BACKGROUND: There are many drawbacks with hormone replacement therapy for menopausal syndrome. The blood levels of 5-HT and norepinephrine are lower. Fluoxetine hydrochlorde(ProzacR) is a selective serotonin reuptake inhibitor which is widely used in treating anxiety and depression,OBJECTIVE: To evaluate the effect of combined antidepressant and estrogen therapy compared to estrogen alone in the treatment of perimenopausal syndrome in this prospective open study.DESIGN: Randomized comparative study.SETTING: Department of Obstetrics and Gynecology of the First Affiliated Hospital of Chongqing Medical University PARTICIPANTS: From November 2003 to December 2004, 60 female patients with diagnosed menopausal syndrome of 3-12 month duration, aged (46±3) years, from Department of Obstetrics and Gynecology of the First Affiliated Hospital of Chongqing Medical University were enrolled into the study after giving their informed consents. The patients were randomly divided into two equal groups with Group 1 (n=30) receiving a combination of antidepressant + estrogen and Group 2 (n=30) receiving estrogen only.METHODS: Patients in Grgup 1 received fluoxetine hydrochloride (ProzacR) 20 mg orally every morning plus oral estradiol 1 mg once every two weeks for 2 months. Patients in Group 2 received only oral estradiol 1 mg once every two weeks for two months. Patients were not taking any other drug during the treatment period. At the end of two month treatment all patients were evaluated with the following 3 assessment tools: ①female menopausal symptom evaluation with the following 4 categories: Complete symptom relief, markedly improved, improved and no effect. Overall efficacy was defined as 50% symptom improvement. ② Hamilton Depression Scale which reflects energy level and psychosomatic factor of sleep and anxiety. ③Menopause index: Which are description of clinical evaluation and adverse effects; this would help to assess the safety of using both drugs in treating the menopausal syndrome.MAIN OUTCOME MEASURES: female menopausal symptom assessment, hamilton depression scale, and menopause index.RESULTS: ① In female menopausal symptom assessment group 1 showed better results in the complete relief and markedly improved scores. ②Hamilton Depression Scale group 1 also showed better scores than Group2(In Groupl, the scores at week 1 to 8 were 25,18,15,10,8,5,5,4 respectively ,in Group 2, the scores at week 1 to 8 were 25,17,15,14,13,12,13,13 respectively). ③ Group 3 showed a significant better score in the menopausal index with improvement in sleep disorder, anxiety and depression than Group 2 (In Group 1 the scores at week 1-8 were 32,22.5,15,15,14,15,15,14 respectively,In group 2, the scores at week 1 to 8were 33,21,16,14,13,12,13,13 respectively) ,there was no significant difference of incidence of adverse events as compared with Group 3 .CONCLUSION: Combined therapy of fluoxetire hydrochlarde(PROZAC)plus estrogen showed better efficacy in the treatment of menopausal syndrome than estrogen alone.

Background and Objective Keshan disease is clinically characterized as a dilated eardiomyopathy. We analyze the prevalence trend during last decade of hypertension and Keshan-disease in Yangzhuang village which was a Keshan-disease epidemic area.Method The survey including medical history,blood pressure and ECG were carried out every two years during the follow up 13 years.Results During follow up period,the total detection rate(hypertension:13.4 % vs Keshan-disease:10.7 %,?~2=8.555,P=0.002)and the accumulative rate of hypertension were higher than those of Keshan-disease,which was on the contrary to that before 1993,when increasing rate of Keshan-disease was higher than hypertension.Furthermore,the accumulative increasing rate of hypertension was 240.0%,which was higher than the national average level during corresponding period with no significant differences between female and male.Conclusion The detection rate of hypertension in Keshan disease epidemic area was higher than the average rate nation-wide.Whether the hypertension prevalence was re- lated to Keshan-disease needs further investigation.

Objective To discuss the significance of HPV16, 18,31,33 subtype infection in cervical cancer screening for women whose age is beyond 30. Methods The patients who choose the combination use of TCT and HPV-DNA genotyping for screening during Jan. 2008-Mar. 2009 in our Gyn.Out-patient department, for that HPV16,18,31,33 positive ones, colposcopy and biopsy were used for further examination to get the histopathology result. Results There were 275 patients in total who suffers HPV16,18,31,33 infection, their age ranges from 30-72, the average age is 41.76 ± 8.88; HPV 16 infection accouts for 64.0%, one single subtype infection accouts for 64.7%; Among 210 ones who have an abnormal cytology test result, 127(60.5%)were confirmed to be CIN Ⅱ + by histopathology. In patients whose cytology test result were ASC-US,ASC-H,LSIL, HSIL,SCC and AGC, there were 32.6% ,67.8% ,42. 3%,81.8% , 100. 0%, 50.0% P = 0.000) of them who were confirmed to be CIN Ⅱ + by histopathology separately;There were 65 ones whose cytology result is negative, 10 patients were certified of CIN Ⅱ , Ⅲ by histopathology(15.4%) ,it accounts for 7.3% of all patients whose histopathology result is advanced of CIN Ⅱ,Ⅲ, 9 were found in HPV 16's group. Conclusion HPV16, 18,31,33 subtype infection have a significance in cervical cancer screening program for women whose age is beyond 30. We can detect another extra 7.3% CIN Ⅱ , Ⅲ ,especially in HPV16's group.

