Objective:To evaluate the efficacy of loop electrosurgical excision procedure(LEEP) in the treatment of different grade of cervical intraepithelial neoplasia(CIN). Methods:898 cases with CIN treated by LEEP were retrospectively analyzed. Operation time, blood loss during the operation, changes of histopathologic results and high-rick HPV before and after the operation were studied. The diagnosis and treatment results by LEEP were evaluated. Results: The average operation time was 5.1 minutes. The average blood loss during the operation was 5.6 ml. The concordance rate of pathologic results under colposcope before operation and after LEEP was 77.73% (698/898) .96 cases had increased CIN grade after LEEP(10.69%). The HPV-DNA loading dose after operation declined significantly (P< 0.01). Conclusions: The detection rate of invasive cervical cancer by LEEP is higher than multiple punch biopsy under electronic colposcope. LEEP is an effective method for the diagnosis and treatment of CIN, and it can eliminate high-rick HPV at the same time of ablating the cervical lesion.

Free amino acids were analysed in 90 human milk samples during the first 6 weeks of lactation in Nanjin city. Glutatnic acid was the most and taurine was the second abundant component of the free amino acids in human milk. The free essential amino acids were highest in colostral milk and declined with advancing lactation. The possible roles of free amino acids in human milk for feeding infant in the first stage was discussed. The results of this study support that breast milk is beneficial for infants and suggest that the formulas should be supplemented with taurine.

Objective: To examine the association between neonatal birth weight and maternal type 2 diabetes (T2DM), so as to provide insights into the formulation of the early T2DM prevention and improvements of maternal and children health. Methods: Single-nucleotide polymorphisms (SNPs) were collected from two genome-wide association studies (GWAS) that examined the association between neonatal birth weight and maternal T2DM. Inverse variance weighted method was employed for forward Mendelian randomization with 26 birth weight-associated SNPs as instrumental variables and maternal T2DM as the study outcome and for reverse Mendelian randomization with 18 maternal T2DM-associated SNPs as instrumental variables and maternal effects of neonatal birth weight as the study outcome. The heterogeneity was examined using Cochran's Q test, and the pleiotropy was evaluated using MR-Egger regression, while the robustness of the results was evaluated using leave-one-out test. Results: Cochran's Q test detected heterogeneity across two studies (P=0.019, 0.038), and random effect models were employed. Mendelian randomization showed that an increase in neonatal birth weight by per standard error (approximately 488 g) resulted a 29.9% reduction in the risk of maternal T2DM (OR=0.701, 95%CI: 0.547-0.899), and maternal T2DM increased the neonatal birth weight by 0.074 standard errors (OR=1.074, 95%CI: 1.043-1.106). No horizontal pleiotropy was seen for instrumental variables (P=0.241, 0.188). With each SNP excluded in turn, the results of Mendelian randomization study were robust. Conclusion There are bidirectional associations between neonatal birth weight and risk of maternal T2DM.

AIM To study the influence of Huangqi Powder (Puerariae lobatae Radix,Astragali Radix,Mori Cortex) on femur and tibia in rats with glucocorticoid-induced osteoporosis (GIOP).METHODS Thirty one-month-old male SD rats were divided into three groups by randomized block design,which were control group (normal saline),prednisone group (3.5 mg/kg prednisone acetate),Huangqi Powder group (clinical adult dosage).Experimental test was maintained for one hundred and twenty days.Double fluorochrome labeling with calcein was performed before necropsy;bone resorption and bone formation index were determined by using blood serum;the femur structural and material mechanics were analyzed by using bone biomechanics method.The cancellous bone of proximal tibial and the cortical bone of tibial shaft static parameter and dynamic parameter were analyzed by bone histomorphometry method.RESULTS Huangqi Powder had no obvious improving effects on bone biomechanics and bone static parameter,but could increas the area,width and number of the proximal tibia bone trabecular.Mark perimeter percentage and mineralization rate of deposition could be increased.CONCLUSION Huangqi Powder can significantly increase proximal tibia cancellous bone mass and enhance bone trabecula structure of glucocorticoid-induced osteoporosis rats.

