Objective To observe cerebral apoplexy patients complicated with carotid atherosclerosis plaque given aggressive lipid lowering treatment on the prognosis of stroke and reduce the recurrence rate through the large sample study on neurological department of internal medicine.Methods 300 cases of cerebral infarction complicated with different degree of neck lesions were selected and randomly divided into 3 groups,each group had 100 cases.Intensive lipid-lowering group received fluvastatin,80mg/d + 100mg aspirin,conventional dose group received fluvastatin,40mg/d + 100mg aspirin,aspirin group was given aspirin 100mg.After 4 weeks,8 weeks,12 weeks,16 weeks,20 weeks,24 weeks,blood lipid level,changes in internal carotid artery plaque (CIMT),plaque area,and the incidence rate of cerebral vascular events after 24 weeks were observed.Results The results of intensive lipid-lowering treatment group IMT (1.06 ± 0.36) mm,plaque area (8.09 ± 0.47) mm3,the incidence rate of cerebral vascular events after 24 weeks (12％),serum lipid levels and regular dose group after treatment with IMT (1.19 ±0.39) mm,plaque area (9.91 ± 0.78) mm3,the incidence rate of cerebral vascular events after 24 weeks (18 ％),serum lipid levels after aspirin group were significantly reduced(P ＜ 0.05).Aspirin group before and after treatment,IMF,plaque area and lipid levels had no significant differences(P ＞ 0.05).Intensive lipid-lowering treatment group compared with the conventional dose group,IMT,plaque area and lipid levels improved obviously(P ＜ 0.05),the recurrence rate of ischemic cerebral vascular disease had significant difference compared with the other two groups (P ＜ 0.05).Conclusion Intensive lipid-lowering treatment on blood lipid levels,delay and reverse the carotid atherosclerosis is superior to conventional dose using fluvastatin group and simply antiplatelet group,and can prevent the recurrence of ischemic cerebrovascular disease.

Objective To explore the clinical value of Doppler tissue imaging (DTI) in evaluating abdominal aortic wall motion to predict pregnancy-induced hypertension (PIH).Methods The velocities of anterior abdominal aortic wall motion in 112 pregnant women with normal 20-40 weeks' pregnancy were detected by DTI and combined with simultaneous electrocardiography.Electromechanical time (EMT), left ventricular pre-ejection period (PEP), patients' height and weight were measured and recorded respectively.Pulsed wave time (PWT, PWT = EMT-PEP) and relative pulse wave velocity (RPWV) were calculated and analyzed.Medium and late stage PIH eases and time were recorded in clinical follow-up.Results PIH group were 11 cases, non-PIH group were 101 cases.E, S_1, S_2, D peak value in PIH group were significantly lower than those in non-PIH group [(2.02 ± 0.39 ) cm/s vs (2.32 ± 0.45 ) cm/s, (6.08 ± 0.87 ) cm/s vs(7.12 ±1.11 ) cm/s, (2.22 ± 0.65 ) cm/s vs( 2.83 ± 0.81 ) cm/s, (3.26 ± 0.54) cm/s vs( 3.86 ± 0.72 ) cm/s, P < 0.01]; EMT shortening[(120.87 ± 11.34) ms vs (134.32 ± 10.62) ms,P<0.05];PEP longer[(92.36±9.04) ms vs(83.11±8.95) ms,P< 0.05];PWT shortening[(31 ± 11) ms vs(45 ± 13) ms,P<0.01]; RPWV faster [( 1 02.28 ± 20.69) m/s vs (75.37 ± 18.74) m/s, P < 0.01].Conclusions Abdominal aortic wall motion has already changed in early stage of PIH.DTI is a valuable method to evaluate the abdominal aorta wall motion for early detection of PIH with high sensitivity, high accuracy and access to promote.

Objective:To study the variation of recent bladder function of the patients who received radical hysterectomy and evaluate its significance. Methods:Sixty-three patients with cervical carcinoma in International Federation of Gynecology and Obstetrics(FIGO) stage IB1 to ⅡA received urodynamic examination before and after operation. The urodynamic parameters included filling cystometry, pressure-flow rate, and electromyography of sphinctienter. Results:Radical hysterectomy induced significant increase in the first sensation (P<0.01)and post voiding residual of bladder (P<0.01) ;whereas caused significant decrease in the maximum volume(P<0.01), compliance(P<0.01),maximum flow rate(P<0.01) and the pressure at the maximum flow rate(P<0.01), respectively, compared with the corresponding values before the operation. Short-term bladder dysfunctions were observed in 34 patients (54.0%) including bladder detrusor dysfunction, low compliance bladder, bladder outlet obstruction, dyssynergia of urethral external sphincter and detrusor overactivity. The incidences of low compliance bladder and bladder detrusor dysfunction increased significantly after operation (P<0.01). Urinary retention was found in 28.6%(18/63) patients. The incidences of bladder detrusor dysfunction (66.7% vs 20.0%) and detrusor overactivity (33.3% vs 4.4%) in the group with urinary retention were significantly higher than those of corresponding group without urinary retention. Conclusion:The bladder function had obvious short-term changes following radical hysterectomy. In the many types of bladder dysfunction the main dysfunctions were low compliance bladder and bladder detrusor dysfunction. The bladder detrusor dysfunction might be the major cause of the urinary retention following the surgery. Urodynamic test was important for post-operative analysis and treatment of bladder dysfunction.

