Early medical abortion with self-administered low-dose mifepristone in combination with misoprostol.

AIM: The aim of the present study was to investigate the safety and efficacy of low-dose mifepristone combined with self-administered misoprostol for termination of early pregnancy. METHODS: A total of 533 women seeking medical abortion in early pregnancy (≤49 days since the last menstrual period) were divided randomly into hospital- (H-Mis, 250) and self- (S-Mis, 283) administered misoprostol groups. Women in two groups took 100 mg of oral mifepristone in hospital followed by 200 µg of sublingual misoprostol 24 h later in hospital or home. The primary outcome parameter was complete abortion without surgical intervention. Secondary outcomes were uterine bleeding, return of regular menses, side effects and patient acceptability. RESULTS: High rates of complete abortion were observed for both the H-Mis group (243/250; 94.8%) and the S-Mis group (266/283; 94.0%). No significant differences in outcomes (complete abortion/failure rates) or side effects were observed between the two groups. General satisfaction rates were similar for the two groups (H-Mis, 231/250, 92.4%; S-Mis, 263/283, 92.9%; P > 0.05). Higher convenience of administration (H-Mis, 211/250, 84.4%; S-Mis, 270/283, 95.4%; P < 0.05) and privacy protection (H-Mis, 214/250, 85.6%; S-Mis, 267/283, 94.3%; P < 0.05) satisfaction rates were obtained for the S-Mis group than for the H-Mis group. CONCLUSION: Self-administered sublingual misoprostol is as safe and effective as hospital-administered misoprostol following low-dose mifepristone to terminate early pregnancy (≤49 days of amenorrhoea) with fewer side effects.

Feasibility and effectiveness of unintended pregnancy prevention with low-dose mifepristone combined with misoprostol before expected menstruation.

STUDY QUESTION: What is the efficacy of maintaining or restoring non-pregnant status with low-dose mifepristone combined with misoprostol administered before expected menstruation? SUMMARY ANSWER: Low-dose mifepristone and misoprostol administered at the time of expected menstruation was effective and safe in maintaining or restoring non-pregnant status, with no obvious menstrual disturbance. WHAT IS KNOWN ALREADY: Menstrual regulation involves the medical or mechanical stimulation of uterine sloughing in women with up to 2-3 weeks of menstrual delay. Low-dose mifepristone plus misoprostol is efficacious for termination of ultra-early pregnancy (≤ 35 days of amenorrhoea) with no obvious menstrual disturbance. STUDY DESIGN, SIZE, DURATION: A total of 678 women fulfilled all criteria and were recruited. Seventeen women dropped out after deciding to remain pregnant and 11 others were lost to follow-up. Thus, data from 650 women who completed the procedure were included in analyses. Participants were enrolled at any time during their menstrual cycle and administered medication 1 day before expected menstruation. The end of the study was defined on a per-patient basis as the date of completion of the post-treatment menstrual cycle. The primary outcome was the efficacy of abortion induction (for pregnant women) or menstrual regulation (for non-pregnant women). PARTICIPANTS, SETTING, METHODS: Women with regular menstrual cycles (25-35 days) were voluntarily recruited for this study between February 2012 and December 2014. Serum ß-hCG was measured before mifepristone intake. Mifepristone (50 mg) was administered orally 1 day before expected menstruation and 200 µg misoprostol was administered orally on the day of expected menstruation. Efficacy, disturbance in bleeding patterns in the treatment and post-treatment cycles, satisfaction with the treatment, and subsequent contraception preference were analysed. MAIN RESULTS AND THE ROLE OF CHANCE: Retrospective analysis of serum ß-hCG levels at admission indicated that 23.3% (158/678) of the women were pregnant. The success rate for pregnancy termination was 98.6% (136/138). Two women (1.5%, 2/138) had ongoing pregnancy that was subsequently terminated surgically. The overall bleeding induction rate within 7 days was 98.3% (639/650), with 100% (138/138) in pregnant participants and 97.9% (501/512) in non-pregnant participants. Most pregnant and non-pregnant participants experienced no significant menstrual disturbance during the treatment [96.3% (131/136) versus 97.6% (489/501)] or post-treatment [97.8% (133/136) versus 98.4% (493/501)] menstrual cycle. The general rate of satisfaction with the treatment was 96.7% (618/639). Generally, 36.0% (230/639) of participants preferred to use the regimen as a routine contraception method versus the 64.0% (409/639) who preferred to use it as a remedy for pregnancy prevention after unprotected sex (P < 0.001). LIMITATIONS, REASONS FOR CAUTION: Study participants were recruited from a single region; further studies should include participants from multiple centres in different cities and nations. Given the uncertain efficacy of regimen reuse, the assessment of efficacy was based solely on the first treatment administration. Studies with larger samples and long-term follow-up may provide more data on whether repeated use of this regimen hampers its efficacy. WIDER IMPLICATIONS OF THE FINDINGS: Menstrual regulation with low-dose mifepristone and misoprostol at expected menstruation can be efficacious and highly acceptable to maintain or restore non-pregnant status, which may have potential for routine contraception.

