Objective To evaluate the efficacy and safety of a levonorgestrel-releasing intrauterine system(LNG-IUS)for the treatment of dysmenorrhea associated with adenomyosis.Methods We recruited 48 women with moderate or severe dysmenorrhea associated with adenomyosis.All women were inserted of LNG-IUS into their uterine cavity from days 5-7 of their periods and maintained for 12 months.We compared the visual analogue scale(VAS)scores and verbal rating scale(VRS)scores of their dysmenorrhea and dyspareunia at baseline and 12 monthes follow-up.Results Forty-four women completed the study. There were significant differences between mean VAS and VRS scores changes of dysmenorrhea and dyspareunia at baseline and 12 monthes follow-up,those of dysmenorrhea dropping from 75?13 to 11?11 and 2.3?0.4 to 0.4?0.3,those of dyspareunia dropping from 54?19 to 4?4 and from 1.6?0.8 to 0.2?0.2 respectively.Overall 29 women(66%)were very satisfied or satisfied with the one-year treatment. Conclusion Insertion of LNG-IUS alleviates moderate or severe dysmenorrhea associated with adenomyosis remarkably.

ObjectiveTo explore the significance of intrauterine infection of hepatitis B virus in pregnant women with hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) negative by nested polymerase chain reaction (PCR). MethodsTwenty-four pregnant women with HBsAg and HBeAg negative but other HBV markers positive together with their infants were included as study group. Sixteen pregnant women with HBV marker negative and their infants were in the control group. HBV DNA in sera and peripheral blood mononuclear cells (PBMCs) of two groups was detected by nested PCR respectively. Results(1)In the study group, the positive rates of HBV DNA of pregnant women were 33% (8/24) in the sera and 42% (10/24) in PBMCs. Three women were detected HBV DNA in both serum and PBMCs. The rate of HBV infection was 63% (15/24); (2)also in the study group, the positive rates of HBV DNA of the infants were 13% (3/24) in the sera and 25% (6/24) in PBMCs. One newborn was detected HBV DNA in both serum and PBMCs, the rate of intrauterine infection of HBV was 33% (8/24); (3) HBV DNA was detected in sera and/or in PBMCs from four newborns of pregnant women with HBV DNA positive only in PBMCs, the positive ratio was 4/7. ConclusionsHBV intrauterine infection is possible in pregnant women with HBsAg and HBeAg negative. Detecting HBV-DNA in sera and PBMCs of pregnant women and their newborns by PCR is important clinical significance.

Objective To investigate the differentiatial diagnostic value of 99Tcm-methoxyisobutylisonitrile ( MIBI ) SPECT combined with localizable CT in the evaluation of oxygen intervention for suspicious lung lesions,and to establish a cost-effective imaging modality in the detection of malignant lung lesions.Methods From September 2008 to March 2009,47 consecutive patients with suspicious malignant lung lesions underwent 99Tcm-MIBI SPECT/CT prospectively. Patients with suspicious pneumonia were treated with antibiotics for about 4 d before imaging. All patients were cannulized with a nostril tube for oxygen inhalation before 99Tc-MIBI injection. SPECT combined with localizable CT of the chest was performed at 10 min and 2 h after 99Tcm-MIBI injection. The uptake ratios of lesion to contralateral normal lung parenchyma(early uptake ratio:EUR and delayed uptake ratio:DUR) were compared using independent-samples ttest. In addition,the diagnostic efficiency of uptake ratios of lung lesions was analyzed with receiver operating characteristic (ROC) curve. Results Forty-seven patients ( primary lung cancers:32,metastatic tumors of the lung:4,benign lung diseases:11 ) had 51 lung lesions,including 39 malignant and 12 benign lung lesions. The sensitivity,specificity,accuracy,positive predictive value (PPV),and negative predictive value (NPV) were 94.9% (37/39),83.3% ( 10/12),92.2% (47/51),94.9% (37/39) and 83.3% ( 10/12),respectively. The EUR of malignant lesions was 2.95 ± 1.16,whereas of benign lesions was 1.43 ±0.33. The DUR of the malignant lesions was 3.19 ± 1.74,whereas of benign lesions was 1.60 ±0.32. Both EUR and DUR were significantly different between malignant and benign lung lesions,respectively (t= -4.44,-3.12,respectively,both P＜0.01). The ROC curve showed that EUR value ≥1.625 provided the sensitivity of 97.4% (38/39) and specificity of 83.3% (10/12); DUR value ≥ 1.75provided the sensitivity of 94.9% (37/39) and specificity of 83.3% (10/12). Conclusion 99Tcm-MIBI SPECT combined with localizable CT imaging in oxygen intervention has a potential value in differentiating malignant from benign lung lesions.

