Objective To evaluate the optimal dosage of misoprostol administered in the rectum for dilation of the cervix. Methods Two hundred and forty women at 40-60 day gestational age without vaginal delivery history were randomly divided into three groups,with 80 cases in each group. Patients received 200,400 or 600μg of misoprostol rectally one hour before electrical vacuum abortions in group A,B and C,respectively. Cervical dilation,blood loss,and drug side effects in the three groups were compared. Venous blood samples were taken before vein anesthesia,and misoprostol acid concentration in the serum was tested by liquid chromatography-mass spectrometry. Results The analgesic rate was 100. 00%in all three dose groups, and cervical dilation rate was 23. 75%,46. 25%and 70. 00%in groups A,B and C,respectively. The severity of drug side effects such as vaginal bleeding and abdominal pain is dose-dependent. Blood concentration of misoprostal acid was(117±65),(206± 98),and(303±149)pg·mL-1 ,in groups A,B and C,respectively. Conclusion The recommended dose of misoprostol is 400 μg administered in rectum. Rectal administration of misoprostol is cheap,safe,and convenient,and therefore could be widely applied.

Humans ; Multiple Myeloma ; drug therapy

Objective To investigate the oncologic and reproductive outcomes after progestin treatment of complex endometrial hyperplasia(CEH) and grade 1 endometrial carcinoma(EC).Methods In a retrospective study, data were obtained for patients with CEH or grade 1 EC at presumed stage IA(without myometrial invasion) who wished to preserve fertility and were treated at the Peking Union Medical College Hospital, China, between January 1, 2000 and December 31, 2011.Patients had received oral medroxyprogesterone acetate(250-500 mg/d) or megestrol acetate(160-480 mg/d) for at least 6 months.Results Among 55 included patients, median age was 32 years(range 21-41 years).41(75%) achieved complete response after a median period of 6(3-24) months.Complete response was less frequent among obese than nonobese patients(4/12 [33%] vs 37/43 [86%];P=0.001).Disease recurrence was recorded in 10(24%) patients with complete response;the 5-year recurrence-freesurvival rate was 71%.Among the 33 patients who retained a desire to conceive, 17(52%) became pregnant.Conclusions Fertility-sparing management with oral progestin is effective and safe.Obesity is associated with a lower probability of long-term success.

Radiation-induced lung injury (RILI) is a common complication in thoracic cancer patients through radiotherapy, which can be divided into the early-stage radiation-induced pneumonitis (RP) and late-stage radiation-induced lung fibrosis (RILF). At present, glucocorticoids are mainly adopted in the clinical treatment of RP. However, there has been no effective medical treatment for RILF. RILF patients will eventually die from respiratory failure. The exact mechanism of RILI remains unclear. Current studies have proposed that its possible pathogenesis might consist of genetic heterogeneity, oxidative stress and cell damage. In this review, studies related to the pathogenesis of RILI were summarized.

Background Scarring of the filtering bleb is a main cause of filtering surgical failure in glaucoma.It has been reposed that tetrandrine could suppress the proliferation of cultured human fibroblast of Tenons capsule in vitro and thus has the potential effect to prevent scarring after the filtering surgery. Objective Present study was to investigate the anti-cicatricial effect of tetrandrine drug delivery system(Tet DDS)during filtration surgery. Methods Filtration surgery was performed in bilateral eyes of 18 New Zealand white rabbits.The Tet DDS with 0.3 mg Tet,0.2 mg Tet or free-Tet were implanted subcunjunctially during the surgery.The filtering blebs were scored in 1 day,4,7,10,14 days after referring to the corneal thickness and bleb range under the slit-lamp biomicroscopy.The morphology of filtering bleb was assessed by in vivo confocal microscopy in 7 and 14 days after operation.The filtering bleb specimen was prepared in 7 and 14 days for the histopathological examination. Results The filtering bleb scores in Tet DDS implantation groups were significantly higher than those in free-Tet DDS group from 4 days through 14 days after trabeculectomy(P＜0.01),and the scores showed a considerably increase in 0.3 mg Tet DDS group compared with 0.2 mg Tet DDS group from 7 days through 14 days after trabeculectomy(P＜0.05).The filtering blebs of Tet DDS implantation groups were found with distinct subepithelial cystic spaces under the light microscopy and in vivo confocal microscopy on the 7th day and 14th day after surgery.Compared with free-Tet DDS group,the numbers of subepithelial mierocysts were much more(P＜0.01)and the area of microcysts was larger(P＜0.01)in Tet DDS group.The filtering tissue presented with more subepithelial microcysts and larger microcysts range in 0.3 mg Tet DDS group than 0.2 mg Tet DDS group in 7 and 14 days after operation(P＜0.05).The inflammatory cell infiltration wag milder in 0.3 mg Tet DDS group in comparison with 0.2 mg Tet DDS group and free-Ted DDS group.Conclusion Tet DDS has strong inhibitory effects on inflammatory cells activity and fibroblagt activity the early stage after filtering surgery and therefore improve the surgery success rate.

