Objective To investigate the correlation between the characteristics of the computed tomography (CT) perfusion parameters and the expression of D2-40 with lymphatic vessel density (LVD) in cervical carcinomas.Methods A total of 42 patients with cervical carcinoma was divided into two groups with and without lymph node metastasis.Patients were evaluated with CT perfusion scan before operation.Monoclonal antibody D2-40 was used for immunohistochemistry to detect the LVD in the carcinoma tissue specimen.CT perfusion parameters and LVD of two groups were compared,and their relationship was analyzed.Results CT perfusion parameters including blood flow (BF),peak enhancement image (PEI),and blood volume (BV) in the lymph node metastasis group were significantly higher than those in the no lymph node metastasis group (t =-2.206,-2.29,-2.336,P ＜ 0.05).The time to peak (TTP) was significantly lower in the lymph node metastasis group than the no node metastasis group (t =6.908,P ＜ 0.01).The LVD in the lymph node metastasis group was significantly higher than the no lymph node metastasis group (t =-5.092,P ＜ 0.01).The CT perfusion parameters (BF,PEI,BV) and LVD of cervical carcinomas had a significantly positive correlation (r =0.65,0.56,0.61,P ＜ 0.01).The TTP and LVD had a significantly negative correlation(r =-0.55,P ＜ 0.01).Conclusions CT perfusion imaging and higher LVD help to diagnose the lymph node metastasis of a cervical carcinoma,and have important guidance role in the surgical options for cervical cancers.

Objective To study the diagnostic value of CT combined CA125 and HE4 in differentiating the ovarian cancer from the benign.Methods A case-control study included 52 ovarian cancer patients,47 patients with benign ovarian tumors,and 40 healthy control subjects.Preoperative serum levels of HE4 and CA125 were measured and CT was performed.Results The serum levels of CA125 and HE4 in the ovarian cancer groups [(264.37 ± 138.46) KU/L,(280.38 ± 135.14)pmol/L] were significantly high-er than that in the benign ovarian neoplasm group [(52.51 ±5.29) KU/L,(40.52 ± 10.34) pmol/L] and healthy control group [(10.69 ±6.15)KU/L,(37.24 ±9.84) pmol/L] (P ＜0.01).The serum levels of CA125 showed statistically significant difference between the benign ovarian neoplasm groups and healthy control groups (P ＜ 0.05).The serum levels of HE4 did not show statistically significant difference between the benign ovarian neoplasm groups and healthy control groups (P ＞ 0.05).The diagnostic sensitivity (65.4％,80.8％,75.0％),specificity (74.5％,85.1％,76.6％),and accuracy (69.7％,82.8％,75.8％) of each CA125,HE4,CT method for ovarian cancer did not show statistically significant difference (P ＞0.05).The diagnostic sensitivity (92.3％),specificity (93.6％) and accuracy (94.8％) of combination of CA125 and HE4 and CT were significantly higher and showed statistically significant difference compared with one method (x2 =7.461 18.711,P ＜ 0.01),but no significant difference compared with any two methods (P ＞ 0.05).Conclusions The serum levels of HE4 and CA125 in the ovarian cancer group were significantly higher,and CT in combination with those two serum indices improved the diagnostic sensitivity,specificity,and accuracy of ovarian cancer.

Anticoagulants ; poisoning ; Humans ; Male ; Middle Aged ; Rodenticides ; poisoning

Objective To investigate the effect of 17?-estradiol (E2) on the expression of hepatocyte growth factor (HGF) mRNA in the myocardial tissues in rats during myocardial ischemia-reperfusion (I/R) process, and explore the relationship between HGF mRNA expression and myocardial apoptosis. Methods Using the random number table, 40 male SD rats were divided into 2 groups (20 rats in each group) randomly, ischemia-reperfusion (control) group and E2 treatment group. Myocardial I/R models of rats were duplicated by ligating the left anterior descending coronary artery for 20 min then reperfusion for 30 min. The expression of HGF and the apoptosis of myocardiocytes were observed with RT-PCR, TUNEL and flow cytometry. Results At the points of cardiac ischemia for 20 min and reperfusion for 30 min, in the E2 treatment group, the expressions of HGF mRNA were significantly higher than corresponding points of the control group (P

Objective To establish the clinical pharmacokinetics research method for Bawei Jiangu Tablet.Methods Drug blood concentration was estimated through analyzing the ingredients and preclinical pharmaceutical research results of Bawei Jiangu Tablet.Results Corresponding cardiac glycoside value in serum of animals treated with oral use of Bawei Jiangu Tablets and cortex periplocae extracts can be detected by drug monitor system of digoxin immunoreaction, which was similar to that in animals treated with digoxin.Corresponding cardiac glycoside value had also been detetected in serum of subjects in phaseⅠclinical tolerance trial,which was related to the time and dosage of administration.Clini- cal negative control trial showed that the reaction was specific.Conclusion Pharmacokinetics study on target of toxic components with cross-reaction of periplocoside is feasible through drug monitor system of digoxin immunoreaction.

