Clinical analysis of cervical lesions in 1 337 postmenopausal women diagnosed during screening / 中华老年医学杂志

Objective:To screen and diagnose cervical lesions in middle-aged and elderly postmenopausal women and analyze the characteristics of cervical lesions in middle-aged and elderly women.Methods:A retrospective analysis was conducted on the screening data of 1 337 postmenopausal women aged between 50 and 86 years who visited the outpatient clinics of the gynecology department of Beijing Hospital between January, 2015 and December, 2019.Participants were divided into groups based on age, with 787 in the 50-59 years old group, 483 in the 60-69 years old group, 60 in the 70-79 years old group, and 7 in the 80-89 years old group.Exfoliated cervical cells were collected, and high-risk human papillomavirus(HPV)detection and liquid-based cervical cytology examination were performed to confirm the diagnosis based on the pathological results of cervical biopsy.Cervical lesions were analyzed.Results:53.0%(708)of the 1 337 enrolled patients made their hospital visits because of symptoms.There were 666 patients(49.8%)with cervical lesions, including 357 with low-grade squamous intraepithelial lesions(LSIL), 252 with high-grade squamous intraepithelial lesions(HSIL)and 57(4.3%)with cervical cancer.The 70-79 group showed the highest incidence of HSIL at 30.0%(18/60), while the 50~59 group had the highest incidence of LSIL at 30.6%(241/787), and there were significant differences in different types of cervical lesions between different age groups( χ2=28.919, P<0.01). Liquid-based cervical cytology examination revealed a positive rate of 51.6%(166/322)for LSIL, a positive rate of 70.8%(143/202)for HSIL, and a rate of 71.4%(25/35)for cervical cancer.There were significant differences in LSIL, HSIL and other above-mentioned positive rates of lesions( P<0.05). In the cervical malignancy group, cytological high-grade squamous epithelial lesions made up 51.4%(18/35). Intraepithelial lesions or cancerous lesions represented 29.2%(59/202)in the HSIL group.The rate of intraepithelial lesions or cancerous lesions in the LSIL group was 48.4%(156/322), with statistically significance in these differences( χ2=118.806, P<0.01). Chronic cervicitis was found in 52.9%(109)of 206 patients with atypical squamous cells and positive HPV, and in 76.2%(16)of 21 patients without HPV.HPV examination was completed in 1 301 patients, with 69.4%(903)having infections by one HPV strain and 30.6%(398)having infections by mixed HPV strains.Biopsy results showed that the rates of HPV infections in LSIL, HSIL and cancer patients were 84.6%(302/357), 95.9(185/193)and 100%(54/54), respectively, and the differences in these pathological results were statistically significant( P<0.01). HPV16 was the most common subtype in single HPV strain infections.The most common subtypes of HPV infections in cervical lesions with HSIL and above were HPV16 and HPV18.The agreement rate was 52.4%(187/357)for LSIL, 60.7%(153/252)for HSIL, and 64.9%(37/57)for cervical cancer between diagnoses based on cervical biopsy and those based on colposcopy.As the severity of lesions increased, the accuracy of colposcopy also increased.Differences between colposcopic diagnosis and pathological diagnosis on different types of cervical lesions were statistically significant( χ2=550.382, P<0.01).1 310 patients underwent endocervical curettage, identifying 120 cases of HSIL and 39 cases of cervical cancer, with a detection rate of 55.8%(159/285). Conclusions:The incidence of cervical cancer is high in elderly women.The incidences of high-grade lesions and cervical cancer in patients with atypical squamous cells plus HPV infections in the cervix are also high.Postmenopausal patients with cervical lesions are mainly infected by a single HPV subtype, with subtype 16 being the most common one.With increasing severity of lesions, the accuracy of colposcopy-based diagnosis increases and the rate of missed diagnosis decreases.Cervical curettage is an important means to reduce missed diagnosis with colposcopy.

