Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Sciatica ; therapy

Objective To investigate the diagnosis,differential diagnosis and treatment of gynecological acute abdomen,and provide a basis for treatment.Methods The clinical data of 749 cases with gynecological acute abdomen in our hospital were retrospectively analyzed.Results The diagnostic accuracy was 100％ of the preoperative uterine perforation,acute pelvic inflammatory disease,tubal ovarian abscess,ovarian cyst torsion and.ruptured ovarian cysts.19 cases with ovarian corpus luteum rupture were misdiagnosed for ectopic pregnancy,1 case with acute hemorrhagic salpingitis were misdiagnosed for ectopic pregnancy,1 case with IUD of ectopic pregnancy lead to pelvic abscess was misdiagnosed for ovarian cyst torsion secondary infection,the total misdiagnosis patients were 21 cases,and the misdiagnosis rate was 2.8％.217 cases with acute abdomen received the surgical treatment,532 cases were given non-surgical treatment.All patients were cured and discharged by the hospital treatment,the average hospitalization time was (8.2 ± 2.5) d.Conclusion In the diagnosis of gynecological acute abdomen,detailed ask the patients' medical history,symptoms,and comprehensive physical examination and collection of signs are important means.The understanding of acute hemorrhagic fallopian tubes,ovarian corpus luteum rupture and ovarian cyst torsion secondary infection should be further strengthened to reduce misdiagnosis rate.

Persistent pulmonary hypertension of newborn (PPHN) is a clinical syndrome,characterized by pulmonary arterial pressure elevated relative to systemic blood pressure,leading to extrapulmonary right-to-left shunting of blood across the ductus arteriosus and foramen ovale,causing severe hypoxemia.Pulmonary vascular remodeling is pathognomonic of hypoxia-induced PPHN.The regulatory mechanism and cell composition of vascular wall were dysfunction,which led to vascular wall thickened.The review focus on three aspects,such as endothelial cells,smooth muscle cells,and adventitial cells,described the relation and the possible mechanisms between hypoxia-induced PPHN and pulmonary vascular remodeling.

Objective:To introduce a programmed death-1 (PD-1) inhibitor nivolumab used as a new antitumor agent. Methods:According to the literatures, the action mechanism of nivolumab and the clinical trial results on the main indications approved or being investigated in phase III trials were reviewed and evaluated. Results:Nivolumab could restore the antitumor activity of T cells through binding with PD-1 and consequently blocking its interaction with the key ligands of PD-L1 and PD-L2. Several completed and ongoing clinical trials showed that nivolumab used alone or combined with chemotherapy or CTLA-4 inhibitor ipilimumab exhibited better effica-cy when compared with current clinical used chemotherapy drugs in the treatment of melanoma, non-small cell lung cancer and renal cell carcinoma. Nivolumab was well tolerated during the treatment with such main grade 3-4 adverse events as immune-mediated pneu-monia, abnormal liver functions and fatigue. Conclusion:Through its anti-tumor immune response, nivolumab can improve the clinical efficacy in the treatment of various tumors including melanoma, non-small cell lung cancer and renal cell carcinoma.

Objective To explore cardiovascular disease in postmenopausal women with polycystic ovary syndrome(PCOS) phenotype.Methods This study was a prospective follow-up study which included subjects with PCOS phenotype admitted from Jan.1st, 2005 to Dec.31st, 2007 in Gynecology Department of Dongyang People's Hospital.These subjects were divided into two groups according to the presence or absence of PCOS phe -notype and were followed .Kaplan-Meier method was used to estimate survival rate .The survival difference be-tween the two groups was compared using the log-rank test.Multivariate Cox proportional hazards regression was used to determine the independent risk factors of major adverse cardiac events ( MACE) .Results 11 patients in non-PCOS phenotype group had MACE , and 6 patients in PCOS phenotype group had MACE .PCOS phenotype group had a significantly decreased MACE-free survival(χ2 =4.957,P=0.026).Multivariate Cox proportional hazards regression analysis showed that low level of HDL-C, presence of PCOS phenotype and high level of hs-CRP were independent predictors for MACE .Conclusion PCOS phenotype is an independent risk factor for car-diovascular disease in postmenopausal women , help to make further risk stratification and shows cardiovascular disease is closely related to PCOS .

