Objective To analyze the clinical and pathological data of the minimal deviation adenocarcinoma (MDA) of the cervix, and to provide evidence based medicine for diagnosis and treatment. Methods Clinical case reports about MDA or malignant adenoma during 1980-2014 published on CNKI, WanFang, CBM, WeiPu and Medline were retrieved and combined with 2 case with the same diagnosis and treatment. Results Age of onset was 20-86 years old, and the average age was 44.8 years, with median age of 44.5 years. Clinical symptoms of MDA showed massive vaginal apocenosis or irregular bleeding. Gynecological examination common showed cervical hypertrophic and harden. The positive rate of cervical cytology examination was 9.73% (11/113). MDA diagnosed by cervical biopsy and conization accounted for 58.38% (108/185). Immunohistochemical showed that the positive rates of carcinoembryonic antigen, P53 and Ki-67 were 93.91%(108/115), 75.44%(43/57)and 100.00% (42/42). Main operation assisted with postoperative radiotherapy and chemotherapy, early diagnosis, clinical stage and operation methods played important roles in the prognosis. Conclusions The clinical symptoms and physical signs are not obvious for MDA which is difficult to diagnose, so it is easy to diagnose mistakenly and misdiagnose also. The positive rate of cervical cytology is usually lower, repeated and deep cervical biopsy or conization combined with immunohistochemistry can improve the accuracy of diagnosis. The individualized treatment should be selected according to clinical stage for the patients who were confirmed preoperatively.

Objective To evaluate the effect of health education on lung function,quality of life,awareness degree and treatment compliance in chronic obstructive pulmonary disease (COPD) patients during stationary phase.Methods 106 COPD patients during stationary phase were randomly divided into 4 groups,25 patients in group Ⅰ,26 patients in group Ⅱ,20 patients in group Ⅲ,35 patients in group Ⅳ.Group Ⅰ did not accepted the health education,and group Ⅱ,Ⅲ,Ⅳ accepted two,four and eight (or＞eight) weeks health education in file.The lung function,quality of life,awareness degree and inerratic treatment rate were compared before and 6 months after health education by questionnaire and follow-up survey.Results Health education could be successful in delaying the decline of FEV1,FVC and FEV1/FVC and was effective in decreasing the SGRQ score among the COPD patients during stationary phase.The results showed that group Ⅱ,Ⅲ,Ⅳ were superior to group Ⅰ,while group Ⅲ,Ⅳ were superior to group Ⅰ,Ⅱ.Health education could remarkably increase awareness degree and inerratic treatment in COPD patients during stationary phase,and the effect on inerratic treatment was connected with the health education number of times.There were distinct different results among 4 groups.Conclusions Health education could remarkably increase awareness and inerratic treatment rate,and have positive effect to delay lung function decline and to promote quality of life in COPD patients during stationary phase.

Objective To evaluate the role of myocardial contrast echocardiography (MCE) to select target vessel, to monitor the opacification zone and to avoid complications during transcoronary ablation of septal hypertrophy(TASH) for hypertrophic obstructive cardiomyopathy(HOCM). Methods In 37 HOCM patients cardiac apex four chamber view, parasternal left ventricular long axis view and left ventricular short axis view were recorded after injection of the myocardial agents and absolute ethanol 5 minutes later respectively. And the opacification zones of the myocardial agents and absolute ethanol were observed. Results Among 37 patients,2 patients gave up treatment because of no appropriate vessel to provide ablation by coronary Doppler flow imaging.Two of 37 patients gave up treatments and did not undergo myocardial contrast echocardiography because of diffused coronary arteries in coronary angiography. Among 33 patients who underwent MCE, 5 patients gave up TASH including one of the opacification of left ventricular mammary muscles, one of the opacification of right ventricular and right ventricular mammary muscles, one for the opacification zone out of the target area and two for the large opacification zone. Other 28 patients underwent TASH successfully. Just after operations and 7 days, left ventricular outflow tract pressure gradient decreased at no less than 50%. Distribution zone of absolute ethanol was smaller than that of myocardial opacification zone in some patients. Conclusions MCE is a credible reference for selection of target vessels in TASH for HOCM.