[Population characteristics and impact on heart rate variability, heart rate and blood pressure of passive smoking].

OBJECTIVE: To investigate the basic characteristics of passive smoking population, and the impact of passive smoking on heart rate variability, heart rate and blood pressure. METHODS: Eighty-six passive smokers [mean age: (52.4 ± 7.6) years] were recruited from patients and their relatives who visited cardiovascular outpatient department and excluded structural heart disease between June 2010 and June 2012, 80 normal subjects who were not exposed to smoking served as controls. Questionnaire survey, 24 hours ambulatory electrocardiogram examination and blood pressure measurement were performed in all recruited subjects. RESULTS: (1) Non-marriage rate [18.60% (16/86) vs. 3.75% (3/80), P < 0.01] was significantly higher while education level were significantly lower in passive smoking group than in control group. Passive smokers were more likely service industry workers [29.07% (25/86) vs. 15.00% (12/80), P < 0.05] and had longer daily working time [(7.56 ± 1.24) h vs. (6.02 ± 0.96) h, P < 0.01], and were less likely to be professional technology industry employers [20.93% (18/86) vs. 36.25% (29/80), P < 0.05] and managers [13.95% (12/86) vs. 38.75% (31/80), P < 0.01] compared to controls. The main place of passive smoking was workplace (67.44%, 58/86), entertainment venues (63.95%,55/86), restaurants (48.84%, 42/86). (2) Standard of the normal sinus RR intervals (SDNN), the normal consecutive sinus RR interval difference between the root-mean-square (rMSSD) and adjacent the difference between the RR interval>50 ms the number of share the percentage (PNN50) were significantly lower in passive smoking group than in the control group (all P < 0.05). Every 5 min average of the standard deviation of sinus RR cycle (SDNN index) and 24 h every 5 min sinus RR interval mean standard deviation (SDANN) were similar between the 2 groups (all P > 0.05). Ultra-low-frequency power (VLF), low frequency power (LF), high frequency power (HF) and LF/HF were significantly lower in passive smoking group than in the control group (all P < 0.01). (3) Heart rate and diastolic blood pressure were significantly higher in passive smoking group than in control group (all P < 0.05) while systolic blood pressure was similar between the 2 groups (P > 0.05). CONCLUSIONS: Marriage status, education level, profession and daily working time are independent determinants for passive smoking. Passive smoking mainly occurred in the workplace, entertainment venues and restaurants. Passive smoking is linked with reduced heart rate variability, increased 24 h average heart rate and diastolic blood pressure.

[Effect of the smoking cessation services in the out-patient department for patients with coronary heart disease].

OBJECTIVE: To evaluate the effects and clinical prognosis of out-patient department-based smoking cessation services for coronary heart disease (CHD) patients. METHODS: A total of 140 smoking patients diagnosed with coronary heart disease in our cardiovascular department were randomly divided into the intensive smoking cessation clinic follow-up group (intervention group, patients were informed on the importance and methods to quit smoking at the first visit and reminded for that at months interval for 6 months, n = 70) and the conventional treatment group (control group, n = 70). After 6 months, the smoking status, cardiovascular event rates, drug usage, out-patient medical costs and quality of life were compared between the two groups. RESULTS: Age, gender, concomitant diseases, drug usage were similar between the two groups at baseline (all P > 0.05). After 6 months, smoking quit rate [34.2% (24/70) vs. 5.7% (4/70), P < 0.01], drug use rates: lipid-lowering drugs [95.3% (67/70) vs. 80.4% (56/70)], ß blockers [82.4% (57/70) vs. 41.3% (28/70)], and ACEI/ARB [61.4% (43/70) vs. 34.4% (24/70)] were significantly higher in the intervention group than in the control group, while total cardiovascular event rates [21.4% (15/70) vs. 47.1% (33/70), P < 0.01] and out-patient medical costs (3789.3 RMB vs. 4984.2 RMB, P < 0.01) were significantly lower in the intervention group than in the control group. The quality of life scores derived from MYO health survey questionnaire was significantly higher in the intervention group than in the control group (P < 0.01). The top three reasons responsible for continuous smoking for all patients failed to quit smoking were: (1) others smoked more than me and still alive and healthy [90.3% (56/62)]; (2) smoking helped me to keep relaxed and reduce trouble in daily work and life [70.9% (44/62)]; (3) smoking was essential while chatting and drinking with friends [66.1% (41/62)]. The overall satisfactory rate to this smoking cessation program was 42.8% and the satisfactory rate was up to 50.0% by patients. CONCLUSIONS: Intensive outpatient smoking cessation follow-up program can significantly improve the smoking cessation rates, the guideline drug use rate and the quality of life while reduce medical costs for coronary heart disease patients.