Ultraviolet light hardening therapy is an effective method for the treatment of polymorphic light eruption (PLE) . Recent studies have shown that narrow-band ultraviolet B (NB-UVB) is effective and safe for the prevention of recurrence of PLE. However, its treatment mechanisms still need further elucidation, and clinical studies with large sample size are needed for long-term tracking and assessment of initial dose of photohardening, dose-addition principle, treatment frequency and maintenance treatment protocols, in order to confirm the clinical application value of ultraviolet light photohardening therapy.

Objective To observe the nutritional biochemical indicators of paraquat poisoning patients, analyze and compare the nutritional status of patients and understand the changing trend of each indicator. Methods A total of 104 patients with acute paraquat poisoning who were admitted to the emergency department of the Second Hospital of Hebei Medical University from December 2015 to December 2017 were enrolled, and divided into the cure group (patients who survived >30 days) and the death group. Nutritional biochemical indicators including serum protein (ALB, PA, TP) and serum lipids (TCh, TG, LDL) were selected for dynamic observation. The observation time points were set as follows: immediate treatment of poisoned patients (day 1 on admission), on day 4, 7, 10, 13 and 16 after admission, and on day 30 after follow-up. The nutritional biochemical indicators of the two groups on day 1 and 4 were statistically analyzed and compared by t test. The nutritional status of the patients in the cure group was analyzed, and the Repeated Measures Anova was performed to understand the trend of each indicator over time. Results In the cure group, the TP level decreased from (73.34±5.75)g/L on day 1 to (51.95±6.05)g/L on day 4, t=20.34, P<0.01; and the TCh level decreased from (4.37±0.98) mmol/L on day 1 to (3.03±1.01)mmol/L on day 4, t=7.56, P<0.01. In the death group, the TP level decreased from (72.25±8.80)g/L on day 1 to (49.07±5.48)g/L on day 4, t=12.38, P<0.01, and the TCh level decreased from (4.38±0.88)mmol/L on day 1 to (2.51±1.07) mmol/L on day 4, t=7.94, P<0.01. Compared with the cure group, serum levels of ALB, TP and TCh in the death group decreased greater from day 1 to day 4 (all P<0.05). In addition, dynamic observation of the indicators in the cure group within 16 days after admission showed that, after treatment, the levels of ALB and TP recovered slowly and were still lower than normal . While the levels of PA and lipid rose rapidly after 10 days of admission. Conclusions Paraquat poisoning seriously affects the nutritional status of patients, and the serum protein levels decline significantly and can not be recovered easily. Therefore, sufficient attention should be paid to the treatment, and timely and appropriate nutritional support should be provided.

OBJECTIVE: To analyze the clinical pathologic characteristics of cervical intraepithelial neoplasia grade III (CINIII ) and to explore optimal surgery for CINIII patients. METHODS: The clinical pathologic characteristics, surgical treatments, prognosis and history of 383 CINIII patients, who hospitalized from August 2005 to December 2010, were reviewed and analyzed. Among the patients, 213 (55.6%) received cold-knife conization surgery and 170 (44.4%) received ordinary electric knife conization surgery. RESULTS: There was no significant statistic difference between cold-knife conization group and ordinary electric-knife conization group on the level of clearance of the pathologic tissues and the cervical cone diameter and cone high. Intraoperative blood loss was (13.1±5.2) mL and (25.5±17.2) mL. Bleeding of electric knife conization group, compared with that of the cold knife conization group, decreased by nearly 50%. The difference between the 2 groups was significant (P<0.01). Pathological examination after conization operation indicated that 350 out of the 383 patients didn't show pathological upgrade while 33 patients showed pathological development, among which 21 were diagnosed with invasive cervical cancer at Ia1 clincal stage, 7 atIa2 clincal stage and 5 atIb1 clincal stage. In 3 cases (14.3%) Ia1 cervical cancer patients, fertility requirements and negative margins with cervical conization were closely followed up, and one patient (4.8%) with positive margin and fertility requirements had re-conecut. The remaining 17 (80.9%) had resected the uterus outside the fascia (or plus attachments) . All the 12 patients with invasive cervical cancer at Ia2 orIb1 clinical stage received radical hysterectomy. No tumor recurrence was observed in the 383 patients. CONCLUSION Treatment optimazation of CINIII patients should be based on clinical pathological diagnosis and individual requirements. Both cervical conization surgery and total hysterectomy have been proved safe and practical for CINIII patients.
Adult ; Aged ; Cervical Intraepithelial Neoplasia ; pathology ; surgery ; Conization ; methods ; Female ; Humans ; Hysterectomy ; Middle Aged ; Neoplasm Grading ; Uterine Cervical Neoplasms ; pathology ; surgery