Objective To observe the vasodilation effect of extract of Jasminum samba (EJs), a kind of traditional Chinese medicine, on ex vivo rat thoracic aortic rings, and to investigate its mechanism. Methods On ex vivo aortic ring perfusion device, influence of EJs on contraction of the aorta induced by phenylephrine (PE) or potassium chloride (KCl) was observed. Influence of N-nitro-L-arginine-methylester ( L-NAME ), barium chloride ( BaCl2 ), glibenclamide ( Gli ) on vasodilating effect of EJs (0. 5, 1, 2, 4, 8 g·L-1 ) was detected. Effect of EJs on the contraction of calcium chloride (CaCl2 ) and PE in Ca2+-free medium was detected. [ Ca2+ ] i in vascular smooth muscle cells was determined by using laser scanning confocal microscope (LSCM). Results In blood vessels with intact endothelium, EJs concentration-dependently decreased PE- or KCl-induced vasoconstriction, the maximum dilating effect being (105. 0±3. 2)% and (78. 0±6. 5)% , respectively; L-NAME affected the vasodilatory effect of EJs on thoracic aorta rings ( P<0. 01), the maximum dilatory effect being (58. 0 ± 6. 9)% . BaCl2 and Gli had significant influence on vasodilation of EJs, and the contraction was obviously attenuated (P<0. 01), the maximum dilatory effect being (37. 0±5. 2)% and (78. 0±10. 0)% , respectively. EJs significantly inhibited contracting effect of PE on thoracic aorta rings in Ca2+-free medium (P<0. 01). The maximum contraction effect was (70. 0±6. 3)% . EJs inhibited CaCl2-induced vasoconstriction (0. 5-8 mmol·L-1 ), and vasoconstriction was decreased by (65. 0±3. 2)% . LSCM recorded that Fmax / F0 of 4 and 8 g·L-1 EJs was (2. 0±0. 2) and (1. 5±0. 2), respectively. Conclusion EJs exerted a dose-dependent vasodilating effect on rat isolated aorta rings. The mechanism might be related to promoting NO release, activating K+channels and decreasing the concentration of cytoplasmic Ca2+.

Objective To investigate the cardioprotective effect of losartan o n subtotal nephrectomy renal failure rats. Methods Renal failure rats were estab lished by subtotal nephrectomy, and then divided into RF group with subtotal nep hrectomy,RF+Los group with additional losartan(10 mg?kg-1?d-1) gavage. Rats underwent sham operation(sham group) with normal saline gavage as control. Hear t changes of experimental rats were observed 12 weeks after operation. Results T he RF group developed hypertension of arterial systolic blood pressure(SBP) and myocardiac myocytes hypertrophy. The levels of collagen type Ⅰ,type Ⅲ,and fi bronectin in endocardium and surrounding intracardial coronary arteries adventit ia of the RF group were significantly increased as compared to those of the sham group. The SBP and the levels of collagen type Ⅰ,Ⅲand fibronectin were marked ly decreased in the RF+Los group as compared to those of the RF group.Expressio n of angiotensin Ⅱsubtype 1 receptor (AT1R) mRNA in the myocardium of the RF+L os group was significantly down regulated as compared to that of RF group. Concl usions Losartan can prevent the cardiac ventricular remodeling with left ventric ular hypertrophy (LVH) and myocardial interstitial fibrosis by the depression of renin-angiotensin system through the down-regulation of myocardiac AT1R mRNA.

ObjectivesTo report pathological and genetic features of 6 Chinese families with Xlinked Charcot-Marie-Tooth disease type 1 ( CMTX1 ).Methods The index cases from 6 families with CMTX1 are males with onset of disease between 11 and 24 years old.All of them had distal leg muscle weakness,accompanied with areflexia and sensory loss in the feet.Additionally,the index 1 presented with recurrent encephalopathy and the index case 5 with cerebellar ataxia.Peripheral neuropathy was found in 12 family members,while other 7 members showed talipescavus and hyporeflexia.Sural nerve biopsies were performed in all index cases.Connexin 32(Cx32) gene was analyzed in the index cases,8 affected and 10unaffected family members as well as 50 healthy women control subjects.ResultsMild to moderate loss of myelinated fiber with axonal degeneration and regeneration clusters were found in all index cases. Thin myelin fibers were found in 5,small onion bulbs in 3 and inflammatory infiltrates in 2.Five novel mutations (I20T,I127F,D178G,A197V,403_404insT) and one L10L synonymous mutation were detected in the 6index cases and their affected family members.The same mutations,in heterozygous state,were detected in 4 female family members without clinical symptoms,but not found in 6 male unaffected family members.The same mutations were not found in healthy control subjects.ConclusionsThe CMTX1 patients in our study present predominantly axonal lesions.Frequent novel Cx32 gene mutations indicated that private mutations may be common in Chinese CMTX1 patients.