[Types and risk factors of arrhythmia on young patients with acute coronary syndrome in Henan province].

OBJECTIVE: The types and risk factors of arrhythmia were analyzed on acute coronary syndrome (ACS) patients under the age of 44 years who were hospitalized in Henan province between September 2009 to June 2012. METHODS: Medical records of eligible patients were obtained from the information system of the First Affiliated Hospital of Zhengzhou University teleconsultation information center. Middle aged and elderly ACS patients who were hospitalized at the same period served as controls. Data on arrhythmia types, blood pressure, thyroid disease, respiratory sleep apnea syndrome, smoking history, history of alcohol consumption, eating habits, family history of early-onset arrhythmia, laboratory tests were analyzed. RESULTS: (1) Arrhythmia was detected in 110 out of young ACS patients (55%), which was significantly lower than that in the elderly ACS patients (71.05%, P < 0.01). (2) The top three arrhythmias in young ACS patients were: sinus tachycardia (30.50%), the premature ventricular contractions (19.00%), atrial flutter/atrial fibrillation (16.50%). Incidence of sinus tachycardia, atrial flutter/atrial fibrillation were significantly higher while incidence of ventricular tachycardia, ventricular fibrillation, paroxysmal supraventricular tachycardia were significantly lower in young ACS patients than in middle-aged ACS patients (all P < 0.05). The incidence of sinus tachycardia was higher while incidence of ventricular premature accelerated ventricular spontaneous cardiac rhythm, ventricular tachycardia, ventricular fibrillation, non-paroxysmal supraventricular tachycardia, atrial flutter/atrial fibrillation, paroxysmal supraventricular tachycardia, sinus bradycardia, nodal escape, atrioventricular block were significantly lower in young ACS patients than in elderly ACS patients (all P < 0.05). (3) Body mass index, incidence of smoking, coronary three-vessel disease, drinking, eating salty foods, thyroid dysfunction, sleep apnea were significantly higher in youth ACS patients with arrhythmia than in young ACS patients without arrhythmia (all P < 0. 05). (4) Logistic regression analysis found that number of diseased coronary vessels (OR = 24.293), smoking (OR = 1.112) and alcohol consumption (OR = 1.039) were independent risk factor for developing arrhythmia in young ACS patients from Henan province. CONCLUSIONS: The main types of arrhythmia are sinus tachycardia, premature ventricular contractions, atrial flutter/atrial fibrillation and the major risk factors related to the arrhythmia are number of diseased coronary vessels, smoking and alcohol consumption in young ACS patients from Henan province.

[The lowest dosages of mifepristone and misoprostol to terminate ultra-early pregnancy].

OBJECTIVE: To explore the lowest effective dosage of mifepristone combined with misoprostol in terminating ultra-early pregnancy. METHODS: All the cases of ultra-early pregnancy classified by amenorrhea days, ß-hCG and vaginal B-ultrasonic were randomly divided into two groups. One hundred cases in G1 group (minimized dosage) were orally administered 25 mg mifepristone once a day for 2 days and combined with 200 µg misoprostol 48 hours later, while 150 mg mifepristone combined with 600 µg misoprostol 48 hours later were given to 100 cases in G2 group (normal dosage). All cases were observed for 6 hours after taking misoprostol and returned for assessment three days later. RESULTS: None missing. Expulsion of conceptus: G1 and G2 group were 22 (22.0%, 22/100) and 25 (25.0%, 25/100; P > 0.05). Failure rate: cases with incomplete abortion were 1 (1.0%, 1/100) and 2 (2.0%, 2/100) in G1 and G2 group, hospitalization for suspected ectopic pregnancies both was 1 (1.0%). Bleeding: bleeding cases during the administration of mifepristone in G1 and G2 group were 71 (71.0%, 71/100) and 78 (78.0%, 78/100; P > 0.05); the mean bleeding time were (5.3 ± 1.4) days and (6.0 ± 1.5) days (P < 0.01). Other side effects: in G1 group, majority showed light nausea (7.0%, 7/100) and light abdominal pain (20.0%, 20/100). Menses recovery: 99 (99.0%, 99/100) for G1 group and 98 (98.0%, 98/100) for G2 group to recovery on scheduled time. Satisfactions: both were 99 (99.0%, 99/100). Except mean bleeding days and side-effects, the differences above showed no significance (P > 0.05). CONCLUSION: It is safe and effective treatment with the lowest dosages of mifepristone and misoprostol to terminate ultra-early pregnancies.

