Objective To investigate the application value of transvaginal three-dimensional ultrasound combined with tomographic ultrasound imaging (TUI) in the diagnosis of early ectopic pregnancy. Methods One hundred and twenty patients with 4 to 6 weeks menopause were collected. All of the cases were clinical suspected of ectopic pregnancy and the surgical pathology and clinical follow-up results of each case were obtained. Both transvaginal two dimensional ultrasound imaging and three-dimensional ultrasound imaging combined with TUI technique were applied in order to make a diagnosis based on ultrasonographic characteristics for each of the case;surgical pathology and clinical follow-up results were compared with the ultrasonographic diagnosis so as to analysis and conclude the ultrasonographic imaging characteristics of cases misdiagnosed or missed diagnosed by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI technique. Results One hundred and two cases were confirmed as ectopic pregnancy by surgical pathology and clinical follow-up results among 120 patients and eighteenth cases were confirmed as intrauterine pregnancy. Comparing surgical pathology and clinical follow-up results with the ultrasonographic diagnosis showed:(1) Ninety-two cases of tubal pregnancy:80 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (86.9%, 80/92) while 84 cases by three-dimensional combined with TUI technique (91.3%, 84/92); 8 cases were missed diagnosed by both two methods;4 cases were misdiagnosed by transvaginal two-dimensional ultrasound imaging while zero case by three-dimensional combined with TUI technique. Ultrasonographic imaging characteristics:adnexal masses presented as“Donut”sign which was similar to gestational-sac or masses with irregular boundary. The majority of the masses presented as clear boundaries and internal structure and had obvious margins with fallopian tube. A total 36 cases of unruptured tubal pregnancy were correctly diagnosed by the two methods while 43 cases of abortion type and 5 cases of ruptured type were correctly diagnosed. (2) Ten cases of uterine cornual pregnancy:6 cases were correctly diagnosed by transvaginal two-dimensional ultrasound imaging (60.0%, 6/10) while 9 cases by three-dimensional ultrasound imaging joint TUI technique (90.0%, 9/10);4 cases were misdiagnosd by transvaginal two-dimensional ultrasound imaging and 1 case by three-dimensional ultrasound imaging joint TUI technique. Ultrasonographic imaging characteristics:the gestational-sac was located in the uterine horn, 6 cases of gestational-sac was not connected with endometrium showed by transvaginal two-dimensional ultrasound imaging while 9 cases were clearly showed by three-dimensional ultrasound imaging joint TUI technique that the gestational-sac was connected with endometrium, especially in the coronal-section. The surrounding decidua circumvoluted the gestational-sac was unclear in 4 cases by transvaginal two-dimensional ultrasound imaging and in 9 cases by three-dimensional ultrasound imaging joint TUI technique. And‘interstitial line’ sign appeared in 4 cases showed by transvaginal two-dimensional ultrasound imagingwhile 6 cases by three-dimensional ultrasound imaging joint TUI technique. (3) Cases missed diagnosed and misdiagnosed:8 cases of early ectopic pregnancy were missed diagnosed both by transvaginal two-dimensional ultrasound imaging and three-dimensional ultrasound imaging joint TUI. The reasons we concluded were as follow:‘false gestational-sac’ located in the uterine cavity;the location of the gestational-sac was so closed to uterine cavity. Four cases of tubal pregnancy and 4 cases of uterine cornual pregnancy were misdiagnosed by transvaginal two-dimensional ultrasound imaging. The location of the ectopic pregnancy mass and the gestational-sac of 7 cases of uterine cornual pregnancy were clearly showed by three-dimensional ultrasound imaging joint TUI and only 1 case was misdiagnosed. Conclusions Transvaginal three-dimensional ultrasound imaging combined with TUI technique can provide more detailed ultrasound diagnostic information and reduced missed diagnosis and misdiagnosis of the early ectopic pregnancy. The clinical application value of transvaginal three-dimensional ultrasound imaging combined with TUI technique in the diagnosis of early ectopic pregnancy was good.

Objective To investigate the cytidylyl phosphate guanosine(CpG) islands methylation status of E-cadherin (E-cad) promoter region in human ovarian carcinoma cell lines (ES-2,3 AO, SKOV3 ), and the effect of 5-azacytidine-2 '-deoxycytidines (5-Aza-CdR ) on the cell proliferative ability, invasion and the expression of E-cad protein. Methods Methylation specific PCR(MSP) was used to detect CpG islands methylation status of E-cad promoter region in ES-2,3AO and SKOV3 cell lines. After treated with different concentrations of 5-Aza-CdR, morphological changes of cell lines were observed under microscope. The proliferative ability was evaluated by methyl thiazolyl tetrazolium(MTT) assay. E-cad protein expression was detected by western-blot and cellular invasion was investigated by 24-well matrigel invasion chambers. Results Hypermethylatian status of CpG islands of E-cad promoter region was observed in ES-2 and SKOV3 cell lines, but not in 3AO cell lines. After treated with 5-Aza-CdR (0.1,1.0,10.0 μmol/L), ES-2 and SKOV3 cell lines displayed morphological evidence of differentiation. 5-Aza-CdR was found to decrease proliferation as evidenced by cell growth curve , to increase the level of E-cad protein expression (P ＜ 0.01 ), and effectively inhibit the ability of cell invasion(P ＜0.01 ). Conclusions CpG hypermethylation is an important mechanism of E-cad gene inactivation in ES-2 and SKOV3 cell lines. 5-Aza-CdR be found to inhibit proliferation and invasion, and increase the expression of E-cad probably by the inhibition of hypermethylation.

