0.05) . Tube re-adhesion rate was 10.7% and 17.9% (P

Objective To investigate the diagnostic value of color doppler transvaginal scan for patients with ectopic pregnancy. Methods Transvaginal scan and transabdominal scan were used to inspect 109 cases that were clinically doubted as early ectopic pregnancy. 126 cases only received transabdominal scan were as control group. Results Through transvaginal scan,35 cases were found as early unruptured ectopic pregnancy after they stop men-stru-ation about 35 to 42 days. The inspected time of the other 74 cases and control cases was post-poned obviously. All cases were compared with laparoscopy or skive belly operation and got the consilient rate of 97%. And the inspected time was earlier for 11. 3 days than the contrel group. This was a notable discrepancy (P < 0.01). Conclusion Transvaginal scan could improve the inspected rate for the early ectopic pregnancy greatly. It had more value than other methods,so it was worth being utilized widely.

Objective To study the expression of interleukin-18(IL-18)during the progression of renal interstitial fibrosis in rat kidney after unilateral ureteral obstruction(UUO)and the effect of Shenfu injection.Methods The obstructive nephropathy model was established by unilateral ureteral obstruction(UUO).Fifty。Six rats were randomly assigned into shame operation group,operation group(UUOgroup)and treatment group(UUO+Shenfu).After 7 and 14 days,the renal function and histopathological changes were evaluated.Immunohistochemistry was used to examine the expression of IL-18 in renal tissue.Results In comparison with the shame opeartion group,the operation group showed obvious renal interstitial fibrosis.And the expression of IL-18 increased signifieantly(P<0.05).Compared with the operation group,the degree of interstitial fibrosis was obviously ameliorated in the treatment group,and the expression of IL-18 decreased significandy after treatment for 7 days(P<0.05),and decreased more after treatment for 14 days(P<0.05).Conclusions Shenfu injection may protect renal function by decreasing the expression of IL-18 in the progression of renal interstitial fibrosis.

Objective To evaluate the efficacy and safety of therapeutic drug monitoring (TDM ) based vancomycin dose adjustment in patients with gram‐positive infections .Methods A cohort study was designed with 128 inpatients undergoing TDM in Huashan Hospital from January 2005 to September 2014 .The clinical data of these patients were used to analyze the efficacy and safety of vancomycin therapy by Cox model and survival analysis .Results The patients undergoing TDM‐based dose adjustment had a higher daily dose and blood trough concentration ,which may lead to better bacteriological efficacy and overall efficacy .Cox proportional hazards model analysis showed that TDM‐based dose adjustment is a protective factor .No safety‐related risk factor was found .Conclusions TDM‐based vancomycin dose adjustment is important for patients to achieve better outcomes in fighting gram‐positive infections .

OBJECTIVETo investigate an effective method to produce large numbers of pure corporal smooth muscle cells in vitro according to the requirement of study.

METHODSIn this study, we used the primary tissue culture technique to isolate and culture the corpus cavernosum smooth muscle cells (CCSM) from human males with normal erectile function and New Zealand white rabbits. The cells were identified in regard to morphological and growing characteristics via immunohistochemical methods (including alpha-smooth muscle actin, desmin, myocin and factor VIII related antigen), special dye techniques (including Masson and Van Gieson) and transmission electron microscope.

RESULTSCCSM were isolated and cultured successfully with high purity. Morphologically, the cells were spindle shaped and grow on top of each other, resembling a "hill and valley" in appearance. When characterized in immunohistochemistry, the cells were stained with alpha-smooth muscle actin, desmin and myocin, but not with anti-factor VIII, an endothelial marker.

CONCLUSIONThe CCSM, which can be isolated and cultured successfully, may be used for further studying their biological function. The CCSM cultured in vitro was proved to be useful to evaluate and investigate the effect of some new medicine for penile erection. There is also a clinical and theoretical significance in further studying the experimental mechanisms of erectile dysfunction.

Animals ; Cell Division ; Cells, Cultured ; Erectile Dysfunction ; etiology ; Humans ; Immunohistochemistry ; Male ; Myocytes, Smooth Muscle ; chemistry ; cytology ; ultrastructure ; Penis ; cytology ; Rabbits