0.05)and no significant statistical difference was found.But the successful rate of first therapy of group A was 71.42%(85/119)and group B was 56.20%(77/137)(P

Objective To find out iodine nutritional status of pregnant women in the third trimester and the relationship between pregnant women and their neonates thyroid function in a high iodine area.Methods From April to June 2010,210 copies of fasting morning urine and venous blood,and their neonatal umbilical cord blood samples were collected in Haixing Hospital,Cangzhou city,Hebei province.Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry.The levels of free triiodothyronine(FT3),free thyroxine (FT4) and sensitive thyroid-stimulating hormone (sTSH) in serum were measured by chemiluminescence.Results Median urinary iodine of 210 pregnant women(average age 27.69 ± 4.73 years) in the third trimester was 1240.70 μg/L,84.3％(177/210) of them was in excessive iodine nutrition,and only 0.5％(1/210) of them was in adequate iodine nutrition.The prevalence rate of thyroid diseases was 19.5％ (41/210),and the spectrum of diseases were subclinical hypothyroidism(16.2％,34/210),subclinical hyperthyroidism(0.9％,2/210),hypothyroidism(2.4％,5/210) and hyperthyroidism (0,0/210).The number of newborns with sTSH 5 - ＞ 10 mU/L were 104 persons (49.5％); 10 - ＞ 20 mU/L were 44 persons(21.0％),and ≥20 mU/L were 16 persons(7.6％).Of pregnant women suffer from thyroid disease,the ratio(50.0％,24/48 ) of sTSH equal to 10.18 mU/L and ＞ 10 mU/L of their neonates was higher than that of their corresponding non-ill pregnant women(6.78 mU/L,Z =- 2.867,P ＜ 0.05; 22.2％,36/162,x2 =14.000,P ＜ 0.05).There was a positive correlation between neonates' and their mothers' sTSH levels (r =0.278,P ＜ 0.05).There was also a positive correlation between neonates' (sTSH ＞ 10 mU/L) and their mothers' abnormal sTSH levels (r =0.240,P ＜ 0.05).Conclusions Most of the pregnant women in high iodine areas are iodine excess.The level of neonates' sTSH is higher,and it is due to their mothers' abnormal sTSH and suffering from thyroid diseases to some extent.As a result,the monitoring of pregnant women's iodine nutrition and thyroid function and sTSH level of their neonates should be strengthened.

OBJECTIVETo explore the risk factors of acute lymphoblastic leukemia (ALL) recurrence in adult patients and establish a prognosis index (PI) calculation model in order to improve the prevention strategy of ALL in adults.

METHODS104 adult ALL patients from Blood Diseases Hospital & Chinese Academy of Medical Sciences between August 2008 and November 2011 were enrolled. COX proportional hazards regression stratified by Dummy variable was used to set up the prediction model; Kaplan-Meier method and Log-rank test were used to estimate and compare the survival. After calculated individual PI value, patients' expected survival should be estimated by groups.

RESULTSThe overall median survival of adult ALL patients was 22.00 months (95% CI 17.00-27.00). COX regression analysis showed that chemotherapy group patients had a higher risk of recurrence than of ASCT group while setting treatment as the dummy variable (RR=2.052, 95%CI 0.877-4.799, P=0.007). Stratified Analysis showed that the risk factors of B-ALL recurrence in adult patients included HGB <100 g/L (RR=0.186, 95% CI 0.068-0.512, P=0.001), CNSL (RR=7.767,95% CI 2.951- 20.433, P=0.001), number of consolidation chemotherapy<3 (RR=0.445, 95% CI 0.211-0.940, P=0.034) and Ph chromosome positive (RR=2.771, 95% CI 1.353-5.674, P=0.005). Grouped by the PI value, the expected survival of each individual patient could be estimated as PI=0.58 base.

CONCLUSIONHGB, CNSL, number of consolidation chemotherapy and Ph chromosome were independent risk factors of B-ALL recurrence in adult patients. PI value could predict the survival of adult ALL patients and provide reference for individual therapy and prognostic evaluation.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; epidemiology ; pathology ; Prognosis ; Recurrence ; Risk Assessment ; Risk Factors ; Young Adult

OBJECTIVEDry powder inhalers (DPIs) are increasingly being used to deliver drugs for the treatment of asthma. It is known that DPIs require a crucial minimal inspiratory flow. Previous studies have demonstrated that the peak inspiratory flow (PIF, L/min) through a DPI is dependent on the type of device, the age of the patient, and the level of bronchial obstruction. However, the peak inspiratory flow of healthy preschool children in China remains scant in the literature. The present study aimed to analyze the ability of inspiring flow through the resistance state of ordinary use inhaler in Shenzhen healthy preschool children by measuring the peak inspiratory flow through the different analogue dry powder inhalers and go further into the relationship between it and the age, weight and forced expiratory volume of the children.

