Objective To investigate the therapeutic mechanism of bazedoxifene, the third-generation selective ER modulator (SERM), on endometriosis lesions in a rat model. Methods Endometriosis was induced by transplanting pieces of endometrium from other syngeneic rats that were as donors onto the subcutaneous of other unmated female rats. The rats with successful ectopic implants were divided into two groups:control group (n=10) and bazedoxifene group (n=10). The macroscopic morphology, volume, histopathology of ectopic implant and rats uterine wet weight were determined before and after the treatment. Expression of proliferation cell nuclear antigen (PCNA), ER and PR in the eutopic endometrium and endometriosis lesions detected by immunohistochemistry in the two groups. Results (1) The gross morphology and histological changes of endometriosis lesions in rats after treatment: compared with the control group, it was obviously depauperated and had more less glands and blood vessels in the stroma. (2) The change of rats′weight, the volume of endometriosis lesion before and after treatment and rats uterine wet weigh after treatment respectively in the control group and the bazedoxifene group:rats′ weight were respectively before treatment: (201±17) g, (202±18) g, that were respectively after treatment: (266±16) g, (261±16) g, which showed no significant difference between two groups before and after treatment (P>0.05). The volume of ectopic implant before treatment were respectively (85±17) mm3, (85±12) mm3, and showed no significant difference between two groups;that were respectively (48±11) mm3, (24±9) mm3 afte rtreatment, which was significantly decreased compared with the control group (P<0.05). Rats uterine wet weight after treatment were respectively:(0.77±0.16) g, (0.45±0.18) g, and was significantly reduced compared with the control group (P<0.05). (3) The protein expression levels of PCNA, ER and PR in the endometriosis lesions after treatment were respectively 0.282 ± 0.044, 0.51 ± 0.06, 0.49 ± 0.05 in the control group, 0.191 ± 0.020, 0.23 ± 0.03, 0.48 ± 0.06 in the bazedoxifene group; that in eutopic endometrium were respectively 0.369 ± 0.081, 0.56 ± 0.08, 0.56 ± 0.10 in the control group, 0.211 ± 0.037, 0.27 ± 0.05, 0.54 ± 0.08 in the bazedoxifene group;the protein expression levels of PCNA and ER in endometriosis lesions and the eutopic endometrium were significantly decreased in the bazedoxifene group compared with the control group (P<0.05), but the protein levels of PR in endometriosis lesionsand and the eutopic endometrium were not significantly altered by treatment (P>0.05). Conclusion Bazedoxifene could obviously reduce the size of endometriosis lesions, the mechanism may be related with suppressing estrogen-induced proliferation, the expression of ER and direct ER antagonism by this SERM.

Objective To observe the clinical effect of modified Zhisou powder and Symbicort Turbuhaler simultaneously on patients with Cough Variant Asthma. Methods 120 patients with Cough Variant Asthma were randomly recurited into two groups. 60 patients in the treatment group were treated with modified Zhisou powder and Symbicort Turbuhaler; 60 patients in the control group were treated with Symbicort Turbuhaler. 4 weeks was a therapeutic course in both group. Results The markedly controlled rate (MCR) (clinical control+excenence)of the treatment group was 83.3%, obviously surpassed the control group (70.0%) (P＜0.05); There was obvious improvement of cough, expectoration, breath lessness and throaty pruritus after the therapy in both groups, but it was much better in the treatment group than the control group(P＜0.05). The pulmonary function was significantly improved after treatment in both groups(FEV1, FEV1% and PEF, P＜0.05). The improvement showed significant difference between the two groups(P＜0.05). There was obvious decrease of EOS, IL-5 and ECP in both groups. The decrease of ECP and IL-5 in the treatment group was greater than the control group(P＜0.01). Conclusion The therapy of modified Zhisou powder and Symbicort Turbuhaler has advantage over pure western therapy.

BACKGROUND:Arthroscopy can observe the involutive relation of patelofemoral joint directly and dynamicaly, which can be used to judge whether the patelofemoral joint abnormalities can be completely corrected. OBJECTIVE:To analyze the clinical effect of lateral retinacular release and ligament reconstruction under arthroscope for patela recurrent dislocation. METHODS: A total of 58 patients diagnosed as having recurrent patelar dislocations were divided randomly into control and experimental groups, with 29 cases in each group. Patients in the control group received lateral retinacular release and ligament reconstruction under common operation and those in the experimental group received lateral retinacular release and ligament reconstruction under arthroscopy. RESULTS AND CONCLUSION:There was no significant difference in the Lysholm and Kujala scores before treatment in the two groups (P > 0.05), but at 12 months after treatment, the Lysholm and Kujala scores were both increased in the two groups, especialy in the treatment group (P < 0.05). No difference was found in the congruence angle and lateral patelofemoral angle with CT value at 30° of knee flexion (P > 0.05), and CT measurement values of the congruence angle and lateral patelofemoral angle were both decreased in the two groups, especialy in the experimental group, at 12 months after treatment. In addition, the operation time, healing time, and total effective rate were better in the experimental group than the control group (P < 0.05). These results indicate that the lateral retinacular release and ligament reconstruction under arthroscopy has a better effect on recurrent patelar dislocation.

