Objective:To evaluate the consistency of colposcopy diagnosis performed by a single examiner with pathologic diagnosis and to analyze the factors related with colposcopy over-and under diagnosis.Methods:A retrospective study was performed.The initial 200 cases diagnosed by a single colposcopy beginner at Peking University first Hospital out-patient clinic from March 2015 to October 2015 were included in this study.The consistency rate and bias rate of colposcopy diagnosis versus pathologic diagnosis as well as the causes of such differences were analyzed.Results:Of 174 cases with pathologic diagnosis,the consistency rate was 59.2％.The underdiagnosis rate and overdiagnosis rate were 18.4％ and 22.4％ separately.Of HSIL underdiagnosis group,the rate of TCT NILM was 78.6％ which was higher than 18.1％ in HSIL consistency group,P ＜ 0.05.Re-evaluation of the colposcopy pictures revealed that acetowhite epithelium were present in all 14 cased of HSIL underdiagnosis group.The rate of post-menopausal women was higher in HSIL underdiagnosis group than in HSIL consistency group(21.4％ vs 0％),P ＜0.05.The medium numbers of biopsy were higher in HSIL consistency group when compared with HSIL underdiagnosis group,P ＜0.05.The medium numbers of biopsy was higher in overdiagnosis group when compared with consistency group,P ＜ 0.05.Conclusions:Underdiagnosis of colposcopy was related with TCT-overdependent,insufficient understanding of acetowhite epithelium and post-menopausal women.Increasing biopsy numbers may improve the consistency rate of colposcopy and pathologic diagnosis.However,the increasing numbers of biopsy often results from overdiagnosis.

OBJECTIVE: To study the reverse effect of angiotensin - converting enzyme (ACE) inhibitor - fosinopril on the structural changes of mesenteric resistance vessels in sinoaortic - denervated (SAD) rats. METHODS; The rats were randomly divided into SAD group, fosinopril treatment group after SAD operations; besides, another sham operation control group was established. The rats were put to death after medication and (or) feeding for 16 weeks. The histopathological changes of the second order branch of mesenteric artery taken from the rats were observed by light microscope and computer - assisted image analysis. RESULTS: The wall thickness, the ratio of wall thickness to internal diameter, the wall area, the ratio of numbers of smooth muscle cells to field of view of the mesenteric resistance vessels diminished significantly in the fosinopril treatment group; however, no significant change was noted for the relative area of the smooth muscle in this group vs. the SAD group. CONCLUSION: Fosinopril can efficiently inhibit the structural changes of mesenteric resistance vessels in SAD rats.

OBJECTIVE:To observe clinical efficacy and safety of irinotecan combined with tegafur,raltitrexed or 5-fluoroura-cil for advanced gastric cancer. METHODS:One hundred advanced gastric cancer patients with first-line regimen failure were se-lected as research objects from our hospital during May 2013-May 2016. According to random number table,they were divided into observation group(n=32),control group A(n=33)and control group B(n=35). Observation group was given Irinotecan hydro-chroride injection 180 mg/m2,ivgtt(d1)+Tegafur capsule 60 mg/m2,po,bid(after meal),2 weeks as a cycle. Control group A was given Irinotecan hydrochroride injection 180 mg/m2,ivgtt(d1)+ Raltitrexed for injection 3 mg/m2,ivgtt(d1,15 min),3 weeks as a cycle. Control group B was given Irinotecan hydrochroride injection 180 mg/m2,ivgtt(d1)+Calcium folinate injection 200 mg/m2, ivgtt(d1)+5-fluorouracil injection 400 mg/m2,iv+2400~3000 mg/m2,ivgtt(46 h),d1,2 weeks as a cycle. On the 7th day after 2 courses of treatment,clinical efficacies of observation group and control group A were evaluated;on the 12th day after 3 courses of treatment,clinical efficacies of control group B were evaluated. Clinical efficacy and the occurrence of ADR were observed in 3 groups. RESULTS:One patient withdrew from control group A and 2 from control group B. 97 patients were included in the study finally,including 32 cases in observation group,32 cases in control group A,33 cases in control group B. The total remission rate of observation group(53.13%)was significantly higher than that of control group A(43.75%)and control group B(36.36%);to-tal control rate of observation group(81.25%)was significantly higher than that of control group A(68.75%)and control group B (57.58%),with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR among 3 groups (P>0.05). CONCLUSIONS:Clinical efficacy of irinotecan combined with tegafur is better than irinotecan combined with ralti-trexed or 5-fluorouracil in the treatment of advanced gastric cancer with good safety.

Pharmacogenomics is defined as the study of the association between genetics and drug response. This review includes basic concepts of pharmacogenomics, heterogeneity of hypertension and antihypertensive drug responses, genes associate with drug metabolism, and individualized drug therapy. The knowledge of genes that influence the pharmacodynamic determinants of blood pressure response to antihypertensive medications has the potential to provide new insights not only into molecular mechanisms influencing drug response, but also into the role that these genes may play in determining interindividual differences in blood pressure level and the occurrence of hypertension.

