Objective To explore laboratory examination method of vaginal infection disease ,and to investigate the etiology of recurrent vaginitis .Methods 324 patients with recurrent vaginitis were selected to investigated the symptoms ,signs and vaginal discharge examination .Results (1)Among 324 patients ,293 cases (90 .4% ) of single infection and 31 cases (9 .6% ) mixed infec-tions were founded .There were 97 cases with VVC ,81 cases with CV ,17 cases with AV ,12 cases with BV ,and 14 cases with TV in the single infection cases .(2)In the 120 cases with VVC ,Candida albicans were accounted for 65 .0% ,non-Candida albicans strains were founded in 42 cases (35 .0% ) .(3)Among 28 cases of AV ,Escherichia coli ,Staphylococcus aureus ,Streptococcus aga-lactiae and Enterococcus f aecalis were main bacteria .Conclusion Recurrent vaginitis is common in clinical obstetrics and gynecolo-gy .Because of complex pathogeny ,clinicians should pay attention to laboratory results ,combined with the symptoms and signs , comprehensive evaluation ,improve disease diagnosis and treatment .

Objective To observe the dynamic change of activated cytotoxic T lymphocyte (CTL) percentage during periopera-tive period in the patients with breast cancer and to explore the value of detecting the peripheral blood activated CTL in monitoring the perioperative condition of breast cancer patients .Methods The lymphocytes in whole blood were defined by forward scatter and side scatter (FSC/SSC) signal parameters by adopting flow cytometry (FCM ) ,the CD3 ,CD8 and CD38 antigens on lymphocyte surface were detected by CD3-FITC ,CD8-APC and CD38-PE monoclonal antibody ,respectively .The CD3+CD8+CD38+ percentage in 20 healthy people were detected with the established method to determine the reference ranges ,and the dynamic changes of CD3+CD8+ CD38+ cells percentage in total T cells and cytotoxic T cells of 33 patients with breast cancer during perioperative period were observed .Results The percentages of CD3+ CD8+ CD38+ /CD3+ and CD3+ CD8+ CD38+ /CD3+ CD8+ in healthy group were (13 .46 ± 4 .08)% and (29 .98 ± 9 .1)% ,respectively .Both the CD3+ CD8+ CD38+ /CD3+ [(10 .44 ± 6 .61)% ] and CD3+ CD8+CD38+ /CD3+CD8+ [(22 .34 ± 10 .68)% ] before operation in 33 patients with breast cancer were significantly lower than those in healthy group (P<0 .05);CD3+CD8+CD38+ /CD3+ [(9 .64 ± 6 .16)% ] on postoperative 1 d was significantly lower than that in preoperation(P<0 .01);CD3+CD8+CD38+ /CD3+ [(12 .67 ± 7 .73)% ] and CD3+ CD8+ CD38+ /CD3+ CD8+ [(27 .42 ± 10 .65)% ] on postoperative 7 d were significantly higher than those in preoperation (P<0 .05) ,the difference with the healthy control had no statistical significance(P>0 .05) .Conclusion Observing the dynamic change of CD3+CD8+CD38+ cells percentage has an impor-tant significance for monitoring the perioperative condition of the patients with breast cancer ,contributing to get the activated CTL recovery situation of the patients and to choose the correct chemotherapy occasion for the patients .

