Study on Therapeutic Regimen for Threatened Abortion with Low Estrogen / 广州中医药大学学报

Objective To study the relationship between estradiol (E2) and embryonic development, and to explore the optimal therapeutic regimen for threatened abortion with low estrogen. Methods One hundred and sixty threatened abortion patients 14 days after frozen embryo transfer (FET) with E2 in the range of 100-200 pg/mL were randomized into Chinese medicine group 1, Chinese medicine group 2, Chinese and western medicine group, and control group, 40 cases in each group. Chinese medicine group 1 was treated orally with Shoutai Sijun Decoction, Chinese medicine group 2 was treated orally with Shoutai Sijun Decoction combined with Placenta Hominis Granules, Chinese and western medicine group was treated orally with Shoutai Sijun Decoction combined with Femonstone white tablets, and the control group was treated orally with Femonstone white tablets. Pregnancy rate and the changes in E2 level before and after treatment in the 4 groups were compared. The sensitivity and specificity of E2 level to the prognosis of pregnancy were also investigated. Results (1) The pregnancy rate of Chinese medicine group 1, Chinese medicine group 2, Chinese and western medicine group, and control group was 70.0％, 75.0％, 95.0％, 77.5％ respectively, and Chinese and western medicine group had the highest pregnancy rate(P<0.05).(2) E2 level in the pregnant patients of 4 groups after treatment was increased, and the difference was significant compared with that on ET day 14 (P < 0.05 or P <0.01). (3) The results of prognosis of E2 for pregnancy were as follows: sensitivity was 92％, specificity was 80％, and the area of curve was 0.820 when threshold of E2 being 281 on ET day 22. Conclusion The low post-FET E2 level is correlated with disordered pregnancy, and the early monitoring of E2 and prompt intervention should be performed. Shoutai Sijun Decoction combined with Femonstone white tablets is effective on increasing E2 level rapidly and leading to a higher pregnancy rate, and the effect of Shoutai Sijun Decoction combined with Placenta Hominis Granules comes next.

The Hug-up Test: A New, Sensitive Diagnostic Test for Supraspinatus Tears / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The supraspinatus tendon is the most commonly affected tendon in rotator cuff tears. Early detection of a supraspinatus tear using an accurate physical examination is, therefore, important. However, the currently used physical tests for detecting supraspinatus tears are poor diagnostic indicators and involve a wide range of sensitivity and specificity values. Therefore, the aim of this study was to establish a new physical test for the diagnosis of supraspinatus tears and evaluate its accuracy in comparison with conventional tests.</p><p><b>METHODS</b>Between November 2012 and January 2014, 200 consecutive patients undergoing shoulder arthroscopy were prospectively evaluated preoperatively. The hug-up test, empty can (EC) test, full can (FC) test, Neer impingement sign, and Hawkins-Kennedy impingement sign were used and compared statistically for their accuracy in terms of supraspinatus tears, with arthroscopic findings as the gold standard. Muscle strength was precisely quantified using an electronic digital tensiometer.</p><p><b>RESULTS</b>The prevalence of supraspinatus tears was 76.5%. The hug-up test demonstrated the highest sensitivity (94.1%), with a low negative likelihood ratio (NLR, 0.08) and comparable specificity (76.6%) compared with the other four tests. The area under the receiver operating characteristic curve for the hug-up test was 0.854, with no statistical difference compared with the EC test (z = 1.438, P = 0.075) or the FC test (z = 1.498, P = 0.067). The hug-up test showed no statistical difference in terms of detecting different tear patterns according to the position (χ2 = 0.578, P = 0.898) and size (Fisher's exact test, P > 0.999) compared with the arthroscopic examination. The interobserver reproducibility of the hug-up test was high, with a kappa coefficient of 0.823.</p><p><b>CONCLUSIONS</b>The hug-up test can accurately detect supraspinatus tears with a high sensitivity, comparable specificity, and low NLR compared with the conventional clinical tests and could, therefore, improve the diagnosis of supraspinatus tears in clinical settings.</p>

