Objective To investigate the clinical characteristics of postmenopausal patients with cervical intraepithelial neoplasia ( CIN) gradeⅡ/Ⅲand cervical cancer . Methods A retrospective analysis was made on the clinical characteristics of 57 cases of postmenopausal patients who were diagnosed as CIN grade Ⅱor above from January 2014 to September 2015.Their age ranged from 49 to 77 (58.2 ±5.6) years old, and the time of menopause ranged from 1 to 36 (9.4 ±6.9) years. Results ①In postmenopausal women with CIN Ⅱ/Ⅲ and cervical cancer, only about 1/5 (11/57, 19.3%) had clinical complaints, and nearly 2/3 (36/57, 63.2%) had smooth cervical appearance .②There were 36 cases of high-risk human papillomavirus ( HPV) (36/39, 92.3%), 20 cases of single HPV16 infection (20/36, 55.6%), 7 cases of HPV16 type and other high-risk HPV infection (7/36, 19.4%), and 9 cases of other types of high-risk HPV infection (9/36, 25.0%).③The positive rate of high-risk HPV was 92.3%(36/39) and the HPV16 positive rate was 69.2% (27/39).TCT examination showed a positive rate of high grade squamous intraepithelial lesion (HSIL) of only 29.6% (16/54), with significant difference (χ2 =6.686 and 14.286, P =0.010 and 0.000, respectively). Conclusions Postmenopausal women with cervical lesions usually have no obvious clinical symptoms . Gynecological examination alone is difficult to judge whether the cervical lesions exist .Strict cervical lesions screening is particularly important .

Although intensive chemotherapy and hematopoietic stem cell transplant (HSCT) are currently used in the treatment of acute myeloid leukemia (AML),a large proportion of patients relapse after treatment.On the other hand,a minority of cases fail to achieve complete remission (CR) after a standard first line treatment.Leukemia relapse and refractory become the main course of treatment failure,which are also the main points and difficulties of treatment for AML.However,the most effective regimen for refractory/relapsed AML has not been established.This review focuses on the progress of the regimens and major chemotherapy for refractory/relapsed AML (except M3).

Based on M9 culture medium,the concentration of ingredients of culture medium was optimized for the fermentation of pNSR32/BL21(DE3),the engineering bacterial with spider silk protein,and lactose as an inducer.The condition of optimum culture medium was obtained for the expression of the high molecular weight recombinant spider silk protein by using orthogonal and individual factor experimental design.The result was showed that the optimum culture medium was consisted of 0.3% glycerol,3% yeast,0.75% tryptone,0.05%(NH_4)_2SO_4 and a little inorganic salt_.It was confirmed that the optimum culture medium will benefit the growth of bacterial and expression of recombinant spider silk protein.The production level of propose protein will attain at 20% of the total proteins in the fermentation.

Objective To explore the best turn lateral position angle of the patients with stroke in acute phase. Methods 100 patients with stroke in acute phase weredivided into five groups according to 15 ° ,30 ° 45 ° , 60 ° , 90 ° turn lateral position angle separately and then observed the skin temperature of good location of pressure ulcers of the patients before and after turning over 2 h. The changes of blood pressure, heart rate and the finger tip pulse oxygen saturation were recorded within the turn over 2 hours. Results The skin temperature, blood pressure, heart rate, blood oxygen saturation among the groups had no statistical significance (P>0.05) in the difference turn angle of lateral position.The skin temperature, blood pressure, heart rate, blood oxygen saturation between the groups had no statistical significance (P>0.05) in the same turn angle of lateral position.Conclusions Five different turn lateral position angle have no obvious difference on the vital signs and the skin temperature in patients with stroke in acute phase. It is suggested to adopt the turn lateral position angle of less than 90° from the perspective of biomechanics and patients′comfort.

Objective To review the clinical characteristics of adult-onset Still's disease (AOSD) patients with special pulmonary complications.Methods Medical records of 506 AOSD inpatients,who were admitted in Peking Union Medical Hospital from October 1997 through March 2015,were retrospectively reviewed.The clinical features,biochemical parameters,radiology,pulmonary function tests,ultrasound,treatments and prognosis of AOSD patients with special pulmonary complications were analyzed.Results The incidence of special pulmonary complications in AOSD inpatients was 2.2％ (11/ 506),including 3 cases of interstitial lung disease and 8 cases of pulmonary artery hypertension.All 11 patients had common manifestations of AOSD,including fever (11/11),arthralgia/arthritis (11/11),rash (9/11),lymphadenopathy and/or splenomegaly (8/11),serositis (10/11),abnormal liver function (9/ 11),neutrophilia (11/11),and hyperferritinemia (11/11).The patients with interstitial lung disease had no or mild symptom,and were diagnosed by HRCT and pulmonary function test.The patients with pulmonary artery hypertension had various symptoms including dyspnea of exertion (8/8),cough (4/8),chest suppression (2/8),and chest pain (2/8).Four patients died from severe infection,including 3 cases of pulmonary artery hypertension and 1 case of interstitial lung disease.Conclusions Interstitial lung disease and pulmonary artery hypertension are life-threatening complications of AOSD patients.Earlier recognition and prompt treatment should be made to improve patient outcomes.