Purpose To explore the effect of ultrasonic section,patient position and other factors on Young's modulus and shear wave velocity measurement of the muscle,and to study the consistency between Young's modulus and shear wave velocity on reflection of muscle hardness.Materials and Methods Shear wave elastography was used to detect 10 healthy young men and 10 women.Longitudinal and transverse detection of the Young's modulus and shear wave velocity of gastrocnemius and soleus were performed in natural ankle joint position,maximum plantar flexion and maximum dorsiflexion position.Results ① Comparison of the elasticity measurement between gastrocnemius and soleus.There were significant differences in the Young's modulus in the maximum plantar flexion and Young's modulus and shear wave velocity in maximum dorsiflexion position in longitudinal detection (P＜0.05) that gastrocnemius measurements were higher than soleus measurements.There were significant differences in Young's modulus and the shear wave velocity (P＜0.05) in natural position and maximum dorsiflexion position that soleus measurements were higher than gastrocnemius measurements.② In the positions of the ankle joints,the differences between longitudinal detection values and transverse detection values of gastrocnemius or soleus were statistically significant (P＜0.01) and longitudinal detection values were higher than transverse detection values.③ Comparison of the elasticity measurement of gastrocnemius and soleus muscle among different positions of the ankle joints.The measurement in natural position and in the maximum plantar flexion were evidently higher than that in the maximum dorsiflexion position (P＜0.01) in longitudinal detection.The maximum dorsiflexion position showed higher elasticity measurement.Only elasticity measurement in natural position and the maximum plantar flexion of the soleus was statistically different from that in the maximum dorsiflexion position (P＜0.01) that it was higher in the maximum dorsiflexion position.Conclusion The ultrasound elasticity measurements of gastrocnemius and soleus are related with the ultrasonic longitudinal or transverse section and the relative ankle positions.Moreover,there are some differences in elasticity measurements between these two muscles.should be given to all of these in quantitative evaluation of muscle hardness using shear wave ultrasound elastography.

Objective To evaluate the feasibility of low tube voltage (80 kV)with low concentration contrast medium iodixanol (270 mg I/mL)in cerebral perfusion using 640-slice volume CT.Methods Patients who underwent CT cerebral perfusion were randomly divided into two groups.Group A:100 kV,320 mg I/mL contrast medium;group B:80 kV,270 mg I/mL contrast medium.The effective dose(ED)was record,the frontal cortex,temporal cortex and occipital cortex were selected as regions of interest(ROI),and the cerebral perfusion parameters (rCBV,rCBF,MTT,TTP)were measured separately.The CT value of the M1 segment of cerebral middle artery, the C7 segment of internal carotid artery,the basilar artery and the surrounding brain tissue were measured.The signal-to-noise radio (SNR)and the contrast-to-noise ratio(CNR)of two groups were compared and analyzed.All data will be statistically analyzed,and the consistency of two physicians for image quality evaluation was analyzed by Kappa analysis.Results The ED of group B was 4.56 mSv, which was reduced by 35.2% compared to group A(7.04 mSv).The perfusion parameters,the CT value of ROI and the SNR,CNR for two groups were of no statistical difference(P>0.05).Conclusion The feasibility of low tube voltage combined with low concentration contrast media is better,which not only meets the requirements of clinical diagnosis,but also reduces the radiation dose and the probability of contrast induced nephropathy.

Objective To study the effect of exogenous non secreted human urokinase type plasminogen activator(uPA) gene on the production of collagen in activated hepatic stellate cells(HSC) after delivery by replication deficient recombinant adenovirus vector. Methods Non secreted human uPA was inserted into the replication deficient recombinant adenoviruses AduPA in bacteria. After infected by AduPA, the expression of uPA in HSC cell line HSC T6 was detected by Northern blot and immunocytochemical staining, and the level of matrix metalloproteinase 2 (MMP 2) in the supernatant of cultured HSC T6 cells was measured by ELISA. In addition, immunocytofluorescent staining was carried out to evaluate the effect of AduPA on the production of collagen Ⅰ and Ⅲ in HSC after exogenous uPA gene delivery. Results 5?10 11 efu/ml titer of AduPA was obtained in the HSC infected with the recombinated virus. Northern blot and immunocytochemical staining showed that the expression of uPA in HSC increased significantly on the third day after infection with the AduPA. The level of MMP 2 in the supernatant of the cultured HSC was (274.45?7.63) pg/ml, which was higher than that in the control [(145.85?6.58) pg/ml, P

