OBJECTIVE:To compare the efficacy and safety of levonorgestrel intrauterine system and mifepristone in the treat-ment of perimenopausal dysfunctional uterine bleeding. METHODS:200 patients with perimenopausal dysfunctional uterine bleed-ing were randomly divided into observation group (100 cases) and control group (100 cases). Patients in the observation group placed levonorgestrel intrauterine system (containing levonorgestrel 52 mg),patients in control group received Mifepristone cap-sule 10 mg/d,oral,the treatment course for 2 groups were 3 months. Clinical efficacy,endometrial thickness,menstruation(PBAC score),hemoglobin level before and after treatment and incidence of adverse reaction in 2 groups were observed. RESULTS:After treatment,the total effective rate in observation group was significantly higher than control group,incidence of adverse reactions was significantly lower than control group,the differences were statistically significant(P<0.01). Before treatment,there were no significant differences in the endometrial thickness,PBAC score and hemoglobin level between 2 groups;after treatment,endome-trial thickness and PBAC score were significantly lower than before,and observation group was lower than control group;hemoglo-bin level was significantly higher than before,and observation group was higher than control group,the differences were statistical-ly significant(P<0.01 or P<0.05). CONCLUSIONS:The efficacy and safety of levonorgestrel intrauterine system are significant-ly superior to mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding.

Objective To investigate the influence on the proliferation of the precursor cells from the inner ear of SD rats by different ages and growth factors in vitro .Methods The organs of utricle or saccule or cochlear Corti were isolated from different days’ SD rats born on different days(P1 ,P7 ,P14 ,P21 ,P30 ,P60) .From 12 SD rats of different age ,with 24 ears ,precursor cells were dissociated and cultivated under non -adherent conditions as single cell .We then counted the number of cell spheres under inverted phase contrast microscope .The results were statisti-cally anayzed and the quantity change curve of the same organ in different age rats were described until the single cells were cultured for 7 days .The culture medium was supplemented with defferent growth factor to observe the effects of the grow th factor on the number of cell spheres .Immunofluorescence assays were conducted for phenotype characterization .Results ① Some newly isolated single cells ,labeled by nestin ,were from each inner ear organ of rats(P1) .During 7 days in culture ,cells kept proliferation and formed suspended spheres ,which were expressed Br-dU and nestin positive .② The cell spheres could only formed from each cochlear Corti of rats (P1 ,P7) .But cell spheres that formed from each utricle or saccule were observed in a single saccule culture medium of all rats (P1~P60) .③The number of cell spheres ,which were formed by the isolated cells from inner ear organs of single utricle or saccule or cochlear Corti ,increased obviously in the presence of EGF or bFGF or IGF -1 ,but were not obviously in LIF .Statistically significant differences were seen between control group and every experimental group including EGF group ,bFGF group ,IGF-1 group(P<0 .01) ,but were not seen between control group and LIF group (P>0 .05) .Conclusion The highly proliferative cells were present in the vestibular organ (utricle or saccule) and cochle-ar Corti of SD rats .They could express the characterization of neural stem cell .As increase of the age ,the overall trend of proliferative capability is declining .Each of EGF and bFGF and IGF -1 possess the promoting effects for proliferation on the precursor cells alone ,which is not in present of LIF .

Objective The immature platelet fraction (IPF) could be detected quantificationally in Sysmex XE-2100 with the software of XE-pro and IPF master.The study aimed to perform the methodological evaluation of IPF detection and investigate the clinical significance for the monitoring for bone marrow hyperplasia in cancer chemotherapy patients.Methods The high-level, middle-level and low-level whole blood samples were randomly chosen for detection repeatly 20 times to obtain interrun coefficient of variation (CV) for evaluation of the precision and reproducibility. Integrated quality controls were determined for continuous 20 days to obtain intrarun CV, and the stability and carryover was investigated.Furthermore, the correlation between results from Sysmex XE-2100 and results from flow cytometry was assessed.182 healthy subjects and 130 cancer patients undergoing chemotherapy were selected and the latter were divided into two groups according to platelet counts after therapy, one was normal PLT group, the other was decreased PLT group.The IPF of either group was measured and was compared with each other.Results The precision of IPF for high-level, middle-level and low-level were 4.71%, 4.33% and 4.95%, respectively, they were less than 5%.The interrun CV of IPF detection for middle-level and low-level were less than 5%.The interrun CV of IPF detection for high-level were less than 10%.The carryover ranged from 0.6% to 2.7%,and the average rate was 1.2%.A good correlation for IPF detection was shown between results from Sysmex XE-2100 and flow cytometry(r = 0.880 9,P ＜ 0.01).Regarding clinical utility of IPF detection in treatment monitoring for chemotherapy effect, the median of IPF levels in decreased PLT group, normal PLT group,control group were 14.45% ,7.35% and 15.68%, respectively.There was significant difference among the three groups (H =49.032,P ＜0.01 ).The IPF level was higher in decreased PLT group than normal PLT group (t = -5.681, P ＜ 0.O1 ), and was lower in normal PLT group after chemotherapy than the control group (t = -6.662 ,P ＜0.01 ).Conclusions The determination of IPF by the Sysmex XE-2100 owns high precision and good stability. IPF is an effective marker for evaluation of thrombopoietic condition in the cancer chemotherapy patients.

