Objective To evaluate the safety and feasibility of hysteroscopy in the treatment of endogenous type cesarean section scar pregnancy (CSP). Methods Clinical data of 58 cases of CSP from August 2012 to February 2014 in our hospital were analyzed retrospectively.Thirty-one cases were treated by hysteroscopy,while 27 cases were treated by laparoscopy.The intraoperative blood loss,operation time,postoperative hospital stay,postoperative drainage of uterine cavity,β-hCG level resolution time and time to menstruous restoration were compared between the two groups. Results The intraoperative blood loss,operation time,length of hospitalization after operation,and time to menstruous restoration were statistically lower in the hysteroscopy group than those in the laparoscopy group [(109 ±59)ml vs.(143 ±63)ml,t =-2.121 ,P =0.038;(43.7 ±17.5)min vs.(100.8 ±18.8)min,t =-1 1 .974,P =0.000;(3.8 ±0.7)d vs.(4.5 ±0.6)d,t =-4.057,P =0.000;(43.8 ±3.9)d vs.(45.9 ±3.8)d,t =-2.070,P =0.043].There were no significant differences in postoperative drainage of uterine cavity and β-hCG level resolution time between the two groups [(22.1 ±2.8)ml vs.(23.6 ±3.2)ml,t =-1 .904,P =0.062;(20.5 ±7.7)d vs.(22.9 ±9.3)d,t =-1 .075,P =0.287]. Conclusion Hysteroscopy has advantages of less intraoperative blood loss,shorter hospitalization time and quicker recovery in the treatment of endogenous type CSP.

Objective To assess the efficacy of mycophenolate mofetil (MMF) combined with prednisone in the treatment of idiopathic membranous nephropathy (IMN) patients with positive serum phospholipase A2 receptor (PLA2R) antibody.Methods An open prospective study was performed on twenty-four biopsy-proven IMN patients with positive serum PLA2R antibody in Guangzhou First People''s Hospital from June 2012 to June 2016.The 24 patients were divided into two groups: MMF group in which MMF combined with prednisone was given for 12 months and CTX group in which intravenous cyclophosphamide (CTX) was monthly given combined with oral prednisone.Results After 6 months of immunosuppressive therapy,complete remission and partial remission rates were 25.0% vs.16.7% and 25.0% vs.25.0% in the MMF group and CTX group,respectively (P>0.05).In the MMF group and CTX group,serum PLA2R antibody in the same amount (8/12,66.7%) of patients turned negative.At the end of twelve-month treatment,all patients with negative PLA2R antibodies achieved complete or partial remission.Clinical remission (including complete and partial remission) rates in the MMF group and CTX group were both 66.7%.After immunosuppressive therapy,the levels of proteinuria and serum albumin in the two groups were significantly improved,but no significant difference were found between the two groups (proteinuria:F within-grouP=98.688,P<0.01;F between-grouP=0.133,P=0.719;F cross-grouP=1.223,P=0.304;serum albumin:F within-grouP=30.629,P<0.01;F between-grouP=0.137,P=0.715;F cros-grouP=0.455,P=0.565).At the end of six and twelve months of treatment,the proteinuria (after six months,MMF group: (2 893±2 515) mg/g vs.(6 236±2 117) mg/g,t=-3.522,P=0.002;CTX group: (2 690±2 254) mg/g vs.(5 386±2 447) mg/g,t=-2.808,P=0.010;after twelve months,MMF group:1 025(99-4 635) mg/g vs.(6 236±2 117) mg/g,Z=-3.291,P<0.0005;CTX group: (775(41-3 517) mg/g vs.(5 386±2 447) mg/g,Z=-3.118,P=0.001) and serum albumin levels (after six months,MMF group: (28.5±9.7) g/L vs.(19.8±4.4) g/L,t=2.841,P=0.012;CTX group: (29.0±7.6) g/L vs.(22.3±4.1) g/L,t=2.690,P=0.016;at the end of twelve months of treatment,,MMF group: (32.4±8.5) g/L vs.(19.8±4.4) g/L,t=4.570,P<0.0005;TX group: (32.2±7.9) g/L vs.(22.3±4.1) g/L,t=3.862,P=0.001) of the two groups were better than those prior to treatment.Conclusion For the IMN patients with positive serum PLA2R antibody,MMF combined with prednisone was as effective as conventional CTX combined with prednisone in the negative conversion of PLA2R antibody and the remission.The negative conversion of PLA2R antibody after 6 months of immunosuppressive treatment was an important indicator of predicting the remission.

