ObjectiveTo compare the clinical effects of laparoscopically assisted vaginal hysterectomy (LAVH) and transabdominal hysterectomy (TAH).MethodsOne hundred and twenty-six cases operated with hysterectomy were classified into LAVH group and TAH group by random digits table with 63 cases each.The operation time,intraoperative bleeding amount,exhaust time,hospitalization time and postoperative complications were observed and compared.ResultsThe operation time,intraoperative bleeding amount,exhaust time and hospitalization time was ( 115.6 ± 13.8 ) min,(92.5 ± 11.3 ) ml,(21.8 ±4.8) d and (6.1 ± 1.7) d in LAVH group,( 82.5 ± 8.7) min,( 112.3 ± 17.8) ml,(28.9 ± 6.2) d and (9.6 ±2.2) d in TAH group,there were significant differences between two groups (P＜0.05).The incidence of incision pain,delayed wound healing,vaginal stump infection,thrombophlebitis,and gastrointestinal disorders was 9.5％(6/63),0,1.6％(1/63),0 and 7.9％(5/63) in LAVH group,which was significantly lower than that in TAH group [52.4％(33/63),7.9％(5/63),11.1％(7/63),7.9％(5/63) and 22.2％ ( 14/63 ) ] (P ＜ 0.05).ConclusionCompared with TAH,LAVH can shorten exhaust time,hospitalization time,reduce intraoperative bleeding amount,decrease complication rate,which can be further applied in clinic.

Objective To study the effect of acute lymphoblastic leukemia (ALL) children bone marrow mesenchymal stem cells (MSCs) on the resistance of K562cell atd mechanism in vitro.Method MSCs were obtained from AL children bone marrow after derivation, cultivation and identification.The coculture of MSCs and K562 and K562 suspension were established.Effects of MSCs on the growth of K562 cells were investigated in vivo.The two kinds of cells treated with different concentration of adriamycin (ADM) and the rate of apoptosis was evaluated by flow cytometry.Cell cycle was determined by flow cytometry.RT-PCR was used to detect Bcl-2 and Bax in K562 cells.Result Compared with the cell growth curve of K562 alone, the K562 cell co-cultured with MSCs grew slower and the exponential phase of growth was not obvious.The apoptosis index of the K562 cells co- clutured with MSCs was (9.19 ±0.53)% examined by flow cytometry, and that of the K562 cells alone was 4.00 ± 0.37% respectively( P ＜ 0.05 ).The percentage of cells at G0/G1 phase was (50.2 ± 2.26) % and that at S phase was (37.03 ± 3.50) % in the group of K562 alone, but those of the K562 cells co - cultured with MSCs were (80.95 ± 3.83) % and ( 17.40 ± 1.50)% respectively( P ＜0.05).The result of RT-PCR suggested expression of Bcl-2/Bax of the K562 cell co-cultured with MSCs was higher than K562 alone.Conclusion ALL children MSCs suppressed the growth of K562 cell in vitro.Adhesion made K562 depress sensitive to ADM.The mechanism was perhaps caused by adhesion with MSCs, K562 cell cycle was changed and related to Bcl-2 gene high level expression.

ObjectiveTo discuss the clinical value of serum CA125 and endometrial antibody (EMAb) for the diagnosis of endometriosis.Methods216 patients were determined by the presences of CA125 and EMAb before operation.ResultsAll cases were diagnosed by pathology after operation. CA125 positive rate in the endometriosis group was 58.3% and that in the control group was 12.5%. The difference between two groups was significant (P<0.01).EMAb positive rate in the endometriosis group was 31.3% and that in the control group was 14.3%. The difference between two groups was also significant (P<0.01). When determining CA125 alone to diagnose endometriosis, the sensitivity rate was 58.3% and specificity rate was 87.5%. If determining EMAb alone to diagnose endometriosis, the sensitivity rate was 31.3% and specificity rate was 85.7%. When one of them was used as diagnostic criterion, the sensitivity and specificity were 64.6% and 73.2% respectively. If combining use of both CA125 and EMAb as diagnostic criterion, the sensitivity and specificity were 25.0% and 100% respectively.Conclusions The determination of serum CA125 or EMAb levels is helpful for the qualitative diagnosis of endometriosis, especially using them combined, the diagnostic accuracy may be enhanced.

Objective To measure total hemoglobin concentration (THC) of breast lesion using US-guided diffused optical tomography(DOT) and to investigate the THC optimal threshold value in different size breast lesions.Methods DOT was performed on 500 breast lesions and surgical pathology was as the gold standard.The optimal diagnostic threshold and the efficacy were figured out.Results There were 265 benign and 235 malignant lesions.In malignant lesions,THC of ≥2 cm lesion group was higher than that of ＜2 cm lesion group(P =0.000).In benign lesions,there was no statistical difference between ≥2 cm group and ＜2 cm group (P =0.13).As for ＜2 cm breast lesions,when a THC threshold value of 146.9 μmol/L and 102.2 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.2％,70.0％,71.7％,62.9％,79.9％ and 86.7％,44.4％,61.6％,51.6％,83％,respectively.As for ≥2 cm breast lesions,when a THC threshold value of 210.4 μmol/L were used,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 74.0％,86.7％,79.1％,89.2％,69.2％.Conclusions THC of breast cancer increased with the increasing size of lesions.The different diagnostic threshold value should be used according to different size lesions so as to enhance sensitivity,specificity and accuracy.

