Objective To retrospectively analyze the treatment methods of cervical intraepithelial neoplasia (CIN) in women aged 65 years and over.Methods From July 2002 to December 2011,51 postmenopausal women aged 65 years and over with CIN were admitted to our hospital.The diagnosis and treatment were summarized and analyzed,and the CIN related literatures were discussed.Results 31 patients received colposcopy and the colposcopically directed punch biopsy.Squamocolumnar junction (SCJ) was found in 18 patients (58.1％,18/31),and not found in 13 patients (41.9％,13/31).Among the 31 patients,21 patients received conization after biopsy.9 patients were under-diagnosed by biopsy,in which 4 cases (44.4％) SCJ were found and in 5 cases (55.6％)SCJ were not found.In all patients,26 patients received conization and 20 patients received hysterectomy directly.There were 14 patients received hysterectomy after conization.Among 14 patients,the uteruses in 4 patients with conization specimen diagnosed as CIN Ⅱ-Ⅲ and negative margin were 100.0％ (4/4),and the uteruses in 3 patients with conization specimen diagnosed as CINII-Ⅲ and positive margin were 50.0％ (3/6).Conclusions For women aged 65 years and over,it is very important whether SCJ can be seen or not in colpscopy and directed punch biopsy procedure.It is better to do conization if possible.Patients with conization specimen diagnosed CINII-Ⅲ and negative margin needn't subsequent hysterectomy.Patients with positive margin but with bad general conditions or complications can continue to be monitored if they have good follow-up conditions.If patients are diagnosed as carcinoma by conization specimen,total hysterectomy or radical hysterectomy is recommended.

Long tracheal lesions are mainly caused by stenosis, infection, trauma, malignant tumors and other factors. Resection of the diseased tissue or stenosis and end-to-end anastomosis is currently the gold standard for long tracheal lesions treatment. However, these treatment programs have proven to have major limitations. In recent years, tissue engineering technology has been regarded as a promising medical alternative treatment method, and the selection of scaffold materials is one of key parts. With the continuous exploration of domestic and foreign researchers, biological materials have been continuously developed and applied to the research of tissue engineering trachea. Tissue engineering degradable scaffold materials can be divided into natural polymer material scaffolds and synthetic polymer scaffolds according to the different sources. The scaffold material can be modified or compounded as needed to improve the biological properties of scaffolds. In addition, with the continuous development of biological printing technology, different scaffold materials can be better combined and used. Biodegradable scaffolds have become a new research direction in the field of tissue engineering trachea due to their polymer properties, and have good application prospects.

[Objective] To establish a method for determination of Ephedrine Hydrochloride in KMBYL capsules by HPLC.[Methods] The DiamonsilTM C18(250mm?4.6mm,5 ?m)column was used.The mobile phase was mobile phase: acetonitrine-0.02 mol?L-1potassium dihydrogen phosphate(0.2% triethylamine,adjusteding pH to 2.7 with phosphoric acid)(5∶95) with a flow rate of 1.0ml?min-1.The detection wavelength was 210 nm.The column temperature was 30℃.[Results] The linear responses range was 0.2148-2.148 ?g?mL-1 of Ephedrine Hydrochloride(r=0?9999).The average recovery was 98.85% and the RSD was 2.95%.[Conclusion] The method is simple accurate reproducible.It can be used for the quality control of KMBYL Capsules.

Objective To observe the therapeutic effect of exenatide combined with metformin therapy in type 2 diabetes with nonalcoholic fatty liver disease.Methods 50 patients with type 2 diabetes and nonalcoholic fatty liver disease were randomly divided into experimental group and control group with 25 cases in each.The control group were treated with metformin, the experimental group were treated with exenatide on the basis of metformin.Before treatment and at the end of 12-week treatment, patients height, weight, body mass index(BMI), waistline(WC), glycated hemoglobin(HbA1c), fasting blood glucose(FBG),fasting C-peptide(FCP), triglyceride(TG), cholesterol(TCH), high density lipoprotein(HDL), low density lipoprotein(LDL),systolic pressure(SBP), diastolic pressure(DBP), alanine aminotransferase(ALT), superoxide dismutase(SOD), liver lipid contents(LFC) were detected.Results Baseline data were not significantly different between the two groups.Compared to baseline, WC, HbA1c, FBG and LFC in experimental group and control group were obviously improved after treatment(P<0.05), and the experimental group improved more significantly than control group(P<0.05).Conclusion Exenatide combined with metformin has an obvious therapeutic effect on BMI, WC, HbA1c, FBG, FCP, SBP, TG, TCH, HDL, LDL, LFC than mere metformin treatment in treatment of type 2 diabetes with nonalcoholic fatty liver disease.