Effects of Shoutai Pill Containing Serum on Bioactivity Behavior of Trophoblast Cells of Spontaneous Abortion Patients / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Shoutai Pill (STP) containing serum on bioactivity behaviors of trophoblast cells in spontaneous abortion (SA) patients such as cell proliferation, invasion, migration and secretion.</p><p><b>METHODS</b>Trophoblast cells in artificial abortion in normal pregnancy and SA patients were isolated and cultured in vitro, which were then treated with STP containing serum at various concentrations (5%, 10%, 20%, respectively). Blank serum was taken as the normal control group and dydrogesterone containing serum as the dydrogesterone control group. The proliferation, cycle distribution, invasion and migration capacity, and beta human chorionic gonadotropin (p-HCG) level were detected by methyl thiazolyl tetrazolium (MTT) colorimetry, flow cytometry (FCM), Transwell experiments, and ELISA, respectively.</p><p><b>RESULTS</b>Compared with the normal control group, the activity of cell proliferation obviously decreased, ratios of apoptotic cells (SubGO/G1) and G2/M phase were obviously elevated, S phase cell ratio was obviously reduced (all P < 0.05). Transwell experiments indicated invasion and migration capacity obviously decreased, secreted beta-HCG level were obviously reduced after 72-h intervention (P < 0.05). Compared with the SA group, the activity of cell proliferation obviously increased, ratios of apoptotic cells and G2/M phase were obviously reduced, S phase cell ratio was obviously elevated, invasion and migration capacity were obviously enhanced, secreted beta-HCG level were obviously elevated after 72-h intervention in the dydrogesterone control group and each STP containing serum group (all P < 0.05). The activity of trophoblastic cell proliferation, S phase cell ratio, invasion and migration capacity, and secreted beta-HCG level were strengthened along with increased STP containing serum. Besides, the effects of 20% STP containing serum group were significantly superior to those of the dydrogesterone control group (P < 0.05).</p><p><b>CONCLUSION</b>STP containing serum could dose-dependently enhance the proliferative activity of trophoblastic cells, invasion and migration capacity, secretion of beta-HCG, and reduce the apoptosis of trophoblast cells, which might be one of mechanisms for STP preventing and treating SA.</p>

Changes of histology and capsular collagen in a rat shoulder immobilization model / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Shoulder immobilization can induce adhesion of the joint, capsular contracture or lead to the condition of frozen shoulder. However, little is known about the histological effects of immobilization on the shoulder joint. This study aimed to explore the effect of immobility on the subscapular bursa (SSB) and the joint capsular content, including the distribution of types I and III collagen, within an immobilized rat shoulder.</p><p><b>METHODS</b>Forty-six Sprague-Dawley rats were randomly divided into one control group (n = 6) and four immobilization groups (n = 10 in each group), in which the left shoulders were immobilized with plaster for 1, 2, 3 and 4 weeks. At the end of each time point, 2 rats from each group were euthanized and shoulders prepared for serial histological observations of the glenohumeral joints, as well as picrosirius red and immunohistochemical observation of type III collagen. Histological sections of the remaining rat shoulders were used for the immunohistochemical detection of the capsular content of types I and III collagen.</p><p><b>RESULTS</b>The hyperplastic synovium of the anterior capsule obstructed the communication between the SSB and the glenohumeral joint cavity at 2 and 3 weeks. The adhesion of the SSB appeared at 3 and 4 weeks. The quantitative and qualitative results showed that the capsular contents of types I and III collagen progressively increased at 2, 3 and 4 weeks, and that type III collagen was distributed extensively within the joint capsule at 2 and 3 weeks.</p><p><b>CONCLUSION</b>Immobilization of the rat shoulder induced synovial hyperplasia of the joint capsule, adhesion of the SSB and an increase of the capsular content of types I and III collagen.</p>

