Objective: To compare the effects and safety of dydrogesterone (DG) and medroxyprogesterone acetate (MPA) on the treatment in patients with endometrial hyperplasia without atypia (EH). Methods: This was a single-center, open-label, prospective non-inferior randomized controlled phase Ⅲ trial. From February 2019 to November 2021, patients with EH admitted to the Obstetrics and Gynecology Hospital of Fudan University were recruited. Enrolled patients were stratified according to the pathological types of simple hyperplasia (SH) or complex hyperplasia (CH), and were randomised to receive MPA or DG. Untill May 14, 2022, the median follow-up time after complete response (CR) was 9.3 months (1.1-17.2 months). The primary endpoint was the 6-month CR rate (6m-CR rate). The secondary endpoints included the 3-month CR rate (3m-CR rate), adverse events rate, recurrence rate, and pregnancy rate in one year after CR. Results: (1) A total of 292 patients with EH were enrolled in the study with the median age of 39 years (31-45 years). A total of 135 SH patients were randomly assigned to MPA group (n=67) and DG group (n=68), and 157 CH patients were randomly assigned to MPA group (n=79) and DG group (n=78). (2) Among 292 patients, 205 patients enrolled into the primary endpoint analysis, including 92 SH patients and 113 CH patients, with 100 patients in MPA group and 105 in DG group, respectively. The 6m-CR rate of MPA group and DG group were 90.0% (90/100) and 88.6% (93/105) respectively, and there were no statistical significance (χ²=0.11, P=0.741), with the rate difference (RD) was -1.4% (95%CI:-9.9%-7.0%). Stratified by the pathology types, the 6m-CR rate of SH patients was 93.5% (86/92), and MPA group and DG group were respectively 91.1% (41/45) and 95.7% (45/47); and the 6m-CR rate of CH patients was 85.8% (97/113), and MPA group and DG group were 89.1% (49/55) and 82.8% (48/58) respectively. The 6m-CR rates of the two treatments had no statistical significance either (all P>0.05). A total of 194 EH patients enrolled into the secondary endpoint analysis, including 88 SH patients and 106 CH patients, and 96 patients in MPA group and 98 in DG group, respectively. The 3m-CR rate of SH patients were 87.5% (77/88), while the 3m-CR rates of MPA group and DG group were 90.7% (39/43) and 84.4% (38/45), respectively; the 3m-CR rate of CH patients was 66.0% (70/106), and MPA group and DG group had the same 3m-CR rate of 66.0% (35/53). No statistical significance was found between the two treatments both in SH and CH patients (all P>0.05). (3) The incidence of adverse events between MPA group and DG group had no statistical significance (P>0.05). (4) A total of 93 SH patients achieved CR, and the cumulative recurrence rate in one year after CR were 5.9% and 0 in MPA group and DG group, respectively. While 112 CH patients achieved CR, and the cumulative recurrence rate in one year after CR were 8.8% and 6.5% in MPA group and DG group, respectively. There were no statistical significance between two treatment groups (all P>0.05). Among the 93 SH patients, 10 patients had family planning but no pregnancy happened during the follow-up period. Among the 112 CH patients, 21 were actively preparing for pregnancy, and the pregnancy rate and live-birth rate in one year after CR in MPA group were 7/9 and 2/7, while in DG group were respectively 4/12 and 2/4, and there were no statistical significance in pregnancy rate and live-birth rate between the two treatment groups (all P>0.05). Conclusions: Compared with MPA, DG is of good efficacy and safety in treating EH. DG is a favorable alternative treatment for EH patients.
Female ; Humans ; Adult ; Medroxyprogesterone Acetate/adverse effects* ; Endometrial Hyperplasia/pathology* ; Dydrogesterone/adverse effects* ; Hyperplasia ; Prospective Studies

