Objective To analyze the clinical characteristics and prognostic factors of endometrial carcinoma in senile women, explore the optimized therapeutic modality. Method The clinic pathological characteristics and survival outcome of 268 patients of endometrial carcinoma in senile women were reviewed retrospectively, and prognostic factors affected the survival of endometrial carcinoma were evaluated. Results According to univariate analysis, therapeutic modality, surgical-pathological classification and pathological grade were closely correlated with prognosis of endometrial carcinoma in senile women(P < 0.01 ). According to COX multivariate analysis,surgical-pathological and pathological grade were independent prognostic associated-factor (P = 0.002,0.000). Conclusions There are closely correlations between prognosis and surgical-pathological classification,therapeutic modality and pathological grade,surgical-pathological classification and pathological grade are independent prognostic associated-factor. The therapy on endometrial carcinoma in senile women should connect with high risk factors and adopt integrating and individual therapeutic modality.

Objective To explore the clinical value of colposcopy directed biopsy in diagnosis of vaginal intraepitheal neoplasia (VaIN).Methods The clinical data of 106 VaIN patients diagnosed by colposcopy directed biopsy were reviewed and analyzed retrospectively.In the past medical history of 106 patients,46 patients had cervical cancer history,43 patients had cervical intraepithehal neoplasia history,13 patients had previous hysterectomy because of benign disease and 4 patients had uncertain past medical history.Results Among 106 patients,97 patients(91.51％,97/106) had abnormal pap smears of vagina,9 patients (8.49％,9/106) had abnormal pap smears of cervix.Histological analysis revealed that 69 patients were VaIN Ⅰ,24 patients were VaIN Ⅱ,13 patients were VaIN Ⅲ.The high-risk human papilloma virus (HPV) test at diagnosis were positive in 98 patients (92.45％,98/106),negative in 8 patients (7.55％,8/106).Eighty-seven patients VaIN were localized in the upper one third of the vagina,19 patients VaIN were localized in other parts of vaginal wall.Ninety-eight patients VaIN affected to the multifocal vaginal wall,8 patients VaIN affected to the focal vaginal wall.Conclusions It has highly therapeutic value of colposcopy directed biopsy in diagnosis of VaIN.But should closely correlated to past medical history,colposcopy should performed on the whole vagina wall and multiple punch biopsy to elevated positive rate.

18 dogs with hemorrhagic shock were divided into 3 groups. Group Ⅰwascontrol, group Ⅱ and Ⅲ were jetted with air or oxygen respectively and continuouslyoutside the glottis by HFJV (frequency 80 beat/min, driving pressure 0.2 MPa, I:E timeratio=1:2) during the uncompensated period. Results: Not much difference was foundbetween group Ⅰand Ⅱ in their blood gas, acid-base balance and plasma malondialdehyde(MDA). However, the P_aO_2, P_aCO_2, CO_2, combining power and plasma MDA in group Ⅲwere markedly higher than those of group Ⅰand group Ⅱ (P

OBJECTIVE:To study the effects of Akt inhibitor MK-2206 on the proliferation and apoptosis of lung adenocarcino-ma A549 cells. METHODS:The optical density of A549 cells was detected by MTT assay after treated with 0(blank control),0.5, 1,2.5,5,10,20 and 30 μmol/L MK-2206 for 24 h;after pretreatment with 0(blank control),5,10 and 20 μmol/L MK-2206 for 24 h,morphological changes of A549 cells were observed with inverted microscope. Cell cycle and apoptosis rate were analyzed by flow cytometry. Western blot was used to detect the expression of cell cycle-related proteins Cyclin D1,p21 and p27 and apopto-sis-related protein PARP(cf-PARP),cf-caspase-3,Bcl-2 and Bax. RESULTS:Compared with blank control,the optical density of A549 cells decreased,cells shrank and presented vesicular state after treatment of MK-2206;A549 cells arrested in G0/G1 stage, the protein expression of p21 and p27 strengthened while that of Cyclin D1 decreased;the apoptotic rate of cells increased,the ex-pression of cf-PARP,cf-caspase-3 and Bax in cells increased while that of Bcl-2 decreased. All reponse were in concentration-de-pendant manner (P<0.05 or P<0.01). CONCLUSIONS:MK-2206 can inhibit the proliferation of A549 cells,and induce the apoptosis of A549 cells by adjusting the expression of activating caspase-3,down-regulating Bcl-2 and up-regulating Bax.

