Objective To investigate the effect of ectopic pregnancy tubal resection or common disease retention on female reproductive endocrine and menstrual traits.Methods 286 patients with ectopic pregnancy lapa-roscopic operation were selected.According to the different treatment methods,the patients were divided into resection group (n =199),retention group 87 cases,in surgical operation on the third day and the thirtieth day and tested for female reproductive hormone (P,LH,FSH,E2 )and human chorionic gonadotropin (hCG).Results Resection group in the third day after surgery of FSH[(8.5 ±4.9)IU /mL]was significantly higher than that of preserving group[(3.9 ± 0.9)IU /mL],with significant difference (t =5.44,P <0.05),the amounts of LH,E2 ,P and HCG were insignificant (t =0.56,1.24,0.82,all P >0.05).30 days after the surgery,there was no significant difference between the two groups in FSH,LH,E2 ,P and HCG (t =0.92,0.77,1.02,0.65,all P >0.05),but at the age of more than 40 years old and bilateral absence of fallopian tube in patients with,menorrhagia and menstrual cycle change obviously,and female ovarian endocrine function to reduce the clinical symptoms.Conclusion Tube resection has some influence on the ovarian function of tubal ectopic pregnancy,especially older,lack of bilateral fallopian tube.

Objective To explore the clinical effects of injecting methotrexate with hysteroscopic tubal can-nulation combined with Huayu shapei prescription in the treatment of salpingocyesis.Methods 82 unruptured salpin-gocyesis patients were randomly divided into the two groups.41 patients in the observation group were treated by hyst-eroscopic tubal cannulation injection of methotrexate combined with Huayu shapei prescription,41 patients in the con-trol group were treated by methotrexate intramuscular injection with oral mifepristone.The clinical efficacy of the two groups were observed,the level of serumβHCG required for tubal pregnancy,the mass absorption and after treatment of tubal patency.Results Compared with the control group,the difference was significant of the decline of serum βHCG in the treatment group (t=2.67,P<0.05).Compared with the control group,the treatment effectiveness and the absorption of the mass in fallopian tube in the treatment group,the difference was significant (t =3.57,P<0.05 ).Tubal patency detected treated group was superior compared with the control group,the difference was signifi-cant(χ2 =100.23,P<0.05).Conclusion Compared with traditional treatments,injecting methotrexate with hyste-roscopic tubal cannulation combined with Huayu shapei prescription in the treatment of salpingocyesis can effectively reduce the HCG levels,promote the absorption and softening of the ectopic pregnancy mass,to achieve the purpose of killing embryos eliminate micro,it will help to improve patients with clinical symptoms and signs,to maximize the recovery of the patient's reproductive function and physical health.

In regional anatomy the appliance of the methods of problem based learning can cultivate students' practical ability,slimulate their motivity and raise their passion for study.It is also effective to improve their capabilities of self-study,cooperation,as well as analizing and solving problems.

Objective To improve work efficiency and lower management cost. Methods Based on experiences from the 95th hospital in six years, PACS application benefits were analysed from such seven aspects as digital film management,economic benefit, efficiency and quality of diagnosis, evidence support for solving medical dispute,simplified treatment procedures, social effect, and remote disgnosis. Results Better economic benefits and social effect were obtained. Conclusion It is proved by practice that construction of PACS in small & midium-sized hospitals is necessary and feasible.

