Seventy eight patients suspected of intrauterine adhesion (IUA) were scanned with two-dimensional (2D) and three-dimensional (3D) transvaginal uhrasonography, the results were analyzed with hysteroscopic findings as the gold standard. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of three-dimensional transvaginal ultrasonography in diagnosis of IUA were 97% (58/60), 18/18, 97% (76/78), 100% (58/58) and 90% (18/20). Three-dimensional transvaginal ultrasonography was more accurate in diagnosis of IUA than two-dimensional ultrasonography ( P < 0. 01 ),and the IUA classification and grading with three-dimensional transvaginal ultrasonography was better correlated with hysteroscopic findings.

Renal cell carcinoma (RCC) is a common lethal urological cancer,the distant metastasis of which is the leading cause of death.Although targeted agents have remarkably improved the overall prognosis of RCC patients,nearly all the patients eventually acquire therapeutic resistance.With the advent of immune checkpoint inhibitors,immunotherapy based on tumor microenvironment (TME) has shown a broad scope in clinical application.The deepening understanding of TME leads to the changes of therapeutic strategies for advanced RCC,and the combination of targeted therapy and immunotherapy is exhibiting a promising prospect.Herein,we reviewed the TME characteristics,candidate predictive biomarkers,and possible targets for future development of drugs against RCC.
Carcinoma, Renal Cell/therapy* ; Female ; Humans ; Immune Checkpoint Inhibitors ; Immunotherapy ; Kidney Neoplasms/therapy* ; Male ; Tumor Microenvironment

Objective To quantitatively analyze the coronary artery ostia by three-dimensional trans-esophageal echocardiography (3D-TEE).Methods The full-volume images of aortic root and coronary artery ostia were acquired by 3D-TEE in 95 adult patients.The Philips QLab 3DQ measurement technology was employed to determine three mutually perpendicular planes:(1) The transverse plane cross the bottom of three coronary artery sinus.(2) The sagittal plane perpendicular to sino-tubular junction.(3) The coronal plane perpendicular to the aforementioned two planes .The following relevant parameters were measured and recorded:(1) Length, width, height and area of bilateral coronary artery ostia .(2) The angle between coronary arterial outflow tract and aortic root in sagittal plane .(3) The spatial distribution of coronary artery ostia, aortic root and coronary artert sinus .Results The shape of left coronary artery ostia were more regular (round or oval) than right coronary artery ostia ( teardrop-shape or oval ).Calcification was more frequent in right coronary artery ostia (81/95, 85.26%) than that in left coronary artery ostia. There were statistical differences between left and right coronary artery in the parameters of ostial wide , area and height (t =3.85, 3.86, -4.49, all P<0.01).Most left coronary artery ostia were located inside the sinus (76/95, 80.00%), mainly in the upper third segment (69/95, 72.63%); while more than half of the right coronary artery ostia were found outside the sinus ( 53/95, 55.79%).The difference was statistically significant( χ2 =25.91, P<0.01).Conclusion The quantitative analysis of aortic root and coronary artery ostia based on the full-volume images originated from real-time 3D-TEE is feasible, which is helpful for further clinical research .

Objective To explore the clinical effects of enema combined with massage therapy on jaundice in premature infants.Methods Seventy-five premature infants with jaundice were randomly divided into 3 groups,enema combined message therapy group(group A),abdominal massage therapy group(group B),and double-side phototherapy group(group C).All 3 groups were received the same formula fee-ding,intravenous nutrition and identical drug treatment.Group A was given enema with mixed kaiselu and normal saline together with 60 times clockwise abdominal massage once a day for 2 weeks.Group B only received abdominal massage twice per day for 2 weeks.Transcutaneous bilirubin(TB) indexes of all the premature infants in the 3 groups were detected and transformed into total TB concentrations every morning,through version of MINOLTA JM-102 transcutaneous bilirubin radiometer made in Japan.When TB index counted more than 196.58 ?mol/L,group A and B were given single-side phototherapy for 24 hours.Neither enema nor abdominal massage was given to group C,and double-side phototherapy was applied when TB indexes were above 196.58 ?mol/L.Daily TB indexes,duration of jaundice and phototherapy,time of meconium exhaustion,defecation times in each day,incidence of constipation and feeding intolerance were recorded.Results Duration of jaunhospitalized and phototherapy were significantly shortened in group A compared with those of the other groups.In 34 premature infants who were hospital for at least 2 weeks,TB indexes in group C were lower than those in group B on the 9th day.On the 12th day and the 14th day,TB indexes in group A and C were lower than those in group B(Pa