Objective To evaluate the effectiveness of thoracic electrical bioimpedance(TEB)in monitoring the cardiac function of peritoneal dialysis patients.Methods One hundred and one patients with continuous ambulatory peritoneal dialysis (CAPD) and 30 healthy persons (control group)were included in the study.Thoracic electrical bioimpedance (TEB) noninvasive hcmodynamic monitoring and echocardiography were taken to analyze the correlation between indexes.Results Echocardiography showed that left atrial diameter (LAD),left ventricular end diastolic diameter (LVDd),left ventricular end systolic diameter (LVDs),interventricular septal thickness （IVST),interventricular septal thickness (PAP),left ventricle weight index (LVMI) of CAPD group were higher than that of the control group (all P ＜ 0.05),early and late wave of mitral valve flow (E/A) of CAPD group was lower than that of control group (P ＜ 0.05).TEB monitoring showed that cardiac output (CO),stroke volume (SV),acceleration index (ACI),ejection fraction (EF),velocity index (Ⅵ) of CAPD group were significantly lower than that of control group (all P ＜ 0.01),systolic time ratio (STR),SVR,TFC of CAPD group were significantly higher than that of control group (P ＜ 0.01).Correlation analysis show that left ventricular ejection fraction (LVEF) was negatively correlated with BNP (r =-0.467,P ＜ 0.01),LVMI was positively correlated with BNP (r=0.416,P ＜ 0.01),PEP,STR and TFC were positively correlated with BNP (r =0.404,P ＜ 0.01; r =0.572,P ＜ 0.01; r=0.471,P ＜ 0.01),EF was negatively correlated with BNP (r =-0.664,P ＜ 0.01).Correlation analysis between echocardiogaphy and TEB monitoring index showed there was significant correlation between EF and LVEF (r =0.451,P ＜ 0.01),SVR and TFC were positively correlated with LVMI (r =0.232,P ＜ 0.05; r =0.284,P ＜ 0.05),SV was positively correlated with E/A (r =0.285,P ＜ 0.05),pre-ejection period (PEP) and STR were negatively correlated with LVEF (r =-0.389,P ＜ 0.01; r =-0.446,P ＜ 0.01),TFC was positively correlated with LAD (r=0.279,P ＜ 0.05).Conclusion TEB monitoring can accurately evaluate the cardiac function with the advantage of dynamic monitoring and simple operation.It can partly replace the echocardiography test.

Objective To investigate the role of gray-scale sonography in the diagnosis of thyroid microcarcinoma(TMC).Methods The sonographic characteristics of 58 TMC and 61 benign thyroid nodules(≤1 cm)were retrospectively reviewed and compared with each other.The size,echogenicity,internal solid/cystic component,configuration,anteroposterior to transverse dimension ratio(A/T),margin,halo sign and calcification type of the nodules were studied.Statistical analysis was performed using the chi-square test.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of individual sonographic characteristics were calculated respectively.Results In ultrasonography,TMC manifested as marked hypoechoic in 48.3%,solid lesion in 98.3%,irregular-shape in 74.1%,irregular halo sign in 37.0%,with internal microcalcifications in 62.1%.There were significantly statistical differences between the benign and malignant nodules in those findings (P＜0.001).However,there was no obviously statistical difference in the obscure margin.The sensitivity,specificity and accuracy were 86.2%,77.0% and 81.5% respectively when using marked internal hypoechoic echo,A/T≥1 and microcalcification as a new combined criterior.Conclusions The gray-scale sonographic findings between the small benign and malignant thyroid nodules(≤1 cm)are different.Combining these sonographic signs can significantly improve diagnostic value of TMC.

Objective To analyze the expression characteristics of chemotherapeutic related genes (ERCC1 ,BRCA1 ,APE1 , RRM1 ,TUBB3 and TS) in non-small cell lung cancer(NSCLC) and their associations with the pathological types to provide the ex-perimental evidences for clinical individual chemotherapy .Methods The immunohistochemical SP method was used to determine the expression of ERCC1 ,BRCA1 ,APE1 ,RRM1 ,TUBB3 and TS genes in 733 patients with NSCLC .Chi-square test was performed to analyze the gene expression characteristics among different pathological types .Spearman relationship was conducted to evaluate the associations among the six genes and different pathological types .Results The expression of BRCA1 ,TUBB3 and TS had sta-tistical differences among three pathological types (P<0 .01);and these three genes showed a relationship with the pathological type (r=0 .107 ,-0 .229 and 0 .168 ,respectively ,P<0 .01) .ERCC1 vs .BRCA1 ,ERCC1 vs .APE1 and APE1 vs .RRM1 showed the pos-itive correlation(r=0 .214 ,0 .316 and 0 .222 ,respectively ,P<0 .01) .Conclusion The chemotherapeutic related gene expressions of NSCLC are related with the clinical pathological types .And the expressions of multiple markers are associated with each other .The combined detection of the chemotherapeutic related markers and the pathological types would be helpful to the decision making of individual chemotherapy in clinic .

