A multicenter, randomized, open and positive parallel controlled clinical study of clotrimazole vaginal expansion suppository and vaginal tablet in the treatment of mild and moderate vulvovaginal candidiasis / 中华妇产科杂志

Objective:Using clotrimazole vaginal tablet as a positive control, to evaluate the results of clotrimazole vaginal expansion suppository in the treatment of mild and moderate vulvovaginal candidiasis in terms of efficacy, patient satisfaction, side effects, and recurrence rate.Methods:This study was jointly conducted by 5 hospitals from August 2017 to October 2018, patients with mild and moderate vulvovaginal candidiasis confirmed by fungal culture and symptoms scores were selected. They were randomized to experimental group and control group as 1∶1 ratio. In the experimental group ( n=105), the subjects applied clotrimazole vaginal expansion suppository (150 mg) daily at night for 7 days. In the control group ( n=106), the subjects used a single dose of clotrimazole vaginal tablet (500 mg). Follow-ups were performed at (8±3) and (30±5) days after the discontinuation of the drugs, respectively. The difference in clinical symptoms and signs scores was used to evaluate the improvement of clinical symptoms, and the patient′s satisfaction and side effects were recorded. Results:At the first follow-up, the experimental group and control group were followed up by fungal culture on the cure rate [66.7% (70/105) versus 63.2% (67/106), P>0.05] and total effective rate [98.1% (103/105) versus 99.1% (105/106), P>0.05], the differences were not statistically significant. At the second follow-up, the recurrence rates of the experimental group and the control group were 5.7% (4/70) and 14.9% (10/67), respectively, with no significant difference ( P>0.05). In the evaluation of patient satisfaction, the leakage of the drug in the experimental group was significantly better than that in the control group ( P<0.01). The side effects mainly included vaginal stimulation, itching and burning sensation, and there was no statistical difference between the two groups ( χ2=1.070, P=0.586). Conclusions:In the treatment of mild and moderate vulvovaginal candidiasis, clotrimazole vaginal expansion suppository is no less effective than clotrimazole vaginal tablet, and there is no significant difference in the recurrence rate between the two. In terms of patient satisfaction, clotrimazole vaginal expansion suppository is superior to clotrimazole vaginal tablet.

Roles and mechanisms of chemokine CX3CL1 in cerebral ischemia / 国际脑血管病杂志

Chemokine CX3CL1 mainly participates in the physiological and pathological processes of nervous system by activating its receptor CX3CR1. Under physiological conditions, CX3CL1 can inhibit the activation of microglia; when cerebral ischemia and hypoxia, CX3CL1 can affect the expression of multiple downstream target genes involved in activation of adenosine receptor, inhibition of Ca2+ influx, and promotion of blood vessel growth. It is of great significance to improve the energy metabolism disorder and to establish microcirculation around infarcts after cerebral ischemia.

Roles and mechanisms of chemokine CX3CL1 in cerebral ischemia / 国际脑血管病杂志

Chemokine CX3CL1 mainly participates in the physiological and pathological processes of nervous system by activating its receptor CX3CR1.Under physiological conditions,CX3CL1 can inhibit the activation of microglia;when cerebral ischemia and hypoxia,CX3CL1 can affect the expression of multiple downstream target genes involved in activation of adenosine receptor,inhibition of Ca 2+ influx,and promotion of blood vessel growth.It is of great significance to improve the energy metabolism disorder and to establish microcirculation around infarcts after cerebral ischemia.

Roles and mechanisms of connexin 43 in cerebral ischemia-reperfusion / 国际脑血管病杂志

In the central nervous system, gap junctions exist between neurons and glial cells. Among them, connexin 43 (Cx43) is one of the most abundant connexin proteins in the central nervous system,involved in the metabolic coupling of intercellular substance exchange and electrical coupling of electrical signaling. It plays an important role in regulating cell metabolism, homeostasis, and cell differentiation. After cerebral ischemia, the uncoupling of gap junctions and abnormal hemichannel activity cause a steady-state imbalance of the internal and external environment of the cells, eventually leading to brain tissue damage.Therefore, maintaining the normal function of Cx43 is essential for protecting brain tissue from neuronal damage induced by cerebral ischemia-reperfusion.

