Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Uterine arteriovenous fistula (UAVF), a relatively rare vascular anomaly, may lead to life-threatening hemorrhage and poses diagnostic and management challenges for primary hospitals during initial encounters. This article reports four cases of UAVF treated with Drospirenone and ethinyl estradiol tablets at Department of Gynaecology, Zhuji Maternal and Child Health Hospital between 2023 and 2024. Combined with literature review, we systematically analyzed the etiological mechanisms, clinical characteristics, and diagnostic-therapeutic strategies of this condition, with particular focus on evaluating the efficacy and safety of conservative pharmacological management. By summarizing case features and individualized treatment protocols, this study aims to provide clinical references for early identification, accurate diagnosis, and rational intervention of UAVF, thereby reducing risks of massive hemorrhage and long-term complications while improving patient prognosis.

Emaciation is a common physical condition in clinical practice,often accompanied by symptoms related to"excessive fire in thin people".Insufficient yin-qi is the main physiological and pathological basis of emaciation,and excessive dryness-heat is the secondary manifestation.The disease involves five viscera,with the spleen as the core.The principle of treatment is to nourish yin-qi as the main method,and to dissipate stagnant heat as the auxiliary method.Specifically,it includes two aspects:treating the root cause and treating the symptoms.Treating the root cause should nourish yin-qi to improve the"emaciation"constitution,and treating the symptoms should dissipate stagnant heat to eliminate the"excessive fire"state.The importance of the two should be determined ac-cording to the severity and urgency of the excessive fire.Clinically,the addition and subtraction of medicinal ingredients are made ac-cording to factors such as the urgency of the root cause and symptoms,the state of emaciation and the ability to eat,the degree of defi-ciency or excess of fire-heat,the pathogenesis of the disease,and the season.

To optimize the process of hydrogenation reduction in the synthesis of apremilast (APST), 3-nitrophthalic anhydride (4) and (S)-1-(3-ethoxy-4-methoxyphenyl)-2-(methylsulfonyl) ethanamine-(S)-2-acetamido-4-methylpentanoate (7) were used as starting materials to synthesize (S)-2-(1-(3-ethoxy-4-methoxyphenyl)-2-(methylsulfonyl)ethyl)-4-nitroisoindoline-1,3-dione (8) by amination.Then compound 8 was reduced to (S)-4-amino-2-(1-(3-ethoxy-4-methoxyphenyl)-2-(methylsulfonyl) ethyl) isoindoline-1,3-dione (9) with ammonium formate as hydrogen source and palladium hydroxide as catalyst.Finally, apremilast was obtained by the acetylation reaction with acetic anhydride.The structure of the products were verified by optical rotation, 1H NMR, 13C NMR, MS and elemental analysis.And the total yield of three steps was increased to 67.0%.The improved reduction process can avoid the special reaction of hydrogenation and pressurization, and reduce the safety risk and production costs with high commercial value.

Objective:To establish and evaluate a follicle isolation method, combination of enzymatically digestion with strainer filtration, for synchronously collecting mouse follicles across different developmental stages.Methods:Pre-cutted ovarian tissue blocks were digested with enzymes mixed by Collagenase I and DNase I, and then filtered through three different pore size cell strainers to synchronously separate the follicles at developmental stages. The follicles obtained by turning over and washing the 100 μm strainer were recorded as group A (>100 μm), as same as the follicles obtained by turning over and washing the 40 μm strainer were recorded as group B (40-100 μm), and the follicles obtained by turning over and washing the 20 μm strainer were recorded as group C (20-40 μm). The quantity, morphology, viability and developmental potency were examined among these harvested follicles.Results:In terms of quantity, follicles in group C accounted for most, followed by follicles in group A, and the follicles in group B were the least. Morphologically, the basal membrane integrity rate of follicles in group C was higher than that of groups B and A ( P<0.001 and P<0.001, respectively). As for viability, the survival rate of follicles in group A was 70.59% (120/170), which was higher than that in group B (51.79%, 58/112) and group C (35.90%, 28/78) ( P=0.001 6 and P<0.001, respectively). In terms of developmental potency, after 96 h of in vitro culture, the diameter of follicles in group A increased from (113.64±9.57) μm to (150.95±45.90) μm ( P=0.002 4), and the diameter of follicles in group B increased from (88.12±9.12) μm to (120.61±18.00) μm ( P<0.001). In group C, monolayer-layer granulosa cells were attached to the follicles within 24 h of culture, and the connection structure between oocytes and granulosa cells was lost. The oocytes were completely exposed and failed to be cultured successfully. Conclusion:Combining enzymatically digestion with multiple strainers filtration is a rapid and effective method for follicle collecting, which is capable to isolate different developmental stage mouse follicles synchronously with morphological integrity, favorable viability and good developmental potency.

