OBJECTIVETo investigate the clinical efficacy of estrogen in management of postpartum hemorrhage due to uterine atony.

METHODSTotalling 112 puerperants with postpartum hemorrhage due to uterine atony were randomly assigned into 2 groups and received routine managements for uterine atony such as uterine massage and uterotonics administration. The puerperants in one group (n=52) was treated with 4 mg estradiol benzoate injected intramuscularly, and the amount of blood loss 2 h after delivery and between 2 and 24 h after delivery was recorded.

RESULTSThere were significant differences in vaginal blood loss at 2 h after delivery between the 2 groups (P<0.05). The puerperants with estrodiol benzoate treatment had blood loss of 589.6-/+226.4 ml at 2 h and 110.8-/+76.2 ml within 2-24 h after delivery, which were both less than those in the control group (864.5-/+359.5 ml and 161.5-/+98.3 ml, respectively). Postpartum hysterectomy was performed in 3 cases of the control group while none in estradiol benzoate-treated group. In the mothers and neonates, no major adverse effects were observed.

CONCLUSIONEstrogen shows cooperative efficacy with uterotonics in stimulating uterine contraction for managements of postpartum hemorrhage due to uterine atony, and can be of value in clinical application.

Adult ; Delivery, Obstetric ; adverse effects ; Drug Therapy, Combination ; Estradiol ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Oxytocics ; therapeutic use ; Postpartum Hemorrhage ; drug therapy ; etiology ; Pregnancy ; Treatment Outcome ; Uterine Inertia ; drug therapy

OBJECTIVETo study the chemical constituents of Phellinus igniarius.

METHODCompounds were isolated by nomal phasc sillica gel and Al2O3 chromatography and reverse phase HPLC. Their structures were elucidated by spectroscopic methods including IR, MS and NMR.

RESULTFive flavonoids and two coumarins were isolated from Phellinus igniarius and their structures were identified as naringenin, sakuranetin, aromadendrin, folerogenin, eriodictyol, coumarin and scopoletin.

CONCLUSIONAll these compounds were obtained from this genus for the first time.

Flavanones ; chemistry ; isolation & purification ; Flavonoids ; chemistry ; isolation & purification ; Polyporaceae ; chemistry ; Scopoletin ; chemistry ; isolation & purification

OBJECTIVETo explore the clinical and laboratory features and the prognosis of juvenile dermatomyositis (JDM) complicated with interstitial lung disease (ILD).

METHODData of 39 cases of JDM complicated with ILD hospitalized in Beijing Children's Hospital from January 2005 to December 2011 were collected. The clinical features, laboratory data and prognosis of these children were analyzed.

RESULTOf the 39 cases studied, 16 were boys, and 23 girls. The average age of onset was 5.6 years, and 61.5% of the patients' age of onset (24 cases) was under 6 years. Rashes (17 cases, 43.6%), simultaneous eruption of rashes and muscle weakness (14 cases, 35.9%), fever (4 cases, 10.1%), or muscle weakness (3 cases, 7.7%) were common initial symptoms of the disease. Only 51.3% of the patients (20 cases) had the symptoms of respiratory system, but (24 cases) 61.5% were complicated with that of the gastrointestinal system; (27 cases) 69.2% had at the same time electrocardiographic and echocardiographic abnormalities. The chest high resolution computed tomography (HRCT) showed cord or band-like shadows in their lungs of more than half of the cases (25 cases, 64.1%), and other changes included ground glass-like shadow (10 cases, 25.6%), net and lineation-like shadow (9 cases, 23.1%), nodular change (5 cases, 12.8%). The patients complicated with lung essential infiltration accounted for as high as 71.8% (28 cases). These imaging changes were largely seen on both dorsal sides of their lungs. Severe patients also had mediastinal emphysema, pneumothorax, pneumorrhagia or aerodermectasia. Twenty-four patients underwent pulmonary function examination, and 62.5% of the patients' pulmonary function (15 cases) was abnormal. The fatality rate of the cases studied was 10.1%.

CONCLUSIONThe imaging changes of patients suffering from JDM with ILD were often more severe as compared to the clinical symptoms, and were often complicated with damages to other systems and organs. The prognosis of those patients was poorer than others. Patients with JDM especially at a younger age of onset and with various organ damages should be examined with chest HRCT examinations as early as possible.

