Objective To evaluate the role of TVS in assessing endometrial pathology in women with postmenopausal bleeding and in evaluating the depth of myometrial invasion in endometrial carcinoma.Methods A group of 111 women with postmenopausal bleeding were examined by TVS,endometrial thickness,echotexture,blood flow characteristics were evaluated.Results An endometrial thickness less than 5 mm was associated with normal or benign condition.This suggested that endometrial biopsy or curettage might not be necessary in this situation,visualization of abnormal blood flow within the endometrium in the endometrial carcinoma with mean resistance index constituted a statistical difference compared with that of benign endometrium(P<0.05).TVS accurately detected depth of myometrial invasion in endometrial carcinoma,and had significant relation with pathologic assessment(r=0.98,P<0.001).Conclusion TVS could be implemented as a routine first-step procedure in patients with postmenopausal bleeding.

Objective To discuss the clinical significance of serum pyridinoline cross-linked carboxy-terminal telopeptide of typeⅠcollagen in patients with rheumatoid arthritis (RA). Methods Serum ⅠCTP was measured by ELISA and RF, CRP by immunonephelometry assay in 55 patients with active and 25 with stable RA as well as 52 age and sex-matched normal controls. Results SerumⅠCTP was positively correlated with RF and CRP (rs=0.407, 0.534, P0.05). The sensitivity, specificity and accuracy of serumⅠCTP test were 67.3%, 84.6%, 75.7% in serum of the patients with active RA respectively. The mean serumⅠCTP in normal controls was (3.5?2.0) ?g/L. The serumⅠCTP was more sensitive than CRP in the patients with active RA. Conclusion SerumⅠCTP in patients of RA is a reliable assistant marker for early diagnosis, monitoring of the course and the effectiveness of treatment.

Objective To compare gait patterns in patients with metal-on-metal resurfacing hip arthroplasty(RHA)and big-femoral-head total hip arthroplasty(BHA)at one year postoperatively.Methods From June 2006 to March 2009,two groups of 30 RHA and BHA patients participated in the study.Gait parameters,knee and hip joint range of motions(ROMs)in gait cycles were measured at one year postoperatively by Vicon gait analysis system,and the values were used to calculate affected/unaffected ratios of patients themselves.Results No significant difference were found in affected/unaffected ratios of cadence,single limb support time,foot off,peak value of vertical ground reaction force,the hospital for special surgery score and the university of California at Los Angeles activity assessment between the two groups.However,several ROM affected/unaffected ratios in RHA group(hip range of flexion/extension,abduction/adduction,and rotation were 1.0323,0.9747,and 1.0558,respectively.The knee range of flexion/extension for affected/unaffected ratios was 1.0027)were significantly higher than those in BHA group(the corresponding values were 0.8615,0.7824,0.8162,0.9472,respectively).The P values were 0.007,0.005,0.006,and 0.037,respectively.Conclusion(1)Gait parameters of patients who underwent RHA and BHA were close to normal values at one year postoperatively.(2)At the follow up time point,joint ROMs of RHA patients are larger than those of BHA patients during gait cycle.(3)RHA can retain enough bone stock for future revision option,moreover,it can achieve maximum recovery of joint function.

Objective To compare effects of the whole prescription of Guanxin Ⅱ(GXⅡ),the hemorheologic agents and the Qi-regulating agents of the whole prescription on acute myocardial infarction in rats.Methods Acute myocardial infarct(AMI)model was established by coronary artery ligation,and then the model rats were treated with intraduodenal administration of different compositions of GXⅡ 5～10 minutes after the artery ligation.Five hours after modeling,blood was collected to determine the levels of endothelin(ET),thromboxane(TXB2),isoenzymes of creatine kinase(CK-MB)and andlactate dehydrogenase(LDH).The heart of rats was cut into five slices and dyed by nitrotetrazolium blue chloride(N-BT)for 5 minutes,and then the infarcted area(non-N-BT staining area)and the noninfarcted area(N-BT staining area)were detected.Results Compared to the model group,both the whole prescription of GXⅡ and the hemorheologic agents significantly reduced infarct size,ameliorated blood ET,TXB2,CK-MB and LDH levels(P

