OBJECTIVE:To study the adhibition of misoprostol combined with palace cavity attraction tube in the treatment of painless abortion after cesarean section. METHODS:214 patients who received painless abortion after cesarean section were ran-domly divided into group A(71 case),group B(71 case)and group C(72 case). After all patients were given conventional intrave-nous anesthesia,Group A was given misoprostol 0.6 mg for oral administration in preoperative 2 h. Group B was given Misoprostol tablet 0.2 mg abrasive powder put in posterior fornix in preoperative 3 h. Group C did not give any drugs. All the groups used dis-posable suction curettage tube. The efficacies of sedation and cervical dilatation,operation time,intraoperative blood loss,recovery time,dosage of propofol and incidences of complications and adverse reactions in the 3 groups were observed. RESULTS:The op-eration time,intraoperative blood loss in group A were lower than group B and lower than group C,the differences were statistical-ly significant(P<0.05);recovery time and dosage of propofol in group A were lower than group B and C,the differences were sta-tistically significant(P<0.05),howerer,there was no significant difference between group B and C(P>0.05). The total effective rates of sedation and cervical dilatation in group A and B were significantly higher than group C,and the difference was statistical-ly significant(P<0.05),however,there was no significant difference between group A and B(P>0.05). The incidence of compli-cations in group A was lower than group B and lower than group C,and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions among 3 groups(P>0.05). CONCLUSIONS:The efficien-cy and safety of misoprostol for oral administration or medicated vaginal suppository combined with palace cavity attraction tube in the treatment of painless abortion after cesarean section is similar,but oral administration can reduce the dosage of anesthetics,op-eration time and smaller intraoperative blood loss volume.

Objective To study the effect of baicalin on the expression of receptor activator of nuclear factor-?B ligand (RANKL) and osteoprotegerin (OPG) in cultured human periodontal ligament cells (HPDL cells) as well as its action mechanism. Methods We first constructed small interferring RNA (siRNA) eukaryotic expression vector targeted transforming growth factor ?Ⅱ receptor (TGF-?RⅡ),and then transfected it into T cells. Then HPDL cells together with T cells transfected with siRNA or not were placed in medium that had been added with lipopolysaccharide (LPS) and baicalin. They were divided into six groups and cultured for 48 hours. Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to observe the effect of baicalin on OPG-RANKL expression in HPDL cells. Results The clone sequence correctly identified by RT-PCR was consistent with the designed target sequence. The recombinant vector was constructed successfully and the expression of TGF-?ⅡR of T cells which had been transfected with siRNA1 was inhibited obviously. Ratio of RANKL/OPG in each group differed significantly (P

Objective To evaluate the effects of reduced glutathione (GSH) on contractile and diastolic functions of the thoracic aorta of rats with obstructive jaundice.Methods Twenty-four adult male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 4 groups (n =6 each) using a random number table:sham operation group (group S),GSH group,bile duct ligation group (group BDL),and GSH + bile duct ligation group (group GSH + BDL).In GSH and GSH + BDL groups,GSH 300 mg/kg was infused via stomach everyday for 7 consecutive days,while the equal volume of normal saline was given in the other two groups.The common bile duct was ligated in the animals on 1 d after the end of intragastric administration in GSH and GSH + BDL groups.In GSH and GSH + BDL groups,after the model was established,GSH 300 mg/kg was infused via stomach everyday for 7 consecutive days,while the equal volume of normal saline was given in the other two groups.On 7th day after the model was extablished,blood samples were collected for determination of the levels of serum total bilirubin (TB),alanine aminotransferase (ALT) and aspartate aminotransferase (AST),tumor necrosis factor-alpha (TNF-α),interleukin-lβ (IL-1β) and 3-nitrotyrosine (3-NT),malondialdehyde (MDA),nitric oxide (NO) and GSH.The thoracic aortic rings were obtained and perfused with different concentrations of norepinephrine (NE),acetylcholine (Ach) and sodium nitroprusside (SNP).The maximum contraction and dilatation of aortic rings were recorded and the percentage was calculated.Some thoracic aortic rings were obtained again and perfused with different concentrations of NE after removal of the endothelium or after being perfused with L-NAME (nitricoxide synthase inhibitor).The maximum contraction of aortic rings was recorded and the percentage was calculated.Results Compared with group S,the serum levels of TB,ALT,AST,TNF-α,IL-1β,MDA,3-NT,NO and GSH were significantly increased in group BDL,and the serum levels of TB,ALT,AST,MDA,GSH and NO were increased in group BDL + GSH,the percentage of the maximum contraction amplitude of aortic rings in response to NE was decreased,and the percentage of the maximum dilatation amplitude of aortic rings in response to Ach and SNP were decreased in groups BDL and BDL + GSH,and no significant changes were found in the parameters mentioned above in group GSH.Compared with group BDL,the serum levels of TB,ALT,AST,TNF-α,IL-1β,MDA,3-NT and NO were significantly decreased,the level of GSH was increased,the percentage of the maximum contraction amplitude of aortic rings in response to NE was increased,the percentage of the maximum dilatation amplitude of aortic rings in response to Ach was increased,and no significant change was found in the percentage of the maximum dilatation amplitude of aortic rings in response to SNP in group BDL + GSH.Compared with the aortic rings from which the endothelium was removed or which were perfused with L-NAME in group BDL,no significant change was found in the percentage of the maximum contraction amplitude of aortic rings after removal of the endothelium or after being perfused with L-NAME in response to NE in group BDL + GSH.Conclusion GSH can improve the contractile and diastolic functions of thoracic aorta of rats with obstructive jaundice and this effect depends on the vascular endothelium.