[Effects of long-term fertilization on organic carbon functional groups in black soil as revealed by synchrotron radiation soft X-ray near-edge absorption spectroscopy].

A 20 years (1984-2004) stationary field experiment was conducted to evaluate the effects of long-term application of chemical fertilizers (N or NPK) alone or in combination with low (0.125 kg x hm(-2)) or high dose of corn stalk (0.25 kg x hm(-2)) on organic carbon functional groups in black soil using synchrotron radiation soft X-ray near-edge absorption spectroscopy (C-1s NEXAFS). Compared with the control (CK) treatment, the aromatic C and the carboxyl C of soil increased, whereas the aliphatic C, the carbonyl C and the aliphatic C/aromatic C ratio decreased after the application of chemical fertilizer alone. After the application of chemical fertilizations in combined with corn stalk, the aromatic C decreased while the aliphatic C and the aliphatic C/aromatic C ratio increased as compared to N or NPK fertilizer treatment. And the change tendency was more obvious with the increase in the dose of corn stalk applied. Regardless of corn stalk application, the aromatic C, the aliphatic C, and the aliphatic C/aromatic C ratio were all higher for NPK than for N fertilizer treatment. The above results indicated that, compared with the no-fertilizer control treatment, the application of chemical fertilizers alone resulted in the relative proportion of aromatic compounds increased whereas that of aliphatic hydrocarbon compounds decreased. On the other hand, the relative proportion of the aliphatic hydrocarbon compounds was higher after the application of chemical fertilizers with than without corn stalk, with high than with low dose of corn stalk, and with NPK than with N fertilization. C-1s NEXAFS spectroscopy could characterize in situ the changes of organic carbon functional groups in soil under long-term stationary fertilization.

[Quality of life change and its influencing factors in patients with acute coronary syndrome after drug-eluting stent implantation].

OBJECTIVE: To prospectively evaluate the change of quality of life in patients with acute coronary syndrome following percutaneous coronary intervention (PCI) with drug-eluting stents and explore the influencing factors of quality of life. METHODS: There hundred and thirty four consecutive patients with acute coronary syndrome receiving drug-eluting stents implantation between September 2008 and December 2009 were enrolled. Of them, two hundred and ninety three patients completed 36-item short form health survey at baseline and 6 months after PCI procedure. Change of quality of life and influencing factors on quality of life were analyzed. RESULTS: Compared with baseline, quality of life improved significantly after PCI in terms of both physical component summary and mental component summary [ (51.07 ± 20.39) scores vs. (61.69 ± 19.73) scores and (63.27 ± 20.00) scores vs. (68.81 ± 18.71) scores, respectively; all P < 0.01]. Multiple linear regression analysis showed that female, diabetes and ST-segment elevation myocardial infarction were independent predictors of physical component summary improvements post PCI (ß values were -0.310, -3.880 and 1.302, respectively; P < 0.05 or P < 0.01). Previous PCI and diabetes were independent predictors of mental component summary improvements post PCI (ß values were -1.483 and -2.790, respectively; all P < 0.01). CONCLUSIONS: Quality of life of acute coronary syndrome patients is significantly improved at 6 months after drug-eluting stents implantation. The predictors of physical quality of life improvement are female, diabetes, and ST-segment elevation myocardial infarction. Predictors of mental quality of life improvement are previous PCI and diabetes.

Plastic properties affect the composition of prokaryotic and eukaryotic communities and further regulate the ARGs in their surface biofilms.

