Version 2015 of the National Comprehensive Cancer Network (NCCN) Guidelines for Uterine Neoplasms uses the 2009 International Federation of Gynecology and Obstetrics (FIGO) staging system.These NCCN guidelines divide pure endnmetrioid cancers into three categories to delineate treatment:(1) disease limited to the uterus;(2) cervical involvement;(3) extrauterinc disease.Surgery is recommended for medically operable patients.Continuous progestin-based therapy may be considered for highly selected patients with stage IA disease who wish to preserve their fertility.Preoperative chemotherapy can be considered if extrauterine disease is suspected.Factors that may influence the decision regarding adjuvant therapy include lymph vascular space invasion (LVSI),patient age,tumor volume,and lower uterine segment or surface cervical glandular involvement.When administering adjuvant radiotherapy,it should be initiated as soon as the vaginal cuff has healed,no later than 12 weeks after surgery.

Objective To investigate the mechanism of the pathogenesis of diabetic nephropathy (DN) by detecting the expressions of transforming growth factor (TGF)-β, Smad proteins andα-smooth muscle actin (α-SMA) in kidney biopsy of patients with diabetic nephropathy (DN). Methods Twenty-eight patients with DN who underwent renal biopsy were col-lected as DN group. Ten subjects without DN who underwent nephrectomy were taken as control group. The expressions of TGF-β1, TGF-βRⅠ,TGF-βRⅡ,Smad2/3 andα-SMA in renal tissues were detected by immunohistochemistry stain. Results (1)TGF-β1,TGF-β RⅠ,TGF-β RⅡ,and Smad2/3 were expressed in the glomeruli and tubules of both DN group and control group, while the expressions of TGF-βand Smad proteins were significantly higher in DN group than those in control group. At the early stage of DN, TGF-βand Smad proteins were significantly expressed even though there was no remarkable lesions observed by light microscopy. There was no correlation between increased expression and the progres-sion of DN. These proteins were not expressed after glomerulus and renal tubule fibrosis. (2) In control group,α-SMA was identified only in the vascular walls, glomerulus and renal tubules, while it was expressed in almost all parts of kidney in DN group. Conclusion TGF-β and Smad signals involved in the pathogenesis of DN, which may have similar pathogenesis with immune complex glomerulonephritis.

OBJECTIVE:To establish a method for quality control of Shentekang capsules.METHODS:The Radix astragali,Radix ginseng,fermental cordyceps powder in this medicine were identified by TLC.The contents of berberine hydrochloride in this medicine were measured by HPLC.RESULTS:The spots in TLC were clear and well distinguished.The method was linear within a range of0.0351～0.263?g for berberine hydrochloride(r=0.9999),the average recovery was98.88%,and RSD=1.07%(n=5).CONCLUSIONS:The method is simple,sensitive and accurate,which can be used to control the quality of Shentekang capsules.

OBJECTIVE:To provide reference for medication and chemotherapy in patients with colorectal cancer. METH-ODS:Through retrospective study,case histories and doctor’s advice of the colorectal cancer patients receiving chemotherapy in our hospital during 2011-2014 were consulted to analyze the chemotherapy,medication and irrational drug use. RESULTS:A total of 593 cases of colorectal cancer patients with chemotherapy frequency of 1 940 times were collected to analyze the choice of che-motherapy regimen mainly from the following aspects:indications of chemotherapy,choice of chemotherapy regimen,chemothera-py process and chemotherapy period. There was 409 cases of irrational drug use according to the analysis of drug dosage,selection of solvents and drug concentration,the unqualified rate was 21.08% . CONCLUSIONS:The medication and chemotherapy in pa-tients with colorectal cancer in our hospital are basically rational,but there are still certain problems and shortcomings. In future clinical applications,the medication and chemotherapy need to be improved.