Objective To evaluate prognostic indicators in severe traumatic brain injury and intracania hamatomas with hernia and analyze which is the most important indicator.Methods Data of 84 cases with severe traumatic brain injury were retrospectively analyze .Age,GCS,pupil reflex,midline shift,compression of the cisteme,decompression time and complex injury were considered as possible prognostic indicators.SPSS13.0 was employed to analyze the data,Logistic regression(Forward conditional)analysis was done to confirm which are the most important prognostic indicators for severe traumatic brain injury and to evaluate the practical value in predicting prognosis(X2= 22.92,P＜ 0.01).Results 48 patients died and 36 survived.56(67%)patients had a bad prognosis(GCS≤3)and 28(33%)had a good prognosis(GCS ＞3).Those who had a shorter decompression time(≤3h)had a better prognosis than those who had a longer decompression time(＞3h),with the mortality rate of 11% and 67% respectively.Lesser cisteme compression predicts better outcome.GCS,pupil reflex,midline shift,and complex injury didn' t enter the logistic regression equation.According to compression time,90.5% of the cases' prognosis was accurately predicted,according to compression time and cisterne compression,95.2% was accurately predicted.Conclusion The mortality rate of severe traumatic brain injury with hernia was high and surgical intervention was effective.Decompression time and cisteme compression were the most important factors affecting prognosis in severe traumatic brain injury and they could predict prognosis of most cases correctly.

Objective To investigate the effect of cold atmospheric plasma (CAP) on the healing of skin ulcers using Balb/c mice. Methods Wounds with a diameter 6 mm were created on each side of the backs of BalB/c mice ( n = 150) using a punch bioptome. The mice were assigned randomly into a control group ( wounds healed naturally), a laser group (wounds treated with a He-Ne laser for 10 min daily) and a CAP group (wounds treated with CAP for 10 min daily). Wound healing was evaluated on postoperative days (PODs) 4, 7, 10 and 14 in terms of percent wound closure. Ten mice per group were sacrificed on each of the evaluation days. Both wounds were removed and a histological examination was conducted. A scoring system was used to evaluate the wounds. The expression of vascular endothelial growth factors (VEGFs) in the wounded tissue was detected by using immunohistochemical methods on POD 7. The results were quantified using an HPIAS-1000 system. Results Compared with the control group, the average percentage of wound healing was significantly greater in the CAP group on PODs 7 and 10. The average scores on the histological examination were significantly higher in the CAP group on PODs 7, 10 and 14. Compared with the other two groups, the expression of VEGF was up-regulated significantly in the CAP group.Conclusions CAP can positively affect the wound healing process. This might be related to the up-regulation of VEGF in the wounded tissues.

Aged ; CD3 Complex ; metabolism ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; metabolism ; Lymphoma, T-Cell, Peripheral ; drug therapy ; metabolism ; pathology ; surgery ; Male ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; drug therapy ; metabolism ; pathology ; surgery

ObjectiveTo investigate the action mechanism of CD20 lymphocyte infiltration in the renal allograft biopsy with chronic allograft nephropathy (CAN).MethodsCAN cases confirmed by renal biopsy within 2 years after renal transplantation served as study subjects. By using immunohistochemistry,the deposition of C4d and the CD20-positive lymphocytes infiltration in the renal grafts were examined.The clinical follow-up data were analyzed.ResultsForty-four cases of CAN were enrolled in the study, including 13 cases (29.5％ ) of CD20-positive lymphocytes infiltration,and 31cases (70.5％ )of CD20-negative lymphocytes infiltration. CD20-positive lymphocytes in biopsy showed nodular and scattered lymphocytes infiltration.There were 5 (26.3％)cases of CAN Ⅰ,4 cases (25.0％) of CAN Ⅱ,and 4 (44.4％) of CAN Ⅲ in CD20-positive group.There was no statistically significant difference between the only CAN group and CAN with AR group in CD20-positive rate.Immunohistochemical staining showed there were 12 cases (27.3％) with C4d linear deposition in peritubular capillary endothelial cells (PTC).C4d positive rate had no significant difference among the CAN classifications. There was no significant relationship between C4d deposition and CD20-positive lymphocytic infiltration.The average serum creatinine in CD20-negtive group and CD20-posigtive group was 140.8 ± 22.0 and 183.5 ± 25.5μmol/L before biopsy,and 165.6 ± 37.6 and 242.2 ± 59.1 μmol/L one year after biopsy.The average serum creatinine level in CD20-positive group was higher than in CD20-negtive group before and after biopsy.ConclusionProgressive chronic humoral immunity is high risk in the process of CAN. The CD20-positive lymphocyte infiltration has no relevance with CAN grade and C4d deposition in PTC,but is associated with circulating antibody PRA and allograft long-term outcome. Pathogenetic mechanism may not contribute to chronic humoral immune,but B cells presenting donor antigens,are recognized and activated by T cells as antigen-presenting cells.

BACKGROUND: The soft tissues would shrink with nasal framework collapse following surgical trauma, which cause aseptic inflammation, lead to parts of cartilage resorption. Accordingly, long-term saddle nose deformity usually accompanied by short nasal columella. Complications such as skin perforation or ulceration would appear if corrected the deformity using medical silicone rubber with large tension.OBJECTIVE: To explore the effectiveness of repairing post-traumatic saddle nose deformity with autologous costal cartilage transplantation.METHODS: A total of 21 cases with post-traumatic saddle nose deformity accompanied by short nasal columella were selected, including 6 males and 15 females, aged 16 45 years. All of the cases had trauma history and agreed with the treatment. The costal cartilage was obtained from the seventh rib and formed to babylon weeping willow leaf shape and columella nasi stent to repair post-traumatic saddle nose deformity. The "V-Y" progradation suture was used in the philtrum introcession and the botton of nasal columella to extend the nasal columella. The recovery of saddle nose deformity after transplantation, discharge of transplanted cartilage, as well as the incision scar status was observed.RESULTS AND CONCLUSION: The results were satisfactory and there were no complications after transplantation. All the cases were followed up from 6 months to 2 years. No case suffered costal cartilage grafts discharge or chondral deformation. The scar was little at the bottom of nasal columella. It is an ideal method for repairing post-traumatic saddle nose deformity using transplantation of autologous costal cartilage with "V-Y" progradation suture.