Cervical cancer, a common malignant tumor in female reproductive system, seriously threatens women's life and health. The standard surgery for early cervical cancer is radical hysterectomy + pelvic lymphadenectomy±para-aortic lymph node sampling. Lymph node metastasis is an independent risk factor for the prognosis of cervical cancer patients. Several researches showed that the incident of lymph node metastasis in early cervical cancer was approximately 20%. Giving the complications and sequelae of systematic lymph node resection, its application in early cervical cancer is still doubted. The sentinel lymph node, where lymph node metastasis firstly occurs, attracts much attention in the surgical treatment of malignant tumors. Hence, sentinel lymph node biopsy (SLNB) came into being. Recent studies have indicated that SLNB is safe and feasible for early cervical cancer and SLNB is recommended to patients with early cervical cancer. This article will introduce the application of SLNB in cervical cancer in the recent years and discuss its clinical value and related challenges.

Objective To set up the determining method of quercetinum in Kuding Cha of Ligustrum by HPLC. Method Hypersil ODS2 chromatographic column (4.6 mm?250 mm, 5 ?m) was adopted. Methanol 0.4% phosphoric acid (47∶53) was used as mobile phase, the flow rate was 1 mL/min, and the detecting wavelength was 360 nm. Result The linear range of quercetinum was 0.050 4～1.008 0 ?g, r =0.999 99, and the average recovery was 101.61% (RSD=1.75%, n =5). Conclusion The method is convenient and accurate, and can used be as basis of quality control for Kuding Cha of Ligustrum.

Endoscopes ; Humans ; Nasal Septum ; surgery ; Nose Deformities, Acquired ; surgery

Objective To explore a quick and feasible method of screening malaria parasite by using a Sysmex XE-2100 hematology analyzer though alarm information on high eosinophil count and atypical eosinophil distributions in the WBC scattergram. Methods Sysmex XE-2100 hematology analyzer was used for complete blood cell analysis. Microscopic review was used when high eosinophil count and atypicaleosinophil distributions in the WBC scattergram were found. If the review showed normal eosinophil cells, wecontinued to focus on red cell for searching malaria parasite. Results Among 1 501 specimens showing higheosinophil counts and atypical eosinophil distributions, nine cases with normal eosinophil cells were indisaccordance with the hematology analyzer, six of them showed high eosinophil count in the Sysmex XE-2100 hematology analyzer, whose distribution was located close to neutrophil clusters in scattergram. The otherthree had an abnormal WBC scattergram. There was no gap between eosinophil clusters and neutrophilclusters, which brought no classified results. But all the nine specimens had been found the trophozoite,schizont and merozoite in blood smears. Conclusions There were great possibility of the existence of themalaria parasite in specimens when hematology analysis showed high eosinophil count and atypical eosinophildistributions in the WBC scattergram in a Sysmex XE-2100 hematology analyzer, although these alarm wasnot comfirmed by microscopic review. This method provides not only a simple and reliable way for quickscreening malaria parasite but also has a great value in preventing the undetected ratio on malaria parasite.

Juvenile idiopathic arthritis is a common connective tissue disease of children.The rate of disability is high.Therefore,early diagnosis is important.There are some study on the value of antibodies in juvenile idiopathic arthritts,such as rheumatoid factor,antiperinuclear factor,antikeratin antibody,antibodies to cyclic citrullinated peptides and so on.This review introduces the progress of them.

