Objective To investigate the effects of Kidney nourishing decoction in the treatment of reproduce patients in serum hormone .Methods 120 cases with reproduce patients from June 2014 to June 2016 in hangzhou traditional chinese medical hospital were selected,and divided into control group and experiment group, 60 cases in each group.The control group was given artificial cycle treatment, the experiment group was treated with Kidney nourishing decoction, two groups were treated for three months.Serum sex hormone and AMH content, clinical effect and pregnancy rate were compared before and after treatment.Results Compared with before treatment, levels of FSH, LH, E2 and FSH/LH in two groups decreased, AMH content increased after treatment,the thickness of endometrium and ovarian antral follicle number increased,symptom scores decreased after treatment (P <0.05);Compared with the control group, levels of FSH, LH, E2 and FSH/LH in the experiment group were lower, AMH content were higher, the thickness of endometrium and ovarian antral follicle number in the experiment group were higher,and the symptom scores were lower (P<0.05).The total effective rate of the study group was 90.00% higher than the total effective rate of the control group 73.33% (P<0.05).There was no significant difference in adverse reaction rate between the two groups, the pregnancy rate in the experiment group 30.00% was higher than the control group 11.67% ( P <0.05 ) .Conclusion Kidney nourishing decoction can reduce the sex hormone and increase the content of AMH , and increase the pregnancy rate in the treatment of reproduce patients.

Objective To evaluate feasibility of flap fenestration in management of the condition that a stent-graft is wrongly deployed in false lumen of aortic dissection.Methods A retrospective analysis was conducted on a case of Stanford type B aortic dissection who was confirmed that the stent-graft had been wrongly deployed in false lumen of aortic dissection by CT angiography (CTA) after endovascular repair.Thereafter,an additional surgical management was carried out.At length,flap fenestration at 2 cm below pre-deployed stent-graft was performed using an Outback catheter so as to link false and true lumens.Successively,another stent-graft was placed via the access to draw blood flow from false lumen back to true lumen and then coil embolization was performed for distal breach of the dissection.Results Surgery was carried out under local anesthesia,with operation duration of 170 minutes and intraoperative blood loss of 350 ml.The chest and back pain disappeared after operation.The patient commenced to take food and take off-bed activity at the very day of operation in absence of paraplegia,visceral ischemia,or other complications.Aortic CTA at postoperative one week showed ideal positioning of stent-graft,fluent blood flow of aorta and major visceral artery,and vanishing of false lumen.Conclusions Flap fenestration at far-end of pre-deployed stent-graft so as to draw blood flow back to true lumen by connecting the new placed stent graft to pre-deployed stent-graft is an effective treatment for mis-deployment of stentgraft in false lumen of aortic dissection.Outback catheter for flap fenestration is characterized by accurate location and high safety.

OBJECTIVE:To evaluate the pharmacoeconomic characteristics of dapagliflozin combined with metformin in the treatment of type 2 diabetes mellitus systematically. METHODS:Retrieved from Health Technology Assessment(HTA),Cochrane Library,PubMed,Embase,CNKI,Wanfang and CBM during database establishment to Jul. 2017,published pharmacoeconomics literatures about dapagliflozin combined with metformin were collected,using"sodium-glucose-transporter-2 inhibitors""SGLT2 inhibitor""metformin""dapagliflozin""cost""benefit""utility""effectiveness""pharmacoeconomic""economic"as English retrieval words and"SGLT2 inhibitor""dage liejing""metformin""cost""benefit""utility""effectiveness"as Chinese retrieval words. Outcome indexes included incremental cost,incremental effect,cost-effectiveness ratio and incremental cost-effectiveness ratio(ICER).The results of the economic research in the included literatures were evaluated systematically. RESULTS:Totally of 4 literatures were included,and all of them were cost-effectiveness analysis. Dapagliflozin was more cost-effective than sulfonylurea because the ICER of dapagliflozin were €2 709/QALY,€10 494/QALY,€7 939/QALY,€5 433/QALY,€4 767/QALY and €6 094/QALY in the UK,Greece,Denmark,Finland,Norway and Sweden,respectively,which were all lower than willingness-to-pay threshold. Dapagliflozin was more cost-effective than DPP-4 inhibitor,and the ICER were €7 200/QALY and €15 120/QALY in the UK and Greece,respectively,which were all lower than willingness-to-pay threshold. CONCLUSIONS:Current economic research shows compared with sulfonylurea and DDP-4 inhibitor,dapagliflozin is a cost-effective treatment alternative for patients with T2DM whose metformin regimen does not provide sufficient glycemic control.