Objective To explore the high risk factors,clinical prediction and treatment methods of the shoulder dystocia to reduce the incidence of complications in mother and child.Methods The clinical data of 41patients with shoulder dystocia were retrospectively analyzed,and they were divided into the huge baby group and normal weight baby group.The causes,incidence of complications in mother and child and the treatment were ana-lyzed.Results In the 41 cases of shoulder dystocia,the incidence of complications in mother and child in the macro-somia group was higher than the normal weight baby group(the incidence of postpartum hemorrhage,the incidence of neonatal asphyxia in the huge baby group were higher than the normal weight baby group,χ2 =4.439,5.225,all P <0.05;the incidence of gestational diabetes mellitus,III -degree perineal lacerations,new born injury were higher than the normal weight baby,but the difference between the two groups was no significant),the midwife methods was more than normal weight baby group(6 huge baby cases using McRobert method was lower than the 15 normal weight baby cases;12 huge baby cases using McRobert method and press -front shoulder method was higher than the 3 normal weight baby cases,the difference between the two groups was significant,χ2 =10.896,5.036,P <0.05;using 3 and 3 above methods in huge baby group was more than normal weight baby group,but the difference between the two groups was no significant,χ2 =0.139,1.267(likelihood ratio),P >0.05,and the difference between the two groups reach the significant level.Conclusion The shoulder dystocia is a serious maternity emergency,the huge baby is the high factor of the shoulder dystocia,the important treatment to reduce the incidence of complications in mother and child is the correct prevention,prediction,early identification and proper treatment.

Syncope is one of the most common emergencies in the pediatric population.Autonomic -mediated reflex syncope,including postural tachycardia syndrome and vasovagal syncope,is the main cause.Although the clinical manifestations are similar,each subtype has its optimal treatment option.With the development of translational medicine in recent years,as well as the emergence of biomarkers,precision medicine has become possible,and will be the main direction in the future researches.

Isoflavones as a kind of phytoestrogen exist in soy plant widely. With the advantages of estrogen, they can regulate endocrine function of the human body, reduce blood cholesterol, decrease the incidence of coronary heart disease, prevent osteoporosis, inhibit tumor growth, and relieve pain. This article summarized the investigations on the medical value of isoflavones in recent years.

Aim To study mechanisms of Stigma Maydis Polysaccharide(SMPS) on weight loss in experimental animals. Methods Observe changes of gastric discharge, intestinal peristalsis, biliary secretion, weight of gallbladder, body weight, appetite and cholecystokinin(CCK)level in plasm of rats and mice after being administrated with SMPS. Results SMPS increased the gastric residual rate of methyl orange and the intestinal propulsive rate,advanced first time black dejecta,increased the quantity of dejecta,decreased the weight of gallbladder in mice. SMPS also inhibited appetite,decreased body weight,prolonged gastric emptying,accelerated the propulsion speed of intestinal contents,promoted the biliary secretion,increased CCK level in plasm. Conclusion Mechanisms of weight loss are probably related to the increasing of CCK level in plasm and prolonging of gastric emptying,appetite inhibition, accelerating of intestinal peristalsis,the quantity increasing of dejecta.

Objective To study the regulating effect of in the regulation of cell surface receptor linked signal transduction pathway-related genes on rat liver regeneration(LR) at transcriptional level. Methods Genes involved in the above pathways were obtained by data collection and literature review.The gene expression changes during LR were checked by Rat Genome 230 2.0 array,and LR-related genes were identified by comparing gene expression difference between partial hepatectomy(PH) and sham operation(SO) groups. Results 491 genes were identified as LR-related.There were 742 kinds of interactive relations in 226 before-mentioned genes.In the 12 kinds of signaling pathways cytokine and chemokine mediated,enzyme linked receptor,G-protein coupled receptor,glutamate,antigen receptor-mediated,integrin-mediated,lipopolysaccharide-mediated, Notch,osmosensory,smoothened,Toll and Wnt——the numbers of up-regulated and down-regulated LR-related genes were 26 and 23,164 and 54,59 and 51,5 and 1,22 and 14,21 and 10,1 and 1,4 and 11,23 and 11, 32 and 17 respectively.In LR,the numbers of up-regulated and the down-regulated genes were 188 and 128,464 and 190,308 and 207,13 and 5,88 and 46,123 and 50,2 and 1,20 and 43,148 and 30,174 and 62 in the corresponding pathways.The genes which up regulated mainly occurred 0.5-16,30,42,54,96 hours and which down regulated mainly occurred 18-24,36,60-72,120-168 hours.Conclusion In liver regeneration,lipopolysaccharide-mediated and osmosensory signaling pathway have less effect,and the smoothened signaling pathway's role is attenuated,but the activities of the other 9 pathways are enhanced.