Objective:To explore and compare the therapeutic effect of hysteroscopic cesarean scar pregnancy and transvaginal scar pregnancy.Methods: 63 cases of uterine scar pregnancy patients were divided into treatment group (32 cases) and control group (31 cases) depend on the different surgical methods. The difference of operation time, intraoperative blood loss, HCG descent, postoperative hospital stay and postoperative recovery situation were compared. Results: 32 cases of hysteroscopic surgery patients were successful in one-time operation, no serious complications. Every indicator of hysteroscopic surgery group, such as operation time, intraoperative blood loss, postoperative hospital stay and postoperative blood HCG decline situation, was better than the vaginal surgery group (t=6.743, t=4.329,t=2.482,t=2.181;P<0.05).Conclusion: Hysteroscopy surgery is an important method for minimally invasive treatment of cesarean scar pregnancy, and different individual treatment program should be adopted to treat different cases of CSP and objective in clinical practice.

Objective To investigate the effect of 36 h continuous sleep deprivation(SD) on circadian clock gene expression in the rat liver and kidney and the alteration of urine biomarker levels.Methods Twelve rats were randomly divided into control group and SD group.An SD device was used to deprive the rats of sleep.After 36 h continuous SD, the abdominal cavity was exposed to obtain livers and kidneys, and RT-PCR and Western blotting were used to detect expression of clock genes.Then,the pelvic cavity was exposed to obtain urine, and the changes in bio-marker total bile acids(TBA) were tested with ELISA.Results Compared with the control group, the mRNA level of liver clock and bmal1 was obviously reduced in the SD-treated rats (P<0.05).However, no obvious change was found in the samples from the kidney.Sharp down-regulation of CLOCK and BMAL1 protein expression was also observed in the rat liver after SD treatment.Urine TBA content in SD treated rats was raised obviously (P<0.001), compared with control.Conclusion Thirty-six hours of continuous SD could result in deregulation of circadian clock gene and cholesterol metabolism disorder in the rat liver.TBA might be used as a noninvasive biomarker of liver injury under SD stress conditions.

OBJECTIVETo study the effect of Xiaoyu Tablet (XYT) on blood flow parameters and morphology of carotid artery in atherosclerotic patients.

METHODSUsing color Doppler ultrasonographic technique to examine the blood flow parameters and intimal thickness of carotid artery in 20 patients of carotid atherosclerosis after 24 weeks treatment of XYT, and compared with those in 10 patients treated with gastrodine lipid-lowering tablet.

RESULTSAfter 24 weeks treatment, blood flow parameters of carotid artery were obviously improved and intimal thickness of common carotid arteries in both side was markedly decreased. XYT showed an effect better than that of gastrodine lipid-lowering tablet.

CONCLUSIONXYT is effective in increasing blood flow of cervical and cerebral arteries.

Arteriosclerosis ; diagnostic imaging ; drug therapy ; physiopathology ; Blood Flow Velocity ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Stenosis ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Tablets ; Tunica Intima ; pathology ; Ultrasonography, Doppler, Color

Objective To evaluate the electrocardiographic(ECG)-gated 4-dimensional computed tomographic angiography (4D-CTA) in the determination of pulsation of unruptured cerebral aneurysms (URCAs).Methods This study included 48 patients with 62 URCAs.Examinations of ECG gated 4D-CTA of dual-source CT were performed.Twenty sets of image data with the time intervals of 5％ in a cardiac cycle were obtained after postprocessing on the workstation.The convex was defined as the point of pulsation if small bubble or small pointed convex could be found in continuous three or more images at the same location.The 62 URCAs were divided into two groups based on whether having a point of pulsation.All the URCAs were scanned at the follow-up by 3D-CTA or ECG gated 4D-CTA more than 120 days later.The diameters of aneurysms and aspect ratio between the two groups were compared with independent t test,while neck of aneurysms and follow-up time were compared with two-independent samples Mann-Whitney U test.The other variables including history of hypertension,type 2 diabetes,smoking et al between the two groups were analyzed by x2 test.The sensitivity and specificity of aspect ratio for diagnosis of pulsation were analyzed by receiver operating characteristic (ROC) curve.Results Pulsation was observed in 28 of the 62 URCAs.Aspect ratios in whose pulsation was or was not detected were 1.5±0.3 and 1.1±0.3,respectivelyThe difference between the two groups was statistically significant (t=-2.274,P＜0.001).The sensitivity and specificity of the aspect ratio were 75.0％ and 70.6％.After follow-up more than 3 months,of the 28 URCAs in which pulsation was observed,11 showed a change in shape,while in 34 URCAs without visible pulsation,5 showed a change in shape.The aneurysms with detectable pulsation were more likely to show a change in shape (x2=4.891,P=0.027),with an odds ratio of 3.753.Conclusions URCAs with a large aspect ratio are easily to show the pulsation by ECG gated 4D-CTA.Besides,the aneurysms with visible pulsation are more likely to show a change in shape after follow-up,which suggests a higher risk of rupture.

