2016 Vol. 7, No. 6

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Ovarian Aging Column
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  Objective  To investigate the change of uterine size in ovarian aging in women living in a Beijing community.  Methods  A total of 418 healthy women aged 30 to 68 years who could be staged by STRAW+10 staging system were recruited from a Beijing community and prospectively followed up for 5 years. Menstrual dairy was recorded daily by every woman during the research. Transvaginal ultrasonography was performed for measurement of uterine size at baseline and each year during the 5 years. Serum estradiol (E2) was tested as well.  Results  At baseline, various diameters and volume of uterus began to shrink significantly since the early post-menopausal stage+1a and shrank further at stage+1c (P < 0.05), while not changed much at late post-meno-pausal stage. The thickness of endometrium decreased from stage+1a (P < 0.05) and showed no significant change after that (P>0.05). E2 in menopausal transition and the first 2 years after menopause had a large variation that no significant difference was found comparing with reproductive stage (P>0.05). E2 level decreased significantly at stage+1c(P < 0.05) and kept at a low level at late postmenopausal stage, with no statistically significant difference compared with stage+1c (P>0.05). For women still at the same STRAW+10 stages after 5-year's follow-up, there was only decline in some diameters at early and late postmenopausal stages and no obvious change in endometrial thickness. E2 level only decreased in the late postmenopausal stage(P < 0.01). For women with stage progress after 5-year's follow-up, each line diameter and volume of the uterus changed significantly during transition to early postmenopausal stage +1a/+1b, or from menopausal transition stage to ensuing stages. Change in endometrial thickness was only found in those transformed since menopausal transition stage. E2 level changed mainly after menopausal transition stage. Uterine fibroids increased significantly during the transition from the reproductive stage to the menopausal transition stage (P < 0.01) and began to shrink after menopause but with no statistically significant difference(P>0.05). The decline in uterine volume in women with uterine fibroid was mainly observed at early postmenopausal stage, with no obvious change afterwards.  Conclusions  Uterine size, endometrial thickness, and E2 level do not change in synchronization. Uterine size shrinks during a rather long time since menopause, endometrial thickness begins to reduce mainly in the early stage after menopause. E2 in menopausal transition and the first 2 years after menopause has a big variation which does not decrease obviously until 2 years after menopause.
Original Contributions
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  Objective  To design a visualized self-assessment questionnaire for patients with knee osteoarthritis in order to facilitate patient self-assessment and long-term management of this condition.  Methods  Several databases including PubMed and China National Knowledge Infrastructure (CNKI) were searched for existing scales on osteoarthritis that reflect patients' complaints, based on which a pool of dimensions and items was generated. Ninety orthopedists were invited to rate the intelligibility, importance, and feasibility of these items. Then an expert consultation meeting consisting of 15 senior orthopedic specialists was convoked to optimize the questionnaire based on the rating results. A pilot investigation was conducted in 77 patients with knee osteoarthritis, from whom opinions and feedback were collected for further optimization of the items and graphs in a following expert consultation meeting to formulate the first draft of the questionnaire.  Results  The initial pool of items covered 38 items in 3 dimensions, namely, pain, inflammation, and function. The response rate of the 90 orthopedists was 100%, while 26 items were ranked within the top 75% regarding items expression and usage intention. The number of items was streamlined to 16 after the first round of specialist consultation meeting, and further reduced to 14 items in the first draft on the basis of patient feedback, still in the 3 dimensions of pain, inflammation, and function.  Conclusions  The visualized self-assessment questionnaire for patients with knee osteoarthritis is the first independently developed knee osteoarthritis assessment scale in China. It is a simple, comprehensive, and quantitative self-assessment tool for patients with knee osteoarthritis based on expert and patient opinions, with high feasibility and clinical significance.
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  Objective  To establish the diagnostic model for lung cancer by protein fingerprint techniques and to further explore the serum protein biomarker for early diagnosis and surgical effect assessment of lung cancer.  Methods  Serum samples from 32 healthy controls, 38 lung cancer patients, and 12 lung benign tumor patients were analyzed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) combining with magnetic bead technique to establish proteomic spectra. The data were categorized and analyzed with Biomarker Patterns Software (BPS) to develop a preliminary diagnostic model of serum protein fingerprint of lung cancer. Efficiency of this diagnostic model was tested. Combining with the diagnostic model, the proteomic spectra before and after surgery were compared to identify the proteins suitable as indicators of surgical effect.  Results  Within the mass-to-charge ratio (m/z) range of 1000-50 000, 215 protein peaks were detected and marked in the enrolled patients and healthy controls. Of these protein peaks, 6 peaks were identified as showing statistically significant difference in expression (m/z 1115.37, 1929.70, 3217.57, 3246.34, 3318.57, 11 508.90, P < 0.05). The primary sensitivity for diagnosing lung cancer was 92.11% (35/38) and its corresponding specificity was 90.91% (40/44). The cross validation suggested that the sensitivity and specificity were both 86.67% (13/15). The protein peaks with m/z being 1115.37, 1929.70, 3246.34, and 11508.90 were significantly increased in lung cancer patients(P < 0.05), and significantly reduced after surgery compared with before surgery in these patients (P < 0.01), suggesting potential value of these 4 protein peaks in diagnosis and treatment effect assessment of lung cancer.  Conclusion  The serum protein fingerprint diagnostic model for lung cancer based on SELDI-TOF-MS technique yields fairly high sensitivity and specificity, which may provide innovative thoughts for identification of biomarker for early diagnosis and treatment effect assessment of lung cancer.
