Objective: To introduce a method to classify the labia minora hypertrophy and to investigate its significance to the selection of surgical method. Methods: From August 2014 to April 2018, 1 058 patients with labia minora hypertrophy were treated in the Plastic Surgery Hospital. According to the hyperplastic degree of the labia minora and praeputium clitoridis, the labia minora hypertrophy was classified to three types, namely simple clitoridis hypertrophy, simple labia minora hypertrophy and mixed type. For patients with simple labia minora hypertrophy, the methods of margin resection, or wedge resection or combination were applied. For patients with simple clitoridis hypertrophy, the reduction of clitoris hood could be performed. For mixed type, firstly the relationship of clitoris hood and labia minor should be recognized, then the appropriate surgical method should be taken. Results: The age of the patients was 18 to 46 years (mean age was 25 years). 83 cases (7.8%) were simple labia minora hypertrophy. 25 cases (2.4%)were simple clitoridis hypertrophy. And 950 cases (89.8%) were mixed type. All the patients received appropriate surgical method to repair the malformation. All the surgeries were successfully performed and the cosmetic results were satisfying. Conclusions As the homologous tissues, whether praeputium clitoridis hypertrophy or labia minora hypertrophy could result poor appearance of female vulva. The concept of holism should be kept in mind when repair surgeries are performed. The labia minora hypertrophy was classified to three types and appreciate surgical methods were applied to repair the hypertrophy. The cosmetic result was satisfying.

Traditionally,conventional imaging modalities used to assess neoplasms for neoadjuvant chemotherapy responses have their own limitations.Functional imaging can predict neoadjuvant chemotherapeutic responses early and thus guide personalized therapies.However,there is no standard method of imaging assessment for neoadjuvant chemotherapy follow-up.The aim of this arti-cle is to discuss the accuracy,advantages,limitations,and future directions of various imaging methods,especially functional imaging, for evaluating the response to chemotherapy in patients with breast neoadjuvant chemotherapy.

Objective To establish a method for the determination of nigeglanoside in seeds of Nigella glandulifera. Methods The content of nigeglanoside was determined by HPLC.The separation was performed on a C18column ( YMC-Pack ODS-A,250 mm×4.6 mm,5 μm) with a gradient elution system of acetonitrile and 0.017 5 mol·L-1acetic acid solution at the flow rate of 1.0 mL·min-1.The detection wavelength was set at 290 nm,and column temperature was 30 ℃. Results The linear range of nigeglanoside was 0.01-0.30 mg·mL-1(R2＝0.9991).The RSDs of precision,stability and repeatability were all less than 2%.The average recovery was 96.66% (RSD＝1.25%,n＝6). Conclusion The method is accurate and reproducible. It is effective in controlling the quality of seeds of Nigella glandulifera .

Objective: To investigate the spectrum of gene mutations in adult patients with B-acute lymphoblastic leukemia (B-ALL), and to analyze the influences of different gene mutations on prognosis. Methods: DNA samples from 113 adult B-ALL patients who administered from June 2009 to September 2015 were collected. Target-specific next generation sequencing (NGS) approach was used to analyze the mutations of 112 genes (focused on the specific mutational hotspots) and all putative mutations were compared against multiple databases to calculate the frequency spectrum. The impact of gene mutation on the patients’ overall survival (OS) and recurrence free survival (RFS) was analyzed by the putative mutations through Kaplan-Meier, and Cox regression methods. Results: Of the 113 patients, 103 (92.0%) harbored at least one mutation and 29 (25.6%) harbored more than 3 genes mutation. The five most frequently mutated genes in B-ALL are SF1, FAT1, MPL, PTPN11 and NRAS. Gene mutations are different between Ph⁺ B-ALL and Ph^- B-ALL patients. Ph^- B-ALL patients with JAK-STAT signal pathway related gene mutation, such as JAK1/JAK2 mutation showed a poor prognosis compared to the patients without mutation (OS: P=0.011, 0.001; RFS: P=0.014,<0.001). Patients with PTPN11 mutation showed better survival than those without mutation, but the difference was not statistically significant (P value > 0.05). Besides, in Ph⁺ B-ALL patients whose epigenetic modifications related signaling pathway genes were affected, they had a worse prognosis (OS: P=0.038; RFS: P=0.047). Conclusion Gene mutations are common in adult ALL patients, a variety of signaling pathways are involved. The frequency and spectrum are varied in different types of B-ALL. JAK family gene mutation usually indicates poor prognosis. The co-occurrence of somatic mutations in adult B-ALL patients indicate the genetic complex and instability of adult B-ALL patients.