Plastic wastes are ubiquitous in the offshore and oceans with an increasing quantity, and inevitably, microbial communities colonized the plastics to form biofilms, which have become dispersal vectors for antibiotic resistance genes (ARGs). This study focused on the impact of plastic properties including hardness, wettability, and zeta-potential on the biomass, prokaryotic and eukaryotic communities and ARGs in biofilms formed on specific plastics (polyethylene (PE), polypropylene (PP), and polyethylene terephthalate (PET)) in an estuarine environment. The results showed that, in comparison to PP, more biomass characterized by more dry weight, chlorophyll a (Chl a) and total organic carbon (TOC) was found in biofilms formed on PE and PET, which may be related to their lower surface wettability. Proteobacteria were the dominant prokaryotic phyla, and they accounted for 53.06%, 81.90%, 37.06%, 76.25%, and 54.27% of the total sequences in biofilms on PE, PP, PET, water and sediment, respectively. Ascomycota were the predominant eukaryotic phyla in biofilms, water, and sediment, and their abundances were elevated in biofilms on PP, which accounted for 34.73%. The biofilms on PP had a higher relative abundance of ARGs (3.13) compared to those on PE (2.59) and PET (0.23). Furthermore, both the plastic-biofilm properties (e.g. dry weight, Chl a, and TOC) and microbial communities (e.g., Fungi and Proteobacteria) may be involved in regulating the abundance of ARGs. Moreover, mobile genetic elements (MGEs) were significantly correlated to both the absolute and relative abundance of ARGs, indicating that MGEs may regulate the migration of ARGs in biofilms. Taken together, this investigation provides the significance of the plastic type, surface properties, and surrounding environments in shaping microbial communities and ARGs in biofilms formed on plastics.

[FTIR spectroscopic analysis of Cu2+ adsorption on hematite and bayerite].

The changes in surface hydroxyl structures and their absorption peaks after the adsorption of Cu2+ on the hematite and bayerite were studied by FTIR spectroscopy under the different pH values and Cu2+ concentrations. The result indicated that: (1) with the increase of Cu2+ concentrations, the H-O-H and OH deformation vibration of the hematite participated in the adsorption and Cu2+ combined with the Fe-O structure strongly, then Fe-O-(Cu) had been formed on the hematite surface. (2) In acid conditions, H+ in the solution destroyed the O-H structure of hematite surface and the existence of NO3- prompted the production of a new peak (1 131 cm(-1)). With pH value increasing, the hydroxy structure of hematite surface changed gradually from stretching vibration to deformation vibration, then the structures of Fe-OH and Fe(3+) -O(2-) constantly changed. (3) The adsorption of Cu2+ on the bayerite happened in the high wave position. With the Cu2+ concentration increasing, the free OH bending vibration, the OH- stretching vibration and its H-O-H bending vibration were all involved in the adsorption, and at the same time, Al3+ of Al-O was gradually replaced by Cu2+, which enhanced the vibration intensity of the low waves position. (4) With the increase in pH, the Al-OH bending vibration and Al-O stretching vibration changed gradually, which indicated that AlOCu+ and AlOCuOH structure had been formed on the bayerite surface after the adsorption.

[Novel mutations of cardiac troponin T in Chinese patients with hypertrophic cardiomyopathy].

OBJECTIVE: To screen the cardiac troponin T (TNNT2) mutations in Chinese patients with hypertrophic cardiomyopathy (HCM) and to analyze the potential link between the genotype and the phenotype. METHODS: Clinical features of 100 probands with HCM and some family members were evaluated, 200 unrelated normal subjects served as control. The exons and flanking introns of TNNT2 were amplified with PCR and direct sequencing was used to screen TNNT2 mutations/polymorphisms. RESULTS: Two novel missense mutations were detected in 2 HCM patients: R92W and R286H. These 2 mutations were not found in 200 non-HCM controls. A five-basepair insertion/deletion polymorphism in intron 3 of TNNT2 was identified in this HCM cohort but was not related to the phenotype. CONCLUSIONS: Two missense mutations, R92W and R286H, were found in 2/100 patients with HCM, TNNT 2 mutation is relatively low in Chinese patients with HCM.

[Relationship between polymorphism of interleukin-8 and silicosis susceptibility].

