Objective To investigate the clinical effect of mifepristone in treatment of perimenopausal dysfunctional uterine bleeding.Methods 80 cases of patients with perimenopausal dysfunctional uterine bleeding were selected and randomly divided into control group and research group,with 40 cases in each group.The control group was in the diagnosis of curettage after 10 days of oral provera 10mg every night before going to bed,stopped drug application in 14 days,15 days to retreat hemorrhages oral provera 10mg/day,stayed for 10 days,repeated drug use 5 months.The research group was treated with oral mifepristone every night before going to bed since cleaning up the uterus,12.5mg,for 6 months.Outpatient follow -up for 6 months,the recent curative effect,long -term curative effect,hormone level changes,anemia and adverse drug reactions were observed.Results The total effective rate of the research group was 95.0%,which of the control group was 82.5%,there was statistically significant difference(χ2 =7.82, P =0.005);The recurrence rate of the research group was 5.0%,which of the control group was 15.0%,there was statistically significant difference(χ2 =5.56,P =0.018).The FSH,LH,E2 and P of the two groups were decreased, but which of the research group were lower significantly than those of control group,the differences were statistically significant (all P <0.05).The decreased degree of endometrium in the research group was larger than that of the control group,the difference was statistically significant(P =0.0001).Conclusion Treatment of mifepristone perimenopausal dysfunctional uterine bleeding is significant,safe and convenient,which is worthy of clinical application.

Objective Exploring different strengthening immune strategy on long-term immune memory effects for tuberculosis vaccine lays the theoretical foundation.Methods The fusion protein AMM,adjuvant DDA and BCG-PSN mixed built AMM subunit vaccine.Choose only 50 C57BL/6 mice (SPF),according to the table of random number method was divided into 5 groups and each group 10 only,the experiment 1 group injected mice to phosphate buffer solution (PBS) as control; Experiment 2 mice only injected BCG vaccine (BCG) from early; Experiment 3 mice BCG initial free,in 10 weeks with AMM subunit vaccine strengthen immunity; The four mice from early after BCG,respectively on 8 weeks,10 weeks with AMM subunit vaccine strengthen immune mice one time.Experimental 5 groups of mice after BCG initial free,respectively on 6 weeks,8 weeks,10 weeks with AMM subunit vaccine strengthen immune mice a.28 weeks to remove spleen lymphocytes in mice,add 2.5μg/ml Ag85B stimulus 72 h after collecting spleen cell culture supernatant,with ELISA test Ag85B specificity splenic lymphocyte caused IFN ppar-gamma level.Results Spleen cells by antigen Ag85B stimulation,BCG initial free,AMM subunit vaccine strengthen immune once,twice,three times group and PBS compared all had difference (P ＜0.01 orP ＜0.05) ;BCG initial free-AMM subunit vaccine strengthen immune once,twice,three times group and BCG compared all had difference (P ＜0.01 or P ＜0.05) ; BCG initial free-AMM subunit vaccine strengthen immune once and twice or three times group compared with difference (P ＜0.01 orP ＜0.05) ; Initial free-AMM subunit vaccine strengthen immune two group and three times than group difference was statistically significant (P ＞0.05).Conclusion Mice strong immune strengthened the number is not the more the better,the appropriate number of strengthen the immune to induce the most lasting immunity memory,subunit vaccine strengthen immunization strategy may affect the immune memory is one of the important factors.

Objective The purpose of study was to investigate the differences in the value of urine acute kidney injury ( AKI) biomarkers in the diagnosis and prognosis of AKI in patients with or without acute respiratory distress syndrome ( ARDS ) . Methods We collected the clinical data about 304 ICU patients, in-cluding 105 ARDS (49 in the lungs and 48 outside the lungs) and 199 non-ARDS cases.Using ELISA, we determined the levels of uN-GAL, uL-FABP, uKIM-1, and uIL-18 in the first 48 hours, compared the clinical data and AKI biomarkers between different groups of patients.We analyzed the differences in the diagnostic value of the AKI biomarkers using the ROC curve and their value in predicting hospital mortality by logistic regression analysis. Results Compared with the patients without AKI, the AKI cases exhibited a signif-icantly increased level of uKIM-1 (1.02 [0.57, 3.01] vs 4.68 [54.74, 270.54], P=0.000) in the ARDS group and that of uL-FABP in the non-ARDS group (102.69 [37.98, 348.09] vs 53.52 [10.86, 141.39], P=0.009).In the ARDS group, the area under the ROC curve (AUC) for the combined efficiency of the four AKI biomarkers was 0.81 (95% CI 0.70-0.92), markedly higher than that of uNGAL (0.57 [95%CI 0.43-0.70]), uL-FABP (0.55 [95%CI 0.39-0.71]), and uIL-18 (0.56 [95%CI 0.40-0.72]) alone (P<0.05), so was the AUC for the combined efficiency of the four biomarkers than that of each biomarker alone in the patients with ARDS in or outside the lungs (P<0.05).The OR value of uKIM-1 for predicting hospital mortality was 1.529 (95%CI 1.148-2.036) in the ARDS group, 1.593 (95%CI 1.070-2.369) in the patients with ARDS in the lungs, and 1.512 (95%CI 1.005-2.274) in those with ARDS outside the lungs. Conclusion There were differences of diagnostic and predictive value of Urine AKI biomarkers have different values in the diagnosis and prognosis of AKI in ARDS and non-ARDS patients and in those with ARDS in or outside the lungs.