Objective To observe the effect of fleabane injection on serum level of D-dimer, fibrinogen and hypersensitive C-reactive protein in patients with IgA nephropathy and to explore the mechanism of fleabane injection for treating IgA nephropathy. Methods 29 patients with IgA nephropathy were given fleabane injection together with routine treatment. Another group of 28 patients with IgA nephropathy were only treated with routine treatment as con-trol. Determinations of 24 hours urine protein output(24HPQ), serum level of D-dimer(D-D), Fibrinogen(Fib) and hypersensitive C-reactive protein (hsCRP) were carried out pre- and post-study. Results Significant decrease in 24HPQ , serum level of D-D, Fib and hsCRP were observed in both treatment group and control group(P <0. 01 ～0. 05), but more significant in treatment group as compared with control group ( P < 0. 05). Conclusion Flea-bane Injection plus routine treatment could significantly decrease 24HPQ in patients with IgA nephropathy, and this maybe contribute to regulation of D-D, Fib and hsCRP by fleabane injection.

Objective To describe the changes of cell development associated contracture and structure proteins in vascular smooth muscle cells (VSMCs) in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). Methods The clinical manifestation of probands in 6 families showed the recurrent cerebral ischemic event. A part of patients showed dementia. The genetic analysis in all probands showed Notch3 gene mutation. All probands received the sural nerve biopsy. The primary antibodies against α-smooth muscle actin, smooth muscle myosin heavy chain, desmin and vimenfin were used in immunohistochemistry staining on all of them. Results VSMCs showed hypertrophy or atrophy in the arterioles with different caliber. The granular osmiophilic material (GOM) could be found within the basal lamina of arteriole VSMCs in all of the probands. The expressions of α-smooth muscle actin and smooth muscle myosin heavy chain were partly lost, negative or unevenly distributed in the VSMCs in the arteriole. The expression of desmin showed also unregular distribution or partial loss. The expression of vimentin was partly enhanced. Conclusions The VSMCs show the physiological features of synthetic configuration, indicating the hypoplasia of VSMCs in the arterioles of CADASIL. The VSMCs of the larger arteriole were more severely involved.

Objective To report clinical,myopathological and genetic features in a family with oculopharyngeal muscular dystrophy(OPMD).Methods The proband,a 60 year-old man,presented proximal weakness of both lower limbs since 50 years old.He developed dysphagia and dysarthria after 53 years old and mild exophthalmos with ptosis after 57 years old.The serum creatine kinase was mildly elevated.Electromyography showed neurogenic involvement and the nerve conduction velocity decreased 20%-143%.Other 5 members in 3 generations developed also dysathria after 45 years old.followed by ptosis 4-20 years afterwards.Three of them showed mild limb weakness.Muscle was biopsied in the proband and specimen was examined with histological,enzymhistochemical,immunohistochemical stainings (first antibody were anti.desmin and ubiquitin antibedies) and ultrastructural examination.PABPN1 gene was sequenced in the proband and 18 family members.Results Rimmed vacuoles with ubiquitin positive material appeared in the muscle fibers.Additionally.there were a few angular atrophic fibers in small groups,COX negative fibers and desmin positive regenerative fibers.Intranuclear palisading filamentous inclusions were observed electromicroscopically in 3% of the nuclears.(GCG)6in PABPN1 was expanded to (GCG)9 in the proband and 11 members.Conclusions The onset symptoms is pharyngeal weakness in OPMD due to heterozygous expanding of PABPNl(GCG)9,accompanied with demyelinating neuropathy.Intranuclear inclusions are also identified in Chinese patient.

Objective To explore mRNA and protein expression of PAl-1 in kidney tissue of mice with IgA nephropathy (IgAN) and the effects of YiShen Decoction. Methods The IgAN model was built by the method of oral intake of bovine serum albumin(BSA)together with the injection of staphylococcus enterotoxin B(SEB)through caudal vein. The mRNA expression of PAI-1 was measured by fluorescent quantitative polymerase chain reaction (FQ-PER)and the expression of PAI-1 protein was measured by immunohistochemistry. Results No significant difference of mRNA and protein expression of PAI-1 was found between the low concentration and high concentration Yishen Decoction group. But the secretion and mRNA expression of PAI-1 in the low and hiigh concentration Yishen Decoction group was decreased more than that in the IgAN model group. Conclusion The abnormal expression of PAI-1 mRNA and protein played an important role in the onset and development of IgAN. The TCM Yishen Decoction could reduce the abnormal expression of the mRNA and protein of PAI-1 in kidney tissue of mice with IgA nephropathy.