events were associated with promestriene use. Conclusion The premestriene capsule was safe and effective in the treatment of postmenopausal atrophic vaginitis.

BACKGROUND: The purpose of this study was to introduce the mechanism and clinical application of muscular atrophy that is a hotspot in the 65th Annual Meeting of American College of Sports Medicine and the 9th World Conference on Exercise Is Medicine and the World Conference of Basic Science of Muscle Hypertrophy and Atrophy. OBJECTIVE: To summarize and analyze the frontiers and hotspots of research findings on muscular atrophy, in order to provide new ideas for further research of exercise improving muscle function and the mechanism and application in this field, and provide a reference for the study on sports science, sports medicine, and sports rehabilitation in China. METHODS: Related reports and cutting-edge research findings in 65th Annual Meeting of American College of Sports Medicine were collected. Meanwhile, PubMed database between January 1993 and August 2018 was retrieved. The keywords were "skeletal muscle, muscle atrophy, movement and muscle, resistance movement". Thirty-five articles related to the molecular mechanism and clinical application of muscle atrophy were included for analysis and discussion. RESULTS AND CONCLUSION: The World Congress is a unique opportunity to bring together interdisciplinary investigators for the most comprehensive meeting ever held on this topic. The program will include a keynote lecture, tutorials, and symposia from leading experts. The meeting focused on the intrinsic and extrinsic variables that regulate skeletal muscle hypertrophy and atrophy. How exercise brings about skeletal muscle atrophy and its application in clinical problems such as aging, disease, injury, chronic diseases, and how these changes may relate to chronic disease were discussed as well. The research on muscle hypertrophy is mostly concentrated in the field of competitive sports.

Objective To explore the best operation method in the patients with papillary thyroid microcarcinoma.Methods A total of 139 patients with papillary thjroid microcarcinoma were treated at our institute between Jan.2000 and Jan.2010.The data on the clinicopathological characteristics of patients and treatment were collected.Results The mean tumor size was (0.45 ± 0.24) cm.Of the 139 patients,30.2％ had multifocal tumors,19.4％ had bilateral tumors,42.4％ neck lymph node metastases.The number of eases of lymph node metastasis in level Ⅵ,Ⅱa,Ⅲ and Ⅳ was 58(41.7％),3(2.2％),10(7.9％),5(3.6％),respectively.Only one had lymph node metastasis in Level Ⅲ Microscopic extrathyroid extension was associated with neck lymph node metastases in papillary thyroid microcareinoma patients (x2 =38.39,P ＜0.001).No one developed permanent hypoparathyroidism.The median follow-up time was 103 (range,30-154) months,and local recurrence in the thyoid was diagnosed in 2 patients who underwent hemi-or subtotal thyroidectomy.Follow-up of 10 years was done in 16 cases,and the survival rate of 139 patients for 10-year was 100％.Conclusions It suggested that patients with papillary thyroid microcarcinoma has uniform clinicopathologic characteristics and the pattern of lymph node metastasis from those with papillary thyroid carcinoma.Total thyroidectomy plus level Ⅵ dissection is the optimal surgical treatment of papillary thyroid microcarcinoma.

