[Objective]To probe into the immune protective effect of Astragalus polysaccharide on mice ,whose genital tract was infected with Chlamydia trachomatis. [Methods]After the murine model of genital tract infected with chlamydia trachomatis was established, we could obtain the minimum effective infective dose. Mice were immuned by different doses(10 mg·kg-1, 20 mg·kg-1, 40 mg·kg-1) of Astragalus polysaccharide(APS) and 0.9%NS , meanwhile the blank group was regarded as the control group. After mice were immuned, we detected serum IgG antibody levels by ELISA method,and took the twice effective dose of chlamydia trachomatis to attack the genital tract after a week. Then the mice genital shedding of epithelial cells were cultured at each interval 2d. After 10 days, we kil ed the mice to calculate spleen(thymus) index, and observed the pathological changes in the reproductive tract of the mice. [Results]Compared with the control group, spleen(thymus) index and serum IgG antibody levels of Astragalus polysaccharide group are significantly higher. The results of vaginal exfoliated cells from Ct training show that, Ct positive rate of Astragalus polysaccharide group is significantly reduced, the number of inclusion bodies is also significantly decreased. And with the increasing concentration of Astragalus polysaccharide, the protective effect is more obvious. The NS group has no significant difference from the control group in al indicators. [Conclusions]Astragalus polysaccharide can induce immune protection on Ct genital tract attacked mice, and in the concentration range, with the increase of the concentration, the protection effect is better.

Objective To study the changes of serum NO, TGF-β1, IL-10 and IL-17 Levels and study of the efficacy of Bismuth - containing quadruple and standard triple therapy for patients with Hp positive peptic ulcer. Methods 109 cases of peptic ulcer treated in our hospital were retrospectively selected, and Hp test was positive. According to different dosing regimen, the patients were divided into two groups. There were 54 patients in the control group, using standard triple therapy, and the regimen was lansoprazole, amoxicillin, and metronidazole. 55 patients in the study group were treated with bismuth-based western therapy with bismuth potassium citrate, rabeprazole, amoxicillin, and furazolidone. Two weeks after treatment were regarded as the observation period, and the levels of serum NO, TGF-β1, IL-10 and IL-17 in the two groups were compared before and after treatment. The effective rate of ulcer healing, Hp clearance rate and incidence of adverse reactions were compared. Results The level of serum NO, TGF-β1, IL-10 and IL-17 was significantly lower than that in the control group (P <0.05). The effective rates of ulcer healing and Hp clearance in the study group were significantly higher than those in the control group (P <0.05). There was no significant differences between the study group and the control group in the incidence of adverse reactions. Conclusion Western medicine with bismuth in the treatment of Hp peptic ulcer patients, the serum NO, TGF-β1, IL-10 and IL-17 levels of indicators have significantly improved, and has obvious advantages in clinical treatment, and it is a reasonable dosing regimen of high efficiency and low recurrence.

Objective To explore the value of the electronic colposcopy Reid Score in diagnosis of cervical lesions and HPV infection in women with HIV infection, so as to find out an inexpensive, convenient and feasible screening methods. Methods 95 cases of HIV-infected women were screened by cervical liquid based cytology, HPV testing, colposcopy and Reid Score. The patients with abnormal results in any one test mentioned above underwent cervical biopsy. The colposcopy was combined with pathological as a gold standard for case-control study. Results There was a statistically signi?cant correlation between colposcopic ndings and histopathological ndings and the score was increased as parallel as malignancy grade (r=0.753,P=0.00) . The specificity of Reid score for high grade CIN was better than high-risk HPV testing for CIN diagnosis and the sensitivity was better than liquid based cytology. Acetic acid staining has relatively high sensitivity and specificity in the diagnosis of cervical lesions. Conclusions Colposcope Reid score for cervical lesions has a predictive value, especially for high grade cervical precancerous lesions. Colposcopy for HIV-positive women cervical cancer screening is an efficient and feasible way, especially for the area where lack of medical resources.

Objective To analyze histopathological and clinical features of dermatofibroma,and to explore the relationship between them.Methods Clinical and histopathological data were collected from 150 patients with histopathologically confirmed dermatofibroma in Department of Pathology,Shanghai Skin Disease Hospital from September 2017 to August 2018,and analyzed retrospectively.Results Among the 150 patients,65 were males,and 85 were females.Their age was 42 ± 13.8 years,and the course of disease ranged from 3 months to 30 years.Some of the patients had concomitant symptoms,mainly manifesting as itching,some had spontaneous pain and mild tenderness,and 18 patients had a history of injury,insect bite or infection at lesion sites.Skin lesions mainly occurred on the extremities (107 cases,71.3％),and most were solitary (105 cases,70％).Before pathological examinations,102 cases were clinically diagnosed as dermatofibroma,16 as epidermoid cyst,13 as pigmented nevus,3 as keloid,12 as skin mass,1 as malignant melanoma,1 as xanthogranuloma,1 as prurigo nodularis,and 1 as neurofibroma.Among 169 hematoxylin and eosin (HE)-stained sections,25 (14.8％) appeared to be consistent with aneurysmal dermatofibroma,66 (39.1％)with cellular dermatofibroma,36 (21.3％) with sclerosing dermatofibroma,and 22 (13.0％)with epithelioid dermatofibroma.Coexistence of two or more subtypes could be seen in 12 sections.There were also a few new variants,such as dermatofibroma with hyperplastic sweat duct (1 case),deep dermatofibroma (3 cases),dermatofibroma with epithelioid cells intermingled with hyperplastic collagen (1 case).The duration of aneurysmal dermatofibroma varied from 7 months to 30 years,and most manifested as skin masses on the lower extremities.A relatively short course of disease was observed in patients with cellular dermatofibroma,who often visited a hospital several months after the onset,and cellular dermatofibroma was commonly observed on the extremities and frequently accompanied with itching and pain.The duration of sclerosing or atrophic dermatofibroma was usually long for years or decades,and it commonly occurred on the upper limbs without concomitant symptoms.Epithelioid dermatofibroma of varied durations had various clinical manifestations,frequently occurred on the lower limbs without concomitant symptoms.Conclusions The clinical and pathological manifestations of dermatofibroma are diverse.Different dermatofibroma lesions can share similar typical histopathological manifestations,and atypical pathological features can interfere with the diagnosis of dermatofibroma.

