Objective:To observe the clinical curative e ect of treating diarrhea-predominant irritable bowel syndrome(D-IBS) with Lichang Tang(Intestine-Regulating Decoction) and sertraline hydrochloride.Methods:72 patients with(D-IBS) was randomly divided into 2 groups:32 cases in the treatment group was given self-prescribed Lichang Tang(modi ed Tongxie Yaofang [Main recipe for painful diarrhea]+Jinlingzi San [Toosendan Powder]) and sertraline hydrochloride(50 mg,p.o.once in the early morning);35 cases in the control group were given Lichang Tang alone for oral administration.During administering these drugs,other drugs were discontinued in the 2 groups.Psychological counseling and dietary modi cation were used in all patients.The course of treatment lasted for 4 weeks.Results:The total e ective rates in the treatment group and the control group were 86.49% and 65.71% respectively,and there was signi cant di erence(P

Objective To evaluate the mid-long term effects of hysteroscopic treatment of abnormal uterine bleeding(AUB).Methods A total of 432 patients admitted from January 2002 to November 2005 with AUB were treated with hysteroscopy.All the patients were followed for at least 12 months.Among the 432 patients,391 were diagnosed as having benign lesions,including endometrial polyp in 96 patients(22.2%),submucous myoma in 38 patients(8.8%),and endometrial hyperplasia in 257 patients(59.5%),receiving transcervical myoma resection or transcervical endometrium resection.The other 41 patients were diagnosed as having stage Ⅰ endometrial carcinoma,and a total hysterectomy and bilateral adnexectomy with selective pelvic lymphadenectomy was performed.Results All the operations were successfully completed,without uterine perforation or other complications.During a follow-up of 12～57 months(mean,39 months) in the 391 patients with benign lesions,amenorrhea was found in 63 patients(16.1%,63/391),hypomenorrhea( 1.5 cm in 8 patients,and a second hysteroscopic endometrial resection was given at 5～19 months after first operation.All the 8 patients were further followed for 18～36 months,with findings of amenorrhea in 5 of them and hypomenorrhea in 3.All the 41 patients with stage Ⅰ endometrial carcinoma survived without recurrence during a follow-up period for 26～41 months(mean,38 months).Conclusions Hysteroscopic treatment can be the first choice for treating non-malignant AUB.Pre-operational pathological examination and ultrasonography can enhance the safety and efficacy of the operation.

Objective To evaluate the mid-long term effects of laparoscopic treatment of ovarian endometriosis cysts.Methods Clinical data of 209 cases of ovarian endometriosis cysts treated by laparoscopic operation from January 2002 to December 2005 were retrospectively analyzed.All the patients were followed for at least 12 months(12-54 months).There were 115 cases of unilateral ovarian cyst enucleation,62 cases of bilateral enucleation,11 cases of unilateral adnexectomy,and 21 cases of unilateral adnexectomy combined with contralateral cyst enucleation.Oral gestrinone was administrated in patients without childbearing intentions,while in patients demanding a child,no drug was given and an early pregnancy was encouraged.Results Conversions to open surgery were required in 7 cases.No complications occurred.Ovarian endometriosis cysts recurred in 17 cases(8.1%),including 7 cases of stage Ⅲendometriosis and 10 cases of stage Ⅳ endometriosis.Of the 35 cases of infertility,intrauterine pregnancy was obtained in 16 cases,with a pregnancy rate of 45.7%.The pregnancy occurred at 4-29 months after operation(within 2 years in 10 cases).Of the 157 cases of dysmenorrhea,a complete relief was achieved in 95 cases(60.5%)and an improvement was obtained in 62 cases(39.5%).Conclusions Laparoscopic treatment is suitable for all stages of ovarian endometriosis cysts.Postoperative drug administration and long-term follow-up are necessary to lower the recurrence rate.

Objective To make a nationwide external quality assessment of tests for isolation and identification of N.gonorrhoeae in medical and healthcare facilities at different levels,and to analyze current problems.Methods Lyophilized quality control samples were uniformly delivered to 252 medical and healthcare facilities providing sexually transmitted disease (STD) services at different levels.Test results were analyzed by the National Center for STD Control,China Center for Disease Control and Prevention,and evaluation results were fed back to participating laboratories.Results Finally,test results were received from 203 (80.56％) facilities.The comprehensive score averaged at 87.14,and facilities achieving a comprehensive score of 80 or greater amounted to 80.30％ (163/203).The coincidence rate was 53.69％ (109/203) for all of the 5 quality control samples,82.76％ (168/203) and 87.68％ (178/203) respectively for two quality control samples containing only N.gonorrhoeae,86.21％ (175/203) and 96.06％ (195/203) respectively for a sample containing Neisseria sicca and a sample containing Enterococcus faecalis,69.46％ (141/203)for a sample containing different species of Neisseria.Conclusion The external quality assessment reveals a disparity in the capability to isolate and identify Neisseria among medical and healthcare facilities providing STD services at different levels.

