Objective By analyzing the cesarean delivery rate (CDR) and the indications of cesarean section in Jiangsu Province from 2012 to 2014, to find the strategy to reduce CDR.Methods Data of 40 hospitals whose number of delivery was over 2 400 per year from the database of the Quality Control Center of Gynecology and Obstetrics of Jiangsu Province from 2012 to 2014 were selected.The cohort was divided into two groups, one was specialized hospital including 11 maternal and child health hospitals and the other included 29 general hospitals.After analyzing the current status of cesarean section of the whole province, the average CDR and the distribution of the first indications of cesarean section in two groups were compared using Chi-square test.Results The average CDRs at year 2012, 2013 and 2014 were 53.8％(96 347/178 970), 51.8％ (97 509/188 142) and 48.8％(106 323/217 877), which had a trend of decrease (x2=1 026.2, P ＜ 0.01).CDR without medical indications for each year were 15.7％ (28 098/178 970), 15.5％ (29 162/188 142) and 12.8％ (27 888/217 877).The rate had decreased apparently from both 2012 and 2013 to 2014 (x2=217.6, P ＜ 0.01;x2=341.3, P ＜ 0.01).The CDRs of specialized hospitals for year 2012, 2013 and 2014 were 51.2％ (45 496/ 88 916), 50.6％ (45 853/90 607) and 49％ (55 404/113 105), while the CDRs of general hospitals for each year were 56.6％(50 851/90 054), 53.0％(51 656/97 535) and 48.6％(50 919/104 772).Both showed significant decreasing trend (x2=105.8 and 1 215.7, both P ＜ 0.01).The average CDR of general hospitals was obviously higher than that of specialized hospitals in 2012 and 2013 (x2=505.6 and 104.3, both P ＜ 0.01).However, the difference disappeared in 2014 (x2=3.2, P ＞ 0.05).The three main first indications of cesarean section were associated and postoperative pregnancy complications, and no medical indications.Interestingly, from 2012 to 2014, the CDR for scarred uterus in specialized hospitals raised from 5.4％ to 20.3％, and that in general hospitals increased from 6.7％ to 21.6％, which became the first.Conclusions The average CDR in Jiangsu Province tends to decrease each year, so does the CDR without medical indications.The first indication of cesarean section is associated or postoperative pregnancy complications, while scarred uterus becomes the most common in cesarean section.

Objective To evaluate the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in combination with flow cytometry (FCM) in lymphoma.Methods From January 2011 to December 2011,the cases of suspicious lymphoma with EUS-FNA examination at Shanghai Ruijin Hospital were retrospectively analyzed.The final diagnosis was according to pathological diagnosis of specimen from the surgery and follow up results.The sensitivity,specificity and accuracy of EUS-FNA combined with FCM in lymphoma diagnosis were initially analyzed.Results A total of 14 suspicious lymphoma patients were collected,eight cases were diagnosed as lymphoma by pathological examination of specimen from the surgery or.tissue from aspiration,four cases were non-lymphoma lesions and two cases still had no final diagnosis.The sensitivity and specificity of FCM alone in lymphoma diagnosis were 4/8 and 4/4 respectively.Six cases of lymphoma were detected by EUS-FNA with FCM.The sensitivity,specificity and accuracy of EUS FNA combined with FCM were 6/8,6/6 and 10/12 respectively.Conclusion EUS-FNA combined with FCM has better diagnostic value in lymphoma,especially for gastrointestinal lymphoma and those surrounding deep lesions.

Neurodegenerative diseases are threating our health seriously.Inflammation plays an important role in the initiation and development of neurodegenerative diseases, and its primary characteristics are the activation of microglia and the increasing level of inflammation cytokines.This review describes the relationship between neuroinflammation and several neurodegenerative diseases, and the models in vivo and in vitro.In addition, combining with traditional Chinese medicines knowledge of encephalopathy, we summarizes pharmacological effects and mechanisms of multiple herb extracts and monomer compounds in preventing the activation of microglia and inhibiting neuroinflammation, thus, to provide the basis for gradually revealing the related rules and characteristics of treating encephalopathy by traditional Chinese medicine, and improving the accuracy of the clinical drugs, as well as developing new drugs for the prevention and control of encephalopathy.

