Objective To observe the clinical efficacy and adverse reactions of desogestrel ethinylestradiol in the treatment of dysfunctional uterine bleeding ( adolescent Dub ) .Methods 86 cases with adolescent functional bleeding were divided into the treatment group and control group ,43 cases in each group .The control group received conjugated estrogen(Premarin) treatment,the treatment group was given desogestrel ethinylestradiol treatment .The hemostatic effect and drug adverse reaction of the two groups were observed .Results The cure rate of the treatment group was 65.1%,that in the control group was 23.3%,there was significant difference between the two groups (χ2 =15.28,P<0.01).The hemostatic time of the treatment group was (33.24 ±12.85)h,which was shorter than (50.31 ± 16.32)h of the control group (t=5.39,P<0.05).The incidence rate of adverse reactions between the two groups had no significant difference (χ2 =0.49,P>0.05).Conclusion Desogestrel ethinylestradiol in the treatment of ado-lescent functional bleeding has exact curative effect ,it has low incidence of adverse reactions and better acceptance .

ObjectiveTo investigate the feasibility and superiority of video-assisted minithoracotomy surgery (VAMT) in treatment of adolescent patients with primary spontaneous pneumothorax. MethodsThe clinical data of 103 adolescent patients with spontaneous pneumothorax were analyzed retrospectively. VAMTS was performed in 56 cases and video-assisted thoracoseopic surgery(VATS) was performed in 47 cases. complications Statistical analysis were undergoing in middle-operation, post-operation and ambi-operation in the two groups were analyzed. ResultsNo statistically significant difference were found in blood loss ,operating time,pain grade, out-of-bed activity time, antibiotics use time,chest drainage time,hospital day pulmonary infection between the two groups( all P ＞0.05 ). The cost of hospitalization was lower in VAMTS group compare to VATS group ( P ＜ 0.05). ConclusionVAMT in treatment of adolescent patients with primary spontaneous pneumothorax had the advantage of simple performance, reliable effectiveness, practical,lower cost of hospitalization fee.

BACKGROUND:Our preliminary studies have shown that basic fibroblast growth factor can induce the differentiation of bone marrow mesenchymal stem cells into disc cells of the temporomandibular joint, and for basic fibroblast growth factor, 10μg/L is superior to 5μg/L in col agen synthesis.
OBJECTIVE:To observe ultrastructural changes of bone marrow mesenchymal stem cells after being induced by different concentrations of basic fibroblast growth factor.
METHODS:We cultured primary sheep bone marrow mesenchymal stem cells and selected passage 3 and 4 cells at good growth state. Bone marrow mesenchymal stem cells were stimulated with 5 and 10μg/L basic fibroblast growth factor and their growth state was observed under inverted phase contrast microscope. Uninduced cells served as controls. The slides with cellcrawling pieces were stained with Safranin O, picrosirius and type I col agen immunohistochemistry at days 7, 14 and 21, respectively. Simultaneously we col ected the cells at day 21 to observe the ultrastructural changes of bone marrow mesenchymal stem cells.
RESULTS AND CONCLUSION:After being induced with different concentrations of basic fibroblast growth factor, bone marrow mesenchymal stem cells were able to differentiate into disc cells of the temporomandibular joint;and after being induced with 10μg/L basic fibroblast growth factor, cells were more like fibroblast-like cells of the temporomandibular joint disc. These findings indicate that bone marrow mesenchymal stem cells have morphological basis for differentiation to the fibroblast-like cells of the temporomandibular joint disc.

Objective To investigate the impact of subclinical hypothyroidism (SCH) on macrovascular complications in elderly type 2 diabetic patients.Methods A total of 1170 hospitalized elderly patients with type 2 diabetes mellitus were enrolled in the study through systematic sampling and underwent testing for blood biochemical indicators, thyroid function and C peptide.Parameters for macro-vascular complications, including the ankle/brachial index (ABI), transcranial Doppler vascular ultrasound (TCD), electrocardiogram (ECG), ejection fraction (EF), history of coronary heart disease, and hypertension grading were also monitored.Results All the subjects were divided into two groups based on the thyroid stimulating hormone (TSH) level: the euthyroid group (4 mU/L≥TSH＞0.4 mU/L) and the SCH group (TSH＞4 mU/L), and the latter was further sub-grouped into the mild SCH group (10 mU/L≥TSH＞4 mU/L) and the severe SCH group (TSH＞10 mU/L).ABI was significantly decreased in SCH (R/L: 0.86/0.92, P＜0.01).Levels of basal C-peptide (CP0) and post glucose-challenge C-peptide (CP1-3) were higher in the SCH group than in the euthyroid group [(2.16±0.93)pg/L vs.(1.56±1.05)pg/L, (0.53±0.25)pg/L v, (0.38±0.37),(0.72±0.23) pg/L vs.(0.56 ±0.32) pg/L, (6.21± 2.69) pg/L vs.(4.46 ± 2.62) pg/L,respectively, P＜0.01 for all].EF was higher in the SCH group than in the euthyroid group[(70.87± 6.66)％ vs.(65.10 ± 8.08％), P＜ 0.01].There were no significant differences in other biochemical indicators, ECG, TCD, history of coronary heart disease, hypertension grading and intervention treatment (P＞0.05 for all).Conclusions Lower extremity atherosclerotic disease has a higher incidence in elderly type 2 diabetic patients with SCH and occurs earlier than other macrovascular complications.Elevated TSH levels and insulin resistance may be the major causes.