CD44-HA Mediate Adhesion of MDA-MB-231 Cells and HL60 Cells under Fluid Shear Flow / 医用生物力学

Objective To explore how hyaluronic acid ( HA) in extracellular matrix regulates the adhesion ofCD44+tumor cells. Methods MDA-MB-231 cells or HL60 cells were perfused in a parallel plate chamber. Themovement of cells over immobilized HA was observed and analyzed to obtain the characteristics of cell adhesionand rolling. Results The adhesion number of MDA-MB-231 cells on HA substrate was positively regulated by HAconcentration, but not by HA molecular weight. Compared with physically adsorbed HA, immobilized HA byavidin-biotin could significantly improve the cell adhesion ratio. With the increase of shear stress in the range of30-50 mPa, the rolling velocity of cells increased and the adhesion ratio decreased, but the tether lifetime of cellswas not affected. In the same flow field, compared with MDA-MB-231 cells, HL60 cells with low expression ofCD44 rolled more quickly on immobilized HA, with shorter tether lifetime and much lower adhesion ratio(<1. 5% ). Conclusions Fluid shear stress might mediate the rolling velocity of MDA-MB-231 cells by regulatingthe CD44-HA association rate rather than their dissociation rate. The interaction between CD44 and HA is involved in the initial adhesion of HL60 cells, but it does not play a major role. This study will provide references for the design of anti-tumor drugs.

Analysis of immune regulation and prognosis of chronic hepatitis B virus infection / 公共卫生与预防医学

Objective To investigate the immune regulation and prognosis of hepatitis B virus (HBV) infection in infected patients, and to analyze the relationship between immune regulation and clinical outcome. Methods The data of 633 cases of HBV infection in Huhhot from January 2015 to December 2018 were retrospectively analyzed. At the same time, healthy people from the Affiliated Hospital of Inner Mongolia Medical University were selected as the control group. Immune cell regulatory factors and lymphocyte subsets in blood of HBV infected and healthy people were tested. The results of one-year clinical outcomes were calculated. The relationship between immune cell regulatory factors and lymphocytes and the clinical outcomes of patients was analyzed by multiple logistics regression. Results The levels of CD4+T cells, CD8+T cells, NK cells, IL-2, and IL-12 in the blood of patients with HBV infection were significantly lower than those in the control group, and decreased as the patients’ clinical outcome deteriorated (P0.05). Low CD4+ T cells, low CD8+ T cells, low NK cells, low IL-2, low IL-12, high IL- 4 and high IL-10 were independent risk factors leading to the deterioration of clinical outcomes (P<0.05). Conclusion The immune regulation of patients with HBV infection is in a state of suppression, which is an independent factor affecting the clinical outcome of patients.

Irradiated glioma cells induce bystander effects in neural stem cells / 中华放射医学与防护杂志

Objective:To investigate whether irradiated U251 glioma cells can induce bystander effects in unexposed neural stem cells (NSCs) thus affecting its proliferation, stemness and differentiation.Methods:The cells were divided into NSCs group, NSCs+ U251 group (co-cultured with U251) and NSCs+ IR U251 group (co-cultured with 10 Gy irradiated U251). Glioma cells and NSCs were co-cultured in a transwell insert set. Cell counting and neurosphere diameter measuring were carried out to evaluate the proliferation and neurosphere formation ability of NSCs. Immunofluorescence assay was performed to detect the expression of Nestin protein to evaluate the stemness maintenance of NSCs, and to measure the expression levels of Tuj1 and GFAP proteins, the number of neuronal dendrites, synaptic length, the number of glial protrusions, as well as the length of glial protrusions.Results:The number of NSCs cultured with irradiated U251 cells was obviously smaller than that of NSCs cultured with sham-irradiated U251 cells ( t=2.52, P<0.05). The neurosphere formation ability of NSCs and the percentage of Nestin positive NSCs after co-culture with irradiated U251 cells significantly reduced in comparison with those after co-culture with sham-irradiated U251 cells ( t=-3.50, P<0.05). The percentages and the extent of NSCs differentiating into neuronal cells and glial cells( t=6.09, P<0.05)decreased obviously after co-culture with irradiated U251 cells in comparison with those after co-culture with sham-irradiated U251 cells. Conclusions:Irradiated glioma cells can significantly inhibit the proliferation, stemness and differentiation of unexposed NSCs due to bystander effect.

