AIM: To investigate the change of estrogen receptor (ER) in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress, and to illuminate the mechanism of dysfunction on ovarian reproductive endocrine function. METHODS: Sound, light and electricity were combined into a psychological stressful stimulus to induce female rat dysfunction on ovarian reproductive endocrine function. Immunohistochemical technique and image analysis were used to assess the expression levels of ER in hippocampus, hypothalamus and pituitary. RESULTS: When exposed to compound stressful stimulus of sound, light and electricity for 20 days in female rats, the expression levels of ER in hippocampus, hypothalamus and pituitary dropped. CONCLUSION: The decrease in estrogen receptor expression in hippocampus, hypothalamus and pituitary of female rats exposed to psychological stress may be one of the mechanisms of ovarian reproductive endocrine dysfunction.

Objective To observe the efficacy of pulsed dual-wavelength 595 and 1064 nm laser in treating ulcerated infantile hemangioma.Methods Lesions from 40 patients were treated with the laser.The distribution of lesion sites was in buttuck and perianal area (13 patients),vulvar lips (7),groin and inside thigh (5),scrotum (4),neck (3),scalp (2),lip (2),trunk and limbs (4).All lesions including ulcer and non-ulcer were conducted with 595 nm plused dye leaser at the first therapy.Later,595 nm pulsed dye leaser was continued or performed with Group 1 or Group 2 parameter of 595 and 1064 nm multiplex mode until the treatment was finished according to the thickness of the lesion.The frequency of treatment was one to six times.The interval of the treatment was four weeks.Results The ulcer from 39 lesions healed gradually in 1 to 2 weeks (average 9.5 days) after the first treatment.These ulcer lesions were healed four weeks after the first time of therapy.The recovery rate of ulcerated lesion was 97.5 ％.For the whole lesion,after 1 to 6 treatments,13 lesions showed excellent result,19 lesions showed good result,and the effective rate was 80 ％.Pain relieved 2 to 7days (average 3.5 days) after the first laser therapy in 35 patients who accompanied with pain.Pain score decreased from 1.875 to 0.125 before and after treatment,with significant difference(P＜0.05).The tolerance of the treatment was good and no side effect was observed.Conclusions 595and 1064 nm dual-wavelength laser is a safe and effective tool for treating ulcerated infantile hemangioma.

Objective:To describe our diagnostic and therapeutic experience of patients with urinary tract endometriosis.Methods:We performed a retrospective analysis of 22 cases of urinary tract endometriosis with histopathological results from 2001 to 2007.Results:The mean patient age was 36.0 years.Of the 22 patients,4 had bladder involvement and 18 ureteral involvement.In those with bladder endometriosis,the diagnosis was made by cystoscopy and biopsy in 4 patients.The treatments consisted of partial cystectomy in 3 patients and transurethral resection of the bladder in 1 patient.One of the patients who underwent transurethral resection of the bladder experienced 1 relapse.The relapse was treated with partial cystectomy.In the patients with ureteral endometriosis,the diagnosis was mainly established by ultrasound(18 cases),intravenous urography(11 cases),retrograde pyelography(7 cases),CT(14 cases) and MRI(5 cases).The treatments consisted of ureterolysis in 1 patient,ureteroneocystostomy in 4,and ureteral resection and end-to-end anastomosis in 13 of them.All the patients pathologic results were of endome-triosis.Conclusion:Urinary tract endometriosis is an uncommon disease.Partial cystectomy should be considered as the therapeutic option for bladder endometriosis.For cases of ureteral endome-triosis,the first technique depends on the location,extent and depth of the lesion.

