[Objective] To explore risk factors for ectopic pregnancy to provide basis for its prevention.[Methods] A case-control study was done on 180 cases of ectopic pregnancy treated in Deqing Chinese medicine hospital from January 2012 to December 2016 and another 180 cases of intrauterine pregnancy were as control who received artificial abortion in outpatient clinic during the same period. The data on the factors that might bring about ectopic pregnancy were analyzed by single-factorial and multi-factorial logistic regression. [Results] The multi-factorial analysis confirmed that the risk factors associated with ectopic pregnancy were prior abortion history, pelvic inflammation, ectopic pregnancy history, fallopian tube surgery history and others. [Conclusion] Ectopic pregnancy is associated with multiple factors, whose occurrence should be prevented and reduced by taking corresponding measures against it.

Objective Blood pressure variability (BPV) is an independent risk factor for the death of patients with maintenance hemodialysis (MHD).There is no study on the influencing factors of BPV at home in HD patients in China.The article aimed to investigate MHD patients'BPV at home and related influencing factors in order to provide theoretical basis for reducing home BPV (HBPV) clinically. Methods We chose 103 patients who were treated with MHD in the Renal Medicine Room of Nephrology Department in three upper first -class hospitals including Jiangsu Provincial People 's Hospital, the First Affiliated Hospital of Suzhou University and the Affiliated Hospi -tal of Jiangsu University from March 2017 to October 2017.We col-lected their 7 days'blood pressure monitoring at home and blood pressure before dialysis, average value and standard deviation in sys -tolic blood pressure monitoring at home, and took the coefficient of variation of systolic blood pressure as the expression of HBPV .The patients were divided into high BPV group (BPV≥5.8％) and low BPV group (BPV<5.8％) according to the average BPV.At the same time, we recorded indexes such as sex , age, dialysis age, primary disease, BMI, inter-dialytic weight gain (IDWG), left ven-tricular mass index(LVMI) and analyzed relative influencing factors by multiple linear regression . Results The age, IDWG and LV-MI were positive independent influencing factors of HBPV (R 2 =0.467,F=10.945,P<0.001).According to standardized regression co-efficient, the contribution of each variable to HBPV was as follows : PIBWG >Age>LVMI. Conclusion In clinical nursing, we should actively control the IDWG of patients , encourage patients to monitor their blood pressure at home , and increase their awareness of the importance of home BPV.Meanwhile, HBPV is an important index for predicting left ventricular hypertrophy and can be used as an objective tool to improve patients 'self-management ability.

OBJECTIVETo analyze the physical growth changes in Chinese children aged from 0 to 7 years old during the past 30 years.

METHODSFour national physical growth surveys of the children under 7 years old were undertaken in the same urban and suburban areas of nine main cities in China from 1975 to 2005. The nine cities were Beijing, Harbin and Xi'an in the northern part; Shanghai, Nanjing and Wuhan in the central part; Guangzhou, Fuzhou and Kunming in the southern part of China. Random cluster sampling method was used. The children aged from 0 to 7 years old were classified into 22 groups by age. The sample size was ranged from 150 to 200 persons for each sex-age group in each area (urban/rural) of each city. Totally, 158 400, 152 874, 157 362 and 138 775 healthy children were examined in 1975, 1985, 1995 and 2005 respectively. The data of weight, height, chest and head circumference obtained from these surveys were analyzed.

RESULTSAverage weight and height in most of the age groups for both boys and girls from urban and suburban rural areas has been significantly improved during the past 30 years, the average increments of weight were 0.76 kg to 1.14 kg in 12 - 15 months group and 2.58 kg to 3.26 kg in 6 - 7 years group; and the average increments of height were 2.7 cm to 3.8 cm in 12 - 15 months group and 5.0 cm to 7.6 cm in 6 - 7 years group. Chest circumference did not show an increase in infants younger than 4 months and increased slightly after 4 months. The average increments of head circumference were 0.1 cm to 1.0 cm. From 1975 to 2005, the increments of weight and height per 10 years was in an increasing trend, e.g. weight increments of 5 - 6 years old were 0.58 kg, 1.02 kg and 1.67 kg and the height increments were 1.5 cm, 2.0 cm and 2.6 cm for every 10 years. The urban-rural difference in height has become smaller, the height difference in 6 - 7 years group for boys was decreased from 4.9 cm in 1975 to 2.6 cm in 2005. The weight has become smaller in children under 3 years old but becoming greater after 3 years, such as the difference increased from 1.14 kg in 1975 to 1.72 kg in 2005 for boys aged 6 - 7 years old. The regional difference also showed a decreasing trend.

