BACKGROUND:Recently, the biodegradable materials with good biocompatibility and with no adverse reaction have been widely applied in the clinical treatment and care of gynecology and obstetrics. The development of the biodegradable material is very rapid. OBJECTIVE:To summarize the application of biodegradable materials in gynecology and obstetrics. METHODS: The first author searched PubMed and CNKI databases for articles related to biodegradable materials in gynecology and obstetrics using the keywords of “degraded materials, biodegradable materials, gynecological care, surgery” in Chinese and English respectively. This article has an outlook of the potential application in gynecology and obstetrics based on clinical experience. RESULTS AND CONCLUSION:Biodegradable materials with good biocompatibility and biological security play an important role in biomedical materials. Their polymers and degradation products show smal adverse reactions to the body, and have good biomechanical properties, physical and chemical properties and good workability, which have been widely used in gynecology and obstetrics, such as absorbable stylolite and tampon tape. Although we have made a great progress on the biomaterial research, it stil has the limitation and safety flaws in the clinic. As the biomaterial research is further developed, the biomaterial application prospect wil be more promising.

OBJECTIVE:To observe clinical efficacy and safety of lanthanum carbonate in the treatment of hyperphosphatemia in uremic patients underwent maintenance hemodialysis. METHODS:A total of 142 uremic patients with hyperphosphatemia under-went maintenance hemodialysis were selected from Xinqiao Hospital of Third Military Medical University and Chongqing Banan District Hospital of TCM during Jan. 2012-Dec. 2016. They were given Lanthanum carbonate chewable tablets with initial dose of 250 mg,tid,when serum phosphate level ranged 1.78-2.26 mmol/L or with initial dose of 500 mg,tid,when serum phosphate lev-el was >2.26 mmol/L. Drug dosage was adjusted according the level of serum phosphate during treatment. After 1,2,3 months of treatment,the levels of serum phosphate,serum calcium,albumin,parathyroid hormone(PTH)and alkaline phosphatase were de-tected and the corrected product of serum calcium and calcium phosphorus was calculated. The occurrence of ADR was observed. RESULTS:After 1,2,3 months of treatment,the levels of serum phosphate and the product of serum calcium and calcium phos-phorus were all decreased significantly compared to before trreatment,with statistical significance (P<0.05). After 3 months of treatment,the level of corrected serum calcium was decreased significantly compared to before treatment,with statistical signifi-cance(P<0.05). There was no statistical significance in the levels of plasma albumin,calcium phosphorus or PTH before and af-ter treatment (P>0.05). Total response rate was 93.7%. There were 19 cases of patients with mild adverse reactions. CONCLU-SIONS:Lanthanum carbonate in the treatment of hyperphosphatemia in uremic patients underwent maintenance hemodialysis shows good clinical response rate,can significantly reduce the levels of serum phosphate and the product of serum calcium and calcium phosphorus with good safety.

Objective To investigate the effect of penehyclidine (PHCD) pretreatment on Toll-like receptor 4 (TLR4) mRNA expression in the lung following acute lung injury (ALI) induced by hemorrhagic shock in rats. Methods Forty healthy SD rats of both sexes weighing 200-250 g were randomly divided into 5 groups( n = 8 each): group Ⅰ sham operation (group S); group Ⅱ ALI (group ALI); group Ⅲ, Ⅴ, PHCD 0.3,1.0, 3.0 mg/kg were given iv respectively at 30 min before hemorrhagic shock (P1-3). Hemorrhagic shock was induced by exsanguinations. MAP was maintained at 35-45 mm Hg for 60 min. The animals were killed at 4 h after resuscitation. Their lungs were removed for microscopic examination, W/D lung weight ratio and determination of TLR4 mRNA expression in the lung tissue (by RT-PCR). NF-κB p65 protein expression in the lung tissue was determined (by immuno-histochemical staining). Results Hemorrhagic shock significantly increased TLR4 mRNA and NF-κB p65 protein expression in the lung tissue and W/D lung weight ratio. Pretreatment with PHCD 1.0 or 3.0 mg/kg significantly inhibited hemorrhagic shock-induced increase in TLR4 mRNA and NF-κB p65 protein expression in the lung and W/D lung weight ratio. The lung injury was significantly ameliorated in group P2,3 as compared to group ALI. Conclusion PHCD pretreatment can attenuate ALI induced by hemorrhagic shock through down-regulation of TLR4 mRNA expression and decreasing NF-κB activity in the lung.

