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Hou S.-P.,Shanghai JiaoTong University | Chen O.-J.,Shanghai Institute of Planned Parenthood Research | Huang L.-H.,Peoples Hospital of Jinghong | Cheng L.-N.,Shanghai Institute of Planned Parenthood Research | Teng Y.-C.,Shanghai JiaoTong University
European Journal of Obstetrics Gynecology and Reproductive Biology | Year: 2013

In China, most women with intrauterine devices (IUDs) ask to have them removed following the menopause. As the cervix is stenotic after the menopause and most IUDs do not have a thread attached, various medical methods are used for cervical ripening prior to IUD removal. A systematic review of the relevant literature was conducted to compare different medical methods for cervical priming with no treatment, or with other methods, prior to IUD removal in postmenopausal women. Multiple electronic databases including the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, the WHO Reproductive Health Library (2011) and the Chinese Biomedical Literature Database were searched systematically. Reference lists of articles published in English or Chinese between 1980 and 2011 were searched. All randomized controlled trials (RCTs) on IUD removal following the menopause using medical agents compared with no treatment, or with other treatments, were included. Outcomes were the ease of IUD removal, need for forced cervical dilatation, cervical width, procedure time, severe pain and any side-effects. Data were processed using RevMan 5 software. Thirty original RCTs were eligible for inclusion. Most medical agents such as oestrogens, mifepristone, misoprostol and methyl carboprost were highly effective for facilitating IUD removal, and reduced the need for further dilatation during the procedure. In particular, treatment with mifepristone or misoprostol prior to IUD removal was found to increase the width of the cervical canal and reduce the procedure time. Mifepristone was more effective than vaginal misoprostol for cervical dilatation, but it showed similar effectiveness to misoprostol and nilestriol in terms of the ease of IUD removal. Sublingual misoprostol was superior to oral misoprostol for facilitating IUD removal. A dose of misoprostol as low as 200 μg was effective for cervical priming. For vaginal and oral misoprostol, the optimum times of application were 2-3 h and 1 day prior to the procedure, respectively. All the prophylactic medical methods were able to alleviate pain during IUD removal, and vaginal misoprostol was more effective than nilestriol. Uterine injury was more common with no treatment and with nilestriol. Gastrointestinal side-effects such as nausea and diarrhoea were common with oral misoprostol and vaginal misoprostol, respectively. Therefore, mifepristone or sublingual misoprostol should be the medical treatments of choice. Oestrogen regimens might be alternatives when mifepristone or misoprostol are contraindicated, and there is a need for further study on combined regimens for cervical priming. © 2013 Elsevier Ireland Ltd. All rights reserved.

Ju H.,Kunming General Hospital of Chengdu Military Area Command | Yang L.,Peoples Hospital of Lijiang City | Fan J.,Peoples Hospital of Jinghong | Shu Z.,Kunming General Hospital of Chengdu Military Area Command
Biomedical Research (India) | Year: 2014

This work aims to compare the levels of blood sugar, hemoglobin and glycosylated hemoglobin between type 2 diabetic patients of different gender and age, living at different altitudes in Yunnan, China. We selected 410 patients with type 2 diabetes from Kunming, Liji-ang and Jinghong of Yunnan Province and compared their levels of fasting blood sugar, 2hour postprandial blood sugar, hemoglobin and glycosylated hemoglobin. We categorized our findings in terms of gender, age, and the altitude where the patients normally inhabit. We analyzed the Pearson correlation coefficient of single factor of altitude and glycosylated hemoglobin. The fasting blood sugar, 2-hour postprandial blood sugar and glycosylated hemoglobin were not statistically different between the patients with type 2 diabetes of different genders and ages living at different altitudes, but the hemoglobin concentration were found to be statistically different. No significant relationship was, however, observed between the levels of altitude and glycosylated hemoglobin. Levels of altitude, gender and age showed effects on hemoglobin concentration in diabetic patients, but they failed to exert any significant effects on blood sugar and glycosylated hemoglobin concentrations.