Objective To analyze the biophysical dosimetric characteristics and clinical application ability of VMAT technology for breast cancer post-mastectomy.Methods 28 patients with breast cancer (10 at left side and the other at right side) were planned in different ways respectively.One was two 90 degree arc VMAT plan and the other were 5 beam IMRT plan.The dosimetric parameters of two different plans including tumor control probability (TCP),conformity index(CI),homogeneity index (HI),V95and V110 in target,normal tissue complication probability (NTCP),V5,V20,V30 for ipsilateral lung,NCTP,D V25 for heart,D for the contralateral breast in OARs,MU and times were compared.Results The average tumor control probability (TCP) in VMAT and IMRT group was(96 ±2)％ and (90 ±2)％ (t =-6.28,P ＜ 0.01),respectively.The PTV dose average homogeneity index (HI) of VMAT plans was better than that of IMRT plan (0.15 ±0.04 vs 0.22 ±0.02,t =13.29,P ＜0.01).For cancer position in left side,the mean dose of heart was decreased by 433.24 cGy in the VMAT plan.The NTCP of the hearts in VMAT plans had statistically significant difference compared with IMRT plans [(1.00±0.12)％ vs (1.70±0.13)％,t =2.14,P ＜0.05].For plans of right breast cancer,the average mean dose of hearts in two control group was (3.27 ± 0.26) Gy and (6.00 ± 0.47) Gy (t =9.21,P＜0.01).The total monitor unit (MU) was 530.7 in the VMAT arm and 693.9 in the IMRT arm (t =9.58,P ＜0.01).The treatment time was shorter in VMAT arm (t =8.40,P ＜0.05).Conclusions VMAT plans have better clinical value and more superior biophysical dosimetric characteristics for breast cancer post-mastectomy.

Objective To study the geometric difference between six different ITV generation methods from 4DCT for patients with non?small cell lung cancer ( NSCLC) treated with stereotactic ablative radiotherapy technique ( SABR) . Methods Between Dec. 2013 and Mar. 2014,16 patients were enrolled in this retrospective study. All patients underwent imaging with 4DCT scans. The MI and DI index were evaluated between six ITV generation methods:combining GTV from all 10 respiratory phases ( ITV10 );combining GTV from four respiratory phases, including two extreme phases ( 0% and 50%) plus two intermediate phases ( 20% and 70%) ( ITVYeo ) which was proposed by Seung?Gu Yeo of Soonchunhyang University;combining GTV from two extreme phases ( ITVEI+EE ) . And combining GTV from five odd phases (10%,30%,50%,70%,90%)(ITVodd).Accordingly the ITVEVEN which was combined from the remaining five even phases (20%,40%,60%,80%,0%),and ITVAVG,ITVMIP were contoured from two reconstructed 4DCT sequences,finally,a method which was not sensitive to the tumor volume and motion characteristic was selected for clinical use. Data were compared using a variance analysis followed by Student?Newman?Keulsa test both in same group or between groups. At the same time, the volume and the three dimensional movements of the tumor, the relativity of MI and DI were analyzed by Multi?parameter regression analysis. Results The mean (range) tumor motion (RLR,RAP,RCC,and R3D) are 3. 5 mm (1. 4?8. 4 mm),4. 5 mm (1. 1?8. 6 mm),9. 5 mm (0?10 mm),12. 3 mm (2. 5?55. 3 mm) respectively. The IGTVx volume are Underestimated by 25. 7%,35. 6%,17. 9%,12. 8%,3. 6%,4. 8%( P=0. 000) respectively. The MI index comparisons between six ITV generation methods and ITV10 showed statistical significance:0. 69,0. 62,0. 80, 0. 86,0. 93,0. 91 ( P=0. 006 ) . The DI index showed no statistical significance:0. 98, 0. 98, 0. 97, 0. 97, 0. 99,0. 98(P=0. 130).The tumor size and motion amplitude were certified not the independent factors for the MI index of ITVodd and ITVEVEN . Conclusions IGTVODD/EVEN based on odd or even 4DCT phases is not sensitive to the tumor size or motion characteristic and is proved to have a good marching with ITV10 meanwhile maintaining a reasonable contouring efficiency,it can be recommend to the institutions which was not equipped with the deformable registration systems.