CONCLUSIONThe physical growth of Chinese children had been much improved during the past 30 years and the secular trend should be still continuing at an accelerated growth stage. The urban-rural difference and regional difference in weight and height had become smaller.

Asian Continental Ancestry Group ; Body Height ; Body Weight ; Child ; Child Development ; Child, Preschool ; China ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Rural Population ; Sampling Studies ; Urban Population

Axons ; chemistry ; Myelin Sheath ; chemistry ; Staining and Labeling ; methods

Objective:To detect the change of proportions of αβT lymphocytes in mesenteric lymph nodes of miR-7 knockdown (miR-7KD)mice,and preliminarily explore its importance.Methods: The volume,weight index and total cells number of mesenteric lymph node in miR-7KD mice were measured.The pathologic morphology change of mesenteric lymph nodes was observed by HE stai -ning.And the changes on proportion of αβT lymphocytes in mesenteric lymph nodes of miR-7KD mice were analyzed by Flow cytometry.Results:Compared with those of WT (wild type) mice,the volume,weight index,and the total cells number of mesenteric lymph node were significantly increased ( P<0.05 ).Moreover ,the pathologic morphology was significantly changed.The proportion and numbers of T lymphocyte were significantly increased;however,the proportion of B lymphocyte were significantly decreased (P<0.05). Notably,the proportion and number of CD4+T cells and CD8+T cells were significantly increased (P<0.05).Meanwhile,CD62L+T cell proportion were vigorously reduced and CD 69+T cell and IFN-γ+T cell proportion were notably up-regulated,which belong to CD4+and CD8+T cell(P<0.05).Conclusion:There was significant influence in the proportion of αβT lymphocytes in mesenteric lymph nodes of miR-7KD mice,suggesting that miR-7 might play an important role in the composition and function of lymphocytes in mesenteric lymph nodes.

BACKGROUNDInside out transobturator vaginal tape (TVT-O) and tension-free vaginal tape (TVT) are predominant surgical treatments for female stress urinary incontinence. This meta-analysis evaluated the complications and cure rates of TVT-O versus TVT.

METHODSA comprehensive literature search was conducted according to the Cochrane Collaboration methodology to identify randomized controlled clinical trials with no language restriction. Two authors independently assessed papers for eligibility and methodological quality. Estimates were measured by relative risk with 95% confidence intervals. Outcome measures were objective cure, subjective cure and complications. Quality rating for each outcome of the meta-analysis and recommendations were performed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

RESULTSTwenty randomized controlled trials met the inclusion criteria, and a pooled estimate of effectiveness and complications was made. Relative risks with 95% confidence intervals for pooled effects under the fixed effects model were: 0.20 (0.09 - 0.45), for bladder injury, 0.37 (0.16 - 0.86) for hematoma, and 2.35 (1.57 - 3.51) for postoperative pain, suggesting an 80% risk reduction of bladder injury, 63% risk reduction of hematoma, and a 1.35% risk elevation for postoperative pain with TVT-O. There was no significant difference between complications of urinary tract infection 1.14 (0.78 - 1.65), lower urinary tract symptoms 1.60 (0.67 - 3.79), recatheterization 0.93 (0.59 - 1.44), and tape erosion 0.90 (0.48 - 1.67), total objective cure rate 1.06 (0.39 - 2.84) and for the subjective cure rate 0.98 (0.93 - 1.04). The quality rating for each outcome and recommendations was high for objective cure, bladder injury, hematoma, lower urinary tract symptoms, and tape erosion and moderate for subjective cure, pain, and urinary tract infection.