BACKGROUND:With the development of surgical techniques and reconstruction material technology, joint replacement has also been widely used in the dislocation of the shoulder;especial y al kinds of custom-made or assembled prosthesis make replacement indications improved evidently. OBJECTIVE:To investigate the long-term effects of arthroscopy or arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects. METHODS:144 patients with recurrent anterior dislocation of the shoulder joint with severe bone defects were enrol ed in this study. They were divided into treatment group and control group based on a random drawing (n=72). The control group was given arthroscopic surgery, and the treatment group was subjected to arthroplasty. The 3 years of fol owed-up were done by telephone investigation and further consultation. Neer shoulder score, shoulder activity and complications were recorded.
RESULTS AND CONCLUSION:After 3-year fol owed-up, the excel ent and good rate of shoulder function was significantly higher in the treatment group (90%) than in the control group (81%) (P<0.05). The magnitude of the flexion in the 3-year fol owed-up was apparently increased, while the lateral margin external rotation was decreased, which showed significant differences after intragroup comparison (P<0.05). Simultaneously, the magnitude of the flexion and the lateral margin external rotation in the treatment group had statistical y significant differences compared to the control group in the 3-year fol owed-up (P<0.05). The complications of wound infection, shoulder dislocation, and implant loosening in the treatment group during fol ow-up were significantly lower than in the control group (P<0.05). These findings verified that compared with arthroscopic surgery, arthroplasty for treating recurrent anterior dislocation of the shoulder joint with severe bone defects in long-term fol ow-up can effectively restore shoulder function and range of motion, and it has few complications, thereby effectively rebuilds shoulder joint.

BACKGROUND:Traditionaly, non-surgical treatment was used to treat degenerative femoral intercondylar fossa impingement syndrome, but it can cause function loss of cruciate ligament, or knee instability. With the development of medical technology, more and more views believed that ligament damage and combined with other knee structural damage should receive surgery as soon as possible.
OBJECTIVE: To investigate the repair effect of knee arthroplasty for treating degenerative femoral intercondylar fossa impingement syndrome, and compare with AO cannulated screw fixation.
METHODS:A total of 72 patients with degenerative femoral intercondylar fossa impingement syndrome were equaly and randomly divided into treatment group and control group. Patients in the control group were treated with open AO cannulated screw fixation, and patients in the treatment group were subjected to knee arthroplasty. At 7 days after treatment, repair effect was evaluated. Before treatment and 7 days after treatment, knee function was assessed by using Lysholm knee Scoring Scale and the international knee documentation committee knee evaluation form. Al patients were folowed up for 6 months after treatment to investigate the occurrence of complications.
RESULTS AND CONCLUSION:The surgery was successfuly completed in al patients. At 7 days after treatment, the excelent and good rate was 94% in the treatment group and 75% in the control group. The excelent and good rate was significantly higher in the treatment group than in the control group (P < 0.05). Lysholm scores were significantly greater, but the international knee documentation committee knee evaluation form scores were significantly lower at 7 days after treatment compared with that before treatment in the treatment group (P < 0.05). Simultaneously, Lysholm scores and the international knee documentation committee knee evaluation form scores were significantly better in the treatment group than in the control group at 7 days after treatment (P < 0.05). During 6-month folow-up, wound infection, intra-articular infection, joint pain, and deep vein thrombosis were significantly less in the treatment group than in the control group (P < 0.05). These findings indicate that knee arthroplasty for degenerative femoral intercondylar fossa impingement syndrome can improve short-term efficacy, effectively restore knee function and reduce the incidence of postoperative complications.