Purpose To investigate the effects ofβ-1apachone on inhibition of pro1iferation and migration and induction of apoptosis in gastric cancer ce11s in vitro. Methods The ce11 viabi1ity was detected using MTT and co1ony formation assay,the migration abi1ity was determined using scratch assay method,and the apoptosis was examined using f1ow cytometry. Meanwhi1e,the expression of biomarkers of pro1iferation,EMT markers andapoptosiswere detected using Western b1ot ana1ysis. Results β-1apachone cou1d significant1y inhibit the pro1iferation of SGC-7901 and AGS gastric cancer ce11s( P<0. 05),and down-regu1ate the expression 1eve1s of Skp2 and DEK pro-teins. β-1apachonecou1d a1so inhibited the invasion and moti1ity of gastric cancer ce11s via down-regu1ating the expression 1eve1s of MMP-2/9 and Ezrin proteins and up-regu1ating the epithe1ia1 markers. In addition,β-1apachone enhanced the apoptosis of gastric canc-er ce11s,down-regu1ation of BCL-2/Bax ratio and up-regu1ation of activated Caspase-3/8/9. Conclusions β-1apachone can effective1y inhibit the pro1iferation and induce the apoptosis of gastric cancer ce11s,and inhibit the migration of gastric cancer ce11s via MMPs and EMT pathways.

Objective There is a huge demand for rehabilitative services in Chongqing whereas detailed information regarding local clinical services and rehabilitative professionals are unknown. Therefore, a cross-sectional survey was conducted to generate a profile of current rehabilitative status in Chongqing for reference of relevant local parties and peers in other provinces of China to create a larger picture of rehabil-itation in China. Methods The survey began in early January of 2015 and ended on October 20th of 2015. With two categories of information, including background of rehabilitation professionals and rehabilitative clinical services, the self-made questionnaire was sent via email to rehabilitation therapists working in local clinical settings which fulfilled the inclusion criteria. The reminder was sent once a month to those who did not yet replied. The software SPSS 20.0 was used to analyze the data descriptively. Results 7 out of 13 in-volved clinical settings responded with an overall response rate of 53.8%. 98 out of 122 copies were adopted based on filling requirement. The result revealed 68.4%(n=67) of the participants were junior practitioners, 57.1%(n=56) of them had less than 5 years experience and 45.9%(n=45) were holding a diploma with little research experience. As for clinical services, assessment of ROM (94.9%, n=93) and manual muscle testing (94.9%, n=93) were mostly used. The physical therapy service was more prevalent than occupational therapy services. The clinical field mostly involved was adult rehabilitation (77.6%, n=76). Bedside training in the acute phase (81.6%, n=80) and one-to-one treatment (92.9%, n=91) was the most commonly seen mode of service in the departments. Conclusion The local rehabilitative professionals were featured by their young age with comparatively low educational level, qualification and weak research skills. The clinical services they provided were yet quite basic and simple. Thus, a set of policies regarding education and profession in rehabilitation therapy should be facilitated instantly and it also calls for the establishment of local academic society for rehabilitation therapists, thus promoting an all-round development of rehabilitative profession.