Children′s unique physiological, developmental and psychological attributes make them one of the most vulnerable groups in large-scale flood disasters.Formulating a reasonable and feasible emergency preparedness plan for flood disasters can improve their ability to cope with flood disasters and optimize the outcomes of children suffering from flood disasters.The emergency preparedness plan for children′s flood disaster should cover the allocation and utilization of various resources during disasters, regional cooperative rescue and evacuation of children, ethical problems in treatment under special circumstances, psychological counseling of children, family members and medical personnel.Relevant staff of pediatric emergency rescue need to consider all aspects and make reasonable plans so that the rescue work of children affected by disasters can be carried out in an orderly manner.

AIM: To investigate the constituents of the effective fractions from Shenshao Xinxin Prescription(Radix et rhizoma ginseng;Radix paeoniae rubra;Radix puerariae lobatae). METHODS: The compounds were isolated by column chromatography on silica gel,polyamide,sephadex gel and their structures were determined on the basis of their spectroscopic evidence including UV,FAB-MS and NMR data. RESULTS: Eight compounds had been isolated and identified as daidzein,4′-O-methyl-daidzin,genistin,PG-3,puerarin,paeoniflorin,daidzein 8-C-Apiosyl(1→6) glucoside,4′,7-diglucoside. CONCLUSION: The compounds obtained were the alcohol-soluble compounds from Shenshao Xinxin Prescription.

Objective To elucidate the analgesic activity of the ethanol extracts from the root of Daphne genkwa (EERD). Methods The analgesic activity of EERD was evaluated by the effects on adjuvant-induced nociceptive response and paw swelling, the formation of PGE_2 and IL-1? in adjuvant arthritis (AA) rats, the activities of SOD and CAT, the levels of NO/iNOS in serum and brain tissue as well as by the effects on c-Fos protein expression in spinal cord of AA rats. Results EERD at used doses significantly delayed the adjuvant-induced nociceptive response and eased the paw swelling in AA rats. EERD also evidently inhibited the production of PGE_2 and IL-1?, and enhanced the activities of SOD and CAT in the tissue of paws being injected by adjuvant. Furthermore, it remarkably reduced the content of NO and inactivated the activity of iNOS in brain tissue of AA rats. In addition, EERD at used doses exhibited prominent inhibition on adjuvant-induced expression of c-Fos protein in the spinal cord of AA rats. Conclusion EERD is an effective agent for analgesia. The possible mechanisms for its analgesia might be the actions of inhibiting the production of PGE_2 and the release of IL-1?, reducing the activity of iNOS and hence the generation of NO in brain tissue, and blocking superoxidation through enhancing the activity of SOD and CAT.

Objective To investigate the clinical significance and abnormal expression of the CREB in different grade gliomas. Methods The expression of CREB was examined by using immunohistochemistry in brain tissues from the brain injury (5 cases) and different grade gliomas (55 cases).The mRNA and protein levels of CREB were further as?sessed using Western blot and RT-PCR in brain tissues from the patients with brain injury (10 cases) and those with dif?ferent grade gliomas (30 cases). Results The positive rates of CREB immunohistochemistry were 2/5 in control, 10/15 inⅠ-,Ⅱ11/12 in Ⅲ, 28/28 in Ⅳ. The positive rates of CREB were significantly different among different groups (H=28.183,P<0.05).The mRNA levels of CREB were 1.00 ± 0.000 in control, 1.35 ± 0.068 inⅠ-Ⅱ, 2.88 ± 0.111 in Ⅲand 3.75 ± 0.196 in Ⅳ. The expression of CREB was higher in the glioma than in control group, and the mRNA levels of CREB were significantly different among different groups(F=1.208,P<0.05). The protein levels of CREB were 0.311 ± 0.014 in control, 0.469±0.026 inⅠ-Ⅱ, 0.641±0.028 inⅢand 0.896±0.024 inⅣ. The protein levels of CREB were sig?nificantly different among different groups(F=1.123,P<0.05). Conclusion The expression of CREB is elevated in glio?mas with different differentiation degrees. The expression of CREB was positively correlated with the degree of differentia?tion, indicating that CREB may have an important regulatory role in the progress of gliomas.

