NDUFS3 is an essential subunit of mitochondrial NADH:ubiquinone oxidoreductase (complex Ⅰ ) and plays a critical role in the mitochondrial typeⅠ respiration chain.Mutations in this gene are shown to cause neurodegenerative disease such as Leigh syndrome (subacute necrotizing encephalopathy).In recent years,many evidences show that the expression of NDUFS3 proteins are lower in many cancerous cells compared to the corresponding normal cells.It comes to the conclusion that NDUFS3 may play a role in the tumorigenesis.

Objective To evaluate accuracy of preoperative tumor grade and intracperative gross examination of myometrial invasion in patients with clinical stage Ⅰ endometriod adenocarcinoma for lymphadenectomy. Methods Clinic-pathological data were retrospectively collected from 687 patients with clinical stage Ⅰ endometriod adenocarcinoma who underwent operation in Women's Hospital, Zhejiang University School of Medicine from January 1999 to December 2008. According to postoperative histology diagnosis, accuracy of preoperative tumor grade by curettage and depth of myometrial invasion by intraoperative gross examination was evaluated, and clinic-pathological factors associated with accuracy were analyzed. Results Sensitivity, specificity, accuracy, false negative rate, false positive rate, and positive and negative predictive value for the prediction of needing for intraoperative lymphadenectomy in patients with clinical stage Ⅰ endometriod adenocarcinoma were 70. 4% ,80. 2% ,77.6% ,12.0%, 43.0%, 57.0% and 88.0%, respectively. Analysis of mutil-factors shown that patient age, tumor size, lymph node metastasis and extrauterine spread lesions were independent factors affected the accuracy of prediction(P ＜ 0. 05 ). Conclusion Prediction of needing for lymphadenectomy by preoperative tumor grade and intraoperative gross examination of myometrial invasion is reliable in clinical stage Ⅰ endometriod adenocarcinoma patients, while there is a highly false negative rate in prediction of not needing for lymphadenectomy, while other prognostic factors such as patient age, tumor size, lymph node metastasis and extrauterine spread lesion should be together considered.

Comparative effectiveness research (CER) has gained more and more popularity, which brought great response in the USA and other developed Western countries. There is no doubt that CER is a new idea and a milestone in health care research. CER is also known as "patient-centered outcomes research", which means patient is the core element in the whole system of CER. Chinese medicine could make new achievements and further development by introducing CER into clinical research. This article mainly introduced the background, features and contents of CER and summarized how to conduct CER in Chinese medicine by referring to some published literature in order to enlighten Chinese medicine researchers.

Objective To explore the characteristics of fetal movement and FHR variation elicited by acoustic stimulation and whether acoustic stimulation can replace vibroacoustic stimulation. Methods Ninety-four and seventy-six normal pregnant women for antenatal visit were recruited from the Woman's Hospital, School of Medicine, Zhejiang University from April 2002 to February 2003. All subjects were divided into 5 groups to be exposed to five different intensities of acoustic stimulations at 95,100,105,110,115 dB respectively and self-control of blank and vibroacoustic stimulation were designed. The fetal movements and FHR were recorded during the study. Results (1) The percentage of fetal movement evoked by 95,100,105,110,115 dB airborne sound was 15% , 89%, 83% , 83% , 95% respectively. The total percentage of fetal movement evoked by vibroacoustic stimulation was 99% for all subjects. The percentages of evoked fetal movement by 100,105,110,115 dB airborne sound were not significantly different from those by vibroacoustic stimulation. (2)The percentages of FHR acceleration ≥15 bpm in 100,105,110 and 115 dB airborne sound groups were 39%, 61%, 56% and 85%, respectively, while 92% for all cases evoked by vibroacoustic stimulation was significantly higher than those evoked by 100,105 and 110 dB airborne sound group but with no significant difference to 115 dB airborne sound group. (3)The peak value in FHR evoked by 95,100,105, 110 and 115 dB airborne sound were -4. 5 bpm, 12 bpm, 17 bpm, 14 bpm and 20. 5 bpm, respectively. The peak FHR acceleration evoked by vibroacoustic stimulation was 23 bpm which was significantly higher than those by 100,105,110 dB airborne sound and no significant difference was detected between 115 dB airborne sound and vibroacoustic stimulation group. (4)Compared with 115 dB airborne sound, vibroacoustic stimulation evoked significantly longer duration of FHR tachycardia (42. 5 s vs 5 s, P = 0. 011) and fetal movement (270 s vs 100 s, P = 0. 000). Conclusions Acoustic stimulation at 115 dB is able to elicit efficient fetal movement and FHR acceleration without prolonged tachycardia, fetal behavioral disorganization or excessive fetal movement and is reasonable to replace vibroacoustic stimulation for awaking fetuses combined with NST.

Objective To evaluate which parameters of transvaginal color Doppler ultrasonography(TVCDU) can effectively reflect blood flow in ovarian tumors. Methods TVCDU was preoperatively used to determine all the parameters of blood flow in 60 women with epithelial ovarian cancer(EOC) and 36 with benign ovarian cystadenomas (control group). Microvessel density(MVD) was tested in the tissue samples by immunohistochemical method(SP method). The parameters of TVCDU in EOC were compared with those in control group.The correlation between MVD and the parameters in EOC group and control group was analyzed. Results ①Statistical differences of arteria showing rate, arteria number, vasculature type, diastolic notch, PI, RI, S/D, TAMXV were seen between EOC group and control group(P

Objective To explore the clinical efficacy of proximal femoral locking compression plate (LCP)fixation in elderly intertrochanteric fractures patients. Methods 30 cases of intertrochanteric fracture fixed with LCP were collected,and the functional recovery of all hip joints was observed. Results The average follow-up and healing time of all cases was 10 months(6 to 14 months)and 3.5 months respectively. Hip joint function of 27 cases was excellent( Harris scoring≥90) ,that of the other 3 cases was good ( Harris scoring:80 ～ 89). Conclusion The proximal femoral LCP fixation had a good clinical value in treatment of elderly intertrochanteric fracture patients. It had many advantages, such as simplicity, rigid fixation, less trauma and bleeding, shorter operative time, less complications, high heal rate, etc.