Background:The incidence of chronic constipation is increasing in recent years,which seriously affects the quality of life of patients. Aims:To investigate the therapeutic efficacy of lactulose combined with Bacillus subtilis and Enterococcus faecium preparation on chronic constipation. Methods:A total of 112 patients with chronic constipation from Jan. 2011 to Jan. 2014 at Emeishan Hospital of TCM were enrolled,and were randomly divided into observation group and control group. Patients in both groups accepted the guidance of diet. In addition,patients in control group were orally administrated with lactulose while patients in observation group were orally administrated with lactulose combined with Bacillus subtilis and Enterococcus faecium preparation. After 4 weeks of treatment,therapeutic efficacy in the two groups was compared,patient assessment of constipation quality of life scale(PAC-QOL)was used to evaluate the quality of life. Results:The overall therapeutic efficacy rate in observation group was significantly higher than that in control group (98. 2% vs. 72. 2% ;χ2 = 12. 399,P < 0. 05). Score of every factor and the total score of PAC-QOL were significantly lower after treatment than those before treatment in both groups(P < 0. 05),while physical discomfort score and the total score in observation group were significantly lower than those in control group( P < 0. 05). Conclusions:Lactulose combined with Bacillus subtilis and Enterococcus faecium preparation can effectively improve the symptoms of difficulty in defecation,hard stool,and improve the quality of life in patients with chronic constipation.

Objective To study the percentage and cause of new seizure types in epilepsy patients and attempt to evaluate the value of new seizure types.Methods All 1074 eapilepsy patients were envolled in the retrospectively study.The types of seizure were diagnosed according to International League Against Epilepsy seizure classification and neuroimaging results of the patients.The Wilcoxon signed rank sum test was used to assess the difference of age at first seizure and mean duration of epilepsy patients with and without new seizure types.The chi-square test was used to compare the abnormal proportion of EEG and neuroimaging results of epilepsy patients.Results Two hundred and thirty-one(21.5%)of 1074 epilepsy patients experienced new seizure type.Five hundred and eighty-four patients had partial seizure with 132 (22.6%)experiencing new types of seizure while 490 patients had generalized seizure with 99(20.2%)experiencing new types of seizure.Five hundred and seventy-six(53.6%)had abnormal EEG and 237 (22.1%)had abnormal neuroimaging in 1074 epilepsy patients.A hundred and twenty-three(52.3%)of 231 patients with new seizure types had abnormal EEG,and 75(32.5%)of them had abnormal neuroimaging. The possible causes for the new types of seizure could be found in 41 patients.There were no significant difference in the age of the first onset between the patients with and without the new types of seizure while there was significant difference in the average course of disease between them(χ~2=18.511-23.836.P＜0.05).There were significant differences in the rates of abnormal results of examination of nervous system and imaging outcomes.Conclusions There may be different causes of new seizure types.The study of new seizure types is helpful in diagnosis,treatment and prevention of epilepsy.

Objective Tostudy the effects ofRheu compositus (Dachengqi Decoction, DD) on the NF-κBactivity of alveolar macrophages in ARDS rats and its inflammatory cytokine expression, and hence to explore the molecular mechanism of the anti-inflammatory effects of DD. Method The 65 male Wistar rats were randomly di-vided into the control group (n = 12), the ARDS model group (n = 21), the DD treatment group (n = 16) and the dexamethasone treatment group (n = 16). The rots of model group received 1 mg/(kg·0.5 mL) LPS injected intra-poritoneally and LPS in dose of 5 mg/(kg·0. 5 mL) was administrated by slow dropping endotracbeally 16 hours later. Modeling was successfully established 6 hours later evidenced by arterial gas analysis. The rats of con-trol group received 0.5 mL normal saline injected intravenously through tail vein instead of LPS. Three days after establishment of modeling, DD was given to rats of DD treatment group by intragastric instillation for 3 days in dose of 2.31 g/(kg·d),in which the weight of drug was calculated on the basis of dried herbal medicine. In dexam-ethasone treatment group, rats had intra-peritoneal injection of 2 mg/kg dexamethasone for 3 days after modeling was established. Seventy-two hours later, the arterial blood gas analysis and pathological study were carried out, in rats of all groups, and the findings were graded. The levels of TNF-α, IL-1 and IL-10 both in the plasma and in the brenchoalveolar lavage fluid were determined by using the enzyme linked immunosorbent assay (ELISA). Besides the nucleopretein concentration of pulmonary alveolar macrophage (PAM) was maeasuredwith the BAC method, and the NF-κB activity was determined with the Western Blotting, and with the evaluation of the DD' s effect on the transcription activity of PAM inflammatory cytokines. All the experimental data were processed by the SPSS 13.0 for statistical analysis. The analysis of variance was used for the comparison between groups, and P < 0. 05 showed the statistical significance of the difference. Results DD didn' t significantly reduce the TNF-α level [(510.97±76.20) pg/mL,(476.16±98.03) pg/mL, P >0.05], but significantly deceased the plasma IL-1 level [(381.99±34.30) pg/mL, (300.69 ± 50.99) pg/mL, P <0.05]. At the same time, there was no signif-icant changes in the plasma IL-10 level [(345.96 ± 67.72) pg/mL, (345.30 ± 78.52) pg/mL, P > 0.05]. Whereas TNF-α level in BALF was significantly decreased [(130.94 ± 33.51) pg/mL, (106.59 ± 26.64) pg/ mL, P < 0. 05, so was the IL-1 level in BALF (82.5 ± 25.36) pg/mL, (63.89 ± 22.96) pg/mL, P < 0. 05], but IL-10 level in the BALF was significantly increased[(77.09 ± 26.05) pg/mL, (148.05 ± 53.50) pg/mL, P <0.01]. DD significantly reduced the nueleoprotein level of PAM[(5.35 ± 2.44) μg/μL, (3.54 ± 2.01) μg/ μL, P < 0.05]and significantly inhibited the NF-κB activity [electrophoretic band optical density × area/consult mtio:(1.45±0.71),(1.11±0.28), P <0.05]aswell. Conclusions DD regulated systemic pro-inflammato-ry media/anti-inflammatory media balance in rats with ARDS by mainly reducing the level of IL-1. The regulatory effects of DD on the local lung injury not only inhibit the producing of TNF-α and IL-1 level,but also increase the IL-10 level to reestablish the local pro-inflammatory factors/anti-inflammatory factors balance so as to inhibit the lo-cal excessive irranune response. DD inhibits the NF-κB activity in the PAM of ARDS rats so as to restrain the pro-duction of pro-inflammatory cytokines (TNF-α and IL-1). This kind of multi-target bidirectional regulation plays an active role in regulating the immune balance and protecting the target organ from the excessive injury.