Objective To observe the effects of Niupo Zhibao pellet, a compound traditional Chinese herbal medicine,on helper T cell(Th cell)expression in rats with endotoxin-induced rapid pulmonary fibrosis (RPF). Methods Two hundred and twenty-four Wistar rats were randomly divided into four groups:normal control,model,dexamethasone(DXM)and Niupo Zhibao pellet(NW)groups(each n=56). By using endotoxin three-hit regimen,the RPF model was established. Three days before and 7 days after the establishment of models in NW group,they were administered with the pellet by intragastric feeding,50 mg/100 g of distilled water twice a day,a total of 10 days medication. Rats in DXM group received DXM intraperitoneal injection,3.0 mg/kg once a day for consecutive 7 days. Rats in normal control group were administered with the same volume of distilled water by intragastric administration. On 1,3,7,9,14,21,28 days after the administration,blood and bronchoalveolar lavage fluid(BALF)specimens were collected. The contents of γ-interferon(IFN-γ)and interleukin-4(IL-4) in the serum and BALF were investigated by enzyme-linked immunosorbent assays(ELISA). The lung tissue was stained by hematoxylin-eosin(HE)and Van Gieson respectively. Morphological changes in lung tissue were observed under light microscope. Results HE staining showed that the pulmonary interstitial tissues of rats in model group were thickened,there was a large amount of inflammatory exudates,and micro thrombi were seem in alveolar space. The pulmonary interstitial tissues in rats of DXM group were thickened too,but the inflammatory exudate in alveolar space was much less. Compared to rats in DXM group,the rats in NW group had slightly more inflammatory exudate and their pulmonary interstitial tissues were basically normal. Van Gieson staining showed that the expression of collagen fiber in model group was obvious,that of DXM group less than the former one but not significant,while that in the NW group was reduced markedly. ELISA assays demonstrated that the levels of IFN-γin BALF and serum in model group were increased significantly,those in DXM group were lowered to the minimum on the 7th day,raised to the levels before treatment on the 14th day,and gradually declined on the 21st day. In the NW group,the IFN-γwas consistently at a high level,and then gradually declined at a slow rate. After 7 days of drug administration,the IFN-γ levels in BALF and serum at various time points in NW group were obviously higher than those in model and DXM groups〔BALF(ng/L):140.47±4.22 vs. 149.23±8.35,90.67±6.65;serum(ng/L):140.47±4.15 vs. 100.43±11.05,99.35±7.85,P<0.05 or P<0.01〕. The levels of IL-4 in BALF and serum in each group increased significantly,reached to their maximum on the 7th day,and then gradually decreased. After the drug administration for 28 days,those levels in NW group were obviously lower than those in model and DXM group〔BALF(ng/L):6.60±1.05 vs. 7.20±1.25,8.55±1.05,serum(ng/L):6.75±1.05 vs. 7.21±1.25,8.25±1.15,P<0.05 or P<0.01〕. Conclusion Niupo Zhibao pellet can suppress inflammation,ameliorate injury of lungs and inhibit lung fibrosis by promoting IFN-γsecretion,restraining IL-4 secretion and adjusting the imbalance of Th cells.

Objective To determine the clinical value of pulsed dual-wavelength 595 and 1064 nm laser in treating superficial infantile hemangioma. Methods The treatments were conducted in 260 patients with 270 lesions. The location of the lesions were 41 cases in scalp, 88 in face and neck, 79 in trunk and 62 in arms and legs. All lesions were treated several times with 595 nm (Group 1) and/or 1064 nm (Group 4) multiplex mode until the treatment was finished. The frequency of treatment was one to six times. The interval of the treatment was four weeks. Results The total effective rate was 95.56 %, with atrophic scar (8.15 %) but without severe ulcer. No significance was found as compared Group 1 parameter with Group 4 in formation of atrophic scars (x2 = 1. 870, P＞0.05). Significant difference in the incidence of atrophic scars was found among different location of lesions (x2 = 15. 743, P＜0. 01) : lesion in face had the highest probability. No obvious difference was found between different location of lesion and the frequence of treatment (x2 = 21.164, P＞0.05), and so did with the efficacy (x2 = 11. 597, P＞0.05). The size and the thickness of lesion had significant difference in the time of treatment (x2 = 58. 171, P＜0. 01 and x2 = 11. 583, P＜0.05, respectively).Conclusions 595nm/1064 nm dual-wavelength laser is a safe and effective tool for treating superficial infantile hemangioma. Choice of treatment parameter in the mode depends on the features of vascular lesions.

OBJECTIVETo study the diagnosis and surgical treatment of penis lymphangioma.

METHODSClinical data of 13 cases of penis lymphangioma were analysed restrospectively.

RESULTSThe 13 cases, treated by radical lymphangiomaectomy, were followed up for 2 to 3 years, and none of them had recurrence. This therapy affected neither the penile appearance, nor the erectile function of the patients. So their sexual life remained intact.

