Purpose To investigate the adverse reactions and management in the process of transvaginal real-time three-dimensional hysterosalpingo-contrast sonography (3D-HyCoSy).Materials and Methods A total of 976 patients with infertility accepting 3D-HyCoSy in Jiangsu Provincial Hospital of Traditional Chinese Medicine,Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,from December 2014 to August 2016 were retrospectively analyzed.The pain degree was evaluated using visual analog scale (VAS).Adverse reactions,including contrast countercurrent,vomiting,syncope and allergies,were recorded.The relationship between adverse reactions and ultrasound imaging signs was explored.Results There were 66 cases (6.76％) of VAS grade 0,346 cases of mild pain (35.45％),374 cases of moderate pain (38.32％) and 190 cases (19.47％) of severe pain.With the increase in the degree of tubal obstruction,the degree of pain gradually increased.Pain was the most common adverse reaction among patients,followed by vomiting (15 cases,1.54％),syncope (1 case,0.10％),and allergies (1 case,0.10％).The incidence of contrast countercurrent was 12.30％ (120 cases).The adverse reaction incidence of patients with abnormal ultrasound imaging signs was significantly higher than that of patients with normal signs (x2=29.02,P＜0.01).Conclusion With the extensive use of 3D-HyCoSy examination,its clinical application value has attracted a lot of attention,meanwhile,the understanding of its safety and related adverse reactions should also be improved.The state of patients should be closely observed before,during and after 3D-HyCoSy.Medical personnel should watch out for syncope and allergic reactions,and prepare for emergency management.

The study on the buds of Jasminum officinale L. var. grandiflorum was carried out to look for anti-HBV constituents. The isolation and purification were performed by HPLC and chromatography on silica gel, polyamide and Sephadex LH-20 column. The structures were elucidated on the basis of physicochemical properties and spectral analysis. Six iridoid glycosides were identified as jasgranoside B (1), 6-O-methy-catalpol (2), deacetyl asperulosidic acid (3), aucubin (4), 8-dehydroxy shanzhiside (5), and loganin (6). Jasgranoside B (1) is a new compound. Compounds 2-6 were isolated from Jasminum officinale L. var. grandiflorum for the first time.

Objective To investigate the influence of injection color regents concentration on completed resection rate, operation time and injection volume of patients with intestinal tumor by ESD.Methods 90 elderly patients with intestinal tumor by ESD were chosen from June 2013 to June 2016. They were randomly divided into 3 groups including A group (30 patients) with glycerin fructose used alone, B group (30 patients) with glycerin fructose combined with 2% mythylene blue on the basis of glycerin fructose and C group (30 patients) with glycerin fructose combined with 4% mythylene blue on the basis of glycerin fructose; and the completed resection rate of tumor, operation time, injection volume and complication incidence in the peri-operative period of 3 groups were compared.Results There was no signiifcant difference in the completed resection rate of tumor among the 3 groups (P < 0.05). The operation time and injection volume of C group were signiifcant better than A group and B group (P< 0.05). There was no signiifcant difference in operation time and injection volume between A group and B group (P < 0.05). There was no signiifcant difference in the complication incidence in the peri-operative period among the 3 groups (P < 0.05).Conclusion Compared with glycerin fructose used alone and glycerin fructose combined with 1% mythylene blue for 2 mg, glycerin fructose combined with 1% mythylene blue for 4 mg by intestinal submucosal injection on patients with intestinal tumor by ESD can efifciently shorten the operation time and reduce the injection volume.

ObjectiveTo explore the best treatment method of cerebral artery dissection.Methods This study included eight patients who were definitely diagnosed as cerebral artery dissection by the cerebral angiography in our department of neurology during Oct.2009 and Nov.2011.They were all treated by the anticoagulation or anti-platelet methods.Some patients received the stent therapy.All patients' were followed for at least three months. The treatment effect was assessed by NIHSS,mRS and by the cerebral angiography.ResultsSix patients had carotid artery dissection,2 had vertebral artery dissection.Four patients were given anticoagulant therapy and the other 4 were given anti-platelet therapy. The reexamination by angiography 10-14 days after admission showed that in 3 patients,the stenosis was aggravated or the infarction occurred.They were diagnosed as having repeated transient ischemic attack (TIA) during pharmacotherapy and received stents for treatment.There was no TIA and cerebral infarction in the follow-up period after individualized therapy.Mean NIHSS scores of 8 patients between pre and post treatment were 5.9,1.6 respectively. Mean mRS scores pre and post treatment were 2.5,0.9respectively.Conclusion The treatment for patients with cerebral artery dissection should be individuated.The patients in acute stage should get anticoagulation,anti-platelet therapy and angiography re-examination.According to the clinical manifestation and cerebral angiography,the next step for the treatment should be done.

