Objective To discuss the diagnosis,treatment and following-up of cervical intraepithelial neoplasia (CIN) during pregnancy.Methods Eighteen pregnant women with CIN,presented to the hospital from Jan.2004 to May.2008,were retrospectively reviewed.Pap smear,HPV,copolscopy and cervical biopsy were performed for diagnosis and all were followed up by Pap smear and copolscopy during pregnancy every 12 weeks,while 15 were followed up until 6-8 weeks postpartum.Results The incidence of CIN during pregnancy was 0.16%.All of the 18 women had abnormal Pap smear,followed by colopscopy and biopsy.Conservative management during the pregnancies every 3 months showed no progress in CIN.Among the 18 cases,17 delivered at term and only 1 preterm (36+4 weeks).Two out of the 18 women had normal delivery (11.1%),2 by forceps(11.1 %) and 14 by cesarean sections (77.8%).No neonatal apnea or neonatal respiratory distress syndrome had been observed.Pathological diagnosis was confirmed in all cases prenatally,including 4 CIN1,4 CIN2 and 10 CIN3.Four out of the 10 CIN3 remained after delivery,while 1 changed to CIN2.These 5 cases underwent leep electrical excision procedure and Pap smear results turned to normal at 6 to 11 months after delivery.One HSIL case were lost.The rest 4 CIN3 and all of the 8 CIN1 and CIN2 cases turned to normal or lesser degree.Fourteen of the 18 women received HPV test during pregnancy,and 12 (85.7%) were positive,among which 7 women were followed up at postpartum and 6 of them were HPV positive.Conclusions The three steps method for diagnosis of CIN during pregnancy is safe and effective.Conservative management of CIN during pregnancy is recommended.

Objective: To compare the effects of bare-handed cardiopulmonary resuscitation (CPR) and cardiopulmonary resuscitator in emergency treatment. Methods: A total of 185 patients received CPR in our hospital from 2013-01 to 2015-10 were enrolled. The patients were divided into 2 groups: Bare-handed CPR (Bare-handed ) group, n=101 and Cardiopulmonary resuscitator (Mechanical) group, n=84;meanwhile, taking 30 min as border time, each group was further divided as short time CPR subgroup and long time CPR subgroup. High quality CPR was conducted in all patients. The success rates, time and blood levels of lactic acid after CPR were compared among short time subgroup, long time subgroup between Bare-handed group and Mechanical group respectively. Results: For short time CPR patients, the success rates, time and blood levels of lactic acid after CPR were similar between Bare-handed group and Mechanical group; for long term CPR patients, the success rates and time were similar between Bare-handed group and Mechanical group, while blood levels of lactic acid after CPR in Mechanical group (6.88 ± 1.82) mmol/L was lower than Bare-handed group (9.39 ± 2.39) mmol/L, P<0.05. Conclusion: The success rates of bare-handed CPR and mechanical CPR were similar for emergency treatment, both methods were effective; while mechanical CPR may save the manual labor, achieve better metabolic result which should be recommended in clinical practice.

Objective To investigate the clinical efficacy of electroacupuncture plus a multi-function cervical rehabilitation system in treating cervical spondylosis.Methods Sixty patients with cervical spondylosis were randomly allocated to treatment and control groups, 30 cases each. The treatment group received electroacupuncture plus treatment with a multi-function cervical rehabilitation system and the control group, electroacupuncture alone. After 30 days of treatment, changes in the pain score, the neck disability index, and cervical active range of motion and isometric muscle strength were observed in the two groups and the clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 96.7% in the treatment group and 93.3% in the control group; there was no statistically significant difference between the two groups (P>0.05). There were statistically significant pre-/post-treatment differences in the pain score, the neck disability index, and cervical active range of motion and isometric muscle strength in the two groups (P<0.01,P<0.05). There were statistically significant post-treatment differences in the neck disability index, and cervical active range of motion and isometric muscle strength between the treatment and control groups (P<0.05).Conclusions Electroacupuncture plus a multi-function cervical rehabilitation system is an effective way to treat cervical spondylosis. It can relieve the clinical symptoms in the patients.

AIM:To prepare the Lyophiled Royal Jelly Soft Capsule and study its stability and Influential factors.METHODS:The suspending agent and processing method were optimized using sedimentation volume rate as the index.Soft capsules were prepared and product stability under high temperature and high humidity environment was studied according to the determination of the content of 10-HAD by HPLC.RESULTS:The finished product yield in pilot test was more than 90%,the soft capsule products stored in cold were stable,while those stored under room temperature or high temperature and high humidity were unstable with a noticeable decrease in quality.Water content in capsule shell affects the 10-HDA content of the finished product.CONCLUSION:The preparative process is feasible and the products should be storaged in cold enviroment.

