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To investigate the clinical value of vaginal endoscopy in the diagnosis and treatment for vaginal and uterine diseases in young girls and adolescent girls. Methods: The clinical data of 156 young girls and adolescent girls treated with vaginoscopy from February 2000 to August 2017 were analyzed retrospectively. Results: Of the 37 cases of young girls, the clinical symptoms were the most common in vaginal hemorrhage, accounting for 40.5% (15 cases), the second one in vaginal foreign body, accounting for 29.7% (11 cases), the third one in abnormal vaginal secretion, accounting for 24.3% (9 cases), and the last one in low abdominal pain, accounting for 5.4% (2 cases). The final diagnosis of vaginal foreign body was 13 cases (35.1%). Of the 119 adolescent girls, the clinical symptoms of the visit were the most common in menstrual abnormalities or irregular vaginal bleeding, accounting for 75.6% (90 cases). The final diagnosis of abnormal uterine bleeding-ovulatory dysfunction was the most common with 59 cases (49.6%), following by 16 cases of abnormal uterine bleeding-polyp, 2 cases of abnormal uterine bleeding-malignancy and hyperplasia, and 1 cases of abnormal uterine bleeding-coagulopathy. There were 37 cases (31.1%) of reproductive tract malformation. All 156 patients successfully completed vaginal endoscopy and operation with only 1 case of urinary system infection. No other complications occurred and no damage in the hymen. Conclusion: Vaginal endoscopy is a safe, effective and near-noninvasive way for the diagnosis and treatment of vaginal or uterine diseases in young girls and adolescent girls. In the case of abnormal vaginal secretions and vaginal bleeding, it should be properly recommended to use the vaginal endoscopy for diagnosis and treatment.
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Adolescent , Female , Humans , Endoscopy , Foreign Bodies , Retrospective Studies , Uterine Hemorrhage , VaginaABSTRACT
Objective@#To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population.@*Methods@#An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t-test or the Mann-Whitney test. χ 2-test was used for the measurement of categorical data.@*Results@#A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD (HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD (HR 1.580; 95.0% CI 1.161-2.152; P < 0.01).@*Conclusion@#An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.
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Objective To analyze the etiologies of severe vitreous hemorrhage in venerable age patients.Methods A retrospective series case study was adopted.Medical records of 30 cases 30 eyes severe vitreous hemorrhage venerable age patients were analyzed in Xuanwu Hospital Capital Medical University,Peking University Third Hospital and Beijing Tsinghua Chang Gung Hospital from July in 1999 to June in 2015.Visual acuity,intraocular pressure,anterior segment slit lamp microscopy,mydriasis funduscopy and ophthalmic B type ultrasound examination were used to evaluate 30 cases 30 eyes.Thirty eyes were all treated with pars plans vitrectomy (PPV).Results Mydriasis funduscopy examination showed that vitreous hemorrhage was so dense in 30 eyes that the fundus cannot be observed.The initial visual acuity examination showed that 8 eyes were count finger,5 eyes were hand move,16 eyes were light perception,and 1 eye was no light perception.There were dense light spots or clusters of high echoes in vitreous cavities,complete/incomplete posterior vitreous detachment (PVD) of all eyes;retinal detachment with different degrees in 5 eyes;proliferating cord adhesion to the wall of eyeball in 3 eyes.The etiologies included retinal vein occlusion (RVO) in 10 eyes (33.33％),retinal tear or retinal detachment in 7 eyes (23.33％),polypoidal choroidal vasculopathy (PCV) in 7 eyes (23.33％),proliferative diabetic retinopathy (PDR) in 4 eyes (13.33％).The above 4 etiologies were in 28 eyes,accounting for 93.33％.The others were ocular trauma in 2 eyes (6.67％).Conclusions The main cause to severe vitreous hemorrhage venerable age patients is RVO,followed by retinal tear or retinal detachment,PCV and PDR.Ocular trauma is rare.Vitrectomy is a diagnostic treatment,which can remove vitreous hemorrhage,improve the visual acuity of the patients,and determine the etiologies of the vitreous hemorrhage.
