Objective:To compare transvaginal ultrasonography and hysteroscopy in diagnosis of intrauterine adhesions.Methods: One hundred and one cases of infertile women were treated by transvaginal ultrasound and hysteroscopy.Results: One hundred and one cases of infertility by hysteroscopy diagnosis of 87 cases of intrauterine adhesions, transvaginal ultrasound 68 cases of intrauterine adhesions, 78.16% sensitivity, sensitivity and different degree of intrauterine adhesions without significant difference. The diagnosis coincidence rate of intrauterine adhesions was consistent with transvaginal ultrasonography and hysteroscopy.Conclusion: In the clinical diagnosis and treatment of intrauterine adhesions, transvaginal sonography has the value of irreplaceable hysteroscopy. Vaginal ultrasonography can be used as the first choice for intrauterine adhesions.

Objective To investigate the anti-tumor effects of total saponins,extracted from stems and leaves ofParispolyphyllavar.yunnanensis. Methods Taking mouse stomach carcinoma MFC cell line,human mammary cancer cell line(MCF-7)and human cervical carcinoma cell line(Hela),and their tumor-bearing mice as models,the antitumor activity was carried out in vitro and in vivo. CCK-8 assay was used to determine the inhibitory effect in vitro. The tumor-bearing mice model was induced by tumor cell vaccination in normal mouse forelimb left axillary subcutaneous and these mice were randomized into NS group,cytoxan group(30 mg/kg),saponins high-dose,medium-dose and low-dose groups(60,30 and 15 mg/kg). They were given intraperitoneal injection once a day for consecutive 15 days. The tumor inhibition rate and survival of the tumor-bearing mice were measured. Results Saponins,extracted from both aboveground and underground ofP.polyphyllavar.yunnanensis could significantly inhibit the growth of MFC,MCF-7 and Hela cells in time- and dose-dependent manners. The tumor weight in each drug treated group was significantly lower than that in the control group. Conclusion Saponins,extracted from both aboveground and underground ofP.polyphyllavar.yunnanensis have antitumor activity.

[Objective] To investigate the change of liver histology, proliferation of BDEC, and expression of TGF-β in different stages of liver chelestusis. [Methods] ①Rat cholestatic livers were induced by common bile duct ligation (BDL) and separated into 3 groups, namely control group (DO), 7 days after BDL group (DT), and 18 days after BDL group (D18). ② Histological changes of livers in different groups were evaluated based on Knodell HAI score. ③ Real-time PCR was used to detect the expression of TGF-β in liver tissue and isolated BDEC in different groups. ④ Statistically analyzing the correlation between Knedell HAl score and the levels of TGF-β_1 mRNA. ⑤ In vitro study was performed to investigate the effect of TGF-β_1 on an immortalized mouse intrahepatic bililary epithelial cell line (mIBEC). [Results] (I) Knedell HAI score and the proliferation of intrahepatic bile ducts increased as the liver cholestasis aggravated. ② The levels of TGF-β_1, TGF-β_2, and TGF-β_3 mRNA were significantly up-regulated in liver tissues and BDEC as the liver cholestasis aggravated. ③ Positive correlation was found between Knedell fibrotic score and the levels of TGF-β_1 mRNA in liver tissues and BDEC(r=0.9376, P<0.05 and r=0.9682, P < 0.01). ④ In vitro study showed that TGF-β_1 inhibited the proliferation of mIBEC. [Conclusion] ① Liver injury, biliary proliferation, and the levels of TGF-β mRNA expression increased as liver cholestasis aggravated. ② The interaction of TGF-β_1 and BDEC plays an important role in the pathogenesis of BDL induced cholestatic liver disease. ④ Up-regulated expression of TGF-β_1 mRNA in the proliferated BDEC participates in the formation of BDL induced cholestatic liver fibrosis.