Background Light-induced retinal damage models vary as many influence factors,herein the modeling method is difficult to copy.It is necessary to establish the grading standardization of retinal damage after retinal light exposure.Objective This study was to improve the modeling method and establish a grading standardization for light-induced retinal damage in rat.Methods Twenty-four SPF 8-10 week-old male SD rats were randomly divided into 4 groups and 6 eyes for each group.The rats were exposed to light intense of 5000 lx for 1,2,3 hours respectively in 3 groups,and other 6 rats served as the normal group.Full-field light exposure experiment was performed for each individual rat separately,and an annular illumination box was used tO ensure the experimental rat moving in a single direction and exposing the right eye in 5000 lx light surrounding during experimental duration.Ganzfeid electroretinogram(ERG)was recorded from the experimental rats at the fifth day after light exposure,and the animals were then sacrificed for histopathology observation to evaluate the retinal thickness change.All procedures which involved animals adhered to the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research.Results After exposing to intensity light for 1,2,3 hours,the b-wave amplitudes of rod response,maximal mixed response,oscillatory potential in scotopic ERG as well as cone response,20 Hz flicker response of photopic ERG were significant declined as lapse of light exposure time(F=71.690,P=0.000；F=56.250,P=0.000；F=23.610,P=0.000：F=27.130,P=0.000；F=27.030,P=0.000)and lowed by 26.2％,52.5％,70.7％,24.4％,39.3％,58.1％respectively at the end of experiment.Meanwhile,the b-wave latencies of rod response,maximal mixed response in scotopic ERG as well as cone response of photopic ERG were evidently different among different groups (F=1.370,P=0.282；F：0.800,P=0.508；F=11.840,P=0.000；F=2.080,P=0.136).Light induced retinal damage located mainly at the temporal retina area.After intensity light exposure for 1,2,3 hours,the thickness of outer nuclear layer at the superior temporal retina attenuated by 11.3％,25.6％and 72.5％,respectively(P<0.05).A significant difference was seen in mean thickness of outer nuclear layer at superior temporal retina among different groups(F=410.27,P=0.000). Conclusion A standardized grading method for light-induced retinal damage is recommended.The continuous illumination in a intensity of 5000 Ix for 1,2,3 hours can induce the mild,moderate or severe retinal damage respectively at temporal retina.

AIM: To observe the clinical efficacy and safety of vincamine sustained release capsules on non- arteritic anterior ischemic optic neuropathy ( NAION) . · METHODS: Patients who were diagnosed with monocular onset NAION in acute stage from January to September 2015 were divided into two groups. Routine treatment such as steroid pulse therapy and neurotrophic treatment were given to all the patients. Vincamine was added to the treatment group patients with 30mg twice a day for 3mo. The best corrected visual acuity ( BCVA), mean deviation ( MD) of visual field, retinal nerve fiber layer ( RNFL ) , ganglion cell complex ( GCC ) , pattern visual evoked potential ( PVEP ) and OCT results were analyzed before and after the treatment. ·RESULTS:Totally 42 eyes of 42 patients were enrolled in our study. There were 27 patients in the treatment group, aged from 33 to 79 years old, the average value was 55. 55± 11. 83 years old. The control group has 15 patients, aged from 40 to 70 years old, the average value was 55. 71 ± 10. 06 years old. There were no statistical differences between the two groups in the baseline. After 3mo of the treatment, MD value of the two groups were lower compared with the baseline, the difference was statistically significant in the treatment and control group respectively (t= 2. 342, 2. 692; P = 0. 027, 0. 041). The difference of PVEP amplitude and potential of the two groups before and after the treatment were not statistically significant. The thickness of retinal nerve fiber layer and the ganglion cell complex were all lower than the baseline, and the difference was statistically significant (P<0. 001). The treatment of the two groups were both effective, the treatment group has better treatment effect than the control group. Adverse events related to the treatment of vincamine had not been found. ·CONCLUSION:Vincamine is helpful in the treatment of non-arteritic anterior ischemic optic neuropathy.

