Objective To compare effect of trichosanthin and methotrexate in the treatment of uterine scar pregnancy by a multi-center study. Methods 90 uterine scar pregnancy patients were selected from department of obstetrics and gynecology,in xinyang central hospital,the second affiliated hospital of zhengzhou university,zhumadian central hospital,using random number table divided into 2 groups.The control group of 45 cases were treated by methotrexate,gluteal muscle injection,50 mg one time,and took mifepristone 50 mg,two times a day,a week for a course of treatment;45 cases in the experimental group,were treated with trichosanthin,intramuscular injection of 1.2 mg/time,two times a day,and oral administration of bloven,0.6 g/d,a week for a course of treatment.The end of a course of treatment,2 groups of patients before and after treatment were compared of the serum progesterone level,β-HCG,side reactions after treatment.Results After treatment,progesterone levels were significantly reduced,and the experimental group levels were lower than the control group obviously,the difference has statistical significance(P<0.05).Serum -HCG level after the treatment significantly reduced,and the experimental group in serum -HCG levels were significantly lower,with statistical difference (P <0.05 ). Comparison of adverse reaction of the patients,the experimental group was obviously lower than control group,with statistically significant difference (P<0.05).Conclusion For the treatment of uterine scar pregnancy,trichosanthin and methotrexate have certain effect,but trichosanthin could lower serum progesterone,β-HCG levels more significantly than methotrexate,trichosanthin group side reaction rate is low.

Objective To study the impact of prehypertension on carotid atherosclerotic plaque formation in a mid-dle-aged and elderly population. Methods We studied nine hundred and forty-two residents in a community of Guang-zhou,China by questionnaires,physical examinations,blood chemistry tests and bilateral carotid ultrasonography.Differ-ences of plaque formation were compared among the three populations of normotension(NT),prehypertension(Pre-HT)and hypertension(HT),which were stratified by the JNC-7 classification of blood pressure.Results Pre-HT and HT were associated with the risk factors such as older age,male gender,dyslipidemia,obesity and smoking.Adjusting for relevant risk factors,carotid atherosclerotic plaque formation rate in the Pre-HT was as 2.37 times as that of NT(95%CI:1.42～3.95,P<0.01),difference of plaque formation rate between Pre-HT and HT was not significant(P>0.05).Echolucent plaques were more prevalent in Pre-HT population than in HT population.Conclusions Prehypertension is associated with high risk of carotid atherosclerotic plaque formation and carotid atherosclerotic plaque formation are common among patients with the prehypertension in a middle-aged and elderly population.

Eleven type 1 diabetic patients who received fixed regime of insulin Glargine were included in the study.The levels of fasting serum insulin were measured for each subject at 6:00 in three consecutive mornings.The variability of mean fasting serum insulin in each subject was 3.3%-41.5% (mean 15.4%).The variability did not correlate with the dose of Glargine statistically.

Through the comparative analysis of undergraduate specialty settings of medical colleges and universities in minority areas in the different periods,this paper reveals the characteristics of undergraduate specialty settings.It is necessary to follow the demand for social and economic development,and adhere to the medical and national characteristics,promoting the durable development of undergraduate specialty settings of medical colleges and universities in minority areas.

Insulin secretion and insulin resistance were evaluated in 152 subjects with normal glucose tolerance, impaired fasting glucose (IFG) and (or) impaired glucose tolerance (IGT). The data showed that subjects with IGT exhibited an evident deficit in the early and late phases of insulin secretion after glucose load and mild insulin resistance, and subjects with IFG demostrated evident insulin resistant and a great decline in early phase insulin response and HOMA-β.

The method for analysis and determination the cleavage of soybean sterol, in which the soybean sterol was degraded and the products androst-1,4-diene-,17-dione (ADD) and androst-4-ene-3,17-dion (AD) were developed by Liquid Chromatography-mass Spectrometry. The HPLC conditions adopted were: a All- tima ODS-2 column (250 mm?4.6 mm, 5 ?m), a mobile phase consisted of menthanol-water (70:30), a flow rate of 1.0 mL/min, a room column temperature. and the detective wavelength was 244 nm.The ZMD Micromass electrospray ionization (ESI)-mass spectrometer was employed. In such conditions the corre- sponding HPLC chromatogram and MS spectrum were obtained. The method has a linear ranger of 0.01 mg/mL ~ 0.09 mg/mL, R2 =0.9999, the recoveries of ADD and AD were 102.6% and 105.90%, the RSD of ADD and AD were 3.02%, 3.5% and 3.08%, 3.24%. This method showed high sensitivity, accuracyand easy to perform. It is suitable to analysis the process cleavage of soybean sterol as well as quality control of product.

Objective To probe into the mechanism of anticonvulsant by melatonin (Mel).Methods The rat models of status epilepticus(SE)were induced by pilocarpine(PILO).Changes of expression of γ-Aminobutyric acid(GABA)and GABAA receptor α5 subunit in the hippocampus of SE rats and the effect of Mel on these changes were observed by immunocytochemistry at post-SE 6,48,72 h,7 d. Results The expression of GABA and GABAA receptor α5 subunit began to decrease in PILO group at post-SE 6 h. The expression of GABA and GABAA receptor α5 subunit was significantly lower in PILO group than in control group at post-SE 72 h-7 d(P＜0.01). But the expression of GABA and GABAA receptor α5 subunit was significantly higher in Mel group than in PILO group at post-SE 72 h-7 d (P＜0.05). Conclusions Anticonvulsive effect of Mel may be due to its ability to increase the expression of GABA and GABAA receptor α5 subunit.

OBJECTIVEThis study was designed to compare the short-term and long-term effects of oral rehydration salts, oral rehydration salts plus metoprolol or oral rehydration salts plus midodrine hydrochloride on the treatment of postural tachycardia syndrome (POTS) in children.