Objective To investigate whether arsenic trioxide(As2O3)with different density is capable of affecting the invasiveness of neuroblastoma(NB)cells,and to give grounds for NB therapy with As2O3.Methods 1.Well-developed NB cells were selected and exposed to 0.75 ?mol/L,1.50 ?mol/L,3.0 ?mol/L As2O3 for 24 h;2.Collect the adherence cells,count the number and float them in nutrient medium again,add them into the transwell polycarbonate membrane plate that was covered by matrigel,there were 2?104 NB cells in each well;3.After 24 h,take off the membrane,fix the cells which cross the membrane with mehanol and dye them with hematoxylin;4.Observe the NB cells and count them,so the capability of invasion of LA-N-5 was evaluated by transwell chamber assay.Results After 24 h with the different density As2O3,the number of invading LA-N-5 cells was significantly lower in As2O3 group than that in control group(the number of invading cells of the As2O3 group was 28.0?4.0,19.33?4.16,6.33?1.53,respectively,the cell number of the control group was 46.33?6.11)(P=0.013,0.003,0);among the experiment groups,there was no difference between 0.75 ?mol/L and 1.50 ?mol/L(P=0.06),and it was significantly different between 0.75 ?mol/L and 3.0 ?mol/L,1.50 ?mol/L and 3.0 ?mol/L(P=0,0.007),the number of invading LA-N-5 cells of 3.0 ?mol/L As2O3 was the least.Conclusions As2O3 could inhibit the invasive potential of NB cells;the inhibitory action of 3.0 ?mol/L As2O3 is the most.

ObjectiveTo screen the variations of the human protein kinase Cγ gene (PRKCG) and study their association with Parkinson's disease(PD).MethodsDNA was extracted from blood of patients with PD and matched normal controls. All 18 exons including the exon-intron junctions were amplified in 17 different PCR fragments, which were analyzed for the presence of variations by DHPLC. The PCR products with a heteroduplex peak were sequenced. Significance was evaluated from 2×2 contingency tables byX2 test on the basis of the total number of alleles at each locus. Case-control association analysis was performed between candidate polymorphisms and PD. ResultsIn the 50 early-onset PD(EOPD) patients and 50 controls, there was no missense mutation, insertions or deletions in coding regions of the PRKCG. But 2 different single nucleotide polymorphism(SNPs) in exons, 5 different SNPs and 1 tetranucleotide repeat in introns were identified. Five of them [IVS3+96G>T, IVS11+26T>G, IVS15-41T>C, IVS16-59G>A, IVS16-42(TCTG)1-2] were described here for the first time. Three of them (IVS11+26T>G, IVS13+76T>C,1497T>C),in complete linkage,constituted a haplotype block. In the preliminary association analysis, the frequency of IVS13+76C, IVS11+26G and 1497C allele on this haplotype block was significantly higher in EOPD patients than the controls (24% vs 9%)(X2=8.165,P=0.004,OR=3.193, 95%CI:1.400-7.282). But in a larger sample of 156 EOPD patients, 153 late-onset PD(LOPD) patients and 195 normal controls, there was no significant difference between the three groups (12.8%,13.7% ,14.6%)(X2=0.471,P=0.790). ConclusionThe PRKCG gene might not be a risk factor for sporadic PD.

Objective Research the correlation between expression of MMP-2 in colorectal cancer and patho- logical factors,or biological behaviors in colorectal cancer.Methods The expression of MMP-2 in 68 cases with col- orectal cancer were detected by immunohistochemical staining.Results The expression of MMP-2 in colorectal can- cer was not correlated with tumor region and histologic type,but related with depth of tumor invasion and metasta- sis.The frequency of positive cases in patients with colorectal cancer with of lymph,node metastasis was significantly higher than that in patients without lymph node metastasis(P

OBJECTIVETo study and compare the therapeutic effects of electroacupuncture and probiotics combine Deanxit in treating diarrhea predominant irritable bowel syndrome (D-IBS).

