Objective To evaluate the clinical effect and safety of transvaginal lesion resection for cesarean scar pregnancy (CSP).Methods A total of 30 patients with CSP in our hospital received the transvaginal CSP lesion resection from January 2013 to January 2016 and were followed-up to observe the clinical efficacy and safety.Results The operations were successfully completed except one case of conversion to open surgery.The operation time was 30-120 min (53.4±26.0 min), the intraoperative hemorrhage was less than 50 ml, the hospital time was 3-7 d (4.3±1.3 d), and the postoperative time of serum β-hCG decreased to normal value was 14-36 d (24.1±13.2 d).No continuous pregnancy or complications such as incision non-healing, infection, or bladder injury after operation.Conclusion The clinical effect of vaginal CSP lesion resection is good and has fewer complications, being worthy of application.

Objective To discuss the effect of comprehensive intervention on the quality of life of esophageal cancer patients receiving radiotherapy.Methods 100 patients with esophageal carcinoma treated with radiotherapy for the first timewere selected between October 2012 and December 2014 in Nantong Tumor Hospital in Jiangsu Province and randomly divided into control group and observation group (n =50 in each group) with a random number table.In the control group,routine dietary instruction,fluid infusion support and symptomatic intervention were used;comprehensive intervention was added in the observation group.Scores of core quality of life questionnaire (QLQ-C30) and nutritional indexesbefore and after radiotherapy in the two groups were compared.Results There were no statistically significant differences in QLQ-C30 scores and nutritional indexes between the two groups before radiotherapy (all P＞0.05).After radiotherapy,the physical [(75.6 ±13.1) vs.(63.8 ± 12.4)] and emotional function [(61.9 ± 14.3) vs.(52.5 ± 13.7)],fatigue [(36.6 ± 13.2) vs.(45.8±15.0)],pain [(34.8±16.1) vs.(44.3±17.0)],insomnia [(49.2±15.7) vs.(57.2±14.3)],loss of appetite [(50.2 ± 16.2) vs.(59.0 ± 15.8)],nausea and vomiting [(21.5 ± 10.3) vs.(29.9 ±11.3)],general health status [(68.8 ± 13.4) vs.(58.2 ± 12.8)] inthe observation group were significantly better than in the control group (all P ＜0.05).Innutritional status,body weight [(59.3 ± 8.5) kg vs.(54.4 ± 7.3) kg],body mass index [(21.9 ±2.1) kg/m2 vs.(18.4 ±2.8) kg/m2],hemoglobin [(125.9 ± 8.9) g/Lvs.(107.3±9.5) g/L],albumin [(35.1±6.9) g/Lvs.(29.0±5.3) g/L],and prealbumin [(213.54 ±37.47) mg/L vs.(174.56 ±36.26) mg/L] in the observation group were all higher than thosein the control group after radiotherapy (all P ＜ 0.01).Conclusion Comprehensive intervention for esophageal cancer patients receiving radiotherapymay improve nutritional status,reduce esophagitis,thirsty,fatigue,loss of appetite and other symptoms,improve the quality of life,ensure the completion of radiotherapy.

Objective To investigate the diagnostic value of procalcitonin(PCT) ,high‐sensitivity C‐reactive protein(hs‐CRP) andwhitebloodcelltestsinpatientswithbrucellosis.Methods 37blood‐culturepositivepatientsweredividedinto4groupsac‐cording to the species of bacteria infected .In addition to that ,PCT ,hs‐CRP and white blood cell were tested and the tests results were compared .Results The PCT and hs‐CRP concentrations of the 4 groups all increased and while the increasing extent of bru‐cella group were lower than the other 3 groups ,the differences were statistically significant(P<0 .05) .The counting of white blood cell(WBC) ,neutrophil(NEUT) and lymphocyte(LYMPH) were all in normal range while the monocyte(MONO) raised to 80 .0%in brucella group .WBC and NEUT apparently were higher in the other 3 groups than in brucella group ,while LYMPH and MONO were lower than brucella group ,the differences were statistically significant(P<0 .05) .Conclusion The determinations of PCT ,hs‐CRP and white blood cell may act as the indicators for early stage of brucellosis .

