Objective To study the clinical value of transcervical resection under hysteroscope in treatment of placental remnants.Methods From March 2003 to April 2006,14 cases of placental remnants were treated with transcervical resection under hysteroscope.They included 3 cases of term birth,and 11 cases of midtrimester induction of labor.Drug pretreatment was performed for those who had more than 80 U/L of blood beta-human chorionic gonadotropin (?-hCG) level,including mifepristone (RU486), Chinese herbs and methotrexate(MTX).RU486 was taken orally at 25 mg,three times daily and misoprostol was given 600 ?g at one dose on the third day.MTX was given by deep intramuscular injection at 1 mg/m~2 if ?-hCG was higher than 150 U/L.Bipolar evaporation was used in the operation with alternation of resection and forceps holder under ultrasonographic supervision.After operation a circular contraceptive device was placed followed by hormone periodic treatment such as estradiol valerate for 2-4 months.Results Under the monitoring by ultrasonography,14 operations were all performed smoothly.The follow-up was from 6 months to 2 years.Menstruations in almost all the cases were recovered,and 3 cases of those were pregnant and delivered smoothly 4,6 and 7 months after operation.Conclusion The transcervical resection under hysteroscope is useful in treatment of placental remnants with obvious effects,little trauma and few complications.

Objective To investigate the macular vascular density after successful repair of rhegmatogenous retinal detachment (RRD) for one year using optical coherence tomography angiography (OCTA),and discuss the correlation between the macular vascular density and visual acuity.Methods Totally 42 patients of the RRD (42 eyes),their contralateral eyes (A group) and 42 patients of the normal eyes (B group) were recruited into this study.All participants underwent examination with best corrected visual acuity (BCVA) and OCTA.The difference in macular vascular density was compared and the correlation between BCVA and the vascular density was analyzed.Results The macular vascular density of superficial layer,deep layer and choroidal capillary layer was 0.422 4 ±0.089 3,0.4836 ±0.0748,0.527 1 ±0.039 0 in RRD group,respectively,0.469 3 ±0.112 5,0.550 0 ±0.074 0,0.546 2 ±0.034 3 in A group,respectively,0.5619 ±0.053 7,0.611 2 ±0.035 2,0.562 6 ±0.030 4 in B group,respectively.The macular vascular density was significantly decreased in RRD group when compared with A and B groups (all P ＜ 0.05).There was a positive correlation between BCVA and the macular vascular density in the deep layer and choroidal capillaries layer (r =0.629,0.654,both P =0.000).However,there's no correlation between the macular vascular density of superficial layer and BCVA (P =0.103).Conclusion All the macular vascular densities are decreased in patients of RRD after successful repair of retinal detachment one year later,which indicated that the blood flow does not completely recover.And there is a positive correlation between BCVA and macular vascular densities in deep layer and choroidal capillaries layer.And meanwhile,OCTA can objectively and effectively quantify the status of macular region blood flow.

Objective To explore the risk factors of cardiovascular disease in adolescents with a family history of hypertension.Methods A cross-sectional study was conducted in 3874 adolescents ages 13-18 years,with normal BP in 3724 people.Based on family history of hypertension (FH),the cohort of adolescents were dichoto- mized as postive family history (FH~+,n=1145) and negative (FH~-,n=2579).Height,weight,waist circum- ference,hip circumference,blood pressure and fasting plasma glucose(FPG),total cholesterol(TC),triglyceride (TG) and high-density lipoprotein cholesterol(HDL-C) were determined.Results FH~+ adolescents had signifi- cantly higher levels of body mass index(BMI),waist circumference,WHR,FPG,TC and LDL-C(P

Objective To delineate the relationship between body mass index(BMI),waist-to-height ratio (WHtR)and hypertension in adolescents.Methods A cross-sectional study was conducted in 3874 adolescents ages 13-18 years.They were classified into four groups according to BMI and WHtR,group A:normal BMI and WHtR

Through researches of channels and collaterals and clinical practice of many years, the authors understand that Chinese medicine, which considers the human body as an interrelated, mutual constraints, whole, dynamic living system, has gradually become an important part of modern medicine. Channels and collaterals are a closed loop system which is communicated and linked by energy and information in the form of electromagnetic oscillation, reflecting many characteristics similar to quantum. Channels and collaterals are not a fixed organizational structure. Studies on channel and collaterals find that the track of the propagated sensation along channels (PSC) have the phenomenon drifting about. This exactly reflects the law of channels dynamically running. By information triggering and living resonance, channels and collaterals bring into play entirely regulative action. The innovative treatment of channels and collaterals followed by characteristics and laws of quantum can get a better curative effect. Theory of channels in the position of quantum information medical science provides an important breach for modernization of Chinese medicine.
Medical Informatics ; Medicine, Chinese Traditional ; trends ; Meridians

OBJECTIVETo discuss the safety line to avoid the post-hepatectomy hepatic insufficiency by combining indocyanine green test by pulse dye-densitometry (PDD-ICG) and standard remnant liver volume (SRLV).

