Objective To investigate the efficacy of metholrexate combined with rmifepristone and laparoscopic surgery for treating ectopic pregnancy.Methods 85 patient with ectopic pregnancy were selected.41 cases treated with methotrexate and mifeprisione were considered as the control group,while 44 cases with laparoscopic surgery were considered as the observalion group on the voluntary basis.The clinical efficacy,serum β-HCG value and recovery time after 7d were compared between the two groups.Results After the treatment,the cure rate in the observation group was 100％ which was significantly higher than 90％ of the control group ( P ＜ 0.05 ),the serum β-HCG value of the observation group was lower and the restoration normal time was shorter than the control group ( P ＜0.05).Conclusions Laparoscopic surgery and conservative treatment of methotrexate combined with mifepristone are effective in the treatment of ectopic pregnancy.However,the clinical efficacy of the laparoscopic surgery is better and it has rapid recovery time,and it can completely cure the patients.

Objective To assess the curative effect and safety of endoscopic therapy at duodenum elevated lesions. Methods We retrospectively studied the clinical data including general data, the procedure of performance, the lesions pathological characters, complications and recurrence after the treatment of patients who underwent endoscopic treatment. Results 111 patients of 112 patients were treated by endoscopic treatment successfully, 1 case was treated by surgery. 49 lesions were treated by electrocoagulation, 36 lesions were treated by polypectomy or endoscopic mucosal resection (EMR), 27 by endoscopic submucosal dissection (ESD). Complication rate was 16.96%(19/112), 1 case of active bleeding was treated by surgery in hemostasis difficulty. 6 cases of perforation, 2 cases of delayed bleeding, 2 cases of transient increase in amylase level and 1 case of delayed perforation. All the patients were successfully performed. Post-operation follow-up period was 1~12 months. Conclusion Endoscopic treatment holds advantages of minimally invasive, quick recovery, low cost, and less risk which may be play an important role in duodenal elevated lesions.

OBJECTIVE:To investigate the effect of different processing methods on 4 kinds of flavonoids contents in salt-pro-cessed Cuscuta chinensis. METHODS:Salt-processed C. chinensis piece was processed with different baking temperature (70 ℃, 100℃,130℃,160℃,190℃and 210℃),baking time(10 min,15 min,30 min,45 min,60 min and 75 min)and moisten-ing time(0.5 h,1 h,2 h,4 h and 6 h). HPLC was adopted for contents determination of hyperoside,rutin,quercetin and kaemp-ferol:the column was Synergi 4u Hydro-Rp 80A with mobile phase of methanol- 0.1% phosphoric acid (gradient elution) at a flow rate of 1.0 ml/min,the detection wavelength was 360 nm,and column temperature was 35 ℃. RESULTS:The linear range was 0.416-12.48 μg for hyperoside (r=0.999 9),0.14-4.2 μg for rutin (r=0.999 9),0.185-5.55 μg for quercetin (r=0.999 9) and 0.078-2.34 μg (r=0.999 8);RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 95.55%-99.74%(RSD=2.12%,n=6),95.96%-101.42%(RSD=2.01%,n=6),95.76%-102.75%(RSD=2.77%,n=6), 99.42%-104.93%(RSD=2.02%,n=6). The flavonoids in salt-processed C. chinensis showed highest contents when baking tem-perature was 160℃,baking time was 60 min and moistening time was 2 h. CONCLUSIONS:Different processing methods have certain effects on flavonoids contents in salt-processed C. chinensis.

Objective·To investigate and compare the curative effect of rubber ring and dental floss combined with hemoclipping assisted endoscopic submucosal dissection(ESD) on gastrointestinal tumors.Methods·A total of 54 patients with gastrointestinal tumors were collected.Twenty-seven patients in rubber ring group accepted ESD assisted by rubber ring with hemoclipping,and the other 27 patients in dental floss group accepted ESD assisted by dental floss.with hemoclipping.Duration of the operation,installation time of the traction device,detachment frequency of hemoclipping,injury of mucosa,one-time complete resection rate,and complication rate were analyzed as key indicators.Results·The detachment frequency of hemoclipping in rubber ring group was significantly less than that in dental floss group (t=4.418,P＜0.05).There was no injury of mucosa in rubber ring group,while,three patients had mucosa injury in dental floss group.There was no statistically significant difference on duration of operation,installation time of traction device,one-time complete resection rate,and complication rate between two groups.After 2 ～ 12 months of follow-up,the wound healed well in all patients in rubber ring group.No evidence of tumor recurrence was noted.Conclusion·Compared with dental floss,rubber ring combined with hemoclipping is superior in assisted ESD,especially in the right half colon.It is an effective assist device with little trauma and adjustable direction.

