Objective To analyze the cause of postmenopausal vaginal bleeding and diagnostic method. Methods The clinical and pathological data of 196 patients with postmenopausal vaginal bleeding were retrospectively analyzed. Results The benign diseases accounted for 46.94% (92/196), dysfunctional uterine bleeding accounted for 34.69% (68/196), malignant tumor accounted for 18.37% (36/196).Menopausal time 1--4 years, 5-9 years, 10-14 years, ≥ 15 years of malignant tumor incidence was 2.53%(2/79), 9.38% (6/64), 48.39% ( 15/31 ), 59.09 % (13/22). The age of onset in patients with malignant tumors was (61.28 ± 8.76) years old, menopausal time was (9.38 ±6.73) years, benign disease and dysfunctional uterine bleeding was (54.73 ± 6.72) years old and (4.12 ± 3.54) years, the differences were statistical significance (P ＜ 0.01 ). Conclusion The cause of postmenopausal vaginal bleeding bases mainlyon benign disease and dysfunctional uterine bleeding, but the older, longer menopausal time, which also increase the incidence of malignant tumors.

Muscle unloading due to long-term exposure of weightlessness or simulated weightlessness causes atrophy, loss of functional capacity, impaired locomotor coordination, and decreased resistance to fatigue in the antigravity muscles of the lower limbs. Besides reducing astronauts' mobility in space and on returning to a gravity environment, the molecular mechanisms for the adaptation of skeletal muscle to unloading also play an important medical role in conditions such as disuse and paralysis. The tail-suspended rat model was used to simulate the effects of weightlessness on skeletal muscles and to induce muscle unloading in the rat hindlimb. Our series studies have shown that the maximum of twitch tension and the twitch duration decreased significantly in the atrophic soleus muscles, the maximal tension of high-frequency tetanic contraction was significantly reduced in 2-week unloaded soleus muscles, however, the fatigability of high-frequency tetanic contraction increased after one week of unloading. The maximal isometric tension of intermittent tetanic contraction at optimal stimulating frequency did not alter in 1- and 2-week unloaded soleus, but significantly decreased in 4-week unloaded soleus. The 1-week unloaded soleus, but not extensor digitorum longus (EDL), was more susceptible to fatigue during intermittent tetanic contraction than the synchronous controls. The changes in K+ channel characteristics may increase the fatigability during high-frequency tetanic contraction in atrophic soleus muscles. High fatigability of intermittent tetanic contraction may be involved in enhanced activity of sarcoplasmic reticulum Ca(2+)-ATPase (SERCA) and switching from slow to fast isoform of myosin heavy chain, tropomyosin, troponin I and T subunit in atrophic soleus muscles. Unloaded soleus muscle also showed a decreased protein level of neuronal nitric oxide synthase (nNOS), and the reduction in nNOS-derived NO increased frequency of calcium sparks and elevated intracellular resting Ca2+ concentration ([Ca2+]i) in unloaded soleus muscles. High [Ca2+]i activated calpain-1 which induced a higher degradation of desmin. Desmin degradation may loose connections between adjacent myofibrils and further misaligned Z-disc during repeated tetanic contractions. Passive stretch in unloaded muscle could preserve the stability of sarcoplasmic reticulum Ca2+ release channels by means of keeping nNOS activity, and decrease the enhanced protein level and activity of calpain to control levels in unloaded soleus muscles. Therefore, passive stretch restored normal appearance of Z-disc and resisted in part atrophy of unloaded soleus muscles. The above results indicate that enhanced fatigability of high-frequency tetanic contraction is associated to the alteration in K+ channel characteristics, and elevated SERCA activity and slow to fast transition of myosin heavy chain (MHC) isoforms increases fatigability of intermittent tetanic contraction in atrophic soleus muscle. The sarcomeric damage induced by tetanic contraction can be retarded by stretch in atrophic soleus muscles.
Animals ; Calcium Signaling ; Calpain ; metabolism ; Desmin ; metabolism ; Muscle Contraction ; Muscle Fatigue ; Muscle, Skeletal ; physiopathology ; Muscular Atrophy ; physiopathology ; Myosin Heavy Chains ; metabolism ; Rats ; Sarcoplasmic Reticulum ; pathology ; Sarcoplasmic Reticulum Calcium-Transporting ATPases ; metabolism ; Weightlessness Simulation

Purpose To discuss the relationship between age of onset and the HPV types infection in cervical adenocarcinoma. Meth-ods This study included 120 specimens of cervical adenocarcinoma in Jiangxi Maternal and Child Health Hospital. The specimen blocks were sliced by sandwich method. DNA was amplified by SPF10-PCR method. DNA genotyping was used with LiPA method. All biopsy specimens had pathologic diagnosis. The HPV infection of cervical adenocarcinoma specimens was analyzed. Results 120 ade-nocarcinoma cases were included in this study. HPV positive rate was 77. 5% (93/120). HPV 18 was the most prevalent type, which took up 43. 01% (40/93) of the total HPV positive cases, as same as HPV 16, which took up 43. 01%(40/93) of the total HPV pos-itive cases. The average ages of HPV 16 and HPV 18 were 43. 41 and 41. 06 years old respectively, other HPV types were 46. 85 years old, which showed statistically difference (F=3. 58, P=0. 032). Conclusion HPV 18 and HPV 16 are two most prevalent HPV types in cervical adenocarcinoma. The cases of HPV 18 infection are younger than other HPV-types infection.