Animals ; Arteriosclerosis ; drug therapy ; Cholesterol, LDL ; blood ; Drugs, Chinese Herbal ; pharmacology ; Hyperlipidemias ; drug therapy ; Lipids ; blood ; Lipoproteins ; blood ; Lipoproteins, LDL ; blood ; Male ; Rabbits ; Tablets ; Triglycerides ; blood

OBJECTIVEWilms' Tumor Trial (WT-99) of Shanghai Children's Medical Center was designed and conducted by applying therapeutic regimens stratified by stage and histology in accordance with National Wilms' Tumor Study (NWTS) criteria of U.S.A. The main aim of WT-99 was to reduce treatment of low-stage, favorable-histology (FH) tumors without impairing survival and to improve prognosis of stage III and IV (FH) and unfavorable-histology (UFH) tremors with more intensive chemotherapy.

METHODSDiagnosis and treatment was decided by the multi-disciplinary team including oncologists, surgeons, pathologists, radiologists and diagnostic radiologists. Twenty consecutively diagnosed patients were recruited between October 1998 and October 2002. The regimen for patients at favorable-histology (FH) stage I and II and anaplastic stage I was vincristine (Vcr) and dactinomycin (Act-D) only, while for those at focal anaplastic stage II to IV and FH stage III and IV the regimen was Vcr, Act-D and adriamycin (Adr). Patients at diffuse anaplastic stage II to IV and clear cell stage I to IV received four-drug regimen including Vcr, etoposide (VP16), Adr and cytoxan (CTX). For those at rhabdoid stage I to IV the regimen was carboplatin, VP-16 and CTX. Un-resectable patients received 2 courses of Ifosfamide, Vcr and VP-16 as pre-surgery therapy. No radiation therapy was used for patients at stage I and FH stage II.

RESULTSTwenty patients, from 7 months to 12 years old, were enrolled. Pathologic analysis showed fourteen cases were at their FH, three at unfavorable-histology (UFH), two at clear cell and one at rhabdoid stage. Five patients were at stage I, five at stage II, six at stage III, three at stage IV and one at stage V. Eighteen reached complete response (90%), and two failed. One relapsed after 24 months of CCR and reached the second CR after intensive chemotherapy. No therapy-related death happened. Survival rate (SR) was 90% (18/20) and event-free survival (EFS) was 85% (17/20) at 11-45 months, average 27 months.

CONCLUSIONMulti-disciplinary team work model and protocol WT-99 are safe and effective for Wilms' tumor.

Academic Medical Centers ; Bone Transplantation ; Child ; Child, Preschool ; China ; Combined Modality Therapy ; Female ; Humans ; Infant ; Kidney Neoplasms ; classification ; therapy ; Male ; Neoplasm Staging ; Transplantation, Autologous ; Treatment Outcome ; Wilms Tumor ; classification ; therapy

OBJECTIVETo investigate the effects of adenovirus-mediated PTEN and P27 on the invasion of PC-3 in vitro and angiogenesis, along with their synergy in the treatment of prostate cancer.

METHODSRecombinant adenovirus vectors of the human tumor suppressor genes PTEN and P27 were constructed. The replication-incompetent recombinant adenovirus was packaged and propagated in HEK293 cells. The viral titer was examined by plaque assay and the mRNA and protein expressions of PTEN and P27 in human prostate cancer cell line PC-3 infected with Ad-PTEN and Ad-P27 were determined by RT-PCR and Western blot respectively. The invasion of PC-3 cells in vitro was examined by Boyden chamber assay. MTT assay was used to testify the effect of supernatant from PC-3 infected with Ad-PTEN and Ad-P27 on the proliferation of endothelial cells ECV-304 and the CAM test was used to testify the effect of PTEN and P27 on angiogenesis. The difference between the combined therapy group and the single gene therapy group was also examined.

RESULTSThe viral titers of Ad-PTEN and Ad-P27 were 1.8 x 10(7) pfu/ml and 1.2 x 10(9) pfu/ml respectively. Adenovirus infection verified that the mRNA and protein expression of PTEN and P27 were steady in human PC-3 cells. The invasion in vitro of PC-3 cells was significantly inhibited by infection with Ad-PTEN or/and Ad-P27. CAM and MTT assays of ECV-304 confirmed that the supernatant from PC-3 cells infected with Ad-PTEN or/and Ad-P27 could inhibit the angiogenesis effectively. There was a significant difference between the combined therapy group and the single gene therapy group.

CONCLUSIONThe combined gene therapy of Ad-PTEN and Ad-P27 plays a synergistic role in inhibiting the invasiveness of PC-3 cells and angiogenesis.