Objective To investigate the time course and prognosis of perioperative deep venous thrombosis in hip fracture patients.Methods A prospective study was conducted to analyze the clinical data of 88 patients with hip fractures who were injured within 24 h in the Department of Traumatic Orthopedics,Honghui Hospital,Xi'an Jiaotong University from September 2017 to March 2018.The patients were divided into anticoagulant group (n =53) (low molecular weight heparin combined with physical prevention) and non-anticoagulant group (n =35) (physical prevention only).The patients were examined by deep venous examination of the lower limbs every 24 h after they were admitted to hospital.The number and incidence of new thrombosis within 4 d after injury and 7 d after operation were recorded.The histogram was recorded.The prognosis of thrombosis and the occurrence of thrombosis in different fracture sites were also recorded.Counting data were expressed by percentage (％),and x2 test was used for comparison between groups.Results In the anticoagulant group,33 cases of deep venous thrombosis occurred in 53 cases,and the incidence rate was 62.26％.Deep venous thrombosis occurred in 29 of 35 patients in non-anticoagulant group (82.86％).The difference between the two groups was statistically significant (P ＜ 0.05).In anticoagulant group,thrombosis occurred in 10 cases (18.87％),7 cases (13.21 ％),1 case (1.89％),5 cases (9.43％),7 cases (13.21％) and 3 cases (5.66％) on the 1st,2nd,3rd and 4th day after injury.In non-anticoagulant group,thrombosis occurred in 7 cases (20.0％),8 cases (22.86％),2 cases (5.71％),1 case (2.86％),4 cases (11.42％),3 cases (8.57％),1 case (2.86％),1 case (2.86％),1 case (2.86％),1 case (2.86％) and 1 case (2.86％) respectively on the 1st,2nd,3rd,4th and 6th days after operation.Of the 62 thrombus cases,22 (35.48％) were changed from unilateral to bilateral,6 (9.68％) disappeared,3 (4.84％) from distal to proximal (1 case of pulmonary embolism),1 (1.61％) from proximal to distal,and 30 (48.38％) remained unchanged.43 cases of femoral neck fracture,27 cases of deep vein thrombosis,the incidence rate was 62.79％,45 cases of intertrochanteric fracture,35 cases of deep vein thrombosis,the incidence rate was 77.78％.There was no significant difference between the two groups (P ＞ 0.05).Conclusions Despite routine prophylactic anticoagulation therapy,the incidence of deep venous thrombosis is still high in hip fracture patients.The peak time of perioperative deep venous thrombosis in hip fracture patients was 2 d after injury and 2 d after operation.There was no significant change in thrombus after conventional anticoagulation therapy in patients with deep venous thrombosis during perioperative period,and even some of the thrombus changed from unilateral to bilateral.

Objective : To explore the association between coffee intake and all cancer mortality in East Asian populations. Methods : We searched literatures which assessed the relationship between coffee intake and cancer mortality in Asian populations published by December 10th,2018 from China National Knowledge Infrastructure,Wanfang Database,VIP Database and PubMed. We conducted category and dose-response meta-analyses using Stata 15.0. Results : A total of 335 relevant articles were retrieved; five articles were finally included in the meta-analyses,of which four were carried out in Japanese population and one in Singaporean Chinese population. The total sample size of the five articles was 361 802,and the number of deaths from cancer was 17 664. The results showed that coffee intake reduced the risk of all cancer mortality in East Asian populations（RR=0.93,95%CI：0.87-0.99）. There was no statistical significant association between coffee intake and all cancer mortality in East Asian men（RR=0.94,95%CI：0.77-1.15）. Among East Asian women,coffee consumption reduced the risk of all cancer mortality by 12%（RR=0.88,95%CI：0.81-0.95）. All cancer mortality risk decreased with the increase of coffee intake,and reached the lowest point at one and a half cups of coffee per day（RR=0.92,95%CI：0.86-0.98）. Conclusion Coffee intake reduced the risk of all cancer mortality in East Asian populations,which was obviously found in East Asian women. Drinking one and a half cups of coffee a day had the lowest risk of all cancer mortality.