ObjectiveTo investigate the predisposing factors and pathogenic fungal species of Malassezia folliculitis in different geographical areas and body sites.MethodsTotally,241 patients diagnosed with Malassezia folliculitis were asked to complete a questionnaire.The content of hair follicles was obtained and subjected to fungal smear and culture examination.Fungal species were identified according to morphological,physiological and biochemical features.Results Of the 241 patients with Malassezia folliculitis,204 (84.65％) were positive for smear examination.A total of 259 specimens were collected from these patients,and fungal culture grew 213(82.24％) strains,of which,209 belonged to Malassezia species,4(1.54％) to Candida species.Among the 209 Malassezia strains,186 were activated and subjected to species identification which resulted in 6 species,including M.furfur (111 strains,59.68％ ),M.sloofiae (43 strains,23.12％ ),M.sympodialis (17 strains,9.14％),M.globosa (9 strains,4.84％),M.pachydermatis (4 strains,2.15％),and M.obtuse(2 strains,1.08％ ).Of the pathogenic fungi of Malassezia folliculitis,M.furfur predominated in the chest,back,abdomen,face and neck,M.sloofiae in the upper limbs,shoulders and vertex,M.globosa in the lower limbs.There were obvious differences in the distribution of pathogenic fungal species at different body sites in a same host,and M.furfur with M.sloofiae or M.sympodialis appeared to be the most common pathogens.ConclusionsIn this study,6 Malassezia species are identified in patients with Malassezia folliculitis in Nantong and Nanjing area,M.furfur and M.sloofiae appear to be the dominant pathogens.

Objective: To investigate whether there is additi ve effects of hyperinsulinemia and ischemia on expression of canine myocardial G LUT4 gene in vivo. Methods: The expression of myocardial GLU T4 was determined by semiquantitative immunoblotting.The expression of GLUT4 mRN A was determined by semiquantitative Northern blotting. Results: Dramatic changes were seen in GLUT4 mRNA and GLUT4 expression in the ischemic hearts.After infusing insulin for 8 h,regional GLUT4 mRNA and GLUT4 levels in is chemic hearts were 2.5, 2.3-fold that of expression in normal hearts(P<0.01 ). Myocardial glucose uptake in ischemic hearts was increased by 4-fold when co mpared with normal hearts(P<0.01). Conclusion: There are not only additive effects of hyperinsulinemia and low-flow ischemia on canine myoc ardial GLUT4 mRNA and GLUT4 expression in vivo, but also increase of myocar dial glucose uptake. Enhanced GLUT4 expression may be an important protective m echanism by which myocardial cells enhance glucose uptake and metabolism during low-flow ischemia.