METHODSSeventy-five hepatic cancer patients undergone hepatectomy from March 2007 to February 2008 were included. According to the liver function decompensatory grades after operation, the relationship between ICG retention rate at 15 min (ICGR15) and standard remnant liver volume by linear regression were analyzed.

RESULTSThere were 60 cases with slight hepatic insufficiency, 12 cases with moderate hepatic insufficiency, and 3 cases with severe hepatic insufficiency. There were no difference in age [(50 +/- 13) years old and (53 +/- 9) years old], prothrombin time [(13.6 +/- 1.0) s and (13.5 +/- 1.0) s], international normalized ratio (1.09 +/- 0.10 and 1.06 +/- 0.10) between slight hepatic insufficiency group and moderate and severe hepatic insufficiency group (P > 0.05). And there were difference in K value (0.20 +/- 0.04 and 0.17 +/- 0.03), ICGR15 (6 +/- 4 and 9 +/- 4), SRLV [(545 +/- 93) ml and (398 +/- 82) ml] between two groups (P < 0.05). Compared ICG test and standard remnant liver volume of the patients with moderate hepatic insufficiency after operation, the liner relationship was found (R = 0.640, P = 0.025), and the regression equation was: standard remnant liver volume (ml/m(2)) = 1594.6 x ICGR15 + 265.

CONCLUSIONSPDD-ICG test and standard remnant liver volume are effective to estimate hepatic function reserve of patient undergone hepatectomy.

Adult ; Female ; Hepatectomy ; methods ; Hepatic Insufficiency ; etiology ; Humans ; Indocyanine Green ; pharmacokinetics ; Liver ; pathology ; Liver Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology

OBJECTIVETo study the clinicopathologic features of urothelial hyperplastic lesion with an endophytic growth pattern and the role of immunohistochemistry and multitargeted fluorescence in situ hybridization (FISH) in the differential diagnosis.

METHODSForty-one cases of urothelial lesions exhibiting endophytic growth patterns were reviewed and reclassified as inverted papilloma, urothelial carcinoma with an endophytic growth pattern, and florid von Brunn nest. The gains of chromosomes 3, 7, and 17 and loss of 9p21 was detected by FISH, and performed immunohistochemical staining for CK20, p53, and Ki-67. Follow-up data of 12 cases were obtained.

RESULTS(1) Twelve inverted papillomas sized 1.2 cm in average, consisted of anastomosing cords and nests with uniform width distribution involving the lamina propria, the central portion contained streaming cells with squamous metaplasia, and the periphery showed palisading. No or rare atypia and mitosis were found. Focal exophytic papillary component lined by less than 6 layers of normal urothelium were observed in 4 cases. (2) Twenty-four urothelial carcinomas with an endophytic growth pattern sized 2.1 cm in average, demonstrated the similar architecture with inverted papilloma, but exhibited thick columns and variable thickness of the cords, irregular size and shape of large nests with transition into solids. Mild to moderate cytologic atypia was shown, and mitotic figures ranged 1 to 8 per 10 HPFs. Exophytic papillary component was not observed in 3 cases, but the superficial urothelium showed dysplasia, while coexisted exophytic component in other cases was associated with low malignant potential or low grade tumor. (3) Five florid von Brunn nests sized 0.9 cm in average, had normal or hyperplastic urothelium, variable nests with cysts compacted in lamina propria, no cytologic atypia and mitosis. Twenty-one of 24 (79.1%) urothelial carcinomas with an endophytic growth pattern displayed abnormally positive results by multitargeted FISH, whereas all inverted papillomas and florid von Brunn nests were negative. Immunohistochemically, CK20 was weakly positive in 2 cases of urothelial carcinoma with an endophytic growth pattern, and negative in all inverted papillomas and florid von Brunn nests. p53 weakly stained 5% to 50% nuclei of the tumor cells in 16 cases of urothelial carcinomas with an endophytic growth pattern and 1 inverted papilloma. 1%-5% tumor cells expressed Ki-67 in urothelial carcinoma with an endophytic growth pattern, and less than 1% in inverted papilloma and florid von Brunn nests. Follow-up study revealed that 2 cases of urothelial carcinoma with an endophytic growth pattern had developed invasive carcinoma, underwent cystectomy, and metastasized remotely. No recurrence occurred in cases of inverted papilloma.

