[Concomitant extragenital malformations of female reproductive tract anomalies: analysis of 444 cases in Peking Union Medical College Hospital].

Objective: To analyze the incidence and clinical phenotype of the concomitant extragenital malformations in the patients with female reproductive tract anomalies. Methods: A retrospective study was conducted using clinical data of hospitalized patients diagnosed with uterine, cervical, or vaginal malformations from January 2003 to December 2022 in Peking Union Medical College Hospital. The malformations were classified according to American Society for Reproductive Medicine müllerian anomalies classification 2021, and in each type, the incidence and specific manifestations of concomitant extragnital malformations were analyzed. Results: A total of 444 patients were included. The overall incidence of concomitant extragenital malformations was 43.5% (193/444), including urinary system, skeletal system, and other system malformations. Renal malformations on the obstructed side were present in all patients with oblique vaginal septum syndrome (100.0%, 78/78). The total incidence of concomitant extragnital malformations was as high as 8/11 in uterus didelphys, 43.5% (10/23) in unicornuate uterus, 33.6% (79/235) in Mayer-Rokitansky-Küster-Hauser syndrome, 18.8% (6/32) in septate uterus and 18.5% (12/65) in cervical agenesis. Urinary system malformations (30.6%, 136/444) and skeletal system malformations (13.5%, 60/444) were the most common concomitant malformations in all types, in which, unilateral renal agenesis and scoliosis were the most common. Conclusions: Urinary and skeletal system malformations are important features of female reproductive tract anomalies. Urologic ultrasonography and spinal roentgenogram are recommended for all patients with female reproductive tract anomalies.

[An analysis of long-term survival trends for nasopharyngeal carcinoma in Qidong, Jiangsu].

Objective: To analyze the survival of nasopharyngeal carcinoma patients in Qidong from 1972 to 2016, and provide a basis for the prognosis evaluation and prevention for nasopharyngeal carcinoma patients. Methods: A total of 1 060 registered nasopharyngeal carcinoma patients were followed up for survival outcomes until December 31, 2021. Observed survival rate (OSR) and relative survival rate (RSR) was calculated by Hakulinen method in SURV3.01 software, and Hakulinen's likelihood ratio test was used for statistical difference comparison. Age-standardized relative survival rate (ARSR) was calculated according to the International Cancer Survival Standard (ICSS). Joinpoint 4.7.0.0 software was used to conduct the annual average percentage change (AAPC) in nasopharyngeal carcinoma survival rate. The period from 1972 to 2016 is divided into 9 periods for grouping processing according to 5 years. Results: The OSR of nasopharyngeal carcinoma at 1, 5, 10 years were 63.02%, 34.70% and 24.72%, the RSR at 1, 5, 10 years were 64.44%, 38.98% and 31.64%, respectively. The uptrends of RSR in the nine periods were statistically significant (χ(2)=112.16, P<0.001). The 1, 5, 10 years RSR for males were 62.66%, 35.89% and 27.94%, while the 1, 5, 10 years RSR for females were 68.30%, 45.67% and 39.68%, respectively. There was no statistically significant difference in RSR between males and females (χ(2)=14.16, P=0.656). The 5-year RSR for the age groups of 25-34, 35-44, 45-54, 55-64, 65-74, and over 75 years old were 52.83%, 40.92%, 42.64%, 38.65%, 27.23% and 28.88%, respectively. There was a statistically significant difference in RSR among different age groups (χ(2)=42.33, P=0.003). Moreover, the ARSR of nasopharyngeal carcinoma at 1, 5, 10 years were 63.64%, 37.33% and 27.10%, for males were 61.82%, 35.60% and 25.20%, for females were 68.36%, 43.12% and 32.93%. Period trend showed that the AAPC of 5-ARSR was 2.71% (t=7.47, P<0.001) from 1972 to 2016 in Qidong. The AAPC of 5-ARSR in males and females were 2.63% (t=4.98, P=0.002) and 2.71% (t=6.08, P=0.001). There was statistically significant increase in 5-year ARSR among both genders. Furthermore, the AAPC of 5-year RSR among 25-34, 35-44, 45-54, 55-64, 65-74 and 75+ years old were 2.16% (t=4.28, P=0.004), 3.38% (t=5.06, P=0.001), 1.99% (t=2.82, P=0.026), 2.82% (t=3.39, P=0.012), 2.20% (t=2.82, P=0.026) and -0.91% (t=-0.42, P=0.689), respectively. Except for the 75+ years old age group, the other age groups were significantly upward trend. Conclusions: The overall survival rate of nasopharyngeal carcinoma in Qidong from 1972 to 2016 has shown an upward trend. It is necessary to introduce standardized multi-disciplinary treatment mode to improve treatment effect and survival rate.