CONCLUSIONSTVT-O is associated with a reduced risk of bladder injury and hematoma and an elevated risk of postoperative pain. Other complications, including tape erosion, urinary tract infection, lower urinary tract symptoms, and recatheterization, are similar to those of TVT.

Female ; Humans ; Randomized Controlled Trials as Topic ; Suburethral Slings ; Treatment Outcome ; Urinary Incontinence, Stress ; surgery ; Vagina ; surgery

The distinction of some particular forms of periapical area, involving diseases from regular periapical disease, is a matter of considerable importance when choosing a correct treatment. The aim of this study is to describe the differential diagnosis of periapical diseases from six rare cases in clinical practice. The six rare cases are examples of situations where it is difficult to make a differential diagnosis in clinical practice. By retrospective surveys on the clinical examination, radiographs and pathological results, six patients referred to endodontic treatment in our department were analyzed for the accuracy of diagnosis and therapy. The pathoses of the six cases included two atypical radical cysts, periapical cemental dysplasia, cemento-ossifying fibroma, thymus cancer metastasis in the periapical site and tuberculosis. This report indicates that endodontists should be cognizant of a few particular circumstances when clinically treating periapical diseases.
Adult ; Aged ; Bone Neoplasms ; diagnosis ; secondary ; Diagnosis, Differential ; Female ; Fibroma, Ossifying ; diagnosis ; Fibrous Dysplasia of Bone ; diagnosis ; Humans ; Male ; Middle Aged ; Periapical Diseases ; diagnosis ; Radicular Cyst ; diagnosis ; Tuberculosis, Osteoarticular ; diagnosis

In order to explore the diagnosis and therapy of Diamond Blackfan anemia (DBA), the clinical data of 45 cases of DBA admitted in our hospital from February 1994 to July 2011 were analyzed retrospectively. The clinical characteristics, results of laboratory examination, treatment reaction and outcome of disease were investigated. The results indicated that out of 45 children diagnosed as DBA, 14 cases (31.1%) had short stature and physical malformation. All patients had anemia with reticulocytopenia. Thirty-four patients (75.6%) had mean corpuscular volume. Eleven patients (24.4%) had macrocytic anemia. Bone marrow examination showed a marked erythroid hypoplasia in all patients. Out of 29 cases tested for fetal hemoglobin (HbF), 13 cases (44.8%) had high level of HbF. Erythroid colony-forming unit of bone marrow was tested in 25 patients, among them 12 patients (48%) showed normal plasia, 13 (52%) showed hypoplasia. The erythropoietin (EPO) levels of 17 patients were elevated. Karyotypes were examined in 28 patients, and showed all normal. The treatment was based on corticosteroids and Cyclosporine A. Thirty patients had good response to corticosteroid therapy, and 10 of them obtained a sustained corticosteroid-induced remission. Twenty cases discontinued corticosteroid therapy after remission, as a result, 15 cases (75%) relapsed, moreover all the relapsed cases still had good response to corticosteroid. Two relapsed patients suffered from aplastic anemia, one of them died of therapy failure. Six patients were unresponsive to corticosteroid, 1 of which achieved remission with cyclosporine A and the others continued to receive regular transfusions. 3 patients received iron chelation therapy. It is concluded that the clinical characteristics, complete blood count, bone marrow smear, HbF level and EPO level are useful to make a diagnosis of DBA. Most patients have a good response to corticosteroid therapy, but relapse rate is high when drug was discontinued. Patients unresponsive to corticosteroid should receive regular transfusions and chelation therapy.
Anemia, Diamond-Blackfan ; diagnosis ; therapy ; Bone Marrow Examination ; Child ; Child, Preschool ; Erythroid Precursor Cells ; Female ; Humans ; Infant ; Male ; Retrospective Studies

OBJECTIVESTo establish DHPLC method in detecting mutations of mismatch repair genes, hMLH1 and hMSH2, and to identify germline mutations of hMLH1 and hMSH2 in HNPCC kindreds fulfilling Chinese HNPCC criteria.

