Evaluation of the Efficacy and Safety of Hyaluronic Acid Vaginal Gel to Ease Vaginal Dryness: A Multicenter,Randomized, Controlled,Open‐Label,Parallel‐Group,Clinical Trial

IntroductionAtrophic vaginitis is a common occurrence, particularly among postmenopausal women; however, few seek or receive treatment. One therapeutic solution is topically applied products. Estrogen‐based treatments have been shown to be effective; however, many patients are reluctant to use such formulations due to health concerns, hence the need to assess the efficacy of acceptable alternatives.AimThis multicenter, randomized, controlled, open‐label, parallel‐group clinical trial set out to evaluate the efficacy and safety of hyaluronic acid vaginal gel to treat vaginal dryness compared with estriol cream in postmenopausal women.MethodsOne hundred forty‐four subjects were randomized, 72 to the test group treated with hyaluronic acid vaginal gel (Hyalofemme) and 72 to the control group treated with estriol cream (Ovestin). Treatment in both groups was applied by means of a device once every 3 days for a total of 10 applications over 30 days.Main Outcome MeasuresEfficacy was measured by grading vaginal dryness and three other vaginal symptoms on a visual analog scale. Safety assessments included vital signs, laboratory examinations of the vaginal microecosystem, vaginal pH value, vaginal B ultrasound, and incidence of adverse events. Assessments were performed at baseline, by telephone after the third application, and at the final visit.ResultsBoth hyaluronic acid vaginal gel and estriol cream can significantly improve the clinical symptoms of vaginal dryness in postmenopausal women, with improvement rate of 84.44% and 89.42%, respectively, after 10 applications, without statistically significant difference between them.ConclusionBoth hyaluronic acid vaginal gel and estriol cream are effective in the treatment of vaginal dryness. Hyaluronic acid vaginal gel may be considered as a valid alternative to estrogen‐based treatments in relieving the symptoms of vaginal dryness.     

伴原发不孕症的子宫腺肉瘤临床病理分析

目的：探讨伴原发性不孕症的子宫腺肉瘤临床病理特点及误诊分析。方法观察分析2例伴原发不孕症的子宫腺肉瘤临床表现、病理特点。结果患者年龄分别为29岁和31岁，主要表现为不规则子宫出血及宫腔占位；组织学特征为良性子宫内膜腺体伴肉瘤性间质，其中1例合并有高级别子宫内膜间质肉瘤，另1例伴肉瘤成分过度生长。2例均采用全子宫＋双侧附件＋盆腔淋巴结清扫治疗，术后在随访中。结论子宫腺肉瘤常发生于中老年妇女，伴原发性不孕症的病例尚未见报道。作者认为，不孕症的原因除与宫腔占位有关外，下丘脑-垂体-卵巢轴的协调功能紊乱与不孕症和腺肉瘤的发生相关。     

A comparative study on the diversity of clinical features between the sero-negative and sero-positive rheumatoid arthritis patients

To investigate the similarities and differences in clinical features between the sero-negative and sero-positive rheumatoid arthritis (RA) patients. Two hundred and sixty-two RA patients who fulfilled the 1987 ACR RA Classification Criteria were enrolled into this study. They were divided into sero-negative and sero-positive group depending on the presence or absence of rheumatoid factor (RF) and anti-cyclic citrullinate peptide (anti-CCP). The clinical features were compared between these two groups. Forty-six (17.6%) RA patients were classified as sero-negative group. The disease onset of sero-negative RA patients was later than that of sero-positive RA patients (52.4?±?15.9 vs. 47.4?±?15.5?years, P?<?0.05). At the end of the first 2?years after disease onset, bone erosion shown in the hand X-ray occurred in 4 out of 24 (16.7%) patients with sero-negative RA. However, only 5.2% (5/97) patients with sero-positive RA developed bone erosion (P?<?0.05). In the sero-positive RA patients, the titer of RF was correlated with swollen joint counts (SJC), tender joint counts (TJC), erythrocyte sedimentation rate (ESR), and disease activity score in 28 joints (DAS28) (P?<?0.05), but anti-CCP was not. Sero-negative and sero-positive RA are probably two distinct disease subtypes driven by different mechanisms.     

Construction and characterization of a cigR deletion mutant of Salmonella enterica serovar Pullorum

Salmonella enterica serovar Pullorum (S. Pullorum) is the causative agent of pullorum disease (PD) and results in severe economic losses to the poultry industry. As a Salmonella type III secretion system 2 (T3SS2) effector and predicted membrane protein, CigR is encoded by the cigR gene within Salmonella pathogenicity island 3 (SPI3). In order to research the influence of the cigR gene on S. Pullorum, a cigR mutant of S. Pullorum S06004 was constructed by the lambda Red recombination system, and then its characterization was analysed. Lack of cigR did not affect the growth and biochemical properties, but resulted in decreased biofilm formation. The mutant strain was stable with the deletion of the cigR gene. Macrophage infection assay and in vivo competition assay showed that the mutant strain increased the replication and/or survival ability in the HD11 cell line and in chickens compared to that of the parent strain, the median lethal dose (LD₅₀) of the mutant strain was one-fifth of the parent strain for 2-day-old chickens when injected intramuscularly. These results demonstrate CigR plays roles in biofilm formation and pathogenicity of S. Pullorum, deletion of cigR can significantly decrease biofilm formation and significantly increase virulence.