Objective To investigate the diagnostic value of ADC histogram obtained from MR DW imaging for stage ⅠB cervical cancer. Methods Seventy three patients diagnosed by cervical smear screening as cervical cancer without priortreatment were included prospectively in the patient group, and staged according to the international federation of gynecology and obstetrics (FIGO) staging system. Forty three patients with uterine leiomyoma detected by gynecologic examination, ultrasonography or CT and with negative result of cervical smear screening who were scheduled for hysterectomy were included prospectively in the control group. The patients of both groups underwent routine pelvic MR sequences, dynamic contrast enhanced imaging and DWI before hysterectomy. ADC histograms of the entire tumor and cervix volume were generated by post-processing software. Features of ADC histogram for the 2 groups were observed. Histogram parameters such as mean ADC (ADCmean), median ADC (ADCmedian), the 25th percentile of ADC (ADC_25th), the 75th percentile of ADC (ADC_75th), skewness and kurtosis were recorded. Student's t test or Mann-Whitney U test depending on homogeneity of variance was employed for the comparison of
those parameters. ROC analysis was employed for assessing the diagnostic performance of ADC histogram in distinguishing the 2 groups. Results Thirty five patients in the patient group were staged as FIGO IB. Five patients in the control group ended up with pathologic findings of cervical intraepithelial neoplasia grade 3. Therefore 38 patients in the control group were investigated. ADC histograms of the patient group were mostly skewed positively, while the curves were largely skewed negatively. ADCmean, ADCmedian, ADC_25th, ADC_75th, skewness and kurtosis for the IB stage patient group were (1.10±0.21)×10-3mm2/s, (1.05±0.21)× 10-3 mm2/s, (0.90 ± 0.19) × 10-3mm2/s, (1.26 ± 0.23) × 10-3mm2/s, 0.83 (median) and 1.25 (median) respectively. ADCmean, ADCmedian, ADC_25th, ADC_75th, skewness and kurtosis for the control group were (1.62 ± 0.25)×10-3mm2/s, (1.64±0.24)×10-3mm2/s, (1.42±0.24)×10-3mm2/s, (1.84±0.27)×10-3mm2/s,-0.11(median) and 0.29 (median) respectively. All parameters showed statistically different (t values were -9.693,- 11.117, -10.255, and -9.988 for ADCmean, ADCmedian, ADC_25th and ADC_75th respectively;Z values were -6.360 and -4.445 for skewness and kurtosis respectively; P< 0.01). ROC analysis indicated that ADCmedian had the highest diagnostic accuracy for differentiating the 2 groups, with the area under the curve being 0.97, a cutoff value of 1.21×10-3mm2/s, and a sensitivity of 95.6%and a specificity of 89.3%. Conclusion ADC histogram of DWI may be valuable for diagnosing stage IB cervical cancer by distinguishing stage IB cervical cancer from normal cervix or cervical benign lesions.

Objective Gynecologic minimally invasive surgery has become popular in the treatment of tumor therapy in re-cent years, but improper application can result in tumor metastasis.In this paper, we presented 6 uterine neoplasm cases of tumor me-tastasis after minimally invasive surgery and analyzed the causes and the preventive measures. Methods Retrospective analysis was made on the clinical data and pathology characteristics of the 6 uterine neoplasm cases of tumor metastasis after primary minimally inva-sive surgery in our department from January 1, 2013 to 2015 June 30, and related literature were reviewed. Results The ages of 6 patients were 39-52 years old.The primary operation methods included 2 cases of hysteroscopic myomectomy, 3 cases of laparoscopic myomectomy and 1 case of radiofrequency ablation.The pathological diagnosis after primary operations were 4 cases of uterine sarcoma ( low grade endometrial stromal sarcoma in 2 cases and leiomyosarcoma in 2 cases) who were found metastatic tumor at 3-16 months after primary surgery and finally died of the disease and 2 cases of uterine fibroids who were found metastatic tumor in abdominal cavity and puncture hole at 60 months and 108 months respectively after primary operation followed by a good prognosis after the second surgi-cal resection. Conclusion Owing to uterine neoplasm by hysteroscopy, laparoscopy often needs certain pressure and morcellation which may result in easy plantation of crushing tumor tis-sue or metastasis with circulation and puncture under pressure.Ra-diofrequency ablation lack of histopathologic diagnosis has heating effect which is inclined to speed up the spread and transfer of tumor cells once it is diagnosed as malignant.Therefore, clinicians should know the defects and risk of being lack of histopathologic diagno-sis, diagnostic curettage pathology and fast pathology to avoid tumor metastasis induced by minimally invasive surgery.

In order to further study mouse embryonic stem cells(ES cells),lentiviral vector PLL-IRES-Nanog-Neo was constructed.Mouse ES cells overexpressed nanog by mediation of lentiviral were cultured on mouse fetal fibroblast feeders after 2 weeks under G418 media and examined according to gowth characteristics. Results were showed that 918 bp nanog fragments were expressed in mouse ES cells mediated by lentiviral vector PLL-IRES-Nanog-Neo,mouse nanog-ES cells were taken on mass-like image and positve with alkaline phosphatase staining and Oct4 and SSEA1 immunocytochemistry under no LIF condition in the media. It is concluded that mouse ES cells Elevated nanog gene expression by mediation of lentiviral were constucted and cultured.