Objective:To establish and evaluate a follicle isolation method, combination of enzymatically digestion with strainer filtration, for synchronously collecting mouse follicles across different developmental stages.Methods:Pre-cutted ovarian tissue blocks were digested with enzymes mixed by Collagenase I and DNase I, and then filtered through three different pore size cell strainers to synchronously separate the follicles at developmental stages. The follicles obtained by turning over and washing the 100 μm strainer were recorded as group A (>100 μm), as same as the follicles obtained by turning over and washing the 40 μm strainer were recorded as group B (40-100 μm), and the follicles obtained by turning over and washing the 20 μm strainer were recorded as group C (20-40 μm). The quantity, morphology, viability and developmental potency were examined among these harvested follicles.Results:In terms of quantity, follicles in group C accounted for most, followed by follicles in group A, and the follicles in group B were the least. Morphologically, the basal membrane integrity rate of follicles in group C was higher than that of groups B and A ( P<0.001 and P<0.001, respectively). As for viability, the survival rate of follicles in group A was 70.59% (120/170), which was higher than that in group B (51.79%, 58/112) and group C (35.90%, 28/78) ( P=0.001 6 and P<0.001, respectively). In terms of developmental potency, after 96 h of in vitro culture, the diameter of follicles in group A increased from (113.64±9.57) μm to (150.95±45.90) μm ( P=0.002 4), and the diameter of follicles in group B increased from (88.12±9.12) μm to (120.61±18.00) μm ( P<0.001). In group C, monolayer-layer granulosa cells were attached to the follicles within 24 h of culture, and the connection structure between oocytes and granulosa cells was lost. The oocytes were completely exposed and failed to be cultured successfully. Conclusion:Combining enzymatically digestion with multiple strainers filtration is a rapid and effective method for follicle collecting, which is capable to isolate different developmental stage mouse follicles synchronously with morphological integrity, favorable viability and good developmental potency.

ObjectiveTo investigate the effects of exogenous transforming growth factor β1 on the apoptosis of nerve cells and its functions following spinal cord injury in rats.MethodsNinety-six male Wistar rats were randomly divided into 4 groups:group A(control group),group B(spinal cord injured group),group C (spinal cord injuried +TGF-β1 treated group),group D (spinal cord injuried +anti-TGF-β1 treated group).The rat model of spinal cord injury was found by the Allen's method.In group C and D,drugs were injected into subarachnoid cavity continuously by minipump.The changes of spinal cord were observed by HE staining.Nerve cells apoptosis was detected by transferase-medi-ated dUTP nick end labeling (TNUEL) method and the expression of cell apoptosis factor Fas by immunohistochemistry staining.Functional recovery of hind limbs was measured by Basso-Beattie-Bresnahan locomotor open field behavioral rating test.ResultsThe expression of TGF-β1and Fas increased following spinal cord injury.The amount of TGF-β1and Fas reached the peak 7days and 1day after injury.The apoptosis of neuron had increased and peaked 8 hours after injury.The apoptosis of neuroglia cells had increased and peaked 7 dayss after injury.The slight changes was found in spinal cord in group C.Both of the number of apoptosis of nerve cells and expression of the apoptosis factor (Fas) decreased significantly; compare with group B and D.The BBB score was higher in group C than that in group B and D.ConclusionTGF-β1 can improve the functional recovery of spinal cord by inhibiting the nerve cell apoptosis after the spinal cord injury.

0.05). After operation about 50% cases (11/22) improved the menstrual dysfunction, and most cases avoid doing operation again in short period. Conclusion While cases chosen properly and adequate operative preparation, it is feasible and valuable to carry out cesarean section and myomectomy at the same time.