Objective:To study the effect of Huanglian-Jiedu Decoction on the white matter lesion of rats with focal cerebral ischemia and to explore the regulative role of the active fraction of Huanglian-Jiedu Decoction on NogoA/NgR. Methods:Male SD rats were randomly divided into sham operation group, model group, total alkaloid group, total flavonoid group, and total iridoid group. Except for the sham operation group, the rats in the other groups were used to establish the middle cerebral artery occlusion rat model by the suture method. 2 hours after modeling, rats in the total alkaloid group were given intragastric administration with 44 mg/kg total alkaloids; rats in the total flavonoid group were given intragastric administration 50 mg/kg total flavonoids; rats in the total iridoid group were given intragastric administration 80 mg/kg total iridoids, the sham operation group and the model group were intragastrically given equal volume of normal saline, once a day, for 7 consecutive days. The pathological changes of rat white matter were observed by HE staining, the pathological changes of rat myelin sheath were observed by Luxol fast blue (LFB) staining, and the expression of Amyloid precursor protein (APP), NogoA, and NgR in the internal and external capsule areas of the brain was detected by immunohistochemical staining. Real-time fluorescence quantitative PCR was used to detect the expression of NogoA and NgR in the tissues surrounding the ischemic infarct.Results:Compared with the model group, the total alkaloid group, total flavonoid group, and total iridoid group had lower pathological damage scores in the internal and external capsule areas of rats ( P<0.05 or P<0.01), increased integral optical density value of LFB staining ( P<0.01), decreased expression of APP and NogoA; the expression of NgR in the internal and external capsules of rats in the total alkaloid group and the total iridoid group decreased ( P<0.05 or P<0.01), and the expression of NgR in the inner capsule of rats in the total flavonoid group decreased ( P<0.01); the expression of NogoA (1.20 ± 0.17, 1.55 ± 0.30, 1.19 ± 0.38 vs. 2.22 ± 0.58) and NgR (1.98 ± 0.55, 1.48 ± 0.31, 1.58 ± 0.27 vs. 3.36 ± 0.41) genes in the tissues around the infarct focus of rats in the total alkaloid group, total flavonoid group and total iridoid group decreased ( P<0.01). Conclusion:The present study investigates the therapeutic effects of Huanglian-Jiedu Decoction, promoting white matter repair by decreasing the overexpression of NogoA and NgR in an experimental animal model of stroke.

Objective:To evaluate the expression of CXCR4 and the migration rate of bone marrow stromal CD34+cells in differ-ent risk groups with myelodysplastic syndromes (MDS) using correlation analysis. Methods: Forty MDS patients were divided into low-and high-risk groups based on the International Prognosis Scoring System (IPSS). The former was composed of 20 patients with IPSS<1.5, whereas the latter was composed of 20 patients with IPSS≥1.5. Bone marrow (BM) samples of these patients and 10 nor-mal controls were collected. CD34+cells were separated and purified. The expression of CXCR4 was determined by flow cytometry. The migration rate of CD34+cells on the chemotactic effect of SDF-1αand on the effect of bone marrow stromal cells were measured. Results:The expression rate of CXCR4 was higher in the high-risk MDS group than in the low-risk and control groups (P<0.000 1). No significant differences existed between the low-risk and the control groups (P>0.05). The migration rate of CD34+cells on the ef-fects of SDF-1αand marrow stromal cells were significantly increased in the high-risk MDS group compared with those in the low-risk and control groups (P<0.000 1). Migration rate of CD34+cells on the effect of marrow stromal cells was positively correlated with CX-CR4 expression (P=0.000 1). Conclusion:The CXCR4 expression and migration rates of CD34+cells on the effect of marrow stromal cells are significantly higher in the high-risk MDS group than in the low-risk group. Migration rate has a positive correlation with the CXCR4 expression, which further indicates that MDS is a heterogeneous group of hematopoietic stem cell malignancies. The expres-sion and function of SDF-1 and its receptor CXCR4 differ within each group with various risks. SDF-1 and CXCR4 may be involved in MDS pathogenesis.

Objective To evaluate safety and efficacy of EUS-FNA for occupying pancreatic lesions.Methods Data of 62 patients with occupying pancreatic lesions,who underwent EUS-FNA between June 2011 and June 2014,were analyzed for completion and complications,with surgery and clinical follow-up as the golden standard.Accuracy,sensitivity and specificity of EUS-FNA were calculated.Results A total of 62 patients with pancreatic lesions successfully underwent EUS-FNA and median puncture number was 4.2(3 to 8).Success rate of puncture was 100％ and sampling satisfaction rate was 90.3％ (56/62).No complications such as fever,infection,bleeding,perforation,severe pancreatitis or death were found.With the final diagnosis as the golden standard(39 malignant lesions and 23 benign lesions),overall diagnostic accuracy of EUS-FNA was 88.7％(55/62).The cytology diagnostic accuracy was 69.4％ (43/62),significantly higher than that of the tissue pathology of 30.6％ (19/62,P＜0.01).Sensitivity and specificity of the procedure were 87.2％(34/39) and 91.3％(21/23) respectively.Conclusion EUS-FNA is an effective and safe procedure in diagnosis of occupying pancreatic lesions.