Objective To make a nationwide external quality assessment for drug sensitivity testing of Neisseria gonorrhoeae, analyze the problems in and factors associated with the drug sensitivity testing, and to enhance the quality of drug sensitivity testing of N. gonorrhoeae at different monitoring sites. Methods Samples were uniformly delivered to monitoring sites by express mail service. Test results were analyzed in the National Center for STD Control, and the evaluation results were fed back to these monitoring sites. Results A total of 105 quality control samples were delivered from 2007 to 2009, with a response rate of 88.57% (93/105). Thirteen monitoring sites were enrolled in the external quality assessment, including 9 laboratories in 2007, 9 in 2008 and 13 in 2009. The total percentage amounted to 77.42% (24/31) for qualified laboratories during the 3 years, including 6 laboratories in 2007, 7 in 2008 and 11 in 2009. The coincidence rate increased for the detection of penicillinase-producing N. gonorrhoeae (PPNG), N. gonorrhoeae with chromosome-mediated ciprofloxacin resistance, and N. gonorrhoeae with chromosome-mediated spectinomycin resistance, and declined for the detection of N. gonorrhoeae with plasmid-mediated high level tetracycline-resistance (TRNG) and N. gonorrhoeae with chromosome-mediated ceftriaxone resistance. Conclusions The 3-year external quality assessment reveals an improvement in the overall quality of drug sensitivity testing of N. gonorrhoeae at national monitoring sites; the accuracy is improved markedly for the detection of PPNG, N. gonorrhoeae with resistance to spectinomycin and ciprofloxacin, but is needed to increase for the detection of ceftriaxone-resis- tant N. gonorrhoeae and TRNG.

Kidney transplantation is a high-cost and high-risk surgery,thus genuine informed consent from the patients and their family members is indispensable both for protecting rights of patients and ensuring medical safety.Guided by related regulations and ethical guidelines,this paper proposes necessary information which should be provided for patients,one example of Informed Consent Form(ICF) composing of information sheet,and consent signature form offered for reference.The proposed ICF applies three accepted requirements for informed consent,i.e.,completely being informed,fully understood and free to make choice.

Objective To investigate the effect of fluctuant high blood glucose on the pathology profile and BCL-2,BAX expression in neurons of the hippocampus from diabetic rats.Methods The diabetic rat models were developed by injection with l% streptozotocin(STZ),followed by insulin administration.Regular insulin was used to set up fluctuant high glucose group model.After 12 experimental weeks,the expression of Fas protein in hippocampus was checked by immunohistochemistry,pathological changes and ultrastructure were observed by using light microscopy and electron microscopy in three groups.Results Compared with those in N group,the expression of BCL-2 in pyramidal cells of diabetic rat's hippocampus was lower,while that of BAX was higher(P

Objective To determine Neisseria gonorrhoeae multi-antigen sequence typing (NG-MAST) sequence types in different geographical areas of China,including Changzhou and Yangzhou cities of Jiangsu province,Wuzhou and Hezhou cities in Guangxi Zhuang Autonomous region,Sanya and Qionghai cities of Hainan province,Jiangmen and Maoming cities of Guangdong province.Methods DNA was extracted using Qiagen DX extraction kits from 88 urine samples which were collected from male patients attending sexually transmitted disease (STD) clinics and positive for nucleic acid amplification test (NAAT) for N.gonorrhoeae.Two rounds of PCR were carried out to amplify the porB and tbpB genes of N.gonorrhoeae followed by gene sequencing.Sequence alignment was performed on the NG-MAST website (http://www.ng-mast.net) to determine the genotype of N.gonorrhoeae.Results The first-round PCR yielded positive results for porB and tbpB in 13.6％ (12/88) and 14.8％ (13/88),respectively,of these urine specimens,and 12 samples were successfully genotyped with the efficiency of genotyping being 13.6％.The amplification efficiency of second-round PCR was enhanced to 71.6％ and 72.7％ for porB and tbpB,respectively,and the efficiency of genotyping increased to 70.5％ (62/88).Compared with the first-round PCR,the second-round PCR showed an increase in amplification efficiency for porB and tbpB by 58.0％ and 57.9％ respectively,as well as in genotyping efficiency by 56.9％.Forty-five genotypes were identified in the 62 samples,including 40 known genotypes and 5 novel genotypes.Of these genotypes,ST1866 was the most abundant (6/62),followed by ST1972 (4/62) and ST3356 (4/62),all of which were from Jiangsu province.The ST532 genotype was identified in 3 samples from Guangdong province,ST2221 genotype in 2 samples from Guangxi Zhuang Autonomous region.Each of the remaining genotypes was identified in only 1 sample and scattered in all of these cities.The 5 novel MAST-genotypes were as follows:porB-892 and tbpB-46 (98％ similarity),porB-130 and tbpB-504 (96％ similarity),porB-2790 and tbpB-32 (99％ similarity),porB-1053 and tbpB-856 (99％ similarity).Conclusions Urine samples can be used for NG-MAST analysis,and two rounds of PCR can enhance the efficiency of genotyping.NG-MAST genotypes appear to be diverse in different geographical areas of China.

