Objective To investigate the clinicopathologic characteristics of premalignant and malignant endometrial polyps (EP) in premenopausal and postmenopausal women.Methods A retrospective analysis was conducted in 42 cases of premalignant and malignant EP from 1993 to 2012.Polyps were classified into premenopausal (group A,10 cases) and menopausal (group B,32 cases),including 26 cases of endometrioid adenocarcinoma,4 of clear cell carcinoma,9 of serous adenocarcinoma,and 3 of atypical hyperplasia.Results The prevalence rate of premalignant and malignant EP was 1.42％ (42/2 965),the prevalence rate of malignancy in postmenopausal and postmenopausal women was 0.48％ (10/2 064) and 3.55％ (32/901),respectively.The mean size of EP was (1.6 ± 0.8) cm,abnormal uterine bleeding was positive in 90％ (38/42) of cases.The EP pathological diagnosis showed all were endometrioid adenocarcinoma in group A,while there were 4 of clear cell carcinoma,9 of serous adenocarcinoma in group B.The mean size of EP was (1.1 ± 0.6) and (1.7 ± 0.9) cm in group A and B respectively (P ＜0.05).According to immunohistochemistry,all cases of group A were ER positive,but 41％ (11/27) of group B were ER negative (P =0.059).The PR positive rate was 8/9 and 56％ (15/27) in group A and B,respectively (P =0.169).Conclusions The risk of the EP malignancy rate is higher,while ER,PR positive rate are lower in postmenopausal womcn.Postmenopausal EP,especially accompanied by abnormal uterine bleeding and large polyps should be removed as soon as possible.

Objective To identify the existence of chromosome 9 open reading frame 72 (C9ORF72) intermediate hexanucleotide (GGGGCC) repeat expansions as well as the mutation-related clinical phenotypes in familial amyotrophic lateral sclerosis (fALS) population from mainland China.Methods DNA samples and clinical data of 62 fALS cases were collected,then the pathological GGGGCC repeat expansions were detected.Haplotype analysis for 20 single nucleotide polymorphisms (SNPs) was performed finally.Results The C9ORF72 intermediate repeat expansions were found in one fALS patient (1.61％,1/62),and repeat number was 24.In addition,2 siblings of this fALS patient also had a 24 repeats allele.These 24 repeat alleles were associated with the pathogenic founder haplotype.Conclusions This study illustrates the existence of the C9ORF72 intermediate repeat expansions in fALS population from mainland China for the first time.An intermediate repeat length in C9ORF72 is related to fALS in mainland China.

Objective To compare the differences between external standard method and relative correction factor method for determination of the flavonoids from Sorbus tianschanica Rupr.Methods Using HPLC external standard method for determination of hyperoside,rutin,isoquercitrin,quercetin-3-O-(6″-O-malonyl)-β-D-glucoside,astragalin and Kaempferol-3-O-(6″-O-malonyl)-β-D-glucopyranoside in Sorbus tianschanica Rupr.,HPLC relative correction factor method was adopted to establish relative correction factor of the other five flavonoids above with hyperoside as reference.The difference was evaluated by comparing the external standard method with the relative correction factor method.Results There was no significant difference between the T test external standard method and relative correction factor method(P>0.05).Conclusion External standard method and relative correction factor method can be used for determination of the flavonoids from Sorbus tianschanica Rupr.,but in the case of lack of reference substance or mass detection,using the relative correction factor method for determination of rutin,hyperoside isoquercitrin,quercetin-3-O-(6″-O-malonyl)-β-D-glucoside,astragalin and kaempferol-3-O-(6″-O-malonyl)-β-D-glucopyranoside in Sorbus tianschanica Rupr.It was more feasible and it can be used as a new quality evaluation method in determination of flavonoid components from Sorbus tianschanica Rupr.