The vaginal microecology in gynecological outpatients: a report from China / 中华检验医学杂志

Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China.Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China.200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed.Results A total of 2 093 specimens were collected in this study.The detection rate of Trichomonas was 5.5%(115/2 093). The detection rate of Candida mycelia was 15.9%(333/2 093), with germinal spores was 4.1%(86/2093).The detection rate of bacterial vaginosis was 18.8%(394/2 093).The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3%(571/2 093).The normal flora with the insufficiency of H2O2 accounted for 23%(480/2 093).The bacteria inhibiting flora accounted for 3.8%(79/2 093).The abnormal microflora(non BV type)accounted for 14.9%(312/2 093).The abnormal microflora(BV intermediate type)accounted for 13.4%(280/2 093).The abnormal microflora(BV type)accounted for 17.6%(369/2 093).The average pH of vaginal discharge was 4.58 ±0.495.There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river, while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north.The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors.The patients′age from bacteria inhibition group was 49.64 +16.68 which was significantly higher than that of the other microecology groups.The proportion of abnormal microflora of patients from the oral contraceptive group was 40%(20/50).The proportion of abnormal microflora of patients from IUD group was 36.6%(63/172).Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327)which was significantly lower.The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups.Conclusion This study showed the vaginal microecology status of the Chinese outpatient ′s clinic and found that the vagina microecology was related to age, region and contraceptive methods.The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med,2018, 41:287-291)

Measurement of thrombelastograph index and their correlation with serological indexes in patients with acute cerebral infarction / 心血管康复医学杂志

Objective:To analyze correlation between thrombelastograph (TEG) indexes and serological indexes in patients with acute cerebral infarction (ACI) .Methods :A total of 116 ACI patients treated in our hospital were se‐lected as ACI group ,another 98 cases without ACI , who underwent routine physical examination were regarded as healthy control group .According to severity of neurological function defect during acute phase ,ACI group was fur‐ther divided into mild ACI group (n=51) ,moderate ACI group (n=32) and severe ACI group (n=33) .TEG inde‐xes and serum indexes of platelet activation were measured and compared among above group ,and the correlation a‐mong TEG indexes and serum levels of platelet activation indexes were analyzed .Results:Compared with healthy control group ,there were significant reductions in R value [ (6.17 ± 1.38) min vs .(5.26 ± 0.77) min] and K value [ (2.39 ± 0.53) min vs .(1.71 ± 0.58) min] ,significant rise in α angle [ (63.27 ± 9.23) deg vs .(77.45 ± 12.08) deg] ,MA value [ (55.09 ± 6.38) mm vs .(77.13 ± 13.25) mm] of TEG ;clot index [CI ,(1.68 ± 0.53) vs .(2.56 ± 0.87)] ,D-dimer level [(0.24 ± 0.07) mg/L vs .(0.38 ± 0.09) mg/L] and platelet aggregation rate [PAR ,(56.12 ± 6.75)% vs .(69.17 ± 9.33)% ] in ACI group after treatment ,P<0.05 all .Among ACI subgroups with different severity ,the more severe neurological function defect was ,the lower R and K values were ,the higherαangle ,MA value ,CI ,D-dimer level and PAR were ,there were significant difference in pairwise comparisons ( P<0.05 or <0.01) .Linear regression analysis indicated that PAR was significant inversely correlated with R (B= -2.254) and K values (B= -2.286) ,and significant positively correlated with αangle (B=2.536) ,MA (B=2.537) and CI (B=2.352) ,P<0.05 or <0.01 ;D-dimer level was significant inversely correlated with R (B= -2.276) and K val‐ues (B= -2.259) ,and significant positively correlated with α angle (B=2.621) ,MA (B= 2.462) and CI (B=2.647) , P<0.05 or <0.01. Conclusion:TEG indexes are significantly correlated with platelet activity in ACI pa‐tients .TEG possesses good practical value in diagnosis ,severity judgment and therapeutic guidance for these pa‐tients .