Objective To compare the efficacy and safety of levofloxacin 750 mg for 5 days versus 500 mg for 7‐14 days intravenous (IV ) infusion in the treatment of community‐acquired pneumonia (CAP ) . Methods This study was a multi‐center , randomized , open‐label , non‐inferiority , controlled clinical trial .The CAP patients were randomized to receive levofloxacin 750 mg IV daily for 5 days or levofloxacin 500 mg IV daily for 7‐14 days .The clinical symptoms , laboratory tests , imaging results and microbiology data were collected and compared between the two treatment groups in terms of efficacy and safety .Results A total of 241 patients were enrolled in this clinical trial from 10 study centers .Among these patients ,223 were eligible for full analysis set (FAS) analysis ,including 111 in 750 mg group and 112 in 500 mg group .Of the 223 patients in FAS ,211 were eligible for per‐protocol set (PPS) analysis ,including 107 in 750 mg group and 104 in 500 mg group .Two hundred and forty‐one patients were included in safety set (SS) ,including 121 patients in 750 mg group and 120 in 500 mg group .The median treatment duration was 5 .0 days in 750 mg and 9 .0 days in 500 mg group .The median total dose was 3 750 mg in 750 mg group and 4 500 mg in 500 mg group .The overall efficacy rate was 86 .2% in 750 mg group and 84 .7% in 500 mg group in terms of FAS at visit 4 ,which suggested that the efficacy of 750 mg group was non‐inferior to 500 mg group .Of the 111 FAS patients in 750 mg group ,40 were bacteriological evaluable ,and 41 strains of pathogens were isolated .Forty‐nine of the 112 FAS patients in 500 mg group were bacteriological evaluable ,and 51 bacterial strains were obtained .The bacterial eradication rate was 100% in both groups .The clinical treatment efficacy rate for atypical pathogens was 100% in both groups .In 750 mg group ,the most common clinical adverse drug reactions (ADRs) were injection site adverse reactions including injection site pruritus ,pain and hyperemia .The other common ADRs were insomnia ,nausea ,skin rash .The most common drug‐related laboratory abnormalities were neutrophil percentage decreased , decreased white blood cell (WBC ) count , alanine aminotransferase (ALT) and aspartate aminotransferase (AST) elevation .Most of the ADRs were mild in severity and well‐tolerated .The safety profile of the two treatments was comparable in terms of the drug‐related treatment discontinuation and the incidence of ADRs .Conclusions The short‐course regimen of levofloxacin 750 mg IV for 5 days is at least as effective and well tolerated as the long‐course regimen of 500 mg IV for 7‐14 days in treatment of CAP .

OBJECTIVETo assess the accuracy of immunological fecal occult blood test (iFOBT) for detection of colorectal cancer (CRC).

METHODSA total of 1 197 studies published before June 2014 were selected from PubMed and Embase and 17 of which were finally included in this meta-analysis. A bivariate mixed-effects models was used for overall value merging and heterogeneity testing. In addition to the overall sensitivity and specificity, the analyses were also performed among certain subgroups, including a "colonoscopy group" (all were referred for colonoscopy diagnosis regardless screening results) and a "follow-up group" (only the screening positive were referred and all were then followed up), a qualitative group and a quantitative group (classified by the way of iFOBT result reading).

RESULTSA total of 161 502 subjects aged from 48 to 63 years were included in the analysis. IFOBT had an overall integrated sensitivity of 0.85 (95% CI: 0.79-0.89) (heterogeneity test: Q = 59.67, P < 0.001) and an overall integrated specificity of 0.93 (95% CI: 0.92-0.94) (heterogeneity test: Q = 1 722.53, P < 0.001) for detection of CRC. In the subgroup analysis, it was found that in the "colonoscopy group" and in the "follow-up group", the sensitivity were 0.81 (95%CI: 0.73-0.87) and 0.88 (95% CI: 0.81-0.92), respectively; the specificity were 0.92 (95% CI: 0.89-0.93) and 0.95 (95% CI: 0.94-0.96), respectively. It was also found that in the qualitative group and the quantitative group, the sensitivity were 0.84 (95% CI: 0.76-0.90) and 0.86 (95% CI: 0.78-0.92), respectively; the specificity were 0.94 (95% CI: 0.91-0.96) and 0.93 (95% CI: 0.91-0.94), respectively.

CONCLUSIONIFOBT had high overall sensitivity and specificity for detecting colorectal cancer.

Colonoscopy ; Colorectal Neoplasms ; Hematologic Tests ; Humans ; Mass Screening ; Occult Blood ; Sensitivity and Specificity

OBJECTIVE: To assess the diagnostic value of whole exome sequencing (WES) for patients with intellectual disability (ID) or global developmental delay (GDD). METHODS: 134 individuals with ID or GDD who presented at Chenzhou First People's Hospital between May 2018 and December 2021 were selected as the study subjects. WES was carried out on peripheral blood samples of the patients and their parents, and candidate variants were verified by Sanger sequencing, copy number variation sequencing (CNV-seq) and co-segregation analysis. The pathogenicity of the variants was predicted based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). RESULTS: A total of 46 pathogenic single nucleotide variants (SNVs) and small insertion/deletion (InDel) variants, 11 pathogenic genomic copy number variants (CNVs), and 1 uniparental diploidy (UPD) were detected, which yielded an overall detection rate of 43.28% (58/134). The 46 pathogenic SNV/InDel have involved 62 mutation sites in 40 genes, among which MECP2 was the most frequent (n = 4). The 11 pathogenic CNVs have included 10 deletions and 1 duplication, which have ranged from 0.76 to 15.02 Mb. A loss of heterozygosity (LOH) region of approximately 15.62 Mb was detected in 15q11.2q12 region in a patient, which was validated as paternal UPD based on the result of trio-WES. The patient was ultimately diagnosed as Angelman syndrome. CONCLUSION WES can detect not only SNV/InDel, but also CNV and LOH. By integrating family data, WES can accurately determine the origin of the variants and provide a useful tool for uncovering the genetic etiology of patients with ID or GDD.
Humans ; Exome Sequencing ; Intellectual Disability/genetics* ; DNA Copy Number Variations ; Mutation ; Loss of Heterozygosity