Objective To study the expression and significance of matriptase in different metastatic potential of human ovarian cancer cells.Methods High-metastatic human ovarian cancer cell HO8910PM and ovarian cancer cell HO8910 were collected.The ability of metastatic of the former was stronger than that of the latter.Compared the ability of invasion and migration in HO8910PM and HO8910 by scratch assay and by millicell chamber artificial reconstituted basement membrane invasion assay.Detected the matriptase mRNA and protein expression levels in HO8910PM and HO8910 through reverse transcription(RT)-PCR and immunocytochemistry methods.Results The 24 hours' migration distance(347 ± 8) μm of HO8910PM cells were significantly higher than that in HO8910 group (154 ± 10) μm (P ＜ 0.01) ;The number of HO8910PM cells that penetrated the matrigel after 24 hours' incubation were significantly higher than that in HO8910 group (90.7 ±2.1 vs 63.3 ± 1.5,P ＜0.01).The expression of matriptase mRNA in HO8910PM cells was higher than that in HO8910 group (0.72 ± 0.03 vs 0.38 ± 0.04,P ＜ 0.01).The migration was positively correlated with the matriptase mRNA expression levels (r =0.992,P ＜ 0.01); and the invasiveness was also positively correlated with the matriptase mRNA expression levels (r =0.973,P ＜0.01).As far protein level,the expression of matriptase protein in HO8910PM cells was higher than that in HO8910 group (15.6 ±0.8 vs 7.6 ± 1.3,P ＜0.01).The migration was positively correlated with matriptase protein expression levels (r =0.971,P ＜ 0.01) ;And the invasiveness was also positively correlated with the matriptase protein expression levels (r =0.958,P ＜ 0.01).Conclusions The relationship between the expression levels of matriptase and the metastatic of ovarian cancer cells may be correlative.The function of matriptase in ovarian cancer cells metastatic machanism still need to be confirmed.

Objective To seauch the ideal management for gross hematuria in autosomal dominant polycystic kidney disease (ADPKD).Methods ADPKD patients who were ever hospitalized and followed up in our department since 1993 were enrolled in the study.Demographic and clinical data were colloected,such as gender,age of gross hematuria,level of renal function,causative factors,management strategies,duration of gross hematuria,blood platelet count,activated partial thromboplastin time,prothrombin time,international normalized ratio,size of kidney cyst and so on.ADPKD patients were divided into different groups according to causative factors or management.The clinical data were compared among groups.Results A total of 905 ADPKD patients were screened,among whom 279 patients ever had gross hematuria (male/female:150/129),One hundred and forty-six patients had integrated therapeutic process records,while only 101patients could provide relevant laboratory examination results.In these 101 patients,gross hematuria was found in any stage of chronic kidney disease (CKD); the average eGFR was (56.4±44.1) mml·min-1 ·(1.73 m2)-1; the duration of gross hematuria was (8.8±8.0) d; no significant difference between male and female in duration of gross hematuria existed [(8.2±7.3) d vs (9.5±8.8) d,P=0.426]; coagulation parameters were all normal.The platelet count was also normal in 91 patients.Duration of gross hematuria among groups divided according to different causative factors was significantly different (P＜0.05).The patients in bed rest group had significantly shorter duration of gross hematuria compared with other groups (P＜0.05).The platelet count,prothromhin time and international normalized ratio were all at similar level in different groups.Conclusions The causative factors in ADPKD patients with gross hematuria should be confirmed as the first step of management strategies.Bed rest is the key point in management.Antifibrinolytic agent is a proper choice in the cases receiving bemostatic drugs.It is unnecessary to use antibiotic agent for prevention.