Role of coaptation imaging of mitral valve on ischemic mitral regurgitation by real-time three-dimensional transesophageal echocardiography / 中华超声影像学杂志

Objective To explore the impact of morphological changes of mitral valve coaptation on ischemic mitral regurgitation (IMR),and observe coaptation image of mitral valve in systole in patients with IMR by using real-time three-dimensional transesophageal echocardiography (RT3D-TEE).Methods RT3D-TEE was performed on 112 patients with IMR and 38 patients without MR as the control.Patients with IMR were divided into group of mild IMR (n =46),group of moderate IMR (n =45) and group of severe IMR (n =21),according to the severity of mitral regurgitation.Mitral valve quantification (MVQ)software of Qlab 8.1 was used for image post-processing of RT3D-TEE.The coaptation parameters was measured,included length of anterior combination(LCA3dlf),length of posterior combination(LCP3dlf),area of anterior combination(A3DTANT) and area of posterior combination (A3DTPOST) at end-systole.Then,these coaptation parameters of mitral valve were compared statistically.Logistic regression assessing was applied for analyzing the results.Results Coaptation line of anterior and posterior leaflets was almost same in normal subjects.With increasing of mitral regurgitation,a tendency to prolong in LCA3dlf and LCP3dlf were observed in IMR (P ＜0.05).Compared to that in mild and moderate IMR groups,besides A3DTANT and A3DTPOST,LCA3dlf and LCP3dlf were also increased significantly in severe IMR group (P ＜0.05).LCP3dlf was an independent correlation factor of IMR by Logistic regression analysis.The sensitivity was 73.3％ and the specificity was 94.7％ when LCP3dlf≥32 mm was regarded as cut-off point,and the area under the ROC curve was 0.949 (0.900～0.999).Conclusions Abnormal coaptation of anterior and posterior leaflets of mitral valve might be one of main cause of IMR.Involution structure of mitral valve before surgery is helpful for surgeon to select an optical surgical procedure and evaluate effects of treatment in patients with IMR.

Accuracy of measurement of left ventricular volume and function in coronary heart disease with real-time threedimensional echocardiography / 中华超声影像学杂志

ObjectiveTo evaluate the accuracy of measurement of left ventricular(LV) volume and function in coronary heart disease(CHD) by real-time three-dimensional echocardiography(RT-3DE) using cardiac magnetic resonance imaging (CMRI).Methods LV end diastolic volume(EDV),LV end systolic volume(ESV) and LV ejection fraction(EF) were measured with RT-3DE in patients with CHD ( n =37) and in the control ( n =30).The results measured by RT 3DE were compared with those of CMRI.The diagnostic value of RT-3DE was evaluated using receiver operating characteristic(ROC) curve.Results Compared with that measured by CMRI,EDV,ESV and EF by RT 3DE( P ＞0.05) were almost similar as that in the control.Area under ROC curve of in EDV and ESV were 0.912 and 0.944 in the control.However,EDV determined by RT-3DE was smaller than that by CMRI( P ＜0.05) in CHD group.A difference (10.95 ± 31.26 ml) was existed in EDV between the two methods.ESV measured by RT-3DE was smaller than that calculated by CMRI( P ＞0.05) with a mean differance of (3.17 ± 16.42)ml in CHD group.EF by RT-3DE( P ＞0.05)was almost as same as that by CMRI in CHD group,with a mean difference of (1.54 ± 11.85)％.The area under ROC curve of EDV and ESV were 0.834 and 0.873 in CHD group and their diagnostic performance was moderate.ConclusionsMeasurment of LV volume and function by RT 3DE in control was more acurrate than that in CHD.In the cases of LV remodeling in patients with CHD,RT-3DE would underestimate the LV volume.

Advances in relationship between WNT5A and neoplasms / 国际肿瘤学杂志

WNT5A is associated with embryonic development and the development, invasion, metastasis and chemoresistance of tumor cells. The WNT5A signal in different tumors is specifically mediated by a number of factors, including receptors, downstream targets, inhibitors and external influences from tumor microenvironment and extracellular matrix. Eventhough it is still under debate whether WNT5A functions as a tumor suppressor or a promoter, WNT5A signal transduction pathway is closely associated with various tumor behaviors.