In order to explore the chemical constituents of Sarcandra glabra (Thunb.) Nakai, 10 compounds were isolated and identified from the water extraction of fresh aerial parts of Sarcandra glabra by silica gel column chromatography, polyamide column chromatography, gel column chromatography, and preparative high-performance liquid chromatography, including 2 elemane-type sesquiterpenoid glycosides, 6 violet ketone sesquiterpenoid glycosides, and 2 phenolic acid compounds. Based on their physicochemical properties and NMR data, the above compounds have been identified as sarcaglaboside C (1), sarcaglaboside D (2), byzantionoside B (3), lauroside E (4), (4Z)-4-[(3S)-3-(β-D-glucopyranosyloxy)butylidene]-3,5,5-trimethyl-2-cyclohexen-1-one (5), dihydrovomifoliol-O-β-D-glucopyranoside (6), (+)-abscisyl-β-D-glucopyranoside (7), 9ξ-O-β-D-glucopyranosyloxy-5-megastigmen-4-one (8), rosmarinic acid methyl ester (9) and methyl isorinate (10). Among them, compounds 3 - 5 and 8 - 9 were firstly isolated from S. glabra. The discovery of these compounds further enriches the structural types of compounds in S. glabra plants and provides an important material basis for subsequent pharmacological activity research.

OBJECTIVETo lay a foundation for the study on good variety selection of Isatis indigotica, comparison of plant traits and quality evaluation of Isatis germplasm resources from different production area was conducted.

METHODField cultivation and randomized block experiment were adopted to compare those plant traits of leaf, root, silique and seed of Isatis from different production area and the content of R,S-goitrin and polysaccharide in the root was determined.

RESULTDifferent cultivation forms of Isatis had significant difference from each other in leaf, root, silique and seed, content of R,S-goitrin and polysaccharide in the root were also different. R,S-goitrin content in Isatis of Chinese cabbage leaf type ( production area: Yunnan ) was comparative higher, 0.59% , while polysaccharide content in autotetraploid Isatis was comparative higher, 8.68%.

CONCLUSIONAccording to the plant traits, Isatis were classified into three types: Chinese cabbage leaf type, cabbage leaf type and mustard leaf type, of which R,S-goitrin content in Chinese cabbage leaf type (production area: Yunnan) was comparative higher, while polysaccharide content in autotetraploid Isatis was comparative higher.

China ; Drugs, Chinese Herbal ; analysis ; Isatis ; chemistry ; growth & development ; Phenotype ; Plant Leaves ; chemistry ; growth & development ; Plant Roots ; chemistry ; growth & development ; Seeds ; chemistry ; growth & development

Objective: To understand the epidemiological characteristics and differences of HIV-positive cases among 15-24 years old in Jiaxing city and provide evidence for the development of targeted prevention and control measures. Methods: A descriptive epidemiological method was used to analyze the data of HIV cases aged 15-24 reported in Jiaxing from 1999 to 2018. Results: A total of 375 cases of young HIV were reported in 1999-2018, with an average age of 21.29±1.90 years, of which 42 were students. The ratio of male to female was 2.47∶1. The proportion of foreign household registration was higher (76%, 285 cases). The proportion of off-campus youth cases in total cases showed a downward trend(χ2=8.26, P=0.00), but the proportion of student cases showed an upward trend(χ2=15.73, P<0.01). Off-campus youth cases were mainly heterosexual transmission(59.16%, 197 cases), and the students’ cases were mainly homosexual transmission(88.10%, 37 cases). There were significant differences in gender, age, household registration, education level, route of transmission, late detection, CD4 level and source of detection among students and off-campus adolescents(P<0.05). Conclusion The prevalence of AIDS in adolescents and students is worthy of attention. The characteristics of adolescents inside and outside the school are different. Targeted prevention measures should be taken to reduce the harm of AIDS to young people.