Xiao Y.,University of Sichuan | Xiao Y.,Sichuan Academy of Medical Science | Hu G.,Surgery Academy | Dong D.-D.,Sichuan Academy of Medical Science | And 4 more authors.
International Journal of Clinical and Experimental Pathology | Year: 2016

Whether NF-E2-related factor-2 (NRF2) in breast cancer is oncogenic or tumor-suppressive remains under debate, and little is known about its functions. The aim of this study was to evaluate the pathological and clinical significance of NRF2 in breast cancer patients and its functional roles. We immunolocalized NRF2 in 72 invasive ductal breast cancer patients. Clinicopathological parameters and disease-free survival (DFS) was assessed. Correlation between NRF2 and human epidermal growth factor receptor 2 (ErbB2/HER2) expression was detected in patients and breast cancer cell lines by Real-time PCR, western blotting and proliferation assay. Chromatin-immunoprecipitation (CHIP) assays were used to determine if NRF2 interacts with HER2 promoter. We found that NRF2 was positive in 89% of the cases, and its status was significantly associated with HER2 immunoreactivity. Multivariate analyses revealed that NRF2 status was an independent good prognostic factor for DFS. Inverse correlation between NRF2 and HER2 expression was not only observed in breast cancer patients, but also verified on breast cancer cell lines using NRF2 inducer curcumin. Direct regulation of HER2 expression by NRF2 through its binding to ARE (antioxidantresponse element) on the HER2 promoter was confirmed by CHIP analysis, and more NRF2 was enriched on the HER2 promoter when cells were treated with curcumin. Our findings suggest that NRF2 might be a marker of good prognosis in breast cancer patients, and that the NRF2-HER2 interaction might be a promising therapeutic target for treating breast cancer.

Lin Z.,Peoples Hospital of Jinghong
Applied Mechanics and Materials | Year: 2012

OBJECTIVE: To investigate the clinical efficacy and safety of low-energy direct current defibrillation combined with intravenous application of β-receptor blocker in the treatment of ventricular tachycardia storm (VTS). METHODS: A total of 59 patients with VTS were randomly divided into two groups. In the control group (n = 31), intravenous administration of Lidocaine or Amiodarone and routine electrical defibrillation were performed. In the esmolol group (n = 28), intravenous administration of esmolol and low-energy electrical defibrillation were performed in addition to the same drug treatment as the control group. RESULTS: The success rate of terminating recurrent ventricular tachycardia or ventricular fibrillation was significantly higher in the esmolol group than in the control group (89.71% vs. 39.89%, P < 0.05). The necessary discharge times and average discharge energy to terminate ventricular tachycardia or ventricular fibrillation were significantly decreased in the esmolol group compared with control (5.69 ± 1.34 times vs. 8.63 ± 3.79 times, 95.32 ± 13.21J vs. 185.39 ± 25.63J, both P < 0.05). There was no significant difference in the incidence of hypotension (45.16% vs. 39.29%), sinus bradycardia (3.23% vs. 3.57%), and junctional/ventricular escape (38.71% vs. 39.29%) between the esmolol and control groups (all P > 0.05). The mortality was significantly lower in the esmolol group than in the control group (21.43%, 6/28 vs. 77.42%, 24/31, P < 0.01). CONCLUSION: Compared with conventional treatment, intravenous administration of a β-receptor blocker combined with low-energy electrical defibrillation could be a safe and effective therapy to treat VTS.

Li T.-T.,Central South University | Li T.-T.,Peoples Hospital of Jinghong | Zhang Y.-S.,Central South University | He L.,Central South University | And 4 more authors.
Canadian Journal of Physiology and Pharmacology | Year: 2012

Myeloperoxidase (MPO) is involved in myocardial ischemia-reperfusion (IR) injury and vascular peroxidase (VPO) is a newly identified isoform of MPO. This study was conducted to explore whether VPO is involved in IR-induced cardiac dysfunction and apoptosis. In a rat Langendorff model of myocardial IR, the cardiac function parameters (left ventricular pressure and the maximum derivatives of left ventricular pressure and coronary flow), creatine kinase (CK) activity, apoptosis, VPO1 activity were measured. In a cell (rat-heart-derived H9c2 cells) model of hypoxia-reoxygenation (HR), apoptosis, VPO activity, and VPO1 mRNA expression were examined. In isolated heart, IR caused a marked decrease in cardiac function and a significant increase in apoptosis, CK, and VPO activity. These effects were attenuated by pharmacologic inhibition of VPO. In vitro, pharmacologic inhibition of VPO activity or silencing of VPO1 expression significantly suppressed HR-induced cellular apoptosis. Our results suggest that increased VPO activity contributes to IR-induced cardiac dysfunction and inhibition of VPO activity may have the potential clinical value in protecting the myocardium against IR injury.

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