[Objective]To comprehensively compare the feasibility of three different treatment strategies consisting of low-dose chemotherapy(LDC),surgery and surgery with adjuvant low-dose chemotherapy(SLDC)for children with solitary bone lesions of eosinophilic granuloma(SBL-EG).[Methods]We retrospectively reviewed the records of 149 pediatric patients with SBL-EG at our institutions from 2002 to 2014. Our study included 86 patients who received LDC ,33 patients who received surgery and 30 patients who received SLDC. The duration of hospital stay ,time to symptom relief,recovery time,cost,complications and relapse-free sur-vival(RFS)of each strategy were analyzed.[Results]Hospital stay,time to symptom relief,recovery time and cost in the LDC group were significantly shorter or less than those in the surgery or SLDC group (P < 0.05). No statistically significant differences were observed in the above-mentioned factors between the surgery and SLDC groups (P > 0.05). Chemotherapy-related adverse events in the LDC and SLDC groups included nausea(8.62%),aminotransferase elevation(7.76%),slight hair loss(4.31%), immunity decline (21.55%),growth retardation (10.34%) and moon face (7.76%). LDC and SLDC treatment resulted in a significantly longer RFS (147 months and 126 months ,respectively) than surgery alone (114 months)(P = 0.005 and 0.019 , respectively). However ,there was no statistically significant difference in RFS between the LDC and SLDC groups (P = 0.732).[Conclusions]Compared with surgery or SLDC,LDC appears to promote more rapid recovery,less invasion,increase safety and eco-nomic treatment strategy for pediatric patients with SBL-EG.

Objective To evaluate the feasibility of CEUS in Crohn discasc (CD) activity.Methods Thirty-nine patients with CD were analyzed.The clinical disease activity index of 18 cases were less than 150 (inactivity),and 21 cases were between 150 and 450 (activity).The thickness of intestinal walls were measured and Limberg classification were determined by power-Doppler results.The CEUS was performed,and the parameters including rise time,peak intensity,mean transit time,time from peak to one half,wash in slope and time to peak were statistical analyzed.Results The thickness of the lesions,peak intensity and wash in slope of activity CD were greater than those of inactivity CD,which had significant difference (all P＜0.05).The Limberg classification of type Ⅰ was 1 case,type Ⅱ was 4 cases,type Ⅲ was 10 cases and type Ⅳ was 6 cases in activity CD.The Limberg classification of type Ⅰ was 10 cases,type Ⅱ was 7 cases and type Ⅲ was 1 case.The Limberg classification were mainly type Ⅲ and type Ⅳ in activity CD,and type Ⅰ and type Ⅱ in inactivity CD,which had significant difference (P＜0.001).Conclusion CEUS can provide quantitative parameters in CD activity and has great clinical value.

Objective To investigate the amplifying results of repairing degenerated distal receptor nerves with normal proximal donor nerves.Methods The study was carried out on 12 adult male SD rats that randomly derided into degeneration group and control group.The distal tibial nerve stumps as receptor nerve were denervated for 8 weeks before cross-sutured with partial freshly transected proximal common peroneal nerve stumps in the degeneration group,while in the control group,freshly transected distal tibial nerve stumps were sutured with partial freshly cut proximal common peroneal nerve stumps.The motor nerve conduction (MCV),muscle rigidity contraction force were measured,the histological examinations were carried out and the numbers of myelinated axons were calculated 3 months after the operation.Results The degeneration group showed a poorer regeneration capacity than the control group (P＜0.05).The MCV were (16.992 ± 3.737) m/s,(23.092 ± 2.788) m/s respectively;The ratio of muscle force were (39.642 ±5.865)% and (71.098± 6.778)% respectively.The regenerated myelinated nerve fiber number were 1718.2± 282.0 and 3340.0 ± 506.5 respectively in degeneration group and control group.The amplifying ratio of the degeneration group and control group were 1.581 ± 0.329 and 3.098 ± 0.642.Conclusion The amplifying results of repairing the degenerated nerves are poorer than repairing the freshly injury distal nerves with the freshly transected proximal donor nerves,the results demonstrate a progressive inability of chronically degeneration of the distal nerve to support axonai regeneration.

