This article introduces the experience of CHEN Ying-yi, chief physician and one of the teacher of the fourth group of inheriting academic experience of veteran TCM experts of China, in treating perimenopausal women’s dysfunctional uterine bleeding. Chen holds that the basic pathogenesis of perimenopausal dysfunctional uterine bleeding is kidney deficiency with fever or stagnation. Treatment should focus on replenishing kidney and using the traditional Chinese drug by stages. The methods of stopping bleeding, clearing origin and reinstating the status quo are used flexibly. In clinic, it should grasp the key points of syndrome differentiation, and modify the therapy in accordance with the symptoms. Validated by clinical application, Chen’s experience has satisfactory curative effect and reference values for the treatment of perimenopausal women’s dysfunctional uterine bleeding.

Purpose To investigate the influence of paraquat on substantial nigra and doparine levels ofstriatum in C57BL mice. Methods 39 neonatal C57BL mice were randomly divided into 5 groups andwere given paraquat or 1-methyl-4-phenyl-1,2,3,6-tetra-hydropyridine(MPTP) orally in 10 th and 11 thdays odl; ( 1 ) MPTP 0.3 mg/kg, n = 8; (2) MPTP 20 mg/kg, n = 8; (3) paraquat 0.07 mg/kg, n = 8; ( 4 )paraquat 0.36 mg/kg, n = 8; (5) normal saline, n = 7. Adult spontaneous motor activity was observed atages of 120 days, then the mice were decapitated and the contents of dopamine(DA), serotonin(5-HT), andtheir metabolites in striatum were analyzed. Meanwhile, the dopamine neuons at the mesencephalon vereobserved by the method of ABC immunohistochemistry. Results Mice given Paraquat 0.36 mg/kg andMPTP 20 rng/kg showed a marked bypoactive behavior and reduced the striatal contents of DA andmetabolites without affecting 5-HT. Immunohistochemical staining showed that the amount of dopamineneurons at the midbrain decreased. Conclusions C57BL mice exposed to great amount of paraquat duringthe neonatal period could yield the alterations of behavior and some pathological and biochemical changessimilar to parkinson disease.

Objective To evaluate the prevalence and risk factors of human papillomaviruses (HPV)infection among human immunodeficiency virus(HIV)-positive women.Methods Totally 178HIV-positive and 122 HIV-negative women were enrolled.Structured interviews,peripheral CD4 + T cells counts and cervical specimens were obtained.Polymerase chain reaction(PCR)assay was used to identify HPV types. SPSS 16.0 was used for statistical analysis,and logistic regression was used to identify independent prognostic factors for high-risk HPV infection. Results HPV positive rate,high-risk and multiple HPV infection rates were 38.2% vs.12.3% ,35.4% vs.8.2% ,and 13.5% vs.3.3% in HIVpositive women and HIV-negative women,respectively,and the differences were of statistical significance (x2 =24.77,29.08 and 8.91,P ＜0.05).The common types of high-risk HPV were similar between HIV-positive and HIV-negative women(HPV16,52,58 and 18).CD4 + T count ＜ 350/pL,HIV-positive in husband,and HIV infection through sexual contact were risk factors for high-risk HPV infection in HIV-positive women.Conclusion sThe prevalence of HPV infection in HIV-infected women is high,especially for high-risk HPV infection and multiple infection.High-risk HPV infection usually occurs in HIV-positive women with low immune status,HIV infection through sexual contact and HIV-positive husband.

Objective To investigate the effects of recombinant tissue plasminogen activator (rt-PA)intravenous thrombolysis on blood-brain barrier (BBB) permeability,the expressions and the activities of MMP-2 and MMP-9 after cerebral ischemia in rats.Methods A total of 40 adult male Sprague-Dawley rats were allocated into 3 groups:Sham operation group (n =10),middle cerebral artery occlusion (MCAO) group (n =18),and rt-PA thrombolysis group (n =18).A MCAO model was established by using autologous thromboembolism.The sham operation group did not inject any thromboembolus,the MCAO group only made MCAO,and the rt-PA thrombolysis group received intravenous thrombolysis with rt-PA at 3 hours after MCAO.Brain infarct volume was determined by 2,3,5-triphenyl tetrazolium chloride staining BBB permeability was measured by Evans blue dye leakage.The activities and the expressions of MMP-2 and MMP-9 in brain tissue were detected by Gelatin zymography and Western blot,respectively.Results Compared to the MCAO group,the neurological function was improved significantly in the rt-PA thrombolysis group,and the infarct volume was also reduced significantly (t =7.365,P =0.005).However,the hemorrhage score (t =-3.286,P =0.017) and BBB permeability (t =-3.947,P =0.029) were increased significantly.The activities and the expressions of MMP-2 and MMP-9 in the sham operation group were lower.The activities and the expressions of MMP-2 (t =-45.121,P =0.000; t =-11.624,P=0.000) and MMP-9 (t=-71.849,P=0.000; t=-8.992,P=0.000) in the MCAO group were increased and upregulated significantly.Compared to the MCAO group,the activities and the expressions of MMP-2 (t =-28.792,P =0.000; t =-3.809,P =0.013) and MMP-9 (t =-53.506,P =0.000; t =-2.640,P =0.046) in the rt-PA thrombolysis group were increased and upregulated significantly.Conclusions After rt-PA intravenous thrombolytic therapy,the BBB permeability was increased.The activities and the expressions of MMP-2 and MMP-9 were increased and upregulated.MMP-2 and MMP-9 might participate in the increased BBB permeability,and thus inducing hemorrhagic transformation after rt-PA intravenous thrombolytic therapy in rats with cerebral ischemia.

