Objective To find out the clinical effects of mifepristone in the treatment of perimenopausal dysfunctional uterine bleeding.Methods 87 patients with perimenopausal dysfunctional uterine bleeding were received mifepristone treatment.The thickness of the endometrium and sex hormones indicators,including progesterone(P),estrogen (E2),the corpus luteum generated hormone (LH),follicle hormone (FSH),prolactin (PRL) and testosterone (T),were checked before and after treatment.Results The treatment efficiency was 90.8％.Endometrial thickness before treatment (10.9 ± 1.9) mm,endometrial thickness after treatment (5.4 ± 1.1) mm,with significant differences between them(t =0.684,P ＜ 0.01).After treatment,patients with hemoglobin (102.5 ± 7.1) g/L,significantly increased compared with before treatment (t =0.539,P ＜ 0.01).After treatment,the P,E2,LH,FSH levels were significantly lower than those of before treatment (t =0.690,0.552,0.513,0.376,all P ＜ 0.05) ; PRL,T levels after treatment compared with before treatment,there were no significant differences (all P ＞ 0.05).Conclusion The mifepristone treatment for perimenopausal uterine bleeding has high effective rate,less adverse reactions,and high clinical value.

OBJECTIVE:To calculate pharmacokinetic parameters and compartment model's parameters by extravascular administration based on Excel function.METHODS:The parameters of pharmacokinetics and compartment model were calculated using residual method and Excel function.RESULTS:Excel can be used to directly demonstrate calculation process of parameters of pharmacokinetics and compartment model,with calculation results in line with those stated in textbooks.CONC-LUSION:The established method is simple,direct-viewing,reliable and easy to be extended,and it can be used to calculate pharmacokinetic parameters in clinical teaching or experiments.

Objective To study the histological and immunohistochemical features of primary and metastatic ovarian mucinous adenocarcinoma. Methods 24 cases of primary ovarian mucinous adenocarcinoma and 16 cases of metastatic mucinous adenocarcinoma (5 gastric, 5 appendix, 6 colorectal) with definite diagnosis were included in this study. All the tissue sections with either HE staining or immunohistochemical staining with CK7 and CK20 monoclonal antibodies were studied. Results All the 24 primary mucinous adenocarcinoma were positive for CK7 and only 3 cases showed focal positive for CK20. Among the 16 secondary mucinous adenocarcinoma, 6 colorectal and 5 appendiceal metastatic adenocarcinoma were positive for CK20 and only one metastasis showed focal positiveness for CK7. The five gastric metastatic mucinous adenocarcinoma showed strong CK7 expression and four of them were CK20 positive. Conclusions The primary and secondary mucinous adenocarcinoma of the ovary had different immunohistochemical features. CK7 and CK20 were valuable markers in the differentiation of these two entities.

Leukoencephalopathy with ataxia (LKPAT) is a rare autosomal recessive disorder caused by mutations of CLCN2 gene. LKPAT is clinically characterized by cerebellar ataxia, headache and cognition impairment. Brain magnetic resonance imaging showed characteristic hyperintensities along the pyramidal fiber tracts. Few cases have been reported so far. This article reported the clinical data of a 48 years old female patient with LKPAT for clinical reference.

Objective To retrospectively analyze the mid-term functional outcome and quality of life in elderly patients undergoing the mobile-bearing versus fixed-bearing total knee arthroplasty.Methods Patients aged over 65 years who underwent total knee arthroplasty during January 2002 to December 2010 were followed up.The knee joint function was assessed by Western Ontario and McMaster Universities (WOMAC) score.Quality of life was assessed by using SF-16 (Short Form36) questionnaire.Data of mobile-bearing versus fixed-bearing groups were statistically analyzed.Results 157 cases (194 knees) were followed up completely.The mean follow-up period was (5.06±2.47) years (range 2.08-10.75 years).The mean age was (72.4±4.3) years (range 65-86 years old).Preoperative versus postoperative WOMAC scores were (48.2 ± 14.9) vs.(10.7±9.1) (P＜0.01).There was no significant difference in WOMAC score between the fixed-bearing group and the mobile-bearing group during the follow up [(10.12±8.76) vs.(11.38±9.55),t=0.861,P＞0.05].The mean SF-36 score was (119.65± 12.03) in the overall population of patients,which showed no significant difference as compared with the good and moderate optimal truncation value of 117 (t =2.759,P＞0.05).There was no significant difference in SF-36 score between the fixed-bearing group and the mobile-bearing group [(120.17±11.06) vs.(119.06±13.07),t=0.575,P＞0.05].Conclusions Total knee arthroplasty can improve the knee joint function and quality of life in elderly patients with severe knee osteoarthritis.For the elderly,the mid-term functional outcome and life of quality are similar in the mobile-bearing and the fixed-bearing total knee arthroplasty,and any kind of prostheses can be chosen to use,