Objective To analysis the activity of transcriptional factors in endometrial cancer cell lines with different estrogen receptor subtypes. Methods The mRNA levels of estrogen receptor (ER) was detected by quantitative RT-PCR , and the activity of transcriptional factors was also analysed by 345-channel protein/DNA array in RL-952 ( the expression status of ERα and ERβ both positive), HEC-1A [ERα(±),while ERβ negative] and HEC-1B (ERα and ERβ both negative). The transcription factors of NFkBp65 and p38MAPK with different activity were tested by enzyme-linked immunosorbent assay(ELISA) to confirm the results of protein/DNA array. Results The mRNA levels of ERα in RL-952, HEC-1A and HEC-1B were (6780±282 ), ( 684±84 ) and ( 168±38 ) eopy/ng, respectively. Among 345 candidate transcriptional factors, there were 28 factors associated with ER status. Compared with RL-952 cells, 13 transcriptional activity factors were concomitandy up-regulation, while 15 concomitantly down-regulation in HEC-1A and HEC-1B cells. Transcriptional activities of TrF (1)-1, NRF-1, TCE were significantly correlated with the high-expression status of ERα mRNA ( r =0.523, P=0.037 ), while RFX123 and Ikaros were signitleanfly correlated with the low-expression status of ERα mRNA ( r=-0.312, P=0.041 ). Conclusion Transcriptional factors of TTF(1)-1, NBF-1, TCE may be associated with ER-mediated signal pathway, while RFX123 and Ikaros may be associated with non ER-mediatecl signal pathway in endometrial cancer.

Objective To study the effect of urodynamic factors on the urinary retention of the patients with cervical cancer received radical hysterectomy. Methods Seventy-two patients with cervical cancer Ininternational Federation of Gynecology and Obstetrics (FIGO) stage Ⅰ bl to Ⅱ a hospitalized in Fujian Provincial Maternity and Child Health Hospital between June 2006 and August 2009, who were not found any abnormal representation of urodynamics before the operation, were divided into the group with urinary retention and the group without urinary retention based on whether urinary retention after the operation. All patients were detected by urodynamic examination following radical hysterectomy. Data obtained from urodynamic examination were analysed by logistic regression to evaluate the influence of urodynamic factors on the urinary retention postoperation. Results Twenty-one patients out of all were found with urinary retention after the operation , the incidence rate of urinary retention was 29%. The first sensation after operation in both groups were increased significantly than those before operation[ ( 171 ±61 )ml vs.(126 ±28)ml, (134±39)ml vs. (119 ± 17)ml,all P＜0.05], while the maximum volume[ (337 ±66) and (300 ±66)ml, respectively], the compliance[ (31 ±25) and (29 ± 18) ml/cm H2O (1 cm H2O =0. 098 kPa), respectively], the maximum flow rate[ (10 ±4) and (12 ±5) ml/s, respectively] and the pressure at the maximum flow rate [ (27 ±9) and (32 ±8) cm H2O, respectively] were decreased obviously after radical hysterectomy in both the group with urinary retention and the group without urinary retention ( all P ＜0.05), compared with the corresponding value before the operation. The urodynamic changes in urinary retention group was much more severe than those in group without urinary retention ( P ＜ 0. 05 ). The single factor analysis results showed that bladder destusor dysfunction ( OR = 8. 20, 95% CI: 2.62 - 25. 66, P ＜0. 01 ) and lack of sensation ( OR = 6. 90, 95% CI: 1.95 - 24. 43, P ＜ 0. 01 ) were relevant to the urinary retention post-operation. While there were not relationship was found between low compliance bladder( OR =1.99, 95% CI:0. 70 - 5.63, P = 0. 195 ), detrusor overactivity ( OR = 2. 51, 95% CI: 0. 73 - 8.67, P =0. 144), bladder outlet obstruction ( OR = 3.77, 95% CI: 0. 76 - 18. 57, P = 0. 104 ) or dyssynergia of urethral external sphincter( OR =2. 67, 95% CI:0. 49- 14. 45, P =0. 255 ) and urinary retention following the operation. There were an antagonistic effects ( OR = 7.60, 95% CI: 1.43 - 40. 39, P = 0. 017 ) of detrusor overactivity and bladder destrusor dysfunction on urinary retention. The multiple factors analysis results revealed that bladder destusor dysfunction( OR = 7.01, P ＜ 0. 01 ) and lack of sensation( OR = 5.45, P =0. 018)were the independent risk factors influening on the urinary retention post-operation. Conclusions There are obvious urodynamic change in cervical cancer patients following radical hysterectomy. Bladder destrusor dysfunction and lack of sensation are the independent urodynamic risk factors influencing on urinary retention following radical hysterectomy, while detrusor over activity may be a protective effect on bladder destrusor dysfunction post-operation in some degree. Urodynamic test is important for analysis and treatment of urinary retention following radical hysterectomy.