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The widespread application of next generation sequencing (NGS) in clinical settings has enabled testing, diagnosis, treatment and prevention of genetic diseases. However, many issues have arisen in the meanwhile. One of the most pressing issues is the lack of standards for reporting genetic test results across different service providers. The First Forum on Standards and Specifications for Clinical Genetic Testing was held to address the issue in Shenzhen, China, on October 28, 2017. Participants, including geneticists, clinicians, and representatives of genetic testing service providers, discussed problems of clinical genetic testing services across in China and shared opinions on principles, challenges, and standards for reporting clinical genetic test results. Here we summarize expert opinions presented at the seminar and report the consensus, which will serve as a basis for the development of standards and guidelines for reporting of clinical genetic testing results, in order to promote the standardization and regulation of genetic testing services in China.
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Objective:To study the relationship between IL-1β and TNFα expression and cell apoptosis in gingival tissue of the subjects with diabetes associated periodontitis(DAP).Methods:20 cases of DAP(group DAP) and 20 cases of health controls(group H)were included.The cell apoptosis and the ultrastructural changes in gingival tissue were observed by Tunnel staining and transmission electron microscope (TEM).IL-1β and TNFα expression in gingival tissue were detected by immunohistochemical staining.SBI,GI,PD and AL of the subjects were measured.The relationship between the level of IL-1β,TNFα and the cell appotosis was analyzed.Results:Apoptosis was obvious in prickle cells and basal cells of gingival tissue of DAP group.The percentage of apoptosis cells of DAP group was significantly higher than that of group H(P＜0.01).The expression of IL-1β and TNFα in group DAP was significant higher than that of group H (P＜0.01),and the mainly positive expression cells were macrophages,plasmocytes and lymphocytes.Conclusion:IL-1β and TNFα play a role in cell apoptosis in the gingival tissue of the patients with DAP.
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Objective To explore the clinical efficacy of methylprednisolone injection and magnesium sulfate injection in the treatment of severe bronchial asthma and the impact on inflammatory cytokines.Methods 87 cases of severe bronchial asthma were selected for the study,and they were divided into two groups according to the order of admission,the control group (43 cases ) was given methylprednisolone treatment,while the observation group (44 cases)was given methylprednisolone injection and magnesium sulfate treatment.The clinical treatment and inflammatory cytokine levels before and after treatment were compared between the two groups.Results The effective rate of the observation group was 93.18%,which was higher than 74.42% of the control group,the difference was significant(χ2 =10.33,P <0.05 ).After treatment,pulmonary functions of the observation group [FVC (3.72 ± 0.42)L,FEV1 (2.72 ±0.32)L and PEF(3.48 ±0.49)L/s]were increased significantly than before treatment(t =7.87,7.81,8.41,all P <0.05),and had significant differences compared with the control group(t =6.93,7.44, 7.20,all P <0.05).After treatment,inflammatory cytokines indicators of the observation group[IL -6 (67.44 ± 0.43)μg/L,TNF -α(80.32 ±7.34)ng/L,hs -CRP(3.32 ±0.89)mg/L]were significantly increased than before treatment(t =6.85,7.41,7.33,all P <0.05),compared with the control group,the differences were significant(t =6.55,7.04,6.45,all P <0.05).Conclusion The methylprednisolone combination with magnesium sulfate in treat-ment of severe bronchial asthma had significant effect,and it can effectively improve the airway inflammation,promote lung function in patients'recovery,and it has great clinical value.