OBJECTIVETo explore the effects of lead on the thyroid function of occupationally exposed workers.

METHOD157 workers occupationally exposed to lead in a smelting factory were investigated. The concentration of lead in air at workshop was measured by flame atomic absorption spectrophotometry (FAAS) and the levels of blood lead (PbB) by atomic absorption spectrophotometry (AAS), zinc protoporphyrin (ZPP) by ZnPP meter, as well as the indexes of thyroid function, thyroid-stimulating hormone (TSH), triiodothyronine (T(3)), thyroxin (T(4)), free T(3) (FT(3)), and free T(4) (FT(4)) in serum by radioimmunoassay.

RESULTSThe workers with higher level of blood lead (> 2.88 micro mol/L) showed lower levels of T(3) [(1.54 +/- 0.39) nmol/L] and FT(3) [(5.50 +/- 1.26) pmol/L] than those with lower blood lead level [PbB: (1.92 approximately 2.88) micro mol/L group, T(3): (1.71 +/- 0.45) nmol/L, FT(3): (6.12 +/- 1.64) pmol/L, P < 0.05]. There was no obvious effect of length of service on thyroid hormone of exposed workers.

CONCLUSIONHigher level of blood lead may cause certain damage to thyroid function by inhibiting deiodination of T(4). No obvious relation between length of service and thyroid function was found.

Adult ; Female ; Humans ; Lead ; blood ; toxicity ; Male ; Middle Aged ; Occupational Exposure ; Thyroid Gland ; drug effects ; physiology

OBJECTIVETo establish quality standard of Zhuang medicine Lonicera dasystyla, and provide scientific basis for the quality control of L. dasystyla.

METHODCharacteristics of materia medica, microscopic features, TLC indentification, inspection, extractum and determination of chlorogenic acid, macranthoidin B, dipsacoside B were carried out through the experience, microscopic, physical and chemical methods, respectively. The standard of quality control was formulated thereafter.

RESULTThe characteristics of materia medica, microscopic features, TLC indentification were specified, the average contents of water, total ash, acid-insoluble ash, alcohol-soluble extracts, chlorogenic acid were 11.6%, 6.6%, 0.2% , 24.4%, 1.16%, respectively, the total amount of macranthoidin B and dipsacoside B was 3.13%. Quality standard of L. dasystyla was proposed according to experimental results.

CONCLUSIONThe quality of L. dasystyla can be controlled effectively with the quality standard.

Chlorogenic Acid ; analysis ; isolation & purification ; Chromatography, Thin Layer ; Drugs, Chinese Herbal ; chemistry ; standards ; Lonicera ; chemistry ; Oleanolic Acid ; analogs & derivatives ; analysis ; isolation & purification ; Quality Control ; Saponins ; analysis ; isolation & purification ; Solubility

BACKGROUNDThe aim of this study was to compare specimen adequacy of SAP-1 provided for cytology with that of dilation and curettage (D & C) or hysteroscopy for histology, and evaluate the accuracy of combining endometrium sampling by SAP-1 and liquid-based cytology using SurePath preparation for screening endometrial carcinoma and its precursor.

METHODSEndometrial specimens from women (n = 1514) with risk factors were obtained using an SAP-1 device for cytological analysis; histological samples were obtained from 375 of these women who underwent D & C or hysteroscopy. Cytological specimens were prepared to liquid-based smear using SurePath technology and stained by Papanicolaou. Histological samples were processed in routine pathology and stained by hematoxylin and eosin.

RESULTSAdequate specimens for cytology were obtained from 1458/1541 patients (96.3%), while adequate samples for pathology were obtained from 285/375 patients (76%). However, for postmenopausal women, 1006 of 1045 cytology (86.3%) were adequate, 153 of 238 histology (64.3%) were adequate, it was easier to collect cytological specimens than histological specimens (P < 0.05). The accuracy of endometrial cytology for detecting endometrial carcinoma and its precursor was 92.4% (sensitivity, 73%; specificity, 95.8%; positive predictive value, 75%; and negative predictive value, 95.3%).

CONCLUSIONSEndometrial cytology using SAP-1 sampling and SurePath preparation may be a reliable approach for screening patients with endometrial carcinoma and its precursor.

Adult ; Biopsy ; methods ; Cytodiagnosis ; methods ; Endometrial Hyperplasia ; diagnosis ; Endometrial Neoplasms ; diagnosis ; Female ; Humans ; Specimen Handling ; methods

OBJECTIVETo investigate the changes in the systemic inflammatory response and T cell induced immunity after systemic administration of recombinant human growth hormone (rhGH) during early postburn stage.