Objective To explore the relationship between neutrophil‐to‐lymphocyte ratio (NLR) and early‐stage diabetic nephropathy in patients with newly diagnosed type 2 diabetes(T2DM ). Methods A total of 160 patients with newly diagnosed T2DM were enrolled in this study and divided into two groups:early‐stage diabetic nephropathy (EDN ) group and non‐DN group (T2DM group). The clinical and biochemical data were collected. Results NLR ,neutrophia cell count ,2 hPG ,HbA1 c ,age were significantly higher in EDN group than in T2DM group[NLR (2.27 ± 0.92)vs(1.81 ± 0.56) ,neutrophia cellcount(4.35±1.47)vs(3.78±1.08)109/L,2hPG(21.98±4.30)vs(20.37±4.40)mmol/L,HbA1c (11.06±2.02)% vs (10.22 ± 1.89)% ,age(49.22 ± 12.71) vs (44.41 ± 10.81)years] (P< 0.05).Logistic regression analysis showed that NLR (OR= 6.529 ,95% CI:1.946 ~ 21.873 ,P= 0.002)and 2 hPG(OR = 1.213 ,95% CI:1.002 ~ 1.467 ,P= 0.047 ) were independent risk factors for EDN.Conclusion Increased NLR is significantly associated with EDN. High NLR level may be a reliable predictive marker for EDN.

Objective To explore the size of access channel that may influence the intrarenal pelvic pressure during percutaneous nephrolithotomy.Methods From April 2014 to July 2015,83 patiens with unilateral renal calculus,ranged from 20 to 40mam were divided into 2 group randomly.40 cases underwent F24 channel PCNL and 43 cases underwent F16 channel PCNL.There was no statistically significant difference between the groups in preoperative variables,such as age,gender,preoperative status of infection,status of hydrpnephrosis,size and location of stone (P ＞ 0.05).We used a 6Fr ureteral catheter positioned into the renal pelvic,and the intrarenal pelvic pressure was measured by anesthesia monitor IBP channel during PCNL in different stages (entrance into the collecting system,calculi fragmentation,and termination)for all patients.Removing calculus time,postoperative hemoglobin changing,fever rate,procalcitonin abnormal rate,white blood cell counts and calculi clearance rate were recorded and compared.Results The intrarenal pelvic pressure in different stages on F24 channel and F16 channel were (7.5 ± 1.3)、(22.5± 4.3)、(14.0 ± 2.7) mmHg and (10.3 ± 1.1)、(34.6 ± 4.1)、(23.0 ± 3.6) mmHg,respectively.There was statistically significant difference between 2 groups (P ＜ 0.05).Compared with F16 channel,F24 channel had significant differences in removing calculus time [(12.8 ± 3.7) min vs.(23.3 ± 3.6) min],fever rate [17.5％ (7/40) vs.39.5％ (17/43)],procalcitonin abnormal rate [15.0％ (6/40) vs.34.9％(15/43)] and white blood cell counts abnormal rate [10.0％ (4/40) vs.27.9％ (12/43)] (P ＜ 0.05).However,no significant difference in postoperative hemoglobin changing [(11.8 ± 4.4)g/L vs.(13.7 ±4.7)g/L] and calculi clearance rate [87.5％ (35/40) vs.81.4％ (35/43)] (P ＞0.05).Conclusions Compared with F16 channel,the F24 channel PCNL maintains lower renal pelvic pressure,which is less than reflux limit,during calculi fragmentation,It might be contributed to reduce the postoperative fever rate.It can short time for removing calculi and achieve the better effect.

Idebenone is a synthetic analogue of coenzyme Q10. As a potent antioxidant,idebenone operates under low oxygen tension situations, protects cell membranes and mitochondria from oxidative damage through inhibiting lipid peroxidation, thereby protects against cerebral ischemia and nervous system damage. Idebenone also interacts with the mitochondrial electron transport chain and maintains the formation of ATP under ischemic conditions. Because idebenone has a good tolerability and safety, it is expected as a neuroprotective agent for the treatment of acute ischernic stroke. Studies in recent years have showed that idebenone has a certain therapeutic effect in a variety of nervous system diseases involving mitochondrial dysfunction and oxidative stress damage, such as mitochodrial encephalomyopathy, lactic acidosis, stroke-like episodes syndrome, Friedreich's ataxia, Alzheimer's diseases, Leber's hereditary optic neuropathy, and Duchenne muscular dystrophy. At present, some clinical trials in the mitochondria-related diseases and neuromuscular diseases are underway, and their results are expected to further expand the indications of idebenone.