METHODA survey in 370 healthy preschool children aged 3 to 6 years (75 children aged 3 years, 104 children aged 4 years, 100 children aged 5 years and 91 children aged 6 years) was carried out in Shenzhen. Peak inspiratory flow (PIF) was measured without and with resistances, which mimicked the internal resistances of several inhalers, Diskus, Turbuhaler, Autohaler, Surehaler by PIF meter (In-check DIAL) and then data PIF-N, PIF-D, PIF-T, PIF-A and PIF-S were obtained. Peak expiratory flow (PEF) was measured by PEF meter (MicroPeak, USA). These two measurements were made in a well-controlled setting, and at least three attempts were recorded to establish maximum achievement. Six spirometry parameters forced vital capacity (FVC), forced expiratory volume at 0.5 second (FEV 0.5), forced expiratory volume at 0.75 second (FEV 0.75), forced expiratory volume at one second (FEV1), maximal mid expiratory flow rate (FEF 25 - 75, PEF were measured by using COSMED spirometry of Italy and the FVC measurements should be around the quality control for spirometry in preschool children which we suggested and published in 2005. All data were expressed as mean +/- SD and analyzed with the statistical software SPSS 12.0 for Windows. Pearson's test was used for calculation of the significances of the correlation coefficients. Variance analysis was used for analysing the variability of inspiratory flows through the inhalers.

RESULTSResults were obtained from 295 children aged 3 - 6 years who successfully finished the tests. The PIF-N, PIF-D, PIF-T, PIF-A and PIF-S were significantly different among the groups aged 3 yrs, 4 yrs, 5 yrs and 6 yrs. The peak inspiratory flow significantly increased with age. The PIF-N, PIF-D, PIF-T, PIF-A and PIF-S in the children of 110 cm height and above were significantly higher than those in the children below 110 cm height, so were the parameters between the children of 120 cm height and above and the children below 120 cm. PIF correlated significantly with age, height and weight and the Pearson coefficient was 0.3 - 0.5. The PIFs in different inhalers varied because of the different inner resistances. The minimum and optimum PIFs in resistances of Diskus, Autohaler and Surehaler could be achieved in almost all subjects, but those in resistances of Turbuhaler could be achieved in only 87.5% subjects, most of whom aged 3 yrs or below 100 cm height. There were good correlations between the PIFs in different resistances and main parameters of ventilation function (FVC, FEV 0.5, FEV 0.75, FEV1, FEF 25 - 75, PEF), PEF was the best among them (Pearson correlative coefficient was 0.6).

CONCLUSIONThe inspiratory ability of the children can be predicted and assessed by using routine measurement of lung function of normal pre-school children. As to the pre-school children of varying ages, the variety of inspiratory ability should be considered completely in the selection of inhaler used during the treatment. The best inhaler suitable for them should be selected properly in order to obtain the best efficacy of treatment individually.

Child ; Child, Preschool ; China ; Female ; Humans ; Inspiratory Capacity ; Male ; Maximal Expiratory Flow Rate ; Metered Dose Inhalers

Objective To understand the application situation of Chinese patent medicine during 2014-2017 in Changshu No.1 People's Hospital (hereinafter referred to as "our hospital"); To provide references for clinical rational medication. Metheds The data of Chinese patent medicine used in our hospital in 2014-2017 were retrieved from our hospital HIS. The consumption sum, annual growth rate, DDDs, sorting ratio and DDDc of Chinese patent medicine were analyzed statistically according to the defined daily dose recommended by WHO. Results During 2014-2017, the consumption sums of Chinese patent medicine were 49.155 2 million yuan, 51.352 7 million yuan, 49.463 7 million yuan and 45.650 4 million yuan, respectively. The consumption sums of Chinese patent medicine of 2015, 2016 and 2017 increased by 4.47％, -3.68％ and-7.71％, respectively. The proportions of consumption sum of Chinese patent medicine in all medicines were 13.63％ in 2014, 13.36％ in 2015, 12.83％ in 2016 and 12.44％ in 2017. Of all the dosage forms of Chinese patent medicine, capsule (32.67％), injection (25.21％) and tablet (14.71％) ranked the top 3 on the list of consumption sum. Of all the single kinds of Chinese patent medicine, blood rationing medicine, heat-clearing medicine and tonifying medicine ranked the top 3 on the list of consumption sum. The blood rationing medicine, gynecologic medicine and tonifying medicine ranked the top 3 on the list of DDDs. The first varieties of single item of consumption sum were salvianolate injection, Pudilan Xiaoyan Oral Liquid and Xueshuantong Injection (freeze-dried). The first varieties of single items of DDDs were Yinxing Tongzhi Dispersible Tablet and Pudilan Xiaoyan Oral Liquid. Conclusion The use of Chinese patent medicine in our hospital is becoming more reasonable, and the role and advantages in the prevention and control of diseases are constantly emerging. However, there are still problems about irrational medication, which need to be further strengthened.

