Objective To investigate the clinical efficacy of Jiawei Guizhi Fuling Decoction combined with mifepristone on uterine fibroids and the changes of serum sex hormone levels in patients after treatment.MethodsForty-two patients were randomly divided into three groups: control group (42 cases) and control group (41 cases).The rats were treated with Guizhi Fuling Decoction plus mifepristone combination for three months.The control group was given only monotherapy with normal mifepristone tablets.The time of treatment was consistent with that of the study group.The levels of serum sex hormones were measured quantitatively before and after treatment.By comparing the therapeutic effect of the patients in different experimental groups and the levels of hormone Differences in evaluation between groups.ResultsThe total effective rate of 92.9% in the study group was significantly better than that in the control group (73.8%).The difference between the two groups was statistically significant (P<0.01).After treatment, the study group and the control group Uterine / tumor volume was significantly reduced, the difference was significantly different (P<0.01), compared between the two groups after treatment of uterine / tumor volume, the study group than the control group, the volume was significantly reduced, the difference was statistically significant (P<0.05).Serum levels of sex hormones: Serum levels of E2 and P were significantly lower in the study group than in the control group (P<0.05).Before and after treatment, the levels of serum E2 and P were lower in the two groups than before treatment (P<0.05).ConclusionJiawei Guizhi Fuling Decoction combined with mifepristone has a better effect on the treatment of uterine fibroids with mifepristone monotherapy, which significantly reduces the level of serum sex hormones and promotes the reduction of uterine / tumor volume after administration.It is worthy of promotion the combination of traditional Chinese and Western medicine conservative treatment of uterine fibroids means.

[Summary] All patients with cholesterol side-chain cleavage enzyme ( P450scc) deficiency that have been reported presented with early adrenal failure. Here we described a 35-year-old male presented with infertility as the only initial presenting complaint. He had received two separate surgeries to remove bilateral testicular masses. We reevaluated the resected tumors and found testicular adrenal rest tumor ( TART) pathology in the resected tumor. We profiled steroid hormones and found significantly elevated ACTH. CT scan revealed bilateral adrenal hyperplasia. Mutation screening identified compound heterozygous mutations (R353W and P432L) in the P450scc encoding gene (CYP11A1). The patient was finally diagnosed as congenital adrenal hyperplasia.

Objective To investigate the observation effect of Fuji intelligent chromoendoscopy (FICE) in central type lung cancer,to select the optimal wavelength combination and to explore its diagnostic value for central type bronchogenic lung carcinoma. Methods One hundred and forty-six cases of definite histopathological diagnosis by bronchoscopy examination with preserved intact data in the Chongqing Municipal Tumor Hospital from January 2016 to October 2016 were included into this study. The white light bronchoscopy(WLB) and FICE were used to conduct the observation respectively. The capillary morphology was respectively scored by using the 10 wave combinations in FICE. The best wave combination was selected for conducting the forceps biopsy. Finally the pathological results served as the gold standard for conducting the comparative study. Results The difference of lesion observation effect among 10 sets of FICE wave combination had statistical significance (P<0.01), the wave combination 8 [R= 540 (2), G= 505 (4), B= 420 (5), wavelegnth(nm gain value)] was superior to that of other wave combinations in observing lesion vascular texture (Rank% = 9.74). The coincidence rate of FICE for judging the lesion property was 88.4 %. The detection rate of FICE combined with WLB for central type lung cancer was 96.6 %, compared with that of single WLB, the detection rate had statistically significant difference (P<0.01). Conclusion FICE wave combination 8 [R= 540 (2) ,G=505 (4),B=420 (5) ,wavelength(nm, gain value)] is most ideal for observing superficial mucosal capillary vascular morphology of central type lung cancer lesion tissue.

