Objective To analyze the efficiency of mifepristone combined with norethindrone in treating dysfunctional uterine bleeding of peri-menopause. Methods 56 patients with dysfunctional uterine bleeding of peri-menopause were randomly divided into two groups, the study group(30 cases) and the comparision group(26 cases). The patients in the study group were treated with mifepristone in small doses combined with norethindrone. And the patients in the comparision group were treated only with norethindrone. Before treating, all the patients were observed and measured symptom of dysfunctional uterine bleeding, blood routine,the function of liver and ren.the en-dometrial thickness and pelvic by ultrasonography. Through hysteroscopy or uterine curettage of diagnosis, en-dometriums were measured by pathology. Results 26 cases in the study group were evaluated as effective,2 cases as obviously effective,and 2 cases as no effective. In the comparision group, 10 patients were evalutated as effective,8 patients as obviously effective,8 patients as no effective. The total effective rates of study group was significantly higher than those of comparison group(P

Objective A rapid method was constructed for detection of 3 kinds of phosphodiesterase 5 (PDE5) inhibitors (sidenafil,vardalafil,tadalafil) in invigorative health food by paper spray ionization mass spectrometry (PSI-MS method).Methods The characteristic ions of the PDE5 inhibitors could be used for preliminary identification and semiquantitative analysis with internal standard method using PSI-MS method.Results The 24 kinds of commercially available health-care products includes capsule,tablet,pill,powder,wine,syrup and liquid were tested.Results from PSI-MS were consistent with the HPLC-UV date.The calibration curves of PSI-MS has a good linearity in a given range.The linear coefficients of analytes were higher than 0.99.The LODs of 3 kinds of PDE5 inhibitors were lower than 1.0 mg/L.The RSDs of this method ranged from 20％ to 24％.Conclusion The PSI-MS method was rapid,accurate and targeted,which is compliant for quickly screening the PDE5 inhibitors in large complex matrix samples.

Objective To investigate the effect of cellular membrane phospholipids on CD14 protein expression of macrophage stimulated by LPS. Methods Changes of CD14 protein expression and CD14 mRNA of macrophages stimulated by LPS in vitro were determined by Western blotting and RT PCR. Effects of membrane phospholipids on CD14 protein expression were also detected. Results After stimulation by LPS, CD14 expression increased at 1 h, reached the peak value at 5 h and decreased to the normal level at 8 h but CD14 mRNA reached the peak value at 3 h and decreased at 5 h. The levels of phospholipids and membrane fluidity decreased at 5 h but CD14 protein expression increased after LPS stimulation. After pretreatment with liposomes, membrane phospholipid microenvironment improved and CD14 protein expression decreased. Conclusion LPS can up regulate CD14 protein expression, which might be regulated at least at the transcriptional level of the CD14 gene. Changes of membrane phospholipid microenvironment may be an important reason for the up regulation of CD14 induced by LPS.

Objective To evaluate the clinical characteristics of epithelioid trophoblastic tumor (ETT).Methods Six cases of ETT treated in Women's Hospital,School of Medicine,Zhejiang University from 2005 to 2007 were retrospectively analyzed,together with a literature review.Results Six cases of ETT were diagnosed pathologically after surgery.The age of patients ranged from 27 to 46 years.The most common presentation was abnormal vaginal bleeding(5/6).The preceding gestational events were hydatidiform mole in 1 case,abortion in 2 cases,and term delivery in 3 cases.The interval between the preceding gestation and the diagnosis of ETT ranged from 15-48 months.The serum human chorionic gonadotropin(hCG)level was 46-121 147 IU/L.Four cases presented with metastasis,including lung metastasis in all of the 4 cases,liver metastasis in 1 case,and pancreas metastasis in another 1 case.The main therapies were surgery combined with chemotherapy.All of the 6 cases received total abdominal hysterectomy.and 1 case also had lung lobectomy.One ease had a recurrence but refused any treatment again,and was lost to follow up;the therapy of 1 case unfinished;another 4 cases were without evidence of disease 9 to 19 months after surgery.Condusions The confirmation of ETF diagnosis is difficult before surgery.Surgical management is mostly recommended in ETT. The role of chemotherapy in ETT is not clear yet.

