Objective To investigate the change of local vaginal microenvironment in atrophic vaginitis after estrogen therapy.Methods A prospective study was conducted in 128 patients with atrophic vaginitis.The patients were treated with estriol cream by vaginal administration,and the efficacy was observed after treatment.Results The PH value was decreased and the detection rate of lactobacilli was significantly increased after estrogen therapy(P＜0.01).Average vaginal health score was also increased (P＜0.01).Interleukin-6 (IL 6) level in vaginal secretion was decreased after the treatment (P＜0.01).Interferon-γ (INF-γ) level was increased obviously after treatment,while there was no significant difference between the two groups(P＞0.05).Conclusions Estrogen can significantly improve the local vaginal microenvironment in atrophic vaginitis.Estrogen may regulate the immune function of vagina by reversing the imbalance of Th1/Th2.

Objective To investigate whether early goal-directed therapy ( EGDT ) could lower the mortality rate in patients with severe sepsis and septic shock. Methods Articles with items sepsis, severe sepsis, septic shock, EGDT were retrieved from MEDLINE, EMBASE, Cochrane, Wanfang Data and CNKI. Inclusion criteria included randomized controlled trial, subjects concerning patients with severe sepsis or septic shock, endpoints with short-term mortality [ in-hospital, intensive care unit ( ICU ) or 28-day ] and long-term mortality ( 60-day or 90-day ). Related risk ( RR ) and 95% confidence interval ( 95%CI ) were used as indices to judge the difference in mortality rate between EGDT group and standard treatment group. RevMan 5.2 software was used for Meta analysis. Results There were 8 studies meeting inclusive criteria with a total of 4 853 patients. For patients with severe sepsis and septic shock, compared with the group with routine treatment, EGDT showed a decrease in the short-term mortality ( RR = 0.74, 95%CI=0.66-0.82, P<0.000 01 ), but did not decrease the long-term mortality ( RR=0.99, 95%CI=0.92-1.06, P=0.81 ). Conclusion EGDT strategy may decrease the short-term mortality in patients with severe sepsis and septic shock, but it showed no influence on the long-term mortality.

Objective To study the value of the intervention of Nitroglycerin(NTG) on ~(99m)Tc-MIBI myocardial tomography imaging in the estimation of myocardial viability.Method According to the analysis of autologous electrocardiogram(ECG),a total of 66 patients with unstable angina(UA) was divided into group A and group B.The patients in group A were without old myocardial infarction and those of group B were with old myocardial infarction.The patients in the two groups were respectively underwent the resting ~(99m)Tc-MIBI myocardial tomography imaging and the NTG administration intervened the next day.The imaging was collected and tested by the computer.Results Of 594 myocardial segments in the 66 cases,242 segments(40.7%) in testing myocardial imaging were proved to be perfusion abnormal,while after the intervention of NTG administration,the perfusion of 114 segments(47.1%) had been improved according to the imaging.Conclusion The intervention of NTG administration on ~(99m)Tc-MIBI myocardial tomography imaging for myocardial viability is simple,safe,objective and accurate,which provides a forceful means for the post-operative evaluation and the selection of indication before the rebuilding of coronary artery of the UA patients.

Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.