Objective To investigate the causes,diagnostic methods,prevention and cure of postmenopausal bleeding(PMB).Methods The clinical and pathological data of 210 PMB patients admitted in this hospital were retrospectively analyzed.Results The causes for PMB were benign diseases(69.5%),the most of which were infec- tious diseases(49.5%),non-organic disease(20.5%)and malignant tumor(10.0%).Compared with benign diseases and non-organic diseases,the attack age of malignant tumor was higher[(67.1?6.9)years old],menopausal dura- tion was longer(11.6?2.9)years,bleeding duration was longer[(157.6?26.4)days],and mucous membrane was obviously thickened[(14.6?3.2)mm](P0.05).Conclusion The main cause for PMB is benign diseases,followed by non-organic diseases.More attentions should be paid to the PMB patients with higher attack age,longer menopausal duration and bleeding dura- tion,and obviously thickened mucous membrane,so as to be precautions to the occurrence of malignant tumor.

Endemic dental fluorosis has been reported in some regions of the world. China seemed to have high prevalence of endemic dental fluorosis, especially in southwest China. It is now most likely that excessive fluoride intake during enamel development play a key role in the pathogenesis of dental fluorosis. However, excessive intake of fluoride-induced cellular and molecular mechanisms of dental fluorosis are not entirely conclusive. Scholars at home and abroad have made a lot of research on pathogenesis of enamel fluorosis by using various experimental techniques. More recent studies mainly suggest that endoplasmic reticulum stress and calcium overload-associated apoptotic pathway may participate in fluoride excess-evoked pathogenesis of dental fluorosis. Furthermore, the functional changes of enamel matrix protein and protease activity may be involved in the pathological event. This paper summarized the recent research progress on this topic.

ObjectiveTo explore the particular inner world of the children with attention deficit hyperactivity disorder (ADHD)with the sandplay therapy and the initial sandtray's clinical diagnosis role and value on the ADHD.MethodsThe differences of the initial sandtrays between 28 children with ADHD and 24 normal children were compared.Results 1.On the use of toys,the experimental group was significantly higher in transports ((5.04 ±6.60),(1.38 ±2.12),t=2.73) and lower in stones((0.00 ±0.00),(8.00 ± 12.33),t=-3.18).2.On the scene of sandtrays,the experimental group was significantly higher in the fight( x2 =12.96,P ＜ 0.01 ),dynamic scenes ( x2 =13.37,P ＜ 0.01 ).3.On the use of self-images,the experimental group was lower than the normal children,and the differences were significant ( x2 =4.75,P ＜ 0.05 ).4.There were no significant differences in the use of sand between two groups( x2 =3.46,P ＞ 0.05).ConclusionThe results show that the children with ADHD have significantly characteristics in sandtrays.Initial sandtray is valuable to be an aid to clinical diagnosis and intervention means.

ObjectiveTo investigate the difference of the spontaneous neuronal activity between attention-deficit hyperactivity disorder (ADHD) and normal children with amplitude of low-frequency fluctuation (ALFF) of the resting-state fMRI,and to discuss the correlation between the activity level of brain and symptom severity.MethodsThirty-two children with ADHD of school age and thirty age-and gender-matched controls were experienced with resting-state fMRI scans while blood oxygenation level dependent (BOLD) signal was acquired to calculate the amplitude of low-frequency fluctuation (ALFF).Linear correlations were performed between the aggregate score of RS-Ⅳ and ALFF voxels in ADHD patients.ResultsCompared to the controls,the ADHD group exhibited decreased ALFF in right superior frontal gyrus ( BA9,t =- 4.61 ),left superior medial frontal gyrus ( BA10,t =- 3.63 ),left mediate frontal ( BA46,t =- 4.09 ),and left anterior cingulate cortex ( BA24,t =- 4.02).Meanwhile,it showed increased ALFF in the medial orbitofrontal cortex( BA11,t =3.52 ),right cuneus gyrus ( t =3.93 ),right mediate occipital gyrus ( BA 19,t =3.82),right cerebellum ( BA37,t =3.77),right mediate temporal gyrus( BA37,t =3.76),and left paracentral lobe ( BA6,t =3.77 ).Altered ALFF in left superior medial frontal gyrus(P=0.009,r=0.492)and the right cuneus gyrus(P=0.024,r=0.433) showed correlation with the aggregate score of RS-Ⅳ.ConclusionThe spontaneous neuronal activity decreases in prefrontal cortex and increases in default mode network of ADHD group,the activity level of left prefrontal and right cuneus gyrus is positively correlated with symptom severity.

