Objective:To determine the levels of Th1 and Th2 type cytokines in patients with unexplained habitual abortion(UHA).Methods:A total of 54 patients with UHA were studied,including 35 cases of nonpregnant woman which were called UNP group and 19 cases of pregnant women with inevitable abortion(IEA) which were called UIEA group.15 cases of normal pregnant(NP) and 15 cases of normal nonpregnant(NNP) women were selected as control groups.Supernatants from trophoblast-activated peripheral blood mononuclear cells(PBMC) of nonpregnant women groups were tested by enzyme-linked immunosorbent assay(ELISA) for interferon gamma(IFN-?),interleukin-2(IL-2),IL-4,IL-10.Also,these cytokines were tested in the supernatants from PBMC and decidual mononuclear cells(DMC) of pregnant women groups.Results:①The levels of IL-2,IFN-? in trophoblast-activated PBMC supernatants of UNP group were higher and IL-4,IL-10 were lower than those of normal nonpregnant group( P

Objective To investigate the influences of active immunotherapy on T helper cell (Th)1/Th2 type cytokines in women with unexplained habitual abortion(UHA) Methods A total of 55 patients with UHA were studied, including 30 cases after active immunotheraphy (AIT) and 25 cases without any therapy(NAIT). Fifteen cases of normal nonpregnant (NNP) women were selected as control group. Supernatants from trophoblast activated peripheral blood mononuclear cells (PBMC) of the three groups were tested by enzyme linked immunosorbent assay (ELISA) for interferon gamma (IFN ?), interleukin 2 (IL 2), IL 4, IL 10. Results (1) The levels of IL 2 and IFN ? in AIT group [(108?37) ng/L and (110 ?52) ng/L, respectively] were lower significantly than those in NAIT group[(223?85) ng/L and (326 ?92) ng/L, respectively]( P 0.05). (2) Twenty six women in AIT group got pregnant, but 8 women experienced pregnancy loss repeatedly whose IL 2?IFN ? levels were higher than those in other 18 women got successful pregnancy and IL 4,IL 10 levels lower than the latter. Conclusions UHA patients have Th1 type immunity to trophoblast and produce high level Th1 type cytokines which probably result in pregnancy loss. Active immunotheraphy could make a shift from Th1 to Th2 immunity, thus favoring the maintenance of pregnancy.

Objective To study the efficacy and safety of estradiol and drospirenone tablets (Angeliq)in treatment of menopausal symptoms among postmenopausal Chinese healthy women.Methods Total 244 postmenopausal Chinese healthy women who had moderate to severe hot flushes were randomly assigned for 16 weeks in this randomized multi-center double-blind placebo-controlled study.During the trial.the follow-up visits were conducted at week 4,8,12,16 of treatment and 2 weeks after treatment respectively.Height,weight,vital signs,hot flushes,other relevant menopausal symptoms and vaginal bleeding were observed in each follow-up visit,while the clinical global impression scale Was assessed at 16 weeks as well.Results It showed that hot flushes were reduced significantly more in observation group than that in placebo group ( P＜0.01 ), although both treatments were effective. The absolute values of mean severity index of total hot flushes decreased by - 0. 6± 0. 5 in observation group and - 0. 4 ± 0. 4 in placebo group from baseline respectively, which reached significant difference ( P ＜ 0. 05 ). However, the absolute values of mean severity index of moderate to severe hot flushes decreased by - 0. 6± 0. 8 in observation group and -0. 3± 0.6 in placebo group from baseline respectively, which had no significant difference (P ＞ 0. 05 ).After 16 weeks treatment, it also showed that estradiol and drospirenone had significant better efficacy than placebo on moderate to severe sweating, vaginal dryness and clinical global impression scale (P ＜0. 01 ).During the trial, blood pressure in observation group was stable. The rate of vaginal bleeding in observation group was higher than that in the placebo group, especially during the week 4 to week 8 when 48. 9% (87/178) in observation group and 10. 7% (6/56) in placebo group of patients bled. Although the cumulative amenorrhea rate of observation group was lower than that of placebo group in each cycle (28 days), it increased gradually along with duration of the treatment. The commonest adverse event in observation group was breast tenderness which accounted for 12.0% (22/183 ). The level of serum potassium was in the normal range in observation group mostly. Meanwhile, the other adverse events rate was low. Serious adverse events reported in this trial were assessed as not study drug related or as unlikely study drug related. Conclusion Estradiol and drospirenone tablets which could effectively alleviate menopausal symptoms in postmeuopausal Chinese healthy women is a novel hormone replacement therapy regimen with high safety and efficacy.