Objective To explore effects of fosinopril and losartan on renal Klotho expression and oxidative stress in spontaneously hypertensive rats (SHR) and the mechanisms underlying the protection against renal damage. Methods Fifteen male SHRs (22 weeks old) were randomly divided into 3 groups (n=5 in each group): a SHR group, a fosinopril group ［10 mg/(kg?d)］, and a losartan group ［50 mg/(kg?d)］. Age-matched Wistar-Kyoto (WKY) rats were chosen for a control group. Eight weeks later, tail arterial pressure, 24 hours urinary protein (Upro)，urinary N-acetyl-β-D-glucosaminidase (NAGase) were measured. Renal pathological changes were examined under light microscopy by HE staining. The renal mRNA and protein expression of Klotho were determined by RT-PCR, immunohistochemical staining or Western blot. The levels of total antioxidant capacity (TAOC), malondialdehyde (MDA), Cu/Zn superoxide dismutase (Cu/Zn-SOD), Mn superoxide dismutase (Mn-SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) were determined.Results The typical pathological characteristics of hypertensive renal damage were observed in the kidney of the SHR group．Compared with the SHR group, the systolic pressure, Upro, and urinary NAGase, the content of MDA and renal pathological damage was reduced while the renal Klotho expression and activities of TAOC, Cu/Zn-SOD, CAT, and GSH-Px were increased (P<0.05 or P<0.01) in the fosinopril or losartan group. There was no significant difference in renal Mn-SOD level among the 4 groups (P>0.05). Conclusion Fosinopril and losartan can exert protection against hypertensive renal damage through upregulating Klotho expression as well as reducing oxidative stress.

Objective To investigate the prevalence,related factors and individualized health management strategy of female urinary incontinence.Methods Questionnaire survey has been adopted on 4105 female subjects in the east coastal,middle and southwest areas of Shandong Province from Jan.2011 to Dec.2011.Logistic regression model was used to analyze the influencing factors of urinary incontinence.The degree of risk was conducted according to the UI affected to the quality of life.Results The available questionnaires were 4105.Logistic analysis showed that age,delivery frequency,first delivery age,newborn birth weight,perineum injury history,chronic cough and constipation were risk factors of urinary incontinence.However,the protective factors of urinary incontinence included abdominal delivery and whitecollar worker.Mild,moderate and strong impacts of urinary incontinence on the quality of life were found 77.68％ (1079/1389),21.38％ (297/1389) and 0.94％ (13/1389) of the participants,respectively.Unfortunately,doctor's office visiting was as low as 1.08％ (15/1389).Along with the increase of age,parity,age of first time delivery,injury of perineum,chronic cough,constipation,may add the risk of incidence of urinary incontinence while caesarean section and brainwork may decrease the risk of incidence of urinary incontinence.Conclusions The overall of incidence of urinary incontinence in Shandong province is in a high level.Urinary incontinence may significantly reduce the quality of life of the patients.More investigation on individualized health management strategy for female patients with urinary incontinence should be needed in the future.

The aim of the research is to study the prevalence and antimicrobial resistance of Campylabocter jejuni isolated from poultry in Jiangsu Province.A total of 753 samples from poultry meat and cloacal swabs were investigated,after the pure culture and the polymerase chain reaction of the mapA gene,207 isolates were examined for antimicrobial resistance by using K-B method according to World Health Organization.Results showed that all isolates performed different degree of antimicrobial resistance except meropenem,gentamycin,kanamycin,florfenicol and fosfomycin,the resistance rates of 194 strains to trimethoprim,norfloxacin,ceftriaxone and tetracycline were 100％,84.02％,80.9％ and 79.4％ respectively,1 strain isolated from Xuzhou was resistant to 92.6 ％ antibiotics.The multi-drug resistance appeared and the advantage of drug-resistant spectrum was LIN/CTX/CRO/NOR/CIP/T/TE,the resistant type focused on 40％-60％.The research provided evidence for surveillance of the antimicrobial resistance of C.jejuni and highlighted the need to employ more prudent use of critically important antimicrobial.

An iodine analysis instrument with sequential injection of urine samples was developed. A method for measurement of urine iodine was also developed by combining sequential injection and catalysis kinetics,and making use of catalysis facilitation of the iodine in the redox reaction of As~(3+) and Ce~(4+) . The sequential injection and stopped-flow stabilization determination were made possible by the program-controlled injector with controlled flow rate and the 16-hole program-controlled selection valves. The arsenic-cerium reaction with iodine-catalyzed at constant temperature state might proceed with the constant temperature flow cell. Using the syringes with program-controlled velocity,pushing and suction,Using the digital connected circuit and micro-iodine determination software,the reaction temperature of (32.0±0.1)℃,injection time of 45 s,stabilization time of 60 s,detection time of 20 s,injection volume of 400μL,linear range of 15 -600μg/L,detecting limitation of 5.01 μg/L(n=11) and recovery rate of 94. 1 % - 105. 1 % were obtained. With this method,the detecting result of the National Standard Reference (GBW09109 and GBW09110) materials was within a given standard range. Through this method,the detecting results had no significant differences comparing with those by standard method of National Health Service(P >0.05).