Objective To evaluate osteoporosis and the bone turnover markers in patients with Graves′ disease(GD) and the association of bone turnover markers including serum osteocalcin ( OCN ),I procollagen Nterminal propeptide( PINP),serum alkaline phosphatase ( ALP),and β- I collagen carboxyl-terminal peptide ( β-CTX)with thyroid hormone levels.Methods A total of 163 patients with Graves′ disease were enrolled.Serum thyroid hormone,OCN,PINP,and β-CTX levels were measured by the method of ethchemiluminescence.Serum ALP,calcium,phosphorus,and urinary calcium/creatinine ratio were measured by automatic biochemical system.Bone mineral density ( BMD ) of lumbar spines 1-4 ( L 1-4 ) and the proximal left femur was detected by dual energy xray absorptiometry.Results GD cases enrolled were composed of 43 men (26.4％ )and 120 women ( 73.6％ ),with an average age of ( 47 ± 1 ) years.There were 126 cases ( 77.3％ ) with normal BMD,and 37 cases ( 22.7％ ) with osteoporosis.OCN,ALP,PINP,β-CTX,and free T3 levels were significantly higher in the group of osteoporosis than those in the group with normal BMD( P＜0.05 or P＜0.01 ) after adjusting for sex,age,and BMI.The levels of OCN,P1NP,and β-CTX were positively correlated with serum FT3 level ( all P＜0.01 ) and were also progressively increased according to the quartile groups of FT3 levels ( P＜0.01 ) after sex,age,and BMI were adjusted.Conclusion Patients with Graves′ disease had a high incidence of osteoporosis with characristic high rate of bone turnover,which is related to the raised thyroid hormone levels.

Objective To analyze the laboratory detection findings in infectious mononucleosis(IM) and mucocutaneous lymphnode syndrome(MCLS)and find the main points of the differential diagnosis and direct the treatment. Methods Five hundreds and twenty-five children were in-patient department over these past 10 years .These patients were divided into 2 groups,IM group (225 patients) and MCLS group(280 patients). EB-virus antibody,Paul-Bunnell test,the circumference blood numeration ,classification of leucocytes,the numeration of atypical lymphocytes were detected and compared,as well as blood platelet of these patients.Results The positive rate of EB-virus antibody in IM and MCLS were high, and had no discrepancy. However, the positive rate of Paul-Bunnell test and numeration of atypical lymphocyte in IM group were significantly higher than those in MCLS group. The total circumference blood leucocyte numeration of the groups increased,but the numeration neutrophil increased significantly in MCLS group, the rising numeration of lymphocyte in IM; the blood platelet numeration was elevated significantly in MCLS group and continued when the total circumference blood leucocyte numeration tended normally.Conclusions The causes of IM and MCLS are related to the infection of EB-virus. The laboratory characteristics of IM and MCLS are different,understanding the main points of the differential diagnosis contributes to the clear diagnose and early treatment.

Objective:To discuss the results interpretation and clinical significance of Acinetobacter Baumanni ( AB) positive spu-tum samples .Methods:The anti-infection treatment of one patient with lung infection after colon cancer surgery in ICU was analyzed , and the results interpretation and clinical significance of AB positive sputum samples were discussed .Results:Although the culture re-sults of sputum samples were positive , the quality of sputum samples was low and the credibility was poor .The possibility of multiple drug resistance AB ( XDR-AB) screened by antibiotics selective stress was small .Meanwhile, the clinical infection symptoms were mild, and the treatment with imipenem was effective .Although the patient had high risk factors for the colonization of Baumanni infec-tion, XDR-AB was not a pathogen .Conclusion:When respiratory samples are AB positive , the quality of samples should be evaluated by smear results firstly , especially the existence of white blood cell phagocytosis or accompanying should be paid attention to , and then the possibility of AB screened by antibiotics selective stress and high risk factors for colonization should be analyzed .Finally, combined with the clinical symptoms of patients and the treatment efficacy before drug sensitivity tests , whether XDR-AB is pathogenic bacteria should be judged , and then the corresponding anti-infection treatment plan should be determined .