Objective To test the ceftriaxone susceptibility of Neisseria gonorrhoeae (NG) isolates from Nanjing city,and to assess their genotypes by using the NG multi-antigen sequence typing (NG-MAST) method.Methods A total of 204 NG strains isolated in 2007 and 81 in 2012 from Nanjing city were included in this study.The minimum inhibitory concentration (MIC) of ceftriaxone was determined for these strains using an agar dilution method.DNA was extracted by the Qiagen commercial kit from these strains followed by NG-MAST.Results All the isolates were susceptible to ceftriaxone (MIC,≤ 0.25 μg/ml).The MIC of ceftriaxone was ≥ 0.06 μg/ml for 63.2％ of all the NG strains,70.6％ of those isolated in 2007 and 44.4％ of those in 2012,and ≥ 0.125 μg/ml for 31.6 ％ of all the NG strains,39.7％ of those isolated in 2007,11.1％ of those in 2012.Totally,166 genotypes were identified among the 285 isolates,of which,73 had been reported,and 93 were previously unreported.The most prevalent genotype was ST568 (n =13) in NG strains isolated in 2007,followed by ST270 (n =9),ST421 (n =7),ST2288 (n =5),ST1731 (n =4),ST1766 (n =4),ST1866 (n =4),ST1870 (n =4),while ST2318 (n =5),ST1053 (n =4),ST5990 (n =4),ST8726 (n =4) were the common genotypes in 2012.Those isolates with identical or similar genotypes tended to display similar MICs for ceftriaxone.Conclusions The prevalent genotypes of NG are markedly different between 2007 and 2012 in Nanjing region,and there is a strong association between the genotypes and ceftriaxone susceptibility of NG.NG-MAST results may serve as a genetic marker in the surveillance of antibiotic susceptibility in NG.

Objective To study the current status of antimicrobial resistance of clinical Neisseria gonorrhoeae isolates in China by analyzing the surveillance results in 2008.Methods N. gonorrhoeae strains were collected from 951 eligible patients at national monitoring sites for resistance of N. gonorrheae,including 156 patients from Jiangsu province,71 from Zhejiang province,102 from Fujian province,207 from Guangdong province,77 from Guangxi province,43 from Hainan province,80 from Sichuan province,44 from Chongqing,45 from Xinjiang Uygur Autonomous Region,72 from Shaanxi province,and 54 from Tianjin.The production of β-lactamase was detected by paper acidometric testing,and minimum inhibitory concentrations(MICs)were determined by agar dilution method for spectinomycin,ciprofloxacin,cefiriaxone,tetracycline,respectively.Results Among the 951 N. gonorrhoeae isolates,2(0.21%)were resistant to spectinomycin,451(47.42%)showed reduced sensitivity to ceflriaxone,928(97.58%)were resistant to ciprofloxacin.Penicillinase-producing N.gonorrhoeae (PPNG) and plasmid mediated tetracycline-resistant N. gonorrhoeae (TRNG) accounted for 34.91%(332/951)and 51.21%(487/951) of these isolates respectively.Kendall rank correlation analysis showed that there was a positive correlation between the positivity rate of TRNG and PPNG(r=0.20,P<0.01),but a negative correlation between the susceptibility to cefiriaxone in N.gonorrhoeae and positivity rate of PPNG(r=-0.09,P<0.01).No correlation was observed between the susceptibility to cefiriaxone and susceptibility to ciprofloxacin or the positivity rate of TRNG,or between the susceptibility to ciprofloxacin and positivity rate of PPNG or TRNG.Chi-square analysis showed a marked increase in the percentage of N.gonorrhoeae isolates with reduced susceptibility to ceftriaxone in Guangxi province,Hainan province,Xinjiang Uygur Autonomous Region and Shaanxi province,the percentage of N.gonorrhoeae isolates with resisitance to spectinomycin in Shaanxi province,prevelance of TRNG in Guangdong province,and prevelance of PPNG in Sichuan and Zhejiang provinces compared with the average level (all P<0.05).Conclusions Thero is a significant diffefence in antimicrobial susceptibility of N.gonorrhoeae from difierent areas of China.A significant elevation is observed in the percentage of N.gonorrhoeae with reduced susceptibihty to cefifiaxone and resistance to spectinomycin in Shaanxi province.to which close attention should be paid.