BACKGROUND: Various types of collagen affect differentiation and expression of chondrocytes in the process of tissue engineered culture for cartilage. The reliability of cartilage tissue engineering is determined by resource, structure and property of collagen.OBJECTIVE: To characterizing the structure of collagen type Ⅰ,Ⅱ and Ⅲ, to clarify the structural characteristics of collagen for cartilage tissue repairing and provide guidance for choosing cartilage tissue engineering scaffolds. METHODS: The type Ⅰ and Ⅲ collagen was obtained from neonatal calf skins, and type Ⅱ collagen was obtained from porcine articular cartilage. The differences of structures of collagen type Ⅰ,Ⅱ and Ⅲ were analyzed and compared by FTIR, DSC, SDS-PAGE and picrosirius-red staining.RESULTS AND CONCLUSION: The neonatal calf collagen type Ⅰ,Ⅱ and porcine collagen type Ⅱ had the similar functional group. The thermal denaturation temperature of the three type collagen was 104.2 ℃, 99.7 ℃ and 92.5 ℃. SDS-PAGE analysis showed the collagen type Ⅲ percentage in collagen type Ⅰ was (11.29±0.91)%. Picrosirius-red staining exhibited that the collagen type Ⅰ was comprised red and orange raw fibers, with strongly birefringent. Collagen type Ⅲ was lax and thin, greenish fibers, but collagen type Ⅱ was red, loosely cancellated fibers. The functional groups and important characteristics of the three of collagen are similar. However, there are some differences in advanced structure. To analyze the relationships of collagen type Ⅰ,Ⅱ and Ⅲ is important to choose and prepare scaffolds for cartilage tissue engineering.

Objective To explore the application and efficacy of laparoscopic radical operation for rectal cancer after preoperative short-time radiotherapy.Methods The clinical data of 108 patients with Dukes B and C rectal cancer were analyzed retrospectively.Thirty-five patients underwent laparoscopic radical operation after preoperative short-time radiotherapy,meanwhile 30 patients underwent laparoscopic radical operation,and 43 patients underwent open operation,both later groups without preoperative radiotherapy.Results There were not significant differences in preoperative general condition,tumor size and stage,pathological type,site of operation,and mode of operation between the 3 groups.But there was a higher rate of radical resection and sphincter preservation in the laparoscopic operation plus radiotherapy group than in the other groups(P

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lymphoma, B-Cell ; drug therapy ; pathology ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; pathology ; Male ; Middle Aged ; Prednisone ; therapeutic use ; Sarcoma ; pathology ; Spleen ; pathology ; Splenic Neoplasms ; drug therapy ; pathology ; Vincristine ; therapeutic use

Objective　To evaluate the effects of lipid emulsion on parenteral nutrition associated liver dis ease (PNALD) in old tumor patients. Methods　A retrospective study was performed with 402 patients in Renji Hospital from January 2003 to December 2008. Patients were retrieved according to the following criteria: (1)age ≥60 years; (2) confirmed diagnosis of tumor, had no evidence of metastasis, and tumor was completely resected before receiving parenteral nutrition; (3) liver and kidney function was in normal range before receiving parenteral nutrition; (4) parenteral nutrition days ≥7; and (5) parenteral nutrition was infused in "all in one" bag via central venous. Patients with history of viral hepatitis or died in parenteral nutrition episode were excluded. These 402 patients aged (71.7 ±6.8) years and the average parenteral nutrition time was (10. 2 ±5.9) (range, 7-61 )days. In 311 patients (77.4％), non-protein calorie was obtained from carbohydrate and lipid and 91 patients (22. 6％ ) just obtained non-protein calorie from carbohydrate.　Results　The total prevalence of PNALD was 15.2％ (61/402). The prevalence of PNALD was 8.8％ (8/91) in patients receiving parenteral regiment without lipid and 17.0％ (53/311) in patients receiving parenteral nutrition with lipid, and there was no significant difference in prevalence of PNALD between two groups (χ2 = 3.72, P = 0.07 ). Lipid type and amount showed no significant effects on PNALD ( P ＞ 0.05 ). The fever days ( P ＜ 0. 001 ), baseline level of alanine transaminase (P ＜0. 001 ) and γ-glutamyltransferase (P ＜0. 001 ) were risk factors for liver injury by logistic regression. Conclusion　Lipid emulsion can be safely used in old tumor patients without affecting the occurrence of PNALD.