Objective To analyze the expression levels of matrix metallo proteinase-2 (MMP-2) and matrix metallo proteinase-9 (MMP-9) in serum of patients with esophageal cancer,and to analyze the interrelations among MMP-2,MMP-9 and clinicopathologic characteristics of esophageal cancer.Methods The levels of serum MMP-2,MMP-9 from 60 patients with esophageal cancer were detected by enzyme linked immunosorbent assay.The interrelations among MMP-2,MMP-9 and clinicopathologic characteristics of esophageal cancer including age,gender,histological type,whether or not lymph nodes metastasis and TNM staging were analyzed.Results The levels of MMP-2 and MMP-9 in control group were 61.31 ng/ml and 87.67 ng/ml,the levels of MMP-2 and MMP-9 in patients with esophageal cancer were 121.66 ng/ml and 169.73 ng/ml.The levels of MMP-2 and MMP-9 were significantly higher in patients with esophageal cancer than that of general population (t =3.015,P =0.007; t =2.037,P =0.04).The level of MMP-2 was significantly associated with whether or not lymph node metastasis (t =2.150,P =0.04) and clinical staging (t =2.186,P=0.03).The level of MMP-9 was significantly associated with whether or not lymph node metastasis (t =2.390,P =0.02) and clinical staging (t =2.149,P =0.03).The levels of MMP-2 and MMP-9 have no reference to age,gender and histological type (all P＞0.05).Conclusion MMP-2 and MMP-9 may correlate with tumor invasion and metastasis in patients with esophageal cancer.

Objective To form a concise and useful warning scale of suicide ideation of inpatients with somatic disease.Methods 2 677 inpatients who were more than 15 years old were randomly selected in a comprehensive hospital during the period of 2010.11-2013.02.Self-rating Depression Scale (SDS),Self-rating Anxiety Scale(SAS) and self-designed questionnaires which included general information,suicide risk factors and somatic disease were applied.Chi square test,partial correlation analysis,t test,correlation analysis and ROC curve analysis were used for statistical analysis.Results 1.The warning scale of suicide ideation which contained 18 items was formed.2.The Cronbach's Alpha reliability of the warning scale was 0.84 and its split-half reliability was 0.60.Criterion-related validity studies showed that the scores of the 18 items were positive correlated with SDS and SAS(r SDS =0.50,r SAS =0.54,P＜0.01).This scale also had good structure validity.3.The ROC curve concluded that the area under curve was 0.83,the sensitivity was 68.40％ and the specificity was 79.20％.Positive and negative predictive values were 21.22％ and 96.83％ respectively.Conclusion The reliability and validity of the warning scale entirely accorded with psychometric demands.It also has good specificity and negative predictive value,so it is suitable for clinical promotion.

Objective To assess the effect of levothyroxine , lipoic acid and their combination therapy on improving the cognitive deficit and on the level of oxidative stress in the serum and hippocampus tissue of adult hypothyroid rast .Methods Fifty male SD rats were randomly divided into five groups:normal group , hypothyroidism group [ propylthioaracil ( PTU ) group], the levothyroxine sodium (L-T4) treatment group (PTU +L-T4 group), the lipoid acid(LA) treatment group (PTU+LA group), and the two-drug combination group (PTU+LT-4+LA group).After 8 weeks of treatment, the learn-ing and memory abilities of the rats were evaluated by Morris Water Maze ( MWM ) .The content of malondialdehyde ( MDA) and the activities of superoxide dismutase ( SOD) in the serum and hippocampus were respectively measured using thiobarbituric acid ,and xanthine-xanthine oxidase methods .Results Compared with the normal group , the escape latency was longer(P<0.01), the MDA level was increased and the SOD activity was decreased in the serum and hippocampus in the PTU group (P<0.001).Compared with PTU group, the SOD activity was increased and the MDA level was decreased in the PTU +L-T4 group, PTU +LA group and PTU +L-T4 +LA group(P<0.05).There was significant difference in MWM test score .Conclusion The L-T4 and LA combination therapy can significantly improve the cognitive function of hypothyroid rats.