[The relationship between serum HBV pgRNA and antigen status in patients with chronic hepatitis B after long-term nucleotide analogues treatment].

Objective: To study the relationship between serum HBV pgRNA and antigen status in patients with chronic hepatitis B treated with long-term nucleotide analogues, and to elucidate the reason and possible mechanism of high relapse rate in antiviral therapy of nucleotide analogues in chronic hepatitis B. Methods: 94 patients with chronic hepatitis B who had been treated with long-term antiviral therapy with nucleotide analogues (more than 2 years) were divided into 5 groups according to their HBeAg and HBsAg levels: e antigen positive group(group1), e antigen negative and HBsAg > 1 500 IU/L group(group2), e antigen negative and 100 IU/L< HBsAg < 1 500 IU/L group(group3), e antigen negative and HBsAg < 100 IU/L group(group4), e antigen negative and HBsAg negative group(group5). The level and detection rate of HBVpgRNA in different antigen states groups were analyzed and compared. In addition, in order to exclude the influence of other factors on the results of this study. The study was divided into groups according to age, gender and treatment time. Results: The detection rate of HBVpgRNA was 95.0% in patients with e antigen positive, while 43.2% in patients with e antigen seroconversion, which was significantly lower than that in patients with e antigen positive (P < 0.05). The detection rate of serum HBVpgRNA was 95.0% in e antigen positive group, 75.0% in group 2, 65.0% in e antigen negative with group 3, 15.0% in group 4 and 0% in group 5. Among them, group 1, group 2 and group 3 was significantly higher than that in group 4 and group 5. There was significant difference between the two groups (P < 0.05). However, there was no difference in the positive rate of serum HBV pgRNA among group 1, group 2 and group 3 (P > 0.05). Similarly, there was no difference in the positive rate of serum HBV pgRNA between group 4 and group 5 (P > 0.05). Moreover, the detection rate of serum HBV pgRNA was not correlated with age, gender and treatment time of nucleotide analogues (P > 0.05). Conclusion: There is a significant correlation between the serological antigen status and the presence of HBV pgRNA in chronic hepatitis B after long-term treatment of nucleotide analogues. The persistence of HBV pgRNA is closely related to the low seroconversion rate of e antigen and the high level of HBsAg. HBV pgRNA can be used as one of the biomarkers to judge the transcription activity and replication status of HBV cccDNA in liver.

[Imaging features and clinical analysis of diffuse uterine leiomyomatosis cases].