Object To study the protective effect of Rodobryum roseum (Hedw) Limpr. on acute myocardial ischemia. Methods Rat acute myocardial ischemia models were prepared by ligating their left coronary arteries. Changes of their S-T segment was observed on lead Ⅱ dynamic ECG. Degree of ischemia was assessed by the extent of S-T segment elevation. Lactic dehydrogenase (LDH), creative phosphokinase (CPK), superoxide dismutase (SOD) and malondialdehyde (MDA) were determined at the same time. Results R. roseum can significantly alleviate S-T segment elevation, being most evident at the dose of 2 g/kg (P

Objective To investigate the evaluation standard and proper time point of anti-tuberculosis trial for differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD). Methods Clinical data and endoscopic changes of 28 patients with confirmed ITB and 11 with confirmed CD,who underwent anti-tuberculosis trail, were retrospectively analyzed. Results No significant difference could be found in clinical characteristics of ITB and CD patients on baseline, such as active pulmonary tuberculosis, strong positive skin test and anal fistula/perianal abscess. Clinical symptoms were relieved in both groups right after anti-tuberculosis treatment. After 3 months of treatment, the no-improvement rate in ITB group was 0, whereas that of CD group was 27.3% (P =0. 004). The disappearance rate plus improvement rate of ulcer in ITB group was 90. 9% (20/22) plus 9. 1% (2/22) and 100% ( 28/28 ) plus 0 at 3 and 6 months of treatment, respectively. The disappearance rate plus improvement rate of nodular lesion was 58. 8% (10/17) plus 41.2% (7/17) and 76. 5% (13/17) plus 23.5% (4/17), respectively. There was no obvious improvement of active ulcer or nodular transformation in CD group at any time point ( P ＜ 0. 01 ).Conclusion With deficiency of special index for differential diagnosis of ITB and CD, some cases hard to differentiate still have to accept anti-tuberculosis treatment. Three months of anti-tuberculosis treatment is a proper time point to evaluate the efficacy. Disappearance of active ulcer and nodular transformation, together with cure or obvious improvement in clinic are taken as effective for treatment trail.

Objective To inspect the efficacy and mucosa healing condition of infliximab with azathioprine combination therapy in Crohn's disease (CD) and its correlation with prognosis.Methods A total of 20 active CD patients who received infliximab and azathioprine combination therapy at The First Affiliated Hospital of Sun Yat-sen University were objects of this study.The clinical efficacy was evaluated at 10 weeks,30 weeks,54 weeks and 2 years respectively according to CD activity index.The efficacy was evaluated under endoscopy at 10 weeks,30 weeks,54 weeks and 2 years respectively according to mucosal response situation under endoscopy.The data were analyzed by analysis of variance or Fisher's exact test between two groups.The factor affecred mucosal healing was analyzed by Logistic regression analysis.Results The clinical remission rate of patients without steroid at week 10,30,54 and 2 year were 12/20,16/20,15/20 and 15/20 respectively.Mucosal healing rate at week 10,30 and 54 weeks were 8/20,12/20 and 10/20 respectively.Logistic regression analysis indicated that age was the only factor affected mucosal healing at 30 weeks (OR =0.774,95％ CI:0.630 to 0.950).There was significant differences in clinical remission between mucosa response patients and invalid under endoscopy at 30 weeks and 2 years without steroid (at 30 weeks:14/14 vs 2/6; at 2 years:14/14 vs 1/6; all P＜0.01).Infliximab were withdrawn in 4 of 16 patients who was in non-steroid clinical remission at 30 weeks,and the other 12 patients were continued with infliximab therapy.There was no significant difference in non-steroid clinical remission rate (4/4 vs 11/12) and mucosa healing rate (2/4 vs 7/12) between withdrawal and continue of infliximab therapy (all P＞0.05).Conclusions Infliximab with azathioprine combination therapy can effectively promote and maintain mucosa healing in CD.The mucosa response patients can maintain long time non-steroid clinical remission.