Child ; Child, Preschool ; Dermatomyositis ; complications ; diagnosis ; drug therapy ; Female ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Immunosuppressive Agents ; administration & dosage ; therapeutic use ; Lung ; diagnostic imaging ; pathology ; Lung Diseases, Interstitial ; diagnosis ; drug therapy ; etiology ; Male ; Methotrexate ; administration & dosage ; therapeutic use ; Muscle Weakness ; diagnosis ; epidemiology ; etiology ; Prognosis ; Respiratory Function Tests ; Retrospective Studies ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinical efficacy of estrogen in preventing postpartum hemorrhage and shortening the birth process during induced abortion.

METHODSTotally 320 puerperants for termination of pregnancy for medical reasons were randomly assigned into 2 groups, the estrogen group (n=175) and the control group (n=145), and the former were given oral estrostilben 3 mg thrice a day from the day before acrinol injection to the end of delivery. The amount of blood loss 2 h after delivery, cases of postpartum hemorrhage, and the duration of total birth process were recorded.

RESULTSSignificant differences were noted in blood loss 2 h after delivery between estrodiol and control groups (123.3-/+81.8 vs 206.3-/+114.4 ml). Two cases of postpartum hemorrhage were found in estrogen group and 10 in control group. The duration from acrinol injection to delivery was similar between the two groups (31-/+11 vs 33-/+12 h), but the former had significant shorter duration from contraction onset to delivery than the latter (6.03-/+3.19 vs 9.7-/+5.9 h). No side-effects were found in either group.

CONCLUSIONEstrogen given before delivery can be effective in stimulating uterine contraction for preventing postpartum hemorrhage and shortening the birth process in women undergoing induced abortion.

Abortion, Induced ; adverse effects ; Adult ; Estrogens ; therapeutic use ; Female ; Humans ; Labor Onset ; drug effects ; Postpartum Hemorrhage ; etiology ; prevention & control ; Pregnancy ; Time Factors ; Treatment Outcome ; Uterine Contraction ; drug effects

Objective To observe the efficacy difference between different needling manipulations in treating acute stroke with point-toward-point needling at scalp acupoints, for seeking the optimal treatment protocol. Method Ninety patients with acute stroke were randomized into a manual needling group, an electroacupuncture group, and a needle-retaining group, 30 cases each. In addition to the neurological treatment, the three groups were all given point-toward-point needling from Baihui (GV20) to Taiyang (EX-HN5) on the affected side, respectively with manual twisting, electroacupuncture and needle retaining methods. Before and after 14-day treatment, the Neurological Deficit Score (NDS), level of neuron specific enolase (NSE) and total efficacy were compared among the three groups. Result The NDS dropped significantly in the three groups after the intervention (P<0.05); the manual needling group showed the most significant improvement, better than the electroacupuncture group and needle retaining group. The level of NSE declined significantly in the three groups after the intervention (P<0.05); the decrease in the manual needling group was the most significant compared to that in the electroacupuncture group and needle retaining group. The total effective rate in the manual needling group (90.0%) was significantly higher than that in the electroacupuncture group and needle retaining group (P<0.05). Conclusion Point-toward-point needling at scalp acupoints with manual operation can effectively improve the neurological deficit in stroke patients, and the application of needling manipulations can further enhance the therapeutic efficacy, which is specific.

Objective To evaluate contrast-enhanced fluid-attenuated inversion recovery (FLAIR) imaging in the detection of leptomeningeal lesions.Methods Seventeen patients with a variety of leptomeningeal lesions were analyzed.The MRI protocol included un-enhanced and contrast-enhanced FLAIR images and contrast-enhanced T_1WI,Comparisons between contrast-enhanced FLAIR images and T_1WI and between un-enhanced and contrast-enhanced FLAIR images were made to determine which sequence better depicted the lesions.Results Leptomeningeal lesions showed as either diffusely or locally abnormal hyper-intensity along sulci or cistern on three sequences.Comparison between contrast-enhanced FLAIR and T_1WI showed that only contrast-enhanced FLAIR revealed the abnormalities in 7,both revealed the abnormalities but the former was superior in 2 ,and both were conspicuous in 7. In 1 patient of tuberculous meningitis,diffuse abnormalities of sulci were shown only on contrast-enhanced FLAIR, abnormalities of cisterns were shown on both sequences but the former was superior.Comparison between un- enhanced and contrast-enhanced FLAIR showed that only contrast-enhanced FLAIR revealed the abnormalities in 9,both revealed the abnormalities but the former was superior in 3,and both were conspicuous in 4. In 1 patient of tuberculous meningitis,abnormalities of cisterns were shown only on contrast-enhanced FLAIR,diffuseabnormalities of sulci were shown on both sequences but the former was superior.Conclusions Contrast-enhanced FLAIR images were superior to un-enhanced FLAIR images and contrast-enhanced T_1WI in the detection of leptomeningeal lesions. Contrast-enhanced FLAIR images are helpful and should be considered when findings on un-enhanced FLAIR images and/or contrast-enhanced T,WI are inconclusive.