Objective To explore the expression of TLR4/NF-κB pathway in cerebral injury resulting from DHCA ( deep hypothermia circulatory arrest ) as well as the effect of SACP ( selective antegrade cerebral perfusion). Methods Twelve pigs were randomly assigned to DHCA group (n = 6) or SACP group (n = 6) at 18 ℃ for 80 min. IL-6 was assayed by ELISA. Apoptosis and NF-κB proteins were detected by fluorescence TUNEL and Western blot, respectively. The level of TLR4 was determined through qRT-PCR and Western blot. Results Serum IL-6 level of SACP group was significantly lower at the end of circulation arrest and experiment and apoptotic index and NF-κB protein were apparently lower in SACP group (P < 0.05). The level of TLR4 protein and mRNA from SACP group decreased significantly (P < 0.05). Conclusions TLR4/NF-κB pathway plays a critical role in pathogenesis of DHCA cerebral injury and attenuating TLR4/NF-κB cytokines probably contributes to neuroprotection of SACP. TLR4/NF-κB pathway may be a novel target for DHCA.

Objective To systematically evaluate the comprehensive effect of subglottic secretion drainage (SSD) on patients with mechanical ventilation (MV) in intensive care unit (ICU). Methods The randomized controlled clinical trials (RCTs) comparing SSD (intervention group) versus non-SSD (control group) in adult patients with MV in ICU was collected through the databases such as the PubMed database of the National Library of Medicine, CNKI, Wanfang database and the Chinese journal of science and technology database (VIP). The subjects were ICU patients with MV, and the retrieval time ranged from January 2006 to December 2016. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, and assessed the quality. Then RevMan 5.3 software was used for Meta-analysis. Sensitivity analysis was performed using Stata 11.0 software. Funnel plot was used to analyze publication bias. Results In the 1004 documents obtained from preliminary screening, a total of 13 studies involving 2052 patients were enrolled after excluding duplicated documents and literature did not meet the inclusion criteria, with 1021 patients in intervention group, and 1031 in control group. Meta-analysis showed that compared with control group, the application of SSD in patients with MV could contribute to the reduction of the incidence of ventilator-associated pneumonia [VAP; risk ratio (RR) = 0.54, 95% confidence interval (95% CI) = 0.46-0.64, P < 0.00001], the duration of MV [mean difference (MD) = -3.29, 95%CI = -4.53 to -2.05, P < 0.00001] and length of hospital stay (MD = -4.27, 95% CI = -7.36 to -1.18, P = 0.007) were shortened, while there was no significant difference in ICU or hospital mortality rate between the intervention group and control group (RR = 0.89, 95%CI = 0.73-1.09, P = 0.25). The sensitivity analysis for studies enrolled in Meta-analysis of MV duration showed that individual research results were stable through step remove of the included literatures and combined calculation of the remaining literature value, suggesting that individual research results were stable, and would not have a significant impact on the overall results. The results of the funnel analysis showed that there was a symmetry in the inclusion studies, and no significant publication bias was found. Conclusions SSD did have effect in reducing the incidence of VAP, shortening the duration of MV and length of hospital stay, while there was no significant effect on reducing mortality rate. Effective use of SSD is an important measure to prevent VAP. It is necessary to objectively evaluate the clinical effect of SSD.

Objective To explore the value of linear blending and non-linear blending images of dual-energy CT in improving the image quality of portal venography.Methods 60 patients clinically confirmed as liver cirrhosis with portal hypertension and gastric fundus esophageal varices were enrolled in the study.The patients underwent dual-energy (Sn140/80 kVp) scans in the portal phase, and four groups with 80 kVp and 140 kVp were defined as group A (linear blending images with M=0.3), B (linear ones with M=1.0), C (non-linear ones with c=150 and w=200) and D [non-linear ones with c=(CThepatic portal+CThepatic parenchymal)/2 and w=(CThepatic portal-CThepatic parenchymal)/2, and the CThepatic portal and CThepatic parenchymal were measured on M=0.3 image].The in portal vein enhancements, image noise, signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) and CT value difference between portal vein and liver parenchyma among four groups were compared by one-way ANOVA analysis of variance test.VRT imaging quality among four groups were assessed by Kruskal-Wallis test and Mann-Whitney U test.Results In four groups, the SNR and CNR of portal vein,and the CT value difference between portal vein and liver parenchyma(14.36 HU±3.23 HU,9.78 HU±2.39 HU,107.66 HU±21.28 HU) of group D were the highest (F=34.94,68.10 and 162.43,all P<0.01),and VRT image quality score of group D(4.78±0.42) was the best when compared to others (all P<0.01).Conclusion Non-linear blending technique of group D can improve the image quality of CT portography, which may be used in clinical practice.