Objective　To explore the possibility of R plasmid (pRST98) encoding resistance to antimicrobial agents in S. typhi mediate virulence to its host bacteria. Methods　pRST98 was transferred into a less virulent strain of S. typhimurium RIA for creating a transconjugant pRST98/RIA. The standard S. typhimurium virulence strain SR-11 which carries a 100kb virulence plasmid was used as a positive control, and RIA as a negative one. Infection with S. typhimurium was employed to assess the effect of pRST98 on the virulence of host bacteria by LD50 of peroral (p.o.) and intraperitoneal (i.p.) infection of BALB/c mice. After oral inoculation of the bacteria into BALB/c mice, mesenteric lymph nodes, spleen and liver were examined for quantity of bacteria and for the histopathological changes. The three strains were also studied for their in vitro adhesion and invasion of HEp-2, CHO and HeLa cells. Three chromosomally isogenic strains, i.e., plasmid-containing wild-type S. typhi strain, plasmid artificially cured strain and plasmid-reintroduced into the cured strain were compared for their resistance to the bactericidal activity present in human, rabbit and guinea pig sera. Results　The p.o. and i.p. LD50 of pRST98/RIA was 700 and 75 folds less than that of RIA. The bacteria counting in mesenteric lymph nodes, spleen and liver were more (P<0.05) and more severe histopathological changes were observed in pRST98 harboring S. typhimurium. However, pRST98 did not affect the adhesion and invasion of S. typhimurium to the cells. Experiments showed that pRST98 mediated resistance to serum bactericidal effect in host bacteria (P<0.05). Conclusion　This is the first report about a plasmid carrying genes coding for drug resistance and virulence in S. typhi. The data presented here suggested that novel virulence gene or related sequences, which are important in the pathogenesis of Salmonella infection could exist on pRST98.

Objective To evaluate neuropsychiatric adverse effects of cycloserine therapy for multidrug resistant pulmonary tuberculosis (MDR-TB).Methods A total of 82 patients with MDR-TB who were enrolled in Global Fund Round Five MDR-TB Control Program were admitted in Center for Diagnosis and Treatment of Tuberculosis,Hangzhou Red Cross Hospital from May to December 2012.All patients received the standard treatment containing cycloserine for MDR-TB.The adverse reactions during the treatment were recorded,and symptom checklist-90 (SCL-90) scores at different time points were compared with t test.Results Adverse reactions were observed in 66 patients (66/82,80.5％) within 3 months after the initial treatment.Common adverse reactions included arthralgia (42.7％),gastrointestinal reactions (40.2％),central nervous system symptoms (22.0％) and electrolytes disturbance (17.1％).Nine patients had severe neuropsychiatric symptoms characterized by convulsions,depression,anxiety,schizophrenia and attempting suicide,6 of whom had used fluoroquinolones before the study.The above symptoms were relieved after stopping cycloserine or antitubercular agents,and cycloserine was replaced in the following treatment.The total SCL-90 score,depression and anxiety scores were significantly higher during onset of symptoms than those one month after the following treatment (t =2.241,2.301 and 5.659,P ＜ 0.05).Conclusion Cycloserine may induce severe neuropsychiatric adverse reactions in patients receiving standard treatment for MDR-TB.