treatment in the observation group were lower than before treatment (t =5.171,3.632,all P ＜ 0.01).The level of luteinizing hormone (LH) and follicle stimulating hormone (FSH) after treatment were higher than before treatment (t =6.478,4.662,P ＜ 0.01).Conclusion Mifepristone is effective and safe to endometriosis.It can obviously improve sex hormone levels for the endometriosis patients.

Objective To evaluate the clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism.Methods 80 cases of patients with subclinical hypothyroidism who were admitted to our hospital from May 2011 to May 2016 were selected, they were divided into thyroxine replacement therapy treatment group ( replacement treatment group ) and conventional treatment group two groups according to the treatment methods, 40 cases in each group.The serum TSH, FT4, TG, CHO levels, childbirth, pregnancy outcomes and complications, neonatal status of the two groups were statistically analyzed.Results The serum TSH, TG, CHO levels of the replacement treatment group were significantly lower, the FT4 level was significantly higher, the difference was statistically significant (P<0.05), the trans vaginal yield rate 70.0%(28/40) was significantly higher than the conventional treatment group 35.0%(14/40), the cesarean section rate 30.0%(12/40) was significantly lower than the conventional treatment group 65.0%( 26/40 ) , the difference was statistically significant ( P<0.05 ) , the incidences of preterm delivery, postpartum hemorrhage, preeclampsia, hypoproteinemia, fetal development restriction 2.5%(1/40), 2.5%(1/40), 5.0%(2/40), 7.5%(2/40), 0 were significantly lower than the conventional treatment group 17.5%(7/40), 15.0%(6/40), 20.0%(8/40), 17.5%(7/40), 15.0%(6/40), the difference was statistically significant (P<0.05), the neonates body weight was significantly higher than the conventional treatment group, the difference was statistically significant (P<0.05), the proportions of low birth weight infants, giant infants, premature infants, asphyxia, death 0, 2.5%(1/40), 5.0%(2/40), 7.5%(2/40), 0 were significantly lower than the conventional treatment group 15.0%(6/40), 20%(8/40), 22.5%(9/40), 27.5%(11/25), 20.0%(8/40), the difference was statistically significant (P<0.05).Conclusion The clinical efficacy of thyroxine replacement therapy in the treatment of pregnancy patients with subclinical hypothyroidism is more significant than conventional treatment .

OBJECTIVE To investigate the pathogen spectrum distribution in respiratory tract infection during the past twelve years.METHODS The method was retrospectively analyzed.RESULTS A total of 7596 strains in(clinical) specimens were isolated.It showed that the isolating rate of Gram positive cocci,Gram negative bacilli and fungis was 34.56%,48.62% and 10.10%,respectively.The isolating rate of Gram positive cocci was 25.96% between Jan 1991 to Dec 1996,the most commonly isolated bacteria of which were Staphylococcus(aureus),Streptococcus pneumoniae and ?-hemolytic streptococci,with isolating rates being 6.85%,4.84 % and(4.26%),(respectively);the isolating rate of Gram negative bacilli was 63.33%,the most commonly isolated bacteria of which were Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae,with isolating rates being(8.46%),7.97% and 7.09%.The isolating rate of Gram positive cocci was 37.91% between Jan 1997 to Dec 2002,the most commonly isolated bacteria of which were S.aureus,?-hemolytic streptococci and Str.pneumoniae,with isolating rates being 10.28%,7.02% and 6.68%,respectively;the isolating rate of Gram negative bacilli was 47.64%,the most commonly isolated bacteria of which were P.(aeruginosa),E.coli and K.pneumoniae,with isolating rates being 8.19%,7.07% and 5.21%,respectively.The isolating rate of fungi was 6.06% and 11.43%,respectively during the two stages,the most commonly pathogen of which was Candida albicans.(CONCLUSIONS) The pathogen spectrum distribution in respiratory tract infection during the past twelve years has changed significantly.The isolating rate of Gram positive cocci and fungi,respectively is gradually increasing,but that of Gram negative bacilli is decreasing.