OBJECTIVE: To explore the relationship between the polymorphisms of interleukin-8 (IL-8) and the silicosis susceptibility. METHODS: The case group consisted of 101 male patients with stage I silicosis diagnosed by the Pneumoconiosis Diagnosis Expert Panel according to the Chinese National Diagnosis Criteria of Pneumoconiosis (GBZ 70-2009). The control group consisted of 121 workers without silicosis exposed to same dusts. The cases and the controls had the same dust exposure history. The peripheral venous blood was drawn from each subject. DNA was extracted from leucocytes by the salting method. The polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) techniques and PCR were used to examine polymorphism of IL-8 (Met31Arg, 781C/T, -251A/T and RA+860). RESULTS: There were no the differences of age, cumulative exposure time and smoking between the cases and the controls (P > 0.05). The frequencies of IL-8 (Met31Arg) GT genotypes in cases and controls were 12.87% and 2.48%, respectively, there was significant difference (P < 0.05). The frequencies of allele G in cases and controls were 6.44% and 2.07%, respectively, there was significant difference (P < 0.05). The frequencies of IL-8 (-251A/T) AA genotypes in cases and controls were 9.90% and 25.64%, respectively, there was significant difference (P < 0.05). The frequencies of IL-8 (781C/T) CC, CT, TT genotypes in cases and controls were 38.61%, 40.59%, 20.79% and 46.28%, 40.50%, 13.22%, respectively, there was no significant difference (P > 0.05). The frequencies of IL-8 (RA+860) GG, GC and CC genotypes in cases and controls were 75.25%, 21.78%, 2.97%, 80.17%, 14.88%, 4.96%, respectively, there was no significant difference (P > 0.05). CONCLUSIONS: IL-8 (Met31Arg and -251A/T) genetic polymorphisms might play a role in the development of silicosis. The risk of pneumoconiosis in workers carrying (Met31Arg) genotype GT is likely to increase. The risk of pneumoconiosis in workers carrying IL-8 (-251A/T) AA genotype is likely to decrease. The relationship between IL-8 781C/T and RA+860 genes polymorphisms and silicosis is not found.

[Novel MYBPC3 mutations in Chinese patients with hypertrophic cardiomyopathy].

OBJECTIVE: To screen the MYBPC3 gene mutations in Han Chinese patients with hypertrophic cardiomyopathy (HCM). METHODS: Sixty-six patients with HCM were enrolled for the study. The exons in the functional regions of MYBPC3 were amplified with PCR and the products were sequenced. RESULTS: Four novel mutations and four common polymorphisms were identified in this patient cohort. A Lys301fs mutation in exon10 was evidenced in a H30, and when he was 47 years old, he had the chest tightness, shortness of breath with septal hypertrophy of 18.7mm; a Asp463stop mutation in exon17 was detected in a H48, he was 24 years old 24-year-old when a medical examination showed ventricular septal hypertrophy of 15.4 mm; both Gly523Arg mutation in exon18 and Tyr847His mutation in exon26 were found in a H53 with onset age 36 years old, feeling chest tightness after excise and his ventricular septal hypertrophy was 27 mm that time. MYBPC3 mutations occurred in 4.5% patients in this cohort. These mutations were not found in 100 non-HCM control patients. CONCLUSION: MYBPC3 mutation is presented in a small portion of Han Chinese patients with HCM.

[Relationship between gene polymorphism of fibronectin and pneumoconiosis].

OBJECTIVE: To explore the relationship between the genetic polymorphism of fibronectin (FN) (4 genetic locus) and pneumoconiosis. METHODS: 128 male I-period pneumoconiosis were selected as cases who were examined with radiography and diagnosed by the Pneumoconiosis Diagnosis Expert Panel, based on the Chinese National Diagnosis Criteria of Pneumoconiosis (GBZ 70 - 2002). According to 1:1 paired matching method, 128 dust exposure workers were selected as control who were exposed to same dust as cases. The difference of age and cumulative length of service between case and control was not over five years and two years, respectively. 5 ml peripheral venous blood was drawn and anticoagulated with 2% EDTA. The polymorphisms of FN (MspI, TaqIb, HindIII, HaeIIIb) were detected, using the method of polymerase chain restriction fragment length polymorphism (PCR-RFLP) techniques and PCR. RESULTS: The frequencies of FN Msp I (CC) in cases and control groups were 10.9% and 3.9%, respectively. The difference was significant (P < 0.05). The frequencies of FN (MspI) C allele were 41.8% and 31.2% in case and control, and the difference between cases and controls was significant (P < 0.05). The frequencies of FN HaeIIIb (AA) genotype in cases (24.2%) was higher than that in control groups (17.9%), OR = 5.0 (95% CI: 4.840 approximately 24.210). The frequencies of FN (HaeIIIb) A allele were 51.9% and 42.2% in case and control, and the difference was significant (P < 0.05). The difference of TaqIb and HindIII genotype between cases and controls were not significant (P > 0.05). CONCLUSION: The risk of suffering from pneumoconiosis increases in workers carrying FN (MspICC or HaeIIIb AA) genotype after exposure to dust. Workers both carrying FN (HaeIIIb AA) and (MspICC) genotypes are more susceptible to pneumoconiosis. The relationship between genetic polymorphism of FN (TaqIIb, HindIII) and pneumoconiosis has not been found.

Spontaneous Abdominal Bleeding from an Infundibulopelvic Ligament Tear in a Patient with Large Ovarian Fibroma.