METHODSTotally 64 D-IBS patients accompanied with anxiety and/or depression were randomly assigned to the Western medicine group (Group A) and the electroacupuncture (EA) group (Group B), 30 patients in Group A and 34 patients in Group B. Patients in Group A took Bacillus licheniformis and Deanxit, while those in Group B received EA. Four weeks consisted of one therapeutic course. Three-month follow-up was carried out. The scoring for the digestive tract symptoms, HAMA score, and HAMD score were evaluated before and after treatment. The recurrence in the 3-month follow-up was also observed.

RESULTSThe total effect rate was 86.67% in Group A and 88.24% in Group B with no statistical difference between the two groups (P > 0.05). There was statistical difference in the scoring for the digestive tract symptoms, HAMA score, and HAMD score (P < 0.05, P < 0.01). There was no statistical difference in the improvement of defecation frequency score, HAMA score, HAMD score between the two groups after treatment (P > 0.05). Better effects on improving abdominal pain score and abdominal distention score was obtained in Group B (P < 0.01), while better effects on improving the stool form score and mucus score were obtained in Group A (P < 0.01). There was no statistical difference in the recurrence rate between the two groups within the two-month follow-up (P > 0.05). The recurrence rate within the 3-month follow-up was obviously lower in Group B than in Group A (P < 0.05).

CONCLUSIONSEA and Western medicine (probiotics combined Deanxit) could effectively treat D-IBS patients accompanied with anxiety and/or depression. Both of them had different superiorities in improving symptoms. But EA had better long-term therapeutic effects.

Adult ; Anthracenes ; therapeutic use ; Diarrhea ; therapy ; Drug Combinations ; Electroacupuncture ; Female ; Flupenthixol ; therapeutic use ; Humans ; Irritable Bowel Syndrome ; therapy ; Male ; Middle Aged ; Probiotics ; therapeutic use ; Treatment Outcome

Objective o evaluate the characteristics and treatments of the medial-extension type of posterior malleolar fractures.Methods Data of 75 patients with posterior malleolar fractures from May 2007 to December 2010were retrospectively analyzed.13 patients whose X-ray showed Cotton fracture while CT scan showed medial-extension type of posterior malleolar fractures were involved in this study.There were 8 males and 5 females,with an average age of 40.3 years old (range,15-75 years).The mechanisms of injuries were as follow:6 patients with falling injury,4 patients from motor vehicle accidents and 3 patients from severe sprain.All the patients combined with distal fibular fracture.The preoperative clinical manifestations included foot and ankle swelling,deformity and restricted movement.The fracture line could be found on coronary X-ray.10 of those patients had double lines sign in medial malleolus.According to Haraguchi CT scan classification system,8 patients were Type Ⅰ fractures (61.6％,8/13),3 with Type Ⅱ fractures (23％,3/13),and 2 with Type Ⅲ fractures (15.4％,2/13).Posterior medial incision,cannulared screws after reduction were conducted.Wound and fracture healing were recorded postoperatively.Function was evaluated according to Baird-Jackson criterion.Results All 13 cases had been followed up for 8-45 months (mean 16 months).Post-operation X-ray showed articular surface displacement was less than 1mm; widening of the medial ankle mortise was no more than lmm; anatomy reduction was achieved or approximately achieved.All cases got union and the union period was 12-20 weeks with an average of 15.1 weeks.The incisions were primary healed in all patients.According to Baird-Jackson criterion,10 cases were excellent and 3 were good.76.9％(10/13) patients got excellent results.No instrument failure,fracture displacement,and infection were found.All patients could walk without accessory appliance.Conclusion Most of medial-extension type of posterior malleolar fractures have articular cartilage damage.It may be caused by rotational force combined with axial load.It needs open reduction and internal fixation early.The posterior medial incision has certain superiority.

[Summary]_ Transient neonatal diabetes mellitus is a kind of rare special types of diabetes. It should be distinguished from type 1 diabetes. Genetic analysis can be used to define the subtype of neonatal diabetes mellitus, which helps us to select the most appropriate treatment and to predict the disease recurrence. Sulfonylureas is able to improve insulin secretion in most patients with transient neonatal diabetes mellitus and provide effective glycemic control. A case of transient neonatal diabetes mellitus is reported in order to call attention to the diagnosis and treatment of this disease.