METHODSForty Sprague-Dawley (SD) rats were randomly divided into three groups for the study. The rats in control group (C, n = 6) were only used for the determination of plasma levels of the cytokines, such as TNFalpha, IL-2, IL-6 and CD4(+) and CD8(+) cells. The SD rats in burn with rhGH treatment group (BT, n = 18) and burn without treatment group (B, n = 18) were inflicted with III degree scalding injury on the back. rhGH was injected subcutaneously on the abdomen of the rats in a dose of 6 IU/kg for 10 days in BT group. The blood samples were harvested from the rats in the two groups for the evaluation of the above indices.

RESULTSThe plasma levels of TNFalpha, IL-2, IL-6 and CD4(+) and CD8(+) cells were increased on the 3(rd) postburn day (PBD) and decreased on the 6(th) PBD in B group, while the CD4(+) and CD8(+) cells were increased significantly and the plasma levels of TNFalpha, IL-2, IL-6 decreased obviously on the 3(rd) PBD in BT group. And the plasma levels of IL-2 and IL-6 in BT group on the 6(th) PBD showed no difference from those in C group. But the plasma TNFalpha level in BT group was evidently higher than that in B and C group on the 6(th) PBD. Furthermore, the plasma levels of TNFalpha, IL-2 and IL-6 in BT group were still increased gradually on the 10(th) PBD, while the IL-2 and IL-6 levels were decreased obviously in B group, but the TNFalpha level was increased.

CONCLUSIONSystemic administration of rhGH during different states of stress exerted different effects on T cell induced immunity and systemic inflammatory response.

Animals ; Burns ; blood ; drug therapy ; immunology ; CD4-Positive T-Lymphocytes ; immunology ; CD8-Positive T-Lymphocytes ; immunology ; Female ; Human Growth Hormone ; therapeutic use ; Interleukin-2 ; blood ; Interleukin-6 ; blood ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; therapeutic use ; Tumor Necrosis Factor-alpha ; blood ; Wound Healing ; drug effects

Objective To understand the mental authorization status and job burnout for domestic nursesandanalyze the correlation between them, and to explore new strategies to prevent and reduce nurse job burnout.Methods There were 203 clinical nursesinvolved, who were chosen from 5 first-class leveltop first class hospitals in Guangzhou, using mental authorized scale and job burnout scale questionnaires made by ourselves to investigate the basic information, psychological empowerment and job burnout.Results Perception of nurses’ mental authorizationachieved (4.75 ±0.67) (the medium level), while self-efficacy acquired the highest score (5.34 ±0.73) compared work effectiongained the lowest one (3.64 ±0.11).The nurses had suffered severe burnout, which performed asloss of personal accomplishment dimension (3.83 ±0.62), emotional exhaustion dimension (2.96 ±0.81) and depersonalization tendency dimensions (1.89 ±0.84);nurses perceived psychological empowerment and job burnout had negative correlation with emotional exhaustion, depersonalization tendencies, personal accomplishment dimension ( r = -0.436, -0.366, 0.514, respectively;P<0.01).Working influence had less correlation with job burnout dimensions, especially with the dimension of depersonalization work and job burnout dimensions affect the correlation was not obvious, especially with the tendency to personify no correlation dimension (r=-0.094,P>0.05).Conclusions The mental authorizationof clinical nurses just acquires middle level;hence, clinical nursing managers should enhance nurse's mental authorizationto release job burnout.

Objective The aim of this study is to evaluate the clinical significance of High-risk Human Papilloma virus DNA Detection Kit(Cervista HPV HR) designed to the utilized in cervical cancer screening programs. Methods The investigation for Cervista HPV HR test is designed to detect 437 residual liquid-based cytology specimens collected during routine liquid-based Pap tests at standard care vistis and to identify the presence of HR HPV. We compared Cervista HPV HR Test against standard PCR,in order to examine the performance of Cervista HPV HR Test in populations with cervical intraepithelial neoplasia grade 2 + ( CIN 2, CIN 3 and Cancer, CIN 2 + ), and the capabilities of A5/A6, A7, A9 oligonucleotides of Cervista for predicting CIN2 +. Results The accuracy of Cervista compared to PCR with bi-directional sequencing was 88.26%. The positive percent of Cervista HPV HR Test and PCR were 38.96% and 29.08%, respectively. The sensitivity, specificity, negative predictive value (NPV) and positive predictive value ( PPV ) of Cervista HPV HR Test for the detection of CIN2 + were 98.46%,58.49% ,99. 54% and 29. 68%, respectively. The A9 oligonucleotides positivity percent was significantly higher in CIN2 + (odds ratio:24. 037,95% CI:10. 086 -57. 283). Conclusion The Cervista HPV HR test can be clinically used for detecting HR HPV types during routine cervical cancer screening. A9 oligonucleotides were also strongly associated with CIN2 + diagnosis, which is improtant in cervical cancer screening for triage to colposcopy.

Clinical breakpoints are used in phaseⅡorⅢclinical trials to categorize microorganisms if susceptibility to new tested antibacterial agents that means the patient infected by the pathogen will be enrolled the study or not.The role of this consensus is to define procedure and required data to setting breakpoints and how to revaluate it in clinical trials.