Aim To investigate the effect of nicotinyl salicylic acid(NSA) on rabbit platelet aggregation induced by Collagen,ADP and AA.Methods Platelet aggregation induced by collagen,adenosine diphosphate(ADP) or arachidonic acid(AA) was studied with turbidimetry in rabbtis blood,in vitro and vivo.Results NSA significantly inhibited the platelet aggregation induced by Collagen and ADP,in vitro and vivo.The inhibition by NSA was dose-dependent.NSA had no effect on the platelet aggregation induced by AA.Conclusion NSA can inhibit rabbit platelet aggregation induced by Collagen and ADP.

Objective To investigate effects of hormone replacement therapy with conjugated equine estrogen (CEE) in different doses combined with medroxyprogesterone acetate ( MPA) on mammographic density among postmenopausal women and its clinical significance. Methods Ninety eligible postmenopausal women were randomized into three groups with varied treatment continuously for one year, Croup A receiving 0.3 mg CEE with 2 mg MPA and caltrate 600 mg and vitamin D 125 U daily; Group B receiving 0. 625 mg CEE combined with 2 mg MPA and caltrate 600 mg with vitamin D 125 U daily; and Group C receiving caltrate 600 mg and vitamin D 125 U daily. Mammographic density was analyzed using Wolfe and semi-quantitative methods for all of them and compared each other one year after treatment, as well as mammographic density before and after treatment in Groups A and B. Results One year after treatment, mammogrphic density reached the highest in postmenopausal woman of Group B and the lowest in those of Group C, with significant difference among the three groups (P ＜ 0. 01) and between Groups A and C (P ＜ 0. 01) and between Groups B and C ( P ＜ 0. 05 ). Mammogrphic density with semi-quantitative method increased significantly in Group A ( P ＜ 0. 05 ) and Group B ( P ＜ 0. 01 ), respectively, after treatment as compared with that before it. Change in mammografic density before and after treatment was greater in Group B than that in Group A, but not reaching statistically significant level (P ＞ 0. 05). Conclusions Hormone replacement therapy can cause the increase of mammographic density in postmenopausal women, possibly in a dose-dependent pattern, which suggest that HRT has side effect on breast tissue and the lowest effective dose of estrogen should be selected in HRT. Mammographic density can be used as an indicator to monitor side effect of HRT on breast.

Objective To investigate the efficacy and safety of immediate intravesical instillation combined with short-term maintained intravesical instillat.ion chemotherapy of pirarubicin (THP) after operation for preventing postoperative recurrence of superficial bladder tumor.Methods One hundred and seven patients with superficial bladder tumor were divided by random digits table method into two groups:group A (50 cases ) was treated with immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy after operation,and group B (57 cases) was treated with conventional intravesical instillation chemotherapy.Patients in group A underwent intravesical instillation of THP within 24 hours,maintained intravesical instillation once a week for 8 weeks.Patients in group B underwent intravesical instillation of THP in one or two weeks after operation,once a week for 8 weeks.And then once a month for 10 months.All patients were followed up with regular cystoscopy examination.Results Patients were followed up for 13-84 months,the incidence of partial vesical toxic reaction in group A was 26.00 ％ (13/50),general symptom rate was 4.00％ ( 2/50 ),the rate of recurrency was 16.00％ ( 8/50 ).The incidence of partial vesical toxic reaction in group B was 22.81％( 13/57 ),general symptom rate was 1.75％( 1/57 ),the rate of recurrency was 19.30％ (11/57).There was no significant differences between two groups (P ＞ 0.05 ).Conclusions Immediate intravesical instillation of THP after operation is safe and effective,but it is not suitable for patients with obvious bladder perforation and large wound surface of bladder mucosa after transurethral rescection.Immediate intravesical instillation combined with short-term maintained intravesical instillation chemotherapy of THP after operation for preventing postoperative recurrence of superficial bladder tumor is effective and well tolerated.