Objective To investigate the change of 14-3-3 protein in cerebrospinal fluid (CSF) in different types of meningoencephalitis in children and its value in judging brain injury.Methods CSF 14-3-3 protein bands were detected by means of Western blot in 22 patients with viral meningoencephalitis and 20 cases of purulent meningoencephalitis and with 15 cases of febrile seizures as the control group from Jul.2009 to Jun.2010,and in addition,the quantitative detection of 14-3-3 protein was done by way of ELISA.Correlation was analyzed between the clinical manifestations,prognosis,EEG,head CT or MRI and the changes of 14-3-3 protein.Results The positive rate of 14-3-3 protein in cases of purulent meningitis was 65.0(13/22 cases),higher than viral meningoencephalitis group(27.3％,6/22 cases),and the difference was significant.In the quantitative detection,14-3-3 protein was increased in both the purulent meningitis [(5.6 + 0.2) μg/L] and viral encephalitis groups[(3.2 + 0.3) μg/L] compared with the control group [(0.9 + 0.1) μg/L].After treatment,14-3-3 proteins were less than before in the purulent meningitis and viral meningoencephalitis groups.In the cases with severe clinical manifestations and severe injury brain suggested by imaging and EEG,the 14-3-3 protein in cerebrospinal fluid was elevated;and the prognosis of the cases with increased 14-3-3 protein was poor,as a result of epilepsy,death and so on.Conclusions 14-3-3 protein in the CSF increases with disease severity,so to a certain extent,it can be used to identify viral meningitis and purulent meningitis.

Background Macular edema following phacoemulsification with intraocular lens (IOL) implantation is a main factor to influent visual function.The administration of traditional medicine can relieve tissue edema,but its preventive and treatment efficacy on macular edema after phacoemulsification with IOL implantation remaines unclear.Objective This study was to investigate the protective effect of huoxuehuayu decoction on macula after phacoemulsification with IOL implantation.Methods A case-controlled observational study was designed.One hundred and eighty eyes of 150 patients with age-related cataract were randomized into operation group and operation + medicine group.Phacoemulsification with IOL implantation was performed in both groups,but huoxuehuayu decoction was orally administered for 14 days in operation+medicine group.The best corrected visual acuity,inflammatory reaction of the ocular anterior segment,and macular edema were recorded before operation and 1 week,2,4,6,8 and 12 weeks,and the central macular thickness was measured using optical coherence tomography.Results Twelve weeks after surgery,the ratio of visual acuity ≥ 1.0 was in significantly higher in operation+medition group than that of in operation group (x2 =1.066,P＞0.05).One week after surgery,the eyes of the aqueous flare were much nore in the operation group than that of operation+medicine group(x2 =9.341,P＜0.05).The thickness of the central fovea was significantly increased in both groups at 1 week,2,4,6,8 and 12 weeks after surgery,showing significant differences in comparison with preoperation (operation group:P ＜ 0.01 ; operation + medicine group:P ＜0.05).Macular edema occurred in 13 eyes in operation group during the following-up duration,including 11 eyes with thickened fovea and 2 eyes with cystoid macular edema.Maeular edema disappeared in 10 eyes 12 weeks later.In the operation+medition group,3 eyes happened macular edema,including thickened fovea in 2 eye and cystoid macular edema in 1 eye.Four to six weeks after surgery,macular edema disappeared in 3 eyes 12 weeks later.The fovea thickness in the operation+medicine group was statistically significantly lower from 2 through 8 weeks after surgery than that in the operation group(t=2.315,2.323,3.104,2.470,P＜0.05).Conclusions Oral administration of huoxuehuayu decoction is helpful for the restoration of the anterior ocular segment.Huoxuehuayu decoction can protect macula from the edema induced by phacoemulsification.