OBJECTIVE: To report on the clinical, metabolic and genetic characteristics of a child with carnitine palmitoyl transferase 1A (CPT1A) deficiency. METHODS: Clinical data and the level of acylcarnitine for a child who initially presented as epilepsy were analyzed. Genomic DNA was extracted from peripheral blood samples of the child and her parents and subjected to next-generation sequencing (NGS). RESULTS: Mass spectrometry of blood acylcarnitine indicated increased carnitine 0 (C0) and significantly increased C0/ (C16+C18). DNA sequencing revealed that the child has carried compound heterozygous variants of the CPT1A gene, namely c.1846G>A and c.2201T>C, which were respectively inherited from her mother and father. CONCLUSION CPT1A presenting initially as epilepsy was unreported previously. Analysis of blood acylcarnitine C0 and C0/ (C16 + C18) ratio and NGS are necessary for the identification and diagnosis of CPT1A deficiency. The c.1846G>A and c.2201T>C variants of the CPT1A gene probably underlay the disease in this child. Above finding has also enriched the spectrum of CPT1A gene variants.
Carnitine/blood* ; Carnitine O-Palmitoyltransferase/genetics* ; Child ; DNA Mutational Analysis ; Female ; Humans ; Hypoglycemia/genetics* ; Lipid Metabolism, Inborn Errors/genetics*

Objective: To understand the consciousness of the cancer early treatment and its demographic and socioeconomic factors. Methods: A cross-sectional survey was conducted in 16 provinces covered by the Cancer Screening Program in Urban China (CanSPUC) from 2015 to 2017. A total of 32 257 local residents aged ≥18 years old who could understand the investigation procedure were included in the study by using the cluster sampling method and convenient sampling method. All local residents were categorized into four groups, which contained 15 524 community residents, 8 016 cancer risk assessment/screening population, 2 289 cancer patients and 6 428 occupational population, respectively. The questionnaire collected personal information, the consciousness of the cancer early treatment and relevant factors. The Chi square test was used to compare the difference between the consciousness of the cancer early treatment and relevant factors among the four groups. The logistic regression model was used to analyze the influencing factors related to the consciousness of the cancer early treatment. Results: With the assumption of being diagnosed as precancer or cancer, 89.97% of community residents, 91.84% of cancer risk assessment/screening population, 93.00% of cancer patients and 91.52% of occupational population would accept active treatments (P<0.001). If the immediate family members were diagnosed as precancer or cancer, people who would encourage their family members to receive early treatment in the four groups accounted for 91.96%, 91.94%, 92.44% and 91.55%, respectively (P<0.001). The company employees, annual household income with 40 000 yuan and more and other three groups had a relatively better consciousness of the cancer early treatment (P<0.05). Male, widowed, unemployed and from the central and western regions had a relatively worse consciousness of the cancer early treatment (P<0.05). Conclusion Residents in urban China participants had a good consciousness of the cancer early treatment. The marital status, occupation, annual household income and residential regions were major factors related to the consciousness of the cancer early treatment.

A questionnaire survey of 1 000 clinicians having experience in treating uncomplicated lower urinary tract infections from different levels of hospitals was conducted to mainly evaluate the applicability and effectiveness of clinical application of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for uncomplicated lower urinary tract infection(hereinafter referred to as Guideline). The research was conducted with the three-level quality control strictly throughout the process, and the data was real and reliable. The survey's results showed that: most clinicians considered that the Guideline had good clinical applicability. The availability and price of the recommended medicine were moderate. Traditional Chinese medicine had obvious features and advantages in treating lower urinary tract infection for it could reduce the usage of antibiotics and shorten the course of antibiotic application. In the recommendation section, clinicians proposed increasing medication guidance, updating the Guideline timely, as well as increasing treating methods and techniques, strengthen propaganda and promotion, and improve the use of evidence-based methods. In the evaluation of effectiveness, the majority of clinicians agreed that the definition in both traditional Chinese medicine (TCM) and Western medicine and differential diagnosis in the Guideline were accurately described and the basic principle of treatment as well as the treating method of TCM were recommended appropriately. The TCM formulas and Chinese patent medicine had good effect. Some clinicians suggested refining the syndrome differentiation of stranguria. Some clinicians considered that the formulas and herbs recommended in Guideline didn't have obvious effect and some had doubts about the manipulation of fumigation and washing in the part of other methods recommended in Guideline. Moreover, specification and procedure of manipulation of fumigation and washing using herbs and the acupuncture included in characteristic TCM therapy treating uncomplicated lower urinary tract infection remained to be developed.
Acupuncture Therapy ; Anti-Bacterial Agents ; Diagnosis, Differential ; Drugs, Chinese Herbal ; Humans ; Medicine, Chinese Traditional ; Urinary Tract Infections

