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 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.

Objective: To study the in vitro antilipid-peroxidation effects of tannins extract from Sanguisorba officinalis on heart, liver, brain and kidney of rats.Methods: The in vitro inhibitory effects of tannins extract from Sanguisorba officinalis on lipid-peroxidation of heart, liver, brain and kidney of rats induced by Fe2+-cysteine (Fe2+-Cys), Fe2+-vitamin C (Fe2+-Vit C) and Fe2+-H2O2 were determined by spectrophotometry.Results: The inhibitory effects of tannins extract from Sanguisorba officinalis on MDA produced by lipid-peroxidation of brain, heart, liver homogenate, kidney and mitochondria of rats induced by Fe2+-Cys, Fe2+-Vit C and Fe2+-H2O2 were all significant.Conclusion: Tannins from Sanguisorba officinalis has good in vitro protective effects on antilipid-peroxidation of heart, liver, brain and kidney of rats, which is worth studying further.

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.

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 study the effects of gossypol acetic acid(GAA)on the methylation level and the mRNA expression of hM-LH1 in human tongue cancer Tca8113 cells.Methods:Tca8113 cells were treated by GAA at various doses for 24 h,48 h and 72 h respectively.MTT assay was used to detect the cell proliferation.Nested methylation specific PCR(nMSP)was used to detect methyl-ation level of hMLH1 .Real-time fluorescence quantitative PCR(RFQ-PCR)was applied to investigate the mRNA expression of hM-LH1 gene.Results:GAA inhibited the proliferation of Tca8113 cells dose-and-time dependently,decreased the DNA methylation level of hMLH1(P<0.05)and increased hMLH1 mRNA expression in Tca8113 cells(P<0.05).Conclusion:GAA can suppress proliferation of Tca8113 cells by demethylation of hMLH1 gene and increase of hMLH1 mRNA expression.

Objective:To systematically review the teaching effects of flipped classroom (FC) in undergraduate medical education in China.Methods:Such databases as CNKI, VIP Data, and WanFang, were electronically searched for literature of randomized controlled trials (RCTs) on FC versus lecture-based learning (LBL) applied in medical education in China up to March, 2018. The included literature were evaluated for the quality, and RevMan5.3 software was used for Meta-analysis.Results:A total of 26 RCTs were included in the study, including 4 249 students, of whom the FC group had 2 135 cases, while LBL group had 2 114 cases. The students in FC group got significantly higher scores than those of the students in LBL group in the theoretical scores (WMD = 7.81, 95%CI = 5.18 -10.43, P < 0.05), skills tests (WMD = 4.69, 95%CI = 0.65 -8.73, P < 0.05). Conclusion:The FC can significantly improve the teaching results in undergraduate medical education.

Objective The purpose of this study was to investigate the effects of gossypol acetic acid (GAA) on protein and mRNA expressions of hMLH1 gene in human tongue carcinoma cell line Tca8113 in vitro in order to discuss the mechanism of tumor suppression of GAA. Methods (1) Western-blot was used to study the effects of GAA on protein expressions of hMLH1 gene in Tca8113 cell line treated by different concentrations of GAA for 48 h. (2) Real-time fluorescence quantitative PCR (RFQ-PCR) was used to investigate the effects on the mRNA expressions of hMLH1 gene in Tca8113 cell line treated by GAA for 48 h. Results (1) Compared with the control group, the results of Western-blot showed that the protein expression of hMLH1 gene was increased after treatment by GAA for 48 h ( <0.05) . (2) The results of RFQ-PCR indicated that the mRNA expression of hMLH1 gene was increased after GAA treatment for 48 h ( <0.05) . Conclusion GAA could up-regulate protein and mRNA expression of hMLH1 in Tca8113 cell line, which indicated that it may be one of the mechanisms of tumor suppression effect of GAA.

Objective To explore the clinical characteristics,pathological features,therapy and prognosis of a case of splenic marginal zone lymphoma (SMZL) with central recurrence,evaluation the safety and efficacy of rituximab intrathecal injection combined with intravenous chemotherapy.Methods Retrospectively analyze the case of SMZL with the central recurrence,and review the relevant literatures.Results According to the tests of MICM of bone marrow,spleen pathology,PET-CT and laboratory examination (LDH),patient was diagnosed as SMZL,IV group B,IPI and aaIPI was high risk group.After first-line therapy,the patient achieved complete remission.But then the central nervous system relapsed.The patients was treated with rituximab intrathecal injection combined with intravenous chemotherapy,the central focus disappeared.Conclusion SMZL belongs to low-grade lymphoma,which combined with central nervous system relapse is very rare.Rituximab intrathecal injection combined with intravenous chemotherapy in the treatment of the patients is safe to use,and have good clinical efficacy.