Objective To parse the concept of self-management in the context of coronary heart disease based on the content analysis,to clarify the connotation of the concept of self-management.Methods Thirty-four references were recruited through the databases of CNKI,VIP journals knowledge service platform,Wanfang Data Services Platform and Pubmed.We broke the concept of self-management in the context of coronary heart disease into such three aspects as implementing body,major behavior,and facilitators.Results The most common indicators were symptom management(which was mentioned by 78.57％ of domestic literature and 66.67％ of foreign literature),and protect and promote healthcame second,the person with the chronic diseasewas 42.85％,other indicators' frequency existed differences.The major body of coronary artery disease self-management was the patient itself,with the help of assist staff and using lifestyle management,symptom management,rehabilitation and exercise,environmental control,emotional awareness behavior management and medication to maintain patients' satisfactory functional status.Conclusions To parse the concept of self-management in the context of coronary heart disease can be applied as the basis for clinical nursing research and build an effective reference and guidance for future coronary heart disease self-management model building.

PNS (Panax notoginseng saponins) is the main medical bioactive component in Panax notoginseng. The medical value of PNS cannot be extended because of its low production. With the deep study of saponins biosynthetic pathway, the control of PNS biosynthesis through metabolic engineering has gradually become possible. In this study, the Squalene synthase (SS) over-expression vector was established. By the way of agrobacterium-mediated method, the vector was transfered and integrated into the Panax notoginseng genome. The result of the PCR detection and the saponin content detection shows that over-expression SS is able to produce high level of Panax notoginseng saponins, and confirms the regulatory function of SS in the biosynthesis of ginsenosides in Panax notoginseng. It provides a theoretical basis and technical basis for the construction of PNS homologous or heterologous efficient expression system in the future.

Objective: Clinical study on Jangzhuo Decoction for treating plasma concentrations of oxidized low density lipoprotein, d dimer of ischemic stroke and its relation to preventing repeated stroke.Methods: 72 cases with ischemic stroke were divided randomly and blindly into two groups. 36 patients with ischemic stroke in therapeutic group were treated with Jangzhuo Decoction M ASA, and 36 patients in control group were treated with M ASA alone. The follow up survey for six months was conducted when physical signs and symptoms of the paints with ischemic stroke begain to be stable. Results: The incidence of the repeated stroke in therapeutic group were one case(2.7%) and in control group were three cases(8.3%) respectively. Ox LDL levels of therapeutic group was 1021?102?g/dl( ?s ), decreased to 604?77?g/dl( P 0.05). There was significant difference between the two groups. D dimer levels of two grouups were all increased significantly( P

Objective To evaluate the diagnostic accuracy of contrast-enhanced MR angiography (CE MRA) in infrapopliteal occlusive diseases of diabetic patients.Methods A total of 105 patients with known diabetes and peripheral vascular occlusive disease who underwent both CE MRA and DSA examnations were included in this study.They had no obvious stenosis or with stenosis of less than 75％ in iliac,femoral,and popliteal arteries.Every infra-popliteal artery was anatomically divided into 9 vascular segments as tibiofibular trunk artery,proximal and distal anterior tibial artery,proximal and distal posterior tibial artery,proximal and distal peroneal artery,plantar and dorsalis pedis artery.There were 945 segments.The arterial stenosis was accessed with CE MRA and DSA respectively.The segments were scored in 5 categories as＜30％,≥30％ and＜50％,≥50％ and＜75％,≥75％ and＜100％,and 100％ according to stenostic degrees.The Kappa test was used to compare the diagnostic consistency of CE MRA and DSA.Taken DSA as a gold standard for reference,ROC curve was drawn to calculate the diagnostic accuracy of CE MRA in diagnosis of lower limb arterial disease.Results The ratio of statistically valid segments for both CE MRA and DSA were 97.7％ (923/945) in 945 vessel segments of 105 patients,and 390 of 923 arterial segments were both indicated as occlusion by CE MRA and DSA.The diagnostic consistency for the segments was listed in the decreasing order as follows:proximal peroneal artery,proximal posterior tibial artery,distal posterior tibial artery,proximal anterior tibial artery,distal anterior tibial artery,tibiofibular trunk artery,dorsalis pedis artery,plantar artery,distal peroneal artery,and corresponding Kappa values were 0.88,0.86,0.84,0.84,0.81,0.77,0.75,0.75 and 0.73,P＜ 0.05.The AUC(area under ROC curve) of CE MRA was 0.893 with 95％ confidence interval of 0.882 to 0.904.Conclusion CE MRA is an accurate imaging modality in the diagnosis of infrapopliteal occlusive disease s for diabetes.