Relationship between abnormality of pelvic floor muscle strength and pelvic floor dysfunction in elderly women / 中华老年医学杂志

Objective To analyze the characteristics and the related risk factors of the contractility of pelvic floor muscles in old women with pelvic floor dysfunction(PFD).Methods A cohort of 125 elderly patients with symptoms of pelvic floor dysfunction,including 60 of postpartum urinary incontinence(SUI)and 65 of pelvic organ prolapse(POP),were recruited.60 women volunteers with normal pelvic floor function were recruited as a control group.A questionnaire survey was conducted to record the general situation of the subjects.The pelvic floor muscle strength was determined by the methods of electromyography and pressure feedback recording.Results The body mass index,the average number of delivery,newborn baby's body weight were significantly higher in the SUI and POP group than in control group,with statistically significant difference(F=5.29,6.27,5.26,P=0.007,0.003,0.008),but without statistically significant difference between SUI and POP groups (P =0.674,0.554,0.578).The rapid contractility value was significant lower in SUI group than in POP and control groups(all P＜0.01),and the sustained contractility value was significant lower in POP group than in SUI and control groups(all P＜0.01).Conclusions The postpartum pelvic floor dysfunction may be correlated with BMI,vaginal delivery rate,the average number of delivery,newborn baby's body weight and a history of increased abdominal pressure.The postpartum pelvic floor dysfunction may be associated with the declined contractility of pelvic floor muscle,among which the POP may be associated with class Ⅰ muscle and the SUI with class Ⅱ muscle.

Trasmission of rabies virus from an organ donor to two renal transplant recipients / 中华器官移植杂志

Objective To investigate the clinical characteristics and strategy of prophylaxis and treatment of rabies.Methods Two recipients and their donors with rabies were reviewed to confirm the transmission through kidney transplantation.Saliva,urine,and sputum samples from recipients were collected for the detection of rabies virus by reverse transcription PCR (RT-PCR).Results The donor was a 6-year old boy,died of viral encephalitis of unknown cause.His kidneys and corneas were donated for transplantation.Two recipients who received the donor kidneys had neurological symptoms associated with rabies successively.Both of the two recipients died 44 days and 34 days after onset of post-transplant symptoms.Saliva,urine,and sputum samples were positive for rabies virus nucleic acid.The epidemiological investigation revealed that the boy had a history of close contact with his dog.The parents denied the history of animal bites or rabies prophylaxis.Conclusion The rabies virus can be transmitted through organ transplantation.Incubation period of rabies transmitted from donor is shorter than general population and the mortality rate is up to 100％ after onset of symptoms.So,both coordinators and doctors should deeply understand the rabies.The evaluation and supervision of donor derived diseases should be strengthened.The donors should not be donated whenever the rabies is not completely excluded,especially those died of encephalitis of unknown cause.Furthermore,post-exposure prophylaxis of rabies should be administered as soon as possible before onset of symptoms after transplant from a donor with rabies.

New Concept of Medical Ethics Education Based on General Education / 中国医学伦理学

Combined with the purpose of medical ethics education , the influence of general education on social and cultural values of medical students , and the main problems of domestic ethics education , this paper put forward a new concept of medical ethics education based on general education .According to the characteristics of medical students, it also proposed a preliminary planning assumption of curriculum provision of general education , namely that general education should be mainly dominated by humanities science , which enable students to think independ-ently and critically and further to make a reasonable choice through comprehensive judgments of social and personal values in the face of medical ethics .

New Concept of Medical Ethics Education Based on General Education / 中国医学伦理学

Combined with the purpose of medical ethics education , the influence of general education on social and cultural values of medical students , and the main problems of domestic ethics education , this paper put forward a new concept of medical ethics education based on general education .According to the characteristics of medical students, it also proposed a preliminary planning assumption of curriculum provision of general education , namely that general education should be mainly dominated by humanities science , which enable students to think independ-ently and critically and further to make a reasonable choice through comprehensive judgments of social and personal values in the face of medical ethics .

