Objective To investigate the clinical efficacy and safety of hysteroscopy surgery combined with methotrexate (MTX) for treating the patients with cesarean scar pregnancy(CSP).Methods The clinical data of 64 patients with CSP were retrospectively analyzed.The patients were divided into observation group (46 cases) and control group (18 cases) according to treatment methods,the control group was given the therapy of local pregnancy intracapsular MTX combined with uterine curettage,and the observation group was given the therapy of local pregnancy intracapsular MTX combined with lesions removed surgery by hysteroscopy.The intraoperative blood Ioss,epistrophy time of β-human chorionic gonadotrophin (hCG),hospitalization time,clinical efficacy of the two groups were observed.Follow-up for 6 months the menstruation of the two groups was observed.Results The total effective rate in observation group was significantly higher than that in control group [100.0％ (46/46) vs.66.7％ (12/18),x2 =16.920,P ＜ 0.01].The intraoperative blood loss,epistrophy time of β-hCG and hospitalization time in observation group were significantly lower than those in control group [(35.46 ± 11.63) ml vs.(176.78 ± 57.96) ml,(21.04 ± 6.79)d vs.(39.65 ± 12.79) d,(13.89 ±4.63) d vs.(26.82 ±8.94) d,P＜0.01].The observation group had a successful surgery and no complications.In the control group,4 cases occurred uterine curettage intraoperative bleeding,2 cases underwent open lesion resection and then were forced to line hysterectomy.The rate of menstruation in observation group after operation 30-39 d was significantly higher than that in control group [84.8％ (39/46) vs.25.0％ (4/16),P ＜ 0.01].Conclusions Hysteroscopy surgery combined with MTX for treating the patients with CSP has exact clinical effect.It is safe and reliable,and is worthy of promotion and application.

Abstract?AIM: To investigate the risk factors and prognosis of posterior capsular rupture in phacoemulsification cataract surgery through analyzing the cataract patients in our hospital.?METHODS:Totally 1825 patients (1912 eyes) treated in our hospital were selected from November 2012 to November 2015. The patients with posterior capsular rupture were as observation group.Control group was randomly selected with a 1: 4 ratio in patients without posterior capsular rupture.All the patient's age, gender, type of cataract, ocular disease history, other medical history, surgical history, preoperative intraocular pressure, the eyes affected, the health situation, visual acuity at 1d before and after surgery and other factors were recorded and analyzed for risk factors and prognosis.?RESULTS: Statistical results showed gender, type of cataract, preoperative intraocular pressure, history of tobacco and alcohol, eyes affected and other factors did not impact on the rupture rate ( P>0.05 ); and type of nucleus, preoperative visual acuity, some eye diseases were the risk factors for posterior capsule rupture ( P<0.05).Postoperative visual acuity of the two groups was all improved, but visual acuity of patients with posterior capsule rupture significantly decreased.?CONCLUSION: With eye disease history ( a history of vitreous hemorrhage, retinal detachment before surgery and preoperative visual acuity <20/200) are more likely to result in intraoperative posterior capsular rupture.Nuclear hardness over grade Ⅳ is also an important risk factor. Before one surgery, it is needed to learn more about the medical history of cataract patients, to conduct a reasonable comprehensive assessment for risk factors, to decrease the risk in the surgery, which are to increase the success rate and to improve the prognosis.

Bisphosphonate,as a first line medicine for treating osteoporosis,has been efficacious in reducing the incidences of fractures and some tumors.Although severe side effects such as osteonecrosis of the jaw (ONJ) and atypical fracture of femur would take place,its very low incidence does not affect the current status of bisphosphonates in the treatment of osteoporosis.

Bisphosphonates have been efficacious in preventing bone loss and reducing fractures in men and postmenopausal women with osteoporosis.Possible risks of osteonecrosis of the jaw and atypical femur fractures have been reported with bisphosphonates treatment,despite these incidences are very low.Oral bisphosphonates are associated with upper gastrointestinal side effects and iv bisphosphonates with acute phase reactions,the association of bisphosphonate use with esophageal cancer and atrial fibrillation is not well supported by current data.

Objective To study the correlative risk factors of uterine cavity adhesion (UCA),and observe the clinical efficacy of hysteroscope operation treatment of UCA.Methods According to whether the occurrence of UCA,120 patients with spontaneous abortion were divided into two groups.The correlative risk factors of UCA were analyzed by multiple factors regression analysis.The patients with UCA were treated with hysteroscope operation treatment,and the clinical efficacy were observed.Results In 120 patients with spontaneous abortion,46 patients (38.3％) had UCA.Single factor analysis result showed:UCA was correlated with pelvic inflammation,gravidity,uterine cavity suction negative pressure,uterine cavity suction time (P ＜ 0.05),but UCA was not correlated with age,years of education,occupation,gestational weeks,menarche age (P＞ 0.05).Multiple factors analysis result showed:UCA was correlated with pelvic inflammation,uterine cavity suction negative pressure,uterine cavity suction time (P ＜ 0.05).The total effective rates of hysteroscope operation treatment of mild,moderate and severe UCA were 100.0％ (18/18),93.8％ (15/16)and 83.3％ (10/12) respectively,there was no significant difference among them (P ＞ 0.05).Conclusions Along with the increasing of uterine cavity suction negative pressure and extension of uterine cavity suction time,the risk of UCA is also increasing,pelvic inflammation is also an independent risk factor of UCA.Hysteroscope operation treatment of UCA has better curative effect,especially for mild UCA,it is worth clinical application.

Pancreatic cancer is one of the most malignant cancer of all neoplasm.85% cases are not suitable for surgery when at first counsultation to doctors.The effects of chemotherapy and radiotherapy are not satisfactory either.With the advancement of the study of molecular biology,the research of the molecular targeted drugs such as EGFR inhibitor and VEGF inhibitor,become one of the hot spots.This article reviews progress in the research of molecule-targeted therapy.