Objective To observe the final adult height of 20 boys with idiopathic central precocious puberty (ICPP) treated with slow-releasing gonadotropin-releasing hormone analogue(GnRHa).Methods Twenty boys with ICPP were treated with GnRHa for( 20.0 ± 6.1 ) months.At the beginning of therapy,mean chronological age and bone age was( 11.4 ± 1.0 ) years and ( 13.0 ± 0.4 ) years,respectively,GnRHa was discontinued when the boys reached the chronological age and bone age of( 13.2 ± 1.1 ) years and ( 13.7 ± 0.6 ) years,respectively.After the end of treatment,all the boys had been followed up for( 3.3 ± 1.5 ) years and had achieved adult height.Comparisons were made among their predicted adult height ( PAH ),final adult height ( FAH ),and target height ( THt ).The long-term outcome of final adult height in boys with ICPP was investigated after GnRHa treatment.Results All the boys reached target height range.Final height was similar to the target height [ ( 169.8 ± 5.8 vs 167.8 ± 4.6 ) cm,P＞0.05 ].The height gain,defined as the difference between predicted adult height at the start of treatment using the height SDS for bone age and actual adult height was( 3.62 ± 3.57 ) cm with the residual growth capacity of ( 11.82 ±3.99)cm,PAH significantly improved after GnRHa treatment compared with before treatment [ ( 169.0 ± 5.0 vs166.2 ± 4.2 ) cm,P＜0.01 ].There were no differences among PAH,FAH,and THt.Conclusion GnRHa treatment improves final height within the range of target height in boys with central precocious puberty.

Objective To explore the relationship between adrenarche and gonadarche.Methods Total 49 idiopathic central precocious puberty(ICPP)girls,whose serum dehydroepiandrosterone sulfate(DHEAS)Z scores for chronological age were higher than+2 s at diagnosis.were enrolled.Physical examinations during pubertal stage were repeated at 3-6 months intervals,and serum DHEAS levels were monitored yearly within an average period of 4.08 years.Of them,16 girls were followed up until more than one year after discontinuation of gonadotropin-releasing hormone analogue(GnRHa)treatment.Results Before GnRHa treatment,these49 girls presented a younger average age at attainment of pubic hair stage2(PH2)and pubic hair stage3(PH3)than normal(8.07 years vs 11.16 years,8.82 years vs 12.40 years respectively).During GnRHa treatment,the intervals between PH2 and PH3,PH3 and pubic hair stage4(PH4),breast stage 2(B2),and PH2 were longer than normal(1.69 years vs 0.83 years,1.64 years vs 0.60 years,and3.62 years vs 0.76 years respectively).The intervals between PH2 and PH3,as well as B2 and PH2 during GnRHa treatment were also longer than that before GnRHa treatment(1.69 years/35 0.88 years,3.62 years vs 1.13 years respectively).The serum DHEAS Z scores decreased during GnRHa treatment,and increased significantly after GnRHa cessation.Conclusion Gonadarche after age of 6-year-old may lead to earlier adrenarehe.GnRHa treatment might slow down the progression of adrenarche and suppress the hypothalamuspituitary-gonadal axis.

Objective To evaluate the long-term final adult height outcome of combined treatment with gonadotropin-releasing hormone analogue(GnRHa)and recombinant human growth hormone(rhGH)in girls with idiopathic central precocious puberty(ICPP).Methods Out of 49 sirls with ICPP[treated with GnRHa at a dose of 60-80 μg/kg every 4 weeks for at least 6 months,whose height velocity fell below 4 cm/year and showed no improvement of predicted adult height(PAH)in 6 months],26 received(rhGH-combined group),in addition to chronological age,and duration of GnRHa treatment,who showed the same growth pattern but refused rhGH treatment,served to evaluate the efficacy of rhGH in addition.At the conclusion of the smdy,all the girls had been followed up for(3.3±1.9)years,and(3.2±0.9)years in rhGH-combined group and control group,respectively;and had achieved adult heisht.To compare the PAH with the final adult height(FAH)before and after treatment in the two groups.Results During rhGH treatment, height velocity of the rhGH-combined girls increased significantly[(6.7±2.0 vs <4)cm/year baseline],RhGH-combined gids showed an adult height far higher than pretreatment PAH [(157.5±4.5 vs 148.1±4.6)cm,P<0.01],and target height[(154.4±4.6)cm] was,significantly excceded.The control group reached an adult heisht also significandy higher than pretreatment PAH[(154.7±5.5vs 150.3±6.0)cm,P<0.01],while target height[(155.6±4.3)cm]was just reached but not significantlyexcceded.The gain in height obtained,calculated between pretreatment PAH and final heisat,(9.4±4.9)cm in rhGH-combined group was much more than that(4.3±4.2)cm in the control group(P<0.01).Conclusion RhGH may accelerate the linear growth and improve adult height of GnRHa-treated ICPP girls.

