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@#Objective To use the ultra-performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS)to authenticate the chemical composition of Morinda citrifolia,and further experiments verify that Morinda citrifolia regulate miR-223-3p/NLRP3 signaling pathway to inhibit the inflammatory response in rats with polycystic ovary syndrome(PCOS).Methods Use UPLC-MS/MS analyze the chemical composition of Morinda citrifolia.SD female rats were randomly divided into three groups:normal control group(n=5),PCOS model group(n=5)and Morinda citrifolia gavage group(n=5).HE staining observe the morphology of ovarian histology,ELISA method detect the expression levels of testosterone(T),luteinizing hormone(LH),follicle stimulating hormone(FSH),interleukin(IL)-1βand IL-18,RT-qPCR detect the mRNA expression of miR-223-3p and NLRP3,and Western blot detect the protein expression of NLRP3.Results UPLC-MS/MS identify 641 chemical composition of Morinda citrifolia,including luteolin,Apigenin,emodin and other composition.Compared with the normal control group,the number of cell layers of ovarian granule in the PCOS model group is reduced,and follicular cystic dilation,atresia follicles increased,T and LH levels increased(P<0.05),FSH levels decreased(P<0.05),IL-18 and IL-1β levels increased(P<0.05),and ovarian tissue miR-223-3p mRNA expression decreased(P<0.01),NLRP3 mRNA and protein expression increased(P<0.01)in PCOS model group.Compared with the PCOS model group,the proportion of follicles at all levels is normal,the number of granule cell layers increased,T and LH levels decreased(P<0.05),FSH levels increased(P<0.05),IL-18 and IL-1β levels decreased(P<0.05),miR-223-3p mRNA expression in ovarian tissue increased((P<0.05),NLRP3 mRNA and protein expression decreased(P<0.05)in Morinda citrifolia gavage group.Conclusion Morinda citrifolia can improve the ovary pathological state of PCOS rats,change the abnormal sex hormones and reduce the levels of inflammatory factors IL-18 and IL-1β.The mechanism maybe regulate the miR-223-3p/NLRP3 signaling pathway to inhibit the inflammatory response in PCOS rats.
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Cervical adenosarcoma is a very rare type of Mullerian adenosarcoma and it is easily confused with benign polyps, therefore, differential diagnosis is necessary. The primary clinical symptoms are vaginal abnormal bleeding and abdominal pain, which can be prevented through the study of high-risk factors. Surgery excision has been considered as the main treatment at present. Due to the low incidence of cervical adenosarcoma, its etiology, pathogenesis, diagnosis and treatment need to be discussed further. This paper reviews the diagnosis and treatment progress of cervical adenosarcoma.
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of wheat cellulose particles (testa triticum tricum purify, Fiberform) in the treatment of internal hemorrhoid.</p><p><b>METHODS</b>A multicenter randomized controlled clinical trial was adopted. From October 2015 to July 2016, 60 patients with internal hemorrhoid were enrolled from three medical centers, including Department of Anorectum, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Department of Anorectum, The Third Affiliated Hospital of Nanjing University of Chinese Medicine, Department of Anorectum, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine. Enrollment criteria: Patients aging from 18 to 65 years old; being diagnosed with the second or third grade internal hemorrhoid; having good communication skills and being able to complete the records and follow-ups according to the research program requirements.</p><p><b>EXCLUSION CRITERIA</b>Patients combined with other anal diseases, or whose anus tube or rectum suffering occupying lesions; patients currently using other methods and defecation drugs in the treatment of their hemorrhoids; patients in pregnancy or with diseases of heart, liver, kidney or metabolic disorders; patients suffering from constipation due to other diseases and drugs, and long-term laxatives abusers. According to the random number table method, 60 patients were randomly divided into the combined treatment group [30 cases, wheat cellulose particles 1 bag each time, 2 times per day; Diosmin tablet 2 pills, 2 times per day] and the single treatment group [30 cases, Diosmin tablet 2 pills, 2 times per day]. The treatment courses for both groups were 7 days. According to the four-grade scoring method, the efficacy evaluation would be made on six indicators, which were the degree of hematochezia or bleeding, the degree of pain, hemorrhoid prolapse, the shapes and properties of stool, the defecation frequency and the defecation duration. The higher the score a participant got, the more severe the symptom was. The effectiveness was evaluated by the scoring reduction rate, and marked effectiveness and effectiveness were both found to be effective. Incidence of adverse events was compared between two groups before the treatment, and on postoperative 3-day and 7-day respectively.