The fruit of Ziziphus jujuba was known as fine quality in the Shennong's Herbal. It is sweet in taste and mild in property with the effect of regulating the middle, invigorating the spleen, assisting twelve meridians, harmonizing stomach-qi, unclogging nine orifices, and moderating hundreds of herbs. In recent years, the efficacies of Ziziphus jujuba have been widely studied with considerable meaningful achievements. In this article, main research progresses in recent ten years were reviewed, which included resources, chemical components and pharmacological effects of Ziziphus jujuba. The research and development of medication, health care product and food with Ziziphus jujuba as its main ingredient were summarized for further references in related studies.

Objective To review the clinical diagnosis and treatment of acute focal renal infarction. Methods Three cases of focal renal infarction were reported and the literature was reviewed.The patients aged from 45 to 63 years with mean age of 54. Two cases had low back pain, 1 case with abdominal pain. Based on clinical history, B-ultrasonography and CT scan, focal renal infarction was diagnosed in 3 patients. There were 2 cases on left kidney and 1 case right. All cases were applied digital subtraction angiography (DSA) and thrombolytic anticoagulant therapy. Results Two cases received DSA and thrombolytic therapy. The other one case received pethidine 50 mg, progesterone 20 mg treatment, the salvia infusion and low molecular heparin 6000 U anticoagulant therapy. All patients had symtoms relieved after 1 d. A week later CT scan, 3 cases of renal infarction were apparently disappeared. Serum creatinine and urea nitrogen were normal. Three patients were followed, mean follow-up time was 1. 5 (0. 5-2) years. Conclusions The diagnosis of acute focal renal infarction mainly depends on B-ultrasound and CT. Early diagnosis and treatment is important for achieving recovery of the compromised renal function. Renal infarction should be suspected in the presence of abdominal pain of sudden onset.

Multi-drug resistance (MDR) is one of the major obstacles to successful chemotherapy for tumors. Traditional Chinese medicine that can reverse MDR has been intensely studied because of its low toxicity, high efficacy and multi-targets. In recent years, more and more traditional Chinese medicine (TCM) has been found to be effective in reversing MDR. In this review, we analyze the current status of traditional Chinese medicine on reversing tumor MDR and describe recent progress on it.
Drug Resistance, Multiple ; drug effects ; Drug Resistance, Neoplasm ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Medicine, Chinese Traditional ; Neoplasms ; drug therapy

OBJECTIVETo study the expression of nNOS and ultrastructural changes in the penile tissue of rats with prolactinoma-induced erectile dysfunction (ED).

METHODSWe established the model of prolactinoma in 20 male Westar rats by peritoneal injection of diethylstilbestrol (DES) and treated the control rats with normal saline (n = 10) or sterilized arachis oil (n = 10). After 8 weeks, we performed the apomorphine test and measured the weight of the pituitary gland and the levels of serum prolactin (PRL) and testosterone (T) to confirm the successful construction of the prolactinoma-induced ED model. Then we determined the expression of nNOS in the penile tissue by immunohistochemistry and examined the ultrastructural changes of the penile cavernosum under the transmission electron microscope.

RESULTSThe prolactinoma-induced ED model was successfully established in 15 rats. The weight of the pituitary gland was significantly increased in the rats treated with DES as compared with the normal saline and sterilized arachis oil controls ([46.7 ± 15.5] vs [11.7 ± 2.4] and [12.4 ± 2.3] mg, both P < 0.05). The level of serum PRL was markedly higher while that of T remarkably lower in the former than in the latter two groups ([1,744.9 ± 304.5] vs [11.5 ± 2.4] and [10.6 ± 1.9] ng/ml, both P < 0.0l; [1.54 ± 0.46] vs [3.11 ± 1.08] and [3.04 ± 1.11] ng/ml, both P < 0.05). The rate of penile erection was significantly reduced in the prolactinoma-induced ED model rats in comparison with the normal saline and arachis oil controls (16.7% vs 100% and 87.5%, both P < 0.05), and so was the expression of nNOS in the penile tissue (0.024 ± 0.011 vs 0.066 ± 0.019 and 0.058 ± 0.021, both P < 0.05). Transmission electron microscopy manifested significant ultrastructural changes in the endothelial and smooth muscle cells of the cavernous tissue in the prolactinoma-induced ED models.

