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.

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.

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 assess whether treatment with compound danshen tablets plus alendronate would be safe and effective in women with postmenopausal osteoporosis. Methods 180 women with postmenopausal osteoporosis were randomized to receive combination therapy and independent therapy with compound danshen tablets and alendronate for 6 months. Scores of VRS were assessed,mean serum alkaline phosphatase, serum osteocalcin, urinary creatinine, urinary hydroxyproline, urinary calcium were detected. Bone mineral density of lumbar vertebra 1 ~5 was determined by dual X - ray absorptiometry. Results Mean serum alkaline phosphatase, serum osteocalcin, and urinary creatinine, urinary hydroxyproline, urinary calcium were statistically different between the combination therapy group and the independent therapy group, and bone mineral densities increased in all therapy groups while there was higher elevated level in the combination therapy group. Conclusions The combination therapy of compound danshen tablets with alendronate has a favorable influence on women with postmenopausal osteoporosis.

Objective To estimate direct economic burden of patients with moderate to severe psoriasis in China,and to assess its influencing factors.Methods A questionnaire survey was carried out in 150 patients with moderate to severe psoriasis from 29 third-grade class-A hospitals in 7 cities.Data on demographic characteristics,clinical features and direct economic burden were collected.Descriptive statistics were performed to analyze the direct economic burden of moderate to severe psoriasis,and multiple regression analysis was carried out to determine predictors of cost of illness.Results The patients were aged (43.87 ± 13.42) years,with an average clinical course of 3 years(range,2-6 years).Of them,82 had moderate psoriasis,and 68 had severe psoriasis.The average direct cost was (6 452 ± 6 391)RMB per patient-year,with significant difference between the patients with moderate psoriasis and those with severe psoriasis ((4 163 ± 4 605) vs.(9 212 ± 7 146) RMB,z =5.70,P ＜ 0.001).Regression analysis indicated that disease severity,clinical type,hospitalization,complications,and inhabited cities were factors influencing the direct economic burden of patients with moderate to severe psoriasis.Conclusions The direct eonomic burden of severe psoriasis seems to be twice that of moderate psoriasis in China.Physicians should strengthen the control of complications and disease severity,and pay more attention to other types of psoriasis than psoriasis vulgaris,during the treatment of psoriasis.

Objective To assess the prevalence and related factors of postpartum depression in mothers of preterm infants in neonatal intensive care unit (NICU).Methods A total of 83 mothers who met the inclusion and exclusion criteria were investigated by using Edinburgh Postnatal Depression Scale (EPDS) and the comprehensive questionnaire for mothers of preterm infants in NICU,and the analysis was performed on SPSS 13.0 using the Spearman correlation analysis and Logistic regression analysis.Results Among the 83 mothers,38 got the EPDS score of 10 and above,which accounted for 45.78％ (38/83).The disease severity (OR =3.318,P ＜ 0.01),the worry about disease prognosis (OR =4.348,P ＜0.01),the worry about mental development of the newborn (OR =5.420,P ＜ 0.01) were the risk factors for postpartum depression in mothers of preterm infants in NICU.Conclusions It's different from the correlation to postpartum depression in mothers of full-term newborns,the correlation to postpartum depression in mothers of preterm infants in NICU are closely related to premature and admission in NICU.The mothers of preterm infants in NICU are the high-risk population for postpartum depression.Routine screening mechanism for mothers of preterm infants should be established for early detection and treatment of postpartum depression,and to promote maternal and infant health.

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.