To investigate the clinical course and management of congenital vaginal atresia.This retrospective analysis included patients with congenital vaginal atresia treated from March 2004 to August 2014 at the Obstetrics and Gynecology Hospital of Fudan University.Thirty-nine patients were included in this study.Their average age was 16.87±2.2 years when they came to our hospital.Totally,51％ of the patients had isolated congenital vaginal atresia with a normal cervix,whereas the others had either cervical atresia or imperforate hymen.The primary presenting signs and symptoms included primary amenorrhea (71.8％),periodic abdominalgia (41.0％),abdominal pain (36.0％),dyspareunia (10.3％),menstrual disorders (5.1％),and pelvic mass (5.1％).Ultrasound and magnetic resonance imaging (MRI) were effective inspection methods for the screening of urogenital tract-associated anomalies.Vaginoplasty mainly included simple vagina reconstruction with insertion of a mold (n=22) and split-thickness skin grafting (n=4).In 64％ of surgical patients,normal menstrual bleeding was achieved.Four of the patients subsequently became pregnant and delivered at term.Primary amenorrhea,periodic abdominalgia and abdominal pain are the main reasons for the post pubertal patients to visit doctors.Surgical methods can successfully provide these patients an opportunity for subsequent conservative management,can result in normal menstrual bleeding,resolve cyclic pelvic pain,and provide some potential for fertility.

OBJECTIVETo evaluate the efficacy and safety of Xinmailong Injection (XI) in treatment of chronic heart failure (CHF) patients with qi-yang deficiency and blood stasis resistance syndrome (QY-DBSRS).

METHODSTotally 238 CHF patients with QYDBSRS were assigned to the treatment group (118 cases) and the control group (120 cases) by randomized, double-blind, placebo parallel controlled method. Patients in the treatment group received routine therapy and XI (100 mg/2 mL, by dripping at 5 mg/kg, twice per day for 5 consecutive days), while those in the control group received routine therapy and XI mimetic agent (100 mg/2 mL, by dripping at 5 mg/kg, twice per day for 5 consecutive days). The heart function classification of New York Heart Association (NYHA), 6-min walking distance, left ventricular ejection fraction (LVEF), scores for Chinese medical symptoms were observed before and after treatment, and safety assessed.

RESULTSTotally 235 patients actually entered full analysis set (FAS), including 120 cases in the control group and 115 cases in the treatment group. The total effective rate of heart function, 6-min walking distance and increased post-pre-treatment distance in the experimental group were superior to those of the control group with statistical difference (all P < 0.05). Compared with the control group, increased value of post-pre-treatment LVEF, the total effective rate of Chinese medical syndrome efficacy, scores for Chinese medical symptoms and decreased post-pre-treatment value of Chinese medical syndrome scores were obviously improved (all P < 0.05). There was no significant difference in the incidence of adverse events between the two groups (P > 0.05).

CONCLUSIONSXI could improve the heart function of CHF patients, improve Chinese medical symptoms, elevate exercise tolerance, and improve LVEF. It had no obvious toxic and side effects.

Chronic Disease ; Double-Blind Method ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Heart Failure ; drug therapy ; Humans ; Injections ; Medicine, Chinese Traditional ; Phytotherapy ; Qi ; Syndrome ; Yang Deficiency

OBJECTIVETo provide reliable evidence of "J in three-needle therapy" for treatment of stroke.

METHODSMulti-central randomized controlled trials were adopted, 180 hemiplegia patients of ischemic stroke were randomly divided into a fin three-needle group (90 cases) and a routine acupuncture group (90 cases). Two groups were both treated with basic neurology therapies, and J in three-needle group was treated with J in three-needle therapy, three acupoints of tempora, hand and foot etc. were selected; the routine acupuncture group was treated with traditional acupuncture, Quchi (LI 11), Huantiao (GB 30), Futu (ST 32) etc. were selected. Both groups were treated with acupuncture for 5 weeks. The cognitive function score of functional comprehensive assessment scale (FCA), the scores of mini-mental state examination scale (MMSE) and modified Barthel index (BI) were compared before and after treatment between two groups. Results After treatment, the scores of FCA, MMSE and BI in both groups were significantly improved compared to those before treatment (P < 0.01, P < 0.05); the improvement of FCA score, MMSE score and BI score in the J in three-needle group were superior to those of the routine acupuncture group after treatment (P < 0.01, P < 0.05). The total effective rate of 85.4% in the J in three-needle group was superior to tohat of 70.0% in the routine acupuncture group (P < 0.05).