Objective To investigate the survival and recurrence data after treatment in neuroendocrine carcinoma of the uterine cervix(NECUC)with stageⅠb-Ⅱa, and to analyse its prognostic factors. Methods Thirty-two cases of primary NECUC in early-stage disease treated from Jan. 2005 to Dec. 2013 at Cancer Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences were reviewed, and their data of clinicopathologic characteristics were collected and analysed. The median age was 37 years (range, 23-57 years). The distribution by International Federation of Gynecology and Obstetrics (FIGO) clinical stage:19 cases stageⅠb1, 10 cases stageⅠb2, 1 case stageⅡa1, 2 cases stageⅡa2. Pathologic types: 22 cases of small cell carcinoma, 1 case of atypical carcinoid, 9 cases of mixed carcinoma. The diameter of cervical tumor:12 cases≥4 cm, 20 cases<4 cm. All patients underwent radical hysterectomy and pelvic ± para-aortic lymphadenectomy, and 15 cases of them were preserved unilateral or bilateral ovaries. Pathologic examination showed that 25 cases with cervical deep stromal invasion thickness ≥1/2, 21 cases with lymph-vascular space invasion (LVSI), and 18 cases with pelvic and (or) para-aortic lymph nodes involvement. Ten cases were performed neoadjuvant chemotherapy (range,1-3 cycles), all patients received postoperative chemotherapy (range,3-6 cycles), and 15 patients were treated with radiotherapy after surgery. The follow-up data were updated on Jul. 2014. The median follow-up time was 18 months (range, 7-71 months). A retrospective analysis was conducted to analyse the survival and recurrence data,and to explore the prognostic factors of NECUC. Results Thirteen patients died during the follow-up period. The cumulative progression-free survival (PFS) of 2 and 5 years were respectively 54.2%and 38.1%, and the estimated median PFS was 29 months. The cumulative overall survival (OS) of 2 and 5 years were respectively 56.1%and 44.9%, and the estimated median OS was 31 months. Fourteen cases had recurrence, and the median recurrence time was 9 months (range, 3-30 months). Recurrent or metastatic sites:2 cases in pelvis, 4 cases in liver, 3 cases in lung, 3 cases in adrenal glands, 3 cases in bones, 2 cases in brain, 1 case in pancreas, 1 case in lymph nodes of para-aorta and neck, and 3 cases had metastasis in two or more organs. Thirteen cases with recurrence died of disease, and another one is alive with disease. The univariate analysis showed that lesion size of the cervix and FIGO stage were significant prognostic factors (P<0.01), while age, tumor components, deep invasion in cervical stromal, LVSI, pelvic and (or) para-aortic lymph nodes involvement, neoadjuvant chemotherapy, adjuvant radiotherapy and preserving ovaries were not significantly associated with prognosis(all P>0.05). Conclusion The prognosis of NECUC in early-stage is poor and the lesion size of the cervix and FIGO stage are prognostic factors.

Objective To explore the pattern of cervical nodal metastasis and the clinical significance of total thyroidectomy plus functional neck lymphadenectomy in papillary thyroid carcinoma patients. Methods Clinical and pathological data of 172 patients with papillary thyroid cancer who underwent total thyroidectomy plus functional neck lymph node dissection at Jinan Military General Hospital were retrospectively reviewed, including patient demographics, extent of surgery, parathyroid hormone level,recurrence, tumor pathology, such as tumor size, multifocality, capsular invasion, vascular invasion,extrathyroidal extension, and lymph node status. Results Of the 172 functional neck dissection patients (47 ambilateral), the incidence of lymphonodus metastasis in regions Ⅵ, Ⅳ and Ⅲ was 96. 3% ,78. 5%and 62.1% respectively. Rate of nodal metastasis was higher in patients with extracapsular invasion than in patients with no invasion ( P ＜ 0. 05 ). Serum parathyroid hormone levels significantly decreased immediately postoperatively in total thyroidectomy plus functional neck dissection and remained low for several weeks thereafter ( P ＜ 0. 01 ). The 5-, 10- and 15-year survival rate was ( 98. 83 ± 0. 82) %, (98. 23 ± 1.02 ) % and (96. 42 ± 1.43 )%, respectively. Conclusions Therapeutic neck lymph node dissection for papillary thyroid cancer is recommended for cervical nodal metastasis patients. Total thyroidectomy plus functional neck dissection is important in the treatment of papillary thyroid cancer.