Objective:To reports the nursing care of a patient with superior mesenteric artery syndrome after posterior spinal correction for adolescent idiopathic scoliosis.Methods:While in hospital, conservative treatment requires fasting and water deprivation, gastrointestinal decompression. Combined with perioperative nursing measures of spinal orthopedics, the nursing focus of patients during hospitalization includes: enteral and parenteral nutrition, designed the condition record sheet, and dynamically monitor the patient′s condition; personalized guidance about function exercise was gibien.In addition,continuous care after discharge were provided through health education before discharge and post-discharge follow-up.Results:After the implementation of the nursing measures, the patient recovered well after surgery, the symptoms of superior mesenteric artery syndrome were effectively controlled, and the patient resumed eating through the mouth. Two months after discharge, the patient gained 4kg of body weight.Conclusion:The treatment and nursing of superior mesenteric artery syndrome is a long-term process, nurses should place emphasis on observation and nutrition support, and also the patient psychological care.

Objective To test the the reliability and validity of the Chinese version of the adult haemophilia activities list (HAL).Methods A Chinese version of the HAL was prepared by translation,back-translation and revision.Adult hemophilia patients were used to test it and a short-form arthritis impact measurement scale (AIMS-SF) simultaneously.A total of 98 valid questionnaires were collected.The internal consistency,reliability,split-half reliability,content validity,construct validity and convergent validity were tested.Results The Cronbach's α coefficients for the total questionnaire and its dimensions were all 0.7 or more.The half-reliability test produced a Spearman.correlation coefficient of 0.97.The Pearson correlation coefficients relating each dimension score with the total score and each dimension's entry score with the dimension score were all greater than 0.6.The correlation coefficient between the dimensions of the two questionnaires was smaller than the correlation coefficients relating each dimension with the total scale.There was relatively good correlation between the HAL sum score and the AIMS2-SF sum score (r=0.640,P≤0.01),as well as between the HAL sum score and the AIMS2-SF physical score (r=0.576,P≤0.01).Conclusion The Chinese version of the adult HAL has good reliability and validity.

Objective To investigate the correlation between the quality of life and joint health status of adult hemophilia patients. Methods Forty-nine adult hemophilia patients were selected.The quality of life and joint health status of patients were evaluated by hemophilia-specific health related quality of life questionnaire for adults (Hemo-QOL-A) and hemophilia joint health score (HJHS). Results The Hemo-QOL-A score of adult hemophilia patients was (39.34 ± 18.97) scores, and HJHS score was(33.16 ± 13.17)scores.The Pearson correlation analysis result showed that Hemo-QOL-A score was positively related with HJHS score (r = 0.490, P<0.05), and Hemo-QOL-A score was positively correlated with muscular condition,joint activity and joint friction sound score of HJHS score(r=0.469, 0.396 and 0.290; P<0.05). Hemo-QOL-A score was not correlated with swelling, swelling duration, arthralgia and gait of HJHS score (P>0.05). In 294 joints of 49 patients, the total abnormal rate of the joint was 82.7%(243/294),the abnormal rate of the elbow joint was 72.4%(71/98),the abnormal rate of the knee joint was 90.8%(89/98),and the abnormal rate of ankle joint was 84.7%(83/98).Conclusions Decreased joint health status, mainly including the surrounding muscle condition and joint mobility, results in lower quality of life in patients with hemophilia.