Ovarian fibromas are rare benign solid tumors of the ovary which are often difficult to differentiate from uterine leiomyomas preoperatively. The symptoms usually include abdominal discomfort and may have ascites and/or an elevation in CA-125 levels. There have been no publications of associated abdominal bleeding to date. The treatment is surgical removal via a laparoscopic or laparotomic approach. We present a case of a 19 cm unilateral ovarian fibroma with abdominal bleeding from a spontaneous right infundibulopelvic ligament (IPL) tear who underwent a laparoscopic and mini-laparotomic right salpingo-oophorectomy. Patients with large ovarian fibromas should be cautioned that abdominal bleeding and/or acute abdominal pain can occur and that a minimally invasive surgical approach is feasible.

[The mechanistic rote of KCNH2 gene L413P and L559H mutations in long QT syndrome].

OBJECTIVE: To investigate the molecular pathogenesis for two novel mutations L413P and L559H of KCNH2 found in Chinese patients with long QT syndrome. METHODS: L413P and L559H mutant constructs were generated by site-directed mutagenesis using human wild-type (WT) pcDNA3-HERG cDNA as a template. WT and mutant constructs were transiently transfected into human embryonic kidney 293 cells using lipofectamine method. After transfection, the recording of HERG current was performed using patch clamp technique. The expression and cellular localization of HERG protein were studied with Western blot and immunofluorescence methods. RESULTS: Electrophysiological recordings showed that L413P and L559H mutations did not express HERG current. Western blot analysis revealed that only 135 000 immature HERG protein was expressed in L413P and L559H-transfected cells, whereas both mature and immature forms of HERG protein were observed in WT-transfected cells. Immunofluorescence study showed that L413P and L559H mutant proteins were predominantly localized around the nucleus, suggesting that the mutant channels are retained in the endoplasmic reticulum. When L413P or L559H was co-transfected with equal amount of WT plasmids, both 135 000 and 155 000 forms of HERG protein were observed, and the HERG current was not significantly changed as compared with that of WT transfection alone. Low temperature and E-4031could not rescue these two mutant channels. CONCLUSIONS: The L413P and L559H mutations resulted in protein trafficking defects with failure of mutant proteins to reach the plasma membrane. However, both biochemical and electrophysiological results showed that the mutations did not have a dominant-negative effect on WT, indicating that the mechanism of the L413P and L559H mutations might be haploinsufficiency.

[Clinical study of terminating biochemical pregnancy and early clinical pregnancy with mifepristone and misoprostol].

OBJECTIVE: To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol. METHODS: Mifepristone (150 mg) combined with misoprostol (600 microg) 3 days later were given to 500 biochemical pregnancies (G(1)), 500 early clinical pregnancies (G(2)) and 500 clinical pregnancies (G(3)) which were classified according to amenorrhea days, serum human chorionic gonadotropin-beta subunit (beta-hCG) and vaginal B-ultrasonic examinations. All were observed for 6 hours after taking misoprostol and returned for assessment per week. RESULTS: Expulsion of conceptus was G(1) 123 (24.6%, 123/500), G(2) 438 (87.6%, 438/500) and G(3) 467 (93.4%, 467/500). Failure rate was G(1) 6 (1.2%, 6/500), G(2) 24 (4.8%, 24/500) and G(3) 79 (15.8%, 79/500) for ongoing pregnancies, hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding. Bleeding cases during the administration of mifepristone were G(1) 272 (54.4%, 272/500), G(2) 141 (28.2%, 141/500) and G(3) 87 (17.4%, 87/500); the mean bleeding days were G(1) (5.8 +/- 1.5), G(2) (9.0 +/- 2.9) and G(3) (14.3 +/- 5.9) days. Other side effects including abdominal pain, nausea, vomiting and diarrhea were low and light in each group, increasing with advancing gestational age. Menses recovery was 486 (97.2%, 486/500), 452 (90.4%, 452/500) and 433 (86.6%, 433/500) for each group on scheduled time. Satisfaction was 499 (99.8%, 499/500), 485 (97.0%, 485/500) and 369 (73.8%, 369/500) respectively. CONCLUSION: Mifepristone and misoprostol in combination is as safe, and effective for termination of biochemical pregnancies as ordinary medical abortion. It does not need to wait till ectopic pregnancy is excluded.

Efficacy, Safety, and Acceptability of Low-Dose Mifepristone and Self-Administered Misoprostol for Ultra-Early Medical Abortion: A Randomized Controlled Trial.