Objective To study the time-toxicity and dose-toxicity relationship of hepatotoxicity induced by Paracetamol Tablets (PT),Compound Paracetamol and Amantadine Hydrochloride Tablets (CPAH),Compound Dextromethorphan Hydrobromide Tablets (CDH),and Chaiqin Qingning Capsules (CQC) with single dose in mice.Methods In the Time-Toxicity relationship study,Kunming mice were randomly divided into control,PT,CPAH,CDH,and CQC group,and mice of.each drug administration group were randomly divided into nine subgroups according to the time (1,2,4,8,12,24,48,72 and 96 h after administration) of blood collection.The acetaminophen contents in PT,CPAH,and CDH groups were 425.98 mg/kg,and the dose of CQC group was 3 680.50 mg/kg.In the Dosage-Time relationship study,mice were randomly divided into control,PT,CPAH,CDH,and CQC high,medium and low dose group.The acetaminophen contents of high,medium,and low dose were 266.24,425.98,and 681.57 mg/kg in PT,CPAH,and CDH group,and the dose of CQC group was 1437.70,2300.31,and 3680.50 mg/kg,10 mice in each group,sex in half.Blood was collected 12 h after administration.Animal behavior was observed every day,blood and organs were collected at the corresponding time points,serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),and alkaline phosphatase (ALP) level were detected,and the organs index of spleen and thymus,liver were calculated.Results There were no significant changes of ALT,AST,ALP,and organs index after once ig administration of CQC at dosage of 1437.70 mg/kg to 3680.50 mg/kg in mice.The study on time-toxicity relationship indicated that,after once administration of PT,CPAH,and CDH at 425.98 mg/kg,mice showed toxic symptom such as hypokinesia,dry hair and so on,12 h was the most obvious,24 ～ 72 h disappeared.The level of ALT,AST,and ALP in serum increased and reached to the peak at 12 h and then restored near normality after 72,24,and 24 h in PT,CPAH,and CDH group.Their organ index of liver,spleen and thymus all had no significant changes.The study on the dosage-toxicity relationship indicated that,there were no significant changes of animal behavior,ALT,AST,ALP,and organs index after once ig administration of PT,CPAH,and CDH at 266.24 mg/kg.Obvious liver injury can be induced by the three drugs with dosage of 425.98 to 681.57 mg/kg and the level of ALT,AST,and ALP increased significantly with the increase of dosage.Their liver index increased significantly with dosage of 681.57 mg/kg,but the organs index of spleen,thymus had no significant changes.Conclusion There was no hepatotoxicity after once ig administration of CQC with dosage of 3680.50 mg/kg in mice.Mice were once ig administration ofPT,CPAH,and CDH with a large dose,may induce acute liver injury and show obvious time-toxicity and dose-toxicity relationships.

Objective To study the dose-time-toxicity relationship of hepatotoxicity in mice with multiple administration of Paracetamol Tablets (PT),Compound Paracetamol and Amantadine Hydrochloride Tablets (CPAH),Compound Dextromethorphan Hydrobromide Tablets (CDH),and Chaiqin Qingning capsules (CQC).Methods Mice were randomly divided into control,PT,CPAH,CDH,and CQC high,medium,and low dose groups.The acetaminophen contents of high,medium,and low doses were 266.24,425.98,and 681.57 mg/kg in PT,CPAH,and CDH groups,and the doses of CQC group were 1437.70,2300.31,and 3 680.50 mg/kg,ig administration,once daily for 5 d.General state and toxicity of mice were observed.The changes of ALT,AST,AKP,TBIL,and ALB levels in serum and organ indexes of liver,spleen,thymus,and kidney were tested on day 1,3,7,11,and 14 after multiple administration.Results CQC with the dosage range of 1 437.70-3 680.50 mg/kg to mice within 14 d,has not yet induced the increase of AST,ALT,AKP,TBIL,and ALB levels and changes of organ indexes of liver,thymus spleen,and kidney compared with normal control (P ＞ 0.05).PT,CPAH,and CDH with repeated dose of 425.98-681.57 mg/kg could induce significant increase of the levels ofALT,AST,AKP,and TBIL which reached the peak on day 1 (P ＜ 0.05),and then gradually decreased on day 3-14.The level of ALB significant decreased on day 1-11 (P ＜ 0.05),and then gradually recovered on day 11-14.The liver index significant increased on day 1-3 (P ＜ 0.05),and recovered on day 7-14.Conclusion Multiple administration of CQC could not induce liver injury in mice within 14 d,while multiple administration ofPT,CPAH,and CDH could induce hepatotocixity in mice with a certain dose,and show an obvious dose-time-toxicity relationship.

Objective:To investigate frequency of blood stasis syndrome(BSS) defined by traditional Chinese medicine in cerebral infarction and its correlations with carotid atherosclerotic plaque(CAP).Methods: All subjects comprised 151 patients aged 40 to 80 years(Mean ? SD age,65 ?11 years) with 67.9% for males and 32.1% for females.With the use of ACUSON7 color Doppler ultrasound,carotid atherosclerosis was evaluated by the plaque score,the left plaque score,the right plaque score,the numbers of the plaque respectively as defined by the sum of all plaque heights in bilateral carotid arteries.On the basis of neurological signs and symptoms,medical history,and brain MRI,we diagnosed stroke and its subtypes as follows: stroke(n=117),and vertebrobasilar insufficiency(VBI)(n=34) without the history of the stroke,which were based on Diagnostic Criteria for Cerebral Vascular Diseases in 2005.Diagnosis for syndromes defined by traditional Chinese medicine were made according to Diagnostic Criteria for Stroke in 1994.One-way ANOVA was used in comparison between groups,and multivariant Logistic Regression Analysis was conferred in correlations between several variables.Results: 47.0% of all cases with cerebral infarction presented the BSS,with as lower than syndrome of fire-heat(51.0%),as but significantly higher than syndrome of Qi deficiency(32.0%),liver-wind syndrome(27.0%),phlegm syndrome(23.0%) and syndrome of asthenic yin causing predominant yang(6.0%).There is a significant difference between groups for 44(79.0%) cases of 56 patients with cerebral infarction and the BSS have CAP,and only 35(57.0%) cases of 61 patients with cerebral infarction but without the BSS have CAP(P

