Objective-To-investigate-surgical-skills-and-safety-of-laparoscopic-hysterectomy-procedure-for-enlarged-uterus-in-woman-with-adenomyosis-.-Methods-Fourteen-cases-of-adenomyosis-with-uterus-larger-than-twelve-week-pregnancy-accepted-laparoscopic-hysterectomy-form-December-2012-to-December-2013-in-our-hospital-.-Some-operating-techniques-,-including-the-management-of-uterine-vessels-and-separation-of-cardinal-ligament-and-uterosacral-ligament-,-were-modified-.-Results-The-operation-was-performed-successfully-under-laparoscopy-in-all-the-cases-.No-conversion-to-open-surgery-was-required-.No-operating-complication-happened.The-operating-time-was-(160.7-±66.1)-min,-and-the-intraoperative-blood-loss-was-(184.3-±50.5)-ml.-Conclusion-Modified-laparoscopic-techniques-should-be-considered-as-an-acceptable-alternative-in-hysterectomy-for-the-management-of-large-uterus-in-woman-with-adenomyosis-.

Thirty-six healthy women were divided into 3 groups according to their calcium intake at week 18 of gestation. The levels of their blood calcium, phosphate, parathyroid hormone (PTH) and calcitonin were assayed during pregnancy and postpartum, and bone mineral density ( BMD) was measured postpartum. The levels of PHI and calcitonin were increasing with advancing pregnancy and reached the highest at the end of pregnancy. The women with higher calcium intake during pregnancy period had higher BMD than that of the women with ordinary diet during pregnancy period.

Objective To explore the role of Th17-and Treg-derived catecholamines during collagen-induced ar?thritis (CIA) progression. Methods Eighteen male DBA/1 mice were randomly divided into control group, CIA model groupⅠ(day 35) and CIA model groupⅡ(day 55). The CIA models were induced by typeⅡcollagen (CⅡ) injection from tails. mRNA expression of Th17 specific transcription factor include ROR-γt, cytokines, IL-17 IL-22, Treg specific transcription factor, Foxp3, cytokines, TGF-βand tyrosine hydroxylase (TH) in lymph nodes were examined by real-time PCR. Co-local?ization of ROR-γt or Foxp3, with TH, vesicular monoamine transporter-2 (VMAT-2) or monoamine oxidase (MAO) in lymph nodes were observed by immunofluorescence staining. Results In lymph nodes of mice in CIAⅠgroup and CIAⅡgroup, mRNA expression of ROR-γt, IL-17, TH and IL-22 were upregulated, while mRNA expression of Foxp3 and TGF-βex?pression was downregulated compared to those expression in control group. The upregulated expression of IL-17 was signifi?cantly reduced in CIAⅡgroup compared with that in CIAⅠgroup. In the lymph nodes of both intact and CIA mice, co-lo?calization of ROR-γt or Foxp3 with TH, VMAT-2 or MAO was seen in some cells. The numbers of cells that are double-pos?itive of ROR-γt/TH,ROR-γt/VMAT-2 and ROR-γt/MAO IL-17 were increased in CIA groups compared to those in con?trol group. And they are significantly reduced in CIAⅡgroup compared with those in CIAⅠgroup. Conclusion The abili?ty to synthesize catecholamines in Th17 cells was increased in lymph node in mice from CIA groups compared to that in con?trol group. The increased catecholamines production from Th17 cells in lymph nodes may be involved in the anti-inflammato?ry progression in CIA.

Objective To study the application value of the combined detection of serum HE4 ,CAl25 ,CA72‐4 and IL‐6 in the di‐agnosis of ovarian malignant tumor .Methods The serum levels of CA125 and CA72‐4 were determined by ECLI ,and the serum levels of HE4 and IL‐6 were determined by ELISA in 32 patients with ovarian cancer ,56 patients with benign ovarian disease and 40 healthy controls .The detection results were performed the statistical analysis .Results The serum levels of HE4 ,CAl25 ,CA72‐4 and IL‐6 in the ovarian cancer group were significantly higher than those in the other two groups with statistically significant differ‐ences(P< 0 .01) ;the sensitivity of CA125 detection in the single index detections was highest(75 .0% ) ,the specificity of HE4 was highest(83 .9% ) ,the highest diagnostic efficiency of single index detection was 79 .5% .The sensitivity ,specificity and efficiency of the combined detection for diagnosis were 96 .9% ,71 .4% and 80 .7% .Except the specificity ,the sensitivity and diagnostic efficien‐cy of the combined detection were higher than those of any one of single index detection .Conclusion The combined detection of se‐rum HE4 ,CAl25 ,CA72‐4 and IL‐6 could increase the diagnostic efficiency of ovarian cancer and conduces to the diagnosis and help to the diagnosis and differential diagnosis of ovarian malignancies .

