Purpose To investigate the clinicopathologic characteristics, differential diagnosis, treatment and prognosis of differentia-ted-type vulvar intraepithelial neoplasia ( dVIN) . Methods Clinicopathologic findings and immunophenotypes of 6 cases diagnosed as“dVIN” were retrospectively analyzed, and the relevant literatures were also reviewed. Results 6 patients were all female ranged 53~80 years old with mean age of 62 years old. Clinical aspects included leukoplakia vulvar, pruitis, irritation, pain, ulcer and so on. The histopathological features were hyperplasia of basal and parabasal layer with elongation and anastomosing reteridges. Cells were marked atypia with obvious nucleoli, atypical mitosis, and dyskeratosis. In the middle and surface layer, cells were well differentiated with pronounced intercellular bridges, and eosinophilic cytoplasm, hyperkeratosis and parakeratosis. Oedema and band of infiltration of chronic inflammatory cells of subepidermal could been seen. Immuohistochemistry showed the expression rates of p53 and p16 in totally 6 cases were 83. 3% (5/6), 0 (0/6), respectively. The Ki-67 index was more than 90% in basal and parabasal cells. Four patients were followed up ( mean follow-up 17 months, range 6~36 months) , one patient died at 9 months later after surgery, another patient recurred at 6 months later after surgery, both of the 2 cases were all with invasive lesions after resection, and the rest two cases had no recur in 18 months and 36 months after surgery, respectively. Conclusion dVIN is a high grade squamous intraepithelial lesions of vulvar with low incidence rate, but had more risk of progression. p53, p16 and Ki-67 stain were useful in the diagnosis of dVIN.

Objective To explore the effects and safeties of desmopressin on nocturia in elderly men.Methods We used random number table to divide patients into 2 groups.The patient in treatment group took desmopressin acetate tablets 0.2 mg orally and the patient in control group took tamsulosin hydmchloride sustained release capsule 0.2 mg orally before sleep for 4 weeks.The patient recorded 24 hours voiding diaries for 3 days and worked out mean number of nocturnal voids,hours of undisturbed sleep (HUS) before treatment and before subsequent visit weekly.Before treatment and 1 to 4 weeks after treatment,mean number of nocturnal voids,HUS,night quality of life (NQOL),quality of life (QOL),adverse event were recorded.Before treatment,1 week and 4 weeks after treatment,blood serum sodium was checked in treatment group.Results 42 men had been diagnosed with nocturia in outpatient department of investigator from December 2014 to March 2016,34 of them were recruited in our study and randomly enter the treatment group or control group.Each group consisted of 17 cases.There was no statistical difference in the baseline data between two groups (all P ＞ 0.05).The average ages of treatment group and the control group were (65.1 ± 11.2) and (63.9 ± 9.3) years old,the courses of disease were (3.0 ± 5.0) and (2.3 ± 2.6) years,respectively.Before treatment mean numbers of nocturnal voids were (3.8 ± 1.2) and (3.2 ± 1.4) times,HUS were (1.8 ± 1.7) and (1.8 ± 0.6) h,NQOL were (51.8 ± 13.8) and (41.2 ± 13.6),QOL were (4.0 ± 1.0) and (3.9 ± 0.9),respectively.Four weeks after treatment,mean numbers of nocturnal voids decreased to (1.6 ± 1.0) and (2.0 ± 0.9) times,HUS increased to (4.0 ± 0.7) and (2.6 ± 0.7) h,NQOL decreased to (20.9 ± 12.0) and (30.6 ± 12.4),QOL decreased to (1.4 ± 1.1) and (2.9 ± 1.0) in treatment group and control group,respectively.Every index of the two groups were statistically significant differences compared with that before treatment (P ＜ 0.05).There were statistically significant differences in the degree of improvement between treatment group and control group from 2 weeks to 4 weeks after treatment (P ＜ 0.05).Therefore,the degree of improvement of treatment group was superiored to the control group.Before treatment and both 1 week and 4 weeks after treatment,the blood serum sodium of patients in treatment group were (140.3 ± 3.9),(139.2 ± 4.3) and (140.6 ± 3.1) mmol/ L,respectively.Two patients of treatment group appeared dizzy during the follow-up period.In one of both,the symptom disappeared after the dose decreased from 0.2 mg to 0.1 mg per night.The symptom sustained and the dose was not changed in the other one.In treatment group,two other patients suffered from dyspepsia,one palpitation and one thirst.Those symptoms could be tolerated and the dose was not changed.In control group,2 patients suffered from thirst,one nasal congestion,one dizzy and one short of breath.All of those symptoms could be tolerated and the dose was not changed.There was not statistical differencebetween the occurrence rate of adverse events in the 2 groups (P =0.714).Conclusions Desmopressin can improve the symptoms of nocturia in elderly men,improve the quality of life of patients,and has goodsafety.