Objective To understand the incidence and mortality of colorectal cancer in China. Methods The data from GLOBOCAN 2012,Chinese Cancer Registry Annual Report 2012, Cancer Incidence in Five Continents(CI5),the Three National Death Cause Surveys in China and WHO Mortality Database were used to learn about the incidence and mortality of colorectal cancer and related trends in China. Results It was estimated by GLOBOCAN 2012 that in 2012 the age-standardized incidence of colorectal cancer in China was 16.9 per 100 000 in males and 11.6 per 100 000 in females,and the age-standardized mortality was 9.0 per 100 000 in males and 6.1 per 100 000 in females. GLOBOCAN 2012 estimated that colorectal cancer incidence and mortality would increase with the level of human development index. China’s human development level was high, suggesting that the burden of colorectal cancer would be more serious in China with the development of social economy. The data from CI5 VolumeⅣand GLOBOCAN 2012 indicated that the incidence of colorectal cancer began to increase obviously at age of 50 years in China. Chinese Cancer Registry Annual Report 2012 showed that the incidence and mortality of colorectal cancer in urban population were two times higher than those in rural population in 2009,the proportions of colon cancer among colorectal and anus cancers,which was 49.0% in males and 54.2% in females,53.4% in urban population and 41.7%in rural population. CI5 VolumesⅣ-Ⅹshowed that colon cancer and rectum and anus cancer incidence in Shanghai for both males and females were increasing during the period 1973-2007. The percentage change in colon cancer and rectum and anus cancer incidence between 1973-1977 and 2003-2007 increased by 138.8%and 31.1%in males,146.7%and 49.1%in females, respectively. The data from the Three National Death Cause Surveys showed that the crude mortality of colorectal cancer increased by 77.9%form mid 1970’s(1973-1975)to mid 2000’s(2004-2005). WHO Mortality Database showed that average annual percentage change(AAPC)of age-standardized colorectal cancer mortality increased by 0.7%(P<0.05) from 1987 to 2000. Conclusion More attention should be paid to the prevention and control of colorectal cancer in urban area and in male population in China. Similar to the western countries,the burden of colorectal cancer in China would continue to become serious if no population based prevention and control programs are conducted.

Objective To gather available evidence related to the economic evaluation on breast cancer screening in mainland China and to provide reference for further research.Methods A systematic review was conducted to identify articles in PubMed and three Chinese databases (CNKI,Wanfang and VIP) during 1995-2015.Data related to descriptive characteristics,rates on participation and detection for population-based studies,methods for model-based studies,types of economic evaluation and results,were extracted.A Consolidated Health Economic Evaluation Reporting Standards (CHEERS) was used to assess the reporting quality of included studies.Results Of the 356 records searched in the databases,13 studies (all published between 2012 and 2015) were included in the current paper involving 11 population-based studies and 3 model-based evaluations (1 study using both methods).Age of the participants who started to be engaged in the screening program ranged from 18 to 45 years old,but terminated at the age of 59 years or older.The screening modalities included single-used clinical breast examination,mammography and ultrasound or combined applications.Study persepectives were described in 7 studies,with 5 from the healthcare providers,and 2 from societal angles.Only 5 studies discounted cost or effectiveness.Out of 11 papers,9 showed the results on cost-effectiveness analysis (CEA) that reporting the cost per breast cancer detection,with median as 145.0 thousand Chinese Yuan (CNY),ranging from 49.7 thousand to 2 293.0 thousand CNY.From 4 papers with results of cost-utility analysis (CUA),the cost per quality adjusted life year (QALY) gained or cost per disability adjusted life year (DALY) averted,were evaluated.The incremental cost-effectiveness ratio (ICER) was from 2.9 thousand to 270.7 thousand CNY (GDP per capita of China was CNY 49.3 thousand in 2015).In 13 studies,the quality of reporting varied,with an average score of 14.5 (range:9.5-21.0).In the domains of study perspective,discounting,ICER and uncertainty,all the scores of equalities were relatively levels.Conclusions Currently,evidence on economic evaluation of breast cancer screening in mainland China remained limited and weakly comparable,particularly model-based studies.Comprehensive analysis from societal perspective and QALY or DALY related cost-utility analysis should be implemented.