CONCLUSIONJ in three-needle acupuncture treatment can obviously improve the cognitive function and activity ability of daily life of hemiplegia patients after stroke, and the therapeutic effect of J in three-needle therapy is superior to that of traditional acupuncture treatment.

Activities of Daily Living ; Acupuncture Therapy ; Adult ; Aged ; Cognition ; Female ; Hemiplegia ; etiology ; psychology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications

OBJECTIVETo assess the clinical effect and safety of the Chinese medicine Longbishu Capsule combined with mesylate doxazosin in the treatment of benign prostatic hyperplasia (BPH) of the kidney deficiency and blood stagnation type.

METHODSThis was a randomized, double-blind, double-simulation control study. We equally assigned 60 men diagnosed with BPH of the kidney deficiency and blood stagnation type to an experimental and a control group, the former treated with mesylate doxazosin plus Longbishu Capsule and the latter with mesylate doxazosin plus placebo. We compared the International Prostate Symptom Score (IPSS), quality of life (QOL), Chinese symptom score (CSS), maximal urinary flow rate (Qmax), and prostate volume between the two groups of patients before and after 6 months of medication.

RESULTSAfter treatment, there were 5 cured cases, 13 markedly effective cases, 9 effective cases, 1 ineffective case, and 2 eliminated cases in the experimental group, as compared with 2 cured cases, 8 markedly effective cases, 10 effective cases, 7 ineffective cases, and 3 eliminated cases in the control group. The total effectiveness rate was obviously higher in the former (96.4%) than in the latter (74.1%). IPSS, Qmax, and CSS were improved in both of the groups after medication, even more significantly in the experimental than in the control group (IPSS: 15.22 ± 2.98 vs 18.15 ± 5.88, P <0.05; Qmax: [13.56 ± 2.26] ml/s vs [11.78 ± 2.97] ml/s, P <0.05; CSS: 6.18 ± 2.13 vs 9.52 ± 3.15, P <0.05). Because of the difference in the QOL score between the two groups at the baseline (P = 0.038 <0.05), no more comparison was made in this aspect after treatment.

CONCLUSIONThe combination of Longbishu Capsule with mesylate doxazosin is safe and effective for the treatment of BPH.

Adrenergic alpha-Antagonists ; therapeutic use ; Capsules ; Double-Blind Method ; Doxazosin ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Prostatic Hyperplasia ; drug therapy ; physiopathology ; Quality of Life ; Treatment Outcome ; Urination

OBJECTIVETo investigate the effect of low-temperature plasma on inactivation of bacterial spores and explore the mechanism.

METHODSDielectric barrier discharge (DBD) was employed to generate the atmospheric low-temperature plasma for treatment of B.subtilis var. niger spores with the gas spacing of 3, 4 and 5 and treatment time intervals of 5, 10, 15, 20, 25, 30 and 35 s. The survived colonies was counted with plate counting method, and the killing log value (KLV) at different treatment times was calculated. The inactivation effect of electric field on B.subtilis var.niger spores was also investigated and the spores treated with low-temperature plasma were observed with transmission electron microscope.

RESULTSWith the gap spacing of 3, 4 and 5 mm, the KLV of low-temperature plasma on B.subtilis var.niger spores within 25, 30 and 35 s of exposure was more than 5. The germicidal effects of the electric field on B. subtilis var.niger spores were rather poor. Transmission electron microscopy demonstrated total destruction of the surface and interior structure of the spores by low-temperature plasma.

CONCLUSIONSLow-temperature plasma is effective for inactivation of the bacterial spores with a time and dose dependence. The penetrating effect of charged particles and oxygenation effect of the reactive oxygen species might play a dominant role in plasma-induced bacterial spore inactivation, while the role of electric field is negligible.