The aim of this study was to prepare a high drug-carrying capacity micellar drug delivery system(CTD@Sol)of the polymer zebra tetracycline and to preliminarily investigate the feasibility of this drug delivery system for the treatment of breast cancer.Firstly,CTD@Sol was prepared using sol as the carrier material and CTD as the model drug,and its pharmacological properties such as appearance and morphology,particle size,potential and in vitro release were evaluated.The growth inhibitory and apoptotic effects of CTD@Sol on breast cancer(4T1)cells were investigated by MTT assay and Annexin V-FITC/PI double staining assay;the uptake efficiency of 4T1 to this delivery system was investigated by flow cytometry;and the in vivo tissue distribution of the delivery system and the targeting of tumour tissues were investigated by small animal in vivo imaging technique.The results showed that CTD@Sol appeared as a light pale blue creamy white colour,with an average particle size of(159.73±1.96)nm,a PDI of 0.198±0.006,Zeta potential of-(47.60±1.77)mV,an encapsulation rate of(90.29±1.69)%and a drug loading capacity of(45.00±0.84)%;the in vitro release and haemolysis experiments showed that the drug release rate of CTD@Sol in acidic environment(pH 5.5)was significantly faster than that in neutral environment(pH 7.4),suggesting that the system is acid-sensitive and has good biosafety under endocytosed pH conditions.Cellular uptake,cytotoxicity and apoptosis experiments showed that CTD@Sol was more lethal to 4T1 cells,and the sol-gel polymer micelles as a drug delivery vehicle could significantly improve the cellular uptake efficiency of the drug;in vivo experiments showed that the delivery system had a significant targeting effect on tumour tissues.In conclusion,this study has successfully produced a CTD@Sol drug delivery system with high drug loading capacity(>45%),good pharmacological performance,strong targeting and biosafety,which has the potential to be used in the treatment of breast cancer.

Objective: To evaluate measurement acquisition, operability, and measurement agreement of the OA-2000 in cataract eyes with high myopia. Methods: A diagnosis test examined 1 030 eyes of 780 high-myopia cataract patients at the Wuhan Aier Eye Hospital from October 2017 to October 2018.The eyes were examined using the OA-2000, the IOLMaster 500 and the Lenstar-LS900 preoperatively.Measurement acquisition was recorded.The total ophthalmic exam, the duration of patient data entry, the actual measurement process, and the time from intraocular lens power calculation to printout were calculated.Ocular biometric parameters, including anterior chamber depth (ACD), axial length (AL), keratometry for the flattest meridian (Kf), and keratometry for the steepest meridian (Ks) were compared among the devices.This study complied with the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Wuhan Aier Eye Hospital (No.2017IRBKY07). Results: The OA-2000 was capable of obtaining an AL measurement in 94.95% of the eyes, which was significantly higher than the 83.98% and 83.01% measured by the IOLMaster 500 and Lenstar-LS900, respectively (χ²=38.171, 46.208; both at P<0.001). The total ophthalmic exam with the OA-2000 took a significantly shorter time than the Lenstar-LS900 ([109.34±2.22]s vs. [135.64±5.55]s) (P<0.05). Excellent correlations were found for the AL, ACD, Kf, and Ks measurements between the OA-2000 and the IOLMaster 500 (r=0.999, 0.937, 0.996, 0.996; all at P<0.001). Good correlations were also found between the OA-2000 and the Lenstar-LS900 (r=0.999, 0.965, 0.995, 0.996; all at P<0.001). The respective 95% limits of agreement of the OA-2000 and IOLMaster 500, and the OA-2000 and Lenstar-LS900 were -0.19 to 0.20 mm and -0.13 to 0.17 mm for AL; -0.23 to 0.23 mm and -0.18 to 0.16 mm for ACD; -0.48 to 0.47 D and -0.64 to 0.65 D for Kf; -0.49 to 0.47 D and -0.60 to 0.61 D for Ks. Conclusions In terms of AL, ACD, Kf and Ks in cataractous eyes with high myopia, the OA-2000, IOLMaster 500, and Lenstar-LS900 show excellent correlation and agreement.The OA-2000, a new swept-source OCT-based biometer, outperforms both the IOLMaster 500 and the Lenstar-LS900 in terms of AL measurement acquisition and operability.