Objective To investigate the change of high‐sensitivity C‐reactive protein(hs‐CRP) and white blood cell(WBC) in patients with positive sputum culture results .Methods hs‐CRP and WBC were determined in 116 patients with positive sputum culture results ,which were divided into 5 groups according to strains ,and control group of patients with negative sputum culture re‐sults .Levels and abnormal rates of various parameters were compared between each group .Results hs‐CRP levels significantly in‐creased in the 5 sputum culture positive groups ,compared with control group(P<0 .05) ,and that of Candida albicans group was the most high .WBC and neutrophile granulocyte(NEU) levels of 4 positive groups were obviously raised(P<0 .05) besides Haemophi‐lus influenzae group ,and the elevation tendency was the most obvious in Streptococcus pneumoniae group .The 5 positive groups were all with high detectable rates of hs‐CRP elevation .The detectable rate of WBC elevation in Streptococcus pneumoniae group was 64 .7% ,higher than Haemophilus influenzae group(P<0 .05) .Conclusion The majority of patients with positive sputum cul‐ture results could be with inflammatory response because of bacterial infection or colonization .

Objective To evaluate the diagnostic value of two tuberculosis-specific IFN-γ release assays in latent tuberculosis infection among HIV-infected individuals. Methods The levels of tuberculosis antigen-specific IFN-γin 102 HIV patients from AIDS Outpatient Clinic of Shenzhen Third People's Hospital were detected by in-house tuberculosis-specific IFN-γ ELISpot assay and commercial T-SPOT TB kit, and tuberculin skin test (TST) were done at the same time. There were 66 males and 36 females,and the average age was 35. Results Seventeen HIV infected patients were positive in both IFN-γ ELISpot and T-SPOT TB methods, the sensitivity, specificity positive predictive value(PPV), negative predictive value(NPV) and compliance rates of ELISpot were 94. 4% ,94. 0% ,77. 3% ,98. 8% and 94. 1% ,respectively. Three patients were positive in both IFN-γELISpot and T-SPOT TB methods, the sensitivity, specificity, PPV, NPV and compliance rates of TST were 16. 7%, 98. 8%, 75.0%, 84. 7% and 84. 3%, respectively. The average number of spots using three kinds of antigen ESAT-6, Pool A,Pool B obtained were 26. 89 ±5. 77,18. 96 ±4. 75 and 14. 51 ± 3.77, respectively. Only ESAT-6 and Pool B have a statistically significant difference (H=7.557,P = 0.022 9), no significant difference was shown between other groups. There was no significant difference between the positive rate and the CD4+ T cellls number(x2 =0. 860 8 ,P =0. 650 2) ,as the same as the T-SPOT TB (x2 = 1. 396 4, P = 0. 497 5 ). Conclusions The performance of this in-house tuberculosis-specific IFN-γ ELISPot assay was comparable to T-SPOT assay in diagnosis of latent tuberculosis infection, and the sensitivity and specificity of both these two assays were all much higher than TST. They canbe recommended in diagnosing latent tuberculosis infection in HIV infected patients.

Aim To investigate the proliferative effect and the apoptosis of rat epididymal epithelial cells induced by podophyllotoxin and its underlying mechanisms.Methods Primary epididymal epithelial cells were cultured in vitro.CCK-8 assay was used to analyze proliferation of epididymal epithelial cells induced by podophyllotoxin on 24, 48 and 72 h.The ultra structural changes of the epididymal epithelial cells were observed by transmission electron microscope.AnnexinV-FITC/PI staining was used to quantify the percentages of apoptosis in the total cell population.The TdTmediated dUTP nick end labeling(TUNEL) technique was applied to observe the morphological changes of apoptotic cells.The expression of tumor necrosis factor alpha(TNF-α) mRNA was investigated by real-time RT-PCR.The level of TNF-α in cell culture supernatant was measured by enzyme-linked immunosorbent assay(ELISA) technology.Western blot was per-formed to determine the protein expression of cytochrome C, caspase-3, caspase-8, caspase-9.Results Podophyllotoxin significantly inhibited the activity of proliferation and induced apoptosis of epididymal epithelial cells in a dose-and time-dependent manner(P<0.05), with a 50％ inhibitory concentration(IC50) value and corresponding 95％ confidence intervals(CI) of 59.36(15.50～227.41), 0.37(0.080～1.70), 0.077(0.017～0.35) μmol·L-1 at 24, 48 and 72 h, respectively.Podophyllotoxin induced cell volume turned round and cell nuclear fragmentation and mitochondrial vacuolation.RT-PCR and ELISA results showed that podophyllotoxin improved the expression of TNF-α mRNA and protein.Western blot results demonstrated that podophyllotoxin activated the protein expression of cytochrome C, caspase-3, caspase-8 and caspase-9.Conclusion Podophyllotoxin can induce rat epididymal epithelial cell apoptosis through both the mitochondria-regulated intrinsic pathway and the TNF receptor-mediated extrinsic pathway.