CONCLUSIONSBenign and malignant urothelial lesions with an endophytic growth pattern present histologic overlapping. Urothelial carcinoma with an endophytic growth pattern displays unique characteristics in morphology and immunohistochemistry. Multitargeted FISH analysis is helpful in the differential diagnosis.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; genetics ; metabolism ; pathology ; surgery ; Chromosome Aberrations ; Diagnosis, Differential ; Follow-Up Studies ; Humans ; Hyperplasia ; In Situ Hybridization, Fluorescence ; Keratin-20 ; metabolism ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Papilloma, Inverted ; genetics ; metabolism ; pathology ; surgery ; Tumor Suppressor Protein p53 ; metabolism ; Urinary Bladder Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Urothelium ; metabolism ; pathology

OBJECTIVETo characterize dark-adapted and light-adapted oscillatory potentials (OPs) in human electroretinogram (EGR) elicited by flashing light stimulation of the same intensity.

METHODSDark- and light-adapted ERGs of normal eyes were studied. The frequency spectra of the extracted dark-adapted OPs and light-adapted OPs were analyzed by a fast Fourier transform. The peak frequency, latency and total power of the OPs were determined.

RESULTSThe averaged peak frequency, latency, and power of the dark-adapted OPs was 125.3∓9.93 Hz, 41.7∓3.56 ms, and 9.25∓5.55 (V·s)(2), as compared with 79.5∓6.79 Hz, 50.8∓5.36 ms, and 3.56∓2.18 (V·s)(2) for light-adapted Ops, respectively, showing significant differences in the parameters between dark- and light-adapted Ops (P<0.001).

CONCLUSIONSCompared with dark-adapted OPs, light-adapted Ops is characterized by a lower peak frequency and a lower power with a prolonged latency.

Adaptation, Ocular ; physiology ; Adult ; Dark Adaptation ; physiology ; Electroretinography ; methods ; Female ; Humans ; Male ; Oscillometry ; Retina ; physiology ; Young Adult

OBJECTIVETo evaluate the effects of radiotherapy in the treatment of small-cell lung cancer and the optimal radiation doses, irradiation volume and fractionations.

METHODSUsing evidence-based principles to search and evaluate clinical evidence on radiotherapy of small-cell lung cancer and giving grades of recommendation in clinical practice.

RESULTS AND CONCLUSIONThe combination of chemotherapy and thoracic irradiation were the treatment strategy in limited stage small-cell lung cancer (LD SCLC). There were no clear answers on optimal irradiation dose and volume. Early thoracic irradiations were better than later ones. Radiotherapy should be started at the first or second cycle of chemotherapy. Hyperfractionated irradiation may have therapeutic benefit compared with conventional irradiation. Prophylactic cranial irradiation could improve survival for patients with complete response after chemotherapy and radiotherapy.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma ; drug therapy ; radiotherapy ; Combined Modality Therapy ; Evidence-Based Medicine ; Humans ; Lung Neoplasms ; drug therapy ; radiotherapy ; Radiation Dosage

OBJECTIVETo investigate the methods of isolating and identifying human adipose derived EPCs.

METHODSThe cells obtained from human lipoaspirates were plated on culture dishes coated with human fibronectin and were cultured in DMEM containing 2% FBS. Cells of passage 2 cultured in EGM-2 (2% FBS) served as the induced cells (experimental group), with cells cultured in DMEM (2% FBS) as the non-induced cells (control group) . Immunofluorescence was used to detect the expression of cell markers, including CD34, vWF and PECAM-1. FACS (fluorescence activated cell sorter) was used to quantitatively analyze the expression rate of cell markers (CD34, CD45, CD133 and PECAM-1). Fluorescence microscope was used to observe the function of taking up DiI-ac-LDL by the induced cells. To determine the ability of forming capillary-like structure in three-dimensional matrices, the induced cells were also cultured in methylcellulose.

RESULTSThe induced cells of passage 2 exhibited cobblestone morphology, similar to that of the endothelial cells. In contrast, these morphological changes were not observed in non-induced cells. Immunofluorescence detected expression of vWF, PECAM-1 in induced cells and CD34 in non-induced cells. FACS analysis showed (67.41 +/- 13.35)% of the induced cells expressed PECAM-1 and (6.73 +/- 2.21)% of the non-induced cells expressed PECAM-1 (P < 0.01), while (72.39 +/- 13.45)% of the non-induced cells expressed CD34 and (16.06 +/- 3.86)% of the induced cells expressed CD34 (P < 0.01). Fluorescence microscopy observed the induced cells took up low-density lipoprotein (LDL). The formation of "branch-like" structure confirmed their functional activity.

CONCLUSIONEPCs derived from human adipose may serve as another source of seeding cells for vascular tissue engineering.

Adipocytes ; cytology ; Cell Count ; Cell Culture Techniques ; methods ; Cell Differentiation ; Cell Movement ; Cell Proliferation ; Cells, Cultured ; Endothelial Cells ; cytology ; Flow Cytometry ; Humans ; Stem Cells ; cytology