Objective To observe the effets of telmisartan on oxidative stress and the activity of protein kinase C in type 2 diabetic Rat.Methods Thirty six Wistar rate were divided into three groups as normal rats、diabetic rats and diabetic rats treated with telmisartan.Blood glucose,blood insulin,blood lipid were measured after 4,5,11 and 17 weeks,serum creatinine,blood uria nitrogen,urinary albumin excretory rate, lipid peroxidation(MDA),the activity of protein kinase C(PKC) and of antioxidant enzymes including Cu/Zn superoxide dismutase(Cu, Zn-SOD),catalase(CAT) and glutathione peroxidase(GSH-Px) in renal tissue were measured after 11 and 17 weeks.In addition,the renal tissue were observed by light microscopy.Results The blood glucose and blood insulin were found no significant difference between that in type 2 diabetic rats with and without telmisartan treatment groups.Comparing with untreated group,the level of blood lipid,serum creatinine,blood uria nitrogen,urinary albumin excretory rate, renal MDA and the activity of cell membrane PKC in telmisartan treated group were significantly decreased,but the activity of renal Cu/Zn SOD,CAT and GSH-Px was increased.There was significant correlation between the change of renal MDA and the activity of antioxidase and the activity of cell membrane PKC. Conclusion Telmisartan could inhibit oxidative stress in diabetic rats, and its mechanism perhaps was decreasing the activity of cell membrane PKC.

Sudden cardiac death is still a difficult problem for doctors.Every therapy has its drawback.In the past 20 years,there have been great progress in implantable cardioverter defibrillator.This therapy strategy may bring more benefits to indicated patients.This article reviews the application of implantable cardioverter defibrillator and summarizes its history and development,component,function,curative effect,symptom of adaption and contraindication.

OBJECTIVE: To study the time window of apoptosis and related genes expression of the myocardiocytes in sinoaortic-denervated(SAD) rats.METHODS SAD of shamoperation(Sham) was performed in male SD rats at the age of 10 weeks.After 4, 8, 16, 32 weeks, apoptotic cells were stained in situ using terminal dexynucleotidyl - transferase mediated -dUTP nick end labeling(TUNEL) .All stained results were analysed by computer image analysis techniques.Bel-2, Bax, Fas and Fas-L were detected using immunohistochemical method.RESULTS: Compared with Sham controls, the number of apoptotic myocardiocytes was significantly increased;The expressions of Bel - 2 were significantly decreased, whereas Bax,Fas and Fas-L were significantly increased in SAD rats.The ratio of Bcl-2/ Bax was decreased.CONCLUSION Apoptosis and dysregulation of related gene expressions may be involved in the myocardial remodeling in SAD rats.

Objective To study the surgical treatment of duodenal invasion by cancer of hepatic flexure of (colon). Methods Clinical data of 15 cases of duodenal invasion by cancer of hepatic flexure of colon were analyzed retrospectively.Results Invasion of the second or third portion of the duodenum by cancer of the hepatic flexure of colon occurred in 15 cases.The duodenum was adhered to the cancer in 6 cases,(seromuscular) invasion by the tumor in 5 cases,and duodenocolic fistula in 4 cases. All of the cases received surgical (treatment). 8 cases were mucoid adenocarcinomas, 4 were poorly differentiated adenocarcinomas, two were moderately differentiated adenocarcinomas, and one was signet-ring cell carcinoma. One patient died (after) operation, and the five-year survival rate was 46.7%(7/15). Conclusions Duodenum is the first organ easily to be invaded by cancer of hepatic flexare of colon. Radical and en bloc resection of the colonic cancer and involved organs is the best therapeutic method. The key to recovery is correct treatment of the (surgical) defect of the duodenum.

OBJECTIVE:To study the cooperative effect of arsenic trioxide(As 2 O 3 )and octreotide on the proliferation of human hepatocellular carcinoma(HCC)SMMC-7721and to observe the combining effect of the two drugs.METHODS:The killing effect of drugs was determined by MTT;the cell cycle was determined by flow cytometry(FCM);the drug combination analysis was conducted by the moderate efficiency principle.RESULTS:The combination of arsenic trioxide and octreotide significantly inhibited cell proliferation of SMMC-7721in vitro;and the moderate efficiency concentration of As 2 O 3 and oc-treotide in combination was2.022?mol/L and8.088?mol/L respectively,which were lower than those when used singly.The combination of two drugs can inhibit HCC at the S-phase.The combination index was less than1if the combining domino offect of As 2 O 3 and octreotide was more than0.3.CONCLUSION:Combination of As 2 O 3 and octreotide in vitro can signifi-cantly increase the inhibition effect of each single one on the proliferation of SMMC-7721and the combination of two has a better anticarcinogenic effect when the domino offect of the combination is above0.3.

There are mounting evidences demonstrating that obesity and osteoporosis pose a daunting threat on global public health problem, given their morbidity and mortality. Ω-3 polyunsaturated fatty acids ,besides as a source of energy, may regulate the cellular signal transduction pathway to produce specific patterns of gene expression, and protect from complications of obesity and osteoporosis . This article reviewed the correlation between obesity and osteoporosis, and summarized the effects and potential mechanism of ω-3 polyunsaturated fatty acids on fat metabolism and bone metabolism from both animal experiments and epidemiological studies.