Objective To investigate the cellular immunologic response of TH 17/Treg cells in the peripheral blood of pelvic tuberculosis patients and explore their roles in the pathogenesis of pelvic tuberculosis.Methods The intracellular flow cytometry was performed to evaluate the expressions of TH 17 and Treg cells in 46 pelvic tuberculosis patients and 25 healthy controls in childbearing age.Twenty-eight of the 46 pelvic tuberculosis patients were followed up to monitor the variation of the TH17/Treg cells after 3 months and 6 months of anti-tuberculosis treatment.Results The percentage of TH 17 cells in the peripheral blood of pelvic tuberculosis patients was (3.26 ± 1.30) ％ which was significantly lower than that of healthy controls [(4.92 ± 1.71) ％,P ＜ 0.01].The percentage of Treg cells in the patients was (5.18 ± 1.53) ％ which was significantly higher than that of healthy controls [(3.26 ± 1.10) ％,P ＜ 0.01].The percentage of TH17 cells in the pelvic tuberculosis patients after 6 months of treatment was (4.67 ± 1.75) ％ which was significantly higher than that in the patients before treatment and after 3 months treatment [(3.26 ± 1.30) ％,P ＜ 0.01 and (3.70 ± 1.06) ％,P ＜0.01,respectively].The percentage of Treg cells in pelvic tuberculosis patient after 6 months of treatment was (3.93 ±0.94)％ which was significantly lower than that in the patients before treatment and after 3 months of treatment [(5.18 ± 1.53)％,P ＜0.01 and (4.94 ± 1.51) ％,P ＜ 0.01,respectively].The percentage of Treg cells in the patients after 6 months of treatment was still significantly higher than that of controls (P ＜ 0.05).The TH 17/Treg ratio before treatment was significantly lower than that of healthy controls (P ＜ 0.01),and the TH 17/Treg ratio was increased after 3 months of treatment but it did not show significant difference compared with that before treatment.The TH 17/Treg ratio after 6 months of treatment (1.18 ± 0.34) ％ was significantly increased in contrast to those after 3 months of treatment and before treatment [(0.77 ± 0.21) ％,P ＜ 0.01 and (0.55 ± 0.13) ％,P ＜ 0.01,respectively].The TH 17/Treg ratio could not rise to the normal level even after 6 months of treatment.Conclusion Both the TH 17 and Treg cells may involve in the immunologic responses of pelvic tuberculosis patients and the imbalance of TH1T/Treg cells may remain persistently.

A reversed phase high performance liquid chromatography （HPLC） method was established for the simultaneous determination of 12, 13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture. A Grace Apollo Cl8 column （250 mm × 4.6 mm, 5 μm） was used as the stationary phase and the mobile phase was composed of acetonitrile and aqueous phosphoric acid （0.2%, v/v）. Gradient elution was carried out at the flow rate of 1.0 mL/min and the column temperature was 30 ℃. An ultraviolet （UV） detector was used with a selected wavelength of 240 nm. Calibration curves were linear within the concentration range of 4.6-45.75 μg/mL for 12, 13-dihydroxyeuparin （r〉0.9999） and 106.9-1068.9μg/mL for glycyrrhizic acid （r〉0.9999）, respectively. Recoveries were 102.18% for 12, 13-dihydroxyeuparin and 101.17% for glycyrrhizic acid. The method developed could be applied to the simultaneous determination of 12, 13- dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture.

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A reversed phase high performance liquid chromatography (HPLC) method was established for the simultaneous determination of 12,13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture.A Grace Apollo C18 column (250 mm× 4.6 mm,5 μm) was used as the stationary phase and the mobile phase was composed of acetonitrile and aqueous phosphoric acid (0.2％,v/v).Gradient elution was carried out at the flow rate of 1.0 mL/min and the column temperature was 30 ℃.An ultraviolet (UV) detector was used with a selected wavelength of 240 nm.Calibration curves were linear within the concentration range of 4.6-45.75 μg/mL for 12,13-dihydroxyeuparin (r＞0.9999) and 106.9-1068.9μg/mL for glycyrrhizic acid (r＞0.9999),respectively.Recoveries were 102.18 ％ for 12,13-dihydroxyeuparin and 101.17％ for glycyrrhizic acid.The method developed could be applied to the simultaneous determination of 12,13-dihydroxyeuparin and glycyrrhizic acid in Yanyanfang mixture.