Objective: To discuss the imaging, clinical features and management of diffuse uterine leiomyomatosis (DUL). Methods: Six cases of DUL confirmed in Peking Union Medical College Hospital from August 2009 to September 2019 were reviewed on their image and clinical data. Retrospective analysis was conducted on their perioperative and postoperative follow-up data. Results: The average age of the first diagnosis of DUL was (27±3) years old. All of the patients complained menorrhagia and three patients suffered moderate to severe anemia. Three patients were diagnosed infertility. Pelvic ultrasound and MRI showed symmetrical enlarged uterus with complete replacement of the myometrium by innumerable, confluent leiomyomas.Four patients were treated with GnRH-a before operation to reduce the volume of myoma and correct anemia. Among the six patients, five had undergone myomectomy because of DUL before visiting Peking Union Medical College Hospital. Three patients underwent open myomectomy. The number of resected myoma was 188-300 and the bleeding volume was 1 200-2 500 ml. Two of them suffered recurrence at 51 and 40 months after operation. One received sirolimus for 20 months without recurrence until now. Other three patients underwent hysterectomy. One patient underwent partial small bowel resection and partial omentum resection because of severe pelvic adhesion during hysterectomy, and the blood loss was 2 000 ml. Conclusions: Pelvic imaging especially MRI is helpful for early recognition and preoperative evaluation for DUL. Fertility preservation is a great challenge for DUL patients. The risk of recurrence after myomectomy is high. Hysterectomy is the last choice to completely cure DUL at present.

[Clinical analysis of 30 patients with atypical glandular hyperplasia or malignant transformation in foci of adenomyosis].

Objective: To explore the clinical characteristics of patients with pre-malignant or malignant transformation in ectopic endometrium of adenomyosis. Methods: A retrospective study was performed on 4 818 patients received surgical treatment in Peking Union Medical College Hospital and pathologically confirmed as adenomyosis from January 2010 to October 2016. The clinical features and prognosis of 30 patients among these with pre-malignant or malignant transformation in ectopic endometrium were reviewed. Results: A total of 4 818 patients pathologically diagnosed with adenomyosis. Among these,30 (0.62%,30/4 818) patients were diagnosed with pre-malignant or malignant transformation in foci of adenomyosis, including 16 (0.33%, 16/4 818) of atypical endometrial hyperplasia and 14 (0.29%, 14/4 818) of endometrioid carcinoma. The average age of 30 patients was (50.8±3.0) years (range: 27-65 years). Patients with atypical hyperplasia in foci of adenomyosis coexist with 13 cases of endometrioid carcinoma in situ, 1 case of borderline serous papilloma in eutopic endometrium, 1 case of atypical hyperplasia in eutopic endometrium, and 1 case of normal eutopic endometrium. Fourteen patients with endometrioid carcinoma in foci of adenomyosis coexist with endometrioid carcinoma in situ. Among the 27 patients with pre-malignant or malignant transformation in adenomyosis and coexisting with endometrioid carcinoma in situ, 23 of them were in International Federation of Gynecology and Obstetrics (FIGO) stage Ⅰa (85%, 23/27), 2 in stage Ⅰb (7%, 2/27), and 2 in stage Ⅲa (7%, 2/27). Seven percent (2/27) of patients had deep myometrial infiltration, and 7% (2/27) of patients had lymphovascular space invasion. The median follow-up time was 60 months (range: 32-104 months), and there were no recurrence or death. Conclusions: The incidence of atypical glandular hyperplasia or malignant transformation in foci of adenomyosis is rare, and it may be closely related to endometrial disease in situ. Pre-malignant or malignant change in foci of adenomyosis seems not to increase the risk of deep myometrial invasion, lymphovascular space invasion, and recurrence or mortality in patients of adenomyosis with endometrial adenocarcinoma.

[Effect of gonadotropin-releasing hormone agonist used before surgery on natural pregnancy rates in patients with ovarian endometriomas].

Objective: To evaluate the impact of gonadotropin-releasing hormone agonist (GnRH-a) used before surgery on natural pregnancy rates in patients with ovarian endometriomas. Methods: In this retrospective study, 57 patients with ovarian endometriomas who had a consecutive laparoscopic surgery between June, 2010 to September, 2015 in Peking Union Medical College Hospital were included. Those patients were divided into preoperative GnRH-a treatment group (n=31) and non-GnRH-a treatment group (n=26) . There were no differences in patients' characteristics between the two groups. All of them had a desire for natural pregnancy postoperatively. GnRH-a was no longer used after surgery. After the surgical procedure, the patients were observed over a period of 12 months, during which the frequency of natural pregnancy was assessed. The two groups were compared in terms of natural pregnancy rates. Results: Totally 33 patients had natural pregnancy after surgery. The univariate analysis showed that the pregnancy rates of age, r-AFS stage, infertility, preoperative use of GnRH-a, tumor size, tumor side, deep infiltrating endometriosis and adenomyosis did not have statistically significant differences (all P>0.05) . The two classified logistic regression showed that OR for preoperative use of GnRH-a was 0.250 (95%CI: 0.064-0.978) with a statistical difference (P=0.046) . Conclusion: The use of GnRH-a preoperatively may have a negative effect on natural pregnancy rates of patients after surgery with ovarian endometriomas.