Objective: Analysis of the molecular characteristics of eosinophilia. Methods: Targeting sequence to 24 patients with chronic eosinophilic leukemia (CEL) with rearrangement of PDGFRA, PDGFRB, or FGFR1 and 62 patients with hyper-eosinophilic syndrome (HES). Mutation annotation and analysis of amino acid mutation using authoritative databases to speculate on possible pathogenic mutation. Results: Thirty-seven kinds of clonal variant were detected from 17 patients with CEL, no recurrent mutation site and hot spot region were found. No pathogenic mutation was detected in 19 patients with PDGFRA rearrangement, but pathogenic mutations of ASXL1, RUNX1 and NRAS were detected from 2 patients with FGFR1 rearrangement who progressed to acute myeloid leukemia and 1 patient with PDGFRB rearrangement who progressed to T lymphoblastic lymphoma, respectively. One hundred and two kinds of clonal abnormalities were detected in 49 patients with HES. The main hot spot mutation regions included: CEBPA Exon1, TET2 Exon3, ASXL1 Exon12, IDH1 Y208C, and FGFR3 L164V. CRRLF2 P224L and PDGFRB R370C point mutations were detected separately in 2 patients with HES who treated with imatinib monotherapy and achieved hematologic remission. Conclusion The pathogenesis of CEL with PDGFRA, PDGFRB or FGFR1 rearrangement is usually single, and the progression of the disease may involve other driver mutation. A variety of genes with hot mutation regions may be involved in the pathogenesis of HES, and some mutation sites are sensitive to tyrosine kinase inhibitors.

Objective: To collect preliminary data of normal Chinese female genital appearance, to compare the parameters of Han and Uygur nationality, and to present the preliminary data for normal female external genitalia database. Methods: This study design recruited healthy females referred to the out-patient clinic for physical examination from October 2014 to March 2015 in Xinjiang Petroleum Geological Survey Department Staff Hospital. The recruitment was based on rigid inclusion and exclusion criteria. Demographic data consists of nationality, age, height, weight, marital status, gravidity, parity, vaginal delivery, and intercourse frequency. Anthropometric measurements were taken in 234 females of Han group whereas 278 females of Uygur group. For each individual 16 parameters were measured. The external genitalia appearance in Han and Uygur nationality was compared. The significance of variations in age, height, weight, BMI, gravidity, parity, vaginal delivery and intercourse frequency were analyzed. Results: Primary measurements of Han and Uygur nationality are presented as mean (95% confidence interval). There are many differences in female genital appearance between Han and Uygur nationality. Several parameters were statistically associated with age, BMI, gravidity, parity, vaginal delivery and intercourse frequency. The females with complete labial asymmetry account for 5.6%(13/234) and 5.8%(16/278) in Han and Uygur normal adults, respectively. Conclusions This study presented the external genitalia measurements of normal Chinese female adults in Xinjiang, thus providing the preliminary data for normal female external genitalia database. Females of Han and Uygur nationality have multiple differences in external genitalia appearances. The parameters are associated with age, BMI, gravidity, parity, vaginal delivery, and intercourse frequency. The labial asymmetry is a universal phenomenon.