Objective To investigate the risk factors which indicate behavior problems and degree of conflict function defects in different subtypes of attention deficit hyperactivity disorder( ADHD),and to compare behavioral problems,family environment and conflict function in children with and without ADHD.Methods 87children with ADHD and 38 matched controls performed Simon-Stroop task while questionnaires (Parent Symptom Questionnaire and Family environment Scale)were acquired from their parents.Results Questionnaire indicated that children with ADHD-combined(ADHD-C) had the highest score of conduct problem( 1.05 ± 0.44),learning problem ( 1.97 ± 0.52 ),hyperactivity-impulsion ( 1.56 ± 0.60) and hyperactivity index ( 1.45 ± 0.40 ) than ADHDⅠ(0.65±0.32,1.58 ±0.58,1.06 ±0.46,1.01 ±0.31) and matched controls ( 0.42 ±0.24,0.77 ±0.49,0.58±0.40,0.55 ±0.34) in PSQ.ADHD-Ⅰ and ADHD-C had higher score of contradiction(3.28 ± 1.70,4.61 ±2.56 ) and lower score of family cohesion (6.75 ± 2.27,6.61 ± 2.03 ),emotional expression (5.03 ± 1.54,5.06 ±1.91 ),knowledge (3.83 ± 2.30,3.61 ± 1.81 ) and entertainment (3.70 ± 2.12,3.47 ± 2.32 ) than matched controls (2.36 ± 1.44,8.06 ± 1.71,6.03 ± 1.54,4.86 ± 1.91,4.83 ± 2.29) in FES-CV.Behavior data indicated that the correct rate of children with ADHD-Ⅰ and ADHD-C in Simon-incongruent trials( Siin:0.76 ± 0.13,0.69 ±0.13 ) and Stroop-inconsistent trials( Stin:0.82 ± 0.10,0.78 ± 0.08 )were lower and reaction time of children with ADHD-Ⅰ and ADHD-C in the Siin ( (876.4 ± 97.34) ms,( 893.8 ± 130.1 ) ms) and Stin ( ( 864.4 ± 91.82 ) ms,(860.2 ± 125.0) ms) were longer than matched controls ( (Siin (0.81 ± 0.11 ) ms,(810.4 ± 136.1 ) ms; Stin (0.87 ± 0.08 ) ms,(797.4 ± 136.1 ) ms).Pearson correlation analysis suggested that some factors in the FES-CV had correlation with behavioral problems.Conclusion This finding indicates that poor family environment is the risk factor that indicate behavioral problems in children with ADHD and behavioral problems,conflict function defeet of ADHD-C are more serious than ADHD-Ⅰ and matched controls.

AIM:To observe the changes of macular thickness in patients after cataract operation.
METHODS: A total of 126 patients ( 133 eyes ) were divided into two groups that were included in this study. The group (68 eyes of 64 case) with phacoemulsification combined intraocular lens implantation and ( 65 eyes of 62 cases ) with manual small incision cataract surgery ( MSICS) . There was no complication before and during the surgery. Optical coherence tomography ( OCT) was examined 1, 3mo before and after surgery. The visual acuity and macular thickness were compared after surgery. The SPSS 17. 0 software was used for statistical analysis. The paired t-test was used before and after surgery. Independent-samples t test was used in two groups before and after surgery,α=0. 05.
RESULTS: The cataract phacoemulsification group:preoperative and 1mo after surgery, the mean macular thickness was 241. 3±10. 9μm and 279. 7±16. 5μm, with significant difference ( P < 0. 01 ). The mean macular thickness was 245. 6±12. 6μm 3mo after surgery without statistical difference compared with preoperative ( P>0-05). The mean macular thickness was 279. 7±16. 5μm 1mo after surgery and 245. 6±12. 6μm 3mo after surgery with statistical difference(P<0. 05). Three eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes of them was resolved 3mo after surgery. The group of MSICS: preoperative and 1mo after surgery, the mean macular thickness was 240-5±11. 9μm and 280. 7±16. 8μm, with significant difference (P<0. 01). The mean macular thickness was 246. 6±13. 2μm 3mo after surgery without statistical difference compared with preoperative ( P >0-05). One month after surgery and 3mo after surgery, the mean macular thickness were 280. 7±16. 8μm and 246-6±13. 2μm, with statistical difference (P<0. 05). Two eyes displayed cystoid macular edema at 1mo after surgery and 2 eyes were resolved 3mo after surgery. Between the two groups pre-operation or after operation for 1, 3mo respectively P values were without statistical difference (P>0. 05).
CONCLUSION: The macular thickness and macular edema can be found 1mo after cataract phacoemulsification and MSICS. Three months post-operatively, macular edema disappears and does not show statistical difference compared with preoperative. The increase of macular thickness has no obvious relationship with the choice of surgery.