Objective To apply special staining techniques in pathological diagnosis of fungal infections in HIV/AIDS patients.Methods Pathological data of 20 HIV/AIDS patients complicated with fungi infections in Shanghai Public Health Clinical Center during February 2010 and November 2013 were retrospectively analyzed.Tissue specimens were stained with hematoxylin and eosin (HE),Periodic acidSchiff (PAS) and methenamine silver nitrate (MSN),and the sections were observed under optical microscope.Results Among 20 HIV/AIDS patients complicated with fungi infections,2 were infected with pulmonary cryptococcosis; 3 were penicillium marneffei infections in skin,lung and abdominal mesenteric lymph nodes; 5 were histoplasma capsulatum infections in epiglottis,neck lymph nodes,oral cavity,abdominal cavity and skin; 4 were aspergillus infections in maxillary sinus,lung and vocal cords,and 3 of them were combined with tuberculous lesions; 6 were candida albicans infections in liver,pharynx,esophagus and stomach.In tissues stained with HE the infiltration of inflammatory cells,granuloma formation and coagulative necrosis were observed,and the shape of fungi needed careful observation to avoid missed diagnosis and misdiagnosis.In tissues stained with PAS,fungal spores and pseudohypha were presented in bright amaranth,and cell nucleus was in purple-blue.In tissues stained with MSN,fungal spores and pseudohypha were identified clearly in brown-black.Conclusion HE plus PAS and MSN staining will help pathological diagnosis of fungi infection.

Objective To investigate the correlation between the serum resistin level and carotid artery atherosclerosis in elderly Chinese males. Methods The study enrolled 235 elderly Chinese males [median age 76 (range 60-97) years] scheduled for ultrasound examination of carotid artery plaque and determination of carotid artery intima-media thickness (CIMT). They were divided into carotid atherosclerotic plaque (CAP) and carotid atherosclerotic plaque-free (CAP-free) groups according to the ultrasound results. Their clinical profiles were col-lected, and the serum resistin and other blood biochemistry levels were determined.Results The CAP group was older and had a thicker mean CIMT than the CAP-free group. However, there was no difference in the serum resistin level between the groups. CIMT was positively correlated with age (r = 0.299,P< 0.001). The serum resistin level was not correlated with CIMT, even after controlling for age. Multiple linear regression analysis revealed that age (β = 0.001,P< 0.001) and body mass index (β = 0.002,P= 0.015) were significantly and posi-tively correlated with the mean CIMT. Only age [odds ratio (OR): 1.159; 95% confidence interval (CI): 1.078-1.183,P< 0.001] was associ-ated with the presence of carotid artery atherosclerotic plaque. The serum resistin level was not correlated with the mean CIMT or associated with the presence of carotid artery atherosclerotic plaque.Conclusion The results suggest that resistin might not be a risk factor for atherosclerosis in elderly Chinese males.

OBJECTIVE:To investigate the efficacy and safety of methotrexate (MTX),Mifepristone combined with Huayu xiaozheng decoction in the treatment of uterine scar pregnancy. METHODS:86 patients with uterine scar pregnancy were randomly divided into control group(43 cases)and observation group(43 cases). Control group orally received 50 mg ultrasound-guided lo-cal injections of MTX,once a day+50 mg Mifepristone tablet,twice a day;observation group additionally received 100 ml Huayu xiaozheng decoction,twice a day with warm temperature. The treatment course for both groups was 15 d. Clinical efficacy,HCG levels,mass diameter before and after 7,14 and 28 d of treatment,and the incidence of adverse reactions in 2 groups were ob-served. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was sta-tistically significant(P<0.05). HCG levels and mass diameter after 7,14 and 28 d were significantly lower than before,it gradual-ly reduced by time prolonged,and research group was lower than control group,the differences were statistically significant(P<0.05 or P<0.01). And there was no significant difference in the incidence of adverse reactions(P>0.05). CONCLUSIONS:Ultra-sound-guided local injections of MTX combined with Huayu xiaozheng decoction shows good efficacy and safety in the treatment of uterine scar pregnancy.