Objective To explore changes of expression of pro-and anti-inflammatory cytokines in the hippocam-pus of Aβ1-42-induced Alzheimer’s disease (AD) rat model. Methods Twenty-four SD rats were divided into control group, PBS group (PBS was injected into CA1 area of hippocampus) and AD model group (Aβ1-42 was injected into CA1 area of hip-pocampus). The escape latency was evaluated by Morris water maze in three groups. Nissl staining was used to detect the le-sions of hippocampal CA1 neurons. Levels of amyloid precursor protein (APP) and protein phosphatase 2A (PP2A) in hippo-campus were measured by Western blot analysis. Real-time PCR was employed to examine the expressions of pro-inflamma-tory cytokines, including interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ), and the mRNA expressions of anti-inflammatory cytokines, including IL-4, IL-10 and transforming growth factor-β(TGF-β). Re-sults Rats subjected to Aβ1-42 injection in bilateral hippocampus led to a ability reduction of learning and memory, a loss of neurons in hippocampus and an increase in the expression of APP, and a decrease in PP2A expression in the hippocampus. In AD hippocampus, The mRNA expressions of the pro-inflammatory mediator, IL-1β, TNF-αand IFN-γ, were significant-ly up-regulated, but the expressions of the anti-inflammatory cytokines, IL-4, IL-10 and TGF-β, were markedly down-reg-ulated in AD group compared with those of control and PBS groups. Conclusion The pro-inflammatory/anti-inflammatory imbalance induced neuro-inflammation in AD rats, which was involved in pathogenesis of AD.

Objective To study the proteins related to aging in aortic of old rats for laying the foundation of further study of aging mechanism.Methods The rat model of aging was built,and all model rats were divided into 4 groups:the adult group(9 weeks),the old group(12 months)of WistarKyoto (WKY) rats,and the age-matched spontaneously hypertensive rats (SHR).Blood pressure of 4 groups was observed.Morphological change of aorta was observed by HE staining.Differential proteins were identified by isobaric tags for relative and absolute quantitation,(iTRAQ)-coupled liquid chromatography and tandem mass spectrometry technology.Part of differential proteins was subsequently detected by real time PCR and Western blot.Results The mean SBP of the old group SHR was higher than WKY of 97.1％ (t=39.00,P＜0.05),and the adult group of SHR was also higher than WKY of 5.4％(t=3.64,P＜0.05).Compared with the adult group,aging change in the aortic morphology of old SHR and WKY were shown in HE staining,and the change in SHR rats was more marked.7 proteins related to aging were identified by Mass spectrum analysis,and they were Profilin-1,Prelamin A,HSP70,creatine kinase-M,Fibulin-5,eIF5A and Prohibitin.Part of differential proteins was subsequently confirmed by real time PCR and Western blot.Prelamin-A was up-regulated in the old group of WKY and SHR (0.15±0.01 vs.0.45±0.04,0.34±0.02 vs.0.78±0.06) (t=12.67,12.06,all P＜0.01),Prohibitin was down-regulated in the old group of WKY and SHR(1.34±0.05 vs.1.01± 0.06,1.24±0.05 vs.0.88±0.08) (t=7.41,7.09,all P＜0.01).Profilin-1 was up-regulated in the old group of WKY and SHR (9.12±0.4 vs.20.76±0.8,16.84±0.5 vs.55.16±0.9) (t=22.55,64.46,both P＜0.01),and Profilin-1 expression in the old group of SHR was higher thanWKY (55.16±0.90 vs.20.76±0.8,t=49.49,P＜0.01).Conclusions Differential proteins of the old rat aorta are identified through the comparative proteomics method.These differential proteins will provide new targets for the prevention and control of vascular aging.