Objective To explore the clinical application and diagnostic efficiency of two-dimensional shear wave elastography (2D-SWE) in assessing liver fibrosis of patients with viral and non-viral hepatitis. Methood Seventy-three patients with viral hepatitis and sixty with non-viral hepatitis scheduled for liver biopsy in the third Affiliated Hospital, Sun Yat-Sen University from April, 2011 to January, 2013 were enrolled in this study. The Young's modulus in different fibrosis stages, correlation coefficients of liver fibrosis level and area under receiver operating characteristic curve (ROC) were compared between patients with viral and non-viral hepatitis respectively. Results The hepatic Young's modulus of patients with viral and non-viral hepatitis in S0-1, S2-3, S4 were 6.1(4.8-6.6)kPa,7.4(6.0-8.4)kPa,10.3(7.6-14.0)kPa, and 10.7(8.0-13.5)kPa,24.7(17.4-32.1)kPa,26.8(16.5-31.7)kPa, respectively. The difference of Young's modulus between viral and non-viral hepatitis in S0-1 were statistically significant (Z=-3.45, P=0.001), while not in S2-3 and S=4 (Z=-0.40, -0.06, P=0.686, 0.956). Correlation coefficients of liver fibrosis with 2D-SWE in viral and non-viral hepatitis are 0.964,0.817 ( both P=0.000 ) with statistically significant difference (Z=2.42, P=0.015). The area under ROC for S≥2 and S=4 in viral and non-viral hepatitis were 0.964 and 0.930,0.817 and 0.906 respectively. The comparison was significantly different for S≥2 (Z=-2.47, P=0.014), while not for S=4 (Z=-0.502, P=0.616). Conclusion In liver fibrosis assessment, the diagnosis efficiency of 2D-SWE in patients with viral and non-viral hepatitis was different and dependent on fibrosis stage.

Objective To explore the feasibility of detecting liver stiffness by real-time shear wave elastography (SWE) and establish a reference range of shear modulus in healthy liver of adults.Methods 335 adults underwent SWE detection to obtain the shear modulus of livers.The effects of different gender and age on the shear modulus in normal adult were analyzed.Thirty subjects were performed by two operators respectively to evaluate interobserver agreement.Results 329 health volunteers were detected successfully.The success rate was 98.2 ％.The mean value of SWE measurements in normal individuals was (5.023 ± 0.966)kPa.The liver shear modulus of healthy adults had a 95％ confidence interval from 4.918-5.128 kPa.There were no significant differences between the mean SWE values in men vs women (P =0.218),also among different age groups (P =0.271).No statistically significant was observed between the mean SWE values obtained by two different operators (P =0.498),interobserver ICC value was 0925.Conclusions SWE is a repeatability and stability method to access liver stiffness on healthy subjects.In our study the mean liver stiffness value obtained by SWE in healthy subjects was 5.023 kPa.The mean liver stiffness value obtained by SWE did not influenced by sex and age.

Objective To obtain the elasticity value of benign and malignant breast solid lesion with real-time shear wave elastography (SWE),in order to assess the value of quantitative elastography with SWE in diagnosis of benign and malignant breast solid lesions.Methods From June 2012 to November 2012,SWE was performed in 125 breast lesions of 103 female patients with pathologically confirmed results,to obtain the elastic modulus (mean,maximum,minimum).Taking pathologic results as reference,ROC curves were used to assess diagnostic performance.Results 87 lesions of 66 patients were pathologically confirmed benign whereas 38 lesions of 37 patients were malignant.The maximum,mean,and minimum elasticity value of benign lesions was 47.2 (7.4-192.0) kPa,22.4 (1.8-90.7) kPa,36.3 (5.3-124.7)kPa; whereas of malignant ones was 192.0(42.7-300.0)kPa,68.1 (0.1-192.0)kPa,138.0(23.9-271.1)kPa.The maximum,minimum and mean elasticity value between benign and malignant lesions had statistically significant difference(P ＜0.01).The area under the ROC curve of the maximum,minimum and mean elasticity value was 0.935,0.853 and 0.917(P ＜0.01).Taking 87.65 kPa as the threshold of the maximum elasticity value,the sensitivity was 91.4％ and the specificity was 88.5％.Taking 37.15 kPa as the threshold of the minimum elasticity value,the sensitivity was 80.0％ and the specificity was 83.9％.Taking 66.85 kPa as the threshold of the mean elasticity value,the sensitivity was 85.7％ and the specificity was 88.5％.Conclusions SWE can assess the stiffness of the breast solid neoplasm by quantitatively measuring the elastic modulus,thus providing diagnostic basis in differential diagnosis of breast lesions.SWE elastic modulus value measurement for breast solid lesions provides a new effective and objective diagnostic method.