The aim of this study was to investigate the efficacy, safety, and acceptability of low-dose mifepristone combined with self-administered misoprostol for ultra-early medical abortion. A total of 744 women with ultra-early pregnancy (amenorrhea ≤35 days) who fulfilled the inclusion criteria were enrolled in the study. Equal numbers of participants were allocated randomly to the hospital administration and self-administration groups. All participants took 75 mg mifepristone at the initial visit and 400 µg oral misoprostol 24 hours later in the hospital or by self-administration. The primary end point was complete abortion. Secondary end points were rates of unscheduled reattendance, time required for and cost of hospital observation and follow-up, vaginal bleeding, adverse effects, menstrual disturbance in the posttreatment period, and satisfaction rating. No differences in the rates of complete abortion, unscheduled reattendance, vaginal bleeding, adverse effects, or return of posttreatment menstruation were observed. The time required for (and costs of) hospital observation and follow-up per participant was 557.82 minutes (and US$40.12) in the hospital administration group and 18.46 minutes (and US$1.96) in the self-administration group (both P < .001). Satisfaction rates were similar in both groups, but the rates of "very satisfied" responses (87.60% vs 25.41%) and follow-up compliance (loss to follow-up, 0.45% vs 7.70%) were higher in the self-administration group (both P < .001). Low-dose mifepristone combined with self-administered misoprostol for ultra-early pregnancy termination was as effective and safe as hospital administration, with greater acceptability and lower cost to the women.

[Novel mutations of potassium channel KCNQ1 S145L and KCNH2 Y475C genes in Chinese pedigrees of long QT syndrome].

OBJECTIVE: Hereditary long QT syndrome (LQTS) is a cardiac disorder characterized by prolongation of QT interval on electrocardiograms (ECGs) and syncope and sudden death caused by a specific multi-polymorphic ventricular tachyarrhythmia known as torsade de pointes. LQTS is caused by mutations in cardiac sodium channel gene SCN5A; potassium channel subunit genes KCNQ1, KCNH2, KCNE1, KCNE2, KCNJ2; calcium channel gene Cav2.1. and ankyrin-B gene ANK2. METHODS: We characterized 77 Chinese LQTS patients with clinical manifestations and mutations in the main LQTS genes, KCNQ1 and KCNH2 using PCR and sequence analysis. RESULTS: The spectrum of ST-T-wave patterns of 24 (31.2%) probands were considered as LQT1, 42 (54.5%) as LQT2 and 3 (3.9%) as LQT3. The remaining 8 (10.3%) could not be characterized. The average age for this population of LQTS patients was (27.6 +/- 16.4) years and the average QTc (561 +/- 70) ms, and the age of the first syncopal attack was (17.6 +/- 14.7) years. The triggering factors for cardiac events happening in these mutation carriers included physical exercise, emotional excitement and auditory irritation. We identified 4 KCNQ1 mutations and 7 KCNH2 mutations. Six of them were first identified with some data already shown. In this paper we showed the data of 6 other mutations. CONCLUSIONS: LQT2 is the most common type of LQTS in Chinese; 2 mutations of KCNQ1 and KCNH2 were first identified in this report; there are some differences between Chinese and North American or European LQTS patients in clinical characters and ECG.

[Comparative study of gene mutation between Chinese patients with familial and sporadic hypertrophic cardiomyopathy].

OBJECTIVE: To compare the gene mutation between Chinese patients with familial and sporadic hypertrophic cardiomyopathy (HCM). METHODS: Peripheral blood samples were collected from 36 patients with familial HCM (FHCM) and 50 patients with sporadic HCM (SHCM), all un-related and from different provinces of China. PCR was used to amplify the 26 protein-coding axons of beta-myosin heavy chain (MYH7), 16 exons for cardiac troponin T (TNNT2), and 38 exons for cardiac myosin-binding protein C (MYBPC3). The amplified products were sequenced and compared with the standard sequence in the genBank so as to determine the potential mutation sites. RESULTS: (1) 13 of the 36 FHCM patients (36.1%) harbored 3 different mutations in MYH7 gene: Arg663His in exon18, Glu924Lys in exon 23, and Ile736Thr in exon 20. Of the 50 SHCM patients, only 1 (2%) harbored MYH7 gene missence mutation: Ile736Thr located in exon 20. (2) TNNT2 was not identified in all SHCM patients and FHCM patients. (3) MYBPC3 was not identified in all SHCM patients. Four FHCM patients harbored 2 different mutations: Arg502Trp in exon 18 and Arg346fs in exon 13 respectively. CONCLUSION: MYH7 and MYBPC3 may be the dominant disease-causing genes in Chinese familial HCM patients; however the mutation rate of MYH7 and MYBPC3 genes is significantly lower in the SHCM patients compared with the FHCM patients. TNNT2 seems not the predominant disease-causing gene in all Chinese patients with HCM.