Objective To explore the diagnostic value of Reid Scores under colposcopy in cervical human papillomavirus (HPV)infection. Methods Cervical biopsy under colposcopy was carried out for cervical diseases in 528 patients.With pathological findings as criteria,the value of Reid Scores under colposcopy in diagnosis of HPV infection was analysed.Results The coincidence of Reid Scores under colposcopy in diagnosis of HPV infection and cervical intra-epithelial neoplasia(CIN)was 52.66%,with the sensitivity of 51.05%in diagnosis of low-grade cervical diseases(HPV infection and CIN I)and that of 66.67%in diagnosis of high-grade cervical diseases(CIN Ⅱ and CIN Ⅲ).For the patients with diagnosis of HPV infection examined by pathology,the scores of items of boundary,color and vessels were positively related to the total Reid Score,while the scores of items of boundary and color were not related to that of vessels. Conclusion There may exist clinical significance in diagnosis of HPV infection by colposcopy in combination with RCI Scores.

Systemic lupus erythematosus(SLE)is an autoimmune disease that affects primarily women,commonly in their reproductive years but does not influence fertility.More recent prospective studies indicate that pregnancy is safe for the majority of mothers if it is planned when SLE is quiescent.In pregnant women with lupus nephritis,the outcome of the fetal and maternal is strongly correlated with lupus activity,kidney function and the presence of aPL at the time of conception.To prevent renal complications,prednisone is given after conception,and reinforcement for a few days before the estimated delivery and for a week after delivery or miscarriage with rapid tapering to maintenance levels may be suggested.Treatment of flares includes corticosteroids,hydroxychloroquine,azothioprine and cyclosporin A.Blood pressure is controlled with methyldopa,labetalol nifedipine or hydralazine.

OBJECTIVE:To develop an HPLC Method for the determination of the content of nilestriol in nilestriol vaginal gel.METHODS:The chromatographic separation was carried out on column Hypersil ODS,the mobile phase consisted of methanol-water (80∶20),the detection wavelength was 221 nm,the flow rate was 1.0 mL?min-1 and the injection volume was 20 ?L.RESULTS:The calibration curve was linear in the range of 20.06～200.6 ?g?mL-1 (r=0.999 9),the lowest detection limit was 3.41 ?g?mL-1 and the lowest quantitative limit was 5.92 ?g?mL-1.The average recovery rate was 100.8% (RSD=1.2%).CONCLUSION:The method is simple,accurate and applicable for the determination of the content of nilestroil in nilestroil vaginal gel.

Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Endosonography ; Humans ; Lymph Node Excision ; Neoplasm Staging ; Pancreatectomy ; methods ; Pancreatic Neoplasms ; diagnosis ; pathology ; surgery ; Tomography, X-Ray Computed ; methods

Objective To investigate the current policy of medical insurance expenditure control in Shanghai and put forward feasible advice. Methods Survey in 5 tertiary first-class hospitals in Shanghai involving 400 doctors and patients was conducted.The result of the questionnaire was tracked with Microsoft Excel 2000.The expense reports during 2001 to 2006 from the Office of Medical Insurance of Shanghai Renji Hospital was collected.All the data were statistically analysed. Results The global budget system was accepted by both the doctors and patients.Charging based on disease categories was proved a relatively satisfying method.Drug expenditure control was concerned by both the doctors and patients. Conclusion Ever since the global budget system of medical insurance is implemented in Shanghai,the medical insurance expenditure has been effectively controlled.The key point is the restraint of irrational consumption during the medical treatment.

Objective To observe the effect of short-term treatment with metfbrmin on psychological distress and metabolic feature in patients with polycystic ovary syndrome(PCOS).Methods Ninety women were diagnosed as cases of PCOS based on the 2003 Rotterdam criteria.These patients were divided into three groups:group A,consisted of 26 subjects treated with mefformin only; group B,36 cases treated with metformin plus Dane-35 ; and group C,28 cases treated with placebo and Dane-35.The treatment was carried out for 3 months.Clinical and metabolic parameters were observed.The psychological distress was evaluated by the hospital anxiety and depression scale(HAD scale).Results Compared with group C,patients in group A and B showed significantly lower body mass index(BMI),waist circumference (WC),waist-hip ratio (WHR),serum fasting insulin,homeostasis model assessment for insulin resistance (HOMA-IR),total cholesterol (TC),triglyceride (TG),low density lipoproteincholesterol(LDL-C) levels as well as anxiety and depression scores,but higher high density lipoprotein-cholesterol (HDL-C) levels (all P＜0.05).Compared with group A,patients in Group B had significantly higher WC,WHR,and LDL-C levels(all P＜O.05).No significant differences in BMI,TG,HDL-C,anxiety and depression scores were found between group A and B (all P＞0.05).In group A,a positive correlation was found between the changes of metabolic feature (BMI,WHR,and HOMA-IR) and the changes of anxiety and depression scores (all P ＜0.05).Conclusion Short-term treatment with metformin will benefit patients with polycystic ovary syndrome,regarding psychological distress and metabolic features.