CONCLUSIONRadical ectomy should be the first choice of treatment for penis lymphangioma.

Adolescent ; Adult ; Child ; Humans ; Lymphangioma ; surgery ; Male ; Penile Neoplasms ; surgery ; Retrospective Studies

Objective To investigate radiation-induced carotid and cerebral vascular injury and its relationship with radiation-induced temporal lobe necrosis in nasopharyngeal carcinoma (NPC) patients.Methods Fifty-eight NPC patients with radiation-induced temporal lobe necrosis (TLN) were recruited in the study.Duplex ultrasonography was used to scan bilateral carotid arterials to evaluate the intima-media thickness (IMT) and occurrence of plaque formation.Flow velocities of bilateral middle cerebral arteries (MCAs),internal carotid arteries (ICAs) and basal artery (BA) were estimated through Transcranial Color Doppler (TCD).The result were compared with data from 33 patients who were free from radiation-induced temporal lobe necrosis after radiotherapy and 29 healthy individuals,to study the relationship between IMT,occurrence of plaque and ventricular diastolic dysfunction.Results Significant differences in IMT,occurrence of plaques of ICAs and flow velocities of both MCAs and ICAs were found between patients after and healthy individuals (t =18.624,8.221,P ＜0.05;x2 =17.886,P ＜0.05;t =14.367,10.112,P ＜0.05).IMT had positive correlation with post radiation interval (r =0.368,P =0.049).IMT or incidence of plaques may be related to dose of radiotherapy,course of treatment and T stage (x2 =-17.635,12.006,-3.125,P ＜ 0.05).Compared with result from patients without radiation-induced TLN,the mean IMT was significantly thicker in patients with TLN (t =10.208,P ＜ 0.05).Plaques were more common in patients with TLN than patients without TLN (x2 =13.118,P ＜0.05).In addition,flow velocities of MCAs and ICAs in patients with TLN were much faster (t =5.011,5.035,P ＜ 0.05).Among patients with unilateral TLN,flow velocity of MCAs was significantly different between ipsilateral and contralateral sides to the lesion (t =18.362,P ＜ 0.05).Conclusions Thickening of IMT,occurrence of plaque formation and hemodynamic abnormality are more common in patients after radiotherapy,especially in those with TLN,compared with healthy individuals.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combination use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively analyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some previous studies were not reliable.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.

Objective: To explore the relationship between HCM pathogenic gene mutations and clinical phenotypes by analyzing the prenatal diagnosis and genetic characteristics of a pregnant woman from a family with hypertrophic cardiomyopathy (HCM). Methods: The clinical data of the proband and her family members was collected. The DNA was extracted from the peripheral blood, amniotic fluid cells and cultured amniotic fluid cells of proband. Next generation sequencing (NGS) was utilized for screening pathogenetic loci of the proband. The suspected mutation sequences of HCM pathogenic candidate genes MYH7 and MYBPC3 were directly sequenced after PCR. Pathogenicity prediction of amniotic fluid cells was performed by using genetic data and bioinformatics software, such as Mutation taster, PolyPhen-2 and ANTHEPROT. Results: The sequencing results showed that heterozygous mutations of MYH7 c.1988G＞A (p.Arg663His) and MYBPC3 c.151G＞A (p.Ala51Thr) were found in the proband. The phenotype of her father was normal, and no abnormal mutations were detectable. Her mother also showed normal phenotype but carried MYBPC3 c.151G＞A heterozygous mutation. Only MYH7 c.1988G＞A heterozygous mutation was found in the fetus and no abnormal variation of MYBPC3 was showed. The prediction of mutation effect and analysis of protein structure and function revealed that the two missense mutations could affect the hydrophobicity and antigenicity of the protein. The genetic data demonstrated MYH7 c.1988G＞A was defined as a pathogenic mutation. Conclusion MYH7 c.1988G＞A should be a newly generated pathogenic mutation in the proband, or caused by reproductive chimerism of her parents. MYBPC3 c.151G＞A mutation may promote the occurrence of HCM. Although the fetus only carries MYH7 c.1988G＞A, her phenotype may still display as HCM.