OBJECTIVE:To compare clinical efficacy and safety of intravenous dripping of methotrexate and uterine arterial perfusion embolization combined with complete curettage of uterine cavity (CCUC) in the treatment of cesarean scar pregnancy (CSP).METHODS:A total of 90 CSP patients were randomly divided into group A and B,with 45 cases in each group.Group A was given Methotrexate (MTX) injection 50 mg/m2 intravenously before CCUC.Group B received Seldinger catheterization in supine position before CCUC,and was given sequential infusion of MTX injection 50 mg/m2 and gelatin sponge particles into the uterine artery;the catheter was removed after satisfactory embolization by imaging examination.The levels of β-HCG of 2 groups were reexamined every 24 h,and CCUC was performed when serum β-HCG level was below 1 000 mU/mL.Perioperative bleeding volume,postoperative bleeding volume,the time of blood β-HCG returning to normal,the time of menstruation returning to normal,hospitalization time as well as the lesion diameters,the levels of blood β-HCG,the occurrence of compliance and ADR before and after treatment were compared between 2 groups.RESULTS:The intraoperative bleeding amount and postoperative bleeding amount of group B were significantly lower than those of group A,while the time of blood β-HCG returning to normal,the time of menstruation returning to normal and hospitalization time were significantly shorter than group A,and the incidence of total compliance was significantly lower than group A,with statistical significance (P＜0.05).Before medication,there was no statistical significance in lesion diameters between 2 groups (P＞0.05).Before CCUA,the lesion diameters of 2 groups were significantly smaller than before medication,and the group B was significantly smaller than group A,with statistical significance (P＜0.05).Before medication,there was no statistical significance in blood β-HCG levels between 2 groups (P＞0.05).Before and after CCUC,blood ββHCG levels of 2 groups were significantly lower than before medication,and the group B was significantly lower than group A,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Compared with methotrexate by intravenous drip,methotrexat by uterine artery embolization combined with CCUC for CSP can effectively reduce intraoperative bleeding amount,promote the decrease of blood β-HCG and menstrual recovery,and contribute to the reduction of complication risk with good safety.

A novel and sensitive HPLC-UV method has been developed for the simultaneous determination of twelve major compounds in Longdan Xiegan Pill.The chemical profile of the twelve compounds,including geniposidic acid（1）,geniposide（2）,gentiopicroside（3）,liquiritin（4）,crocin（5）,baicalin（6）,wogonoside（7）,baicalein（8）,glycyrrhizic acid（9）,wogonin（10）,oroxylin A（11）and aristolochic acid A（12）,was acquired using high-performance liquid chromatography-diode array detector coupled with an electrospray tandem mass spectrometer（HPLC-DAD-ESI-MS）.The analysis was performed on a Dikma Platisil ODS C18 column（250 mm×4.6 mm,5 μm）with a gradient solvent system of acetonitrile-0.1% aqueous formic acid.The validation was carried out and the linearities（r〉0.9996）,repeatability（RSD〈1.8%）,intra-and inter-day precision（RSD〈1.3%）,and recoveries（ranging from 96.6% to 103.4%）were acceptable.The limits of detection（LOD）of these compounds ranged from 0.29 to 4.17 ng.Aristolochic acid A,which is the toxic ingredient,was not detected in all the batches of Longdan Xiegan Pill.Furthermore,hierarchical cluster analysis was used to evaluate the variation of the herbal prescription.The proposed method is simple,effective and suitable for the quality control of this traditional Chinese medicine（TCM）.

