This study aimed to investigate the relationship between the promoting effect of Zuogui Pills on ovarian and vaginal angiogenesis in early-aging rats and mobilization factors granulocyte-macrophage colony-stimulating factor(GM-CSF), stromal cell-derived factor-1(SDF-1), and their receptors of endothelial progenitor cells(EPCs) and explore the mechanism of Zuogui Pills in improving reproductive hypofunction in early-aging rats. Ultra-high performance liquid chromatography-tandem mass spectrometry(UHPLC-MS/MS) was used to analyze the chemical components of the extract of Zuogui Pills. Forty 14-month-old female early-aging rats with estrous cycle disorder were randomly divided into a blank group, a conjugated estrogen group(conjugated estrogen suspension, 65 μg·kg~(-1)), and low-(11 g·kg~(-1)) and high-dose(33 g·kg~(-1)) Zuogui Pills groups, with 10 rats in each group. In addition, 10 4-month-old female rats were assigned to the youth control group. The rats in the blank group and the youth control group were treated with 20 g·kg~(-1) distilled water by gavage, while those in the groups with drug intervention were treated with corresponding drugs by gavage, once a day for 15 days. Enzyme-linked immunosorbent assay(ELISA) was used to detect the levels of SDF-1 and GM-CSF in the mobilization of EPCs in serum. Hematoxylin-eosin(HE) staining was used to observe the changes in the number of ovarian follicles at all levels and corpus luteum, the number of vaginal epithelial layers, the number of vaginal folds, and the blood vessels of ovarian and vaginal tissues in the groups with drug intervention. Western blot was used to detect the expression of ER, GM-CSFR, CXCR4, and CXCR7 proteins in ovarian and vaginal tissues. As revealed by the results, the blank group showed decreased number of corpus luteum, gro-wing follicles at all levels, and blood vessels(P<0.05), decreased thickness of vaginal mucosa, the number of epithelial layers, the number of vaginal folds, and the number of vessels in the lamina propria(P<0.05), reduced content of SDF-1 and GM-CSF in the peripheral blood(P<0.05), and down-regulated levels of ER, CXCR4, CXCR7, and GM-CSFR proteins in ovarian and vaginal tissues(P<0.05). The groups with drug intervention showed increased number of growing follicles at all levels, corpus luteum, and blood vessels(P<0.05), decreased number of atresia follicles(P<0.05), increased thickness of vaginal mucosa, the number of epithelial layers, the number of vaginal mucosal folds, and the number of blood vessels in the lamina propria(P<0.05), increased content of SDF-1 and GM-CSF in the peripheral blood(P<0.05), and up-regulated levels of ER, CXCR4, CXCR7, and GM-CSFR proteins in ovarian and vaginal tissues(P<0.05). This experiment suggests that Zuogui Pills may promote ovarian and vaginal angiogenesis and improve the reproductive function of early-aging rats by up-regulating the levels of mobilization factors SDF-1, GM-CSF, and their receptors of EPCs.
Rats ; Female ; Animals ; Granulocyte-Macrophage Colony-Stimulating Factor ; Estrogens, Conjugated (USP) ; Tandem Mass Spectrometry ; Aging ; Genitalia

The deceased was found in the basement staircase of a commercial building. He was drunk the night before his death. He went into the building at 00:45 am as per the security camera recording. He was found at 9:10 am in an inverted and jackknife position causing the hyperflexion of his torso and neck. Autopsy findings revealed facial congestion and conjunctival petechiae. No evidence of critical trauma was noted. Therefore, he can be diagnosed with positional asphyxia. He must have lost his body balance and fallen on his back while climbing up the basement staircase for unknown reasons. His lower body was found to be in the jackknife position due to inertia. The drunken state and the accident prevented movement and this position was sustained for an extended period.
Accidental Falls ; Asphyxia ; Autopsy ; Estrogens, Conjugated (USP) ; Neck ; Purpura ; Torso