The paper is to systematically evaluate the effect and safety of Shenqi Fuzheng injection (SFI) combined with first-line chemotherapy for non-small cell lung cancer (NSCLC). Randomized controlled trials (RCTs) on Shenqi Fuzheng injection (SFI) combined with first-line chemotherapy (experiment group) and chemotherapy alone group ( control group) were electronically retrieved from Medline, EMbase, Clinical Trials, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data base. All trials were assessed for quality according to the Cochrane Reviewer's Handbook for Systematic Reviews of Intervention and then Meta-analysis was performed withRevMan5. 2 Software. A total of 43 RCTs (3433 patients) were included after screening and selecting. Results of Meta-analysis showed that: Objective remission rate (ORR): ORR of experimental group was about 20% higher than that of control group [RR = 1.23, 95% CI (1.11,1.35), P < 0.0001]. Disease control rate (DCR):DCR of SFI combined with first-line chemotherapy was 11% higher than that of first-line chemotherapy alone [RR = 1.11, 95% CI (1.07, 1.16), P < 0.000 01]. Life quality evaluated by Kosovan performance status (KPS) showed that: life quality improvement rate of experimental group was about twice of that in control group [RR = 2.02, 95% CI (1.81, 2.26), P < 0.000 01]. Toxic and side reaction analysis showed that: the incidence of side reactions in experimental group was about 50% lower than that in control group [RR = 0.59, 95% CI (0.53, 0.66), P < 0.000 01]. Immune function test showed that: the function of experimental group was 3.2 (standard deviations) times greater than that of control group [MD = 3.23, 95% CI (2.86, 3.60), P < 0.000 01]. We can see that SFI combined with first-line chemotherapy for NSCLC can increase objective efficacy, improve life quality, decrease toxic and side reactionsinduced by chemotherapy, and improve the immune functions. As most of the included studies in this systematic evaluation had poor quality, the evidence to support conclusion was weak, so it was necessary to conduct more multi-center clinical trials with high quality methods and rigorous design.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Young Adult

There has been much difference between effectiveness and harm in evidence evaluation. Many evidence ranking or grading systems have been developed'by researchers in the world. However, no evidence ranking or grading systems are based on safety research reality. Those existing evidence ranking or grading systems are prone to evaluating effectiveness evidence not proper for harm evidence. It is necessary to develop a new system for harm evidence. We put forward to establishing the body of evidence for harm for postmarketing traditional Chinese medicine as required by our daily research work. We do hope such an ideal could be helpful and indicative for evidence evaluation for harm.
Medicine, Chinese Traditional ; adverse effects ; Product Surveillance, Postmarketing

Objective To evaluate clinical and pathologic factors associated with pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervir.Methods From February 2004 to January 2007,135 patients with stage Ⅰ b-Ⅱ a cervical squamous cell carcinoma in Women's Hospital,School of Medicine,Zhejiang University,were retrospectively studied.The relationship between pelvic lymph node metastasis and age,clinical stage,tumor size,grade of differentiation,depth of muscular invasion,lymphatic vascular space invasion,pretreatment level of serum squamous cell carcinoma antigen,pretreatment plasma level of fibrinogen,pretreatment leveh of hemoglobin and platelet were evaluated by univariate and multivariate analyses.Results Totally 3996 lymph nodes were dissected in 135 patients,with an average of 29.6 lymph nodes in each patient.12.6%of the patients(17/135)had metastasized pelvic lymph nodes.Univariate analysis indicated that tumor size(P=0.003),depth of muscular invasion(P=0.004),vasular space invasion(P<0.01),pretreatment levels of platelet(P=0.006)and fibrinogen(P<0.01)were significantly related to pelvic lymph node metastasis.Multivariate logistic regression analysis showed that lymphatic vascular space invasion(OR:3.674,95%CI:1.825-7.393,P<0.01)and pretreatment plasma level of fibrinogen(OR:4.568,95%CI:1.779-11.725,P=0.002)were significantly related to pelvic lymph node metastasis in patients with early-stage squamous cell carcinoma of the uterine cervix.Conclusion In early-stage cervical squamous cell carcinoma,lymphatic vascular space invasion and higher pretreatment plasma levels of fibrinogen are risk factors of pelvic lymph node metastasis.

Good clinical practice should be based on evidence. Evidence quality should be based on critical appraisal in evidence based medicine (EBM). Evaluation of evidence quality plays an important role in evidence level clarifying, which is the core of EBM. Different recommendations for clinical practice often derive from evidence levels. Thus evidence quality evaluation is the first and most important step in EBM. There are lots of standards to evaluate evidence quality in the world. However there are two aspects of the evaluation, one is methodological evaluation and the other is reporting evaluation. This article collected a series of standards for clinical trials quality evaluation according to different research designs. It is hoped that the resource and introduction about the quality evaluation of clinical trials be helpful for medical researchers in China. Only being familiar with all kinds of standards of methodology and reporting, researchers could publish high quality scientific papers.
Biomedical Research ; Evidence-Based Medicine ; Guidelines as Topic ; Humans ; Meta-Analysis as Topic ; Randomized Controlled Trials as Topic