Objective To explore the related factors to influence the curative effect of focused ultrasound treatment for non neoplastic epithelial disorders of vulva. Methods A total of 382 patients with non neoplastic epithelial disorders of vulva were included in this study and treated by focused ultrasound. During and after the treatment, the symptoms and physical signs of the subjects were observed, and the efficacy was evaluated. We analyzed the relation between pathologic type, age, course, area, or itch degree and curative effect. Results Symptoms of all patients were relieved, and appearance and color of the vulva became normal after the ultrasound treatment, with a total effective rate of 99.74%. The cure ratios of patients with different pathologic types, ages, courses, areas, and itch degrees were significantly different (χ2=9.58, P<0.01; χ2=22.385, P<0.01; χ2=32.260, P<0.01; χ2=57.99,P<0.01; χ2=42.13,P<0.01, respectively). Conclusion Focused ultrasound treatment is safe and effective for the nonneoplastic epithelial disorders of the vulva and the efficacy is associated with the pathologic type, age, course, area, and itch degree.

OBJECTIVE:To preliminarily study the stability of 3 pieces of Chinese medicinal formula(CMF)after decoction, and provide reference for guaranteeing storage quality of decocted liquid and improving safety of drug use. METHODS:3 represen-tative formulas of Gegen Huangqin Huanglian decoction(A formula),Wuling powder(B formula)and Didang decoction(C for-mula)from Shanghan Zabing Lun were selected,the decocted liquid were stored under ambient temperature(25 ℃)and refrigerat-ed temperature (4 ℃) after decocting by automatic boiling-machine and packing. The microorganism,precipitation,pH and con-tents of total flavonoids,alkaloid,polysaccharide,total protein after 1,7,14,21,28 d were detected. RESULTS:Compared with the first day,contents of total flavonoids,polysaccharide in formula A at ambient temperature group were significantly in-creased on the 28th(P<0.05),content of polysaccharide in refrigerated temperature group was significantly increased(P<0.05). Content of polysaccharide in formula B at ambient temperature group was significantly decreased(P<0.05). The pH and content of total flavonoids in formula C at ambient temperature group and refrigerated temperature group were significantly increased (P<0.05 or P<0.01). Other indexes showed no obvious changes during the trial period. CONCLUSIONS:Under ambient temperature and refrigerated temperature,liquid ingredients of above decocted CMF will change when storing for 4 weeks. It indicates that the storage time of decocted CMF should not be more than 3 weeks.

Objective The purpose of the study was to investigate clinical manifestation and the characters of diagnosis and treatment among children with primary angiitis of the central nervous system (cPACNS) in order to improve awareness of the disease.Methods Clinical data of 5 children with cPACNS in the First People's Hospital of Yunnan Province from January 2009 to December 2013 were collected,and the clinical manifestations and laboratory test results were analyzed and summarized.Results Five cases of children with cPACNS were misdiagnosed at the first clinic visit,and were confirmed a clear diagnosis on the average of (4±6) months; clinical manifestations of five cases of varying degrees of headache,one case with severe headache,2 patients with decreased visual acuity,a cases with hearing were loss,two cases with secondarily generalized seizures; five cases with mild abnormal cerebrospinal fluid examination; 1 case with elevated ESR and CRP level,1 case with elevated immunoglobulin IgG level; 5 cases with abnomal MRI examinations,which showed multiple bilateral lesions,diffuse,lesions,involving the cortex and deep white matter; 4 cases had vascular abnormalities on MRA,treated with corticosteroids alone or in combination with cyclophosphamide and achieved good results.Conclusion Children of primary central nervous system vasculitis is ar are autoimmmune disease primarily involving the central nervous system.It is difficult for the clinical diagnosis.Children need to be wary of the major manifestation of headache associated with vision loss,hearing loss,seizures and other focal neurological system damage.