ObjectiveTo explore the effects of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/nuclear factor-kappa B (NF-κB) signal pathway on the process of follicle-stimulating hormone (FSH) facilitating cell proliferation and invasion in human epithelial ovarian cancer. Methods Ovarian cancer cell lines SKOV3 and 3AO were cultured to exponential phase,then assigned to control group,FSH group,LY294002 group and FSH + LY294002 group,respectively.Cells were treated with different concentration of FSH and LY294002,respectively.The effects of FSH on cell proliferation were observed by methylthiazolyl tetrazolium (MTT).Morphological changes were observed by phase contrast microscope.The ability of cell invasion was investigated by transwell invasion assay.The expression of FSH receptor (FSHR),Akt1/2,phosphorylated-Akt (p-Akt) and NF-κB p65 protein were detected by western blot.Results( 1 ) FSH could promote the proliferation of SKOV3 and 3AO cells.When the cells were treated with 40 U/L FSH for 48 hours (SKOV3) and 24 hours (3AO),compared with those in control groups,they reached the highest proliferation rate (P ＜ 0.05 ),respectively.(2) The morphology of SKOV3 and 3AO cells in four groups:in control group,SKOV3 cells were short spindle and 3AO cells were long spindle,the nuclei of them were both roundness or oval,the cytoplasm were bright.In FSH group,the cells changed to slightly longer or polygonal,they were full in shape,meanwhile,the cell intensity were higher than control group.In LY294002 group,some cells changed from spindle to round,and began to shrink.The cell intensity diminished.The morphology of FSH + LY294002 group was similar with control group,but the cell intensity was lower than that in FSH group.(3)The number of SKOV3 cell that passed through the membrane in control group,FSH group,LY294002 group and FSH + LY294002 group was (26 ± 6),( 118 ± 19),( 18 ± 5) and ( 38 ± 7 ),respectively.The number of 3AO cell was ( 19 ± 4 ),( 134 ± 20),(12 ±3) and (58 ± 11 ),respectively.The results showed that the number of cells in FSH group was significantly higher than that in control group ( P ＜ 0.05 ),while the number of cell in FSH + LY294002 group was significantly fewer than that in FSH group (P ＜ 0.05 ).(4) There was no significant difference in the expression of FSHR and Akt1/2 between FSH group and control group (P ＞ 0.05 ),but FSH increased the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm in SKOV3 and 3AO cells,there were significant differences compared with control group ( P ＜ 0.05 ).LY294002 reversed the effects of FSH on increasing the expression of p-Akt and the ratio of NF-κB p65 in the nucleus versus cytoplasm,there were significant differences among LY294002 group,FSH + LY294002 group and FSH group (P ＜ 0.05 ).ConclusionThe effects of FSH on proliferation and invasion of ovarian cancer cell lines SKOV3 and 3AO may be realized by regulating the activity of NF-κB in PI3K/Akt signal pathway.

The medical records of stroke patients at Zhenjiang Emergency Medical Center from January 1 to December 31,2011 were analyzed.A total of 797 stroke patients were managed,accounting for 10.42 percent of the emergency number over the same period.The average ages of males and females were (67 ± 14)and (72± 14)years old respectively (P ＜ 0.01).The incidence rate increased with age (P ＜0.05).The highest incidence occurred from 9:00 to 10:00 (n =61,7.7％),while the lowest incidence at 4:00 to 5:00 (n =9,1.1％).A total of 552 (69.3％) cases were sent to class 3A hospitals; the number of patients who independently option hospital were 626 cases (78.5％).Emergency response time (from call to arrival) was an average of 13.49 minutes.A total of 318 cases (39.9％) took no more than 10 minutes and first aid an average of 38.11 minutes.

BACKGROUND: Nerve growth factor (NGF) is characterized by poor stability both in vitro and in vivo, and liable to lose its bioactivity.OBJECTIVE: To study the stability of liposome-encapsulated NGF injection preserved under various conditions.DESIGN: A controlled study of liposome-encapsulated NGF.SETTING: Department of Surgery of the First Affiliated Hospital of Nanjing Medical University.MATERIALS: This study was carried out at the Central Laboratory of the First Affiliated Hospital of Nanjing Medical University between July 2002and March 2004. NGF from rat submaxillary gland was purified, encapsulated by liposome, and prepared into lyophilized dosage form before preserved under different conditions (at 4 ℃, room temperature, 40 ℃ or 40 ℃ with saturated humidity, respectively).METHODS: Chicken embryo dorsal root ganglion cultured in serum-free medium was used to evaluation the bioactivity of NGF in vitro. The dorsal root ganglion from 8-day-old chicken embryo was inoculated in a polylysine-coated 24-well culture plate and cultured in Dulbecco modified Ea-gle medium (DMEM) containing different testing samples. Only DMEM was used for culture in the negative control group, while DMEM containing NGF at different concentrations used in the positive control group. The ganglion was cultured at 37 ℃ with 50 mL/L CO2 and saturated humidity for 24 hours, and the growth of the nerve fibers was observed under an inverted microscope. The bioactivity of NGF was also evaluated in simulated condition in vivo by adding lyophilized liposome-encapsulated NGF and positive control NGF specimen into 0.5 mL rat serum, which, along with the blank control serum, was added into 2.5 mL DMEM at 0.5, 1, 2, 3, 4,6 hours and thoroughly mixed. The bioactivity of NGF was assessed accord-ing to the length and density of the dorsal root ganglion and graded the prominences (recorded as "++" or "+++ "), and very long and dense growth of the prominences (++++).MAIN OUTCOME MEASURES: In vitro bioactivity of NGF preserved for 10, 30, 60, and 90 days by testing the growth of cultured chick embryo dorsal root ganglion in serum-free DMEM and in test of rats serum containing NGF added at 0, 0.5, 1, 2, 3, 4, and 6 hours into DMEM.RESULTS: Lyophilized liposome-encapsulated NGF exhibited stable bioactivity (+++) after preservation at 4℃ and room temperature for 10-90days; at 40 ℃ for 10-60 days, the it retained its the bioactivity (+++),which, however, slightly decreased by 90 days (++); its bioactivity was preserved (+++) at 40 ℃ with saturated humidity for 10 days (+++), slightly decreased at 30-60 days (++) and noticeably lowered (+) at 90 days. When preserved for 0, 0.5, 1, 2, and 3 hours in rat seum, the NGF preparation retained stable bioactivity (++++ or +++), which slightly decreased at 4 hours and 6 hours (++).CONCLUSION: Liposome-encapsulated NGF has stable bioactivity but its preservation at relatively high temperature with high humidity is difficult.Lyophilized liposome-encapsulated NGF exhibits better bioactivity than NGF-liposome suspension after preservation under various conditions.

Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS),and analysis the correspondence to conventional images.Methods It was a retrospective case series study.Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled.There were 12 females and 1 male,aged from 22 to 57 years,mean age was 34.5 years.All the eyes underwent fundus color photography,optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF).Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes.The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA.All the eyes were followed up every 1 to 2 weeks,with an average of 16.7 weeks.The characteristic images of SW-FAF and corresponding OCT were studied during follow up.Results MEWDS presented with numerous multiple hyper-autofluorescent spots,sized from 50-500 μm,with a vague boundary in ultra-wide field SW-FAF.These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern.The lesions extended to the mid-peripheral retina as well and became more scattered.The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA.It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well.But the number of the spot showed in FAF is much more than that in FFA,and slightly less than that in ICGA.The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.After the recovery,the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely.Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF.The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph,FFA and ICGA in late-phase.The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina.

Objective To explore the effects of early growth response gene-1 (Egr-1) on bone marrow mesenchymal stem cells (BMSC) proliferation and osteogenic differentiation,which is aimed at providing new molecular targets for the treatment of osteoporosis.Methods Bone marrow was collected from adult men and the BMSCs were cultured primarily and observed by microscope.Meanwhile,flow cytometry was used for BMSCs phenotypic identification;After transfection of pcDNA3.1/Egr-1 into BM SCs,the level of BMSCs proliferation was determined by MTT respectively on the 2 d,4 d and 6 d;On the 7 d after transfection,the ALP activity assay was used for testing the ALP activity in BMSCs.And then,alizarin red S-calcium kit was used for measuring the calcified knots respectively on the 7 d,14 d and 21 d;On the 21 d after transfection,real-time qPCR and Western blotting were used respectively for measuring the expression of mRNA and protein of Egr-1,Runx2 and NDRG1;Further,BMSCs were transfected with Egr-1 siRNA,and the content of calcium nodules,ALP activity,the expression of Egr-1,Runx2 and NDRG1 were detected as above methods.Results The cells cultured in vitro showed high level of CD90 and CD29 and very low level of CD34 and CD45,which is accorded with the characteristic of BMSCs.The pcDNA3.1/Egr-1 transfection for BMSCs had no effect on cells prolifera tion.However,the calcified knots,ALP activity and the expression of Egr 1,Runx2 and NDRG1 were increased after transfection of pcDNA3.1/Egr-1 for BMSCs.In addition,Egr-1 siRNA showed the opposite effect with pcDNA3.1/Egr-1 transfection for BMSCs.Conclusion Egr-1 induces osteogenic differentiation of BMSCs by promoting NDRG1 but has no effects on proliferation of BMSCs.

[ABSTRACT]OBJECTIVETo investigate the expression of cytokeratin (CK) 4 and 13 in sinonasal squamous cell carcinoma (SNSCC) and their pathobiological implications for tumor angiogenesis and metastasis. METHODSThe expression of CK4 and CK13 was detected by immunohistochemistry in normal and cancerous tissues in 42 cases of SNSCC, integral optical density (A) was measured by computer analysis of images and analyzed by SPSS13.0.RESULTSCK4 and CK13 were expressed significantly higher in normal tissues than in cancerous tissues of SNSCC. Moreover, the expression level of CK4 and CK13 was related to the differentiation of SNSCC, which was higher in the well/middle differentiated ones than in poor ones. The expression of CK4 was significantly associated with the tumor size, clinical stage and cervical lymphatic metastasis in SNSCC. While CK13 had no relationship with these three factors.CONCLUSIONThe detection of CK-4 and CK-13 might play an important role in the prognostic evaluation of SNSCC.