Objective Assess the value of intraoperative palmar temperature and brachial artery blood flow monitring during sympathectmy. Methods 150 cases palmar hyperhidrosis underwent transthoracic endoscopic sympathectomy. Palmar temperature was all monitored and brachial artery blood flow is also detected by ultrasonography in 33 cases. Results Palmar temperature increase (2.8?1.0)℃ after sympathetic chain has been destroyed [(include a high level increase of (3.24?0.20)℃ in 125 cases and a low level increase of (0.64?0.12)℃ in 25 cases]. Ultrasonography indicate brachial artery radius (R) and blood flow volume (VOL) are significantly increased, Maximum (Vmax) and Minimum (Vmin) speed of blood flow at systole and diastole, pulse index (PI) and systole/diastole blood flow ratio (S/D) are also increased (P

Objective To assess the outcomes,complications,and quality of life following endoscopic thoracic sympathectomy(ETS) of the T2~T4 ganglia for treating primary palmar hyperhidrosis(PH). Methods A total of 200 cases were followed with clinic checkups or telephone inquiries for a period of 1~28 months(mean,18.4 months). Results Of the 200 cases,8 cases were loss of follow-up and 192 cases obtained a complete and fully satisfactory alleviation of palmer and axillary hyperhidrosis.No recurrence and severe complications were found.The prime complication was compensatory hyperhidrosis(52/192,27.1%),whose incidence was slightly higher in female and severe patients and unrelated to age.Other complications included 1 case of pneumothorax and 1 case of pulmonary atelectasis. Conclusions Endoscopic thoracic sympathectomy of the T_2~T_4 ganglia for palmar hyperhidrosis is effective,safe and reliable.The procedure improves patients' quality of life and gives satisfactory outcomes.However,all patients should be informed of the common complications,particularly compensatory hyperhidrosis,before the surgery.

Objective To summarize the experience of 200 cases of endoscopic thoracic sympathectomy(ETS). Methods Clinical materials of T_2~T_4 sympathectomy under thoracoscope for treating palmar hyperhidrosis from January 2003 to April 2005 were analysed. Results [WTBZ] All the 200 cases of operation were successfully completed.Symptoms of hyperhidrosis vanished with both hands dry and warm in all the patients.Plamar temperature increased by a mean of(3.1?0.9)℃ after operation.Follow-up observations in 192 cases for 1~28 months(mean,18.4 months) found no recurrence.Compensatory hyperhidrosis was found in 52 cases(27.1%). Conclusions Endoscopic thoracic sympathectomy is a safe,effective,and micro-invasive treatment for palmar hyperhidrosis.

Objective To summarize the experience of perioperative management of lung volume reduction surgery(LVRS) under video-assisted thoracoscopy.Methods A total of 40 patients with severe chronic obstructive pulmonary disease(COPD) underwent LVRS under video-assisted thoracoscopy.A mini-incision thoracotomy was given in 23 of them.During the operation,the Endo-GIA was utilized to resect 20%~30% of total volume of affected lung.Results The LVRS was performed in bilateral lungs in 13 patients(under thoracoscopy only in 7 patients and with the assistance of mini-incision thoracotomy in 6 patients) and in unilateral lung in 27 patients(under thoracoscopy only in 10 patients and with the assistance of mini-incision thoracotomy in 17 patients).There were no surgery-related deaths.All the patients were discharged from the hospital 9~41 days(mean,18 days) after operation.Not only symptoms of dyspnea were obviously relieved but also the respiratory index was upgraded by 1~2 grades.The comparisons on pulmonary functions between preoperative time and 1 month after operation indicated a great improvement postoperatively,including the forced expiratory volume in 1 second(FEV_1)(48.3%?4.9% vs 68.5%?5.6% predicted;t=17.169,P=0.000),the residual volume(RV)(270.0%?23.6% vs 188.0%?19.8% predicted;t=16.835,P=0.000),and the total lung capacity(TLC)((123.0%?9.8%) vs 102.0%?8.7% predicted;t=10.135,P=0.000).Postoperative complications included air leakage in 10 patients,lung infection in 5 patients,and bronchial asthma in 3 patients,all of whom were cured after symptomatic management.A follow-up was conducted in 37 patients for 3~77 months(mean,46 months).Three patients died of lung cancer at 6,10, and 20 postoperative months,respectively.Two patients died of esophageal cancer at 3 and 8 postoperative months,respectively.And one patient died of cerebrovascular disease at 6 postoperative months.The remaining 31 patients survived. Conclusions Proper perioperative management is of great importance for a successful surgery and a rapid postoperative recovery.