Objective To characterize the clinical features and assess the role of surgery in posterior cortex epilepsy. Methods A retrospective analysis of clinical data was performed in 43 patients with posterior cortex epilepsy. The diagnosis Was established by means of a standard presurgical evaluation, including ictal semiology, MRI, interictal and ictal scalp video-EEG, and additional intracranial EEG monitoring in selected cases. Results The 43 patients included 11 parietal lobe epilepsy, 13 occipital lobe epilepsy, and 19 patients with seizures originating from other part of posterior cortex. Thirty-three patients (76.7%)experienced at least one type of aura, such as visual aura, somatosensory aura, dizziness and so on. The common ictal manifestations included deviation, automatisms, tonic posture and so on. Intracranial EEG monitoring was preformed in 22 selected cases. Transient contralateral hemiparesis occurred in 2 patients, mixed aphasia in 1 patient, and they recovered in 3 weeks after surgery. Visual and visual field deficits were observed in 5 patients, and they did not fully recovered. All patients were followed-up 1 to 5 years, and 27(62.8%)became seizure free (Engel' S I class). Conclusions Some of the specific auras or ictal manifestations may indicate posterior cortex epilepsy. Favorable surgical outcome has been achieved in many of the patients.

BACKGROUND:Vertebroplasty and kyphoplasty have been widely applied in the treatment of osteoporotic thoracolumbar compression fracture. However, cement leakage is a major problem in the application of this technology, especial y for the vertebral posterior wal ruptured patients. OBJECTIVE:To investigate the therapeutic efficacy of high viscosity bone cement and vertebroplasty in the treatment of osteoporotic thoracolumbar compression fracture. METHODS:A retrospective study was conducted in 20 cases receiving high viscosity bone cement and vertebroplasty surgery for osteoporotic thoracolumbar compression fracture. Clinical outcomes were evaluated mainly with use of Visual Analog Scale for lower back pain. Function of lower back pain was assessed using Oswestry Disability Index questionnaire. Quality of life was evaluated using 36-Item Short Form Health Survey and Frankel score was applied to evaluate neurological function. The anterior vertebral height of the fractured vertebrae was assessed with X-ray. The bone cement leakage, pulmonary embolism, incidence of nearby vertebral fractures and other complications were evaluated during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-18 months. The anterior vertebral height of the fractured vertebrae, the lower back pain and function, and quality of life were improved significantly after treatment (P<0.05). Al patients got the same neurological symptoms before surgery. The bone cement dispersion was good after treatment, detected by X-ray and CT scan, only two cases appeared with bone cement leakage, but no clinical symptoms were found. There was no cement toxicity or al ergic complications, pulmonary embolism, infection, nerve injury or new fractures. The high viscosity bone cement used in the treatment of osteoporotic thoracolumbar vertebral compression fractures can significantly relieve thoracic back pain, improve lower back function and quality of life, and greatly reduce the risk of bone cement leakage.

Objective To investigate serum DJ-1 expression and its significance in ovarian cancer. Methods The expression levels of DJ-1 protein were detected by double antibody sandwich method in 52 cases of ovarian tumors (9 cases of benign ovarian tumors, 5 cases of borderline ovarian tumors and 38 cases of ovarian cancer,ovarian tumor group and 20 non-ovarian tumors (control group). Results The expression of DJ-1 protein was lower in the control group than that in ovarian tumor group (P<0.05). The expression of serum DJ-1 protein was higher in ovarian cancer than that in borderline ovarian tumors and in benign ovarian tumors. The expression of serum DJ-1 protein was higher in borderline ovarian tumors than that in benign ovarian tumors (P<0.05).The expression of serum DJ-1 protein was higher in poorly differentiated and moderately differentiated ovarian cancer than that in high-grade differentiated ovarian cancer (P<0.05). No significant dif-ference was found in the expression serum of DJ-1 protein between different pathological and different histological types of ovarian cancer (P>0.05). Conclusion DJ-1 might be used as a serum marker in the diagnosis of ovarian cancer. It might be involved in the pathogenesis of ovarian cancer,and could predit the development and prognosis of ovarian cancer.

