Objective To explore the antitussive action site and potential mechanism of Shegan Zhike Capsule.Methods The mouse cough model induced by concentrated ammonia was used to observe the dose effect relationship of the antitussive effect of Shegan Zhike capsule.The central antitussive effect of Shegan Zhike capsule was observed by using the cough model induced by electrical stimulation of superior laryngeal nerve in guinea pigs.The peripheral antitussive effect of Shegan Zhike capsule was observed by using the cough model of capsaicin desensitized guinea pigs induced by mechanical stimulation.The model of chronic bronchitis in guinea pigs was established by smoking,and the effects of Shegan Zhike Capsule on vasoactive amines histamine(HA)and 5-hydroxytryptamine(5-HT)were observed.Results Shegan Zhike capsule could significantly reduce the number of coughs in mice at the doses of 43.00,86.00 and 172.00 mg extract·kg-1(P<0.05 or P<0.01).The low-dose group,the middle-dose group,and the high-dose group of Shegan Zhike Capsule did not significantly inhibit the cough inducing effect of electrical stimulation of guinea pig superior laryngeal nerve at 30 min and 60 min after administration.Shegan Zhike capsule could significantly inhibit the cough of capsaicin desensitized guinea pigs caused by mechanical stimulation in the low dose group at 60 min,the medium dose group at 30 min and the high dose group at 30 min and 60 min(P<0.05).Compared with the model control group,the content of HA in serum of guinea pigs in low,medium and high dose groups of Shegan Zhike capsule decreased significantly(P<0.05 or P<0.01).The content of serum 5-HT in the high dose group decreased significantly(P<0.05).Conclusion The antitussive effect of Shegan Zhike Capsule was not in the center,and its peripheral antitussive effect was related to the inhibition of RARs receptors,and vasoactive amines such as HA and 5-HT were also involved.

Objective To evaluate the feasible cervical cancer screening strategies in rural China. Methods The study was based on the health industry scientific research project of National Health Commission in 2015, cervical cancer screening technology and demonstration research suitable for rural areas in China, we collected health economics and epidemiological parameters and established the unscreening model and screening model with Treeage Pro 2011 software. Combining with the data acquired from site investigation, including population screening, treatment-related clinical materials and cost data, we simulated the occurrence and the development of cervical cancer of rural women in China under different screening and intervention programs and predicted the screening effects [cumulative incidence, cumulative risk of disease, life years and quality adjusted life years (QALY), gains] and costs after 20 years, and using health economic evaluation analysis (cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis). Screening programs included five screening strategies [visual inspection with acetic acid/lugol's iodine (VIA/VILI), careHPV, ThinPrep cytology test (TCT), careHPV+TCT, careHPV+VIA/VILI] and three screening intervals (1-year, 3-year, 5-year), a total of fifteen screening programs. Results Compared with no screening, fifteen screening programs reduced the cumulative incidence by 22.65%-51.76%. Compared with TCT or VIA/VILI, for the same screening interval, the reduced cumulative incidence, the amounts of life-year saved and QALY and benefits gained of careHPV were the highest. The cost-effectiveness ratios of these screening programs ranged (0.44-3.24)×104 Yuan per life-year saved, cost-utility ratios ranged (0.15-1.01)×104 Yuan per QALY, benefit-cost ratios ranged 7.73-59.10. The results of incremental cost-effectiveness ratios showed that VIA/VILI every five years, VIA/VILI every three years, careHPV every five years, careHPV every three years and careHPV every year were dominant programs. Conclusions VIA/VILI screening is cost-effective, careHPV is slightly more expensive but more effective. In rural China, careHPV screening every five years could be recommended. This study provides a basis for the determination of cervical cancer screening methods feasible for rural areas in China.