OBJECTIVETo evaluate the impact of macroscopic enlarged lymph node on the clinicopathological characteristics of stage II colorectal cancer, and to explore the potential mechanism.

METHODSClinicopathological data of 116 consecutive patients with stage II colorectal cancer, who underwent colorectal radical resection and were identified as stage II colorectal cancer without mesenteric metastasis by postoperative pathology, in our department between December 2001 and December 2002 were analyzed retrospectively. All the patients were examined by the surgeons with gross appearance to decide the enlarged lymph nodes as metastasis during operation. There were 43 patients with macroscopic enlarged lymph nodes and 73 without such lymph nodes. Survival rate was compared between the two groups. Impact of macroscopic enlarged lymph node on the prognosis of stage II colorectal cancer was analyzed. Structure of macroscopic enlarged lymph node was observed. CK expression in 107 macroscopic enlarged lymph nodes from 43 cases was examined by immunohistochemistry.

RESULTSThe 10-year disease-free survival (DFS) of the whole group was 83.5%. The 10-year DFS of patients with macroscopic enlarged lymph nodes was 75.9%, which was significantly lower than 89.3% (P=0.038) of patients without macroscopic enlarged lymph nodes. Univariate analysis showed that macroscopical enlarged lymph node (P=0.038), perioperative blood transfusion (P=0.004), number of retrieved lymph nodes (P=0.016), concomitant disease (P=0.003), and preoperative serum carcinoembryonic antigen (CEA) level (P=0.050) were related to the prognosis of all the 116 patients. Multivariate analysis showed that macroscopical enlarged lymph node (P=0.044), number of retrieved lymph nodes (P=0.021), and perioperative blood transfusion (P=0.032) were independent prognostic factors. Haematoxylin and eosin (HE) staining indicated that enlarged lymph nodes had hyperplasia reaction. Immunohistochemistry showed that among 107 enlarged lymph nodes, 1 had macrometastases, 1 micrometastasis, 4 isolated tumor cell (ITC), and the rest 101 had no positive CK expression.

CONCLUSIONMacroscopic enlarged lymph node indicates a poor prognosis in patients with stage II colorectal cancer.

Carcinoembryonic Antigen ; Colorectal Neoplasms ; Disease-Free Survival ; Humans ; Immunohistochemistry ; Lymph Nodes ; Lymphatic Metastasis ; Multivariate Analysis ; Neoplasm Micrometastasis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate

Objective To evaluate the effect of cyclophosphamide (CTX) on the prognosis of different types of systemic lupus erythematosus (SLE).Methods A retrospective cohort study,in which 1 372 lupus patients were included,was conduted in 26 hospitals in Jiangsu province from 1999 to 2009.The data was analyzed by the chi-square test,Mann-Whitney U test,Kaplan-Meier survival analysis and Cox regression analysis.Results 1 372 SLE patients were followed up,in which 582 patients (42.4％) were treated with cycloph-osphamide and 790 patients (57.6％) were not.There were statistically significant differences in SLE disease activity index (SLEDAI) at admission and discharge between the two groups (t=3.398,P=0.001;t=5.044,P＜0.01).The survival rate was significantly higher in CTX treatment group compared to those without CTX administration (x2=4.667,P=0.031).Female (P=0.018,HR=0.68),disease duration ≤7 years (P=0.033,R=0.697),decreased levels of complement C3 (P=0.047,HR=0.7),and patients treated with cyclophosphamide and glucocorti-costeroid (P=0.047,HR=0.734) were predictors for good prognosis for CTX treatment.In patients with central nervous system (x2=6.611,P=0.010),heart and lung (x2=7.223,P=0.007) and renal system involvement (x2=5.217,P=0.022),there were statistically significant differences in survival rate and survival time between the CTX treated group and untreated group.Conclusion Cyclophosphamide treatment was beneficial for female SLE patients with low complement,short disease duration and important organ involvement such as heart,lung,kidney and central nervous system.