Objective To study the clinical efficacy and follow-up study of ketogenic diet adding treatment for refractor epilepsy in children.Methods Cluster sampling method was employed to select children in children's hospital from January 2015 to June 2017,a total of 25 cases were diagnosed refractor epilepsy and adding ketogenic diet.Engel grade was used to evaluate the efficiency,the side effects,electroencephalogram (EEG) changes and intellectual development at 3 months,3-6 months,and more than 6 months.Results The effective rate of epileptic seizure control was 0,66.7％ and 87.5％ at 3 months,3 -6 months and ＞ 6 months respectively.The improvement rate of EEG discharge index was 33.3％,50％ and 81.3％ respectively.The improvement of intelligence development was 33.3％,50％ and 68.8％ respectively.Gastrointestinal disturbances were the main side effects.Severe side effect occurred in two cases--they had severe food refusal and were stopped the ketogenic diet adding treament.Conclusions The ketogenic diet is effective,safe,few side effects and tolerable in infants and children with refractory epilepsy.The ketogenic diet may improve cognition and behavior in addition to reducing seizure frequency,the interical epileptiform discharges (IED) index and improve the quality of life of epileptic children.However,the acceptance of ketogenic diet therapy for children is not satisfactory.The sample size is small and needs further promotion.While large samples and long-term observations are still desired to better recipes,and to provide possibly effective altemative to other therapies for refractor epilepsy.

Objective To learn the epidemiological characteristics of foodborne disease outbreak in 2015,Zhejiang Province,and to provide evidences for the prevention and control of foodborne disease outbreak.Methods Descriptive epidemiological analysis using ArcGIS 10.2 and SPSS 19.0 was conducted on geographical country data,information of permanent resident population and the incidence data of foodborne disease outbreak reported through foodborne disease outbreak reporting information system in 2015.Results There were 116 foodborne disease events reported in Zhejiang in 2015,resulting in 1 009 persons attacked,115 hospitalization and 10 deaths.The proportion of unknown pathogenic factor for events was 29.31%.The events appearance sporadic,there were some local hotspots in Jiaxing.The vibrio parahaemolyticus was the most common pathogen (32.76%),and poisonous mushrooms(8.62%)come the second.Most foodborne disease incidents occurred during June to November.Restaurants ,family and rural feasts were the major places where the foodborne disease occurred.The proportion of family foodborne disease events because of mistaken and misuse poisonous substances increased,and the hospitalization rate and mortality of events of which were the highest (33.9% and 7.63% respectively).Conclusion The food safety management and of restaurants and rural feasts should be strengthened in summer and autumn,as well as foodborne disease prediction and forewarning to reduce the foodborne disease incidents caused by microorganism contamination and poisonous muchnooms.It is necessary to conduct public risk cognition research for foodborne disease in Zhejiang,which could provide evidence for preventing and controlling family foodborne disease.

OBJECTIVETo study the molecular mechanism of extracts from Euodia rutaecarpa on hepatotoxicity in mice.

METHODTotally 30 KM mice were divided into 3 groups and orally administrated extracts from E. rutaecarpa for consecutively 15 days. The expressions of Erkl/2, CDK8, CK1e, Stat3 and Src were detected by Western blotting method.

RESULTThe extracts from E. rutaecarpa could up-regulated Erkl/2, CDK8 and CK1e expressions (P <0.01) and down-regulate Stat3 and Src (P <0.01).