To construct a recombinant expression system for a single-domain antibody targeting the urease of Helicobacter pylori (Hp), this study employed several strategies. First, using artificial intelligence (AI) auxiliary tools such as Pymol, I-TASSER, and ClussPro2, the molecular interactions between different antibodies and Hp urease subunit B (UreB) were analyzed. The fully humanized single-domain antibody UreBAb was identified as the primary research target. Next, the UreBAb gene sequence was optimized based on Escherichia coli codon preferences, and was inserted into expression vectors such as pET28a and pE-SUMO. The resulting recombinant expression strains were obtained by transforming Escherichia coli Rosetta(DE3). Recombinant antibody proteins were prepared through IPTG induction, and its activity was detected using extracted Hp urease as the antigen. SDS-PAGE analysis confirmed the correct expression of both UreBAb and SUMO-UreBAb, with protein yields of 0.34 mg/mL and 0.41 mg/mL, respectively. Unidirectional immunodiffusion experiments further confirmed that both recombinant antibodies exhibited strong affinity for Hp UreB antigen, with inhibition rates of 51.27% and 74.07%, respectively. Additionally, leveraging artificial intelligence tools such as AlphaFold2, cluspro2, mCSM-AB, OSPREY, and FoldX, the study evaluated and analyzed key binding sites and mutational strategies affecting the stability of the antigen-antibody complex. Subsequently, nine UreBAb evolution mutants were constructed, and their binding activities with the antigen were enhanced. Among these, the I107W mutant showed the most significant improvement, achieving a 24.95% increase compared to the wild-type UreBAb. This research lays a solid foundation for the development of fully humanized single-domain antibodies against Hp.

Objective To investigate the association of PR gene exon 5 region H770H (rs1042839) single nucleotide polymorphism (SNP) with the genetic susceptibility to endometriosis (EM) in southern Han Chinese women. Methods Totally 431 EM patients and 499 non-EM women were collected and separated into EM group and control group, that all cases were confirmed by operation and pathology. A case-control study was performed in EM and control groups to evaluate the association of these SNP with the susceptibility to EM by using a fluorescent quantitative PCR-based high resolution melting (HRM) method. Results The C and T of PR H770H allele frequencies among the EM and control groups were 97.9%(844/862), 2.1% (18/862) and 99.4% (992/998), 0.6% (6/998), respectively. The CC, CT and TT of PR H770H genotype frequencies among the EM and control groups were 95.8%(413/431), 4.2%(18/431), 0 and 98.8%(493/499), 1.2%(6/499), 0, respectively. There were statistical significances in the PR H770H alleles and genotypes distributions between the two groups (χ2=7.386, P=0.007;χ2=8.135, P=0.004). Carrying allele C reduced the risk of EM (OR=0.986, 95%CI: 0.976-0.996), while carrying allele T enhanced the risk of EM (OR=3.319, 95%CI: 1.323-8.325); carrying genotype CC reduced the risk of EM 0.970 time (OR=0.970, 95%CI: 0.949-0.991), whereas carrying genotype CT enhanced the risk of EM 3.473 times (OR=3.473, 95%CI:1.391-8.671). Conclusion There is significant association between the polymorphism of PR H770H and genetic susceptibility to EM in southern Han Chinese women.

Objective: To observe the effect of the application of the "3Y" shape Multipore tape combined with transparent dressing in the maintenance of double lumen PowerPICC. Methods: Totally150 patients inserted double lumen powerPICC were randomly assigned to experimental group and control group, each group included 75 patients. when maintaining PICC, the "3Y" shape Multipore tape combined with transparent dressing were used for experimental group, while traditional method were used for control group. The endpoints were: the time for dressing change,the incidence of catheter migration,the incidence of dressing rolling or loosing,the incidence of PICC related complications. Results: The time for dressing change of experimental group (13.14±0.23) min was significant longer than control group (12.99±0.24) min (t=4.025, P<0.05) ; incidence of catheter migration of experimental group (5.3%,4/75) was significant lower than control group (18.7%, 14/75) (χ²=6.424, P=0.04). Incidence of dressing rolling or loosing of experimental group (9.3%,7/75) was significant lower than control group (22.7%,17/75)(χ²=7.028, P=0.03). Incidence of complication of experimental (1.3%, 1/75) was significant lower than control group (9.3%, 7/75) (χ²=4.754, P=0.03) . Conclusions Application of the "3Y" shape Multipore tape combined with transparent dressing in the maintenance of double lumen PowerPICC cost a little bite more time,while reduce the incidence of catheter migration and related complications, improve patients′degree of comfort, worth to be widely used.