HIV-1 co-receptor usage of patients experienced anti-retroviral therapy / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate HIV-1 co-receptor usage in patients experienced anti-retroviral therapy (ART) in Anhui and Henan province of China.</p><p><b>METHODS</b>A total of 45 HIV-1 infected individuals who have experienced ART and 109 un-experienced ART patients from Anhui and Henan province, which were called as treatment group and treatment-negative group, were selected as study subjects. HIV-1 strains were isolated from peripheral blood mononuclear cells of whole blood from patients. HIV-1 p24 in the culture supernatant was measured using a commercial enzyme-linked immunosorbent assay (ELISA) kit. HIV-1 co-receptor usage was identified using Ghost cell lines expressing CD4 and the chemokine receptor CCR5 or CXCR4.</p><p><b>RESULTS</b>Among 45 HIV strains from the treatment group, 22 (48.9%) strains used CCR5 as a co-receptor (R5 tropic strain), 21 (46.7%) strains used CXCR4/CCR5 as a co-receptor (X4/R5 duel tropic strain), and 2 (4.4%) used only CXCR4 as a co-receptor (X4 tropic strain). In 109 strains from treatment-negative group, 96 (88.1%) strains used CCR5 as a co-receptor (R5 tropic strain), 13 (11.9%) strains used CCR5/CXCR4 as a co-receptor use (X4/R5 strain). A significant difference was found between two groups in X4 co-receptor usages (χ(2) = 27.30, P < 0.05). Furthermore, after treated with AZT + DDI + NVP, the HIV-1 CXC4/CCR5 utilization was 59.09% (13/22), meanwhile after treated with D4T + DDI + NVP, the HIV-1 CXC4/CCR5 utilization was 43.48% (10/23), which the difference was not statistical significant (χ(2) = 1.10, P = 0.30).</p><p><b>CONCLUSION</b>HIV-1 CXCR4/CCR5 co-receptor utilization was higher in ART patients than treatment-negative patients.</p>

A randomized comparison of open and arthroscopic Nirschl debridement for refractory lateral epicondylitis / 中华外科杂志

<p><b>OBJECTIVE</b>To compare open and arthroscopic methods for treatment of recalcitrant lateral epicondylitis.</p><p><b>METHODS</b>A prospective trial of 26 patients (28 elbows) with recalcitrant lateral epicondylitis were treated between May 2006 and September 2008. The mean duration of conservative care was 23. 0 months (4 - 60 months). The mean follow-up was 17.4 months (4 - 32 months). The patients were randomized divided into two groups, 13 elbows with an open Nirschl procedure and 15 with an arthroscopic Nirschl procedure. All patients had pre- and post-operative assessment using VAS (visual analog scale) scores, Mayo 12 points elbow scores, time of return to work or sports, satisfaction, and so on.</p><p><b>RESULTS</b>There were no significant differences in VAS scores at rest and activities of daily living, time of return to work or sports and satisfaction between the two groups. But there was a statistically significant difference in VAS scores at work and sports and Mayo 12 points elbow scores between the two groups. 100% of the patients had excellent or good results in the open group and 93.3% in arthroscopic group. There were no severe complications in this series.</p><p><b>CONCLUSIONS</b>Both open and arthroscopic Nirschl procedures are valid and reliable treatments for patients with refractory lateral epicondylitis. The patients in the open group have a better function in the return-to work and sports postoperatively than the arthroscopic group.</p>

Posterior and superior compression test and weight-bearing on elbow test for the diagnosis of superior labrum anterior to posterior lesion / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the posterior and superior compression test (PSCT) and weight-bearing on elbow test (WBE) on the diagnosis of superior labrum anterior to posterior (SLAP) lesion.</p><p><b>METHODS</b>From July 2000 to March 2007, 4 clinical tests including O'Brien test, Crank test, PSCT and WBE were randomly performed on 207 patients (209 shoulders). Among the patients, 125 were males and 82 were females with the mean age of 39 years. All the patients underwent arthroscopic treatment by the same doctor. The arthroscopic diagnosis was considered as the golden standard. For each test, the parameters on clinical epidemiology were calculated, and the differences of detection rate between the physical tests and the arthroscopic examination were compared.</p><p><b>RESULTS</b>The parameters on clinical epidemiology of O'Brien test, Crank test, PSCT and WBE were comparable. The difference of detection rate between the physical tests and the arthroscopic examination was not statistically significant (P > 0.05). The detection rates of PSCT and WEB in the group of injury of posterior and superior labrum were statistically higher than the group of injury of anterior and superior labrum. The detection rate of PSCT in the group of simple SLAP lesion was relatively higher.</p><p><b>CONCLUSIONS</b>Compared with O'Brien test and Crank test, the new PSCT and WBE have not only comparable clinical value in the diagnosis of SLAP lesion, but also the advantage in predicting the location of SLAP lesion. The detection rate of PSCT in the group of simple SLAP lesion is relatively higher, but the mechanism is to be determined.</p>