Chinese herbal medicine compound Yi-Zhi-Hao pellet inhibits replication of influenza virus infection through activation of heme oxygenase-1

As a leading cause of respiratory disease, influenza A virus (IAV) presents a pandemic threat in annual seasonal outbreaks. Given the limitation of existing anti-influenza therapies, there remains to be a requirement for new drugs. Compound Yi-Zhi-Hao pellet (CYZH) is a famous traditional Chinese medicine (TCM) used in the clinic, whose formula has been recorded into treat common cold. In this study, we found that CYZH exhibited a broad-spectrum anti-influenza activity and inhibited the expression of viral RNA and proteins. Mechanistically, CYZH had no inhibitory activities against viral protein hemagglutinin and IAV RNA-dependent RNA polymerase. Instead, it induced activation of erythroid 2-related factor 2 (Nrf2) and nuclear factor kappa B (NF-B), which subsequently upregulated heme oxygenase-1 (HO-1) expression. Also, CYZH protected cells from oxidative damage induced by reactive oxygen series. In conclusions, CYZH inhibits IAV replication, at least partly by activating expression of the Nrf2/HO-1 pathway.

Clinical pathological characteristics of differentiated thyroid carcinoma in children and adolescents / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the clinical pathological characteristics of differentiated thyroid carcinoma (DTC) in children and adolescents. METHODS The clinical data of 30 children and adolescents with DTC were retrospectively reviewed. Meanwhile the clinical pathological characteristics of DTC were analyzed according to patients' age and gender. RESULTS Papillary thyroid carcinoma (PTC) was found in 27 cases and follicular thyroid carcinoma (FTC) in 3 cases. The average diameter of tumors was (2.56±1.1) cm. In the group of children, the incidence of lymph node metastasis was 92.3% (12/13), pulmonary metastasis was 46.2% (6/13), and those in the group of adolescents was 88.2% (15/17) and 35.3% (6/17) respectively. Children group tended to present with more vascular invasion, thyroid capsule invasion, and invasion out of thyroid, and a higher rate of cervical lymph node metastasis (P=0.025, 0.007, 0.025, 0.033). CONCLUSION Thyroid carcinoma in childhood and adolescent has a stronger invasive feature. It is easy to local invasion, lymph node and distance metastasis.

Trend analysis of malignant tumor after renal transplantation in China / 器官移植

Objective To reveal the change trend of malignant tumor after renal transplantation in China based on the epidemiological and clinical features that were publicly reported in China in recent 10 years. Methods The search terms ‘renal transplantation’and ‘tumor’were searched on China Academic Journal Network Publishing Database and China Science Periodical Database to screen out the qualified researches strictly.General conditions,tumor sites and regional differences of malignant tumors were analyzed.Results Fifteen thousand one hundred and twenty cases from nine literatures published from 2003 to 2014 and a single-center experience of renal transplantation in Beijing Friendship Hospital of Capital Medical University were screened out.Four hundred and fourty-six cases had malignant tumor after renal transplantation with the total tumor incidence of 2.95% (446 /15 120) and the tumors were mainly urinary system tumors after transplantation (55.8%).Conclusions The total incidence of malignant tumor in renal transplant recipients is 2.95% and the urinary system tumors are most common.Thus,tumor screening after renal transplantation should be taken as the routine examination during follow-up.

Synthesis and antiviral activity of some novel indole-2-carboxylate derivatives

A series of novel indole-2-carboxylate derivatives were synthesized and assayed to determine their in vitro broad-spectrum antiviral activities. The biological results showed that some of the synthesized compounds exhibited potent broad-spectrum antiviral activity. Notably, compound 8f showed the highest SI value (17.1) to Cox B3 virus. Compound 14f showed both potent inhibitory activity against influenza A (IC50=7.53 μmol/L) and the highest SI value (12.1). SAR results showed that the alkyloxy at the 4-position of indole ring was not crucial to the antiviral activities. Incorporation of an acetyl substituent at the amino group disfavored antiviral activity towards RNA viruses.