Objective: To investigate calreticulin (CALR) gene mutations classification in BCR-ABL1 negative myeloproliterative neoplasms (MPN), and its relationship with clinical manifestations. Methods: Genomic DNA polymerase chain reaction (PCR) amplification product Sanger sequencing method was used to detect the mutation of exon 9 of CALR gene in 236 patients with BCR-ABL1 negative MPN (excluding polycythemia vera and negative CALR mutations) in Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from November 2015 to November 2018. The mutations were classified into 52 bp deletion (type 1) mutation, 5 bp insertion (type 2) mutation and other mutation types according to PCR sequencing analysis. The clinical characteristics of the carriers with two kinds of mutations in 198 patients with essential thrombocythemia (ET) and 38 primary myelofibrosis (PMF) were compared. For the types of mutations that could not be determined, they were classified according to the α-helix propensity score of the mutant protein peptide chain or the degree of retention of the negatively charged amino acid residues, and the differences between the two classification methods were also compared. Results: Among 236 patients, the CALR gene type 1 or type 2 mutation was detected in 206 cases (87.3%), including 173 ET patients (99 cases of type 1 mutation and 74 cases of type 2 mutation) and 33 PMF patients (28 cases of type 1 mutation and 5 cases of type 2 mutation). The CALR non-type 1 or non-type 2 mutation was detected in 30 cases, including 25 ET patients and 5 PMF patients. Among 173 ET patients with CALR gene mutation, the white blood cell count (WBC) of patients with type 1 mutation was higher than that of patients with type 2 mutation [(8.6±2.7)×10⁹/L vs. (7.6±2.4)×10⁹/L, t = 2.45, P = 0.015]. Among 33 PMF patients with CALR gene mutation, the age of patients with type 1 mutation was older than that of patients with type 2 mutation [(58±13) years old vs. (41±16) years old, t = 2.51, P = 0.018]. According to the α-helix propensity score of mutant protein peptide chain and the degree of retention of the negatively charged amino acid residues, 27 kinds of non-type 1 or non-type 2 mutations were classified by using sequencing method, and there were differences between the two methods. According to the α-helix propensity score of the mutant protein peptide chain, the proportion of type 1/type 1-like mutation in PMF patients was higher than that in ET patients [78.9% (30/38) vs. 56.6% (112/198), P < 0.01]. According to the degree of retention of negatively charged amino acid residues in the mutant protein peptide chain, the isoelectric point (pI) value of the mutant protein peptide chain was higher than that of the wild type sequence. The pI value of the type 1-like mutant protein peptide chain was higher than that of the type 2-like mutation (11.79±0.15 vs. 10.02±0.42, t = 11.51, P < 0.01). Conclusions Type 1 mutated ET patients may be closely related to the high risk of myelofibrosis transformation. The results of the classification of CALR mutations are different according to the α-helix propensity score of the mutant protein peptide chain and the degree of retention of the negatively charged amino acid residues. Further study is necessary to identify the pathogenesis of MPN caused by CALR mutation, and to determine the relationship between mutation type and prognosis of disease.

Objective To evaluate the clinical value of ultrasonography in the diagnosis of hermaphroditism.Methods Ultrasonographic appearances of 45 cases with hermaphroditism were reviewed retrospectively,and the results were compared with clinical data.Results All cases were confirmed pathologically.5 cases showed true hermaphroditism (11.1％),14 cases showed male pseudohermaphroditism (31.1 ％),24 cases showed female pseudohermaphroditism (53.3 ％),2 cases showed gonadal dysgenesis(4.4％).Compared with pathological results in the ultrasound examination,4 cases showed true hermaphroditism,the coincidence rate was 80％.11 cases showed male pseudohermaphroditism,the coincidence rate was 78.6％.20 cases showed female pseudohermaphroditism,the coincidence rate was 83.3％.1 cases showed gonadal dysgenesis,the coincidence rate was 50.0％.Conclusions Ultrasonography can not only evaluate internal reproductive organs in the patients,but also estimate the site,size,morphology and structure,which provides important imaging evidence for the clinical diagnosis and treatment.

Objective To understand affective characteristic of Chinese words. Method 1300 adjectives and nouns of Chinese words were rated in five point scale by 65 participants in three dimensions: emotional valence,arousal and familiarity. Results Neither age effect nor gender effect were found for the word scores in each scale of each dimension. The correlation coefficients between each two dimensions were significant (P＜0.01):0. 787 for valence-arousal, 0. 550 for valence-familiarity and 0. 600 for arousal-familiarity.Conclusion The affective vocabulary system of Chinese words can be used as a tool in future emotional research.