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.

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

OBJECTIVEThe 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.

METHODSThe 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+.

RESULTSThe 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).

CONCLUSIONThe 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.

Adult ; Aged ; Aged, 80 and over ; Alphapapillomavirus ; genetics ; isolation & purification ; DNA, Viral ; genetics ; Early Detection of Cancer ; methods ; Female ; Humans ; Middle Aged ; Papillomavirus Infections ; diagnosis ; virology ; Reagent Kits, Diagnostic ; Uterine Cervical Neoplasms ; diagnosis ; virology ; Young Adult

OBJECTIVETo probe into clinical value of comprehensive program of acupuncture, moxibustion and massage as main for treatment of cervical spondylopathy of the nerve root type.

METHODSFive centers, single blind, randomized controlled method were used, 660 cases were divided into a treatment group of 317 cases and a control group of 311 cases. They were treated respectively with comprehensive program of acupuncture, moxibustion and massage as main, and comprehensive program of physical therapy as main. Establish syndrome detection scale and multiply dimensional effect assessment indexes, and evaluate the therapeutic effects and safety.

RESULTSThe cured rate, the cured-markedly effective rate were 42.9%, 64.4% in the treatment group, respectively, better than 16.7%, 36.3% in the control group (P<0.01); after treatment of 2 weeks, clinical symptoms improved in the both groups, but the treatment group was better than the control group in the improvement degrees of neck-shoulder-limb pain, neck rigidity, abnormality of cervical anteflexion, etc. (P<0.01 or P<0.05); the treatment group was shorter than the control group in the time of producing the effect and therapeutic course (P<0.01).

CONCLUSIONComprehensive program of acupuncture, moxibustion and massage as main is safe and effective for treatment of cervical spondylopathy, with a better therapeutic effect compared with the comprehensive program of physical therapy.

Acupuncture Therapy ; Humans ; Massage ; Moxibustion ; Single-Blind Method ; Spinal Diseases

OBJECTIVE: To study the effects of Kushen gel on the growth of six common vaginal lactobacilli in vitro.METHODS: This study was conducted at Beijing Tsinghua Changgung Hospital from June 2018 to March 2019.Six different vaginal lactobacilli isolated from the healthy women of reproductive age in China were purified and cultured in vitro. The effect of different concentrations of Sophora flavescens alkaloid,which was the main active ingredient of Kushen gel,on the growth of various clinical lactobacillus isolates was observed by the agar dilution method.RESULTS: The minimum inhibitory concentration(MIC)of Sophora flavescens alkaloid to Lactobacillus rhamnosus was 40 mg/mL. The MICs for Lactobacillus crispatus,Lactobacillus jensenii,Lactobacillus gasseri and Lactobacillus reuteri were all 20 mg/mL. The MIC for Lactobacillus vaginalis was 10 mg/mL.When the concentration of Sophora flavescens alkaloid was lower than the MIC value,it had a certain effect on promoting proliferation of both Lactobacillus gasseri and Lactobacillus reuteri,but had no effect on Lactobacillus crispatus or Lactobacillus vaginalis.CONCLUSION: Under the clinical dosage,Kushen gel does not inhibit the growth of common vaginal lactobacilli,which is conducive to the recovery of the vaginal microecosystem.

BACKGROUNDLiquid-based cytology (LBC) offers an alternative method to biopsy in screening endometrial cancer. Cell block (CB), prepared by collecting residual cytological specimen, represents a novel method to supplement the diagnosis of endometrial cytology. This study aimed to compare the specimen adequacy and diagnostic accuracy of LBC and CB in the diagnosis of endometrial lesions.

METHODSA total of 198 women with high risks of endometrial carcinoma (EC) from May 2014 to April 2015 were enrolled in this study. The cytological specimens were collected by the endometrial sampler (SAP-1) followed by histopathologic evaluation of dilatation and curettage or biopsy guided by hysteroscopy. The residual cytological specimens were processed into paraffin-embedded CB after LBC preparation. Diagnostic accuracies of LBC and CB for detecting endometrial lesions were correlated with histological diagnoses. Chi-square test was used to compare the specimen adequacies of LBC and CB.

RESULTSThe specimen inadequate rate of CB was significantly higher than that of LBC (22.2% versus 7.1%, P < 0.01). There were 144 cases with adequate specimens for LBC and CB preparation. Among them, 29 cases were atypical endometrial hyperplasia (11 cases) or carcinoma (18 cases) confirmed by histology evaluation. Taking atypical hyperplasia and carcinoma as positive, the diagnostic accuracy of CB was 95.1% while it was 93.8% in LBC. When combined LBC with CB, the diagnostic accuracy was improved to 95.8%, with a sensitivity of 89.7% and specificity of 97.4%.

CONCLUSIONSCB is a feasible and reproducible adjuvant method for screening endometrial lesions. A combination of CB and LBC can improve the diagnostic accuracy of endometrial lesions.

Adult ; Aged ; Biopsy ; methods ; Cross-Sectional Studies ; Cytodiagnosis ; methods ; Early Detection of Cancer ; methods ; Endometrial Hyperplasia ; diagnosis ; Endometrial Neoplasms ; diagnosis ; Endometrium ; pathology ; Female ; Humans ; Middle Aged ; Sensitivity and Specificity ; Specimen Handling