Evaluation of the permeability mainly focuses on intestinal absorption in biopharmaceutics classification system (BCS). It is more complicated that the absorption and metabolism under multicomponent environment in biopharmaceutics classification system of Chinese materia medica (CMMBCS) compared with single component environment, which needs suitable mathematical models to be described. Therefore, with full consideration of existing single component mathematical algorithm combining with the characteristics of intestinal absorption and metabolism, we explored and designed a new mathematical algorithm of intestinal absorption and metabolism of multicomponent drug. Then we put forward a new coefficient, P (influence), the relative change rate of the single component's intestinal absorption and metabolism under multicomponent environment compared with single component environment, which described the influences of intestinal absorption and metabolism of the component under multicomponent environment. Moreover, P (influence) highlights the distinctive characteristics of multicomponent drug's intestinal absorption and metabolism, and lays the foundation for the construction of CMMBCS.
Algorithms ; Drugs, Chinese Herbal ; chemistry ; pharmacokinetics ; Humans ; Intestinal Absorption ; Intestines ; chemistry ; metabolism ; Models, Theoretical ; Solubility

Objective To study the expression and significance of Th17 cells from peripheral blood of patients with rheumatoid arthritis (RA). Methods Intracelluar flow cytomete detection of IL-17/IFN-γ and IL-17/IL-6 was established using anti-CD3/Anti-CD28/IL-23 as stimulators after isolation of untouched human CD4~+T cells from PBMC. There were three groups in the present study: ①healthy controls group; ② RA stable group; ③RA active group. Results The isolation of untouched human CD4~+T cells from PBMC was effective and its purity was over 90%. The percentage of intracelluar IL-17 in CD4~+ T cells from RA patients was increased significantly. Such percentage in active group (1.54±0.41) was higher than that of stable group (0.70±0.21, P<0.01) and both of them were higher than those of healthy controls (0.42±0.12, P<0.01). Under anti-CD3/Anti-CD28/IL-23 stimulation, the percentage of intracelluar IL-17 was also increased significantly(P<0.01). The porcentage of intracellular IFN-γ was similar to that of IL-17, while that of IL-6 was not significantly different. There is an correlation between IL-17 and IFN-γ or IL-6. Conclusion There is an abnormal expression of IL-17 and IFN-γ in human CD4~+T cells in RA patients, which is related to disease activity . Th17 cells may be used as a new marker for the assessment of RA activity.

CDISC standard has become a set of global data standards that can be used in clinical study, covering the full life cycle of clinical researches. After nearly 20 years of development and continuous version upgrades, CDISC standard can improve the quality and efficiency of clinical research and drug review, and to facilitate all stakeholders involved in researches to exchange the study data and communicate the outcomes. CDISC standard has been or is to be adopted as standard format in data submission by multiple regulatory authorities, and more widely implemented by the global pharmaceutical community. CDISC standard is gradually adopted in China. The feasibility and roadmap of CDISC standard as the Chinese data submission format requirements are undergoing exploration and piloting further.
Biomedical Research ; standards ; China ; Clinical Trials as Topic ; standards ; Data Collection ; standards

Objective:To systematically assess the efficacy and safety of acupuncture therapy for essential hypertension.Methods:A computerized literature search of the Chinese National Knowledge Infrastructure(CNKI),Chongqing VIP Database(CQVIP),Wanfang Academic Journal Full-text Database(Wanfang),China Biology Medicine Disc(CBM),PubMed,Excerpta Medica Database(EMBASE),and Cochrane Library was conducted to retrieve randomized controlled clinical trials on acupuncture as the main intervention for the treatment of essential hypertension published from the inception of the database to 30 January 2021.The risk-of-bias assessment was carried out for each included study according to the Cochrane Handbook.Data analysis was performed using Review Manager 5.4.1 and Stata 15.0.Results:After the screening,46 randomized controlled trials involving a total of 3 859 subjects were included.Primary outcomes included changes in the diastolic blood pressure after intervention[eight studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[mean difference(MD)=1.45,95%confidence interval(CI)(0.48,2.43),P=0.004,fixed effects model;I2=39%]and changes in the systolic blood pressure after intervention{11 studies showed that the acupuncture plus antihypertensive drug group was better than the antihypertensive drug monotherapy group[MD=8.60,95%CI(7.12,10.07),P<0.00001,fixed effects model;I2=26%]}.The secondary outcome was antihypertensive efficacy,12 studies of acupuncture monotherapy group[risk ratio(RR)=1.20,95%CI(1.12,1.28),P<0.00001,fixed effects model;I2=36%]and 15 studies of acupuncture combined with antihypertensive drug group[RR=1.27,95%CI(1.20,1.34),P<0.00001,fixed effects model;I2=6%]showed better results than the antihypertensive drug monotherapy group in antihypertensive efficacy.In terms of the adverse events,four studies showed that the acupuncture monotherapy group had fewer adverse events than the antihypertensive drug monotherapy group[RR=0.10,95%CI(0.04,0.25),P<0.00001,fixed effects model;I2=0%].Conclusion:Acupuncture combined with antihypertensive drugs is superior to antihypertensive drugs alone in reducing blood pressure,and acupuncture therapy is effective and safe for the treatment of essential hypertension with fewer side effects.However,there is still a lack of high-quality multicenter randomized double-blinded controlled trials in this field.Rigorous large-sample clinical trials are needed to validate these findings.