[A clinican linical analysis of 29 cases of chronic pulmonary aspergillosis].

Objective: To improve the understanding of chronic pulmonary aspergillosis (CPA) by analyzing the clinical manifestations, imaging and pathological features, diagnosis, treatment and prognosis of this disease. Methods: Cases of CPA, proven by microbiological evidence based on pathological study in Fuzhou General Hospital of the People's Liberation Army and Affiliated Fuzhou City First Hospital of Fijian Medical University from January 2006 to October 2016 were retrospectively analyzed. Results: The patients consisted of 17 males and 12 females, aged 24 to 75 years, mean (42±16) years. The underlying disorders included post-tuberculosis infection (n=11), bronchiectasis (n=8), chronic obstructive pulmonary disease (n=3) and diabetes mellitus (n=2). The main clinical symptoms included productive cough (n=25), chronic sputum production (n=18) and hemoptysis (n=15). Serum GM antigen tests were performed in 19 cases, and the result was positive in 12 patients. BALF GM antigen tests were performed in 2 cases, both of which were positive. Chest CT showed that the lesions were located predominantly in the upper lobes (n=24). Single cavity with interior irregular intraluminal material (n=16) and multiple cavities with interior irregular intraluminal material (n=10) were the most frequent CT findings, while the "air crescent sign" was found in 13 cases. In the 22 patients who underwent surgical treatment, Aspergillus filaments were found in the cavity (n=20) or the bronchi (n=2) of lung samples, and histological examination didn't show tissue invasion by fungi. Surgical therapy was performed in 22 patients, with complete remission in 19 cases, and death in 3 cases. Anti-fungal therapy was administered in 6 patients, with partial remission in 4, and stable disease in 2 cases. One patient was not treated. Conclusions: CPA is more frequently seen in patients with underlying chronic pulmonary diseases. The common CT findings are single or multiple cavities with interior irregular intraluminal materials. Aspergillus filament in the cavity or bronchi of lung samples, without parenchymal invasion, is the proof of CPA. The surgical cure rate for simple aspergilloma and aspergillus nodule is high, while the risk of operation for chronic cavitary disease is high. GM antigen test may be an evidence for diagnosing CPA.

[Clinical analysis of pelvic abscess with endometriosis].

Objective: To investigate the clinical features, diagnosis and treatments of pelvic abscess with endometriosis. Methods: A retrospective analysis was performed on 129 cases of pelvic abscess in Peking Union Medical College Hospital from January 2000 to January 2016. Among them, 34 women with endometriosis were divided into the study group and the others were in the control group. The clinical characteristics, therapeutic regimens and outcomes were compared. Results: (1) General conditions: there were no statistic differences between the two groups in age, WBC, serum CA(125), intrauterine device in use, pelvic inflammatory disease history; while incidence rates of dysmenorrhea (65%, 22/34) and infertility (21%, 7/34) in the study group were higher than those in the control group (all P<0.05). (2) Clinical manifestations: fever, abdominal pain and pelvic mass were the main symptoms in two groups. The incidence rates of septic shock were 12% (4/34) in the study group and 2% (2/95) in the control group (P<0.05). (3) Treatment: treatment with puncture all failed in the study group (7/7) and surgeries were required. In contrast, there was only 1/19 treatment failure with puncture in the control group. The puncture failure rates were statistically significant (P<0.05). Compared with the study group and the control group, there were significant differences (P<0.05) in the operation time of laparoscopic surgery [(76±41) versus (53±21) minutes] and of laparotomy [(168±58) versus (116±35) minutes], intra-operative blood loss of laparoscopic surgery [(216±296) versus (43±36) ml] and of laparotomy [(448±431) versus (145±24) ml]. Conclusions: Pelvic abscess in women with endometriosis is more severe and refractory to antibiotics and puncture treatment. Active surgical intervention is required. Although surgical procedures are often difficult, prognosis is comparatively satisfied.