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Objective To explore the relationship between thyroid hormone and colorectal adenomatous polyps (CAP) in middle-aged and elderly people.Methods We surveyed 3 042 middle-aged employees and retirees aged 45 years and over at a petrochemical enterprise of Ningbo.Their colonoscopic findings,body mass index,waist circumference and thyroid function were analyzed.Results Age and serum free triiodothyronine (FT3) of females with CAP were higher than those of the corresponding non-CAP group,so were age and waist circumference of males with CAP (P ＜ 0.05).Furthermore,these differences were statistically significant.The detection rate of CAP was significantly higher in males than in females (x2 =49.418,P ＜ 0.01).The detection rate of CAP was higher in females with higher levels of FT3.Multivariate unconditional logistic regression analyses showed the effects of thyroid hormone on the CAP differed by gender.Age and FT3 (OR =1.60,95％ CI:1.12-2.28,P =0.01) were correlated with CAP in females.However,only age and waist circumference were correlated with CAP in males.Conclusion Elevated FT3 may be a risk factor of CAP in elderly females.The detection rate of CAP may not be affected by FT3 levels in males.
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Objective To study the correlation between non-alcoholic fatty liver disease (NAFLD)and glycosylated hemoglobin (HbA1 c) in middle-aged and aged population.Methods A total of 4 127 inservice workers and retirees aged 45 years old or above from one petrochemical enterprise in Ningbo were enrolled in our study.The waistline,body mass index,blood pressure,fasting blood-glucose,blood lipid profile,glutamyltranspeptidase,HbA1c and epigastrium B ultrasound were investigated.According to the quartile of HbA1c level,participants were divided into four groups,namely,Q1 group ≤5.2％,Q2 group ＞ 5.2％-5.4％,Q3 ＞ 5.4％-5.6％ and Q4 group ＞ 5.6％.The prevalence of NAFLD and clinical characteristics of each group were analyzed.Logistic regression was used to predict independent risk factors of NAFLD.Results The morbidity of NAFLD was 27.2％ with 31.9％ in male and 21％ in female,which was significantly higher in men.In Q1,Q2,Q3 and Q4 group,the prevalence of NAFLD were 18.5％ (178/961),22.8％ (185/812),25.6％ (280/1 095),38.1％ (480/1 259) respectively.With the increase of HbA1 c level,the morbidity of NAFLD increased synchronously.The age,systolic pressure,total cholesterol,low densitylipoprotein cholesterin and fasting blood-glucose were all elevated according to the increase of HbA1 c in 1 123 NAFLD patients.Multi-factor logistic regression analysis indicated that high HbAlc level was the risk factor of NAFLD (OR =1.67,95％ CI 1.15-2.43,P =0.007).Conclusion HbA1c is an independent risk factor of NAFLD and both of these are closely related to blood lipid metabolism disorder.
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Objective To explore the effects of anti-tumor immunity induced by dendritic cells (DCs) vaccine pulsed with PEP3-KLH (keyhole limpet hemocyanin) on induction of specific immunity against prostate cancers.Methods DCs were propagated from bone marrow of C57BL/6 mice in vitro with granulocyte-macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4).On day 5 of culture, DCs were harvested and incubated with PEP3-KLH or KLH.Then the DC vaccine was inoculated into C57BL/6 mice by subcutaneous injection for three times with an interval of two weeks.One week after the last vaccination, the levels of IL-2, IL-12, and interferon (IFN)-γwere measured with enzyme-linked immunosorbent assay (ELISA) kit.The aforementioned immunized mice with DC vaccines were challenged with transgenic adenocarcinoma of mouse prostate (TRAMP)-C2 tumor cells, the tumor growth curve was drawn, and survival rate was checked and compared.The cytotoxic T lymphocyte (CTL) activity induced by DCs was tested with lactate dehydrogenase (LDH) release method.The percentages of CD3 + , CD4+ ,or CD8 + T cells in tumor-infiltrating lymphocytes (TILs) were determined with flow cytometry.Results PEP3-KLH-DC group stimulated the body and induced higher levels of secreted IL-2, IL-12, and IFN-γ compared to DCs control and KLH-DC groups (P ＜ 0.01).The tumor of mice vaccinated with PEP3-KLHDC grew significantly slower than that injected with DCs or KLH-DC (P ＜0.01).Compared to the others, the survival rate in PEP3-KLH-DC group raised remarkably (P ＜ 0.01).PEP3-KLH-DC group induced more outstanding specific CTL activities of killing tumor cells than DCs control group and KLH-DC group (P ＜ 0.01), and the cytotoxicities of TILs in PEP3-KLH-DC group was significantly enhanced (P ＜0.01).The percentages of CD3 + , CD4 + , or CD8 + T cells in TILs (40.9％, 34.1％) in PEP3-KLH-DC group were significantly higher than those in DC-KLH (27.3％, 5.2％) or DCs (26.2％, 5.1％) group.Conclusions PEP3-KLH-DC vaccine can inhibit effectively tumor growth, enhance long-term survival in mice,intensify the local immunologic function of tumor, and elicit and promote profound specific anti-prostate cancer cellular immune responses.
