OBJECTIVE:To compare clinical efficacy and safety of intravenous dripping of methotrexate and uterine arterial perfusion embolization combined with complete curettage of uterine cavity (CCUC) in the treatment of cesarean scar pregnancy (CSP).METHODS:A total of 90 CSP patients were randomly divided into group A and B,with 45 cases in each group.Group A was given Methotrexate (MTX) injection 50 mg/m2 intravenously before CCUC.Group B received Seldinger catheterization in supine position before CCUC,and was given sequential infusion of MTX injection 50 mg/m2 and gelatin sponge particles into the uterine artery;the catheter was removed after satisfactory embolization by imaging examination.The levels of β-HCG of 2 groups were reexamined every 24 h,and CCUC was performed when serum β-HCG level was below 1 000 mU/mL.Perioperative bleeding volume,postoperative bleeding volume,the time of blood β-HCG returning to normal,the time of menstruation returning to normal,hospitalization time as well as the lesion diameters,the levels of blood β-HCG,the occurrence of compliance and ADR before and after treatment were compared between 2 groups.RESULTS:The intraoperative bleeding amount and postoperative bleeding amount of group B were significantly lower than those of group A,while the time of blood β-HCG returning to normal,the time of menstruation returning to normal and hospitalization time were significantly shorter than group A,and the incidence of total compliance was significantly lower than group A,with statistical significance (P＜0.05).Before medication,there was no statistical significance in lesion diameters between 2 groups (P＞0.05).Before CCUA,the lesion diameters of 2 groups were significantly smaller than before medication,and the group B was significantly smaller than group A,with statistical significance (P＜0.05).Before medication,there was no statistical significance in blood β-HCG levels between 2 groups (P＞0.05).Before and after CCUC,blood ββHCG levels of 2 groups were significantly lower than before medication,and the group B was significantly lower than group A,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Compared with methotrexate by intravenous drip,methotrexat by uterine artery embolization combined with CCUC for CSP can effectively reduce intraoperative bleeding amount,promote the decrease of blood β-HCG and menstrual recovery,and contribute to the reduction of complication risk with good safety.

Objective To explore the clinical effect of treatment for progressive multiple sclerosis(PMS)by autologous peripheral blood stem cell transplantation(APBSCT).Methods Between September 2001 and July 2004,thirteen patients with PMS were treated with APBSCT in Xuanwu Hospital.Peripheral blood stem cells (PBSCs)were mobilized with G-CSF alone.The stem cell transplants were pured of lymphocytes in 7 patients.The high dose regimen was BEAM conditioning regimen (Carmustine,Etoposide,Cytosine Arabinoside,and Melphalan).The median follow-up time was 22 (3～36)months.Results The result showed that the mean EDSS rating score of patients in 18 months after APBSCT was significantly decreased[(4.05?0.66) vs(6.00?0.30),P

Objective To study the intervention effect and mechanism of integripetal rhodiola herb (IRH) on Alzheimer’s disease model rats. Methods Alzheimer’s disease model was made by injecting D-galactose (10 mg/mL) in abdominal cavity and taking AlCl3 (20 mg/mL) by intragastric administration, and injecting scopolamine. Morris water maze testing system was undertaken to observe the change of learning and memory ability in rats, biochemical indicator tested was to contrast the state of oxidative stress, common HE staining and immunohistchemistry staining were to observe the morphology change of the hippcampus and cortex cell. The model rats were administrated IRH by means of intragastric administration contrasting with hydergine to compare the effect. Results The memory ability of model group was obviously decreased, cellula nervosa were damaged badly. A? and senile plaques appeared on hippcampus and cortex. All of the test indexes in Morris water maze showed that the abilities of space search, learning and memory in different groups remarkably improved compared with that of the model group (P

Background Nowadays,glaucoma is the major cause of irreversible blindness worldwide and the second cause of global visual loss.To accurately obtain the anterior chamber depth (ACD)is of helpful for screening primary angle-closure glaucoma (PACG).ObjectiveThe aim of this study is to explore the difference and agreement in the measurement of ACD between Scheimplug Imaging System (Pentacam)and ultra-sonographic biomicroscope (UBM).MethodsSeventy-seven eyes of 77 PACG patients aged (69.96±7.87)were divided into two groups.Thirty-seven eyes with acute primary angle-closure glaucoma (APACG)were assigned to group 1,and forty eyes with chronic primary angle-closure glaucoma (CPACG)were assigned to group 2.Central ACD was measured with Pentacam and UBM,respectively.The Bland-Altman method was used to evaluate the agreement of the two methods.ResultsThe ACD values measured by Pentacam and UBM were (1.6467±0.2687)mm and (1.5601±0.2677)mm respectively in APACG,indicating a significant difference (t=-7.259,P<0.01)and a positive linear correlation between the results of these two methods (r=0.939,P<0.01).The ACD values measured by Pentacam and UBM were (2.0622±0.2317)mm and (1.9648±0.2176)mm respectively in CPACG eyes with a significant difference between them(t=-10.433,P<0.01)and a significant linear correlation between these two outcomes (r=0.967,P<0.01).The Bland-Altman method showed that the two modalities had comparable results for ACD.ConclusionPentacam,as a new 3-dimensional mathematical model of the anterior segment,presents some different results from UBM in the measurement of ACD,but it is not clinically significant.Combination of Pentacam and UBM may be available for the clinical measurement of ACD.

Individual Chinese herbal medicines and the active ingredients have certain effects of anti-pulmonary fibrosis. Chinese herbal medicine with the effects of benefiting qi and activating blood circulation are commonly used in clinic. This article reviewed the experimental researches on Chinese herbal medicines with the effects of benefiting qi and activating blood circulation and the active ingredients in treating pulmonary fibrosis, with a purpose to find the target spot of the TCM treatment for pulmonary fibrosis and provide references for clinical treatment.