Objective:To investigate the relationship between bedtime procrastination and daytime sleepiness in college students,and to explore the mediating effect of sleep quality and the moderating effect of gender in the a-bove-mentioned relationship.Methods:A total of 2 823 college students(808 males,2 015 females)from two uni-versities were selected.They were assessed with the Bedtime Procrastination Scale(BPS),Epworth Sleeping Scale(ESS,ESS score≥11 indicated daytime sleepiness)and Pittsburgh Sleep Quality Index(PSQI).Process model 4 was used to test the mediating effect of sleep quality and model 14 was used to test the moderating effect of gender.Results:There were 1 214(43.0％)college students suffering from daytime sleepiness.The scores of ESS in college students were positively associated with the BPS scores(β=0.16).The total scores of PSQI partially mediated the effect of BPS scores on college students'ESS scores,and the value of mediating effect was 39.9％.The association between PSQI scores and ESS scores was moderated by gender(β=-0.13).Conclusion:Daytime sleepiness is associated with bedtime procrastination and sleep quality in college students,and the association be-tween sleep quality and daytime sleepiness is moderated by gender.

Objective To analyze the mechanism of Huangwu Ganfu Ointment in relieving pain of knee osteoarthritis(KOA)based on network pharmacology;To verify it in animal experiments.Methods The active components of Huangwu Ganfu Ointment were obtained by TCMSP database,PubChem database and SwissADME platform,the effective components were screened,and the targets were obtained from SEA database.KOA disease-related targets were obtained from GeneCards,OMIM and other databases,and the intersection targets were obtained.A effective component-target-disease network was constructed using Cytoscape 3.9.0 Software.Protein-protein interaction(PPI)network was constructed by STRING database and core targets were screened.GO and KEGG enrichment analysis of intersection targets were analyzed using DAVID platform.The KOA rat model with cold and damp syndrome was established,and the intervention of Huangwu Ganfu Ointment was carried out.The efficacy was observed and the core target expressions were detected.Results Totally 104 effective components were screened from Huangwu Ganfu Ointment,and 59 potential targets were obtained for treating KOA.PPI network interaction analysis obtained the important targets of IL6,IL1B and PTGS2.KEGG enrichment results showed that Huangwu Ganfu Ointment may involve 84 signaling pathways such as IL-17,TNF,TRP and NF-κB in the treatment of KOA,most of which were related to inflammation.The results of animal experiments showed that Lecuesne MG scores increased in the model rats(P<0.05),and paw withdrawal threshold(PWT)significantly decreased(P<0.05).Compared with model group,PWT in Huangwu Ganfu Ointment medium-and high-dosage groups were significantly recovered,and synovitis Krenn score decreased(P<0.05).The Mankin score of cartilage tissue of Huangwu Ganfu Ointment high-dosage group decreased(P<0.05).The contents of IL-6 and IL-1β in all Huangwu Ganfu Ointment groups decreased(P<0.01).Huangwu Ganfu Ointment medium-and high-dosage groups could down-regulate the expression of TRPV1 protein(P<0.05,P<0.01).Conclusion The mechanism of Huangwu Ganfu Ointment in alleviating the pain of KOA may be related to reducing inflammatory response,reducing the release of inflammatory factors of IL-1β and IL-6,alleviating inflammatory pain sensitivity of KOA,and down-regulating the expression level of TRPV1.