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Objective In order to explore the effects of rehabilitation training and acupuncture on the neural function deficit and motor function in patients with ischemic streke.Methods Eighty patients with ischemic stroke were randomly divided into rehabilitation and acupuncture groups.According to different recovery stages,the rehabilitation group received purposeful rehabilitation training for 28 days while the acupuncture group received scalp needling combined with body acuptmcture.The neural deficit scores(NDS)and motor fimction comprehensive assessment(FCA) were evaluated at the recruitment(M_0),the 28~(th)(M_1)and 56~(th)(M_2)days after treatment.Results No significant difierences were found in the NDS and motor FCA between the rehabilitation and the acurluncture groups at the recruitment.The significant differences appeared at the 28~(th) and the 56~(th) days comparing with baseline assessments in each group.There was no significant difference in the changes of NDS and motor FCA between the two groups at 28~(th) day,however,the NDS and motor FCA in rehabilitation group revealed better outcome than the acupuncture group at the 56~(th) day.Conclusion The study indicated that both rehabilitation training and acupuncture could improve the neural function and enhance the motor function in patients with ischemic stroke.
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Objective:To summarize the clinical results of the artificial iris diaphragm (AID)implantation for eyes with silicone oil longstanding tamponade.Methods: In this study,the operation indications,results and complications of 11 consecutive cases of artificial iris diaphragm implantation for eyes with silicone oil longstanding tamponade were studied. Results: In all of the 11 primary ocular disorder cases , 7 cases (7/11) were serious ocular trauma, 2(2/11)cases were diabetic retinopathy with traction retinal detachment , 1 case (1/11) was recurrent retinal detachment with complicated PVR, and 1 case (1/11) was Coats disease; The silicone oil was retained completely behind the surface of artificial iris diaphragm in 7(7/11) of all the 11 cases,in which no visual acuity was affected The complications were low intraocular pressure (IOP)and heavy fibrosis on the surface of artificial iris diaphragm. Conclusion: Open type artificial iris diaphragm implantation in eyes with longstanding silicone oil tamponade can effectively prevent the silicone oil from cotacting the cornea causing complication by spontaneously blocking and rescuing anterior chamber fluid circulation.
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Objective To investigate the characteristics of optical coherence tomography (OCT) in eyes with repaired idiopathic macular hole (IMH) after operation and the relation with recovery of visual acuity. Methods The characteristics of OCT images of 24 patients (25 eyes) with repaired IMH after vitrectomy,internal limiting membrane(ILM)peeling and auto-serum healing were analyzed retrospectively. In the patients with IMH, the macular hole was found in 9 eyes at stage Ⅱ, 13 eyes at stage Ⅲ, and 3 eyes at stage Ⅳ. Examinations of best-corrected visual acuity, slit-lamp biomicroscopy with fundus contact lens, fundus photography, fundus fluorescein angiography(FFA) and OCT were performed on the patients 3 to 24 months after surgery. Results OCT images of the repaired IMH were categorized into 3 patterns: U-type (5 eyes) with relative normal foveal contour; V-type (7 eyes) with steep foveal contour;W-type (13 eyes) with foveal defect of neurosensory retina, but without warped hem of retinal hole or cystic formation. Postoperative visual acuities were improved in all of the patients and the best ones were in group U-type. Conclusion Characteristics of OCT images of repaired IMH may be related to the postoperative visual acuity.