CONCLUSIONThe ultrastructural changes of the penile cavernous tissue and the reduced expression of nNOS in penile tissue may be the most important mechanisms of prolactinoma-induced ED in rats.

Animals ; Apomorphine ; Carcinogens ; Diethylstilbestrol ; Erectile Dysfunction ; etiology ; Humans ; Male ; Myocytes, Smooth Muscle ; ultrastructure ; Nitric Oxide Synthase Type I ; metabolism ; Organ Size ; Penile Erection ; Penis ; enzymology ; ultrastructure ; Pituitary Neoplasms ; chemically induced ; complications ; Prolactin ; blood ; Prolactinoma ; chemically induced ; complications ; Rats ; Rats, Wistar ; Testosterone ; blood

The proliferation of tumor cells is regulated by a complex array of signaling pathways, among these signaling pathways,the programmed cell death. Autophagy and apoptosis are two types of programmed death. There are significant differences in their morphological and functional features, but they also have many links. Both apoptosis and autophagy are involved in activation,expression and regulation of a series of genes. By reviewing the research progress in recent years, this article will discuss the cellular regulation and molecular mechanisms of their related genes. Through summarizing the relationship between autophagy and apoptosis,it aims to get a better understanding of the mechanisms of autophagy and apoptosis in tumor progression,and looking at the perspectives for studies on the autophagy and apoptosis in tumor treatment.

This study discusses the effects of Shenlian extracts (SL) on M1 macrophages in atherosclerosis. The MTT assay was used to detect the growth inhibition rates of RAW264.7 cells. RAW264.7 cells were stimulated with murine interferon-gamma (IFN-gamma) plus lipopolysaccharide (LPS) to induce M1 macrophages. The different concentrations of SL extracts (high-dose 50 mg x L(-1), moderate-dose 25 mg x L(-1), low-dose 12.5 mg x L(-1)) were added. The CD86 of M1 macrophages in cell membrane was measured by flow cytometry. The mRNA expression of iNOS and TNF-alpha gene was detected by reverse transcription PCR (RT-PCR). And the supernatants were collected, the content of IL-6 and TNF-alpha were detected with ELISA kits. The results of this experiment show that the expression of the cell membrane molecule CD86, iNOS and TNF-alpha gene, the content of IL-6 and TNF-alpha was obviously increased in M1 macrophages by IFN-gamma and LPS. The different doses of SL extract could reduce the expression of the above indicators. The above experimental results demonstrate that IFN-gamma combined LPS can induce RAW264.7 cell to type into M1 macrophages, and SL extracts can inhibit M1 macrophages.
Animals ; Cell Line ; Cell Shape ; drug effects ; Cell Survival ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Interferon-gamma ; genetics ; immunology ; Interleukin-6 ; genetics ; immunology ; Macrophages ; cytology ; drug effects ; immunology ; Mice ; Tumor Necrosis Factor-alpha ; genetics ; immunology

OBJECTIVETo determine the value of the use of a pneumatic tourniquet in total knee arthroplasty.

METHODSSixty patients were prospectively randomized into 2 groups, one group underwent total knee replacement with a tourniquet (n = 30) and one without (n = 30). Operating time, blood loss, postoperative mean morphine requirement, swelling, ecchymosis, earlier straight-leg raising and postoperative knee flexion were measured in both groups.

RESULTSThere was no significant difference in the total blood loss between the 2 groups although the intraoperative blood loss was significantly greater in those without a tourniquet. The mean morphine requirement, postoperative swelling, scope of ecchymosis, earlier straight-leg raising and postoperative knee flexion in the patients that had surgery without a tourniquet were significantly better than those with a tourniquet.

CONCLUSIONKnee arthroplasty operation with the use of a tourniquet has only small benefits on the total blood loss, but hinder in patients' early postoperative rehabilitation exercises.

Aged ; Arthroplasty, Replacement, Knee ; Blood Loss, Surgical ; prevention & control ; Female ; Humans ; Male ; Prospective Studies ; Tourniquets ; adverse effects