Cyclophosphamide (CPA) is the most common alkylating antineoplastic agent, as well as a strong immunosuppressant that is frequently applied to autoimmune diseases and organ transplantation. It is metabolized by cytochrome P450 oxidases (CYPs) to its active metabolite which played a critical role in therapy. CPA has serious and even fatal side effects, and its efficacy and adverse reactions are significantly varied among individuals. In this review, the association of the genetic polymorphisms in the metabolic enzymes and transporters involved in the disposition of CPA with the efficacy and adverse effects of CPA were summarized, thereby providing fundamental reference for further pharmacogenomic study of CPA.
Antineoplastic Agents, Alkylating ; pharmacology ; Cyclophosphamide ; pharmacology ; Humans ; NADPH-Ferrihemoprotein Reductase ; metabolism ; Pharmacogenetics

Adult ; Congresses as Topic ; Hearing ; Hearing Tests ; Humans ; Mass Screening

Objective To analyze the correlation of visual acuity and metamorphopsia with foveal morphology before and after vitrectomy with internal limiting membrane peeling (ILMP) in idiopathic macular epiretinal membrane (IMEM) eyes.Methods This is a retrospective case series of 47 IMEM patients (49 eyes).All the patients underwent 25G pars plana vitrectomy with IMEM removal and ILMP.The best corrected visual acuity (BCVA) was measured using the international standard visual acuity chart,and the results were converted to the logarithm of the minimum angle of resolution (logMAR) visual acuity.The severity of metamorphopsia was measured using M-charts.The central macular thickness (CMT),inner nuclear layer thickness (INT),inner retinal layer thickness (IRT),outer retinal layer thickness (ORT),the status of ellipsoid zone (EZ) were assessed with spectral-domain optical coherence tomography at baseline and each month postoperatively.The differences in BCVA,CMT,INT,IRT,ORT and status of EZ before and after surgery were analyzed,so did the correlations between these indexes at the same time.Results Compared with baseline,the postoperative BCVA was significantly increased (F=6.133,P＜0.001),but the M value,CMT,INT,IRT,ORT were significantly decreased (F=12.481,10.565,15.739,6.046,10.569;P＜0.001);the integrity of EZ was improved significantly (x2=12.309,P＜0.001).Preoperative BCVA was positively related to the CMT (r=0.720) and ORT (r=0.720,0.887;P＜0.05),while negatively related to preoperative integrity of EZ (r=-0.295,P＜0.05).The postoperative BCVA was positively related to the preoperative BCVA and postoperative CMT,ORT (r=0.774,0.754,0.842;P＜0.05),while negatively related to postoperative integrity of EZ (r=-0.676,P＜0.05).The preoperative M value was positively related to the preoperative CMT,INT,IRT,and ORT (r=0.931,0.668,0.840,0.637;P＜ 0.05).The postoperative M value was positively related to the preoperative M value and postoperative CMT,INT,IRT,and ORT (r=0.723,0.722,0.767,0.825,0.387;P＜0.05).Conclusions Vitrectomy with ILMP for IMEM can improve the visual acuity,metamorphopsia and foveal morphology.Both visual acuity and metamorphopsia correlate with foveal morphology.

Objective To evaluate the safety and effectiveness of vitrectomy combined with internal limiting membrane (ILM) tamping on macular hole and retinal detachment (MHRD) in highly myopic eyes.Methods 23 patients (23 eyes) were retrospectively reviewed,who were diagnosed as MHRD through examination of the ocular ftmdus,optic coherence tomography (OCT) and B-mode ultrasonography.There were 5 males (5 eyes) and 18 females (18 eyes).The mean age was (62.35 ± 8.28) years.The mean course of disease was 1.1 months.The logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) was 2.31 ± 0.72.The mean axial length was (28.66 ± 1.99) mm.All patients underwent 23G microincision vitrectomy.After vitreous gel and cortex were gently resected,the ILM around the edges of the macular hole was stained with indocyanine green,and was folded and pushed to fill the macular hole gently.Then silicone oil or C3F8 gas tamponade was applied in 18 eyes and 5 eyes,respectively.The silicone oil was removed after 3 months.The follow-up was 6 months.The BCVA,macular hole closure,retinal anatomical reattachment were retrospectively observed,and were used to evaluate the safety and effectiveness of the surgery.Results At the 6 months after surgery,the logMAR BCVA was improved to 1.13 ± 0.38,the difference was significant (t=l 5.33,P=0.00).The postoperative macular hole closure rate and retinal anatomical reattachment rate were 100％.There were no ocular or systemic adverse events observed in all patients.Conclusion Vitrectomy combined with ILM tamping is an effective and safe treatment for the high myopic eyes with MHRD.