Objective To explore the value of ultrasound scoring system in predicting the type and risk of placenta accreta.Methods Clinical data of 180 placenta accreta patients who delivered in the Peking University Third Hospital between January 2005 and November 2014,were retrospectively analyzed.Prenatal ultrasonographic features were analyzed,including position and thickness of the placenta,disappearance of hypoechoes in posterior placenta,continuousness of bladder line,existence of lacuna,condition of the subplacental vascularity,completeness of cervical morphology,existence of cervical sinus,and history of cesarean section.A score of 0,1 or 2 was given to each item,and a sum-up was calculated for each patient.The cut-off scores of patients with placenta accreta,placenta increta and placenta percreta were calculated by receiver operating characteristic carve,respectively.At the same time,blood loss and hysterectomy rate were compared among the three groups.Variance analysis,rank sum or Chi-square tests were used for statistical analysis.Results Among the 180 cases,there were 115 cases of placenta accreta,38 of planceta increta and 27 of placenta percreta.Placenta increta and percreta were defined as the severe type.Blood loss in placenta accreta was lower than in the severe type [200 (100-4 000) ml vs 3 025 (100-15 000) ml,P＜0.01].There was no difference in blood loss between patients with placenta increta or percreta (P=0.350).No hysterectomy was performed for patients with placenta accreta,the rate being lower than in the severe type [0 vs 29.2％ (19/65),P＜0.01].Among the severe type,18.4％ (7/38) of the placenta increta patients underwent hysterectomy,the rate being lower than in placenta percreta patients [44.4％ (12/27),P＜0.01].The score in placenta accreta was lower than in the severe type [(1.88± 1.45) vs (7.01 ±2.15) scores,P＜0.01].In the severe type,the score in placenta increta was lower than in placenta percreta [(6.08 ± 2.62) vs (8.74 ± 2.75),P＜0.01].The receiver operating characteristic curve showed that the cut-off score of placenta accreta and the severe type was 5 [area under the curve (AUC)=94.3％,the score ≥ 4.5,the sensitivity=81.5％,and the specificity=95.7％],the cut-off score of placenta accreta and increta was 3 (AUC=91.1％,score ≥ 2.5,the sensitivity=92.1％,and the specificity=75.7％),and the cut-off score of placenta increta and percreta was 10 (AUC=74.6％,score ≥ 9.5,the sensitivity=55.6％,and the specificity=89.5％).Conclusions Ultrasound scoring system is effective in assessing types of placenta accreta and predicting its associate risks,and alerting the possibility of hysterectomy.It also facilitates preoperative planning and guides physicians in formulating subsequent treatment plans.Placenta accreta and the severe type (placenta increta and percreta) can be distinguished by cut-offscores ≥ 5,and a score ≥ 10 implies a higher risk of placenta percreta.

Objective:To investigate the clinical and molecular genetic characteristics of 6q24-related transient neonatal diabetes mellitus (6q24-TNDM).Methods:The clinical data of two neonates with 6q24-TNDM admitted to Shanghai Children's Hospital, Shanghai Jiao Tong University in 2017, were retrospectively collected. The methylation levels of 16 cytidine-phosphate-guanosine (CpG) sites from the methylated differentially modified region (DMR) in 6q24 were quantitatively analyzed by pyrosequencing.Results:Case 1, aged 5 d, was born at 37 +4 gestational weeks due to fetal growth restriction, and case 2 was 11-days old and born at 38 +2 gestational weeks. Both infants were male and small for age. They were born through a cesarean section. The birth weight of case 1 and case 2 were 2 340 g and 2 600 g, respectively. They were admitted due to hyperglycemia with blood glucose of 12.95 and 8.00 mmol/L on admission, respectively. Physical examination showed slightly poor skin elasticity and thin subcutaneous fat. Laboratory examination revealed lower serum insulin (<1.39 and 3.94 pmol/L) and peptide C (0.05 and 0.14 nmol/L) levels, positive results of urine glucose, negative tests for urine ketone, serum anti-glutamic acid decarboxylase antibody, anti-insulin antibody, and islet cell antibody in both cases. Normal size of the pancreas was observed by ultrasonography. The infants were improved and were discharged after subcutaneous insulin infusion for more than two weeks. The treatment was discontinued at 69 d and 42 d postnatally for case 1 and case 2. Prenatal diagnosis of the two infants showed normal karyotypes and uniparental disomy of chromosome 6 indicated by single nucleotide polymorphism chip. No pathogenic mutations were detected by next-generation sequencing after admission. The methylation levels of 16 CpG sites in DMR of 6q24 in the two cases, which were quantitatively analyzed by pyrosequencing, were lower than 10% (normal value in healthy matched controls: 40%), indicating an obvious hypomethylation. Conclusions:For children with TNDM who are small for gestational age at birth, presenting hyperglycemia with decreased serum insulin and C-peptide levels, pyrosequencing can be used to quantitatively analyze the methylation levels of CpG sites in 6q24 DMR, which can quickly and directly assist in the diagnosis of 6q24-TNDM, thereby contributing to the treatment and prognosis assessment.

Objective To investigate the prognostic value of △SUV and Deauville 5-point scoring (5-PS) in patients with DLBCL.Methods Thirty-nine patients (20 males,19 females;median 58 (23-85) years) with pathologically confirmed DLBCL were retrospectively analyzed from January 2009 to April 2015.PET/CT imaging was performed before and after 4 courses of chemotherapy.The optimum cutoff values of △SUVmax and its decline proportion (△SUVmax％) were calculated by ROC curve,and then the Kaplan-Meier analysis and Cox regression analysis were performed in patients with different △SUVmax and △SUVmax％.Patients were also evaluated by the observers using Deauville 5-PS,Kaplan-Meier analysis and Cox regression analysis were performed in patients with scores ≥ 4 and those with scores ＜ 4.x2 test and Spearman correlation analysis were used.Results (1) There were 10 patients (25.64％,10/39) with progressed disease within the 2 year-follow-up.The △SUVmax,△SUVmax％ of progressed group were markedly lower than those of non-progressed group:9.55± 11.90 vs 15.61±7.86,71.66％ (33.90％-78.91％) vs 87.83％(76.51％-92.43％);t=-2.37,z=-3.25,both P＜0.05.(2)The optimum cutoff values of the △SUVmax,△SUVmax％ were 11.2 and 72.88％ respectively.(3) The patients with △SUVmax ＜ 11.2,△SUVmax％ ＜72.88％ or Deauville 5-PS≥4 showed shorter PFS and △SUVmax％ was proved to be an independent prognostic factor(x2 =5.734,14.821,5.851,all P＜0.05).(4) △SUVmax％ and Deauville 5-PS were correlated (rs =-0.633,P＜0.001).Conclusions △SUV and Deauville 5-PS could be used for prognosis prediction in DLBCL patients and △SUVmax％ might be an independent predictive factor.The values of △SUVmax ％ and Deauville present a negative relationship.