OBJECTIVE: We attempted to discover that Ankylosing spondylitis (AS) has a comprehensive relationship with congestive heart failure and death.METHODS: We used a nationwide database managed by the Korean National Health Insurance Service from 2010 to 2014. Twelve thousand nine hundred eighty-eight patients with a diagnosis of AS and 64940 age- and sex- stratified matching subjects without AS were enrolled in the AS and control groups. Incidence probabilities of 6 years congestive heart failure and death in each group were calculated. The Cox proportional hazard regression analysis was used to estimate the hazard ratio. We divided the AS and control groups into subgroups according to sex, age, income, and comorbidities.RESULTS: During the follow-up period, 102 patients (0.79%) in the AS group and 201 patients (0.32%) in the control group developed congestive heart failure (p < ;0.0001). In addition, 211 (1.62%) subjects in the AS group died during the follow-up period compared to 639 (0.98%) subjects in the control group (p < ;0.0001). The adjusted hazard ratio of congestive heart failure and death in the AS group was 2.28 (95% confidence interval [CI], 1.80–2.89) and 1.66 (95% CI, 1.42–1.95), respectively. The hazard ratios of congestive heart failure and death were significantly increased in all of the subgroups.CONCLUSION: The incidence rates of congestive heart failure and death were increased in AS patients.
Cardiovascular Diseases ; Cohort Studies ; Comorbidity ; Diagnosis ; Epidemiology ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Heart Failure ; Humans ; Incidence ; Korea ; National Health Programs ; Spondylitis, Ankylosing

This commentary is focused primarily on the relationship between menopausal hormone therapy (MHT) and breast cancer risk, the primary adverse outcome measure of the Women’s Health Initiative (WHI) hormone trials. The WHI hormone trials are to date the largest randomized, placebo-controlled studies that evaluated the risks and benefits of hormone therapy in postmenopausal women. There are two arms: the estrogen-progestin (conjugated equine estrogen/medroxyprogesterone acetate) arm for women with intact uterus and the estrogen-alone (conjugated equine estrogen) arm for women who had a hysterectomy1. Both arms, planned to continue for 8.5 years, were stopped prematurely, the CEE/MPA arm after a mean of 5.2 years of follow-up and the CEE-alone arm after a mean of 7.2 years follow-up.
Female ; Estrogens, Conjugated (USP) ; Medroxyprogesterone Acetate

A 19-year-old otherwise healthy male presented to the Emergency Department with left upper quadrant abdominal pain having felt a “pop” in his abdomen which was followed by nausea and lightheadedness. There was no evidence of trauma but 3 weeks earlier he began with symptoms of a sore throat and nasal congestion without cough. On subsequent investigation, given the patient's acute abdominal pain, abnormal vitals and a non-diagnostic computed tomography scan, an emergent exploratory laparotomy was performed. There was 600 mL of blood evacuated from the abdomen. A 643-gram inflamed and ruptured spleen was identified and removed, and follow-up lab work was positive for heterophile antibody. This report describes spontaneous splenic rupture caused by infectious mononucleosis and compares characteristics of traumatic versus non-traumatic cases.
Abdomen ; Abdominal Pain ; Cough ; Dizziness ; Emergency Service, Hospital ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Herpesvirus 4, Human ; Humans ; Infectious Mononucleosis ; Laparotomy ; Male ; Nausea ; Pharyngitis ; Spleen ; Splenectomy ; Splenic Rupture ; Young Adult

Nutcracker syndrome (NCS) refers to left renal vein compression with impaired blood outflow. The etiology of NCS has been attributed to various anatomic anomalies. Posterior NCS is caused by compression of the retroaortic left renal vein between the aorta and spine. The classic symptoms of NCS include left flank pain with gross or microscopic hematuria. The frequency and severity of the syndrome vary from asymptomatic microhematuria to severe pelvic congestion. For this reason, diagnosis of NCS is difficult and often delayed. Here, we report a case of posterior NCS that was incidentally discovered.
Aorta ; Diagnosis ; Estrogens, Conjugated (USP) ; Flank Pain ; Hematuria ; Renal Veins ; Spine

PURPOSE: We report two cases of intraocular lens (IOL) pupillary optic capture following IOL scleral fixation treated with argon laser iridotomy. CASE SUMMARY: (Case 1) A 69-year-old man presented with suddenly decreased visual acuity of the left eye. The best-corrected visual acuity was finger count (FC) 30 cm in the left eye. Slit lamp examination revealed subluxation of the left eye IOL. An IOL scleral fixation and anterior vitrectomy were performed and no specific findings were observed. During the follow-up period, pupillary optic capture was repeated without specific causes, such as trauma, or IOL decentration thus, argon laser iridotomy was performed. (Case 2) A 77-year-old man presented with a 3-day history of congestion of the left eye and decreased visual acuity. Best-corrected visual acuity was 0.4 logarithm of the minimum angle of resolution (logMAR) in the left eye. Slit lamp examination revealed subluxation of the left eye IOL. An IOL scleral fixation and anterior vitrectomy were performed, and no specific findings were observed. During the follow-up period, pupillary optic capture was found, and IOL repositioning and argon laser iridotomy were performed. CONCLUSIONS: Laser iridotomy can be used to prevent recurrence of pupillary optic capture in eyes with IOL scleral fixation without decentration or distortion.
Aged ; Argon ; Estrogens, Conjugated (USP) ; Fingers ; Follow-Up Studies ; Humans ; Lenses, Intraocular ; Recurrence ; Slit Lamp ; Visual Acuity ; Vitrectomy