BACKGROUND: As a kind of unwounded biomagnetism technique, magnetoencephalography (MEG) relfects immediate information of cerebral function by using magnetic source imaging through recording changes of magnetic field of neurocytes under different functional status.OBJECTIVE: To investigate the practicability of magnetoencephalography (MEG) imaging in localizing sensory-motor cortex for brain tumour surgery in 36 patients.DESIGN: Observational study.SETTING: Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICTPANTS: From Janury 2003 to April 2006, 36 patients (17 male and 19 female) with brain tumors selected from Deparment of Neurosurgery, Guangdong 999 Brain Hospital underwent surgery with MEG-guided neuronavigation in the region of the sensory and motor cortex. Ages of the patients ranged from 13 to 70 years. Among the 36 patients, 14 with gliomas (including 5 highly malignant gliomas), 19 with meningomas, 1 with spongy angioma and 2 with adenocarcinoma (due to the metastasis of brain tumor). All patients and relatives provided the confirmed consent and the experiment provided by the local ethics committee.METHODS: A 148-channel biomagnetometer (4-D Neuroimaging, USA) was used to determine motor and/or senory cortex with sampling rate 678.17 Hz, high-pass filter 1.0 Hz and bandwith 200 Hz. MRI images were acquired using a Philips Gyroscan Intera 1.5T MR tomography. And then, the functional maps were transfered to the neuronavigation system for the treatment of brain tumor. All patietns followed up by further consultation and telephone call in 2-26 months after operation.MAIN OUTCOME MEASURES : Operative outcome and prognosis.RESULTS: MEG demonstrated that the tumor lesion changed the sensory-motor cortex in various degrees for the 36 patients. Brain tumors were resected completely in 34 cases. At 2-26 months after surgery, neurological deficits fully recovered in 19 cases, unchanged in 15 cases and deteriorated in 2 cases.CONCLUSION: MEG was found to be practical and useful in localizing sensory-motor cortex and brain tumor. It is a valuable non-invasive method for presurgical planning in the treatment of brain tumors.

Objective To study the effect of carvedilol on heart rate variability and plasma N-terminal brain natriuretic peptide(NT-proBNP) in patients with chronic heart failure.Methods 106 patients with chronic heart fail-ure were randomly divided into the two groups ..53 patients in the control group were treated by the conventional ther-apy plus metoprolol ,while 53 patients in the observation group were treated by the conventional therapy plus carve -dilol.They were treated for six months .Heart rate variability and plasma NT-proBNP were measured before and after treatment in the two groups .Results The total effective rate of the control group was 83.0%,which was significantly lower than 94.3% of the observation group (χ2 =6.26,P<0.05).Before treatment,SDNN,SDANN,RMSSD and PNN50 between the two groups had no significant differences (t=0.284,0.360,0.410,0.302,all P>0.05).After treatment,SDNN,SDANN,RMSSD and PNN50 were significantly increased (t=3.095,9.184,3.622,4.302,2.261, 4.522,2.921,2.992,P <0.05 or P <0.01).Compared with the control group,those in the observation group increased more significantly (t=8.065,3.116,3.209,2.171,P<0.05 or P<0.01).After treatment,plasma NT-proBNP were significantly decreased in the two groups (t=7.093,9.773,all P<0.01).Compared with the control group,plasma NT-proBNP of the observation group decreased more significantly (t=4.773,P<0.01).Conclusion Carvedilol can more significantly improve heart rate variability and plasma NT-proBNP in patients with chronic heart failure.

Glucocorticoids have remained important anti-inflammatory agents in the treatment of chronic kidney disease (CKD).However,the use of glucocorticoids can invoke or enhance insulin resistance,which is closely associated with renal injury and serves as an independent risk of the occurrence and progression of CKD.On the other hand,CKD patients may have insulin resistance,which hampers the use of glucocorticoids in these patients.