Objective To investigate the effect of all-in-one nursing intervention on esophageal carcinoma patients with bad emotion and immune function. Methods From the October, 2012 to the October, 2013, 102 patients with radical operation of esophageal carcinoma were divided into all-in-one nursing intervention group (research group, 52cases) and routine nursing group (control group, 50 cases) according to the random number table method.Two groups of patients were evaluated before and after operation of anxiety and depression emotion scores, with the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) .At the same time, two groups of patients were detected the stress and immune index before and after the operation. Results Before operation, two groups of patients with anxiety, depression, stress reaction and immune index were not significantly different (P>0.05).After operation, the study group patients with anxiety and depression scores were significantly lower than those in the control group [(34.6+6.7) points vs. (44.8+7.5) points, (33.7+6.9) points vs. (40.6+7.3) points], the difference was statistically significant (t values were 7.234, 4.902, P<0.05). Eighth days after operation, patients in the control group FBG, CRP and Cor levels were significantly higher in the study group [(6.98±1.12)mmol/L vs.(6.09±0.85)mmol/L,(18.11±5.93) mg/L vs.(9.24±3.22)mg/L,(293.98±69.09)nmol/L vs.(221.97±67.94)nmol/L],the difference was statistically significant (t values were 4.532, 9.336, 5.307, P<0.05). Eighth days after operation, two groups of patients with IgA, IgM were higher than first days after operation [(2.41±0.46)g/L vs.(1.89±0.56)g/L,(2.51±0.58) g/L vs.(1.35±0.67)g/L and (2.36±0.53)g/L vs.(1.82±0.46)g/L, (2.34±0.62)g/L vs. (1.37±0.64) g/L], the difference was statistically significant (t values were 5.174, 9.439, 5.549, 7.850, P<0.05).The total number of patients blood lymphocytes (LYM) and cytokines (CD3, CD4, CD8, CD4/CD8) were significantly higher than the control group [(2.87±0.65)×109/L vs.(1.98±0.58)×109/L, 0.62±0.10 vs. 0.57±0.07, 0.41±0.08 vs. 0.35 ±0.08, 0.24 ±0.04 vs. 0.26 ±0.05, 2.06 ±0.44 vs. 1.65 ±0.46], the difference was statistically significant (t values were 7.286, 2.915, 6.942, 2.225, 4.601, P<0.05). Conclusion All-in-one nursing intervention can significantly improve the anxiety and depression in patients with esophageal cancer in bad mood, enhance the immune function of patients, conducive to the rehabilitation of patients.

A novel and sensitive HPLC-UV method has been developed for the simultaneous determination of twelve major compounds in Longdan Xiegan Pill.The chemical profile of the twelve compounds,including geniposidic acid (1),geniposide(2),gentiopicroside(3),liquiritin(4),crocin(5),baicalin(6),wogonoside(7),baicalein(8),glycyrrhizic acid (9),wogonin (10),oroxylin A ( 11 ) and aristolochic acid A (12),was acquired using high-performance liquid chromatography-diode array detector coupled with an electrospray tandem mass spectrometer (HPLC-DAD-ESI-MS).The analysis was performed on a Dikma Platisil ODS C18 column (250 mm × 4.6 mm,5 μm ) with a gradient solvent system of acetonitrile-0.1％ aqueous formic acid.The validation was carried out and the linearities ( r ＞ 0.9996),repeatability (RSD＜1.8％),intra- and inter-day precision (RSD＜1.3％),and recoveries (ranging from 96.6％ to 103.4％ ) were acceptable.The limits of detection (LOD) of these compounds ranged from 0.29 to 4.17 ng.Aristolochic acid A,which is the toxic ingredient,was not detected in all the batches of Longdan Xiegan Pill.Furthermore,hierarchical cluster analysis was used to evaluate the variation of the herbal prescription.The proposed method is simple,effective and suitable for the quality control of this traditional Chinese medicine (TCM).

Objective: To explore the role of cytosine-phosphate-guanine oligodeoxynucleotide(CpG ODN)in enhan- cing the radiosensitivity to X-ray in mouse with Lewis lung cancer.Methods: The tumor-bearing mouse model was in- duced by injevting Lewis lung cancer cells into the right infra-axillary dermis.Thirty-two C57BL/6J mice were evenly ran- domized into 4 groups.Group A: the control group;Group B: the X-Ray radiation group;Group C: the CpG group; Group D: the CpG plus X-Ray radiation group.Group B was treated with X-Ray radiation only(3 Gy/F,on day 1,3,5, 8,10,and 12;the total dose was 18 Gy);group C was administered with CpG ODN 0.05 mg on day 1,3,5,8,10, and 12;group D was administered with CpG ODN 6h before X-ray radiation.The tumor growth and tumor growth delay (TGD)were observed in all groups.Meanwhile,the pathological change of the tumor tissue was observed with H-E staining method and the apoptosis of tumor cells were examined with the method of TUNEL.Results: The Lewis hmg cancer-bearing model was successfolly established in mice.The tumor volumes of the treatment groups were smaller than that in lhe control group(P