Objective To compare the effectiveness of nose jejunal tube (NJT) and nasogastric tube (NGT) in providing early enteral nutrition for patients with severe craniocerebral injury. Methods Forty patients with severe craniocerebral injury and required early enteral nutrition were equally and randomly divided into NJT group and NGT group based on the tube type. The biochemical indicators, gastrointestinal tract tolerance, and complications were compared between these two groups. Results Serum albumin, blood glucose, and lymphocyte count were not significantly different between these two groups before and immediately after nutritional support (all P ＞0. 05). However, 14 days after nutritional support, the blood sugar level significantly decreased compared with the baseline levels in the NJT group (P =0. 0001). The incidences of reflux (P = 0. 001) and abdominal distension (P =0.011) were significantly lower in NJT group than in NGT group. Conclusion NJT is superior to NGT in providing early enteral nutrition for patients with severe craniocerebral injury.

Objective To assess and analyze the efficacy and safety of Tegafur Gimeracil Oteracil Potassium capsule plus paclitaxel against advanced gastric cancer. Methods Totally 61 patients with advanced gastric cancer were randomly divided into two groups: the treatment group(32 cases) and the control group(29 cases). Patients in the treatment group were treated with Tegafur Gimeracil Oteracil Potassium capsule (80mg /m2 ) orally, for 14 days continuously, and paclitaxel (175mg/m2 ) on the first day. Patients in the control group were applied with oxaliplatin (130mg/m2 ) on the first day, and the same dose of Tegafur Gimeracil Oteracil Potassium capsule. The two groups both used three weeks as a cycle. Results All 61 patients were included for analysis. No complete response was ob-served. The overall disease control rate was 84. 4%, 79. 3%, respectively. The median progression free survival time was respectively 5. 6 months and 4. 9 months. The median survival time was respectively 13. 1 months and 13. 6 months. There's no significant difference between the two groups. The adverse effects were mostly tolerable, big part of which grade 1/2, mainly included hematological adverse effects, digestive system adverse effect, fatigue and so on. The incidence of neurotoxic effect of control group was higher than treatment group. Conclusion Tri-weekly paclitaxel combined Tegafur Gimeracil Oteracil Potassium Capsule is safe and effective in patients with advanced gastric cancer, which is worthy further study.

Objective To compare the clinical value of CRP and LAC in the evaluating of diagnosis and the prognosis of se‐vere acute abdomen diseases in the elderly patients .Methods Experimental group:The blood of 92 elderly patients diagnosed with critical abdomen mass with infection and followed by surgery were collected .Then ,extracted serum was used to measure the levels of CRP and LAC ,and these patients were divided into 4 groups on base of the degree of infection:SIRS group ,sepsis group ,serve sepsis group and septic shock group .Control group:92 serums of healthy persons were selected to measure the levels of CRP and LAC .Results The CRP and LAC significantly increased in the experimental group ,when compared with the control group(P<0 .05) .The level of LAC raised with the increase severity of sepsis(P<0 .05) among groups of sepsis ,serve sepsis and sepsis with shock ,but the level of CRP had no statistical difference(P>0 .05) .Conclusion Both CRP and LAC of elderly patients diagnosed with critical abdomen mass with infection have important referential meaning .Furthermore ,the CRP has better predictability in the early stage of abdomen mass with infection .However ,to predict the severity of infection level ,LAC seems more sensitive .

The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.

0 05) The histological types in these two groups were not significantly different, except that there were more well differentiated adenocarcinoma in SSO group than that in APR group ( P 0 05). However,the 5 years survival rate (79% in SSO,67% in APR) was significantly different (P

Objective To establish an ICP-MS method for the determination of heavy metals,including copper(Cu),arsenium(As),cadmium(Cd) and plumbum(Pb),in five kinds of Chinese medicinal material.Methods The samples were digested by closed-vessel microwave.The four heavy metals were directly analyzed by ICP-MS,with elements 72Ge,115In,and 209Bi as the internal standards.Results For all of the analyzed heavy metals,the correlative coefficient of the calibration curves was in the range of 0.999 5～ 0.999 7.The recovery rates were in the range of 92.3 % ～ 108.0 %,and RSD were in the range of 2.4 % ～ 5.8 %.Conclusion The method is convenient,rapid,accurate and can be applied to determine four heavy metals,including Cu,As,Cd and Pb,in Chinese medicinal material.

OBJECTIVE:To observe the efficacy and safety of paroxetine combined with buspirone in the treatment of geriatric depression with anxiety. METHODS:78 patients with geriatric depression with anxiety were randomly divided into control group (39 cases) and observation group (39 cases). Control group received 20-40 mg Paroxetine hydrochloride tablet,within half an hour after breakfast. Observation group additionally received 5-10 mg Buspirone hydrochloride tablet for 3 times. The treatment course for both groups was 8 weeks. Clinical efficacy,HAMD,HAMA and TESS before and after 2,4 and 8 weeks of treatment in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). HAMD after 4 and 8 weeks,HAMA after 8 weeks in control group,HAMD and HAMA after 2,4 and 8 weeks in observation group were significantly lower than before,and it gradually decreased by time pro-longed,observation group was lower than control group,the differences were statistically significant (P<0.05 or P<0.01). And there was no significant difference in the TESS rating in 2 groups before and after treatment(P>0.05). CONCLUSIONS:The effi-cacy of buspirone combined with paroxetine is superior to paroxetine alone in the treatment of geriatric depression with anxiety, with better safety.