Bacillus subtilis ; growth & development ; Cold Temperature ; Microbial Viability ; Plasma Gases ; pharmacology ; Spores, Bacterial ; growth & development ; Sterilization ; methods

OBJECTIVETo explore the effect of anterior spinal release on severe scoliosis.

METHODSTwenty-six cases of severe scoliosis were retrospectively reviewed from January 1998 to December 2001. There were 7 males and 19 females with an average age of 15 years (ranging from 10 to 21 years). Twenty-four cases were classified according to King classification for adolescent idiopathic scoliosis, including King type I 4 cases, type II 9 cases, type III 5 cases, King IV 4 cases, King V 2 cases; another two cases were thoracolumbar curve. The major curves were averaged respectively 89.8 degrees, 66.5 degrees, 67.7 degrees, 61.2 degrees on standing, traction, bending and fulcrum film before operation. The distance of apex vertebrae deviated from sacral midline was 39.7 mm before operation.

RESULTSSix cases received anterior spinal release with posterior correction by one stage, 20 cases by two stages. The cases with two stage operation increased the spinal flexibility about 17.8 degrees after anterior release. The major curve was 52.6 degrees on average, and the distance of apex vertebrae deviated from sacral midline was 9.9 mm after operation. The major curve was 54.9 degrees on average, loss the correction 6.4% during follow-up. There was no complication related to the operation in this group.

CONCLUSIONSThe anterior spinal release alone has little effect on severe scoliosis with flexibility less than 20% preoperation. The curve can be corrected to a great degree by anterior osteotomy for spine.

Adolescent ; Adult ; Child ; Female ; Humans ; Male ; Retrospective Studies ; Scoliosis ; surgery ; Spondylolysis ; surgery ; Surgical Procedures, Operative ; methods ; Treatment Outcome

OBJECTIVETo investigate the therapeutic effect of infrared radiation (IR) on the skin scald in rats.

METHODSThirty-nine male Wistar rats were used in the study, and they were randomly divided into normal control (C, n = 13), scald (S, n = 13, no treatment after scalding) and treatment (T, n = 13, with IR radiation treatment for 5 days since 2nd post scalding day (PSD) groups. The rats in S and T groups were subjected to deep partial thickness scalding on the back. The cutaneous tissue samples from rat wound in each group were harvested on the 3rd and 7th PSD for pathomorphological examination. DNA synthesis in wound tissue was analyzed by 3H-TdR incorporation method, and the vascular permeability in cutaneous tissue, degree of tissue edema and MDA content were determined by corresponding methods.

RESULTSEpidermal exfoliation, cutaneous ulcer, follicular atrophy and damage, and massive formation of collagen were identified in the skin wound of rats in S group on the 7th PSD compared with C group. The skin in T group was smooth with slight atrophy and a few collagen fibers in follicles. The 3H-TdR incorporation amount in the rats in T group (1856.33 +/- 343.81 cpm/mg) on the 7th PSD was significantly higher than that in S group (1353.95 +/- 274.48 cpm/mg) (P < 0.01). The tissue permeability, edema degree and MDA content in the cutaneous tissue in S group were obviously higher than those in group C, while these indices were markedly lower in T group when compared with those in S group (P < 0.01-0.001).

CONCLUSIONTreatment with IR seemed to be beneficial to the promotion of skin tissue metabolism and tissue repair.

Animals ; Burns ; metabolism ; pathology ; radiotherapy ; Infrared Rays ; therapeutic use ; Male ; Malondialdehyde ; analysis ; Rats ; Rats, Wistar

OBJECTIVETo explore family risk factors of overweight and obesity focusing on parental characteristics, feeding practice and lifestyle.

METHODSFive kindergartens were selected randomly from two of all the six urban districts in Beijing. The body height and weight of all the children in the 5 kindergartens were measured in light clothing and without shoes. Information on parental characteristics, dietary habits, lifestyle, and feeding practice was collected from 1173 families by parental self-report questionnaires in the 5 kindergartens. Overweight and obesity were defined according to sex- and age-specific body mass index (BMI) cut-points proposed by the International Obesity Task Force. Correlations and multivariate regression analysis was used to explore risk factors of child overweight and obesity.

