OBJECTIVE:To observe the efficacy and safety of mifepristone cycle therapy in the treatment of perimenopausal dysfunctional uterine bleeding. METHODS:Totally 116 patients with perimenopausal dysfunctional uterine bleeding were randomly divided into control group and observation group. Control group was given Mifepristone tablet 10 mg from 3 d after diagnostic cu-rettage on an empty stomach for continuous 90 d,once a day. Observation group was given Mifepristone tablet 10 mg from 3 d af-ter diagnostic curettage on an empty stomach,once a day,and it was stopped after continuous 5 d. Then it continued 5 d from the first day of menstruation,and lasted 3 menstrual cycles. The clinic data was observed,including clinical efficacy,estradiol(E2),fol-licle-stimulating hormone (FSH),luteinizing hormone (LH),progesterone (P),hemoglobin (Hb),endometrial thickness,men-strual conditions and recurrence in 2 groups before and after treatment were observed,and the incidence of adverse reactions were recorded. RESULTS:After treatment,E2,FSH,LH and P in 2 groups were significantly lower than before,and observation group was lower than control group,the differences were statistically significant(P<0.05). Hb in 2 groups was significantly higher than before,endometrial thickness was significantly lower than before,the differences were statistically significant(P<0.05);however, there was no significant difference between 2 groups(P>0.05). Total effective rate in observation group significantly higher than control group,normal proportion of menstruation were significantly better than control group,the differences were statistically sig-nificant(P<0.05). There was no significant difference in the incidence of a dverse reactions and dysfunctional uterine bleeding be-tween 2 groups(P>0.05). CONCLUSIONS:Mifepristone cycle therapy has significant efficacy in the treatment of perimenopausal dysfunctional uterine bleeding,can significantly improve the hormone level and the establishment of normal menstrual cycle and re-duce endometrial thickness,with good safety.

BACKGROUND:Astragaloside Ⅳ is a major component of Huangqi,promoting proliferation and differentiation of bone marrow mesenchymal stem cells;however,the mechanism has been less reported yet.OBJECTIVE:To explore the effect of Astragaloside Ⅳ on expression of multiple hematopoietic growth factors in bone marrow mesenchymal stem cells.METHODS:Bone marrow mesenchymal stem cells were isolated from adult Wistar rats by using the method of adhesive culture and clone,and they were then plated on 96-well plate and separately incubated with 100 uL Astragaloside Ⅳ(25,50,100,200 g/L)for 72 hours.The cells in the control group were cultured with an equal volume of DMEM-LG culture liuquid.Indirect immunofluorescence was used to detect the biological activity,MTT method was used to evaluate the effect of Astragaloside Ⅳ on proliferation and differentiation of bone marrow mesenchymal stem cells,and RT-PCR method was used to measure the expression of hematopoietic growth factors in bone marrow mesenchymal stem cells.RESULTS AND CONCLUSION:The 3~(rd)-passage bone marrow mesenchymal stem cells highly expressed CD44 but lowly expressed CD45.As compared with control group,Astragaloside Ⅳ promoted proliferation of bone marrow mesenchymal stem cells in a time/dosage-dependent manner,in particular,the 200 g/L Astragaloside IV and 72-hour intervention(P＜ 0.05).SCF expression was significantly increased in the drug group compared with control group(P ＜ 0.01);however,TPO,GM-CSF,and TGF-β1 expressions were not changed significantly(P ＞ 0.05).Moreover,interleukin-3 expression was not found in the bone marrow mesenchymal stem cells.Astragaloside Ⅳ promoted in vitro proliferation of bone marrow mesenchymal stem cells,possibly involving in SCF secretion.