Objective To investigate the value of brachial-ankle pulse wave velocity (baPWV) in the prediction of hypertension in middle-aged men with prehypertension.Methods A total of 2580 middle-aged (35 to 55 years old ) prehypertensive individuals who underwent health check-up during September 2006 and December 2007 in our hospital were recruited for this prospective cohort study.After a 4-year follow-up,2451subjects entered final analysis.Logistic regression analysis was used to assess the value of baPWV in the prediction of hypertension.Results(1) Two hundred and eight subjects (8.5％ )developed hypertension after 4-year follow-up study.( 2 ) At baseline,no significant differences of family history of hypertension,heart rate and total cholesterol were found between normotensive and hypertensive subjects (P ＞0.05 ).(3) Logistic regression analysis showed that in age-adjusted model (Model1),the odds ratio (OR) and 95％ confidence interval (CI) of baPWV (140 cm/s) was 2.20 (1.78 to 2.62 )( P ＜0.01) ; while in multi-factor adjusted model ( Model 3 ),OR and 95c％c CI of baPWV was I.49 (1.15 to 1.73) (P ＜ 0.01).(4) Subjects were stratified by quartiles of baPWV at baseline.OR and 95％ CI of hypertension in those of highest quartile was higher than those of lowest quartile ( Model1:OR =10.9,95％CI 5.1-22.7,P＜0.01; Model 3:0R=2.6,95％CI1.2 -6.1,P＜0.05).Conclusion baPWV could be an independent predictor of hypertension among prehypertensive populations.

Objective: To evaluate the efifcacy and safety on clopidogrel combining proton pump inhibitor (PPI) for treating the patient after percutaneous coronary intervention (PCI) by Meta analysis.
Methods: We searched MEDLINE, EMBASE, Cochrane Library and conference databanks, the retrieval time ended at 2014-03 and 14 references were selected for Meta analysis by RevMan 5.2 software. A total of 52274 patients were enrolled and divided into 2 groups, Control group, the patients received clopidogrel, n=43809 and Combination group, the patients received clopidogrel and PPI n=8465. The efifcacy and safety were compared between 2 groups.
Results: Compared with Control group, the patients in Combination group showed increased all cause death rate (OR=1.20, 95% CI 1.05-1.37), re-myocardial infarction (MI) (OR=1.19, 95% CI 1.07-1.33) and in-steut re-vascularization (OR=1.22, 95% CI 1.08-1.39), all P<0.05; while the MACE (OR=1.29, 95% CI 0.98-1.69), in-stent thrombosis (OR=1.22, 95% CI 0.97-1.54) and gastro- intestinal bleeding (OR=0.95, 95% CI 0.55-1.67) were similar between 2 groups, all P>0.05. Further analysis found that PPI (such as omeprazole and esomeprazole) could compete the CYP2C19 enzyme location of clopidogrel, increase the risk of cardiovascular events and decrease the gastrointestinal protection.
Conclusion: Clopidogrel combining PPI may increase the risk of all cause death, MI, in-stent revascularization and decrease the gastrointestinal protection in patients after PCI, especially for omeprazole and esomeprazole which may compete the CYP2C19 enzyme location of clopidogrel.

Objective The purpose of this study was to assess the analysis capabilities of the dot immunogold filtration method on detecting serum amyloid A ( SAA ) protein in blood.It also aimed to research the clinical value of SAA in diagnosing the infectious diseases of children .Methods ( 1 ) The performance evaluation including the accuracy , within-run precision, inter assay variations , the linear and the distraction-analysis of SAA-SPOT was estimated following the EP file; From March to July in 2014, children from five 3A Grade hospitals in Guangdong Province were enrolled into this observational study.Data including white blood WBC count , CRP and SAA were obtained.(2) From March to July in 2014, children from five 3A Grade hospitals in Guangdong Province were enrolled randomly into this observational study.This study used a cross-sectional survey research method , and 386 children with bacterial infection and 219 children with virus infection were as the research object.The general , clinical diagnosis , treatment information as well as the data of blood SAA , C-reactive protein ( CRP ) and white blood cell ( WBC ) of children were collected.Data were analyzed by variance , independent t test, ROC curve analysis and stepwise regression statistics method.Results ( 1 ) The average recovery rate is 103.74 %.Coefficient of variation (CV) for 10 mg/L,100 mg/L within-run assays were 8.77%, 3.61% and between-run assays were 9.01%, 3.74%;the inter-day CV were 9.07%, 4.03%respectively;the linear range was 5 mg/L-200 mg/L, hemoglobin(5 g/L),serum bilirubin(800 μmol/L),triglyceride(TG, 22 mmol/L), and had no interference in SAA detection.When compared to the BNPRO quantitate system of SIEMENS , the coefficient of association of detection of SAA by SAA-SPOT was R2 =0.96.( 2 ) Compared with control group , the serum SAA of infection group ( bacterial infection group , t =13.05, P=0.001;virus infection group t =7.68, P=0.001) and SAA/CRP ratio (bacterial infection group t=2.29, P=0.023;virus infection group t=3.32, P=0.01) were significantly increased.(3) The serum CRP and SAA rose similarly in bacterial infection, while in viral infection, only SAA increased significantly , CRP had no apparent change.In combination with CRP and WBC , SAA had the better diagnostic efficiency apparently.Conclusions As a POCT detection project , analysis capabilities of the SAA assayed by domestic SAA-SPOT can meet the requirements of clinical test.Combined with CRP , WBC and SAA can improve the efficiency in the diagnosing of infectious disease especially in the virus infection.As a new biomarker of infections , SAA is useful for the early auxiliary diagnosis and differential diagnosis of childhood infection.