[Clinical retrospective control study of single-port laparoendoscopic and multi-port laparoscopic ovarian cystectomy].

Objective: To investigate clinical outcomes of laparoendoscopic single-site ovarian cystectomy compared with traditional multi-port laparoscopic ovarian cystectomy. Methods: Data of 81 patients with ovarian cystectomy from January 2016 to May 2017, the single-site group (n=40) and the multi-port group (n=41) in Peking Union Medical College Hospital were retrospectively collected. The outcomes of single-site and multi-port groups were analyzed and compared, including: postoperative fever, operation time, blood loss, hemoglobin change, surgical complications, postoperative pain score, postoperative analgesic requirements, body image scale and cosmetic score, length of hospital stay, postoperative total cost. Results: No complication was found in two groups. No difference was found in postoperative fever, blood loss, hemoglobin change, postoperative pain score, length of hospital stay, and total cost between the two groups (all P>0.05). Operation time was (50±20) minutes in single-site group, and (40±15) minutes in multi-port group; postoperative analgesic requirements was 28%(11/40) in single-site group, and 7%(4/41) in multi-port group; cosmetic score was 22.6±2.6 in single-site group, and 17.3±2.6 in multi-port group; body image scale was 5.7±1.2 in single-site group, and 6.2±1.2 in multi-port group; these four clinical parameters were statistical differences (all P<0.05). Conculsion: Laparoendoscopic single-site ovarian cystectomy is feasible and safe, although it could't relieve the postoperative pian, it do offer a higher cosmetic satisfaction.

[Prospective cohort study on the outcomes of sacrospinous ligament fixation using conventional instruments in treating stage â ¢-â £ pelvic organ prolapse].

Objective: To evaluate the medium and long term safety and efficacy of sacrospinous ligament fixation (SSLF) performed with conventional instruments in treating stage Ⅲ-Ⅳ pelvic organ prolapse (POP). Methods: A prospective cohort analysis was conducted in the Peking Union Medical College Hospital, between May 2007 and June 2015, enrolling 55 women with stage Ⅲ-Ⅳ POP who intended to receive SSLF. Primary end points were objective success rates using pelvic organ prolapse quantitation system (POP-Q) and subjective satisfaction rates with questionnaires after surgery according to vaginal examination and related questionnaires for all patients who received SSLF eventually. Exploratory outcomes included perioperative parameters and complications. Results: Of these 55 POP patients enrolled, 52 (95%, 52/55) received SSLF using conventional surgical instruments, the other 3 cases converted to ischial spinous fascia fixation due to difficulty exposing. Medium blood loss during operation was 100 ml (20-300 ml) and operative time 60 minutes (20-165 minutes). Pelvic hematoma with diameters of 5 cm and 7 cm were observed in two patients, both recovered fully with conservative methods. All patients were able to micturate spontaneously after catheter withdrawal. One patient reported right thigh pain after operation which remained till 3-month follow-up and relieved after physiotherapy. The objective success rate was 100% (52/52) at 3 months. With a medium follow-up time of 23.7 months, the objective success rate was 98% (51/52), the recurrence rate was 2% (1/52) and the satisfactory rate was 94% (49/52). De novo urinary incontinence occurred in 6% (3/52) of patients. Conclusion: Most POP could be corrected with SSLF using conventional instruments which is a feasible, economic and effective procedure for Asian patients with medium compartment prolapse.