OBJECTIVE: To explore the genetic basis for a patient diagnosed with tuberous sclerosis complex (TSC). METHODS: Peripheral blood samples of the patient and his parents were collected for the extraction of genomic DNA. Next generation sequencing (NGS) was carried out to detect potential variant, and the result was verified by Sanger sequencing. RESULTS: The patient was found to harbor a heterozygous c.1053delG (p.Glu352SerfsX10) frameshifting variant of the TSC2 gene. The same variant was not found in his unaffected parents and 100 unrelated healthy controls. Based on the American College of Medical Genetics and Genomics guidelines, the variant was predicted to be pathogenic (PVS1+PS2+PM2). CONCLUSION The novel c.1053delG (p.Glu352SerfsX10) frameshifting variant of the TSC2 gene probably underlay the TSC in this patient.
Genomics ; Heterozygote ; Humans ; Mutation ; Tuberous Sclerosis/genetics* ; Tuberous Sclerosis Complex 2 Protein/genetics*

Objective:To analyze clinical phenotypes and pathogenic mutations of a patient with classic tuberous sclerosis complex.Methods:Clinical data was collected from a patient with classic tuberous sclerosis complex. Next-generation sequencing was performed to screen pathogenic gene variants, and Sanger sequencing to verify the mutations. Minigene plasmids were constructed and transfected into the human renal epithelial cell line 293T, and RNA was extracted for transcriptional analysis.Results:The patient clinically presented with recurrent epileptic seizures, facial angiofibroma, periungual fibroma, pulmonary lymphangioleiomyomatosis, renal angiomyolipoma and multiple osteosclerosis. Next-generation sequencing revealed a suspected pathogenic variant in the TSC2 gene in the patient. Sanger sequencing identified a heterozygous mutation c.336_336+15delGGTAAGGCCCAGGGCG in exon 4 of the TSC2 gene in the patient, but not in his parents or 100 unrelated healthy controls. Moreover, this mutation had not been previously reported. The minigene experiment showed changed mRNA sequence of the TSC2 gene in this patient with loss of the authentic splice site in exon 4 and insertion of a 74-bp intron, which shifted the splice site 90 bp downstream (r.336delins336+16_336+90) .Conclusion:The novel heterozygous mutation c.336_336+15delGGTAAGGCCCAGGGCG in exon 4 of the TSC2 gene can lead to aberrant splicing, and may contribute to tuberous sclerosis complex in this patient.

Objective:To investigate the influence of age on the fresh cycle live birth rate in patients with poor ovarian response in different controlled ovarian hyperstimulation groups.Methods:The clinical data of 3 342 patients in The First Affiliated Hospital of Zhengzhou University from February 2014 to November 2018 were retrospectively collected, including early-follicular phase long-acting gonadotropin-releasing hormone (GnRH) agonist long protocol group (1 375 cases), mid-luteal phase short-acting GnRH agonist long protocol group (1 161 cases) and GnRH antagonist protocol group (806 cases); each group was divided into 4 subgroups according to age: ≤30 years, 31－35 years, 36－40 years and >40 years, the pregnancy outcomes in each age subgroup were analyzed under different controlled ovarian hyperstimulation protocols.Results:In early-follicular phase long-acting GnRH agonist long protocol group, the final live birth rates of each age subgroup were 39.4% (228/579), 36.1% (135/374), 16.6% (48/290) and 3.0% (4/132); in mid-luteal phase short-acting GnRH agonist long protocol group, live birth rates of each age subgroup were 32.1% (99/308), 20.8% (55/264), 13.0% (45/346) and 7.0% (17/243); in GnRH antagonist protocol group, live birth rates of each age subgroup were 22.8% (26/114), 16.3% (25/153), 11.2% (31/278), and 3.8% (10/261); the live birth rate of each group decreased significantly with the increase of age (all P<0.01). When the age≤35 years old, the fresh cycle live birth rate of the early-follicular phase long-acting GnRH agonist long protocol group was significantly better than those of the other two groups (all P<0.01). The multivariate logistic regression analysis of age and live birth rate of the three controlled ovarian hyperstimulation groups showed age was the independent influence factor ( OR=0.898, 95% CI: 0.873-0.916, P<0.01; OR=0.926, 95% CI: 0.890-0.996, P<0.01; OR=0.901, 95% CI: 0.863-0.960, P<0.01). Conclusions:Age is an independent influencing factor for the prediction of fresh cycle live birth rate in low ovarian response patients. No matter which controlled ovarian hyperstimulation protocol is adopted, the final live birth rate decreases significantly with the increase of women′s age. In addition, the early-follicular phase long-acting GnRH agonist long protocol has the highest fresh cycle live birth rate among all controlled ovarian hyperstimulation groups.