Objective To conduct a prospective,randomly controlled trial,evaluating the combination of tacrolimus,corticosteroids and entecavir for the treatment of adult patients with biopsyproven hepatitis B virus-associated membrane nephropathy (HBV-MN).Methods A total of 38 patients with biopsy-confirmed HBV-MN were randomized to the tacrolimus group (n=19) and the control group (n=19).Patients in tacrolimus group received combination therapy of tacrolimus (0.05 mg·kg-1 · d-1),corticosteroids (prednisone acetate,0.5 mg· kg-1 · d-1) and entecavir (0.5 mg/d),whereas patients in control group received entecavir mono-therapy (0.5 mg/d).The primary end point was the percentage of patients reaching complete remission (CR) or partial remission (PR).Results The probability of remission in the treatment group was 88.89％ and 94.44％ after 6 and 12 months,but only 38.89％ and 58.82％ in the control group,respectively.The decrease in proteinuria was significantly greater in the treatment group.Entecavir was used for the treatment of hepatitis in all patients,which caused the disappearance of serum hepatitis B viral DNA(HBV-DNA) and the normalization of ALT and AST levels in 3 months.Notably,two patients in the control group and one patient in the treatment group reached the secondary end point.One patient in the tacrolimus-treated group showed a relapse during the taper period.Conclusion This treatment protocol not only can control the replication of HBV-DNA but also can reduce proteinuria and preserve renal function,it is one of useful therapeutic options for patients with HBV-MN.

Objective To investigate the relationship between subclinical hypothyroidism (SCH) and diabetic retinopathy (DR) in elderly type 2 diabetic patients.Methods 1170 hospitalized patients with type 2 diabetes mellitus were enrolled in our study.After identified by systematic sampling,all the elderly patients received examinations of thyroid function,biochemical indexes,steamed bread meal test and C-peptide releasing test.The serious degree of DR was observed through digital fundus photography and ophthalmofundoscope.The relationship between SCH and DR was analyzed.Results All the subjects were divided into two subgroups:euthyroid group(TSH≤4mU/L)and subclinical hypothyroidism (SCH) group (mild SCH group,TSH ＞4～10 mU/L; serious SCH group,TSH＞10 mU/L).Free thyroxine (FT4) was significantly lower in SCH group than in euthyroid group[(13.91±2.17) pmol/L vs.(16.55±2.81)pmol/L,P＜0.001].The levels of basal (CP0) and post glucose-challenge (CP1-3) C-peptide were significantly higher in SCH group than in euthyroid group (P0-3 value:0.001,0.012,0.004,0.001).There were significant differences in the progress of diabetic retinopathy between SCH and euthyroid groups (retinopathy-L,P=0.018; retinopathy-R P=0.013).Conclusions Elderly type 2 diabetic patients with SCH have a higher incidence of diabetic retinopathy (DR).The elevated FT4 level and decreased basal C-peptide level are probably the main reasons.

Objective To explore the application of 18F-FDG PET/CT combined with high-resolution CT (HRCT) in the same scanner on diagnosis of lung cancer, and its influencing factors. Methods 50 patients, in which some cannot supply HRCT raw date and under highly suspicion of being lung cancer, some were postoperative lung cancer and metastasis of lung cancer, were examined by 18F-FDG PET/CT combined with HRCT in the same scanner. Results 50 patients were all successful (100%) on PET/CT scans after preparation, injection, rest and breathing exercises;46 cases (92%) were successful on PET/CT combined with HRCT scans;4 cases (8%) failed on HRCT scans. Ma-lignant lesions were found in 35 cases, with the metastasis of 21 cases;4 in 6 cases of postoperative lung cancer were found metastasis;9 cases of benign pulmonary nodules need to be observed sequentially. Conclusion 18F-FDG PET/CT combined with HRCT in the same scan-ner is valuable on diagnosis of lung cancer. The diagnostic accuracy and sensitivity significantly increase. It is a non-invasive new imaging technology and systemic metastasis can be observed.

Objective To study the influence of the angle of multileaf collimator leaves on segments (control point for sliding windows) number and monitor units in intensity-modulated radiotherapy (IMRT) plan optimization.Methods 10 cases undergone IMRT with rectangle target volume were choosed,2 plan were designed with step and shot technique and sliding windows technique for running direction of collimator with target long axis vertical and parallel respectively,compared the plans with similar optimization parameters for different angle of the collimator.Results The number of segments and monitor units increased by 52.8％ and 49.6％ more than longitudinal direction of leaf collimator with static IMRT respectively,there appeared significant difference (P =0.000) ; and the number of segments and monitor units increased by 58.2％ and 61.9％ more than longitudinal direction of leaf collimator with dynamic IMRT respectively,there appeared significant difference (P =0.000).Conclusions For the optimization of IMRT based on multileaf collimator,the direction of collimator perpendicular to the target long axis,there could be obviously decrease the number of monitor units,shorten the treatment time,improve the treatment efficiency with similar dose distribution.