Objective:To explore the mechanism of cardiac function decreasing in patients with ankylosing spondylitis based on Keap1-Nrf2-ARE signaling pathway .Methods:Experiment group included 140 ankylosing spondylitis ( AS) patients and control group included 60 healthy individuals .Echocardiography ( UCG) was used to detect cardiac function parameters .Enzyme-linked immunosor-bent assay(ELISA) was adopted to determine serum proteins ,oxidative stress indicators and cytokines .Erythrocyte sedimentation and plasma C reactive protein ,immunoglobulin were detected with Westergren method and Hitachi 7060 automatic biochemical analyzer re-spectively.Results:(1)Compared with the normal control group , character of AS group in active stage:cardiac function parameters(E peak,EF,E/A),antioxidant indicators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)decreased (P<0.01 or P<0.05 all).A peak, Keap1,Nrf2,oxidation index(ROS,RNS,MDA),cytokines(IL-1,TNF-α),inflammatory indicators(ESR,CRP)increased(P<0.01 or P<0.05 all).(2)Compared with the normal control group, character of AS group in stable stage: cardiac function parameters(E peak,E/A),Keap1,antioxidant indicators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)decreased (P<0.01 or P<0.05 all).A peak, Nrf2,oxidation index(ROS,RNS,MDA),cytokines(TNF-α),inflammatory indicators(ESR,CRP) increased(P<0.01 or P<0.05 all).(3)Compared with AS group in stable stage , character of AS group in active stage:cardiac function parameters(E peak,EF,E/A),antioxidant indicators(SOD,TAOC),cytokines(IL-10)decreased (P<0.01 or P<0.05 all).Keap1,Nrf2,oxidation index(ROS, RNS,MDA),cytokines(IL-1β,TNF-α),inflammatory indicators(ESR,CRP),clinical evaluation indicators (VAS,BASDAI,BASFI, BASMI,BAS-G)increased(P<0.01 or P<0.05 all).(4)Compared with AS patients with normal Keap1 or Nrf2 of peripheral blood, A peak increased while E peak and E/A decreased in AS patients with abnormal Keap1 or Nrf2 of peripheral blood (P<0.01 or P<0.05).(5)Spearman correlation analysis showed:AS parameters of cardiac function in patients with E peak and antioxidant indicators (SOD,CAT,TAOC),cytokines(IL-4,IL-10)showed significant positive correlation.E peak and Keap1, Nrf2,oxidation index(ROS, RNS,MDA),cytokines(IL-1β,TNF-α),inflammatory indicators(ESR,CRP),clinical evaluation indicators (VAS,BASDAI,BASFI, BASMI,BAS-G),IgG,course of the disease were significantly negatively correlated .A peak and Nrf2,oxidation index ( ROS,RNS, MDA) ,cytokines ( IL-1β,TNF-α) ,clinical evaluation indicators , Palpitation showed significant positive correlation .A peak and antiox-idant indicators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)were significantly negatively correlated .E/A and Keap1,antioxidant indi-cators(SOD,CAT,TAOC),cytokines(IL-4,IL-10)showed significant positive correlation.E/A and oxidation index(ROS,RNS, MDA) ,cytokines ( TNF-α) ,cxcinical evaluation indicators ,course of the disease were significantly negatively correlated .EF and course of the disease were significantly negatively correlated .FS and Keap1 showed significant negative correlation .Conclusion:Cardiac func-tion decreasing in patients with ankylosing spondylitis is 33.56%.The characteristic performance is that E peak , E/A decreased while A peak increased.E peak,E/A and antioxidant indicators ,anti-inflammatory cytokines show significant positive correlation .E peak,E/A and Keap1,oxidation index,pro-inflammatory cytokines,inflammatory indicators are significantly negatively correlated .A peak and Keap1,oxidation index ,pro-inflammatory cytokines show significant positive correlation .A peak and antioxidant indicators ,anti-inflam-matory cytokines are significantly negatively correlated .The rising of Keap1 expression cause activate the Keap 1-Nrf2-ARE signaling pathway .After the signaling pathway is activated ,the body's antioxidant ability decreased , pro-inflammatory cytokines imbalanced , in-flammation index increased .When the body is long be in unbalance condition , the number of abnormal immune complex deposition in-creased.In the end,the result is that AS is caused and cardiac function is decreased .

Juvenile idiopathic arthritis (JIA)is a type of chronic rheumatism in children. It is mainly charac-terized by joint damage,accompanied by systemic symptoms and result in significant morbidity. The application of bio-logical agents has altered the traditional treatment pattern of JIA and significantly improved the condition of JIA pa-tients. JIA is a heterogeneous disease. Treatment recommendations issued by American College of Rheumatology(ACR) in 2011 have become an important reference for JIA treatment. There is a best response window for JIA treatment. Thus, the clinic application of biological agents should be used as soon as possible after the diagnosis of JIA. Meantime,it should be noted when a preparation is invalid,it need to use another possible biological agent in time to control disease progression.

Gestational trophoblastic tumors (GTTs) are malignant lesions that often cause abnormal genital bleeding and may present with hemoptysis, intraperitoneal bleeding or acute neurologic deficits. GTTs are generally highly chemosensitive with more favorable outcomes than other comparable malignancies. Here we report a rare case of invasive mole (FIGO stage IV, WHO score16) presenting with renal subcapsular hematoma due to bleeding renal metastasis. The patient had a pretreatment β-human chorionic gonadotrophin (β-HCG) level of 462 047 mIU/ml and received combined chemotherapy with etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine with also adjuvant surgeries including hysterectomy and nephrectomy. The patient recovered well and the tumor has remained in complete remission for one year and a half.
Antineoplastic Combined Chemotherapy Protocols ; Female ; Hemorrhage ; etiology ; Humans ; Hydatidiform Mole, Invasive ; complications ; Kidney ; pathology ; Pregnancy ; Uterine Neoplasms ; complications

OBJECTIVE: To investigate the efficacy and safety of NovaSure system for dysmenorrhea and abnormal uterine bleeding of adenomyosis.
 METHODS: A retrospective analysis on 30 patients with adenomyosis, who treated by NovaSure, were carried out. We collected related clinical data before operation and collected postoperative information about dyemenorrhea, menstruation, anemia and uterine volume by visiting outpatient or telephone.
 RESULTS: All patients were followed up for 7 to 31 months after the operation. The relief rate of menstrual pain was 83.3%. All patients got obvious improvements in menstruation and anemia (P<0.05). After operation, uterine volume was significantly decreased (P<0.05). Only one case received intervention in 2 years (3.3%).
 CONCLUSION NovaSure can relieve symptoms of menorrhagia and alleviate dysmenorrhea symptoms. It is a new way for the treatment of uterine adenomyosis.
Adenomyosis ; surgery ; Dysmenorrhea ; surgery ; Endometrial Ablation Techniques ; methods ; Female ; Humans ; Menorrhagia ; surgery ; Retrospective Studies ; Treatment Outcome

BACKGROUNDHemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.

METHODSA cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.

RESULTSIn this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.

CONCLUSIONSThe onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.

Adult ; Botulinum Toxins, Type A ; therapeutic use ; China ; Cross-Sectional Studies ; Female ; Hemifacial Spasm ; diagnosis ; drug therapy ; Humans ; Male ; Middle Aged ; Neuromuscular Agents ; therapeutic use