</p><p><b>RESULTS</b>There were no significant differences between two groups in gender, age, internal hemorrhoids gradings, disease course, and onset time as well as the baseline data, such as the degree of hematochezia or bleeding before the treatment, the degree of pain, hemorrhoid prolapse, the shapes and properties of stool, the defecation frequency and the defecation duration (all P>0.05). After the seven-day treatment, there was significant difference in effective rate between combination group and single group [96.7%(29/30) vs. 66.7%(20/30), Z=-4.376, P=0.000]. Meanwhile, the scores of combined group and single group in hematochezia or bleeding were 0(0, 1) and 0(0, 2) (Z=9.241, P=0.002); in shapes and properties of stool were 0(0, 1) and 0(0, 1) (Z=5.364, P=0.021); in defecation frequency were 0(0, 1) and 0(0, 2) (Z=7.552, P=0.006); and in defecation duration were 0(0, 1) and 0(0, 2) (Z=4.425, P=0.035), whose differences were all significant. The scores of pain degree and hemorrhoid prolapse of two groups also decreased, but the difference was not statistically significant (P>0.05). During the treatment, abdominal pain, diarrhea and other adverse reactions were not observed in participants of two groups.</p><p><b>CONCLUSION</b>Combination therapy of wheat cellulose particles (testa triticum tricum purify, Fiberform) can significantly improve the efficacy of internal hemorrhoid with safety and tolerance.</p>
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Objective To explore appropriate surgical procedures for differentiated thyroid carcinoma. Methods Clinical data of 42 patients who received surgery for differentiated thyroid carcinoma from March 2011 to March 2014 in the department of general surgery in our hospital were retrospectively analyzed. Results Among the 42 patients, 40 patients were papillary thyroid carcinoma and 2 patients were follicular thyroid carcinoma; 26 patients received total thyroidectomy, 12 patients received resection of thyroid lobes+isthmus in affected side+near total thyroidectomy in opposite side, and 4 patients received resection of thyroid lobes+isthmus in affected side.19 patients received lymph node dissection of central group, and 9 patients received selective lymph node dissection. 7 patients showed temporary hoarseness after the surgery; 10 patients showed temporary hypocalcemia. Conclusion As for differentiated thyroid carcinoma, clinical classification, clinical staging and results of rapid pathological examination of frozen sections dur-ing the surgery are considered as proofs for comprehensive decision of surgical procedures. Total thy-roidectomy and near-total thyroidectomy are suggested, and neck lymph node dissection is carried out ap-propriately.
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Objective To explore the pregnancy outcome of large doses of progesterone conservative treatment in early endometrial cancer and endometrial severe dysplasia and analyze the pregnancy-relating factors.Methods Fifty-eight cases with early endometrial cancer and 33 cases with endometrial severe dysplasia from June 2008 to January 2013 were selected.They were given large doses of oral progesterone,endometrial curettage was used to evaluate the therapy response of endometrium after every 3 months of administration.Individualized maintained treatment was given to patients after achieving complete remissionof the endometrium.Pregnancy outcome and pregnancy-relating factors were analyzed retrospectively.Results All of the 91 patients 87.9％ (80/91) achieved complete response.Of the 61 cases who desired to conceive after complete response,29 of them had 35 pregnancies,the pregnant rate was 47.5 ％ (29/61),and 22 women obtained healthy live birth baby,the fertility rate was 36.1％ (22/61).Age,pre-treatment complications,treatment time and treatment before endometrial biopsy result (endometrial severe atypical hyperplasia or endometrial cancer) was not correlated with pregnancy (P ＞0.05).The pregnant rate of patients who received in vitro fertilization-embryo transfer,ovulation promotion,or no treatment was 13/13,12/29 and 4/19,respectively,and there was significant difference (P ＜0.05).Conclusions Conservative treatment for early endometrial cancer and endometrial severe dysplasia with large doses progesterone could achieve higher response rate.Assisted reproductive technologies could significantly increase the chance of conception.