CONCLUSIONThe molecular mechanism of E. rutaecarpa on hepatotoxicity may be correlated with Erkl/2, CDK8, CKle, Stat3 and Src signal molecules.

Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Down-Regulation ; Drugs, Chinese Herbal ; toxicity ; Evodia ; chemistry ; Female ; Fruit ; chemistry ; Gene Expression Regulation ; drug effects ; Liver ; drug effects ; metabolism ; Male ; Mice ; Plants, Medicinal ; Signal Transduction ; drug effects ; Specific Pathogen-Free Organisms ; Triglycerides ; blood ; Up-Regulation

The development history, education, legislation, charge and institutes of acupuncture and moxibustion in Singapore are introduced in this article. Acupuncture and moxibustion has been developed in Singapore since 1840. Nowadays there are three universities that set up standard Chinese medicine courses and two acupuncture-moxibustion associations. Legislation of acupuncture and moxibustion is published in 2000. The acupuncture and moxibustion is applied for approximately 50 kinds of diseases. The acupuncture and moxibustion is at one's own expense in public or private institutions, but cheap or completely free in charity.
Acupuncture ; education ; history ; manpower ; trends ; Acupuncture Therapy ; economics ; history ; trends ; History, 19th Century ; History, 20th Century ; History, 21st Century ; Hospitals ; Humans ; Moxibustion ; economics ; history ; trends ; Singapore

OBJECTIVETo analyze and identify the membrane proteins of endomembrane system in human pancreatic cancer cell by proteomics.

METHODSMembrane protein was extracted from pancreatic cancer cell lines Capan-1, MiaPaCa-2, Panc-1. The membrane protein mixture of the three pancreatic cancer cell lines were separated by two-dimensional electrophoresis (2-DE). Positive dots of staining 2-DE gel were identified by MALDI-TOF mass spectrometry and PMF matching, and then evaluated by bio-informatics searching in NCBI and ExPASy databases. Information of membrane proteins were acquired like sequence, molecular weight, isoelectric point, location and biological functions.

RESULTSForty-nine membrane proteins out of 166 protein dots which could be seen on the 2-DE gel were identified as channel carrier proteins (4 proteins), signal transduction proteins (5 proteins), transcription regulatory and translation modification protein (7 proteins), proliferation and apoptosis related proteins (4 proteins), invasion and migration associated proteins (2 proteins), cytoskeleton proteins (3 proteins), metabolism pathway proteins (14 proteins), and function unknown protein (10 proteins).

CONCLUSIONSEndomembrane proteins of pancreatic cancer cell play key roles in tumor malignant behavior like proliferation, metabolism, motility, adhesion and migration. These membrane proteins might become candidate biomarkers or targets of therapy of pancreatic cancer.

Biomarkers, Tumor ; analysis ; Cell Line, Tumor ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Membrane Proteins ; analysis ; Pancreatic Neoplasms ; metabolism ; Peptide Mapping ; Proteomics ; methods ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

OBJECTIVETo assess the depression and anxious status among transferred injured survivors in Wenchuan earthquake in Sichuan province.

METHODSA total of 43 transferred injured survivors were investigated by questionnaire exploring their trauma symptoms and mental health status.

RESULTSHigh rates of trauma symptoms were remarkably observed in these survivors. Of all the respondents, 60% had some emotional symptoms and sleeping difficulties. About one third of respondents experienced recurrent and intrusive distressing recollection of event, 16 (37.21%) experienced nightmare, 15 (34.88%) had flashback and 7 (16.28%) of them tried to avoid relative stress.

CONCLUSIONMany mental symptoms were observed in transferred injured survivors. The two major factors of mental stress were emotional symptoms and re-experience of the disaster.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Disasters ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Stress Disorders, Post-Traumatic ; psychology ; Stress, Psychological ; Survivors ; psychology ; statistics & numerical data ; Wounds and Injuries ; psychology ; Young Adult