Objective To evaluate the clinical characters, management and prognostic factors of patients with differentiated invasive thyroid carcinoma (DITC). Methods The data were analyzed retrospectively for 114 DITC patients treated at Department of Head and Neck Surgery of Sun Yat-sen University Cancer Center. Survival analysis was performed by Kaplan-Meier method, comparison among/between groups was performed using log-rank test, and multivariate analysis was carried out using Cox proportional hazard model. Results After surgery, 68 patients were with tumor residue. The 5-year and 10-year overall survival rate were 91.9% and 80.1% respectively in all patients, while the 10-year overall survival rate were 88.5% 、78.5% and 53.1% in no tumor residue group, micro-residue group and grossresidue group respectively. This study failed to prove that radiotherapy might improve the survival rate in patients with postoperative tumor residue. Multivariate analysis indicated that age, invasion to esophagus and recurrence predict the prognosis. Conclusion DITC may be treated mainly by surgical operation. Radical resection is the key factor in the treatment of DITC. Patients with DITC have a relatively poor prognosis.Age, esophagus invasion and status of tumor residue are the most important factors affecting the prognosis.

Objective To analyze the clinical characters of childhood adrenocortical tumors, and to enhance the knowledge of diagnosis of this disease. Methods A retrospective analysis of clinical characters,laboratory tests,and imaging findings in 31 cases of childhood adrenocortical tumors was carried out. Results 16 cases of adenoma and 15 cases of carcinoma were included. The average age was (4.49±3.51) years old, and 67.7% of the patients were younger than 5 years old. The ratio of male to female was 1.0: 1.4. 12 patients presented only precocious sexual development, 4 patients presented only Cushing syndrome, 10 patients showed sexual precocity combined with Cushing syndrome, and 5 patients did not have any endocrine abnormalities. Raised testosterone level in 92.3% of these patients was the most common finding in laboratory tests. Only 12.5% of ultrasound images and 20.8% of CT images were consistent with pathologic diagnosis. Conclusions The clinical manifestations of adrenocortical tumors in childhood are precocious sexual development, Cushing's syndrome, or nonfunctional. The common laboratory findings are elevation of sex hormone and disorder of cortisol circadian rhythm. Precocious sexual development and elevation of androgens are more common in childhood adrenocortical tumor than those in adults. Imaging usually cannot give proper diagnosis. Final diagnosis should be established by clinical features, laboratory tests, imaging, and pathologic results.

Objective Deleting the cysteine-rich region (22-37 amino acids)of HIV-1 HXB2 Tat protein(whole length is 101 amino acids) to improve its stability and expression level in E.coli and to analyze the immunogenicity of Tat protein without the cystein-rich region [Tat(△C)protein]. Methods Tat DNA deleted the cysteine-rich region (64-111 nucleotides), named as Tat(△C)DNA, was obtained in vitro by PCR and cloned into pET-32a vector. pET-32a-Tat(△C)plasmid and the pET-32a-Tat plasmid were established and transformed into E.coli BL21(DE3) strains respectively to express and purify the protein. Three rabbits were vaccinated with pET-32a-Tat(△C)protein, then testify the reactivity of sera from rabbits by ELISA and Western blot. Results The dense of the purified pET-32a-Tat(△C)protein was 7.12 mg/ml,which was greatly more than pET-32a-Tat protein(1.50 mg/ml). Dimer of pET-32a-Tat protein can be observed just after the protein purification and stored at 25℃ and 4℃ for 7 days, but dimer of pET-32a-Tat(△C)protein was not formed at the same condition. Experimental rabbits were immunized with pET-32a-Tat(△C)protein and produced high titre of anti-pET-32a-Tat(△C)serum(1∶320 000), the antibody can react specifically with Tat(△C)protein, Tat protein (1-101 AA)and synthetic Tat(1-86 AA) protein. Deletion mutation of the cysteine-rich region of Tat protein was first performed in the study. Conclusion The expression level in E.coli and the stability of Tat protein deleted the cysteine-rich region can be increased greatly, and the protein remains good immunogenicity. The results may provide a novel antigen for further development of HIV-1 Tat vaccine.