Objective To explore the relationship between 24-hour blood pressure variability after admission and early neurological deterioration in patients with acute non-cardioembolic ischemic stroke.Methods This was a case-control study.Patients with acute non-cardioembolic ischemic stroke within 72 hours after stroke onset were prospectively registered.Clinical and 24 -hour continuous blood pressure monitoring data were recorded, and subsequently compared with regard to whether early neurological deterioration ( END) occurred within 7 days after admission.Factors contributing to END were investigated by logistic regression model.Results Of 221 eligible patients, 59 cases ( 26.7%) exhabited END.Patients with END had higher 24-hour mean systolic blood pressure ( SBP) (145.8 ±18.2 mmHg vs.139.9 ± 20.3 mmHg, P=0.014) and SBP coefficient of deviation (SBP-CV) [9.0(7.3 -11.2) vs.8.4(6.9-10.2), P=0.011].After adjusting for crude variables, multivariate analysis showed that the increase in mean SBP (10 mmHg mean SBP,OR=1.285,95%CI(1.059~1.559) and SBP-CV [1 unit of SBP-CV, OR=1.206,95%CI(1.050~1.384)] was associated with higher risk of END.Conclusions Increased 24-hour blood pressure variability after admission is an independent risk factor for occurrence of END in patients with acute non-cardioembolic ischemic stroke.

Objective To investigate the correlation betw een the short-term blood pressure variability and the recent outcome in patients w ith noncardioembolic ischemic stroke. Methods The patients w ith acute noncardioembolic ischemic stroke admitted to hospital betw een January 1, 2013 to June31, 2015 w ere enrol ed consecutively. The demographic and clinical data w ere col ected, and 24 h ambulatory blood pressure monitoring w as performed and each blood pressure variability parameter w as calculated. The modified Rankin scale (mRS) w as used to evaluate recent neurological outcome at the time of discharge or the fourteenth day in hospital. The mRS score 0-2 w as defined as good outcome, and >2 w as defined as poor outcome. Multivariate logistic regression analysis w as used to determine the correlation betw een the blood pressure and the short-term blood pressure variability indicators and recent neurological outcome. Results A total of 229 patients w ith acute noncardioembolic ischemic stroke w ere enrol ed, and 40.2% of them had recent poor functional outcome. The mean systolic pressure ( 147.8 ±19.6 mmHg vs.137.7 ± 19.1 mmHg; t=3.868, P<0.001; 1 mmHg=0.133 kPa) and the actual variation value of the mean systolic pressure (median, interquartile 11.7 [10.0-14.0] mmHg vs.10.6 [8.2-12.5] mmHg;Z=3.544, P<0.001) of the recent poor outcome group w ere significantly higher than those of the good functional outcome group. Multivariate logistic regression analysis show ed that after adjusting other confounders, the increased mean systolic pressure ( each 10 mmHg increase: odds ratio 1.189, 95% confidence interval 1.013-1.369; P=0.034) and the enlarged actual variation of systolic blood pressure (each 1 mmHg increase:odds ratio 1.182, 95% confidence interval 1.046-1.336; P=0.008) w ere associated w ith the recent poor functional outcome. Conclusions The increased short-term blood pressure variability w as associated w ith the recent poor functional outcome in patients w ith acute noncardioembolic ischemic stroke.

OBJECTIVE:To systematically evaluate the effectiveness of probiotics in adjunctive prevention and treatment of chemotherapy-induced diarrhea(CID),and to provide evidence-based reference in the clinic. METHODS:All relevant randomized controlled trials (RCTs) of probiotics in adjunctive prevention and treatment of CID were collected by searching EMBase,Co-chrane library,PubMed,CJFD,VIP,Wanfang databases and CBM. Meta-analysis were performed with Rev Man 5.2 software af-ter data extraction and quality evaluation by Cochrane Hand book 5.0risk-bias assessment tool. RESULTS:10 RCTs were includ-ed,involving 871 patients. The results of Meta-analysis showed that addition of probiotics on the basis of conventional symptomatic therapy significantly reduced the total rate of diarrhea in cancer patients [OR=0.31,95%CI(0.20,0.49),P<0.001] and Ⅲ-Ⅳ diar-rhea rate[OR=0.09,95%CI(0.03,0.24),P<0.001],improved overall response rate [OR=4.16,95%CI(2.40,7.23),P<0.001] and complete remission rate [OR=2.55,95%CI(1.66,3.90),P<0.001],with statistical significance. The probiotics had little effect onⅠ-Ⅱlevel diarrhea rate[OR=0.86,95%CI(0.48,1.56),P=0.62] and partial remission rate[OR=1.00,95%CI(0.67,1.50),P=1.00],with statistical significance. CONCLUSIONS:The use of probiotics before chemotherapy can effectively prevent the occur-rence of severe CID in cancer patients;in the treatment of CID,the combination of probiotics can also improve therapeutic effica-cy of conventional symptomatic treatment.

Objective To investigate the role of IL-13 in the patients with acute and chronic urticaria. Methods In 22 patients with acute urticaria, 20 patients with chronic urticaria and 19 normal controls, the levels of IL-13, IL-4 and IFN-? of peripheral T lymphocytes were measured by flow cytometry. The serum concentrations of IL-13 and total IgE were tested by ELISA. Results The results of flow cytometry showed that the level of IL-13 of the patients with acute urticaria was significantly higher than that of the normal controls (P