Objective To assess the high risk factors associated with the positive margin of conization in patients with cervical intraepithelial neoplasia (CIN). Methods From January 2000 to February 2008, 1699 consecutive patients with CIN undergoing conization was reviewed retrospectively in order to analyze the relationship between the positive margin of conization with clinical prognostic factors,such as patients age, disease grade, size of lesion, the procedure of excision and menopause. X<'2> tests was used to compare the different frequencies of factors in groups of positive and negative margin conization, then seven factors with positive margin were processed into unconditional logistic regression analysis. Results The rate of the positive margin in 1699 patients was 14.01% (238/1699). The mean age of patients with positive margins was (39±9 ) years old, while patients with negative margins was ( 39±8 ) years old, which didn't reach statistical difference(P>0.05). The rate of the positive margin was 8.63% in cold knife cone (CKC) and 18.66% in loop electrosurgical excision procedure (LEEP), which showed significant difference( P<0.01 ). Among 1699 patients, 90 patients were with CIN Ⅰ ,339 patients were with CIN Ⅱ ,1113 patients were with CIN Ⅲ [ including 972 with severe dysplasia and 141 with cancer in situ(CIS) ],87 patients were with cervical cancer stage Ⅰ al, 70 patients were with stage Ⅰ a2 or advanced stages. The rate of positive margin was 1.11% ( 1/90), 3.83% ( 13/339), 10.70% (104/972), 26.24% (37/141),35. 63% (31/87) and 74.29% (52/70),respectively. There was statistic difference among them, except CIN Ⅰ and CIN Ⅱ . When combined CIN Ⅰ with CIN Ⅱ , then compared with CIN Ⅲ, cervical cancer withⅠ al and Ⅰ a2, it also showed statistical difference (P<0.05 ) . The rate of positive margin in postmenopausal women was 21.54% (28/130), which was significantly higher than 13.38% (210/1569)in premenopausal women (P=0.010 ). The logistic regression analysis showed that the procedure of excision, grade of disease, size of lesion, surface of cervix, and menopause were high risk factors associated with the positive margin, the risk ratio were 5.147, 3.048, 1.271, 1.905 and 1.860, respectively.Conclusions High grade, the extent of CIN disease, LEEP and postmenopausal age are high-risk factors associated with positive margin in patients treated by conization. It should be warranted in those patients when designing conization treatment.

Objective To observe the expression and significance of hypoxia inducible factor (HIF)-1α,matrix metalloproteinase(MMP)-9 and transforming growth factor(TGF)-β1 in liver tissues of rats with hepatic fibrosis and the effects of TGF-β1 vaccine on the expressions of HIF-1α,MMP-9 and TGF-β1.Methods The hepatic fibrosis rat model was set up by dimethylnitrosamine (DMN).The rat model was injected with TGF-β1 vaccine.The expressions of HIF-1α,MMP-9 and TGF-β1 were detected by immunohistochemistry in rat fibrosis tissues after 6 weeks.Results The expressions of HIF-1α,MMP-9 and TGF-β1 in fibrosis model group and TGF-β1 vaccine group were all significantly higher than control group(P＜0.01),which was positively correlated with the fibrosis degree(r=0.911,0.814 and 0.836,respectively,P＜0.01).However,the expressions of HIF-1α,MMP-9 and TGF-β1 in TGF-β1 vaccine group were all significantly decreased than fibrosis model group (t=2.62,4.03,3.43;P＜0.01).Conclusion During the development of liver fibrosis,HIF-1α promotes the transcriptions and expressions of MMP-9 and TGF-β1.