[Mediating effects of obesity and metabolic factors in hyperuricemia and prehypertension].

Objective: To assess the mediating effects of obesity and metabolic factors in the relationship between hyperuricemia (HUA) and prehypertension. Methods: A total of 9 399 individuals were selected using a multistage stratified whole-group random sampling method from 90 villages (neighborhood committees) in 30 towns (streets) of 5 districts (counties) in Fuzhou. A total of 4 754 study subjects were included. A linear regression model was used to analyze the association of HUA with obesity and metabolic factors. Single-factor and multi-factor logistic regression models were used to analyze the association of HUA, obesity, and metabolic factors with prehypertension. Mediating effects models were used to analyze the mediating effects of obesity and metabolic factors on the association between HUA and prehypertension. Results: After adjusting for confounders, the association between HUA and cholesterol, triglycerides, HDL-C, LDL-C, BMI, waist circumference, creatinine, and urea nitrogen were significantly correlated (P<0.001). HUA, waist circumference, BMI, and triglycerides were significantly associated with prehypertension (P<0.001). Waist circumference, BMI, and triglycerides mediated the relationship between HUA and prehypertension, with OR (95%CI) of 1.018 (1.007-1.027), 1.010 (1.002-1.018), and 1.010 (1.003-1.017) (P<0.001), with mediating proportions of 7.76%, 4.31%, and 4.31% respectively. No mediating effect of cholesterol, HDL-C, LDL-C, creatinine, and urea nitrogen was found on the relationship (P>0.05). Conclusions: Waist circumference, BMI, and triglycerides all had mediating effects in the association between HUA and prehypertension. For the general population, weight control, waist circumference, and a high-fat diet should be used to reduce the occurrence of prehypertension.

MiR-208a participates with sevoflurane post-conditioning in protecting neonatal rat cardiomyocytes with simulated ischemia-reperfusion injury via PI3K/AKT signaling pathway.

OBJECTIVE: We aimed to evaluate the role of miR-208a in sevoflurane post-conditioning protecting neonatal rat cardiomyocytes with simulated ischemia reperfusion injury (SI/RI) via PI3K/AKT signaling pathway. MATERIALS AND METHODS: The cardiomyocytes of healthy neonatal rats were extracted as the Normal group. Other cardiomyocytes were used to establish the SI/RI model. Sevoflurane post-conditioning, miR-208a inhibitor, or PI3K/AKT pathway activator were used in the treatment of cardiomyocytes. The cell viability, cell cycle, apoptosis, levels of superoxide dismutase (SOD), malondialdehyde (MDA), miR-208a and mRNA, expression of PI3K, AKT, and autophagy-related factors in each group were measured and compared. Monodansylcadaverine (MDC) was used to measure the fluorescence intensity of autophagosomes. RESULTS: In neonatal rat cardiomyocytes with SI/RI, the expression of miR-208a and MDA, apoptosis and the expression of autophagy-related factors increased, with PI3K/AKT pathway inhibited, SOD level decreased, cell viability reduced, and the fluorescence intensity of autophagosomes enhanced (all p<0.05). Sevoflurane post-conditioning can promote the increase of SOD and the decrease of MDA in cardiomyocytes with SI/RI, with PI3K/AKT pathway activated, viability of cardiomyocytes enhanced, apoptosis reduced, the expression of autophagy-related factors and the fluorescence intensity of autophagosomes inhibited (all p<0.05). Sevoflurane post-conditioning combined with miR-208a inhibitor or PI3K/AKT pathway activator further promoted the above-mentioned effects (all p<0.05). CONCLUSIONS: Our results indicate that the inhibited expression of miR-208a suppresses the expression of autophagy-related factors, enhances cell viability of cardiomyocytes, and reduces apoptosis, thereby protecting neonatal rat cardiomyocytes with SI/RI.

High incidence of somatic mitochondrial DNA mutations in human ovarian carcinomas.