Objective To analyze the risk factors of underestimation from core needle biopsy (CNB) diagnosed ductal carcinoma in situ (DCIS) to invasive cancer after surgical excision.Methods One hundred and fifteen cases of CNB diagnosed DCIS treated in Obstetrics and Gynecology Hospital,Fudan University from Jan.,2010 to Dec.,2016 were analyzed retrospectively.According to postoperative pathological conditions,the cases were divided into underestimation group and non underestimation group.The clinicopathological characteristics of two groups were compared,including age,palpability,tumor diameter,microcalcification,BI-RADS classification and CNB method.Results The overall underestimating rate was 27.0％ (31/115).Univariate analysis found correlation between a palpable lesion,diameter of tumor ＞20 mm,microcalcification,a high BI-RADS classification,use of the 14/16-gauge needle method and underestimation from CNB diagnosed DCIS.Multivariate analysis by Logistic regression showed that diameter of tumor ＞20 mm (OR =0.186,95％CI:0.043-0.810,P =0.025),microcalcification (OR=0.229,95％CI:0.070-0.749,P =0.015),use of the 14/16 gauge needle method (OR =0.171,95 ％ CI:0.043-0.679,P =0.012) were independent risk factors of underestimation from CNB diagnosed DCIS.Conclusions Size of lesion ＞20 mm,microcalcification,use of the 14/16-gauge needle method were independent risk factors of underestimation from CNB diagnosed DCIS.

OBJECTIVETo explore the effective strategies for human immunodeficiency virus (HIV) surveillance and identification in rural areas of central China.

METHODSIn a selected rural prefecture area of central China, an epidemiological investigation was conducted for all reported HIV/AIDS cases. A historical and analytic review was performed, with particular interests in examining the HIV epidemic reporting and identification system.

RESULTSAmong all 626 reported HIV-infected individuals in the selected prefecture, 86.1% (539/626) of them were infected through commercial plasma donation or clinically operated blood transfusion. With respect to disease surveillance and identification in the area, 52.2% (327/626) of all the cases were reported by hospitals or clinics. The number and proportion of HIV/AIDS cases identified or reported at county, prefecture, and provincial levels were 207 (33.1%), 303 (48.4%) and 116 (18.5%), respectively. The number and proportion of HIV/AIDS identified through specific epidemiological investigations and/or voluntary testing had been increased in recent years. In addition, among HIV/AIDS cases that were clinically identified, the proportion of those who were identified as outpatients had steadily increased,with the highest proportion (59.3%) observed in 2004.

CONCLUSIONSIn rural areas of central China where the major mode of HIV transmission was through commercial plasma donation or clinically operated blood transfusion, hospitals and clinics seemed to have played and would continue to play important roles regarding HIV identification and surveillance. The role of institutions or settings at the prefecture level regarding HIV identification and surveillance should not be ignored.

Acquired Immunodeficiency Syndrome ; epidemiology ; transmission ; Adolescent ; Adult ; Aged ; Ambulatory Care ; statistics & numerical data ; Child ; Child, Preschool ; China ; epidemiology ; Demography ; Female ; Hospitalization ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Rural Population ; statistics & numerical data ; Young Adult

Pressurized solvent extraction (PSE) is a new extraction technology which has been developed in recent years and widely used as sample analysis in environmental, food and pharmaceutical fields. Extraction technique is a key technology in quality control of Chinese herb. Conventional extraction techniques have been a bottleneck of blocking the development of quality control of Chinese herb. This article attempts to review the basic principle, methods, apparatus and main characteristics of PSE and its applications to quality control of Chinese herb.
Chemistry Techniques, Analytical ; methods ; standards ; Drugs, Chinese Herbal ; isolation & purification ; Plants, Medicinal ; chemistry ; Pressure ; Quality Control ; Solvents ; Technology, Pharmaceutical ; methods ; standards

BACKGROUNDNuclear factor-kappa B (NF-kappaB) is elevated in regulating transcription of many cytokines and inflammatory mediators. The purpose of this study was to investigate the activation and the significance NF-kappaB in lipopolysaccharide (LPS) induced keratitis.

METHODSLPS induced keratitis model was based on Wistar rats. At 0.5, 1, 3, 6, 12, 24 or 72 hours after LPS treatment, the rat corneas were observed with a slit lamp microscope, then the rats were sacrificed and their corneas were excised for routine histological analysis. The expression of NF-kappaB was detected with immunohistochemical staining. The change of tumour necrosis factors-alpha (TNF-alpha) mRNA expression was identified by reverse transcriptase polymerase chain reaction (RT-PCR).