PURPOSE: When there is a mass in the superior temporal orbit area, a lacrimal gland tumor should be suspected. We report a rare case of orbital lymphatic malformation that was histologically diagnosed in a patient with typical clinical features of the lacrimal gland. CASE SUMMARY: A 55-year-old female with no underlying disease and no ophthalmic history visited our clinic with a right upper eyelid edema associated with an enlarged painless eyelid mass 1 month prior to her visit. The patient stated that she discovered the mass 1 year previously.The palpebral lobe of the lacrimal gland protruded slightly with congestion of the surrounding conjunctiva. Enhanced computed tomography showed a 3 cm well-defined heterogeneous mass in the right lacrimal gland area and several well-defined round calcifications within the mass. Orbital tissue or bone involvement was not observed. The pleomorphic adenoma of the lacrimal gland was the most clinically suspicious, so complete resection of the mass was performed using lateral orbitotomy. Histopathologically, lymphangioma (lymphatic malformation) originating from the lacrimal gland was diagnosed. CONCLUSIONS: Orbital lymphatic malformation can occur in the lacrimal gland. The present case showed that differential diagnosis can reveal the presence of an adult lacrimal gland tumor.
Adenoma, Pleomorphic ; Adult ; Conjunctiva ; Diagnosis, Differential ; Edema ; Estrogens, Conjugated (USP) ; Eyelids ; Female ; Humans ; Lacrimal Apparatus ; Lymphangioma ; Middle Aged ; Orbit

Fibrous dysplasia (FD) is a non-malignant bone tumor that typically behaves as a slow and indolent growing mass lesion. We report the case of a female patient presenting with headache and facial deformity and later diagnosed with polyostotic fibrous dysplasia (PFD). A 29-year-old woman visited Mealhada Primary Health Care Unit complaining of headache, nasal congestion, and hyposmia for several weeks. She also presented with facial deformity and painful swelling of the upper left orbit. X-ray imaging revealed a suspicious opacity in the left frontal sinus and a right shift of the nasal septum. Computed tomography and bone scintigraphy later confirmed a tumor involving the ethmoid and frontal bone. The patient was referred to the neurosurgery and otorhinolaryngology departments of a central hospital and the suspected diagnosis of PFD was confirmed. A watchful waiting approach with regular imaging screenings was proposed and accepted by the patient, who is now free of symptoms and more acceptant of the benign condition of her tumor. With this case, we aim to make family physicians more aware of this rare but relevant condition that can be difficult to diagnose. FD is a rare but benign tumor that occurs mainly in adolescents and young adults. Symptoms depend on the location and type of the tumor and include facial deformity, vision changes, nasal congestion, and headache. No clear guidelines exist for its treatment, and options include monitoring the progression of the tumor, in addition to medical or surgical approaches.
Adolescent ; Adult ; Bone Neoplasms ; Congenital Abnormalities ; Diagnosis ; Estrogens, Conjugated (USP) ; Female ; Fibrous Dysplasia of Bone ; Fibrous Dysplasia, Polyostotic* ; Frontal Bone ; Frontal Sinus ; Headache ; Humans ; Mass Screening ; Nasal Septum ; Neurosurgery ; Orbit ; Otolaryngology ; Physicians, Family ; Primary Health Care* ; Radionuclide Imaging ; Watchful Waiting ; Young Adult

BACKGROUND: Motorcycles are one of the important members of commercial transportation because of the convenient use during congested traffic conditions and the ease of parking in narrow streets. This study investigates the characteristics of crashes and traffic signal violations caused by motorcycle couriers. METHODS: From the national compensation data, this study analyzed the traffic crashes caused by 671 motorcycle couriers. RESULTS: Among 671 injured couriers, 50.6% were aged less than 40 years, 49.2% run in a small business of < 5 employees, and 47.2% had work experience of < 6 months. Motorcycle crashes occurred mainly due to “rider overturned alone” (67.5%), in the daytime (73.5%), or on cloudy or clear days (77.2%). However, the violation rate caused by motorcycle couriers was high in couriers in a small business of < 5 employees (13.9%), with work experience of < 6 months (13.9%), on cloudy or clear days (12.4%), on an intersection (29.8%), in the type of “crash with a vehicle” (31.2%), or in a death accident (35.7%). CONCLUSION: The findings of this study can be used as a baseline in devising policies for preventing crashes of motorcycle couriers.
Compensation and Redress ; Estrogens, Conjugated (USP) ; Motorcycles ; Occupational Injuries ; Small Business ; Transportation