To investigate the potential role of somatic mitochondrial DNA (mtDNA) mutations in tumorigenesis, the occurrence of mutations in mtDNA of ovarian carcinomas was studied. We sequenced the D-loop region of mtDNA of 15 primary ovarian carcinomas and their matched normal controls. Somatic mtDNA mutations were detected in 20% (3 of 15) tumor samples carrying single or multiple changes. Complete sequence analysis of the mtDNA genomes of another 10 pairs of primary ovarian carcinomas and control tissues revealed somatic mtDNA mutations in 60% (6 of 10) of tumor samples. Most of these mutations were homoplasmic, and most were T-->C or G-->A transitions, but one represented a differential length within a run of identical C residues. A region of mtDNA sequence including the 16S and 12S rRNA genes, the D-loop and the cytochrome b gene, may represent the zone of preferred mtDNA mutation in ovarian cancer. The high incidence of mtDNA mutations found in ovarian carcinomas and other human cancers suggests that genetic instability of mtDNA might play a significant role in tumorigenesis.

Lansoprazole: an alternative method of administration of a capsule dosage formulation.

A single-dose, open-label, randomized, fasting, two-period, crossover bioavailability study was conducted in 24 healthy adult men to assess an alternative method of administration of lansoprazole capsules. Half of the subjects received regimen A (contents from a 30-mg capsule placed in a tablespoonful of applesauce), and the other half received regimen B (an intact 30-mg capsule) during period 1 of the crossover study. The regimens were reversed during the second period 1 week later. Blood samples were obtained over 12 hours and pharmacokinetic parameters were determined. Mean time elapsed to peak concentration (Tmax) was less than 2 hours for each regimen. The ratio (regimen A:regimen B) of peak concentration (Cmax) means and area under the curve (AUC)0-infinity means were 0.889 and 0.944, respectively. (AUC0-infinity is the sum of AUC0-t and AUCt-infinity, where AUC0-t is the area under the plasma concentration-time curve from time 0 to the time of the last measurable or nonzero concentration as computed by using the trapezoidal rule, and AUCt-infinity is computed as the last nonzero concentration divided by the terminal phase rate constant.) No statistically significant differences (P < or = 0.05) in Tmax, Cmax, and AUC0-infinity were detected between regimens. These data indicate similar bioavailabilities between the two regimens. Lansoprazole granules contained in a standard capsule dosage formulation may be removed and placed directly into applesauce and administered to appropriate patients.

Lansoprazole: administration of the contents of a capsule dosage formulation through a nasogastric tube.

A single-dose, open-label, randomized, crossover bioavailability study was conducted in 24 healthy adult male volunteers to assess an alternative method of administration of lansoprazole capsules. The results of 22 subjects were analyzed. Subjects received regimen A (granules from a 30-mg capsule mixed with apple juice and administered through a nasogastric tube) or regimen B (an intact 30-mg capsule) during the first study period. The regimens were reversed during the second period 1 week later. Blood samples were obtained over 12 hours and pharmacokinetic variables were determined. No statistically significant differences in mean time elapsed to peak concentration, mean peak concentration, area under the curve (AUC)0-t, and AUC0-infinity were detected between regimens by using analysis of variance. Bioavailability was assessed by the 90% confidence interval of the two one-sided tests on the natural logarithm of AUC. The 90% confidence interval for the AUCzero-infinity ratio was 0.955 to 1.140 for regimens A to B. These results indicate similar bioavailabilities between the two regimens and demonstrate that lansoprazole capsules may be administered by mixing the capsule contents with apple juice for administration through a nasogastric tube.

Assessment of intradermal test in longitudinal surveillance of bancroftian filariasis.