Objective : To analyze the trends in incidence of thyroid cancer in Huangpu District, Shanghai from 2002 to 2017, so as to provide insights into the management of thyroid cancer. Methods : The incidence of thyroid cancer in Shanghai from 2002 to 2017 was collected from the cancer registration system created by Shanghai Center for Disease Control and Prevention. The crude and standardized incidence of thyroid cancer were estimated by year, gender and age groups, and annual change percentage ( APC ) was calculated to analyze the trends in incidence of thyroid cancer. Results : A total of 2 854 new cases of thyroid cancer were reported in Huangpu District from 2002 to 2017, and the crude and standardized incidence rates of thyroid cancer were 19.57/105 and 13.47/105, with APC of 18.15% and 17.93% ( P<0.05 ), respectively. The crude and standardized incidence rates of thyroid cancer were 10.02/105 and 7.06/105 in men, with APC of 19.58% and 19.04% ( P<0.05 ), and were 28.90/105 and 19.95/105 in women, with APC of 17.33% and 16.99% ( P<0.05 ), respectively. The crude incidence of thyroid cancer was higher in women than in men ( P<0.05 ). In addition, there were two peaks in the crude incidence of thyroid cancer in patients at age of 35 to 39 and 60 to 64 years, with crude incidence rates of 28.98/105 and 33.36/105, respectively. Conclusions The incidence of thyroid cancer appeared a tendency towards a rise in Huangpu District from 2002 to 2017, and much attention should be paid to females and patients aged 60 to 64 years.

Exosomes are bilayer-lipid membrane nanovesicle from almost all living cell types which are in-volved in intercellular substance transporting and signaling communication .Exosomes are 30 ~120 nm in diameter , can transfer bioactive molecules including DNA , RNA, microRNA, protein as well as lipids derived from parents ' cells to re-cipient cells by body fluids , and specifically influence their physiological or pathological conditions .Leukemia is due to malignant proliferation of hematopoietic stem and progenitor cells .It was reported that leukemia cells derived exosomes play a key role in disease progression , drug resistance , and predict prognosis .This paper will outline the role of exosomes de-rived from leukemia cells and provide important information to help explore the molecular pathogenesis , biomarker as well as therapeutic target of leukemia .

Objective: To investigate the trends in incidence and mortality of lung cancer in Huangpu District, Shanghai Municipality from 2002 to 2019, so as to provide the evidence for formulating lung cancer prevention and control measures. Methods: Data of lung cancer incidence and mortality among residents in Huangpu District from 2002 to 2019 were collected through the Shanghai Cancer Registration and Reporting Management System. The crude incidence and mortality of lung cancer was calculated, and standardized by the data from the Chinese Fifth National Population Census in 2000 (Chinese-standardized rate) and the Segi's world standard population in 1960 (world-standardized rate). The trends in incidence and mortality of lung cancer among residents by age and gender were evaluated using annual percent change (APC). Results: A total of 12 965 cases of lung cancer were reported in Huangpu District from 2002 to 2019, and the crude incidence rate was 80.66/105, the Chinese-standardized incidence rate was 34.54/105, and the world-standardized incidence rate was 31.30/105, all showing upward trends (APC=4.588%, 2.933% and 3.247%, all P<0.05). A total of 10 102 deaths of lung cancer were reported, and the crude mortality rate was 62.30/105, showing an upward trend (APC=0.959%, P<0.05); the Chinese-standardized mortality was 25.93/105, and the world-standardized mortality was 22.05/105, both showing downward trends (APC=-1.282% and -1.263%, both P<0.05). The crude incidence and mortality rates of lung cancer in males were higher than those in females (101.39/105 vs. 60.52/105, 85.45/105 vs. 39.87/105, both P<0.05). The crude incidence and mortality rates of lung cancer showed upward trends with age (both P<0.05), reaching their peaks in the age groups of 80-<85 years (341.37/105) and 85 years or above (355.97/105), respectively. Conclusions The incidence of lung cancer showed an upward trend, while the mortality showed a downward trend in Huangpu District from 2002 to 2019. Elderly men were the high-risk group for lung cancer incidence and mortality.