Objective To investigate prevalence HPV infections in cervix among HIV-infected Chinese women.Methods From September 2009 to May 2011,293 women with positive HIV underwent cervical cancer screening as study group matched with 200 women with negative HIV as control group.Questionnaires including demographic information and HIV associated information were collected,Pap smear and 23 subtype of HPV were performed in those women.The women with positive HPV were followed up per 6 months,and the period of following up were more than 12 months.Binary logistic analysis was used for high risk factors of HPV persistent infection.Results Prevalent HPV infection was 44.4％ (130/293) in study group and 20.0％ (40/200) in control group,respectively,which reached statistical difference( P ＜0.05).The most common genotype of HPV was HPV 16,which prevalence was 13.7％ (40/293)in study group and 7.0％ (14/200) in control group.The other HPV subtype prevalence was HPV-58,HPV-52,HPV- 43 and HPV-18,which was 9.2％ (27/293),8.2％ (24/293),8.2％ (24/293),6.8％ (20/293) in study group and 3.0％ (6/200),2.5％ (5/200),1.5％ (3/200),2.5％ (5/200) in control group.At time point of 12 months following up,the persistent prevalence of HPV was 47.5％ (48/101) in study group and 21.1％ (8/38) in control group,which reached statistical difference (P＜0.05).Multiple HPV infections ( OR =6.4,95 ％ CI:1.6 - 25.6),abnormal cytology ( OR =18.1,95 ％ CI:4.5 - 76.9 ) and lower CD4 T cell count (compaed with CD4 ＞3.5 × 108/L,if 2.0 × 108 ≤CD4 ≤3.5 × 108,OR =8.1,95％ CI:1.3 -56.3 ; if CD ＜ 2.0 × 108/L,OR =9.1,95％ CI:1.8 - 46.9 ) were independently associated with HPV persistence among HIV-positive subjects.Conclusions Prevalence and persistence of HPV infections were more common among HIV-positive Chinese women than those in HIV-negative Chinese women.Improving immune function,decreasing multiple HPV infections,treating abnormal cervical cytology could decrease prevalence of HPV infection.

Objective To establish and validate a modified rat thromboembolic stroke model.Methods After taking femoral arterial blood and mixing it with thrombin,they were injected into PE-50 catheter for preparing in vitro thrombosis in 60 Sprague-Dawley rats.A thromboembolic cerebral ischemia model induced by catheterization of the right external carotid artery and the small blood clot emboli were injected into the internal carotid arteries.Thirty rats were randomly divided into a large number of emboli group (n =10 with 12 emboli),a median number of emboli group (n =10 with 10 emboli) and a small number of emboli group (n =10 with 8 emboli).Two hours after embolus injection,the neurological deficit score was performed and the success rate of the model was compared in all groups.Twenty-four hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage,infarct volume,bleeding incidence and mortality after cerebral infarction were evaluated.The high success rates of the modeling in the emboli groups were selected and they were randomly divided into either a normal saline group (n =12) or a recombinant tissue-type plasminogen activator (rtPA) group (n =12).The rats were given normal saline and rtPA at 3 hours after embolus injection.Before embolus injection and 2,6,12 and 24 hours after embolus injection,the neurological scores were performed respectively; 24 hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage rate,infarction size,degree of cerebral edema,and blood-brain barrier permeability were evaluated.Results Only 40％ of rats had neurological deficits in the small number of emboli group,and the infarct volume was only 10.54 ± 2.82％.The success rates in the median and large number of emboli groups were 80％ and 100％ respectively.They were all significantly higher than those in the small number of emboli group (P =0.011 ).The infarct volume was also significantly greater than that in the small number of emboli group (F =40.897,P =0.000).After administration of rtPA,the mean survival time of the rats in the large number of emboli group was less than 24 hours,so the median number of emboli group was selected to study the thrombolytic effect of rtPA.The infarct volume and neurological function score in the rtPA group were improved significantly compared to the normal saline group (t =7.728,P =0.000),while there were no significant differences in the hemorrhage rate,degree of brain edema and blood-brain barrier permeability between the 2 groups.Conclusions The stability and reproducibility were good in the modified thromboembolic cerebral ischemia model injected with 10 emboli,the neurological function was improved significantly after thrombolysis,and it was applicable to the experimental study of pathophysiology of cerebral ischemia and thrombolytic therapy.