Changes in dendritic cells and dendritic cell subpopulations in peripheral blood of recipients during acute rejection after kidney transplantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Advances in transplantation immunology show that the balance between dendritic cells (DCs) and their subsets can maintain stable immune status in the induction of tolerance after transplantation. The aim of this study was to investigate if DCs and DC subpopulations in recipient peripheral blood are effective diagnostic indicators of acute rejection following kidney transplantation.</p><p><b>METHODS</b>Immunofluorescent flow cytometry was used to classify white blood cells (WBCs), the levels of mononuclear cells and DCs (including the dominant subpopulations, plasmacytoid DC (pDC) and myeloid DC (mDC)) in peripheral blood at 0, 1, 7, and 28 days and 1 year after kidney transplantation in 33 patients. In addition, the blood levels of interleukin-10 (IL-10) and IL-12 were monitored before and after surgery. Fifteen healthy volunteers served as normal controls. Patients were undertaking hemodialysis owing to uremia before surgery.</p><p><b>RESULTS</b>The total number of DCs, pDC, and mDC in peripheral blood and the pDC/mDC ratio were significantly lower in patients than controls (P < 0.05). Peripheral DCs suddenly decreased at the end of day 1, then gradually increased through day 28 but remained below normal levels. After 1 year, levels were higher than before surgery but lower than normal. The mDC levels were higher in patients with acute rejection before and 1 day after surgery (P < 0.005). There was no significant difference in IL-10 and IL-12 levels between patients with and without acute rejection.</p><p><b>CONCLUSION</b>The changes in DCs and DC subpopulations during the acute rejection period may serve as effective markers and referral indices for monitoring the immune state, and predicting rejection and reasonably adjusting immunosuppressants.</p>

The recent advances in the host targets of anti-influenza drugs / 药学学报

The challenge of the emergence of drug-resistant influenza strains, which is caused by wide spread utilization of direct-acting antivirals (DAAs), accelerates the research and exploration towards host targeted agents. In contrast to DAAs targeting viral replication components, host targeted agents, which regulate host factors and pathways linked to viral replication, can interfere the replication of influenza. Additionally, the innate immune system is activated by influenza during the early stage of infection, so manipulating the innate immune response may prevent the viral infection. However, the excessive inflammatory response induced at the late phase of influenza infection would lead to severe tissue injures. Thus, it is very important to explore drugs with anti-inflammatory actions to suppress these immune imbalances and tissue injures. Here we overview the current progresses about host targets related to anti-influenza drugs.

Recombinant human interferon alpha 2b broad-spectrum anti-respiratory viruses pharmacodynamics study in vitro / 药学学报

This study is to investigate the effect of recombinant human interferon alpha 2b against broad-spectrum respiratory viruses in vitro. At the cellular level, the effect of the recombinant human interferon alpha 2b on influenza A virus was detected using real-time fluorescence quantitative RT-PCR. The effects of the recombinant human interferon alpha 2b on influenza B virus, parainfluenza virus, respiratory syncytial virus (RSV) and coronavirus were detected using cytopathic effect (CPE) method. In this study, the therapeutic index of recombinant human interferon alpha 2b anti-HPIV was 1476.63, the therapeutic index of recombinant human interferon alpha 2b anti-RSV was 141.37, the therapeutic index of recombinant human interferon alpha 2b anti-coronavirus was more than 2820.76, and the antiviral effect of recombinant human interferon alpha 2b was better than ribavirin (RBV). Recombinant human interferon alpha 2b has a stronger inhibitory effect on different influenza A virus RNA than drug control. The therapeutic index of recombinant human interferon alpha 2b anti-influenza B virus was 2.74, with modest effect. Recombinant human interferon alpha 2b in vitro has broad spectrum antiviral activities, low toxicity and high therapeutic index. Recombinant human interferon alpha 2b is expected to become the efficient medicine in clinical against respiratory viruses, as well as provide better services for prevention and treatment of respiratory viruses' infections.

Changes of vaginal microecology in elderly postmenopausal women / 中华老年医学杂志

Objective To investigate the changes and significances of vaginal microecology in elderly postmenopausal women.Methods 50 postmenopausal women and 68 reproductive age women with no subjective symptoms and normal vaginal microecological who had health examination in Beijing Hospital were selected.The contents and strains of vaginal lactobacilli in both groups were detected by polymerase chain reaction (PCR),and their differences between the two groups were analyzed.Results 92％ (46 cases) of postmenopausal women had only one vaginal lactobacillus strain in vaginal,and 8％(4 cases) of them had two lactobacillus strains in vaginal.But 4％(3 cases) of reproductive-age women had only one vaginal lactobacillus strain in vaginal,and 96％ (65 cases) of them had two and more lactobacillus strains in vaginal.There was a significant difference in the strains of vaginal lactobacilli between the two groups (x2=91.035,P=0.000).The strains of vaginal lacmbacilli ranking top 4 detection rate was Lactobaeillus jensenii (30.0％),Lactobacillus gasseri (22.6％),Lactobacillus crispatus (16.9％) and Lactobacillus inert (13.2％) in postmenopausal women,while Lactobacillus inert (80.8 ％),Lactobacillus crispatus (70.5 ％),Lactobacillus gasseri (67.6％) and Lactobacillus jensenii (39.7％) in reproductive-age women.The content of 16s rDNA from vaginal lactobacillus was more in reproductive age women than in postmenopausal women [(87.3 ±0.8) ng/g total DNA vs.(35.1±3.6) ng / g total DNA,t=6.514,P=0.048].Conclusions Lactobacillus strains colonizing in vaginal are different between postmenopausal women and reproductive age women,and the content of the vaginal lactobacillus is reduced significantly in postmenopausal women.