Objective To analyze the etiology and prognosis of severe complications of percutaneous nephrolithotomy (PCNL).Methods The clinical data of patients with severe complications after PCNL from December 2004 to December 2015 were retrospectively analyzed.Age of the patients ranged from 25 to 69 years old,with an average of 41 years.There were 64 cases with 29 male and 35 female.Fifty-five cases were diagnosed as renal calculi,including 21 cases of left renal calculi,19 cases of right renal calculi;15 cases of bilateral renal calculi;2 cases of the patients were bilateral upper ureteral calculi;7 patients were renal calculi upper ureteral calculi on the other side.In all cases,the maximum diameter of calculus was 1.8-4.3 cm (mean 2.6 cm) and hydronephrosis depth was 0-5.9 cm (mean 2.3 cm);15 cases were previously treated with nephrolithotomy.The modified Clavien grading system was used to evaluate surgical complications,and ≥grade Ⅲ complications were considered as serious complications.Results Among the 64 cases,28 cases were classified as Clavien Ⅲ class.There were 2 cases of bleeding in operation due to renal parenchyma laceration or multiple access,patients were treated with later open surgery.Postoperative bleeding were revealed in 22 cases,16 of which were hemorrhage from the nephrostomy tubes,4 of which complained of discontinuity gross hematuria and 2 postoperative bleeding were encountered during the nephrostomy tube remove.All the cases received renal arteriography and were diagnosed with pseudoaneurysm,bleeding were stopped after embolization.3 cases of pleural injury were treated with closed thoracic drainage,1 colon injury was treated with open colostomy.There were 32 cases of urinary sepsis considered as Clavien Ⅳ complications,and these patients were transferred to the Intensive Care Unit.Clavien Ⅴ class 4 cases:1 died of hemorrhagic shock due to pleural injury,2 cases died of urinary sepsis and multiple organ failure and another case died of pulmonary embolism.Conclusions PCNL has high risk of serious complications,which should be always strictly follow the principles.Adequate preoperative preparation,appropriate surgery access,carefully and gently operate,appropriate antibiotic use and postoperative management are the key measures to reduce the incidence of complications.

Objective: To explore the effects of miR-124-ROCK1 signal pathway in the damages of glomerular endothelial cells (GEnCs) induced by high glucose. Methods: Rat glomerular endothelial cells were cultured in different glucose concentrations: normal control group (NG: 5.5 mmol/L), high glucose group (HG: 30.0 mmol/L), and cells were treated with ROCK1 inhibitor Y27632, miR-124-3p mimic, miR-124-3p inhibitor. The expressions of ROCK1 activity, cell apotosis and tight junction proteins were detected by Western blot. The cell tight junction protein ZO-1 in those groups were assessed by laser scanning confocal microscope. Results: High glucose significantly decreased miR-124 expression (P<0.01), ROCK1 activity (P-MYPT1/MYPT1), and cell apoptosis (Cleaved-Caspase3/pro-Caspase3) were found increased while the tight junction proteins ZO-1and Occludin were found decreased in these cells (P<0.05 all P<0.01), However, when pretreated cells with ROCK1 inhibitor Y27632, these injuries were significantly reversed. In cells transfected with miR-124-3p mimic, p-MYPT1/MYPT1 was decreased. p-MYPT1/MYPT1 was however increased in cells transfected with miR-124-3p inhibitor (P<0.05), indicating that miR-124 could directly inhibit ROCK1 activity. The increased ROCK1 activity and apoptosis, as well as the decreased tight junction proteins induced by high glucose were significantly suppressed as miR-124-3p mimic transfected in GEnCs. Conclusions According to our experiments, high glucose suppressed miR-124 in glomerular endothelial cells, consequenctly activating ROCK1 activity to damage endothelial cells. MiR-124 overexpression could ameliorate these damages induced by high glucose, suggesting that miR-124 might be a new therapeutic target to prevent glomerular endothelial cells injuries in diabetic nephropathy.

With the appearance of direct-acting antivirals (DAAs), breakthroughs have been achieved in the antiviral therapy for hepatitis C and hepatitis C patients can be cured completely. Due to the insidious onset of hepatitis C, most patients do not know their own conditions, and thus expanding diagnosis and treatment through screening is the key to the elimination of hepatitis C. However, hepatitis C virus is distributed widely and unevenly in the world, which results in difficulties in the screening and diagnosis of hepatitis C. This article introduces the current economic research on hepatitis C screening, analyzes the factors affecting the cost-effectiveness of hepatitis C screening, and shares the strategies and advances for hepatitis C elimination in other countries, so as to provide a reference for eliminating hepatitis C in China.

Purpose To explore the clinicopathologic fea-tures of Epstein-Barr virus-positive inflammatory follicular den-dritic cell sarcoma(EBV+IFDCS).Methods The clinico-pathologic features of 9 cases of EBV+IFDCS were retrospective-ly analyzed and followed up.Results The age of 9 patients with EBV+IFDCS ranged from 22 to 78 years(mean 44.7 years).7 cases occurred in the liver and 2 in the spleen.Fi-brinoid degeneration and hyaline degeneration in the vessel walls(6/9),eosinophilic infiltration(3/9),and epithelioid granulo-mas(2/9)were seen in some cases.The tumor cells expressed CD21(7/9),CD23(8/9)and CD35(9/9),partially ex-pressed SMA(6/9)and D2-40(1/9).It was noteworthy that 2 cases from the spleen accompanied by high expression of IgG4 plasma cells(80-135/10 HPF),and in the liver(0-36/10 HPF).All cases were followed up for 3-84 months,with 6 pa-tients disease-free,2 patients underwent metastasis,1 patient lost of follow-up.Conclusion EBV+IFDCS is a rare low-grade malignant tumor.EBER in situ hybridization and immunohisto-chemical detection play important roles in the diagnosis and dif-ferential diagnosis of EBV+IFDCS.Surgical resection is the main therapeutic intervention for EBV+IFDCS,and patients re-quire long-term post-surgical follow-up.