Objective:To investigate the effect of MT01 on the differentiation of osteoblasts under infected condition through determining the expression level of collagen Ⅰ (Col Ⅰ )mRNA in MG63 cells treated with Porphyromonas gingivalis (Pg).Methods:The cultured MG63 cells were divided into blank control,MT01,Pg, and MT01+Pg groups.MT01 at a concentration of 1 mg·L-1 was added into the MG63 cells,and the cells were incubated for 3 h.The cells treated with PBS (1 mg·L-1 )were used as control group.Then Pg (MOI=100∶1) was added.Real-time PCR was used to detect the expression levels of ColⅠ mRNA in MG63 cells at 2,4,6,8, 12 and 24 h after incubation.Results:Compared with blank control group,the levles of ColⅠ mRNA in the MG63 cells in MT01 and MT01 + Pg groups had no significant changes at 2 and 4 h (P > 0.05);the Col Ⅰ mRNA expression levels in MT01 group at 8,12 and 24 h were increased (P < 0.05 or P < 0.01).Compared with Pg group,the expression levels of ColⅠ mRNA in MT01+ Pg at 2 and 4 h were decreased,but the expression levels of ColⅠ mRNA were increased at 6,8,12 and 24 h (P <0.05 or P <0.01).Conclusion:MT01 can up-regulate the expression level of Col Ⅰ mRNA in the infected MG63 cells; MT01 could promot the differentiation of osteoblasts under infected condition.