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This paper deals with the analysis of the phospholipids and fatty acids in Hippocomnpus kelloggi Jordan et Synder, H. Histrix Kaup, II. trimaculalus Leach, II. kuda Bleeder, II. japonicus Kaup, Solenognathus hardwickii(Gray), Syngnathoides biacufcatus(Bloch) and Tracliyrliamphus serralus (Temminck &. Schlegel).The total phospholipids were extracted with Folch solvent and determined by molybdate blue spec-trophotometric method. The result showed that the contents of total phospholipids in these spccimins were 2. 56-7. 82mg/g.The nine kinds of phospholipid standards of absorbance proportional coefficient were detected in this paper. The phospholipid components were separated and determined by using thin - layer chro-matographic method and Vaskovsky solvent as a specific spray reagent. The quantitative analysis of the distribution of various phospholipids components in these specimen ts were carried out, by using TLC scanning and the corrective method of absorbance proportional coefficient. The resut showed that the Hippocampus contains about five phospholipids: lysophosphatidylcholine, sphingornyelin, phophatidylcholine, phosphatidylinositol, and phosphatidylethanolamine. The phosphatidylserine , phosphatidylglycerol, diphosphatidylglycerol and phosphatidic acid were more in Syugnathus than in Hippocampus, But in all these specimens, the main phospholipid components were lysophos- phatidylcholine, sphingornyelin and phosphatidylcholine.Fourteen fatty acid compositions in these specimens were analysed by GC -MS -DS. The result showed that the main fatty acid were hexadecanoic acid, 9 - octadecenoic acid, 8,11- octadeca-dienoic acid and 1,7,10,13,16,19 - docosahexaenoic acid.
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With the tracer colloidal lanthanum,light micro- scope and transmission electron microscope in animal experiments,we studied the retinal pigment epithe- lium(RPE)barrier of 48 moderately severe cryoge- nic lesions on the retina of 21 rabbit eyes at dif- ferent intervals after cryopexy.Our findings showed that:1.the repair of disrupted RPE barrier by cryopexy was poor or incomplete,the regenerated RPE cells in restored RPE barrier of some cryogenic lesions showed degeneration and decompensation dur- ing the recovery period,and the tracer in choroidal capillaries leaked into the degenerated RPE cells and the subretinal space;2.the biologic effect of cryo- pexy on the retina was closely related to the acting time and the size of cryoapplication probe;and 3. the damaged grade of subretinal space caused by moderately severe cryopexy was comparable to Lincoff and Kreissig's criteria,but it was not absolute.
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The IR determination of phospholipid content in Semen Zizyphi Spinosae and Fructus Psoraleae, both of which are tonics,was reported for the first time.In this method,using PC as standard sample, chloroform as solvent and the absorption band of P-O-C bond as measurement wavelength,the ab- sorptive degree was linear for concentration in ranging from 0.6mg/ml to 4.0mg/ml.The standard deviation was 0.0682.CV was 1。69%。Compared with the result obtained by colorimetric assay, this method was simpler,its result was more stable.
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The effect of solubilization of phospholipid component of Chinese medicines on other active components in decoction is reported in this paper. The experi ment result showed that the dissolution rate of ephedrine and chlorogenic acid increased obviously as the content of phospholipid component in decoction rose.
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A method for the infrared spectrophotometric determination of total ph-ospholipids in seed of Juglans regia and acinus of Citrullus vulgaris was reported. The average recovery of total phospholipid in this test was 97.2%, the CV was 1.66%. The contents of total phospholipid in seed of Juglans regia and acinus of Citrullus vulgaris were 438.46-528.85mg% and 241.78 -247.47mg% respectively. The rapid quantitative analysis of the distribution of various phospholipid components in these two specimens was carried out by using thin layer chromatographic scanning and the corrective method of absorbance proportional coefficient. The results showed that the main phospholipid components in both specimens were PC and PE. The fatty acid composition of the total phospholipids of both specimens were analysed by GC-MS-DS (gas chromatography-mass spectrometry-data system).