Objective : To study the epidemiological characteristics of coronavirus disease 2019 （COVID-19） in Zhoushan, so as to provide reference for improving the prevention and control capability of COVID-19. Methods : All the confirmed cases of COVID-19 in Zhoushan, diagnosed according to China’s “COVID-19 diagnosis and treatment plan （fifth version） ” and reported from January 19 to February 17, 2020, were extracted from the infectious disease surveillance system. Data of general information, clinical characteristics, laboratory Results, transmission and detection routes were collected and analyzed. Results : By February 17, Ten confirmed cases of COVID-19 in Zhoushan had been reported, including 7 males and 3 females. They were all adults, with an average age of （50.90±15.00） years. Five cases were discharged. The incubation period ranged from 2 to 12 days, with a median of 5 days. The first symptoms were fever （8 cases）, cough （7 cases） and muscle pain （2 cases）. Chest computed tomographic （CT） scans showed ground glass opacities in the lungs of all the cases. Six cases had Wuhan related exposure. SARS-CoV-2 was tested positive in the sputum specimens or throat swabs of all the cases and the faeces of 4 cases. The last suspicious exposure of 5 cases occurred before, and that of another 5 cases occurred after the onset of clinical symptoms in the confirmed maternal cases. Three cases were found in active consultation after clinical symptoms, and another 7 cases were found in the monitoring of close contacts. Conclusions The 10 confirmed cases of COVID-19 reported in Zhoushan are all adults, and most have Wuhan related exposure. SARS-CoV-2 can be detected in the fecal samples, but the existence of fecal-oral transmission needs more research. SARS-CoV-2 has strong infectivity, and may also have infectivity before the onset of symptoms （at the end of incubation period）. Isolation and early detection of close contacts are conducive for early case-finding.

Objective:To evaluate the efficacy and safety of azacytidine (AZA) combined with homoharringtonine (HHT) and low-dose cytarabine (LDAC) in the treatment of acute myeloid leukemia (AML) patients with 3+ 7 conventional regimen intolerance.Methods:A retrospective analysis was conducted on the clinical characteristics, efficacy, prognosis, and adverse events of 33 AML patients (15 initially diagnosed and 18 relapsed/refractory) admitted to the Second Xiangya Hospital of Central South University.Results:Among the 33 AML patients treated with this regimen, the median age was 55 years old, 9 patients had a moderate cytogenetic risk, and 18 patients had a high cytogenetic risk. Among the 33 patients, 3 were lost to follow-up and 1 had incomplete data. Among the remaining 29 patients who received AZA+ HHT+ LDAC treatment, the total complete response (CR) rate was 69.0%(20/29), and the total response rate (ORR) was 79.3%(23/29); The median progression free survival (PFS) was 7.0 months. Among the subgroup analysis, including age, gender, Eastern Cooperative Oncology Group (ECOG) score, disease classification, bone marrow progenitor cells, peripheral blood leukocytes, risk stratification, and epigenetic abnormalities, only CR rates and PFS differences were statistically significant among different ECOG scoring groups ( P=0.048; P=0.021). A total of 29 patients underwent 69 AZA+ HHT+ LDAC chemotherapy cycles. Retrospective grading was performed on 69 cycles based on common toxicity criteria for adverse events (CTC AE version 5.0). The most common grade Ⅲ-Ⅳ hematological adverse events were thrombocytopenia (54/69, 78.3%) and granulocytopenia (48/69, 69.6%). Common non hematological adverse events included nausea (19/69, 27.5%), infection (17/69, 24.6%), and hypokalemia (18/69, 26.1%). Conclusions:AZA combined with HHT and LDAC has a good therapeutic effect in the treatment of acute myeloid leukemia, and adverse reaction events are controllable.