Objective:To analyze the causes, influencing factors and trends of dead on arrival cases in children′s Hospital in the past 5 years, aiming to provide direction and basis for reducing the dead on arrival cases of children.Methods:We collected the dead on arrival cases in the department of emergency at Shanghai Children′s Hospital from January 2015 to December 2019, classifed and analysed the gender, age, native place, death season, time of death, and possible causes of death, and then studied the correlation between above factors and the cases.Results:A total of 151 dead on arrival cases were collected.The annual number decreased year by year, and boys were more than girls in gender.Most of them were infants under 1 year old, and nonlocal children were more than Shanghai native.The above differences were statistically significant, but there was no significant difference in the distribution of death season and death time.In terms of the cause of death, perinatal diseases accounting for 33.8%(51/151), those accompanied with severe underlying diseases accounting for 39.1%(59/151), accidental death accounting for 14.6%(22/151), unexplained deaths accounting for 12.6%(19/151). Those distribution differences were statistically significant( χ2=32.497, P<0.001). Meanwhile, there were statistic differences in gender and age of the cases with severe underlying diseases( χ2=4.898, P=0.027; χ2=32.169, P<0.001), and the year and age distributions of the accidental death cases also had significant differences( χ2=16.636, P=0.002; χ2=14.727, P=0.002). Conclusion:To reduce dead on arrival cases of children, we should do a good job in perinatal health care and screening, reduce premature birth and birth defects, actively conduct propaganda to prevent children′s accidental injuries, popularize medical first aid knowledge, and strengthen children′s transport system.

AIM:To observe the effect of plumbagin on the mRNA and protein expression of nicotinamide ade -nine dinucleotidephosphate oxidase 4 ( Nox4 ) , reactive oxygen species ( ROS ) level and protein expression of α-smooth muscle actin (α-SMA) in the HSC-LX2 cells stimulated with transforming growth factor β1 (TGF-β1) in vitro.METH-ODS:HSC-LX2 cells were cultured in vitro and divided into blank group, model group, high-, medium-and low-dose (2, 1.5 and 1 μmol/L) plumbagin groups .After incubated with each drug for 72 h, the mRNA expression of Nox4 was detec-ted by RT-PCR.ROS levels were tested by in situ loading probe method.The protein contents of Nox4 and α-SMA were measured by Western blot .RESULTS:Compared with model group , after treated with plumbagin for 72 h, the mRNA ex-pression of Nox4, ROS level and α-SMA protein were significantly decreased in high-and medium-dose plumbagin groups (P<0.01).CONCLUSION:Plumbagin inhibits the activation of HSC-LX2 cells via decreasing the expression of Nox4, thus decreasing ROS levels .

An ultra-high performance liquid chromatography-tandem mass spectrometry ( UHPLC-MS/MS ) method was developed and validated for the simultaneous determination of 9 kinds of trace endocrine disrupting chemicals in biological samples using ultrasonic-assisted extraction followed by purification with gel permeation chromatography ( GPC) and silica gel columns. The sample extracts were purified by Bio beads S-X3 GPC columns with cyclohexane/ethyl acetate (1:1, V/V) as mobile phase, and the target compounds were eluted in the fraction of 12-28 mL retention volume. Electrospray ionization source operated in positive mode and atmospheric pressure chemical ionization source operated in negative mode were used for mass spectrometric detection. Data acquisition was carried out in multiple reaction monitoring mode. Recoveries were predominately within 65 . 2%-118 . 0%. Method quantification limits were 0 . 1-9 . 7 ng/g dw ( dry weight ) . This method was successfully applied to the analysis of the target endocrine disrupting chemicals in carps collected from the Pearl River. with the exception of carbanilide and triclocarban, the rest analytes were detected in fish tissue samples, with the concentrations varied within the range of 0. 1-22. 6 ng/g dw.