Objective:To evaluate the accuracy of measuring the siae of atrial septal defect(ASD) by transthoracic echocardiography(TTE) on " compression of right superior pulmonary vein sheath during operation" (compression-size) using multi-layer perceptron.Methods:From January 2016 to January 2019, 460 cases of ASD with soft margin, thin growth or central type with atrial septal tumor in the First Hospital Affiliated of Air Force Medical University were analyzed retrospectively. The age was (34.32±18.84)years, 129 males and 331 females. Preoperative TTE and intraoperative TTE were performed to measure the size of ASD and compression-size. With the final occluder size selected as the dependent variable, the preoperative and intraoperative ultrasound measurements were used as covariates, and all patients were randomly divided into training set, test set and verification set according to the proportion of 5∶2∶3, which were imported into multi-layer perceptron. Gradient descent method was used to optimize and adjust the weight, and 10 operations were carried out respectively, and the average value was calculated to evaluate the two ultrasound methods for blocking.Results:The mean values of ASD were (15.26±5.33)mm for preoperative, (23.83±6.39)mm for compression-size intraoperative TTE, and (25.14±6.55)mm for the occluder, respectively. The difference was statistically significant (χ 2=850.450, P<0.001). There were significant differences between the pairwise ( P<0.001). Ten times of multi-layer perceptron were used to obtain a training model for predicting the size of the occluder based on preoperative transthoracic ultrasound and TTE measurement after right upper pulmonary vein sheath compression. The average relative error of the model obtained by preoperative ultrasound measurement in the validation set was (16.55±0.02)%, and that of the model obtained by intraoperative ultrasound measurement in the validation set was (4.81±0.01)%. The difference between the two methods was statistically significant ( t=16.185, P<0.001). Conclusions:It is more accurate to measure the ASD size for selection of occluder by the use of the right superior pulmonary vein sheath compression and TTE, especially for ASD patients with soft margin, thin growth or atrial septal tumor.

Objective To evaluate the safety and effectiveness of excessive dynamic airway collapse(EDAC)treated by laser.Methods 13 patients with EDAC confirmed by bronchoscopy from January 2018 to August 2022 were selected and divided into a simple EDAC group(6 cases)and an EDAC combined with tracheobronchomalacia(TBM)group(7 cases)based on whether they were combined with TBM.All patients underwent laser tracheobronchoplasty under bronchoscope.Symptoms,airway collapse,oxygenation index,modified version of British Medical Research Council dyspnoea scale(mMRC)and 6 min walking test before and after treatment were compared to evaluate the therapeutic effect.Results 13 patients underwent 17 times of laser tracheobronchoplasty with laser power of 8～15 W,and 4 patients underwent 2 times of laser tracheobronchoplasty.After treatment,the clinical symptoms of cough,sputum,shortness of breath and dyspnea were improved in all patients.1 week post-treatment,the EDAC group showed a significant improvement in airway lumen stenosis,with a significant statistical difference(P<0.05),1 month post-treatment,enhancements were observed in airway stenosis,oxygenation index,FEV1%,6-minute walk test,and mMRC,which remained stable over a 6 month follow-up.In the EDAC + TBM group,significant enhancements in airway stenosis,oxygenation index,and mMRC were noted 1 week post-treatment,with statistical significance(P<0.05).Between 8 d～6 months post-treatment,some patients exhibited a recurrence of airway stenosis,necessitating comprehensive interventions like balloon dilation,cryotherapy,and stent insertion.Local necrosis and granuloma occurred in some patients after laser therapy,and no serious complications associated with laser intervention were found in all patients.Conclusion Laser tracheobronchoplasty is a safe and effective technique for the treatment of EDAC.For patients with EDAC alone,the therapeutic effect is good,but for patients with EDAC combined with TBM,the long-term effect is not good.

Congenital generalized lipodystrophy type 1 (CGL1) is an autosomal recessive genetic disease caused by mutations in AGPAT2 gene. The main clinical mainifestations include body subcutaneous fat loss, muscle hypertrophy, obvious subcutaneous veins, pseudoacromegaly, hirsutism, and acanthosis nigricans. What′s more, CGL1 is always accompanied by metabolic diseases. Therefore, it is easily misdiagnosed as metabolic syndrome, type 2 diabetes, polycystic ovary syndrome, acromegaly, or Cushing′s syndrome. Meanwhile, it is difficult to distinguish it from partial lipoatrophy syndrome. In this article, we present clinical and molecular characteristics of a patient with CGL1 and review mutations reported in literature to replenish current knowledge about this orphan disease.