Objective To study the effectiveness and safety of abdominal lifting and compression method in patients sufferred from cardiac arrest (CA).Methods According to the inclusion and exclusion criteria,72 patients from Hainan People's Hospital and Zhengzhou People's Hospital were enrolled for study of abdominal lifting and compression (ALC) method from January 2014 to June 2015.The markers of respiratory and circulatory performance of all patients were recorded,and re-collected after CPR with ALC.In addition,the data of demographics and clinical signs of patients were collected.The rates of restoration of spontaneous circulation (ROSC) and successful resuscitation were calculated.Differential analysis of singlegroup design univariate quantitative and qualitative data was carried out.Results A total of 72 patients were included finally.The ROSC rate was 15.3％ (11/72) after using ALC equipment,and there was no statistically significant difference in rate of ROSC (P =0.566) between ALC and pre-test (13.0％).However,compared with NT group resuscitated without using ALC method or with using chest compression method,the rate of ROSC was significantly improved in the ALC group (15.3％ vs.O.1％,P ＜ 0.01).Conclusions Abdominal lifting and compression CPR equipment is stable,portable and safe in practice.Abdominal lifting and compression CPR method has its prominent role in saving patients from respiratory and cardiac arrest,and it is sufficient to overcome the disadvantages of conventional CPR method.

Objective To investigate the prompt value of abnormal vaginal morphology on diagnosing pelvic organ prolapse . Methods Forty eight pelvic organ prolapse female patients diagnosed by pelvic organ prolapse quantification were enrolled in the pelvic organ prolapse group and 51 normal female volunteers were enrolled in the control group in this study. Pelvic MRI T2WI were performed in all cases. The vaginal shape were evaluated according to Delancey Ⅱ level on the transverse images, which were divided into two categories:normal morphology (H-shaped) and abnormal morphology(non H-shaped). The vaginal shape distribution of different prolapse degree(0,Ⅰ,Ⅱ,Ⅲ,Ⅳstage) and types(anterior,middle, posterior pelvic prolapse) were recorded. Chi-square test was used to analyse distribution difference of vaginal shape between the two groups. The ROC curve was used to analyse the diagnostic efficiency of abnormal vaginal morphology for diagnosing pelvic organ prolapse. Results In the control group, there were 40 cases with normal vaginal morphology and 11 cases with abnormal morphology mainly including W-shaped and U-shaped abnormal morphology. In the prolapse group, there were 5 cases with normal vaginal morphology and 43 cases with abnormal morphologymainly including U-shaped (13 cases), W-shaped (26 cases) and O-shaped(4 cases) abnormal morphology. There was significant difference between the two groups(c2=46.137,P<0.01). The area under the curve (AUC) was 0.800. The sensitivity and specificity of abnormal vaginal shape for diagnosing pelvic organ prolapse were 89.6% and 78.4%respectively.The distribution of vaginal morphology in different degrees and types of prolapse were different:vaginal morphology of 0 stage prolapse showed H-typed mainly (40/51, 78.4%), Ⅰ stage prolapse showed W-shaped (16/28 57.1%), Ⅱ,Ⅲ stage prolapse all showed non H-shaped (20/20, 100%), Ⅱstage mainly showed W-shaped (9/14), Ⅲ stage mainly showed O-shaped (3/6). Anterior pelvic organ prolapse were manifested mainly with W-shaped vaginal morphology (4/9) and middle pelvic organ prolapse mainly showed O-shaped vaginal morphology (4/7). Conclusions The abnormal vaginal morphology has the prompt value on diagnosing pelvic organ prolapse.Moreover, the different shape probably indicates the different degrees and types of pelvic organ prolapse.