Objective: To evaluate the feasible cervical cancer screening strategies in rural China. Methods: The study was based on the health industry scientific research project of National Health Commission in 2015, cervical cancer screening technology and demonstration research suitable for rural areas in China, we collected health economics and epidemiological parameters and established the unscreening model and screening model with Treeage Pro 2011 software. Combining with the data acquired from site investigation, including population screening, treatment-related clinical materials and cost data, we simulated the occurrence and the development of cervical cancer of rural women in China under different screening and intervention programs and predicted the screening effects [cumulative incidence, cumulative risk of disease, life years and quality adjusted life years (QALY) , gains] and costs after 20 years, and using health economic evaluation analysis (cost-effectiveness analysis, cost-utility analysis, cost-benefit analysis). Screening programs included five screening strategies [visual inspection with acetic acid/lugol's iodine (VIA/VILI), careHPV, ThinPrep cytology test (TCT), careHPV+TCT, careHPV+VIA/VILI] and three screening intervals (1-year, 3-year, 5-year), a total of fifteen screening programs. Results: Compared with no screening, fifteen screening programs reduced the cumulative incidence by 22.65%-51.76%. Compared with TCT or VIA/VILI, for the same screening interval, the reduced cumulative incidence, the amounts of life-year saved and QALY and benefits gained of careHPV were the highest. The cost-effectiveness ratios of these screening programs ranged (0.44-3.24)×10⁴ Yuan per life-year saved, cost-utility ratios ranged (0.15- 1.01)×10⁴ Yuan per QALY, benefit-cost ratios ranged 7.73-59.10. The results of incremental costeffectiveness ratios showed that VIA/VILI every five years, VIA/VILI every three years, careHPV every five years, careHPV every three years and careHPV every year were dominant programs. Conclusions VIA/VILI screening is cost-effective, careHPV is slightly more expensive but more effective. In rural China, careHPV screening every five years could be recommended. This study provides a basis for the determination of cervical cancer screening methods feasible for rural areas in China.

Objective To measure in vivo biomechanical properties of pelvic support structures associated with uterosacral ligament suspension(ULS). Methods Ten Chinese female cadavers(death within 48 hours)without embalming were carefully dissected to expose the ligament. After dissection, ligaments were sewn according to standard ULS surgical technique. They were stretched at a steady rate to breakage during constant electronic registration of load and displacement. In vivo biomechanical properties were evaluated by a load-displacement curve. Results Ultimate load of uterosacral ligament, ring around cervix were(37.3±23.5),(49.3±28.4)N, respectively. The differences between the two groups was not significant(P>0.05). Ligament stiffness were(1.26±1.22),(1.45±0.92)N/mm, respectively. There was no significant difference between groups(P>0.05). Conclusions The uterosacral ligament, ring around cervix with sufficient strength are not easy to deform. ULS is an effective procedure for treating middle pelvic defects from a biomechanics perspective.

Through reviewing ancient and modern literatures,the effect evolution and disease treatment changes of Belamcanda chinensis were understood.The pharmacological experiments were used to verify its main effects.The combination of featured advantages of traditional Chinese medicine (TCM) and modern science and technology contributed to the promotion of TCM modernization.It had important significance for the development of effective components,selection of disease types in the treatment for research and development of new TCM drugs.The indication of Belamcanda chinensis was verified from textual research.The treatment of disease types by Belamcanda chinensis was verified from medical books.The treatment of disease types by Belamcanda chinensis compound was analyzed based on the Pujifang database management system.Main indications of Belamcanda chinensis were summarized.Modern pharmacological studies on anti-inflammatory mechanism of main components of Belamcanda chinensis were combined to screen animal models and investigation indexes for the preliminary verification of the efficacy of Belamcanda chinensis.The comprehensive application of classical herbal medicine books and prescription database analysis results showed that removing phlegm and relieving sore throat were the efficacy of Belamcanda chinensis,which was an important medicine in the treatment of pharyngitis and sore throat.In the modern research,serum of experimental group,IL-4 in throat tissues,as well as IgE and LTC4 level in serum and lung tissues were significantly reduced compared to the model group (P＜0.05).It was concluded that the treatment effect of Belamcanda chinensis extract to chronic pharyngitis may be through the decreasing of IgE level in serum and lung tissues,inhibiting IL-4 expression in serum and throat tissues,and the LTC4 expression in serum.

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P<0.01). According to Point Aa, treatment group and control group in the postpartum 6 weeks was (-2.2 ± 0.7) versus (-2.4 ± 0.6) cm, in postpartum 12 months (-2.5 ± 1.1) versus (-2.7 ± 0.6) cm, the improvement in treatment group was statistically significant (P<0.01). And the other points were not significantly different (P>0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.

