Objective To investigate the clinical effect of mifepristone in treatment of perimenopausal dysfunctional uterine bleeding.Methods 80 cases of patients with perimenopausal dysfunctional uterine bleeding were selected and randomly divided into control group and research group,with 40 cases in each group.The control group was in the diagnosis of curettage after 10 days of oral provera 10mg every night before going to bed,stopped drug application in 14 days,15 days to retreat hemorrhages oral provera 10mg/day,stayed for 10 days,repeated drug use 5 months.The research group was treated with oral mifepristone every night before going to bed since cleaning up the uterus,12.5mg,for 6 months.Outpatient follow -up for 6 months,the recent curative effect,long -term curative effect,hormone level changes,anemia and adverse drug reactions were observed.Results The total effective rate of the research group was 95.0%,which of the control group was 82.5%,there was statistically significant difference(χ2 =7.82, P =0.005);The recurrence rate of the research group was 5.0%,which of the control group was 15.0%,there was statistically significant difference(χ2 =5.56,P =0.018).The FSH,LH,E2 and P of the two groups were decreased, but which of the research group were lower significantly than those of control group,the differences were statistically significant (all P <0.05).The decreased degree of endometrium in the research group was larger than that of the control group,the difference was statistically significant(P =0.0001).Conclusion Treatment of mifepristone perimenopausal dysfunctional uterine bleeding is significant,safe and convenient,which is worthy of clinical application.

Objective To analyze the epidemiological trends of leprosy and evaluate the effectiveness of control in Zhejiang Province. Methods A retrospective study was conducted. Results By the end of 1999, 16 262 leprosy patients had been registered, of them 11 935 had been cured and only 97 were still remained. In 1999, active cases decreased by 99.02％ over 1973. The epidemiological trends of leprosy showed the increase of mean age at onset and type ratio, and the decrease of incidence in children. Conclusion The epidemicity of leprosy has been continuously dropping in Zhejiang Province due to the sustained effort and effective control.

This study was aimed to investigate the curative effect on external application and rectal instillation with Chinese medicine in the treatment of chronic renal failure (CRF) with acute gouty arthritis (GA). A total of 82 CRF patients with acute GA from the First People's Hospital of Hengyang City were randomly divided into the study group (n = 42), which was treated with external application and rectal instillation with Chinese medicine, and the control group (n = 40), which was treated with prednisone. The comparison was made on symptoms and body signs of GA, blood uric acid, creatinine, creatinine clearance, adverse reaction, and recurrence rate between two groups. The re-sults showed that there was no significant difference on alleviating of joint swelling and pain between the study group and the control group. Compared with pretreatment, the blood uric acid and creatinine were significantly decreased after treatment in the study group (P< 0.01). The creatinine clearance was obviously increased (P < 0.05). There were no significant differences on blood uric acid, creatinine and creatinine clearance in the control group before and after treatment. There was no adverse reaction in the study group. In the one-month follow-up, there were only three recurrent cases in the study group, which were obviously better than the control group (P< 0.01). It was concluded that external application and rectal instillation with Chinese medicine had a good curative effect on CRF with acute GA in the near future with low recurrence rate and no adverse reaction, which was worthy of popularizing in the clinical practice.

Objective To determine the human milk insulin(HMI) concentrations of healthy,gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) lactating mothers and their correlative factors and to explore the effect of HMI on growth and development of neonates. Methods HMI of colostrum and mature milk collected from 148 healthy lactating mothers and 46 GDM/GIGT mothers were determined by radioimmnuoassay. The intergroup HMI levels were compared by Wilcoxon test. Results (1) In the GDM/GIGT group, colostrum HMI was 28.81 μU/ml(13. 84-43.14 μU/ml), significantly lower than that of mature milk which was 57.50 μU/ml(36. 70-82. 73 μU/ml) (Z=-4. 828,P=0. 000). HMI of mature milk in the healthy group was 35.88 μU/ml(25.91-46.85 μU/ml), lower than in the GDM/GIGT group (Z=-2.874,P=0.004). ( 2 ) The colostrum HMI of the mothers underwent cesarean section was 23.64 μU/ml (14.90-38.51 μU/ml) lower than in the vaginal delivery ones which was 38.89 μU/ml(23.14-65.54 μU/ml)(Z= -4. 510, P= 0. 000). (3) HMI of mature milk in mixed feeding cases was 42.58 μU/ml (26.60-73.06 μU/ml),significantly higher than that of breast feeding ones which was 36.32 μU/ml(26.00-46.16 μU/ml)(Z=-2. 377,P=0.019). (4) Both HMI in colostrum and mature milk were positively correlated with maternal BMI (P＜0.05). Conclusions The mode of delivery significantly affects the HMI in colostrum. GDM/GIGT and the feeding patterns have some effects on HMI levels in mature breast milk. The HMI level is positively correlated with maternal BMI.