Objective To explore the prognostic value for cardiovascular events of elevated NT-proBNP in coronary heart disease(CHD) patients with metabolic syndrome(MS).Methods The level of NT-proBNP was measured in 165 CHD patients with MS diagnosed by coronary angiography.After 2 years follow-up,we recorded the corresponding cardiovascular events in those patients.Results The NT-proBNP level was much higher in ACS group than that in SCHD group( P ＜ 0.01 ).There were totally 45 events after 2 years.After adjustment of traditional risk factors including hypertension,diabetes,smoking history and high sensitivity C reactive protein( hs-CRP),Cox proportional hazard analysis indicated that high NT-proBNP level( ＞ 111.58ng/L)was an independent risk factor for future events (relative risk 2.67,P ＜0.01 ).Conclusion Elevated NT-proBNP level might be one of the independent risk factor for cardiovascular events in CHD patiens with MS.

ObjectiveTo compare the effects of streamlined liner pharynx airway(SLIPA) and endotracheal intubation in the radical mastectomy under general anesthesia,and to evaluate the efficacy and safety.MethodsSixty patients scheduled for radical mastectomy were randomly divided into 2 groups.SLIPA group( S,n =30 ) and endotracheal intubation group(T,n =30).The data were kept regarding the insertion time and successful rate,MAP,HR,BIS were recorded at 6 time points:before induction ( T0 ),during SLIPA incursion or trachel intubation ( T1 ),3min after intubation( T2 ),before extubation( T3 ),after extubation ( T4 ),3 min after extubation ( Ts ).Ppeak,PetCO2 and SpO2 were measured after successful airway placement at 10min,30min,60min and to observe intraoperative and postoperative throat complications.ResultsThe time of endotracheal intubation group is significantly longer than SLIPA group (P ＜0.05).In group T,MAP and HR at T1,T2,T4,T5 were higer than at T0 and the same time points in group S(all P ＜ 0.05 ).No regurgitation and aspiration was found in two groups ( all P ＞ 0.05 ).The incidence of complicaton in group T is significantly higher than that in group S ( all P ＜ 0.05 ).ConclusionSLIPA is easier placement,safety and efficacy when it is used for the radical mastectomy under general anesthesia without significant influences on hemodynamics and fewer complications of throat after operation.

Objective To explore different socio-demographic and clinical characteristics for early onset patients (EOP) with psoriasis and late onset patients (LOP) with psoriasis in Chinese population and to provide scientific evidences for establishing comprehensive prevention and treatment strategy for psoriasis.Methods Cross-sectional study was performed.A total of 942 diagnosed psoriasis patients who paid a visit to outpatient clinic in a tertiary hospital in China from 12th September 2013 to 19th May 2015 was consecutively enrolled and investigated.Exploratory analysis was conducted to detect the association between disease onset age and patients features.Results Among 942 enrolled psoriasis outpatients,the average age was (40.6 ± 13.6) years with a range from 5 to 80 years.The sex ratio was 2.1 in favor of male.The most observed type of psoriasis in the present study was psoriasis vulgaris (98.3％).The average psoriasis area and severity index (PASI) for patients were 9.47 ±7.63.Comorbidity was combined in 20.2％ cases.Patients with EOP had a significantly higher likelihood of family history of disease.Compared EOP to LOP,LOP had a significantly higher likelihood of comorbidities involvement (P ＜ 0.05) and significant higher BMI index (P ＜ 0.05).Conclusions The present study supports the hypothesis that there are clinical differences between EOP and LOP in Chinese population.Both dermatologists and patients should pay more attention to psoriasis-associated features,such as family history and comorbidity diseases involvements.

Objective To evaluate the outcomes of small (5 ～ 10mm),arterially enhancing nodules (SAENs)shown exclusively at the hepatic arterial phase of CT in a hepatocellular carcinoma(HCC) surveillance population and to determine risk factors for developing HCC.Methods The study population included 112 patients (maleifemale =100 ∶ 12 ; aged 36 ～ 92 years) with 1 7 5 SAENs who were at risk of HCC.We evaluated serial changes during follow-up(1.4 ～41.8 months,mean 35.7 months) and analysed the initial CT findings of SAENs and the accompanying lesions to elucidate the risk factors for HCC development.Results Of 175 SAENs,101 (57.7％) disappeared and 34(19.4％) persisted.Forty SAENs(22.9％) became HCC in 33 patients(29.5％).Presence of HCC treatment history(P =0.005,risk ratio =7.429),a larger size of SAEN(P =0.003,risk ratio =1.630),presence of coexistent HCC(P =0.021,risk ratio =3.777) and absence of coexistent typical arterioportal shunts (P =0.003,risk ratio =4.459) turned out to be independently significant risk factors for future development of HCC.Conclusion SAENs are frequently seen in an HCC surveillance population and have a 22.9％ probability of becoming HCC on a per-lesion basis.Risk increased particularly when the lesion is associated with a previous or concurrent HCC,a large size or found without a coexistent typical arterioportal shunt.