Abstract:
  Objective  To establish high-precision irradiation platform for scientific research based on medical accelerator and to evaluate its performance.  Methods  Phantoms were designed referring to the petri dish commonly used in basic medical research. Irradiation platform was built on the phantoms and parameters of medical accelerator were set for the platform. Parameters for precision, stability, uniformity, and security were measured to evaluate performance of the platform.  Results  Under the dose rate of 600 MU/minute, and when the prescription dose was between 0.5 Gy and 20 Gy, the mean dose deviation of the platform was within 2%. The mean dose deviation rose to 3% to 5% when the prescription dose was 50 Gy. Under the conditions of prescription dose being 2 Gy, and dose rate being 100, 200, 300, 600, and 1000 MU/minute, the mean dose deviation was within 2%. The difference between maximum and minimum dose of a petri dish was 0.05 Gy under the condition of 600 MU/minute dose rate and 2 Gy prescription dose; while the doses of central, side, and corner petri dishes were (2.005±0.012), (2.002±0.006), and (2.006±0.012) Gy under the same condition. The doses in the operation room were close to the natural background doses when this platform was in normal operating state. When the platform was in abnormal operating state, under the condition of 600 MU/minute dose rate and 10 Gy prescription dose, the doses in position 10, 20, 30, 50, 100, and 200 cm from the phantom and within mazes of the accelerator room were (0.055±0.002), (0.032±0.002), (0.023±0.002), (0.016±0.001), (0.006±0.001), (0.004±0.001), and (0.002±0.001) Gy, respectively.  Conclusions  The platform can meet the requirements of most scientific researches with its high dose accuracy, high radiation field uniformity, adjustable dose rate, and high safety.
Abstract:
  Objective  To systematically assess the correlation between blood transfusion and postoperative outcomes following cardiac surgery.  Methods  Databases were searched for retrospective case-control studies on blood transfusion and postoperative outcome after cardiac surgery published in Chinese and English between January 1990 and December 2014. A meta-analysis was performed using RevMan 5.3 for quantitative synthesis of findings from included studies.  Results  Thirteen retrospective case-control studies including 88 808 patients (42 991 blood transfusion cases, 45 817 non-transfusion cases) were eligible for inclusion. The pooled analysis revealed statistically significant differences in all the postoperative outcomes:30-day mortality (OR=2.39, 95% CI:1.71-3.34, P < 0.000 01), 1-year mortality (OR=3.08, 95% CI:2.18-4.35, P < 0.000 01), 5-year mortality (OR=1.90, 95% CI:1.42-2.56, P < 0.0001), ischemic accident (OR=2.23, 95% CI:1.71-2.90, P < 0.000 01), and infection (OR=2.18, 95% CI:1.74-2.75, P < 0.000 01).  Conclusion  Perioperative blood transfusion may be strongly related with the risk of postoperative short- and long-term mortality, ischemic events, and infection following cardiac surgery.
Abstract:
  Objective  To identify the clinical features of eosinophilia caused by parasitic infection.  Methods  We reviewed and analyzed the clinical characteristics, peripheral eosinophils count, species of parasites, and system involvement of 87 patients with parasitic infections who were diagnosed and admitted in Peking Union Medical College Hospital (PUMCH) between January 2010 and December 2014.  Results  Of the 87 patients with parasitic infections, increased count of peripheral eosinophils occurred in 33.3% (29/87) patients, and hypereosinophilia with eosinophil count over 1.5×109/L in 14.9% (13/87) patients. Paragonimus westermani (100%), Schistosoma (83.3%), and Clonorchis sinensis (57.1%) were the three most common parasites leading to eosinophilia. The infected patients with pulmonary and digestive system involvement were more likely to develop eosinophilia, with the proportion of patients having eosinophilia being 85.7% and 50.0%, respectively, and the proportion of patients having hypereosinophilia being 28.6% and 33.3%, respectively.  Conclusions  The percentage ofpatients having eosinophilia among those with parasitic infections may vary with the species of parasites and involved organ. The differential diagnosis in hypereosinophilia should consider the possibility of parasitic infection.
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2016, 7(6): 436-438. doi: 10.3969/j.issn.1674-9081.2016.06.007
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2016, 7(6): 439-444. doi: 10.3969/j.issn.1674-9081.2016.06.008
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2016, 7(6): 445-449. doi: 10.3969/j.issn.1674-9081.2016.06.009
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2016, 7(6): 450-453. doi: 10.3969/j.issn.1674-9081.2016.06.010
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2016, 7(6): 453-453.
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2016, 7(6): 454-457. doi: 10.3969/j.issn.1674-9081.2016.06.011
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2016, 7(6): 458-462. doi: 10.3969/j.issn.1674-9081.2016.06.012
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2016, 7(6): 463-467. doi: 10.3969/j.issn.1674-9081.2016.06.013
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2016, 7(6): 468-470. doi: 10.3969/j.issn.1674-9081.2016.06.014
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2016, 7(6): 471-472. doi: 10.3969/j.issn.1674-9081.2016.06.015
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2016, 7(6): 473-476. doi: 10.3969/j.issn.1674-9081.2016.06.016
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2016, 7(6): 477-479. doi: 10.3969/j.issn.1674-9081.2016.06.017
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