OBJECTIVETo develop a best chitosan film for using as a drug sustained-release system through the evaluation of the sustained-release property, degradation property, and cytotoxicity to osteoblast.

METHODSOrthogonal experiments were designed to determine the best combination of chitosan film preparations. Drug release rate was determined with Coomassie brilliant blue G250. In a separate study, chitosan films were placed into the test tubes with buffer solution and 10(7) U/L lysozyme. The degradation rate was calculated. Osteoblasts derived from fetal rat calvarial were cultured on chitosan films. Cell proliferation was tested by methyl thiazolyl tetrazolium (MTT) assay. The relative growth rate was calculated and the cytotoxicity was graded.

RESULTSThe best processing condition was 1% acetic acid, chitosan concentration of 2 mg/mL, 6% sodium tripolyphosphate (STPP) concentration, and cross-linking time of one hour. The resulting chitosan film released 33.13% of bovine serum albumin (BSA) within 8 d, 36.73% of BSA within four weeks and the cytotoxicity grade was 0 or 1.

CONCLUSIONThis chitosan film possesses good sustained release property, and a good degradation rate.

Objective To study local people's habits and customs concerning the prevention of dental fluorosis in an indoor coal-combustion-type fluorosis area of Zhaotong city Yunnan province, and to provide reference value for monitoring and control of the disease. Methods In 2008, 600 people of a 12-year-old group (400 people) and a 35 - 44-year-old group(200 people) were examined for dental fluorosis and oral health status in an indoor coal-combustion-type fluorosis area of Zhaotong. A questionnaire survey of 120 students and 60 adults was carried out on their habits and customs, stove changing status, knowledge of prevention of dental fluorosis, social psychology status, oral health behavior and their need for medical treatment. Results The total prevalence of dental fluorosis was 91.0% (546/600), dental fluorosis index was 2.58. The total prevalence of dental fluorosis of 12-year-old group was 86.5%(346/400), and dental fluorosis index was 2.12. The total prevalence of dental fluorosis of rural student was 90.5% (181/200), which was obviously higher in the rural group than the urban group [82.5% (165/200), χ2 = 5.48, P < 0.05]. The total prevalence of dental fluorosis of 35-44-year-old group was 100% (200/200), which was obviously higher than that of the 12-year-old group(χ2 = 29.67, P < 0.01). The rates of using coal, baking of food, changing stoves were 66.7% (60/90), 14.4% (13/90),57.8% (52/90), respectively, and these values of the urban were much lower than those of the rural[95.6%(86/90) ,31.1%(28/90) ,76.7%(69/90),χ2 = 24.51,7.11,7.29, all P < 0.01]. Only 23.3% (42/180) of people surveied had the knowledge of prevention of dental fluorosis, and the rate in the adult group[56.7% (34/60)]was higher than that of the student group [6.7% (8/120), χ2 = 55.9, P < 0.01]. The same rate in the urban student group was 0(0/60), and the rural student group was 13.3%(8/60), there was a significant difference between them(χ2 = 5.66, P < 0.05). Seventy-three point nine per cent( 133/180) of these people thought dental fluorosis had significant effect on their life, 91.1%(164/180) of these 'people wished to be treated. Eighty-four point four per cent( 152/180) of the people had a habit of toothbrushing,and 50.7% (77/152) of these people were still using toothpaste containing fluorine. Conclusions Zhaotong is a serious indoor coal-combustion-type fluorosis area. Enhancing health education to local people especially to students, and changing people's unhealthy habits and customs are keies to control the prevalence of indoor coal-combustion-type dental fluorosis.

Objective To investigate the influences of mutation at precore and basic core promoter(BCP) region in hepatitis B virus(HBV) on the immune response of specific cytotoxic T lymphocytes(CTL) in patients with chronic hepatitis B(CHB).Methods The number of specific CTL in peripheral blood mononuclear(PBMC) of CHB patients were tested by cytokine flow cytome- try(CFC) and HBV core18-27 peptide.HBV precore and BCP fragments were directly sequenced. Results Twenty-one(38.9%) samples were HBV precore G1896A mutation.Twenty-six(48.1%) samples were BCP region 1762/1764 combined mutation.Thirteen(24.1%) stains were three sites mutated simultaneously.Stimulated with HBV core 18-27 in vitro,the specific CTL level was signifi- cantly higher in the patients with G1896A mutation and BCP region mutation [(0.41?0.09)%, (0.36?0.08)%,(0.48?0.08)%,respectively]than those without mutation[(0.11?0.06)%, P

Air Pollutants, Occupational ; analysis ; Gas Chromatography-Mass Spectrometry ; methods ; Volatile Organic Compounds ; analysis ; Workplace

Objective To study the prevention and treatment of chylous leakage after Whipple operation.Methods Clinical data of 381 patients underwent Whipple operation from Jan 2010 to march 2013 were retrospectively analyzed.Results Among 381 patients,23 patients had chylous leakage,the incidence was 6.04％.While in 89 patients,in which intraoperative precautionary physical ligation or mattress suturing of the lymphatic vessels were undertaken,no chyle leakage occurred ; Most of chyle leakage occurred in malignant tumor after radical resection(21 patients),most chylous leakage was found 5-8 days after surgery,with daily volume of 260-450 ml.All patients of chylous leakage were cured by conservative treatment.Conclusions Chylous leakage are common in PD.Intraoperative preventive measures such as lymphatic duct ligation or safe suturing can effectively prevent chyle leakage.Conservative therapy heals most chylous leakage after Whipple operation.