Clinical investigation of docetaxel combined with nedaplatin in the treatment of recurrent epithelial ovarian cancer in elderly women / 中华老年医学杂志

Objective To evaluate the efficacy and safety of concomitant docetaxal (DTX) and nedaplatin (NDP) therapy for recurrent epithelial ovarian cancer in elderly women.Methods Totally 42 elderly patients with histologically confirmed recurrent epithelial ovarian cancer received chemotherapy with DTX combined with NDP.DTX with the dose of 60-70 mg/m2 was administered intravenously on day 1,followed by NDP with the dose of 70-80 mg/m2 given intravenously on day 2.The treatment was repeated every 3 weeks.The efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) and serum CA125 level.Adverse reactions were assessed according to performance and standard criteria in toxicity of anticancer agents of WTO.Results 4 patients were switched to other chemotherapy strategies due to progression of disease after 2 courses of treament,and the other patients completed 4 to 6 courses.Among 42 patients,18 cases (42.9％)showed complete remission,10 cases (23.8％) showed partial remission,6 cases (14.3％) were in stable conditions,and 8 cases (19.0％) progressed to severe disease.The median progression-free survival (PFS) time was 7 months,and the efficacy rate (complete and partial remission) was 66.7％(28/42).The main adverse effects were alopecia,nausea and vomit,and leucopenia.Patients could get remission by receiving drug therapy.Conclusions Docetaxel plus nedaplatin therapy has a good therapeutic effect with low incidence of adverse reactions,high safety and well tolerance in elderly platinum-sensitive women and in those with platinum-resistant recurrent epithelial ovarian cancer.

Analysis of clinical and pathological features of 187 postmenopausal women with thickening endometrial / 中华老年医学杂志

Objective To investigate the clinical and pathological features of postmenopausal women with thickening endometrial. Methods Totally 187 patients with postmenopausal endometrial thickening by transvaginal B-ultrasound were divided into symptomatic group (n=104)and asymptomatic group (n=83).Their body mass index,age of menarche and menopause,history of menstruation and reproductive,application of estrogen,and hypertension and diabetes were collected.All the patients underwent hysteroscopy and biopsy procedures. Results There was no difference between two groups in body mass index [ (24.3 ± 3.2) kg/m2 vs.(23.3 ± 2.6) kg/m2,t =3.79,P =0.052]. The postmenopausal time of symptomatic patients in the group was shorter than the asymptomatic [ ( 14.6 ± 2.4) years vs.( 16.5 ± 2.9 ) years,t =4.12,P =0.039].The patients in the asymptomatic group were older than the patients in the symptomatic group [(68.1 ±4.8) years vs.(66.1± 5.5) years,F=3.89,P =0.046].The average endometrial thickness of patients in the asymptomatic group showed no difference compared with patients in the symptomatic group [(7.2 ±1.4) mm vs. (7.8 ± 2.0) mm,F=3.21,P=0.065]. There were 5 cases of endometrial adenocarcinoma,1 case of endometrial atypical hyperplasia,38 cases of endometrial polyp,25 cases of submucosal hysteromyoma,14 cases of proliferative phase endometrium in the asymptomatic group;while 8 cases of endometrial adenocarcinoma,1 case of endometrial stromal sarcoma,4 cases of endometrial serous papillary carcinoma,5 cases of endometrial atypical hyperplasia,47 cases of endometrial polyps,21 cases of submucosal hysteromyoma,2 cases of uterine empyema,8 cases of chronic inflammation of the endometrium, 8 cases of proliferative phase endometrium in the symptomatic group,respectively. Conclusions Most of endometrial thickness in postmenopausal women are benign lesions, mainly including endometrial polyps and submucous myoma, but endometrial cancer accounts for a certain percentage. Hysteroscopy is minimally invasive,safe and with specificity for the diagnosis and treatment of endometrial lesions.