Objective To determine whether glucagon-like peptide-1 (GLP-1) receptor PET/CT with 68Ga-exendin-4 is accurate in localizing insulinomas, by comparing with conventional imaging techniques.Methods In this prospective cohort study, patients with biochemically proven endogenous hyperinsulinemic hypoglycemia from March 2014 to November 2016 were recruited consecutively.68Ga-exendin-4 PET/CT, CT, MRI, endoscopic ultrasound (EUS), and SSTR imaging were performed before elective surgery.Surgical pathology results were considered as the gold standard.Sensitivity based on patient-analysis and positive predictive value (PPV) based on lesion-analysis were calculated and compared using χ2 test and generalized score test.Results A total of 109 patients were recruited (47 males, 62 females;average age (45.1±14.8) years), and 96 of them with insulinomas proved pathologically were included in the main assessment.Thirteen patients with positive 68Ga-exendin-4 PET/CT findings did not undergo surgical intervention.Based on patient-analysis, the sensitivities of 68Ga-exendin-4 PET/CT, CT, MRI, EUS and SSTR imaging for detecting insulinomas were 98.96%(95/96), 81.25%(78/96), 79.41%(54/68), 81.40%(35/43) and 21.84%(19/87), respectively.Based on lesion-analysis, the PPV of the above 5 methods were 100%(102/102), 97.56%(80/82), 95.16%(59/62), 83.72%(36/43) and 90.48%(19/21), respectively.68Ga-exendin-4 PET/CT showed the highest diagnostic sensitivity than others (all P<0.01) and higher PPV than MRI, EUS and SSTR imaging (all P<0.05).Conclusion 68Ga-exendin-4 PET/CT is a highly sensitive imaging technique for detection of insulinoma.

ObjectiveTo investigate the role and mechanism of cervical sympathetic ganglia block in alleviation of cerebrovascular spasm (CVS) of rabbits after subarachnoid hemorrhage ( SAH ).Methods A total of 18 healthy male white rabbits whose cervical sympathetic ganglia were successfully blocked were randomly divided into three groups:sham operation group (Group A),SAH group (Group B) and SAH with cervical sympathetic ganglia block group (Group C).Venous blood (2 ml) and cerebrospinal fluid (2 ml) were obtained before the first blood injection ( T1 ),at 30 minutes after injection ( T2 ) and at day 7 after injection ( T3 ),respectively,and conserved in a low temperature refrigerator for spare use.Basilar artery value at T1,T2 and T3 was measured via cerebral angiography.The degree of damage to nervous system at T3 was recorded.ResultsThere was no significant difference in diameter of basilar artery at T1 among three groups.At T2 and T3,the diameters of basilar artery of Groups B and C were shorter than that of Group A,with Group B shorter than Group C,with statistical differences ( P ＜0.01 ).There were no significant differences in NO and NOS in plasma and cerebrospinal fluid at T1 among three groups (P＞0.05).NO and NOS contents at T2 and T3 were lower than those at T1,with Group A lower than Groups B and C,with statistical differences (P＜0.01 ).At T3,the nerve function of Groups B and C were better than that of Group A,with Group C better than Group B ( P ＜0.01 ).Conclusion Cervical sympathetic ganglia block relieves CVS,increases NO content and NOS activity in plasma and cerebrospinal fluid and promotes neural functional recovery after SAH.

OBJECTIVE To investigate the prevalence and resistance of extended spectram ?-lactamases(ESBLs) producers in Escherichia coli and Klebsiella pneumoniae.METHODS ESBLs producing strains were screened by double disk test and confirmed by the NCCLS confirmatory test.Susceptibility test to antimicrobial agents was performed by disk diffusion method and analyzed by WHONET 5.3 and Excel.RESULTS The isolated ratio of ESBLs producing E.coli and K.pneumoniae increased from 14% and 15% in 1999 to 30.1% and 30.4% in 2002.Bacteremia caused by the two kinds of ESBLs producers accounted for 30.2% and 30.4%,respectively.ESBLs producing K.pneumoniae and(ESBLs) producing E.coli were 19.8% and 14.0% for outpatient and 26.6% and 31.6% for inpatient.The resistance of(E.coli) to 17 kinds of agents was similar,no matter it was isolated from blood,urine or sputum.Susceptibility of(ESBLs) producing E.coli and K.pneumoniae in urine to cefoperazone/sulbactam,and piperacillin/tazobactam were 85% and 65.2%,66.6% and 29.4%,although to other 15 agents there were no difference.None of the(isolates) showed resistance to imipenem.CONCLUSIONS There is an increasing trend of ESBLs producing E.coli and K.pneumoniae(isolated) from various kinds of specimens and from different wards.It is important for clinical physicians to understand the distribution and the resistance characteristics of ESBLs producing E.coli and(K.pneumoniae) to antibiotics.