RESULTSHistological findings demonstrated that LPS treated corneas showed significant changes in corneal structure. Corneal edema, pronounced inflammatory cells infiltration and inordinate collagen fibres were observed. Immunohistochemical results showed that the expression of NF-kappaB and its activation obviously increased after LPS treatment compared with the normal group and control group. Positive cells could be observed at 0.5 hour and peak expression of NF-kappaB was observed between 3 hours and 12 hours after infection, but returned to or approached normal level by 72 hours. RT-PCR showed that the level of TNF-alpha mRNA began to increase 0.5 hour after LPS treatment, peaked at 6 hours and then subsided by 72 hours. NF-kappaB had a positive correlation with the expression of TNF-alpha mRNA (r = 0.964, P < 0.01), both NF-kappaB and TNF-alpha had a strong positive correlation with the degree of inflammatory response in LPS treated corneas (r = 0.929, P < 0.01; r = 0.587, P < 0.05, respectively).

CONCLUSIONSThe activation of NF-kappaB was increased in LPS treated corneas and was elevated in LPS induced keratitis by promoting overexpression of TNF-alpha mRNA. NF-kappaB may play an important role in the pathogenesis of LPS-associated keratitis in rats.

Animals ; Aqueous Humor ; cytology ; Epithelium, Corneal ; physiology ; Immunohistochemistry ; Keratitis ; chemically induced ; pathology ; Lipopolysaccharides ; toxicity ; NF-kappa B ; analysis ; physiology ; RNA, Messenger ; analysis ; Rats ; Rats, Wistar ; Tumor Necrosis Factor-alpha ; genetics ; physiology

OBJECTIVETo investigate the expressions of human telomerase reverse transcriptase (h-TERT), c-myc, and proliferating cell nuclear antigen (PCNA) in chronic viral hepatitis (CVH), liver cirrhosis and primary hepatocellular carcinoma (HCC) and understand their possible role in liver carcinogenesis.

METHODSTotally 157 liver disease specimens were collected, including 56 CVH, 52 liver cirrhosis and 49 primary HCC specimens. In situ hybridization was performed on these specimens to examine the expressions of h-TRET and c-myc mRNA, and immunohistochemistry carried out for PCNA detection, with the cell apoptosis detected with in situ ending labeling.

RESULTSIn the CVH, liver cirrhosis and primary HCC specimens, h-TERT expression was detected at the frequencies of 11/56 (19.6%), 43/52 (82.7%) and 44/47 (93.6%), c-myc expression at 7/56 (12.5%), 21/52 (40.4%) and 26/47 (55.3%), with apoptotic index of (27.3-/+4.7)%, (16.5-/+2.6)% and (8.7-/+1.3)% and PCNA expression rate of (17.1-/+2.9)%, (49.3-/+7.8)% and (62.5-/+9.1)%, respectively. Correlations among h-TERT, c-myc, and PCNA expressions and the apoptotic index were not found in the examined tissues (P>0.05).

CONCLUSIONLiver carcinogenesis may involve increased h-TERT, c-myc, and PCNA expressions and suppressed cell apoptosis.

Adult ; Apoptosis ; Carcinoma, Hepatocellular ; genetics ; metabolism ; pathology ; Cell Transformation, Neoplastic ; Female ; Hepatitis B, Chronic ; genetics ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Liver Cirrhosis ; genetics ; metabolism ; pathology ; Liver Neoplasms ; genetics ; metabolism ; pathology ; Male ; Middle Aged ; Proliferating Cell Nuclear Antigen ; biosynthesis ; Proto-Oncogene Proteins c-myc ; genetics ; RNA, Messenger ; genetics ; metabolism ; Telomerase ; genetics