Clinical analysis of infection following ATG and IL-2 receptor antagonists-based induction therapy after renal transplantation / 中华器官移植杂志

Objective To investigate the infection following the lymphocytes deleted agent (ATG) and IL-2 receptor antagonists (Basilixinab and Daclizumab)-based induction therapy after renal trausplantation.Methods A retrospective analysis was carried out on 701 kidney transplant recipients between Jan. 1,2005 to Dec.31,2010.According to exclusive and inclusive criteria,finally 549 patients were evaluated,including 429 patients treated with ATG (ATG group) and 120 patients with anti-CD25 monoclonal antibodies (monoclonal antibodies group; 86 patients with Basiliximab,and 34 patients with Daclizumab).The incidence of acute rejection,infection rate,infection time,hospital stay,severe infection rate and mortality were analyzed.After operation,the patients received an immunosuppression therapy including Tacrolimus (cyclosporine A),Mycophenolate-Mofetil and prednisone to present rejection. Part of the patients were treated with ganciclovir and sulfamethoxazole sulfadiazine and trimethoprim for infection prevention.Results The acute rejection rate in ATG group and monoclonal antibodies group was 15.9％ (68/429) and 10.0％ (12/120),and there was no statistically significant difference (P＞0.05).The infection rate in ATG group was 11.9％ (51/429),including 13.7％ (7/51) with severe infection,and mortality was 7.8％(4/51).The infection rate was 15.0％ (18/120) in monoclonal antibodies group,including 11.1％ (2/18) with severe infection,and mortality was 5.6％ (1/18).There was no statistically significnat difference in infection rate,severe infection rate and mortality between two groups (P＞0.05).The hospital stay in ATG group and monoclonal antibodies group was 25.8 days and 19.1 days respectively (P＜0.05).Dead cases had not received regular anti-infection treatment,and the patients age was over 50 years.Conclusion The infection risk and mortality between these two induction therapies are identical,but hn comparison to the patients using ATG,the infection of patients using anti-CD25 monoclonal antibodies is easier to control.Anti-infection prophylaxis is important to reduce infection rate and decrease infectious mortality.

A survey of nonsteroidal anti-inflammatory drugs and aspirin associated peptic ulcer bleeding in hospitals / 中华内科杂志

Objective To investigate the clinical characteristic and prognosis of nonsteroidal antiinflammatory drugs( NSAIDs)and aspirin associated peptic ulcer bleeding. Method All patients with peptic ulcer bleeding were studied by the same researcher after admission and discharge. Results Fifty-one cases with NSAIDs and aspirin medication of the total peptic ulcer bleeding patients ( 147 cases) were included (34. 7% ). Compared with patients not associated with NSAIDs and aspirin medication, they are older [(41.2 ± 1. 9 ) years vs ( 59.4 ± 2. 2 ) years, P ＜ 0. 001], more commonly associated with hypertension ( 10. 4% vs 39. 2% ,P ＜0. 001 ), coronary heart disease ( 10. 4% vs 17.6% ,P ＜0. 001 ) ,diabetes (4. 2%vs 19. 6%, P = 0. 005 ); and had more severe anemia (7. 3% vs 23. 5%, P = 0. 008 ). Fewer patients in NSAIDs group had epigastric pain (61.5% vs 27.5%, P ＜ 0. 001 ), while there was more re-bleeding (9.4% vs 15.7%, P = 0.034). In all bleeding patients, factors associated with re-bleeding, surgical intervention and death included NSAIDs and aspirin medication, and low platelet count. In patients with NSAIDs and aspirin medication, re-bleeding was associated with previous ulcer history ( P ＜ 0. 05 ).Conclusion Peptic ulcer bleeding patients with NSAIDs and aspirin medication were more severe ill, and less likely to present with epigastric pain.