Adenoviridae ; genetics ; Cell Line, Tumor ; Cyclin-Dependent Kinase Inhibitor p27 ; genetics ; Humans ; Male ; Neoplasm Invasiveness ; PTEN Phosphohydrolase ; genetics ; Prostatic Neoplasms ; blood supply ; pathology ; Transfection

Objective:To study the correlation between the occurrence of diabetes mellitus complicated with erectile dysfunction (DMED) and serum fibroblast growth factor-21 (FGF21) level, analyze the role of FGF21 in the occurrence of DMED, and explore its predictive and diagnostic value for DMED.Methods:61 male patients with type 2 diabetes in Tai′an Central Hospital from January 2017 to June 2018 were selected as subjects. They were divided into 2 groups: DMED group ( n=30) and type 2 diabetes mellitus group (DM group, n=31). And 32 healthy persons were selected as control group. The general data of all subjects were collected, physical examination, genital examination and blood sampling were carried out for biochemical analysis. The erectile function was measured by International Erectile Function Index-5 (IIEF-5) questionnaire, and serum FGF21 level was detected by automatic biochemical analyzer. The correlation between IIEF-5 score with FGF21 and other indicators were analyzed by Spearman correlation analysis. Multiple linear regression analysis was used to analyze the related risk factors affecting DMED. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of FGF21 level for DMED. Results:(1) The serum level of FGF21 in the DMED group, DM group, control group were (112.5±9.2)pg/ml, (103.9±6.2)pg/ml and (91.9±3.9)pg/ml respectively, with significant differences (all P<0.05). (2) Spearman correlation analysis showed that IIEF-5 score was negatively correlated with FGF21, age, smoking, drinking, systolic blood pressure, diastolic blood pressure, glycated hemoglobin A1c (HbA 1c), fasting plasma glucose (FPG), total cholesterol (TC), total glyceride (TG), low density lipoprotein cholesterol (LDL-C), fasting insulin (FINS), homeostasis model insulin resistance index (HOMA-IR), and positively correlated with high density lipoprotein cholesterol (HDL-C) and testosterone( all P<0.05). The serum FGF21 level was positively correlated with smoking, drinking, systolic blood pressure, diastolic blood pressure, HbA 1c, FPG, TC, TG, LDL-C, FINS, HOMA-IR, and negatively correlated with HDL-C and testosterone ( P<0.05). (3) Multiple linear regression analysis showed that FGF21, HbA 1c, HOMA-IR and IIEF-5 were independent risk factors for erectile function (all P<0.05). (4) According to ROC curve, when the optimal cutoff value of FGF21 level was 102.75 pg/ml, the predictive sensitivity and specificity for DMED were 0.867 and 0.714, respectively. Conclusions:Serum FGF21 level is closely related to the occurrence of diabetes mellitus and DMED, which is an independent risk factor of DMED.

Ketamine is a phencyclidine derivative acting primarily as a noncompetitive antagonist of N-methyl-D-aspartate (NMDA) excitatory glutamate receptors. As a common intravenous anaesthetic in clinic, it is also increasingly abused because of its hallucination and addiction effects. Based on the pharmacological and toxicologic characteristics of ketamine and the acknowledged addiction mechanism of other abused drugs, this article reviews the possible addiction mechanism of the ketamine in the aspects of its enhanced effects and reward systems, the anatomic structures, the related receptors and the individual differences.
Anesthetics, Dissociative/adverse effects* ; Animals ; Brain/drug effects* ; Humans ; Illicit Drugs ; Ketamine/adverse effects* ; Mental Disorders/chemically induced* ; Rats ; Receptors, Dopamine/drug effects* ; Receptors, N-Methyl-D-Aspartate/drug effects* ; Substance-Related Disorders

Schizophrenia is one of the common mental diseases. Because the mechanism of the schizophrenia is significantly complicated, the cause is still unknown. N-methyl-D-aspartate receptor antagonist can simulate the positive and negative symptoms, as well as the cognitive disorder of schizophrenia. Thus it has been widely used to establish the animal models of schizophrenia. The relationship of the three blocking agents of ion channels (phencyclidine, MK-801, ketamine) and the establishment of schizophrenia animal models is reviewed in this article.
Animals ; Behavior, Animal/drug effects* ; Brain/physiopathology* ; Consciousness Disorders/physiopathology* ; Disease Models, Animal ; Dizocilpine Maleate/pharmacology* ; Excitatory Amino Acid Antagonists/pharmacology* ; Humans ; Ketamine/pharmacology* ; Mice ; Phencyclidine/pharmacology* ; Rats ; Receptors, N-Methyl-D-Aspartate/antagonists & inhibitors* ; Schizophrenia/physiopathology*