Objective To explore the pregnancy outcome and obstetric management of pregnancy and delivery after vaginal radical trachelectomy (VRT).Methods Forty-two cases of VRT from December 2003 to May 2012 in Peking Union Medical College Hospital were analyzed retrospectively.Among them ten cases got pregnant successfully.Results The average age of patient at VRT surgery was (30.6 ± 3.7) years old and average follow-up time was 29.5 months.There were 31 patients attempted conception.Ten of them got fourteen conceptions successfully.Overall conception rate was 45％ (14/31).There were four cases of first trimester abortion.Among them,two were miscarriage,two were elective abortion.There was one case of ectopic pregnancy operation and non of second trimester loss.Nine cases reached the third trimester.The total preterm delivery rate was 4/9.There were two cases delivered before 32 gestational weeks (2/9).Cesarean section was performed through a transverse incision in all of nine cases.No uterine rupture and postpartum hemorrhage occurred.All newborns had good outcomes.The average follow-up time after postpartum was 22.9 months.All cases were disease-free.Conclusions The conception rate of patients after VRT in our series is 45％.The preterm birth rate of pregnancy after VRT is higher.Routine cerclage of cervix during VRT procedure and pregnancy is not necessary.Cesarean section shortly after full term pregnancy through a transverse incision should be considered as a suitable and safe procedure.

Objective To evaluate clinical efficiency and quality-of-life outcomes in treatment of severe pelvic organ prolapse by the Xiehe pelvic floor reconstruction surgery. Methods From Jun. 2006 to Dec. 2008, 277 severe pelvic organ prolapse patients with stage Ⅲ to Ⅳ from 8 hospitals in China were enrolled in this prospective study. Pelvic organ prolapse quantitative examination (POP-Q) and anatomic improvement in these patients after surgery were analyzed in this interim study. Comparisons of pelvic floor impact questionnaire-short form 7 (PFIQ-7) and pelvic floor distress inventory-short form 20 (PFDI-20) in these patients before and after surgery was used to evaluate quality of life. Comparison of pelvic organ prolapse-urinary incontinence sexual questionnaire (PISQ) in these patients before and after surgery was used to evaluate quality of sexual life. Results With a median follow-up of 14. 0 months (6 -28 months),twenty-three patients showed recurrent prolapse (8. 3%, 23/277), and anatomical success ( ＜ stage 2 in the treated compartment) was 91.7% (254/277). In this series, mesh exposure or erosion rate was 6. 9% (19/277). The postoperative de novo stress incontinence rate was 6. 5% (18/277). The scores for PFIQ-7 and PFDI-20, and its subscales were significantly improved, the scores of before treatment were lower than those after treatment (P ＜0. 01 ). And there was no significant difference in the average score of PISQ before and after the surgery (76. 6 ± 15.4 versus 75.5 ± 14. 5 versus 73.6 ± 12. 6, P ＞0. 05 ), but the rate of de novo dyspareunia was 11% (9/80). Conclusions Xiehe pelvic floor reconstruction surgery was safe and efficacy in treatment of pelvic organ prolapse. It could improve quality of life remarkably with less cost when compared with the traditional total pelvic floor reconstruction surgery.

OBJECTIVETo evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass.

METHODSOne hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI.

RESULTSRMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%.

CONCLUSIONSRMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.

CA-125 Antigen ; blood ; Female ; Humans ; Menopause ; Ovarian Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography

OBJECTIVETo analyze the clinical characteristics of fertility and pregnancy in women with congenital uterine malformations and explore optimal treatments to improve the prognosis.

METHODSA retrospective study was conducted on the fertility and obstetric outcome in 153 patients with uterine malformations treated in our hospital from January 1984 to December 1998. Twenty-seven cases with other kinds of genital and/or urinary anomalies but with normal uterus during the same period were enrolled as the control group.

RESULTSThe infertility rate was 26.6% (34/128), the miscarriage rate 44.3% (86/194), premature birth rate 9.3% (18/194), abnormal fetal presentation rate 28.4% (29/102), the cesarean section rate 61.8% (63/102), and the perinatal mortality rate 11.8% (12/102).

CONCLUSIONWomen with congenital uterine malformation usually have higher incidence of infertility and complications during pregnancy and delivery. Bicornuate and septate uterus can be associated with poor obstetric outcome.

Abortion, Spontaneous ; etiology ; Adult ; Cesarean Section ; statistics & numerical data ; Female ; Fertility ; Humans ; Obstetric Labor, Premature ; etiology ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome ; Retrospective Studies ; Uterus ; abnormalities