Objective To summarize the clinical features of bee sting caused aute kidney injury in children and the effect of he-modialysis therapy .Methods 60 children cases of bee sting caused acute renal injury were performed the retrospective analysis on the clinical features and laboratory data .Results Cystatin C ,serum creatinine ,blood urea nitrogen in children patients with acute kidney injury after hemodialysis were significantly decreased ,while procalcitonin ,high-sensitivity C-reactive protein ,acidosis and e-lectrolyte imbalance also were corrected or improved .After hemodialysis in 60 children cases ,45 cases were clinically cured ,13 cases were significantly improved and discharged and 2 cases died .Conclusion Bee sting is most likely to result in children acute renal in-jury .Hemodialysis is safe and effective treatment measures for acute kidney injury ,can actively improve the renal function without significant complications of acid-base balance and electrolyte imbalance .But the prognosis is closely related with the onset age of the aute kidney injury ,injury severity ,where or not accompanied by MOF ,opportunity of diagnose and treatment ,etc .

Objective The aim of this phase Ⅱ study was to determine the efficacy and safety of combined bortezomib and thalidomide (VT) regime as initial treatment for newly diagnosed multiple myeloma (MM) in China. Methods Thirty-four patients were enrolled in this study and received VT regime up to 21-day cycles. Bortezomib (1.3 mg/m2) was administered intravenously on days 1, 4, 8, and 11, while oral thalidomide ( 100 mg/day) was given from days 1 to 21. The primary end point was clinical response.The secondary end point was safety. Results Among the 34 patients, 20 were male, 14 were female, with a median age of 59 years, and 15 in international stage system (ISS) Ⅲ ,18 in ISS Ⅱ , 1 in ISS Ⅰ . Among them, 28 completed 2 cycles' treatment and achieved an overall response rate (ORR) of 92.9%; 26 were able to complete the planned 8 cycles of therapy. After 8 cycles, the ORR was 100% ( complete response 30. 8%, near-complete response 23.1%, partial response 42. 3%, minimal response 3.8% ). After followed up with a median time of 12 months, the estimated rate without progress of disease was 62%, and the estimated continous remission rate of 12 months was 62%. The median survival time was not achieved. The most common adverse events were mild to moderate ( grades 1, 2). The main toxicities were hematologic (53. 3% ), gastrointestinal ( 40. 0% ), peripheral neuropathy ( 38.0% ), fatigue ( 36. 6% ) and fever (32. 0% ). Conclusions VT regime provides a very high ORR and complete response rate in the treatment of newly diagnosed MM patients. No patients experienced deep venous thrombosis. In conclusion,bortezomib in combination with thalidomide is a very effective regimen for newly diagnosed MM patients and the toxicities are manageable.

Objective To assess the efficacy of triple therapy including proton pump inhibitor (PPI), levofloxacin and amoxicillin for the first-line treatment of H. pylori infection, and the relation between H. pylori eradication and CYP2C19 genetic polymorphism. Methods Two hundred and five H. pylori-positive patients were divided into group E_(20) (esomeprazole 20 mg twice daily), group E_(40)(esomeprazote 40 mg twice daily),group R (rabeprazole 10 mg twice daily) and group L (lansoprazole 30 mg twice daily). Besides PPI, all patients were received levofloxacin 500 mg daily and amoxicillin 1000 mg twice daily for 1 week. The CYP2C19 genotypes were detected in 161 patients. The eradication of H. pylori were analyzed by intention-to-treat (ITT) and per protocol (PP) methods.ResultsThe H. pylori eradication was 86.70% in group E_(20), 88.5% in group E_(40),73.5% in group R and 78.1% in group L. Whereas the H. pylori eradication was 90% in patients with PM genotype,81.5% in patients with HetEM genotype and 82.1% in patients with HomEM genotype. The H.pylori eradication was 83.4% and 79.00% by per protocol (PP) and intention-to-treat (ITT) analyses,respectively. There was no significant difference in H. pylori eradication among four groups (P>0.05), and no relation was found between H. pylori eradication and genotypes (P>0.05). Conclusions PPI based triple therapy was effective in eradication of H. pylori, which is not influenced by CYP2C19 genotypes.