Objective To discuss the differences of the types of cerebral palsy and the comorbidity between premature and full-term infants. Methods 233 children with cerebral palsy were divided into premature group (n=98) and full-term group (n=125). The types of cerebral palsy and the complications were analyzed. Results The high risk factors were low birth weight, jaundice, asphyxia, intracranial hemorrhage and cord around neck in sequence in the premature group, and were asphyxia, jaundice, fetal distress, intracranial hemorrhage and intrauterine infection in sequence in the full-term group. Besides auditory handicap. The frequency of spastic diplegia was higher in the premature group than in the full-term group (P<0.001), and the incidence of spastic hemiplegia was higher in the full-term group than in the premature group (P<0.01). There was no significant difference in dysgnosia, epilepsy and visual disturbance (P>0.05), but auditory handicap (P<0.05) between 2 groups. Conclusion The main clinical types of premature and full-term children with cerebral palsy were spastic diplegia and spastic hemiplegia respectively. The prevalence of auditory handicap was higher in preterm children

OBJECTIVE:To investigate the risk factors for secondary pulmonary fungal infection in patients with severe craniocerebral trauma after tracheotomy,and to provide reference for clinical prevention and treatment. METHODS:In retrospective study,87 severe craniocerebral trauma patients with secondary pulmonary fungal infection after tracheotomy were selected from Ezhou Municipal Central Hospital(called"our hospital"for short)during Jan. 2014-Jun. 2017 as observation group;87 severe craniocerebral trauma inpatients without secondary pulmonary fungal infection after tracheotomy were selected as control group. The distribution and drug resistance of infected fungal in observation group were analyzed. χ2 test and binary Logistic analysis were adopted to investigate risk factors of secondary pulmonary fungal infection in patients with severe craniocerebral trauma after tracheotomy. RESULTS:Totally 174 clinical specimens were detected in observation group of our hospital;7 kinds of fungus were detected and isolated from 87 strains,and the fungi with high detection rate were Candida albicans(41 strains,47.13%)and Candida glabrata(23 strains,26.44%). The resistance rates of C. albicans and Candida tropicalis to commonly used antifungal agents as fluconazole,itraconazole and fluoncytosine were lower than 20%;resistance rates of C. glabrata to fluconazole,itraconazole and fluoncytosine were more than 25%,to amphotericin B and nystatin were lower than 20%. χ 2test and binary Logistic analysis showed that independent risk factors of secondary pulmonary fungal infection included hypoproteinemia,Glasgow coma score(GCS,<8 points)at admission,serum creatinine clearance(<30 mL/min)at admission,tracheal incision ventilation time(≥7 days),the time of antibiotics use(≥14 days),combined use of antibiotics,the use of carbapenems and systemic glucocorticoid [odd ratios were 3.02,2.98,2.21, 2.05,2.48,2.35,4.74,5.97;95%CI were(1.59,5.74),(1.58,5.63),(1.18,4.41),(1.11,3.78),(1.34,4.59),(1.27,4.34), (2.49,8.35),(3.08,11.49),P<0.05]. CONCLUSIONS:The fungus of secondary pulmonary fungal infection in patients with severe craniocerebral trauma after tracheotomy in our hospital are mainly C. albicans and C. glabrata,which are sensitive to commonly used antifungal agents. Hypoproteinemia,GCS at admission,serum creatinine clearance rate at admission,tracheal incision ventilation time,the time of antibiotics use,combined use of antibiotics,the use of carbapenems and systemic glucocorticoid are independent risk factors of secondary fungal infection in patients with severe craniocerebral trauma after tracheotomy. It is necessary to pay attention to predictive value of above risk factors,improve sensitivity and specificity of diagnosis and treatment. Antifungal agent should be selected rationally according to the results of drug sensitivity test. At the same time,early prophylactic or empirical antifungal treatment should be given in time for high risk patients with above factors.