Objective:To explore a medical big data algorithm to screen the core indicators in clinical database that can be used to evaluate the prognosis of elderly patients with pneumonia.Methods:Based on the clinical database of a Beijing Chaoyang Hospital Consortium Chaoyang Emergency Ward in Beijing Chaoyang Hospital, Capital Medical University, patients with pulmonary infection were selected through the big data retrieval technology. According to the prognosis at the time of discharge, they were divided into death group and survival group. The general data of patients were collected, including gender, age, blood gas and laboratory indices. A computer language called Python was used to make batch calculations of key indicators that affect mortality in elderly patients with pneumonia. Logistic regression analysis was used to analyze the relationship between laboratory indicators and patients' prognosis. Receiver operating characteristic curve (ROC curve) was drawn to analyze the predictive value of screening method for patients' prognosis.Results:A total of 265 patients were included in the study, 64 died and 201 survived. The data of the first detection indexes of each patient after admission were collected, and 23 key indicators with significant differences were selected from 472 indicators: blood routine indicators ( n = 7), blood gas indicators ( n = 3), tumor markers indicators ( n = 3),coagulation related indicators ( n = 4), and nutrition and organ function indicators ( n = 6). ① The key indicators of blood gas in patients died of pneumonia: Cl - was 97-111 mmol/L in 51.6% (33 cases) of patients, lactic acid (Lac) was 0.5-2.5 mmol/L in 81.2% (52 cases) of patients, and H + was 0-46 mmol/L in 87.5% (56 cases) of patients. ② The key indicators of blood routine of patients died of pneumonia: hemoglobin count (Hb) of 46.9% (30 cases) patients was 80-109 g/L, the eosinophils proportions (EOS%) in 67.2% (43 cases) patients was 0.000-0.009, the lymphocytes proportions (LYM%) in 51.6% (33 cases) patients was 0.00-0.09, the red blood cell count (RBC) in 50.0% (32 cases) patients was (3.0-3.9)×10 12/L, the white blood cell count (WBC) in 54.7% (35 cases) patients was (0.0-9.9)×10 9/L, and the red blood cell volume distribution width coefficientof variability (RDW-CV) in 48.4% (31 cases) patients was 10.0%-14.9%, serum C-reactive protein (CRP) was 0.0-49.9 mg/L in 48.4% (31 cases) patients. ③ The key indicators of tumor markers in patients died of pneumonia: 76.6% (49 cases) of patients had negative free prostate specific antigen/total prostate specific antigen (FPSA/TPSA, the ratio was 0), 92.2% (59 cases) had cytokeratin 19 fragment (CYFRA21-1) between 0.0-11.0 μg/L, and 75.0% (48 cases) had carbohydrate antigen 125 (CA125) between 0-104 kU/L.④ The key coagulation indexes of patients died of pneumonia: 68.8% (44 cases) of patients had activated partial thromboplastin time (APTT) of 57-96 s, 73.4% (47 cases) of patients had D-dimer of 0-6 mg/L, 93.8% (60 cases) of patients had thrombin time (TT) of 14-22 s, and 89.1% (57 cases) of patients had adenosine diphosphate (ADP) inhibition rate of 0%-53%. ⑤ Nutrition and organ function key indicatorsin patients died of pneumonia: 92.2% (59 cases) of brain natriuretic peptide (BNP) in patients with 0, 46.9% (30 cases) of patients had prealbumin (PA) of 71-140 mg/L, 90.6% (58 cases) of the patients with uric acid (UA) for 21-41 μmol/L, 75.0% (48 cases) of the patients with albumin (Alb) to 10-20 g/L, 93.5% (60 cases) of patients had albumin/globulin ratio (A/G ratio) of 0-0.9, 84.4% (54 cases) of the patients with lactate dehydrogenase (LDH) from 0-6.68 μmol/L·s -1·L -1. ⑥ Logistic regression analysis and ROC curve analysis: Logistic regression analysis showed that PA and Lac were the prognostic factors. PA could reduce the risk of death by 0.9%, Lac could increase the risk of death by 69.4%; the area under ROC curve (AUC) between laboratory indicators and the prediction effect of death prediction model for patients' prognosis was 0.80, which showed that the classification effect was better, and this study model could better predict the prognosis of elderly patients with pneumonia. Conclusion:By using big data technology, 23 core indicators for evaluating the prognosis of elderly patients with pneumonia can be screened from the clinical database of emergency ward, which provides a new perspective and method for clinical evaluation of the prognosis of elderly patients with pneumonia.

Objective To observe the effect of tetrahydroxy stilbene glucoside (TSG) on the behavior on rat model and the expressions of autophagy-associated protein Beclin-1 and LC3- Ⅱ induced by Aβ1-42 Methods Eighty rats were equally randomized into 4 groups (n =20):The control group,the sham operated group,the model group and the TSG group.The behavior of rats was measured by using Y-maze and Morris water maze.The expression of Beclin-1 and LC3- Ⅱ in rats hippocampus was detected by Western blot and RT-PCR at the time points.Results The number of electric-stimulus in hippocampus significantly increased and the Morris water maze test showed that the escape latency prolonged,swimming distance increased and the times of crossing the exact former platform location decreased both in the model and TSG groups after 21 days compared with those in control group.The mRNAs and protein expressions of Beclin-1 (0.51 ±0.03)and LC3-Ⅱ (0.68 ± 0.04) in model group were higher than that in control group (0.31 ± 0.01,0.31 ± 0.02) at that time point ( Beclin-1:t =28.2843,P ＜ 0.05 ; LC3- Ⅱ :t =37.0000,P ＜0.05).Compared to model group,the expression of the Beclin-1 and LC3- Ⅱ was decreased at 21 d in TSG group (Beclin-1:t =9.8387,P ＜ 0.05 ; LC3- Ⅱ :t =16.2698,P ＜ 0.05 ).Conclusions Autophagy self-regulated system is started through the increased expressions of Beclin-1 and LC3- Ⅱ after Aβ deposition in rats,so as to attenuate cerebral injury caused by Aβ neurotoxicity.Autophagy pathway is possible one of the mechanisms in Aβ neurotoxic injury. Tetrahydroxy stilbene glucoside from polygonum multiflorum has protective effect on it.