Objective To explore the effect of mobile internet management in continuing nursing care of premature infants. Methods The convenience sampling method was adopted to divide the premature infants from January to December in the year 2015 into 2 groups according to the time order, the control group (n = 56), and the observation group (n = 57). The control group received continuing nursing care for the whole course from admission to discharge. Based on the nursing care of the control group, the observation group were given an extra continuing nursing care by using the mobile internet. Both group's continuing nursing care were lasted from the birth till 12 month.Comparisons of two groups were made from the following aspects: of preterm infants born at 12 months in the length, weight, head circumference of the preterm infants at 12 months old and 40 weeks corrected gestational age Neonatal Behavioral Neurological Assessment,breastfeeding confidence;parents care knowledge scores at the time of admission, discharge and 1month after discharge; referral rate; parents satisfaction at the time of discharge and the end of extended care). Results In the observation group,the length,weight and head circumference of the preterm infants at birth were(74.10 ± 2.66)cm,(8.70 ± 1.43)kg,(45.40 ± 1.38)cm, Neonatal Behavioral Neurological Assessment at 40 weeks of gestation,self-confidence in breastfeeding,1 post-discharge and 1 post-discharge parents care knowledge score of the month, parents of preterm children satisfaction scores, respectively(37.30 ± 3.22),(120.31 ± 13.65),(82.28 ± 3.99, 96.70 ± 2.28), (93.55±2.91,96.61±2.37),the control group were(73.20±2.80)cm,(8.44±1.02)kg,(44.2±1.40)cm, (36.00±2.87),(114.54±12.21),(80.66±3.51, 95.02±3.87),(92.57±2.41, 95.72±2.02). The difference between the two groups was statistically significant(t=-5.244~-2.014,all P<0.05). Conclusions The mobile internet application of continuing nursing care in premature infants can improve the growth and development of premature infants and maternal breastfeeding confidence,promote parents care knowledge, referral rate and satisfaction,thus guarantee the he living quality of the preterm infants.

Objective:To evaluate the efficacy and safety of microemulsified cyclosporine(Neoral)and tacrolimus(FK506) for immunodepression after Iiver transplantation.Methods:According to the including criteria,fifteen randomized controlled trials were enrolled in this analysis.The data of trial design,characteristics of the subjects,and findings of the studies were reviewed and analyzed by RevMan 4.2.8 software.Results:The patient survival rate,graft survival rate,incidence of nephrotoxicity,and incidence of infection were not significantly different between Neoral and FK506 groups,with the relative risk and(95% CI,P)being 0.99(0.96-1.02,0.37),0.97(0.92-1.03,0.30),0.99(0.87-1.13,0.86)and 1.08(0.97-1.20, 0.16),respectively.The incidences of hypertension(1.34[1.15-1.55,0.000 1])and acute rejection(1.15[1.06-1.25,0.001]) were significantly lower in the FK506 group,with no significant difference found in the degree of acute rejection(1.00[0.92- 1.22],0.98).Interestingly,the incidence of diabetes was significantly higher in the FK506 group within 1 year after the operation,but was similar to that of the Neoral group thereafter,with relative risk(95%CI,P)being 0.72(0.62-0.83,