Longitudinal surveillance was carried out consecutively during 1982-1987 in two pilot villages where bancroftian filariasis was prevalent in different severity before 1982. Intradermal test (IT) with filaria polypeptide (FPT) antigen prepared from Dirofilaria immitis was made. It was shown that the level of immediate hypersensitivity reaction to the antigen in population as shown by IT appeared to be directly proportional to both the prevalence of the disease and the infection rate of mosquitoes harbouring larval filariae before mass and selective treatment with diethylcarbamazine. Time for negative conversion of IT after chemotherapy was significantly longer in previous microfilaraemic patients than that in amicrofilaraemic cases. The selected three criteria of IT used in filariasis surveillance, namely, the positive rate, frequency of strong reaction and positive conversion rate, were diminished gradually after chemotherapy year by year, so that the three criteria were demonstrated to be useful for longitudinal surveillance of lymphatic filariasis.

[Assessment of intracutaneous test in longitudinal surveillance for lymphatic filariasis].

In order to evaluate the usefulness of intracutaneous test (IT) in longitudinal surveillance of filariasis, two administrative villages selected from Queshan County, Henan Province of China, endemic for Wuchereria bancrofti, were surveyed in 1982, 1983 and 1987 respectively, by IT with antigen FPT derived from Dirofilaria immitis. The result showed that the original level of IT to antigen FPT in the population was consistent with the data of either etiological or entomological investigation before chemotherapy. When the microfilaraemia rate and natural filarial infection rate of mosquitoes in a village were high, the positive rate and frequency of strong positivity (skin wheel diameter greater than or equal to 1.3 mm) for immediate hypersensitivity reaction would be high too; and the reverse was true. It is suggested that both criteria of IT mentioned above may be useful in assessing endemicity of lymphatic filariasis before mass chemotherapy. The speed of negative conversion of IT in both groups, the previously microfilaraemic patients and the microfilaraemic inhabitants positive to immediate hypersensitivity reaction before chemotherapy, were different, the former being significantly slower than that of the latter after mass and selective chemotherapy with diethylcarbamazine. All of the three criteria for immediate hypersensitivity, positive rate, frequency of strong positivity and positive conversion rate, decreased gradually after a mass and selective DEC treatment. Until 1987, the 5th year after the chemotherapy, the average positive rate in the two villages dropped to 20.0% from 55.4% in 1982, the frequency of strong positivity to 2.8% from 23.8% in 1982, and the positive conversion rate to 9.7% (1984-1987) form 19.2% (1982-1983).(ABSTRACT TRUNCATED AT 250 WORDS)

Urine peptide patterns for non-invasive diagnosis of endometriosis: a preliminary prospective study.

OBJECTIVE: To detect endometriosis by urine peptide biomarkers using magnetic beads-based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) and to identify interesting peptides using liquid chromatography tandem mass spectrometry. STUDY DESIGN: Prospective case-control study in a university-based gynecological department and central laboratory. A total of 122 patients suffering from dysmenorrhea, pelvic pain and infertility were enrolled in the study. Urine samples were collected before laparoscopy. Urine samples were analyzed by the MALDI-TOF technique to generate peptide profiling and ClinProTools software was used to set up a diagnostic model for endometriosis. Liquid chromatography tandem mass spectrometry (LC-MS/MS) was used to identify interesting peptides. RESULTS: At laparoscopy 60 patients were diagnosed with endometriosis and 62 patients were disease-free. There were 36 different peptides expressed in endometriosis patients detected by MALDI-TOF compared with controls. We established a genetic algorithm as a diagnostic model with the combination of five peptides (m/z=1433.9, 1599.4, 2085.6, 6798.0 and 3217.2). The model showed a sensitivity of 90.9% and specificity of 92.9%. Urine from another 26 symptomatic patients before laparoscopy were randomly selected and analyzed accordingly. A genetic algorithm showed a sensitivity of 90.9% and specificity of 92.9% in predicting endometriosis before laparoscopy. We also identified two peptides not belonging to the diagnostic model as collagen precursors. CONCLUSIONS: Patients with endometriosis have a unique cluster of peptides in urine. Peptide proteomic profiling provides a novel method for non-invasive diagnosis of endometriosis.