METHODA total of 118 children with POTS were divided into oral rehydration salts group (n = 39), metoprolol group (oral rehydration salts plus metoprolol, n = 10) or midodrine hydrochloride group (oral rehydration salts plus midodrine hydrochloride, n = 69). The patients were followed up in clinics or over telephone for 3 - 18 months, with a mean of (11.7 ± 4.1) months. The symptom scores were recorded before treatment, after 3 months and at the end of the follow-up. Reduction of the score by 2 points or more was considered that the treatment was effective. The effective rate in 3 months was applied to evaluate short-term effects of 3 different therapies by chi-square test. Taking futility as events, Kaplan-Meier curves were drawn to compare long-term effects of the 3 different therapies in treating POTS in children.

RESULTNo significant differences among the 3 groups were found in sex, age, body height, weight, the symptom scores before treatment or hemodynamic variables. Oral rehydration salts, metoprolol and midodrine hydrochloride improved clinical symptoms after 3 months. The symptom scores of the 3 groups before treatment and after 3 months were 2.4 ± 3.2 vs. 5.5 ± 2.9, 2.2 ± 3.0 vs. 6.1 ± 3.0 and 1.9 ± 1.6 vs. 5.9 ± 2.7, respectively. The difference was significant (P < 0.05). Descending order of the short-term effective rate was 91.3% in midodrine hydrochloride group, 80.0% in metoprolol group and 74.4% in oral rehydration salts group. The difference was significant (χ(2) = 5.85, P < 0.05). All the 3 different therapies improved clinical symptoms at the end of follow-up. The symptom scores were 2.6 ± 3.2 vs. 5.6 ± 2.9, 2.5 ± 3.1 vs. 6.1 ± 3.0 and 2.2 ± 2.1 vs. 6.0 ± 2.7, respectively. (P < 0.05). The result of the Kaplan-Meier curves showed that the long-term effect of midodrine hydrochloride was significantly superior to metoprolol group and oral rehydration salts group (P < 0.05). There was no significant difference between the latter two groups.

CONCLUSIONOral rehydration salts plus midodrine hydrochloride or plus metoprolol improved the efficacy of drugs in children with POTS. And the efficacy of midodrine hydrochloride was superior to that of metoprolol.

Adolescent ; Child ; Female ; Humans ; Male ; Metoprolol ; therapeutic use ; Midodrine ; therapeutic use ; Postural Orthostatic Tachycardia Syndrome ; drug therapy ; Prospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVESTo investigate the intralaboratory reproducibility of immunohistochemistry (IHC) testing for HER2 status in breast cancer, and to evaluate the factors which influence the reproducibility. The concordance between monoclonal antibody CB11 and HercepTest was also assessed.

METHODSHER2 overexpression on paraffin sections from thirty-seven cases of breast invasive ductal carcinoma was evaluated using CB11 and the evaluation procedure had been repeated for five times scored the tests together according to the HercepTest and new American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) grading schemes by 2 experienced pathologists together. Reproducibility rates of the five rounds were assessed using Kappa statistic, and the results from two scoring systems were compared. HercepTest kit was applied to the same cases afterward and the results were compared with CB11.

RESULTSSubstantial intralaboratory reproducibility was achieved among 5 rounds tests. Excluding the influence effect of changing antibody lots, the intralaboratory reproducibility was closed to the perfect threshold (Kappa = 0.7858, HercepTest scheme). The results derived from the two grading schemes had an almost perfect agreement (Kappa = 0.8549). The concordance (positive vs. negative) between CB11 and HercepTest was 83.78%.

CONCLUSIONSLaboratory work with strict supervision and more experience will ensure a reliable testing consistency. Reproducibility analysis could be adopted to evaluate the intralaboratory staining quality on HER2 testing. Different antibody lots bring some influence to the intralaboratory reproducibility, but not significant. CB11 could be accepted to screen HER2 status in routine practice after testing validation.

Antibodies, Monoclonal ; metabolism ; Breast Neoplasms ; metabolism ; Carcinoma, Ductal, Breast ; metabolism ; Female ; Humans ; Immunohistochemistry ; methods ; Receptor, ErbB-2 ; metabolism ; Reproducibility of Results

OBJECTIVETo investigate the clinicopathological features of pulmonary lymphangioleiomyomatosis (PLAM).

METHODSBy means of HE and immunohistochemistry (SP method) studies, the clinical and pathological features of 5 PLAM cases were analyzed and the related literature reviewed.

RESULTSPLAM was a rare lung disease of unknown etiology and was restricted to females who were generally pre-menopausal. Pathological features showed abnormal smooth muscle cells (LAM cells) line the airways, lymphatics and blood vesssels leading to airflow obstruction and replacement of the lung parenchyma by cysts. LAM cells were positive for HMB45. Clinically the disease was categorized by dyspnoea, haemoptysis, recurrent pneumothoraces and chylous effusions.

CONCLUSIONSPLAM should be considered when recurrent pneumothorax, haemoptysis and dyspnoea occur in females. Pathologic examination of lung tissue biopsy is required for confirmation of PLAM diagnosis.

Actins ; metabolism ; Adult ; Antigens, Neoplasm ; Biopsy ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Lung ; diagnostic imaging ; pathology ; Lung Neoplasms ; diagnostic imaging ; metabolism ; pathology ; Lymphangioleiomyomatosis ; diagnostic imaging ; metabolism ; pathology ; Matrix Metalloproteinase 2 ; metabolism ; Melanoma-Specific Antigens ; Middle Aged ; Neoplasm Proteins ; metabolism ; Tomography, X-Ray Computed