RESULTSThe prevalence of overweight and obesity was 6.9% and 4.1%, respectively, among the sample children. Significantly more overweight and obese children were from obese families (15.2%) than they were from non-obese families (7.5%). Significant associations could be observed between children and parents' characteristics for BMI, frequency of eating in restaurant, television-watching hours, and physical activity hours. Parental obesity, low maternal education level and television watching for > 2 h/d were risk factors of child overweight and obesity after adjusting for sex, age, family income, and kindergarten.

CONCLUSIONSChild overweight and obesity were influenced by family environment. Strategies for prevention should include identified family risk factors.

Body Height ; Body Mass Index ; Body Weight ; Child, Preschool ; Exercise ; Feeding Behavior ; Humans ; Life Style ; Multivariate Analysis ; Obesity ; epidemiology ; Overweight ; epidemiology ; Parents ; Prevalence ; Regression Analysis ; Risk Factors ; Television

OBJECTIVETo explore the value of surgical treatment on spine metastatic tumor.

METHODS31 cases of spine metastatic tumor with severe pain or/and neurological deficit were selected and treated with various operative methods.

RESULTSExcept for 4 cases, all the patients survived from 3 months to 7 years (average 17.6 months). The patients had no complication during treatment. The symptoms and neurological functions recovered with various extent after operation.

CONCLUSIONSSurgical treatment should cautiously be adopted. When the spine metastatic tumor with severe pain and neurological deficit has no response to the conservative methods, the surgical treatment with decompression and internal fixation should be performed to improve the life quality for the patients.

Adult ; Aged ; Breast Neoplasms ; pathology ; surgery ; Female ; Humans ; Lung Neoplasms ; pathology ; surgery ; Male ; Middle Aged ; Quality of Life ; Spinal Neoplasms ; secondary ; surgery

OBJECTIVETo investigate the expressions of the active form of glycogen synthase kinase-3(GSK-3)-pGSK-3α/β (Tyr279/216) and its downstream moleculor X-linked inhibitor of apoptosis protein (XIAP) in cholangiocarcinoma and to analyze their correlation with clinicopathological and survival significance.

METHODSImmunohistoehemistry was used to detect the expressions of the active form of GSK-3- pGSK-3α/β (Tyr279/216) and its downstream moleculor XIAP proteins in 50 cholangiocarcinoma tissues and 20 normal bile duct tissues.

RESULTSThe positive rates of pGSK-3α/β (Tyr279/216) and XIAP were 62.0% and 68.0% in cholangiocarcinoma, and 10.0% and 25.0% in normal bile duct tissues, respectively. The intensity of pGSK-3α/β (Tyr279/216) and XIAP expressions in cholangiocarcinoma were significantly higher than that in the normal bile duct tissues (P < 0.001), and there was a significant correlation between pGSK-3α/β (Tyr279/216) and XIAP expressions (r = 0.544, P < 0.001). The expression of pGSK-3α/β(Tyr279/216) protein in cholangiocarcinoma was associated with TNM stage (P = 0.042), histological grade (P = 0.031), whereas the expression of XIAP protein in cholangiocarcinoma was correlated with CEA level (P = 0.006). Patients with positive expression of pGSK-3α/β (Tyr279/216) and XIAP demonstrate a significantly worse prognosis than that of patients with negative expression of pGSK-3α/β (Tyr279/216) and XIAP for overall survival (P = 0.002, P = 0.018). Multivariate survival analysis revealed that positive pGSK-3α/β (Tyr279/216) expression provided significant independent prognostic value for overall survival (P = 0.002).

CONCLUSIONSThe expressions of pGSK-3α/β(Tyr279/216) and XIAP proteins were significantly associated with the development and progression of cholangiocarcinoma. pGSK-3α/β(Tyr279/216) may be an important prognostic factor for survival of patients with cholangiocarcinoma.

Bile Duct Neoplasms ; metabolism ; pathology ; surgery ; Bile Ducts, Intrahepatic ; Carcinoembryonic Antigen ; blood ; Cholangiocarcinoma ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prognosis ; Survival Rate ; X-Linked Inhibitor of Apoptosis Protein ; metabolism