METHODSFourteen peripheral blood DNA samples from 14 unrelated HNPCC probands fulfilling Chinese HNPCC criteria were obtained respectively. PCR amplified 35 exons of two main mismatch repair genes, hMLH1 and hMSH2. DHPLC followed by DNA sequencing was used to detect and confirm mutations.

RESULTSa total of 41 colorectal cancers and 19 extracolonic tumors were developed in 14 HNPCC kindreds, and gastric cancer was the most common extracolonic tumor type. Twelve single nucleotide changes were identified by DHPLC in 14 probands. Among them, three were missense mutations, one was a nonsense mutation. Other single nucleotide changes included five single nucleotide polymorphisms, two intron single nucleotide changes, one synonymous mutation. hMLH1 EXON19 CODON749 TAC-->TAG (Tyr-->X), hMSH2 EXON12 CODON629 CAA-->CGA (Gln-->Arg) and hMSH2 EXON15 CODON839 CAT-->CGT (His-->Arg) were new discovered mutations.

CONCLUSIONS(1) DHPLC was considered to be highly effective, convenient technique with consistent results for the mutation detection of hMLH1 and hMSH2 genes. (2) Valid mutations of hMLH1 and hMSH2 genes were identified in about one-third HNPCC kindreds fulfilling Chinese HNPCC criteria and missense mutation was the most common mutational types in this cohort of families.

Adaptor Proteins, Signal Transducing ; Asian Continental Ancestry Group ; genetics ; Base Pair Mismatch ; Carrier Proteins ; genetics ; Chromatography, High Pressure Liquid ; Codon, Nonsense ; Colorectal Neoplasms, Hereditary Nonpolyposis ; genetics ; DNA Mutational Analysis ; Female ; Genetic Testing ; Germ-Line Mutation ; Humans ; Male ; MutL Protein Homolog 1 ; MutS Homolog 2 Protein ; genetics ; Mutation, Missense ; Nuclear Proteins ; genetics ; Pedigree

OBJECTIVEAcute myeloblastic leukemia (AML) accounts for 15 to 25 percent of childhood acute leukemias. Cytogenetic information is important for diagnosis, classification and prognosis of AML. Our aim was to analyze the relationship between karyotypic characteristics and prognosis of childhood AML.

METHODAccording to karyotypic characteristics, 128 newly diagnosed children AML were separated into 4 subgroups: patients with t(15;17) (group APL), patients with t(8;21)/inv(16) (group A), patients with -7/t(9;22)/complex karyotypes (group C) and the others (group B). Prognoses of these patients were analyzed.

RESULTSThe ages ranged from 1 to 16 years with the mean age of 7 years. 85 boys and 43 girls were included in this study. The 4-year event-free survival (EFS) and overall survival (OS) rates were (55.9 ± 4.7)% and (69.3% ± 4.5)%, respectively. The 4-year EFS and OS of non-M(3)-AML patients were (49.9 ± 5.2)% and (57.1 ± 6.0)%, respectively. The probabilities of 4-year EFS of the four subgroups were (72.2 ± 1.1)%, (66.3 ± 7.7)%, (38.5 ± 9.1)% and (20.1 ± 12.3)%, respectively (P = 0.000). The probabilities of 4-year OS were (92.6 ± 5.1)%, (69.4 ± 7.9)%, (55.6 ± 8.6)% and (30.0 ± 12.3)%, respectively (P = 0.000).

CONCLUSIONCytogenetic aberrations seen in pediatric AML had a significant impact on prognosis.

Adolescent ; Child ; Child, Preschool ; Chromosome Aberrations ; Chromosome Disorders ; genetics ; Female ; Humans ; Infant ; Karyotyping ; Leukemia, Myeloid, Acute ; diagnosis ; drug therapy ; genetics ; Male ; Prognosis ; Treatment Outcome