Objective To explore the effect of rat nerve growth factor combined with early rehabilitation intervention in the treatment of hearing injury caused by cytomegalovirus (CMV) infection.Methods 106 cases of hearing impairment caused by cytomegalovirus infection diagnosed in our hospital from January 2012 to February 2018 were randomly divided into observation group and control group,53 cases in each group.The control group were treated only with ganciclovir and comprehensive rehabilitation therapy,while the treatment group was treated with nerve growth factor on the basis of the control group.Before and after treatment,the children in both groups underwent multi-frequency steady-state evoked potential test,cytomegalovirus antibody DNA fluorescence quantification,and their mothers underwent cytomegalovirus antibody test.The total effective rate of the two groups and the effective rate of the observation group with different degrees of hearing impairment were compared,and the therapeutic effect of the observation group with congenital and acquired CMV infection was compared.Results The total effective rate was 80.7％ in the observation group,which was higher than 65.9％ in the control group (P ＜ 0.05).The effective rate of mild to moderate hearing loss in observation group was higher than that in severe hearing impairment (P ＜0.05).The efficacy of the rat nerve growth factor in the treatment of hearing loss after CMV infection was higher than that of hearing loss caused by congenital cytomegalovirus infection (P ＜ 0.05).Conclusions Rat nerve growth factor combined with early comprehensive rehabilitation intervention is an effective method to treat acoustic nerve injury caused by CMV infection.The effect of rat nerve growth factor on mild and moderate hearing impairment was better than that of severe hearing impairment.The therapeutic effect of acquired CMV infection on hearing damage was better than that of by congenital infection.

OBJECTIVETo survey the quality of life in children and adolescents with type 1 diabetes.

METHODSNinety-eight children and adolescents with type 1 diabetes who participated in Diabetes Summer Camp held in Chongqing, Wuhan and Cheng during 2012 April and December were recruited in the study. The American juvenile diabetes patients quality of life scale Diabetes Quality of Life for Youths was used to assess the quality of life and SPSS19.0 was used for statistical analysis.

RESULTSThe scale had satisfactory reliability and validity with a Cronbach's Alpha score of 0.942 and a validity score of 0.679. All three dimension of scales: scales of impact, scales of worries and scales of satisfaction were significantly correlated with self-health assessment (P<0.01). The scores of impact and worries accounted for >50% of total scores as the same for the self health assessment scores. The score of disease course, diet and blood glucose control were positive correlated with each other. Age and HbA1c were positively correlated with the scale of impact, while gender has negative correlation with satisfaction scale (P<0.05). The diabetes diet had significant effects on the quality of life.

CONCLUSIONThe quality of life in children and adolescents with type 1 diabetes is decreased, especially for those with longer disease course and female adolescents. The form of Diabetes Quality of Life for Youth used in the study has good reliability and validity, which can reflect the quality of life of Chinese diabetic children and adolescents.

Adolescent ; Child ; Diabetes Mellitus, Type 1 ; Female ; Humans ; Male ; Quality of Life ; Sickness Impact Profile ; Surveys and Questionnaires ; Young Adult

Background: A small shift in high-sensitivity cardiac troponin T (hs-cTnT) assays can lead to different result interpretation and consequent patient management. We explored whether a small bias could be detected using conventional internal quality control (QC) procedures, evaluated the performance of moving average (MA)-based QC procedures, and proposed a new QC procedure based on the moving rate (MR) of positive patient results of hs-cTnT assays. Methods: The ability of conventional QC to detect a 5 ng/L bias was examined using the 1 3s/ 22s/R4s multi-rule procedure as deviation rules.We developed MA and MR procedures for the hs-cTnT assay using eight months of patient data. The performance of different MA or MR procedures was investigated by calculating the median number of patient samples affected until a bias introduced into the dataset was detected (MNPed). After comparing the MNPed across different procedures, we selected an optimal MA or MR procedure for validation. Validation graphs were plotted using the minimum, median, and maximum number of results affected until bias detection. Results: Our conventional QC procedures could not detect a positive bias of 5 ng/L. When a positive bias was introduced, MNPed was much higher using MA than using MR, with cut-off values of 5 ng/L and 14 ng/L, respectively. MR validation charts for optimal procedures provided insight into the MR performance. Conclusions The MR procedure could detect different errors with few false alarms. In the hs-cTnT assay, the MR procedure with a smaller cut-off value outperformed MA and conventional QC procedures for small bias detection.