Objective To analyze clinical features and prognosis of primary intestinal T cell lymphoma (ITCL)which was misdiagnosed as Crohn′s disease (CD),and summarized the key points of differentiation between ITCL and CD.Methods From January 2003 to January 2014,clinical data of patients with ITCL once misdiagnosed as CD were retrospectively analyzed,which included demographic,clinical,pathological and prognostic data.The data of 177 patients diagnosed as CD from January 2012 to January 2014 were collected. The demographic,clinical,pathological and prognostic data of these two groups were analyzed and compared. The continuous variables were compared with t test or Mann-WhitneyU test,and the differences of classification variables between two groups were analyzed by Chi-square test or Fisher exact probability method.Results A
total of 18 patients (17 males and one female)with ITCL misdiagnosed as CD were enrolled in the study,and the median age at diagnosis was 38.5 (28.8 to 42.5)years and the median duration of diagnosis was 6.00 (3.75 to 13.25)months.The common primary symptoms were abdominal pain (12/18),diarrhea (13/18)and anemia (13/18).Intestinal perforation was primary symptom in two cases (2/18).However,B symptoms of lymphoma was observed in 16 patients,which included fever in 13 patients,weight loss in 16 patients and night sweat in one patient.One or more serious complications appeared in 12 patients,which included intestinal perforation in nine patients,severe gastrointestinal bleeding in seven patients and intestinal obstruction in two patients.In 177 patients with CD,104 patients were male (58.8%),and the median age at diagnosis was 22.0 (18.0 to 29.0) years.The primary symptoms were abdominal pain (88.7%,157/177),diarrhea (55.9%,99/177),anemia (63.8%,113/177),fever (33.3%,59/177)and weight loss (59.9%,106/177).During the disease course,30 patients (16.9%)had intestinal perforation (mainly chronic),12 patients (6.8%)had intestinal obstruction and seven patients (4.0%)had severe gastrointestinal bleeding.Compared to CD patients,male patients were more common in ITCL (χ2 =8.837,P <0.01),age at diagnosis was older (χ2 =314.5,P <0.01),the disease course was shorter (U=385.0,P <0.01),weight loss (χ2 =5.867,P <0.05)and fever (χ2 =10.609,P <0.01)were more common in clinical symptoms and intestinal perforation and severe gastrointestinal bleeding were more common in complications (χ2 =9.185,24.908,both P <0.01).The lesions of ITCL were multiple lesions, small bowel involved in eight cases,colon involved in 14 cases and one case with esophagus involved.Under endoscopy examination,most lesions appeared as ulcerations and were segmentally distributed.Compared to CD, lymphocyte proliferation was more common in the intestinal histopathological findings of ITCL (17/18 vs 19.7%(35/177);χ2 =42.844,P <0.01)and granuloma was rare (0 vs 42.8%(76/177),χ2 =12.665,P <0.01). Among 18 patients with ITCL,nine received chemotherapy and the median survival time was two months. Conclusions Primary ITCL had non-specific symptoms and was easily misdiagnosed as CD.More attention should be paid to the differential diagnosis of the two disease.

Evaluation of middle ear function in infants is the key to distinguish sensorineural hearing loss and conductive hearing loss, and acoustic immittance test is the routine audiological evaluation of middle ear function.Because of the characteristics of middle ear in infants, middle ear examination parameters of adults are not suitable for infants. This article reviewd the current multiple acoustic immittance methods for detecting middle ear function in infants, and summarized the advantages and disadvantages of these methods.

Objective To investigate the protective effects of stilbene glycoside(2,3,5,4'-tetrahydroxy-stilbene-2-O-β-D-glucoside,TSG) on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mice model of Parkinson's disease(PD).Methods Mice were randomly divided into the blank control group,the negative control group,the TSG high-dose group,the TSG low-dose group and the positive drug group(n=20 each).Mice were weighted daily to observe the changes of body weight,and mice motor and behavior function were tested by open field test.Level changes of α/β synuclein in brain cortex,cerebellum,midbrain,and hippocampal were detected by Western blot.Results Compared with the blank control group,the negative control group showed that the body weight was decreased (P ＜ 0.05).Compared with the negative control group,the body weight was increased in the TSG high-and low-dose groups and the positive drug group (P ＜ 0.05).The spontaneous behavior was impaired in the negative control group.Compared with the blank control group,the negative control group showed that the open field test showed traveled distance over a 10-min period was significantly shortened at 1 st,7th,28th days after testing(all P＜0.05).The trajectory of motor axons indicated that mice in the negative control group showed dyskinesia,but the groups of positive drug and high-and low-dose of TSG could reverse this dyskinesia.Compared with the blank control group,brain α/β synuclein protein levels were increased in the negative control group,and decreased in positive drug and TSG high-and low-dose groups (P ＜0.05).Conclusions Stilbene glycosides exert neuroprotective effects in MPTP-induced mice model of PD.