Objective To evaluate the bacteriostatic effect of recombinant human lactoferrin(rhLF) on Helicobacter(H .) py‐lori and its influence on CagA ,Ure and gastric mucosal IL‐8 .Methods The minimum inhibitory concentration(MIC)and the influ‐ence of different drug concentrations on the proliferation of H .pylori were detected .The effects of rhLF on the mRNA and protein expressions of CagA and Ure in H .pylori were detected by RT‐PCR and Western blot ,respectively .The animal study :Balb/c mice were adopted and assigned randomly into four groups ,including the standard triple+rhLF(group A) ,rhLF(group B) ,standard tri‐ple(group C) and normal saline(group D) .The histopathological HE staining was used to observe the gastric inflammation and ELISA was used to detect the IL‐8 level of gastric tissue in each group .Results MIC was 0 .5 mg/mL ,moreover rhLF inhibited the bacterial growth and proliferation with a concentration‐dependent manner .rhLF could reduce the expression of H .pylori major viru‐lence factor CagA ,mRNA and protein of Ure .Comparing the group A with the group B ,C and D ,the gastric mucosal inflammation score and the IL‐8 levels of gastric tissue homogenates had statistically significant differences(P<0 .05) .Conclusion rhLF inhibits the growth and proliferation of H .pylori ,moreover inhibit the expression of major virulence factor CagA in H .pylori ,mRNA and protein of Ure in different degrees ,weakens its pathogenicity ,meanwhile reduces the IL‐8 level in mice gastric mucosa ,and allevi‐ates H .pylori related gastric mucosal inflammatory response .

2,6-dimethylbenzenamine was determined as a genotoxic impurity in lidocaine hydrochloride injection, and 2-chloro-N-(2,6- dimethylphenyl) acetamide was determined as potential genotoxic impurity. An LC-MS/MS method was established to research the profiling of genotoxic impurities in active pharmaceutical ingredients (API), homemade preparation and reference preparation on column Agilent ZORBAX Eclipse Plus C18(4.6 mm250 mm，5 μm). The results show that in the homemade preparation the 2,6-dimethylbenzenamine and the 2-chloro-N-(2,6-dimethylphenyl) acetamide may be degraded under oxidation condition and alkaline condition in addition to the introduction from API preparation process. This study provides guidance for genotoxic risk assessment and prescription process optimization of lidocaine hydrochloride.

Objective To discuss the feasibility of single hole thoracoscopy of pleural fibreboard endarterectomy surgical treatment on chronic tuberculous empyema. Methods Retrospective analysis of minimally invasive treatment of 52 cases of chronic tuberculous empyema form January 2013 to May 2016, 50 cases applied single hole thoracoscopy surgery, video-assisted mini-thoracoscopy for another 2 cases. Results There was no death, operation time 60 ~ 240 min, average 160 min, bleeding 150 ~ 2000 ml, average 350 ml, postoperative chest tube drainage time 3 ~ 21 d, average 7 d, postoperative persistent leakage in 3 patients, 3 cases of atelectasis, incisional infection in 1 case, pleural effusion in 1 case, 3 cases of arrhythmia. All the cured patients are received the corresponding treatment, the follow-up of 3 ~ 36 m, the chest CT scan show no atelectasis. Conclusion Under the condition of strict selection of indication, single hole thoracoscopy of pleural fibreboard endarterectomy in treatment of chronic tuberculous empyema is safe and feasible, so it is worthy of making further clinical promotion and application.

Objective:To have a better understanding of congenital leukemia by summarizing its clinical features and prognosis.Methods:This study retrospectively recruited 10 neonates with congenital leukemia treated in Beijing Children's Hospital, Capital Medical University from January 2006 to December 2018. Clinical data including clinical manifestations, laboratory examinations, treatment and follow-up were described.Results:The 10 patients consisted of six boys and four girls. In all cases, symptoms presented within 11 d after birth. The admission complaints were jaundice ( n=4), polypnea ( n=3), fever ( n=2) and rash ( n=2). Physical examinations of the 10 patients showed eight with splenomegaly, seven with hepatomegaly and seven with petechia/skin rash. All patients had significantly increased white blood cell count (from 45.8×10 9/L to 553.0×10 9/L), complicated by different degrees of anemia and thrombocytopenia. By bone marrow biopsy, two cases were diagnosed as acute lymphoblastic leukemia and the other eight cases as acute myeloid leukemia. All cases refused chemotherapy on the preliminary diagnosis. Three cases lost follow-up and six died within two months after discharge requested by their parents. One baby had spontaneous remission, but relapsed two years later. Complete remission was achieved after strict management and no relapse was reported until ten years old. Conclusions:Congenital leukemia is a severe condition with high mortality. Some cases may achieve spontaneous remission, but long-term follow-up is needed.