ObjectiveTo investigate the practicability of gastric intubation with zebra-guidewire under the induction of anesthesia with sevoflurane (zebra-guidewire was the obsolete guide wire in percutaneous nephrolithotomy in urology surgery). MethodsThe patients who needed gastric intubation were randomized into the experimental group and the control group with 20 patients in each group.the experimental group received gastric intubation with zebra- guidewire under the induction of anesthesia with sevoflurane.In the control group,the gastric tubes were catheterized with routine method.The physiological indices changes,incidence rate of adverse reaction and success rate of one-time catheterization and average time of catheterization per patient were compared between the two groups. ResultsIn patients of the experimental group,the blood pressure,heart rate before and during the intubation did not fluctuate evidently,but in the control group the results were the opposite.In the experimental group the incidence rate of adverse reaction,success rate of one-time catheterization and average time of catheterization per patient were superior to the control group. ConclusionsGastric intubation under the induction of anesthesia with sevoflurane was a painless way of gastric intubation.Gastric intubation with zebra-guidewire under anesthesia state was simple and fast.

Objective To observe the change of peripheral blood CD34+ cell level in patients with acute cerebral infarction, and explore its relationships with cerebrovascular risk factors,neurological function and carotid artery intima-media thickness (IMT). Methods The 45 patients with acute cerebral infarction (onset within 72 h) (infarction group) and 27 patients with cerebr ovascular risk factors but without cerebral infarction (high-risk group) were chosen for the study. The cerebrovascular disease risk factors including history of alcohol abuse, smoking, coronary heart disease, hypertension, diabetes, abnormal levels of serum triglycerides, total cholesterol,low-density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C) were recorded in all subjects. The peripheral blood CD34+ cell levels were measured by flow cytometry.The correlations of peripheral blood CD34+ cell level with cerebrovascular disease risk factors were analyzed. The neurological function and carotid artery IMT were recorded in infarction group, and the correlations of peripheral blood CD34+ cell level with neurological function and carotid artery IMT were analyzed. Results (1) The peripheral blood CD34+ cell level was significantly negatively correlated with coronary heart disease, hypertension, diabetes and LDL-C level (r =- 0. 749,-0. 717, - 0. 688, - 0. 764, all P＜0. 01) ; (2) Multiple linear regression analysis showed that peripheral blood CD34+ cell level was an independent relative factor of acute cerebral infarction (P＜0.05); (3) The peripheral blood CD34+ cell level was lower in infarction group than in high-risk group, and was significantly negatively correlated with neurological deficit score (r=-0. 721, P＜0.01) and carotid artery IMT (r= -0. 695, P＜0. 01). Conclusions Peripheral blood CD34+ cell level could be an independent relative factor of acute cerebral infarction; The peripheral blood CD34+ cell level is significantly negatively correlated with neurological function and carotid artery IMT in patients with acute cerebral infarction; And it can be used as cytological marker which reflect early vascular endothelial function in patients with ischemic stroke.

Objective To study the influence of autoblood cardioplegia on ATPase in neonatus myocardium with congenital heart disease and approach the mechanism of self-blood cardioplegia in protecting the myocardium in neonatus.Methods There were 30 cases of neonatus with congenital heart disease with body weight less than 8 kg,including 2 cases of ventricular septal defect(VSD),11 of VSD with severe pulmonary hypertension(PH),9 cases of USD with ASD,2 cases of atrial septal defect (ASD),6 of VSD and FPO.30 neonatus were divided into autoblood cardioplegic solution group(group A,n=10),allograft blood cardioplegic solution group (group B,n=10)and crystalloid cardioplegic solution group(group C,n=10).The biopsies were taken from right atrium just before arrested and after heart self-recovery to measure ATPase.Results Comparing with preoperative one,Na+-K+-ATPase creased obviously after operation in group A,B ,C (P＜0.05 ).There had no significant difference among the three groups before operation (P＞0.05).After operation,myocardial cell's Na+-K+-ATPase,Ca2+-ATPase and Ca2+Mg2+-ATPase in group A were decreased obviously as compared with that in group B and C (P＜0.05).Conclusion There is slight influence of autobloed cardioplegia on ATPase in neonatus with congenital heart disease,which can give a good protection to the myocardium in neonatus.