Objective To compare the value of two‐dimensional shear wave elastography (2D‐SWE) and real‐time tissue elastography (RTE) in the assessment of liver fibrosis in patients with chronic liver disease. Methods One hundred and ten patients with chronic liver disease scheduled for liver biopsy were studied. Both 2D‐SWE and RTE were performed on these patients in a same day. The correlation coefficient of liver fibrosis level, receiver operating characteristic (ROC) curve of S≥2, and S=4 of 2D‐SWE and RTE were compared according to pathologic results. Results The correlation coefficient of liver fibrosis level for 2D‐SWE ( r =0 7.76, 95% CI 0 6.83 -0 8.45, P =0.000) was higher than that of RTE ( r =0 5.61, 95% CI 0 4.07-0 6.84, P =0.000)( Z =2 9.3, P =0.003). The area under ROC curve for S≥2 and S=4 of 2D‐SWE were 0 8.66 and 0 9.57 respectively, RTE were 0 7.50 and 0 8.43 respectively, which indicated that 2D‐SWE was better than RTE. Conclusions The diagnostic performance of 2D‐SWE was better than RTE for the assessment of liver fibrosis and cirrhosis.

Objective To compare the value of acoustic structure quantification(ASQ) and shear wave elastography(SWE) in the evaluation of diagnostic accuracy of liver fibrosis.Methods One hundred and thirty-five patients with chronic hepatic diseases enrolled in our study were underwent ASQ,SWE and liver biopsy.Correlation between Total Mode,BR ratio,the elastic modulus and pathological stages of liver fibrosis were analyzed by Spearman's rank test.ROC curves were set up by evaluating the degree of hepatic fibrosis through Total Mode,BR ratio,the elastic modulus.Results The significant positive correlation were observed between Total Mode,BR ratio,the elastic modulus and pathological stages of liver fibrosis(r =0.46,P =0.000; r =0.49,P =0.000; r =0.68,P =0.000,respectively).Total Mode,BR ratio,and the elastic modulus,of each pathological stages,had statistically significant differences (F =6.05,P =0.000 ; F =5.17,P =0.000; F =48.82,P =0.000,respectively).The areas under the ROC curve (AUC) set up by evaluating the pathological stages of fibrosis (S≥ 1,S≥2,S≥3 and S =4) through the elastic modulus were larger than that of Total Mode and BR ratio(all P ＜0.05).But the AUC for the diagnosis of fibrosis of Total Mode and BR ratio showed no statistically significant differences(all P ＞0.05).Conclusions SWE was more accurate than ASQ parameters (Total Mode,BR ratio) in grading hepatic fibrosis.ASQ parameters (Total Mode,BR ratio) were observed well-correlated with the pathological staging of hepatic fibrosis.

OBJECTIVETo investigate the diagnostic value of MRI in radial head fracture with forearm interosseous membrane injuries.

METHODSFrom December 2011 to December 2012,26 patients with fractures of capitulum radial in our hospital were collected. There were 15 males and 11 females, ranging in age from 21 to 53 years old,with an average of 37.6 years old. All the patients visited hospital within 72 hours after injuries. X-ray radiography of full ulnar radial length in injured side, CT in injured side (three-dimensional reconstruction if necessary) and MRI (including the elbow and wrist joints) were performed within a week after the injury. The MRI manifestations of the forearm interosseous membrane (with or without damage, the injured location and the injury degree ) and the fractures degree of radial head were observed and compared for the relativity.

RESULTSRadial head fracture from Mason type I to III was associated with the forearm interosseous membrane injury. Radial head fracture degree was positive correlated with forearm interosseous membrane injury degree (P < 0.05).

CONCLUSIONRadial head fracture with suspicious forearm interosseous membrane injury is necessary to take MRI for checking for any interosseous membrane injury and injury degree, then choose the right treatment for radial capitulum fracture, only in this way can be helpful for the functional recovery of elbow and forearm.

Adult ; Female ; Forearm ; pathology ; Humans ; Magnetic Resonance Imaging ; Male ; Membranes ; injuries ; Middle Aged ; Radius Fractures ; diagnosis ; pathology ; Young Adult