Preliminary application of diastolic inflow inside left ventricle using color singular value / 中华超声影像学杂志

Objective To develop a new method for describe features of inflow of left ventricle(LV) from color Doppler image by color singular value,and evaluat the value of color singular value in assessment of diastolic dysfunction. Methods Patients with diastolic dysfunction of LV including myocardial infarction (n = 37), angina( n = 35), cardiomyopathy( n = 45) and hypertension ( n =46) were selected and 30 healthy cases as control. CV and AV from color singular value of LV inflow was displayed and calculated automatically by an analyzing system developed in our laboratory. Results Compared with that of control (CV:2.40 0.22 and AV: -0.25 0.05), the absolute value of CV(1.67-1.90 in average)and AV( - 0. 11～-0. 20 in average) from color singular value were decreased significantly( P <0. 001) in groupsof myocardial infarction, angina, cardiomyopathy and hypertension. Conclusions Singular value can be applied to detect color differences in LV inflow from color Doppler signals. Changes of singular value within the diastolic inflow under pathological conditions may reflect the diastolic dysfunction of LV.

Effects of small interfering RNA specific to stably transfected HMGA1 gene on biological characters of ovarian carcinoma cells / 中华妇产科杂志

Objective To investigate the effects of biological characters of the human ovarian cell line (OVCAR) by stable transfection short hairpin RNA into the target HMGA1 gene. Methods Experiments were divided into two groups: transfected the OVCAR cells with pSilence4. 1-CMV-Hs plasmid as group A, while transfected OVCAR cells with pSilence4. 1-CMV-Hn plasmid as group B, in which stably transfected cells were gained by antibiotic screening. The comparative expressions of HMGA1 were detected by RT-PCR and western blot. Methyl thiazolyl tetrazolium (MTT) method was applied to measure cell proliferation and at the same time, the cell growth curve was also be mapped. Vitro invasion assay was used to observe the invasion ability of the cancer cells, and the tumor growth of the nude mice inoculated of tumor cells were compared with before and after transfection. Results In group A, the expression level of mRNA and protein HMGA1 gene in OVCAR cells were remarkably reduced before and after the stable transfected with HMGA1 siRNA, in which the percents of mRNA expression were [(86.3±2.7) % vs. (35.8± 3.1) %, P<0.05], the expression of protein were [(68.6±2.8) % vs. (22.3±4.2) %, P<0.05)]. The OVCAR cell growth in stable transfection status was more significantly decreased than that in non-transfection status (P<0.05). In group B, there were no statistical difference in the expression of HMGA1 siRNA, protein and the cell growth between before and after transfection states (P>0.05). The invasion cell numbers were reduced from before to after transfection state in group A [(53±6)vs. (21±6), P< 0.05] ,while there was no significant difference in group B [(51±6)vs. (47±8), P>0.05]. After inoculated transfected cells into nude mice, it took (6.0±0.9) days to grow the planed tumors in group A, which was much shorter than that (12.3±3.9) days in group B (P<0.05 ). After 5 weeks, the tumor weight and volume in group A was were significantly lower than those in group B [(0.8±0.3)g vs. (2.1± 0.4)g, (205±34)mm~3 vs. (987±82) mm~3, all P <0.05]. Conclusion HMGA1 siRNA could remarkably reduce the expression of HMGA1 gene in ovarian cell and also inhabit the ovarian cell growth.

Evaluation of differences of left ventricular segmental motion in patients with dilated cardiomyopathy using illustration of the bull eye from real-time three-dimensional echocardiography / 中华超声影像学杂志

Objective To explore the differences of systolic segmental motion of left ventricle (LV) in patients with dilated cardiomyopathy (DCM) using illustration of the bull eye (IBE) from real-time three-dimensional echoeardiography(RT-3DE). Methods Quantitative analysis of LV segmental function was made in 43 patients with DCM by IBE. Percentage of compensated segments(PCS) was determined according to the segmental distribution by different color from IBE. Maximal exeursion(Emax),minimal excursion(Emin), average excursion (EA), standard difference of excursion(SD) and dispersion of excursion(Edis) were calculated. Results PCS in patients with DCM was 27.22%. Significant differences between DCM group and control group in Emax, Emin, EA,SD and Edis were observed( P <0. 001 ). Significant difference in segmental motion of LV was existed in patients with DCM and its distribution of motion seems tendency of irregularity. Conclnsions PCS and Edis from IBE might provide a convenient and macroscopic modality in selection of treatment and evaluation of prognosis in patients with DCM.

The Current Situation and Countermeasures of Sexual Education of University Students / 中华医学教育探索杂志

Universities are cradles of leadership and full-developed specific professional.Besides specific courses,reasonable sexual health education should be set up to make the students succeed when they grow up.