ObjectiveTo investigate the correlation of ultrasonographic features of mesenteric fibromatosis and its pathological findings.MethodsTen mesenteric fibromatosis confirmed histopatho1ogica1ly in Peking Union Medical College Hospital were retrospectively reviewed.Results There were 7 females and 3 males. Their ages ranged 32~74 years (mean age 50.5±13.1 years). Of the 10 cases, 5 occurred in mesentery of the small bowels, 4 in the mesocolons, and 1 in junction portion of duodenum and jejunum. On ultrasound image, the diameters of the masses were 4.3~22.0 cm (mean 8.8±5.2 cm). 6 were regular and 4 were irregular. 9 of 10 cases were well-defined and 1 was poor defined. 6 has capsule echoic. All the 10 cases were hypoechoic. 9 presented as solid mass and 1 was solid-cystic leision. On gross pathology,they were solid, firm, grey and yellowish. Histopathology, there were boundles of fibroblasts in collagenous stroma with scarce degeneration. The cystic changes noted on sonograms corresponded histopathologically to areas of myxoid and cystic degeneration.ConclusionsMesenteric fibromatosis is a rare disease with characteristic ultrasonographic features, which were well correlated with their pathology findings. They mostly presents as well-circumscribed masses with hypoecho, regular shape and little vascularity. Ultrasound was important in the diagnosis of this disease.

Objective To investigate the ultrasonographic manifestation of renal oncocytoma. Methods The sonographic appearances of 12 patients with pathologically confirmed RO were retrospectively reviewed, and the size, margin, configuration, echogenicity and blood flow distribution of the lesions were analyzed. Results All of the 12 RO were detected and located correctly, among which 3 cases were misdiagnosed as renal cell carcinoma and 9 cases were not qualitatively diagnosed with ultrasound. The lesions manifested as central stellate scar in 8.33%, homogeneous enchogenicity in 66.67%, well-defined in 75.00%, regular-shape in 91.67% and isoechoic in 58.33%. Among these lesions, 6 (50.00%) were hypervascular with spoke-wheel distribution, 5 (41.67%) were hypovascular, and 1 (8.33%) was avascular, while peripheral blood flow were seen in 7 lesions (66.67%). Conclusion The diagnostic ability of ultrasound for RO is limited, but a homogeneous, well-defined solid lesion with spoke-wheel distribution of blood flow, especially with a stellate scar may suggest RO.

OBJECTIVE To explore the effect of aqueous extract of Zheng Chaihu Yin(ZCH)on paracetamol(acetaminophen,APAP)-induced hepatotoxicity. METHODS Male ICR mice were divided into three scenarios randomly:the single treatment dose of ZCH,multiple treatment or pretreatment dose of ZCH. Each scenario had a up control group and an APAP model group,while single treatment dose of ZCH group had a ZCH group at the same time. The dose of APAP and ZCH was 500 mg·kg-1 and 36 g · kg- 1,respectively. 24 h after the last administration,plasma and liver samples were prepared. Ultra- performance liquid chromatography/quadrupole- time- of- flight mass spectrometry (UPLC-Q-TOF-MS)based metabolomics profiling was used to examine changes in plasma after expo?sure to ZCH,APAP or co-exposure to ZCH and APAP. Glutamic pyruvic transaminase (GPT) and glutamic oxaloacetic transaminas (GOT) values were determined by a biochemical auto analyzer in plasma. Histopathologic changes in the liver were observed and the area was calculated after HE staining. The data were analyzed with SPSS16.0 statistical software and the results were compared with the test between the two groups to find biomarkers. Also,SIMCA software was used for partial least squares-discriminant analysis (PLS-DA) pattern recognition. RESULTS Compared to control group, APAP dosing alone caused an increase in plasma transaminases and alterations in multiple metabolic pathways. Compared to APAP group,decrease in plasma transaminases was noted when ZCH was administered after or prior to APAP. Histopathologic results showed that in the single treatment group, multiple treatment group and pretreatment group,ZCH could alleviate the liver damage induced by APAP from (32.3 ± 12.0)% to (14.2 ± 9.9)%,(8.6 ± 7.9)% to (5.2 ± 1.7)% and (32.5 ± 10.0)% to (5.2 ± 6.4)%(P<0.05). Similarly,the PLS-DA of the LC-MS data showed that the groups dosed with APAP alone were the most distinct from controls,while animals dosed with ZCH prior to or after APAP treatment were located near control group. Metabolic spectrum results showed that ZCH could restore the changes in endogenous substances including lipid metabolism,amino acid metabolism,sugar metabolism and energy metabolism induced by APAP to normal. CONCLUSION ZCH water-extraction plays major roles in the regulation of metabolism on APAP-induced liver injury. These studies demonstrate that UPLC-Q-TOF-MS-based metabolomic analysis can be sensitively and accurately predict the initiation and progres?sion of liver injury and greatly contribute to a better understanding of the hepatoprotective effects of ZCH in a clinical environment.