Heated humidified high-flow nasal cannula(HHFNC) is a relatively new noinvasive method for respiratory support,initially used in premature infant apnea.In recent years,the development of HHFNC applications is rapid,and HHFNC is gradually used in older infants and children.Compared to other noninvasive oxygen supply devices,HHFNC can be used effectively in clinic because of its high comfort,good tolerance,easy care,and reducing the rate of endotracheal intubation.

Objective To analyze 3 different methods for treatment of Tossy Ⅲ acromioclavicular dislocation. Methods Sixty-two patients with Tossy Ⅲ acromioclavieular dislocation who had been treated by 3 different treatment methods in our department were analyzed. Of them, 18 cases were treated with Kirschner wire and tension wire fixation plus repair of coracoacromial and acromioelavicular ligaments(Group A), 21 with clavicle claw steel plate fixation plus repair of acromioelavicular ligament (Group B ), and 23 with intersecting Kirschner wire plus repair and strengthening of acromioclavieular ligament(Group C). Results After follow-ups for 9 to 24 months (with an average of 15. 6), therapeutic effect(by Karlsson system), operation duration, intraoperative blood loss and cost were evaluated for all the pa-tients. The differences in the therapeutic effect between all groups were not significant ( P ＞ 0.05 ). Group C needed less operation time and had less bleeding than groupA ( P ＜ 0. 05), and group C needed less oper-ation time and cost and had less bleeding than group B ( P ＜ 0. 05). Conclusion Intersecting Kirsehner wire plus repair and strengthening of aeromioclavieular ligament is an efficient, convenient and less costly method for treatment of TossyⅢ aeromioclavicular dislocation.

Congenital heart disease often lost the opportunity of radical sureryfor secondary pulmonary hypertension.pulmonary hypertension is pathologicallycharacterizzed by pulmonary vascular remodeling,including the vascular smooth musclecell' s proliferation,migration and extracelluar matrix deposition,Recently,someresearchers have found that connective tissue growth factor can bind with somesurface receptors of vascular smooth muscle cells,causing some biological behaviorchanges such as proliferation,migration and extracellular matrix abnormaldeposition,and activating crresponding gene expression through this signaltransduction pathway.Pulmonary vascular remodeling may be one of the molecularpathogenesis in pulmonary hypertension.

Objective To observe the effect of Xuesaitong injection on the platelet activity in the patient underwent hip orthopedics operation. Methods A total of 80 patients underwent hip orthopedics operation were enrolled from our Hospital. The patients were divided into the control group (n=40) and the observation group (n=40). The control group was treated with the low molecular weight heparin at 12 h before operation and after operation. The observation group was treated with Xuesaitong injection at 12 h before operation and after operation. The deep venous thrombosis (DVT) was diagnosed by color doppler ultrasound. The APTT and PT weredetected by the automated blood coagulation analyzer. The expression of TXB2 was determined by ELISA analysis. The CD62P was detected by the flow cytometry. Results At time of 10 days after operation, the APTT (26.83 ± 3.68 s vs. 32.06 ± 3.65 s, t=2.407), PT (10.84 ± 1.63 s vs. 12.82 ± 1.61 s, t=2.391), TXB2 (159.38 ± 31.75 ng/L vs. 194.23 ± 38.53 ng/L, t=2.388), CD62P (14.28%± 2.52%vs. 29.14%± 6.23%, t=6.415) were significantly lower in the observation group than those in the control group (P<0.01 or P<0.05). The incidence of DVT was 12.5%in the observation group, and 17.5%in the control group. There was no significant difference between the two groups (χ2=0.353, P=0.241). Conclusions The Xuesaitong injection can inhibit platelet activation and has preventive effect of DVT in patient underwent hip orthopedics operation with no bleeding complications.

Objective To study feasibility and effects of early enteral nutrition(EEN) after total gastrectomy in elderly patients of gastric cancer. Methods Sixty-six cases of gastric cancer underwent total gastrectomy were divided into two groups randomly. One group was treated with EEN, another with parenteral nutrition(PN). Results The difference of nutritional status and incidence of posteroprative complications between EEN and PN group had no statistical significance, but the EEN group had earlier recovery of intestinal function and shorter hospital stay when compared with PN group. Conclusions EEN is an effective way of postoperative nutritional support in elderly patients of gastric cancer, which is safe, reliable, simple and clinically valuable.

Neoadjuvant chemoradiotherapy (nCRT) is used to downstage locally advanced rectal cancer before surgery, in order to increase the chance of radical resection, reduce local recurrence, and improve overall survival. Accumulating data suggest that tumor response to nCRT is time dependent. A delay between nCRT and surgery may increase the proportion of patients that achieve a favorable response, and 4-6 weeks are considered to be a universal interval. However, delayed surgery beyond 6-8 weeks may increase the technical dififculty, and the risks of surgical complications and recurrence or metastasis. This article brielfy reviews the relevant literature to evaluate the efifciency and safety of delayed surgery.

Tendon calcification,a common clinical disease,is often complicated after tendon injury or surgery,or as a special manifestation of tendinopathy.It is also one manifestation of acquired heterotopic ossification.However,there are no preventive measures for tendon calcification in clinical treatment as its pathogenesis is still unclear.In addition,the domestic orthopedic surgeons have paid little attention to this issue yet.To enhance understanding of tendon calcification,we have summarized the relevant literature published in recent years.