Objective To explore the clinical value of MRI in diagnosing and treating cesarean scar pregnancy (CSP).Methods A retrospective analysis was conducted on the clinical manifestations of 54 patients diagnosed with CSP between January 2009 to January 2013 in Peking University Third Hospital.Based on the patients' MRI image and other clinical datas,we did transvaginal operation on patients with CSP1,and transvaginal combined with abdominal operations on patients with CSP2.The intraoperative blood loss,operation time,postoperative hospital stay,and the length of time required for of serum hCG dropping to normal of the patients were analyzed.Results The average age of the 54 patients was (34±5) years and the average duration of gestation was (56± 16) days,all patients' vital sign were stable,the hCG level was 23-142 962 U/L before treatment.Twelve patients were diagnosed with CSP1 by MRI,and 5 of them had focus of 1-2 cm in diameter,the 5 patients' serum hCG level was 436-1 159 U/L and 23-32 days after drug administration,their hCG level returned to normal; the other 7 patients had focus of 2.0-4.4 cm in diameter,and their hCG level was 2 218-63 446 U/L,lesion resection was done on the 7 patients by hysteroscope or under B-uhrasound monitor.Forty-two patients were diagnosed with CSP2,and their focus were 1.0-7.1 cm in diameter,and serum hCG level were 23-142 962 U/L.We did bilateral uterine artery occlusion by laparoscope or laparotomy during operation for 22 patients or bilateral uterine artery embolization (UAE) before operation for 20 patients,then we did lesion resections.The blood loss during operation of CSP1 or CSP 2 was 50.1,267.2 ml; operation time was 30,128 minutes; postoperative hospital stay was 4.6,6.7 days;their serum hCG returned to normal 13-30 days after the surgery.All the 54 patients' uterus were preserved,and the patients undergoing operations were all cured without the second operation.Conclusion MRI is an effective method to conduct clinical treatment in CSP.

Objective To understand the mental health status between left‐behind children and un‐left‐behind children during primary school period in Yongchuan district of Chongqing city ,and to provide the theoretical basis for the study of the left‐behind children children′s mental problems and formulating the strategy and measures for preventing their psychological problems .Methods The Mental Health Rate Scale for Pupil (M HRSP) was used to evaluate the mental health condition in 4 987 primary school pu‐pils from 4 primary schools in Yongcuan discrict ,including 3 482 un‐left‐behind children(69 .82% ) and 1 505 left‐behind children (30 .18% ) .Results Totally 4 753 effective questionnaires were taken back with the effective rate of 95 .31% .The detection rate of total score deviation in left‐behind children was 13 .98% ,which was significantly higher than in un‐left‐behind children(6 .33% ) . The deviation detection rate of learning disabilities in left‐behind children was 14 .90% ,emotional disorder was 16 .81% ,character flaw was 12 .36% ,social adjustment disorder was 13 .91% ,moral defect was 14 .27% ,bad habits was 15 .61% ,behavior disorder rate was 16 .53% and the special obstacles was 11 .72% .Compared with un‐left‐behind children ,excluding the character flaw ,social adjustment and moral defect ,the deviation detection rate and scores of other 5 items in left‐behind children were higher than those in un‐left‐behind children .The scores of learning disabilities ,emotional disorder and bad habits in male pupils were higher than those in female pupils with statistical difference(P< 0 .05) .The scores of learning disabilities ,emotional disorder ,character flaw and behavior disorder in the high grade pupils were higher than those in the low grade pupils ,the differences were statistically sig‐nificant(P<0 .05) .Conclusion The mental health level of rural left‐behind children in Yongchuan district is low ,the problems are more serious compared with un‐left‐behind children .In carrying out the mental health education work in primary school pupils ,es‐pecially the mental health education should be paid attention to rural left‐behind children ,moreover the mental health education should be carried out aiming at different ages and different genders .