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic. METHODS:Blood culture positive specimens were collected from our hospital during Jan. 2011-Dec.2016. Distribution of bloodstream infection(BSI)pathogens and drug resistance were analyzed in our hospital retrospectively. RESULTS:During 2011-2016,26 034 blood culture specimens isolat-ed from inpatients of our hospital were examined,including 1 775 positive specimens with positive rate of 6.82%. The specimens mainly came from tumor hematology department(10.65%),neurosurgery department(8.28%)and pediatric department(8.00%). A total of 1 775 strains of pathogens were detected,including 967 strains of Gram-negative bacteria(54.48%)mainly as Escherich-ia coli,Klebsiella pneumoniae,649 strains of Gram-positive bacteria(36.56%)mainly as Coagulase negative Staphylococci, Staphylococcus aureus and 159 strains of fungus(8.96%)mainly as Candida albicans. E. coli and K. pneumoniae were resistant to common antibiotics to different extents,but sensitive to piperacillin sodium and tazobactam sodium,imipenem,meropenem. Aci-netobacter baumanii was highly resistant to enzyme inhibitors,cephalosporins,aminoglycosides,quinolones. Pseudomonas aerugi-nosa was sensitive to third-generation cephalosporins,aminoglycosides and quinolones. S. aureus was highly resistant to penicil-lins,cephalosporins and aminoglycosides. Resistance rate of Coagulase negative Staphylococci to most commonly used antibiotics was higher than 40%. Above two bacteria were sensitive to linezolid and vancomycin with resistance rate of 0. A total of 205 strains of ESBLs-producing E. coli(42.01%),64 strains of ESBLs-producing K. pneumoniae(30.33%)and 31 strains of Methicil-lin-resistant S.aureus(17.61%)were detected.No vancomycin-resistant Enterococcus or vancomycin-resistant S.aureus was detect-ed. CONCLUSIONS:BSI pathogens mainly distribute in tumor hematology department of our hospital. BSI pathogens mainly in-clude Enterobacteriaceae and Staphylococcus,and also involve fungus. The situation of drug resistance and enzyme production are not optimistic.Antibiotics,which are sensitive to the major pathogens,include carbapenems,linezolid and vancomycin.

Objective To investigate MR T2-mapping in evaluating birth-related levator ani muscle injury.Methods 25 primiparas at 6 weeks after first vaginal delivery as primiparous group and 12 nulliparous volunteers as control group were prospectively studied. All the subjects underwent pelvic MRI including T2-mapping,mDIXON-T2 WI sequences.Levator ani muscle were divided into two subgroups:levator ani muscle injury group and non-injury group according to if there were edema,avulsion,or rupture in each levator ani muscle subdivisions[puborectal muscle(PRM);iliococcygeal muscle(ICM)],which were showed on mDIXON-T2 WI images.Two radiologists evaluated T2 values of PRM,ICM and observed artificial color images respectively.The consistency between two observers for T2 values of PRM,ICM were evaluated using the intraclass correlation coefficient (ICC ),the difference of T2 values in each levator ani muscle subdivisions among control group,non-injury group and muscle injury group were analyzed using ANOVA .Results There were 26 PRM injury cases and 24 non-injury cases in primiparous group on mDIXON-T2 WI images,and no ICM injured cases in our study.Inter-rater reliability for T2 values between two observers were good(ICC >0.75).T2 values in PRM injury group,non-injury group and control group were(62.78±1.23)ms,(49.75±3.17)ms,(49.96±4.37)ms respectively and the difference was significant. There were significant difference between PRM injury group and non-injury group,control group respectively(P =0.000,P =0.000). The T2 values of ICM in PRM injury group,non-injury group and control group were(70.80±6.50)ms,(62.41±7.32)ms,(62.78±6.91)ms and there were significant difference(P =0.000),meanwhile the difference between PRM injury group and non-injury group,control group were significant respectively(P =0.000,P =0.000).The color gradation of PRM in PRM injury group were mixed with blue, green,and yellow,and tone were lightened on T2-mapping artificial color images;ICM color gradation were uneven with green and yellow, a d tone were higher than those of control group and non-injurygroup.Conclusion T2-mapping can quantitatively assess birth-related levator ani muscle injury and T2-mapping artificial color images show the range and degree of levator ani muscle injury visually.It is hopeful to find micro lesions that T2 WI images are difficult to find.