Objective To systemically review the efficacy of acetaminophen for the treatment of preterm infants with symptomatic patent ductus arteriosus(PDA).Methods Literatures about the efficacy of acetaminophen for the treatment of preterm infants with PDA were searched in PubMed,the Cochrane Library,Web of science,CNKI,Wanfang and VIP from the establishment of the data base until March 2017.Two researchers screened literatures according to the inclusion and exclusion criteria,extracted the data,and assessed the risk of bias independently.Then meta-analysis was performed by RevMan5.2 software.Results There were a total of 8 randomized controlled trials (RCTs) in the meta-analysis,including 386 cases in the acetaminophen group and 416 cases in the control group.The results of meta-analysis showed that there was no significant difference in the PDA closure rate between the acetaminophen group and the control group [mean difference(MD) =0.91,95％ confidence interval(CI):0.62 ～ 1.31,P =0.60].The rate of adverse reaction in acetaminophen group was lower than the control group(MD =0.41,95％CI:0.28 ～0.62,P ＜0.001).Conclusion Acetaminophen is effective and has lower adverse reaction compared with the traditional nonsteroidal anti-inflammatory drugs for the treatment of preterm infants with PDA.

Objective Inflammatory bowel disease(IBD)is an unexplained chronic and recurrent inflammatory disease of the intestine,including ulcerative colitis(UC)and Crohn′s disease(CD).At present, the etiology and pathogenesis of IBD are still not clear,and it is believed to be related to the environment, inheritance,infection,immunity and other factors.With the increase of people′s living standard and the economic and social development,the incidence of IBD in China is a rising trend year by year,the impact of diet on the incidence of IBD and the influence of nutritional support on the prognosis of IBD have attracted more and more attention.Vitamin is one of the seven nutrients and is an indispensable part of the health of the body.In recent years,some vitamins have been proved to be related with the occurrence and development of IBD.

Objective In order to clarify the identification path and the followed principles in this kind of pathological-related medical damage identification,explore the prevention and resolution ideas of pathological medical disputes in the medical and health departments,and build a path for the people's court to hear the cases of pathological medical injury liability disputes.Methods Taking the judgement of medical damage liability disputes that took effect in 2019-2023 and published on the judgement document network as a sample,conduct a retrospective analysis in terms of the site of lesion,medical fault,the consequences of the damage,the causal relationship and the degree of cause(degree of participation),the degree of accident classification and responsibility,the selection of appraisal method,and the acceptancde of appraisal opinions.Results From the analysis of the lesion site,there is a high proportion of misdiagnosis in breast,lung,thyroid,skin and uterus;from the analysis of medical fault,58.4%of delayed treatment and 41.6%of overtreatment due to improper selection of treatment plan;from the analysis of the consequences of damage,the consequences of death only account for about 20%.Most of them are in the category of living appraisal;from the analysis of responsibility division,medical institutions bear secondary reasons,accounting for 30.3%;from the analysis of appraisal and acceptance,medical damage identification methods are mostly used,and the court's acceptance of appraisal opinions reaches 92.1%.Conclusion(1)There are more pathological disputes involving women's bodies,and misdiagnosis is the most in the type of fault;(2)Forensic clinical professional appraisers can also participate in the identification of medical damage involving pathological diagnosis;(3)For cases of medical damage liability disputes involving pathological diagnosis and the consequences of death,the cause of death should be identified;(4)Medical damage identification should be in accordance with the principle of peer review.

OBJECTIVETo investigate the value of serum IgA/C3 ratio in the diagnosis of IgA nephropathy and explore its relationship with the clinicopathological features of the patients.

METHODSSixty-six patients with IgA nephropathy, 111 with other glomerular diseases, and 40 healthy control subjects without kidney disease were tested for serum IgA and C3 levels using CRM470 adjusted standardized immune turbidimetric method, and the IgA/C3 ratio was calculated. According to Oxford and Lee's classification criteria, we analyzed the pathological grades of the renal biopsy samples from patients with IgA nephropathy. The ROC curve was used to assess the value of serum IgA and IgA/C3 ratio in predicting IgA nephropathy.

RESULTSPatients with IgA nephropathy had an elevated serum IgA/C3 ratio than those with other glomerular diseases and the control subjects, with an area under the ROC curve of 0.776. An elevated serum IgA/C3 ratio was not found to significantly correlate with the pathological grade of renal biopsy samples in patients with IgA nephropathy.

CONCLUSIONIn the absence of renal biopsy findings, serum IgA/C3 ratio can help in the diagnosis of IgA nephropathy.

Biopsy ; Case-Control Studies ; Complement C3 ; analysis ; Glomerulonephritis, IGA ; blood ; diagnosis ; Humans ; Immunoglobulin A ; blood ; Kidney ; pathology

OBJECTIVETo study the clinicopathologic features and differential diagnosis of recurrent Müllerian adenofibroma (MAF) of the uterus.

METHODSClinicopathologic information of 7 cases of recurrent MAF of uterus was retrieved from January 1992 to April 2006 and compared with 12 cases of MAF without recurrence and 14 cases of low-grade Müllerian adenosarcoma (MAS). EnVision immunohistochemistry of estrogen receptor (ER), progesterone receptor (PR), smooth muscle actin (SMA), CD10, Ki-67 and p53 were performed in all cases.

RESULTSAll cases of recurrent MAF of the uterus were polypoid, lobulated, and broad based mass arising from the corpus or cervix. Microscopically, the tumor consisted of benign epithelial and mesenchymal components with low mitotic activity ( ≤ 1/10 HPF). The clinical and pathologic features of 3 recurrent tumors were similar to their primary tumors, while 4 cases of recurrent tumor presented with focally higher cellularity and mitotic activity, meeting the diagnostic criteria of adenosarcoma. The stromal expression patterns of ER, PR, SMA and p53 in recurrent MAF were similar to those of clinically benign MAF and low-grade MAS. Negative or focally positive stromal cell expression of CD10 was seen infrequently in recurrent MAF (1/7) and clinically benign MAF (1/12). In contrast, a moderate to strong CD10 staining was frequently seen in MAS (9/14, P < 0.05). The difference of Ki-67-labeling index between MAF and MAS did not reach a statistical significance (P > 0.05). Ki-67-labeling index increased in areas of periglandular stromal cuffing as compared with interglandular areas in all MAS cases, but it was not observed in either recurrent MAF or clinically benign MAF cases.

CONCLUSIONSRecurrent MAF may be associated with aggressive behavior. It is difficult to distinguish MAF from low-grade MAS. CD10 and Ki-67 staining pattern in stromal cells may be helpful for the differential diagnosis.

Adenofibroma ; metabolism ; pathology ; surgery ; Adenosarcoma ; metabolism ; pathology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Diagnosis, Differential ; Female ; Humans ; Hysterectomy ; methods ; Ki-67 Antigen ; metabolism ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Neprilysin ; metabolism ; Survival Rate ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Young Adult