OBJECTIVE:To observe clinical efficacy and safety of mesalazine combined with Kangfuxin solution retention en-ema in the treatment of active ulcerative colitis(UC). METHODS:A total of 120 patients diagnosed as active UC selected from gastroenterology department of our hospital during Mar. 2012 to Aug. 2014 were divided into observation group and control group according to random number table,with 60 cases in each group. Both groups received conventional treatment of active UC. Control group was additionally given Mesalazine enteric coated tablets 1 g,tid,on the basis of routine treatment.Observation group was ad-ditionally given Kangfuxin solution 30 mL diluted with normal saline 150 mL for enema,qd,on the basis of control group. Both groups were treated for 30 d. The serum levels of TNF-α,IL-1,IL-8,IL-10,SOD,NO and LPO were observed in 2 groups be-fore and after treatment;clinical efficacies,recurrence rates,colonoscopy efficacies and the occurrence of ADR were compared be-tween 2 groups. RESULTS:Before treatment,there was no statistical significance in the serum levels of TNF-α,IL-1,IL-8, IL-10,SOD,NO or LPO between 2 groups(P>0.05).After treatment,the serum levels of TNF-α,IL-1,IL-8,NO and LPO in 2 groups were decreased significantly,while the serum levels of IL-10 and SOD were increased significantly;the serum levels of TNF-α,IL-1,IL-8,NO and LPO in observation group were significantly lower than control group,while the serum levels of IL-10 and SOD were significantly higher than control group,with statistical significance(P<0.05). Clinical response rate,recur-rence rate and colonoscopy response rate of observation group were 83.3%,11.7% and 88.3%,which were significantly better than 66.7%,30.0%,70.0%of control group,with statistical significance(P<0.05).There was no statistical significance in the in-cidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Mesalazine combined with Kangfuxin solution can effectively alle-viate inflammatory reaction in patients with active UC,and reduce oxygen free radical damage with good safety.

OBJECTIVETo analyze the characteristics of repeated renal biopsy-proven primary focal segmental glomerulosclerosis (PFSGS) in 8 children, and to reveal the relationship between clinical features and pathology, between the two times of renal biopsy pathology, and the indications for repeated renal biopsy.

METHODThe records of cases who ever experienced renal biopsy in this hospital were reviewed, of whom 8 cases of repeated renal biopsy-proven PFSGS were enrolled. The clinical manifestations, the reason why they had renal biopsy again, the difference in renal pathological findings, between the two biopsies and their therapeutic response. The classification of focal segmental glomerulosclerosis (FSGS) was based on the new criteria suggested by D'Agati in 2004.

RESULTOf the 8 cases, age of onset ranged from 1 to 12 years, all were diagnosed as nephrotic syndrome (NS), the age of first biopsy ranged from 1.1 to 15.0 years, and the follow-up period was 10 months to 14 years. The reason for repeated biopsy was poor therapeutic response, continuous heavy proteinuria, or the progressive renal dysfunction. Four cases had the both biopsies in this hospital, and the first renal pathology showed minimal change disease (MCD), mesangial proliferation, FSGS CELL type and FSGS GTL type. After the second biopsy, they were additionally treated with immunosuppressive agents or switched to another one, 2 cases with FSGS COLL type presented renal dysfunction or end stage renal disease (ESRD), 1 case who developed the disease at 1.4 years of age, presented renal dysfunction at 10 months follow-up. The remaining 5 cases acquired complete remission.

CONCLUSIONFSGS is a clinicopathological syndrome, NS predominates clinically. It often indicates pathologic transformation when the patients show poor therapeutic response or continuous heavy proteinuria without remission. Mesangial proliferation can convert into FSGS, and the subtype of FSGS can shift. FSGS COLL type and onset at young age may suggest poor prognosis.

Biopsy ; Child ; Child, Preschool ; Female ; Glomerulosclerosis, Focal Segmental ; pathology ; Humans ; Infant ; Kidney ; pathology ; Male