Objective To determine the feasibility of using Tet-on regulatory system to transfect primary rabbit bone marrow stem cells, and to control the activities of the target gene. Methods The Tet-on regulatory system were used to transfect bone marrow stem cells by lipofectamine with the increasing concentration of doxycycline (Dox), the activity of the fluorescence caused by the expression of the target gene (the luciferase gene) which transfected to bone marrow stem cells with Tet-on regulatory system were analyzed. Results Plasmids DNA after being digested by enzymes and agarose electrophoreses were analyzed. The DNA segments were cored with the plasmid map. The two DNA segments with the size of 6.02 kb and 1.38 kb could be detected after the plasmid of pTet-on, 5.2 kb DNA segment could be seen after the plasmid of pTRE-luciferase was digested by Hind Ⅲ. With the increasing concentration of Dox, the activity of the fluorescence caused by the expression of the target gene increased gradually. Although the uninfected bone marrow stem cells were induced, the relative-luciferase-unit(RLU) value was almost the same as that of the blanket control. It showed that uninfected bone marrow stem cells were not induced by Dox. The RLU value in infected bone marrow stem cells before induction was slightly high, but similar with the blanket control. This experiment shed light on that infected bone marrow stem cells showed good response to the induction by Dox. Conclusion With the help of Lipofectamine, the cultured bone marrow stem cells can be transfected by Tet-on regulatory system successfully. The expression of the target gene transfected to bone marrow stem cells with Tet-on regulatory system could be regulated by Dox.

Objective To construct vectors based on adeno-associated virus type 2 (rAAV2) carrying bone morphogenetic protein-7 (BMP-7) and observe their expression in adipose-derived adult stem cells, which can be served as a new gene therapy method and cell source for bone tissue engineering. Methods The coding sequence (1. 3 kb) of BMP-7 was amplified by PCR from the pcDNAl. 1 ( + ) plasmid containing the human BMP-7 cDNA. After purified, the gene fragments were cloned into a plasmid pUC18 and termed plasmid pUC18-hBMP7. The recombinant pUC18-hBMP7 was digested and further ligated to the pSNAV by T4DNA ligase and termed plasmid pSNAV-hBMP7. BHK-21 cells were transfected with the purified pSNAV-BMP7 plasmid according to a standard calcium phosphate precipitation method. The cells were isolated and the integrity of hBMP7 gene was determined by polymerase chain reaction (PCR) using the above PCR primers. To package the virus, stably transfected BHK-21 cells were subsequently infected with recombinant herpes simplex virus type 1 (rHSV-1). The collected cells were processed by chloroform treatment, PEG8000/NaCl precipitation and chloroform extraction for purification. The tiler was determined using quantitative DNA dot blots and the purity was examined by sodium dodecyl sulphatepolyacrylamide gel electrophoresis. Following infection with rAAV2-BMP7 at multiplicities of infection of 1?105 vector genomes per cell and subsequent culture, adipose-derived adult stem cells were assessed qualitatively for BMP7 production. Results The recombinant plasmid pSNAV-hBMP7 was identified by PCR and digested with restriction enzyme. Transfection showed an efficiency of 90 % in ADAS cells. BMP-7 expression in ADAS cells was identified by Western blot. Conclusions The hBMP-7 recombinant adeno-associated virus vectors can be successfully constructed in vitro and rAAV2-hBMP7 can infect ADAS cells.

BACKGROUND:In osteoarthritis cartilage degeneration, connective tissue growth factors as the important effector molecules play an important role in chondrocyte proliferation and differentiation. Clinical application of diacerein for the treatment of osteoarthritis has achieved good effect, but the exact mechanism of the treatment is unclear. OBJECTIVE:To observe the effect of different concentrations of diacerein on the expression of connective tissue growth factor in the articular cartilage induced with interleukin-1βin vitro. METHODS: Chondrocytes of Sprague Dawley rats were culturedin vitro, and then the chondrocytes were induced with recombinant human interleukin-1β to prepare the osteoarthritis model. Rats in the normal control group received no treatment; rats in the model group were treated with recombinant human interleukin-1β; rats in the experimental group were treated with different concentrations of diacerein+10 μg/L recombinant human interleukin-1β. The proliferation of chondrocytes was observed withMTT assay, and Western blot was used to detect the expression of connective tissue growth factor. The experiments above were repeated for three times. RESULTS AND CONCLUSION:The MTT assay results showed that compared with the normal control group, the diacerein could promote the proliferation activity of chondrocytes, and more significant in the concentration of 10-5 mol/L (P < 0.01); the proliferation capacity of chondrocytes in the experimental group was decreased after induced with interleukin-1β (P < 0.05), but when compared with the normal control group, the diacerein with the concentrations of 10-4 mol/L and 10-5 mol/L could promote the MTT proliferation capacity of chondrocytes with or without interleukin-1β (P < 0.05). Western blot results showed that interleukin-1β could reduce the expression of connective tissue growth factor (P< 0.01), and 10-5 mol/L diacerein could significantly promote the expression of connective tissue growth factor induced with interleukin-1β, and the effect was significantly higher than that in the model group (P < 0.01). Diacerein can promote expression of connective tissue growth factor induced with interleukin-1β, it may be one the mechanism of diacerein for promoting chondrocytes differentiation and proliferation and the treatment of osteoarthritis.

The FRAX (Fracture Risk Assessment Tool) calculator is an application of different clinical risk factors to predict the absolute risk of fracture.It is the model based on a series of data of evidence-based medical researches on fracture risk factors.FRAX is limited by a number of factors.However,it is a major achievement in terms of our understanding and measuring fracture risk.