Objective To explore the genetic pathogen of patients with non-syndromic hearing impairment and to provide prenatal diagnosis for the families of hereditary deafness. Methods Mutation screening of GJB2, SLC26A4, GJB3 and mitochondrial 12 S rRNA genes was performed in 208 patients with non-syndromic hearing impairment by gene chip. Then direct sequencing was used in 41 patients who were found one mutation of GJB2 or SLC26A4 gene. And prenatal diagnosis was carried out in two families by direct sequencing. Results Eighty-six patients (41.35％) were found at least one mutation by gene chip. Among them, 40 patients were found to carry two mutations and 46 patients were found to carry one mutation. The most frequent mutation was 235delC, which was found in 46 patients. And 12 cases were found the second mutation through direct sequencing. A total of 52 (25.00％) patients were detected two mutations. Prenatal diagnosis showed that one fetus carried compound mutations of 299-300delAT and 235delC, and another one carried heterozygous mutation of IVS7-2A>G. Conclusion Patients with non-syndromic hearing impairment can be accurately diagnosed by gene chip and Sanger sequencing. The prenatal diagnosis is primary means for high-risk fetuses.

Objective To compare the effect of continuous positive airway pressure (CPAP)and bilevel positive airway pressure(BiPAP)on the cardiac structure and function of patients with obstructive sleep apnea and hypopnea syndrome(OSAHS).Methods 100 patients with OSAHS were selected as the research subjects.The patients were randomly divided into two groups by digital table method,CPAP group had 50 cases,adopted the CPAP ventilation mode,BiPAP group had 50 cases,adopted the BiPAP ventilation mode.The heart rate,blood pressure, blood brain natriuretic peptide(BNP),nitric oxide(NO),endothelin -1 protease,matrix metalloprotein 9(MMP -9), C -reactive protein (CRP) and polysomnography (PSG) related indicators,cardiac structure and function and endothelial function changes before and after treatment were observed in the two groups,compared the clinical effect of the two modes.Results Before treatment,in both groups,there were no statistical differences in blood pressure,heart rate,BNP,NO,endothelin -1,MMP -9,CRP,PSG related indicators,cardiac structure and function,endothelial function.After six months of noninvasive ventilator treatment,results of the heart rate,systolic pressure,diastolic blood pressure,blood oxygen saturation,oxygen partial pressure,the BNP,endothelin -1,NO,MMP -9,CRP,body mass index,the Epworth sleepiness scale(ESS),Apnea hypoventilation index(AHI),oxygen and lowest at night,aortic di-ameter(AO),left ventricular inner diameter (LA),right ventricular(RV)inside diameter,left ventricular ejection fraction(LVEF),pulmonary artery systolic pressure(PASP)of the CPAP group were (79.83 ±11.47)times/min, (114.06 ±11.45)mmHg,(72.44 ±7.38)mmHg,(97.6 ±1.45)%,(93.17 ±1.86)mmHg,(110.78 ±38.32)ng/L, (17.58 ±2.07)ng/L,(8.55 ±0.55)μmol/L,(372.73 ±189.00)μg/L,(3.34 ±2.29)mg/L,(23.87 ±1.59), (0.98 ±0.70),(0.65 ±0.30),(94.04 ±1.62)%,(31.52 ±2.17 )mm,(31.19 ±1.09 )mm,(20.86 ± 1.69)mm,(61.13 ±5.02)%,(20.74 ±5.49)mmHg.which of the BiPAP group were (80.96 ±8.56)times/min, (114.58 ±9.34)mmHg,(71.67 ±8.57)mmHg,(96.96 ±1.43)%,(94.52 ±1.66)mmHg,(87.63 ±28.33)ng/L, (17.76 ±2.20)ng/L,(8.54 ±0.52)μmol/L,(359.63 ±268.95)μg/L,(4.96 ±2.00)mg/L,(24.15 ±1.65), (0.85 ±0.75 ),(0.58 ±0.19 ),(94.50 ±1.18)%,(31.73 ±1.57 )mm,(31.97 ±1.12)mm,(21.58 ± 2.43)mm,(62.24 ±5.79)%,(21.45 ±3.76)mmHg.In the oxygen partial pressure,the BNP,MMP -9,CRP,ESS score,AHI,LA,LVEF and other indicators,BiPAP mode were better than CPAP mode(t =2.13,4.32,2.13,4.32, 1.39,4.93,2.58,4.36,all P <0.05 ).Conclusion BiPAP mode and CPAP mode can improve cardiovascular function in patients with OSAHS,improve the symptoms of low ventilation,reduce obesity,but in terms of reducing cardiac load,improve blood vessel function,BiPAP mode is better than CPAP.