OBJECTIVETo explore genetic background of a pedigree with a rare p phenotype from Guangdong province.

METHODSThe rare p phenotype was identified by a conventional serologic method. With genomic DNA of proband and family members extracted, exon 3 of alpha-(1,4)galactosyltransferase (A4GALT) gene was amplified with PCR and analyzed by direct sequencing. The mutation found in the pedigree was screened in a normal population using direct sequencing.

RESULTSThe proband and 4 family members with the rare p phenotype have all carried a point mutation c.100G>A (p.Val34Ile) in combination with a deletion-insertional mutation c.418_428del11ins34(p.Gln139Trpfs*72), which renders a compound mutation of A4GALT gene. One family member with P2 phenotype has carried a same heterozygous mutation. Of the 100 healthy donors, 5 have carried a heterozygous point mutation c.100G>A, and none carried the deletion-insertional mutation c.418_428del11ins34.

CONCLUSIONThe rare p phenotype of the pedigree has resulted from a compound mutation of the A4GALT gene, which is in keeping with a recessive inheritance pattern of the p phenotype.

Adult ; Base Sequence ; Blood Grouping and Crossmatching ; Exons ; Female ; Galactosyltransferases ; genetics ; Genotype ; Humans ; Mutation ; P Blood-Group System ; genetics ; immunology ; Pedigree ; Phenotype

Nasopharyngeal adenoid cystic carcinoma (NACC) is a rare malignancy with high local invasiveness. To date, there is no consensus on the imaging characteristics of NACC. To address this, we retrospectively reviewed 10 cases of NACC and summarized the magnetic resonance imaging (MRI) features. MR images of 10 patients with histologically validated NACC were reviewed by two experienced radiologists. The location, shape, margin, signal intensity, lesion texture, contrast enhancement patterns, local invasion, and cervical lymphadenopathy of all tumors were evaluated. Clinical and pathologic records were also reviewed. No patients were positive for antibodies against Epstein-Barr virus (EBV). The imaging patterns of primary tumors were classified into two types as determined by location, shape, and margin. Of all patients, 7 had tumors with a type 1 imaging pattern and 3 had tumors with a type 2 imaging pattern. The 4 tubular NACCs were all homogeneous tumors, whereas 3 (60%) of 5 cribriform NACCs and the sole solid NACC were heterogeneous tumors with separations or central necrosis on MR images. Five patients had perineural infiltration and intracranial involvement, and only 2 had cervical lymphadenopathy. Based on these results, we conclude that NACC is a local, aggressive neoplasm that is often negative for EBV infection and associated with a low incidence of cervical lymphadenopathy. Furthermore, MRI features of NACC vary in locations and histological subtypes.
Adult ; Aged ; Carcinoma, Adenoid Cystic ; diagnosis ; pathology ; surgery ; Female ; Humans ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; diagnosis ; pathology ; surgery ; Neoplasm Invasiveness ; Neoplasm Staging ; Retrospective Studies

OBJECTIVETo study a possible association between the three functional polymorphisms in the promoter region of dopamine D4 receptor (DRD4) gene and chronic tic disorder.

METHODSGenomic DNA was isolated from the venous blood leukocytes of 84 unrelated patients with chronic tic disorder (Study group) and 100 healthy unrelated individuals (Control group). Polymorphisms of DRD4, 1240L/S, 616C/G and 521C/T, were genotyped by the allele-specific primer (ASP) PCR. Genotype, allele and haplotype frequencies were analysed by SHEsis online.

RESULTSThere were significant differences in both allele and genotype frequencies (chi(2) = 8.419, P < 0.01; chi(2) = 7.860, P < 0.05 respectively) of DRD4-616C/G between the Study and the Control groups. Haplotypic frequencies of LCT (1240L/S, 616C/G, 521C/T) in the Study group were noticeably higher than in the Control group (chi(2) = 6.371, P < 0.05).

CONCLUSIONSThere is an association between the DRD4-616C/G polymorphism and chronic tic disorder. The individuals with haplotype LCT (1240L/S, 616C/G, 521C/T) are susceptible to this disorder.

Adolescent ; Child ; Chronic Disease ; Female ; Gene Frequency ; Genotype ; Haplotypes ; Humans ; Male ; Polymorphism, Genetic ; Promoter Regions, Genetic ; Receptors, Dopamine D4 ; genetics ; Tic Disorders ; genetics

Child ; Humans ; Liver Diseases ; surgery ; Liver Transplantation ; methods ; Living Donors ; Male ; Portal Vein ; pathology