BACKGROUND:Early identification of patients requiring ventilator support will be beneficial for the outcomes of botulism.The present study aimed to establish a new scoring system to predict mechanical ventilation(MV)for botulism patients. METHODS:A single-center retrospective study was conducted to identify risk factors associated with MV in botulism patients from 2007 to 2022.Univariate analysis and multivariate logistic regression analysis were used to screen out risk factors for constructing a prognostic scoring system.The area under the receiver operating characteristic(ROC)curve was calculated. RESULTS:A total of 153 patients with botulism(66 males and 87 females,with an average age of 43 years)were included.Of these,49 patients(32.0%)required MV,including 21(13.7%)with invasive ventilation and 28(18.3%)with non-invasive ventilation.Multivariate analysis revealed that botulinum toxin type,pneumonia,incubation period,degree of hypoxia,and severity of muscle involvement were independent risk factors for MV.These risk factors were incorporated into a multivariate logistic regression analysis to establish a prognostic scoring system.Each risk factor was scored by allocating a weight based on its regression coefficient and rounded to whole numbers for practical utilization([botulinum toxin type A:1],[pneumonia:2],[incubation period≤1 day:2],[hypoxia<90%:2],[severity of muscle involvement:grade II,3;grade III,7;grade IV,11]).The scoring system achieved an area under the ROC curve of 0.82(95%CI 0.75-0.89,P<0.001).At the optimal threshold of 9,the scoring system achieved a sensitivity of 83.7%and a specificity of 70.2%. CONCLUSION:Our study identified botulinum toxin type,pneumonia,incubation period,degree of hypoxia,and severity of muscle involvement as independent risk factors for MV in botulism patients.A score≥9 in our scoring system is associated with a higher likelihood of requiring MV in botulism patients.This scoring system needs to be validated externally before it can be applied in clinical settings.

BACKGROUNDVulvodynia, or vulvar pain, is a common condition in women; however, there are few evidence-based clinical trials evaluating nonpharmacological therapies for this condition. Acupuncture is one complementary and integrative medicine therapy used by some patients with vulvodynia. This study evaluates two different acupuncture strategies for the treatment of vulvodynia and aims to evaluate whether either of the acupuncture protocols reduces vulvar pain, pain duration or pain with intercourse. The study also examines how long the effect of acupuncture lasts in women with vulvodynia.

METHODS/DESIGNThe study is designed as a randomized controlled trial, focused on two acupuncture protocols. Fifty-one patients who have had vulvodynia for more than 3 months will be recruited. Among them, 34 patients will be randomized into Groups 1a and 1b; those who are unwilling to receive acupuncture will be recruited into the standard care group (Group 2). Patients in Group 1a will have acupuncture focused on the points in the pudendal nerve distribution area, while patients in Group 1b will receive acupuncture focused on traditional (distal) meridian points. Patients in Group 2 will receive routine conventional treatments, such as using pain medications, local injections and physical therapies or other nonsurgical procedures. Acupuncture will last 45 min per session, once or twice a week for 6 weeks. The primary outcome measurement will be objective pain intensity, using the cotton swab test. The secondary outcome measurement will be subjective patient self-reported pain intensity, which will be conducted before cotton swab test. Pain intensities will be measured by an 11-point Numeric Pain Rating Scale. Pain duration and pain score during intercourse are recorded. Local muscle tension, tenderness and trigger points (Ashi points) are also recorded. All measurements will be recorded at baseline (before the treatment), at the end of each week during treatment and at the end of the 6 weeks. Follow-up will be done 6 weeks following the last treatment.

DISCUSSIONResults of this trial will provide preliminary data on whether acupuncture provides better outcomes than nonacupuncture treatments, i.e., standard care, and whether acupuncture focused on the points in pudendal nerve distribution, near the pain area, has better results than traditional acupuncture focused on distal meridian points for vulvodynia.

TRIAL REGISTRATIONClinicaltrials.gov: NCT03481621. Register: March 29, 2018.