Objective:To screen and analyze the prognostic protein biomarkers of DLBCL, and to explore their value in the prognostic evaluation.Methods:163 cases of confirmed DLBCLs from January 2011 to December 2016 were collected with their clinical, pathological and follow-up data, which were all from our hospital. The expression of protein markers were tested using immunohistochemical staining (IHC) . The immune phenotypes independent of the International Prognostic Index (IPI) that affect overall survival (OS) and progression-free survival (PFS) of DLBCL were explored by COX regression model, and the effect of their co-expression on the prognosis were also analyzed.Result:BCL6 negative (PFS: HR=1.652, 95% CI 1.030-2.649, P=0.037) , P53 positive (OS: HR=1.842, 95% CI 1.008-3.367, P=0.047) , and BCL2 strong positive expressions (S+) (OS: HR=2.102, 95% CI 1.249-3.537, P=0.005; PFS: HR=2.126, 95% CI 1.312-3.443, P=0.002) are adverse prognostic factors of DLBCL that are independent of IPI. BCL6 - (PFS: HR=2.042, 95% CI 1.021-4.081, P=0.043) , P53 + (OS: HR=3.069, 95% CI 1.244-7.569, P=0.015) and BCL2 S+ (OS: HR=2.433, 95% CI 1.165-5.082, P=0.018; PFS: HR=3.209, 95% CI 1.606-6.410, P=0.001) are adverse prognostic factors in the group of age≤60-year-old; in the group of IPI score 0-2, cases with BCL6 - (OS: HR=2.467, 95% CI 1.322-4.604, P=0.005; PFS: HR=2.248, 95% CI 1.275-3.965, P=0.005) and BCL2 S+ (PFS: HR=2.045, 95% CI 1.119-3.735, P=0.020) have worse prognosis. The co-expression of BCL6 - and BCL2 S+ has significant influence on prognosis of DLBCL ( P=0.005 and P<0.001) , in which BCL6 +/non-BCL2 S+ ( n=86) has the best prognosis[3-year-OS (71.6±4.9) %, 3-year-PFS (67.0±5.1) %], and BCL6 -/BCL2 S+ ( n=10) has the worst prognosis[3-year-OS (20.0±12.6) %, 3-year-PFS (10.0±9.5) %]; the co-expression of BCL6 - and P53 + has no significant influence on prognosis ( P=0.061 and P=0.089) , however, those cases with BCL6 +/P53 - ( n=98) often get better prognosis[3-year-OS (70.6±4.7) %, 3-year-PFS (64.6±4.9) %] than others; the co-expression of P53 + and BCL2 S+ has significant influence on prognosis of DLBCL ( P<0.001 and P<0.001) , and P53 +/BCL2 S+ ( n=5) has the worst prognosis (3-year-OS and 3-year-PFS are both 0) ; BCL2 S+ cases get shorter OS and PFS, regardless of the expression of BCL6 and P53. Conclusion:The expression and co-expression of BCL6 negative, P53 positive and BCL2 S+ have certain value in the prognostic evaluation of DLBCL, especially in the group of age≤60-year-old and IPI score 0-2.

Objective: To investigate the strong expression (S+) of P53 and BCL2 proteins in MYC/BCL2 double-expression DLBCL (DEL) and whether they can be used for the prognostic evaluation and stratified diagnosis of DELs. Methods: Tissue microarray were made by filed FFPE blocks of 174 DLBCL cases. The translocation of MYC, BCL2 and BCL6 genes were detected by FISH, and the proteins were detected by IHC. Data of clinicopathologic features and follow up of patients were collected and OS (overall survival) and PFS (progression free survival) were analyzed by statistics. Results: Eight double-hit lymphomas (DHLs) were identified in all cases, and 45 DELs were selected from 166 remaining cases, which have no significant difference in OS and PFS compared with non-DEL cases (P=0.668 and P=0.790) . Of 42 DEL-cases with follow up data, 24 cases with P53+ or/and BCL2 (S+) are significantly shorter OS and PFS than others (P=0.003 and P=0.000) , in which the cases with P53+/BCL2 (S+) co-expression were the worst prognosis, and P53/BCL2 co-weaker positive DEL cases even have superior OS and PFS than those non-DELs. Although statistics showed that the cases of P53+ or/and BCL2 (S+) have a lower OS and PFS in total cases (P=0.063 and P=0.024) , it is not the case when the DEL-cases take out from total cases, that is the cases with P53+ or/and BCL2 (S+) are as similar OS and PFS as others in non-DEL group (P=0.590 and P=0.550) . Conclusion The strong expression of P53 and BCL2 proteins can be used as indicators of stratified diagnosis and poor prognosis of DEL.