Objective To discuss the clinical application of individualized strategy of endoscopic retrograde cholangiopancreatography (ERCP) in the treatment of bile duct stenosis after liver transplantation (LT).Methods Fifty-two patients,including 40 men and 12 women,aged 54.3 ± 9.1 years old,who suffered from bile duct stenosis and accepted 88 times of ERCP from June 2014 to May 2016 in our department were investigated.The procedures,clinical features and biochemical criteria were analyzed retrospectively.Results According to the treating occasions and clinical symptoms,single plastic stent,dilatation combined with single plastic stent,and dilatation combined with multiple plastic stents were chosen to use.ERCP in 8 patients out of 52 patients failed technically,and the therapeutic efficacy was 82.7％.The treatment duration was 8.2 ± 2.9 months.The recurrence rate was 4.7％ (2 cases) during the follow-up period.The most common complications were postERCP pancreatitis (2.3％) and cholangitis (3.4％),which would be cured by conservative treatment in most cases.Conclusion ERCP,as an effective and safe method,could be used as the first choice or bridge treatment for bile duct stricture after LT.We recommend individualization strategy,including step by step mode and different combinations of PTC or endoscopic procedures,in order to improve clinical efficacy of all kinds of stricture.

AIM: To investigate the effect of granulocyte colony stimulating factor (G-CSF) on arabinosyl cytosine (Ara-C)-induced apoptosis in HL-60 leukemia cells. METHODS: The proliferation of HL-60 leukemia cell was observed by hemopoietic cell culture. Apoptosis was measured by the morphology of apoptosis cell , the quantitation of DNA fragmentation with the diphenylamine reaction. The change in drug sensitivity was measured by “MTT”. RESULTS: G-CSF could stimulate the proliferation of HL-60 leukemia cell and colonies of cell increased to 76.5?18.0, compared to the control group (46.5?13.5. P

Objective To explore the relationships between erythropoietin( EPO), endothelin - 1 (ET - 1) and perinatal anoxia. Method ELISA was used to test cord blood EPO and ET-1 in 54 high risk neonates as subjects and 14 healthy neonates as controls.Results The cord blood EPO levels in amniotic fluids turbid Ⅲ degree group and group eclampsia/pre - eclampsia were higher than those in control group (t= 4.0842,3 680 allP

Objective To investigate the changes of blood lipid,endothelin(ET)and carbohydrate tolerance in simple obesity children.Methods Serum total cholesterol(TC),triglyeride(TG),low density lipoprotein(LDL),endothelin(ET) and oral glucose tolerance test(OGTT) of 436 cases(light obesity group 242,moderate obesity group 138,heavy obesity group 56) were detected respectively.Results The levels of TC,TG,LDL,ET and OGTT in 3 simple obesity groups were all higher than those in control group obviously and there were significant differences.The significant positive correlation between the obesity children serum lipids,ET and obese degrees were observed.Four insulin resistant children were found in heavy obesity group and none in other groups.Conclusions The levels of serum lipids and ET increases in obesity children and the OGTT decreases in some heavy obesity children.For preventing the obesity related health problems,the simple obesity children should be paid more attention to earlier.

Objective To analyse the changes of a district general hospital before and after management by Shanghai Renji Medical Group through current situation survey,and explore the conditions for the development of district general hospitals.Methods The Zhujiajiao People's Hospital of Qingpu District in Shanghai was selected,and patients(n=50)and hospital staff(n=100) were conducted current situation survey with questionnaires which included the knowledge and evaluation of the hospital's current situation as well as the changes before and after management by Shanghai Renji Medical Group.Results Half year after management by Shanghai Renji Medical Group,great progress in medical work was achieved,with a favourable development trend.The rate of satisfaction on medical service evaluated by inpatients reached 89.60%,and 81.91% hospital staff had confidence in the sustainable development of the hospital. Conclusion Management by Shanghai Renji Medical Group has brought prospects for the Zhujiajiao People's Hospital.Under current environment,only certain conditions are met can a district general hospital achieve sustainable development.

OBJECTIVE To study the mutation profiles of hepatitis B virus(HBV) in the core regions.METHODS Based on the sequence alignment of all HBV genotypes,specific primers targeting all HBV genotypes were designed to amplify the core region of HBV followed by sequence analysis on the sequencing data available.RESULTS Among the 34 cases,23 cases showed mutations in the core region.According to the mutation profiles,the most common mutations were the A1762T(50.0%) and G1764A(52.9%) in the basic core promoter(BCP) regions,and it always showed as double mutations.The L60V in core gene regions was the secondary common mutations(17.6%).Among all patients,there were 18,6 and 10 cases showed mutations in BCP,pre-core,and core gene regions,respectively.The most common mutations in BCP,pre-core,and core gene regions were the double mutations at A1762T and G1764A(94.7%),G1896A(83.3%),and L60V(50.0%),respectively.CONCLUSIONS The most common mutations in the core region of HBV are the double mutations at A1762T and G1764A.Analysis on the mutation profiles of HBV core regions might be helpful for the prognosis and prediction of HBV infections.