Objective To investigate the feasibility and safety of laparoscopic myomectomy in patients with large-diameter hyste-romyoma .Methods A retrospective analysis of data from 37 patients in which the uterus were larger than 14-week gestational size and the diameter of myoma was ≥7 cm treated by laparoscopic myomectomy from January 2007 to December 2011 in our hospital was conducted .The outcome of the operation were compared with that in 53 large-diameter hysteromyoma cases by abdominal sur-gery .Results 37 patients were carried out laparoscopic surgery in which 28 cases were treated successfully by total laparoscopy , and small abdominal incision was made in 6 cases .3 of the cases converted to open surgery .The ureteral abdominal fistula was ob-served in 1 case ,which was cured by a reoperation of abdominal ureteral anastomosis .All patients were successfully cured and re-tained the uterus .The cases converted to open had no significant correlation with the patient′s age ,the fibroids size ,fibroids num-ber ,operative time and blood loss volume(P>0 .05) .Compared with the laparotomy group ,the operative time ,blood loss and post-operative morbidity were similar between groups (P>0 .05) .Postoperative recovery times after laparoscopic group were less than the control group(P<0 .05) .In the follow-up of 51 months(18 to 78) ,the laparoscopic myomectomy is equally effective with the laparotomy group in the number of cases of the postoperative normal menstruation and the postoperative spontaneous pregnancy . There were no statistically significant differences between the two groups (P>0 .05) .Conclusion Laparoscopic myomectomy in pa-tients with large-diameter hysteromyoma is safe and feasible while excellent surgical skills were required for a successful surgery .

Objective To observe the curative effect of using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia and its effect on nursing.Methods A prospective study was conducted, 146 patients with hyperbilirubinemia admitted to Mianyang Central Hospital from January 2015 to December 2016 were enrolled, and they were divided into an observation group (77 cases) and a control group (69 cases) according to random number table method. The observation group was treated by medical treatment and the artificial specific liver bilirubin adsorption, while the control group only treated by medical therapy. The changes of levels of liver function indexes alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil) before and after treatment and clinical curative effect were observed in the two groups.Results Before treatment, there were no statistical significant differences in levels of the ALT, AST, TBil, DBil between the two groups (allP > 0.05), after treatment, the above indexes were significantly decreased compared to those before treatment, and the degrees of decrease in observation group were more obvious than those in control group [ALT (U/L): 341±42 vs. 455±37, AST (U/L): 120±35 vs. 197±37, TBil (μmol/L): 185.4±20.6 vs. 302.6±30.6, DBil (μmol/L): 42.6±10.8 vs. 87.5±11.6, allP < 0.05]. The total effective rate in observation group was obviously higher than that of control group [62.3% (48/77) vs. 40.6% (28/69),P < 0.05].Conclusions Based on liver protection, symptomatic and supportive medical treatment, using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia is safe and effective, and in addition, close observation and careful nursing is beneficial to the reduction of incidence of complications and elevation of therapeutic efficiency.

Objective To study the changes of transforming growth factor-β (TGF-β),connective tissue growth factor (CTGF) and collagen 1 (COL1) in newborn rat's lung tissue and the expressions of 4EBP1 (eukaryotic promoter) and P7OS6K (mammalian target of rapamyein pathway downstream target protein) after rapamycin and hyperoxia intervention,and to study the influence of mammalian target of rapamyein (mTOR) pathway on hyperoxic lung injury and the possible intervention methods.Method A total of 48 21-day-old neonatal rats were assigned into 8 groups (n =6),including air control group,3 d group (3 days after hyperoxic exposure),7 d group (7 days after hyperoxic exposure),14 d group (14 days after hyperoxic exposure),air + RAPA group (air + rapamycin),3 d + RAPA group (3 days after hyperoxic exposure + rapamycin),7 d + RAPA group (7 days after hyperoxic exposure + rapamycin) and 14 d + RAPA group (14 days after hyperoxic exposure + rapamycin).In the hyperoxic group,newborn rats were exposed to 90％ oxygen for 3,7,14 days respectively.The rats in the hyperoxia + rapamycin intervention groups received intraperitoneal injection of rapamycin and inhaled high concentrations of oxygen for 3,7,14 days respectively.Air ± rapamycin group received intraperitoneal injection of rapamycin for 3 days.To study the pathological changes of lung tissures after hyperoxia and rapamycin intervention,we used ELISA to detect the changes of TGF-β,CTGF and COL1 and Western blot to detect the variations of mTORC1,P70S6K and 4EBP1 expression.Result TGF-β,CTGF,COL1 levels at 3 days,7 days and 14 days after hyperoxic exposure (TGF-[β:33.7±2.8 vs.58.6 ±3.1 vs.98.8 ±1.5 ng/mg,CTGF:50.1 ±1.8 vs.68.7 ± 2.2 vs.94.4 ±2.5 ng/mg,COL1:471.9 ±5.7 vs.529.7 ±7.0 vs.556.4 ±8.5 ng/mg) were significantly higher than the air control group (TGF-β:25.5 ± 1.9 ng/mg,CTGF:41.7 ± 1.4 ng/mg,COL1:414.4 ± 8.9 ng/mg) (P ＜ 0.01).While the levels in rapamycin intervention group were significantly lower than all the hyperoxia + rapamycin intervention groups (P ＜ 0.01).The lung tissue pathological grades in 3 d + RAPA group and 7 d + RAPAgroup were significantly lower than those in the 3 d group and 7 d group (3.5 ± 0.8 vs.6.3 ± 2.3 and 9.7 ± 2.0 vs.14.0 ± 2.4) (P ＜ 0.01).The mTORC1,P70S6K,4EBP1 expressions in 3 d + RAPA group were lower than 3 d group (mTORC1:0.26 ± 0.04 vs.0.29±0.08,P70S6K:0.29±0.01 vs.0.31 ±0.08,4EBP1:0.31 ±0.06 vs.0.33 ±0.06) (P＜0.05),while the expressions in 7 d + RAPA and 14 d + RAPA groups were significantly lower than 3 d + RAPAgroup (P ＜0.01).Conclusion mTOR signal pathway may be involved in the repairing process of hyperoxic-induced lung fibrosis.Rapamycin can reduce the levels of TGF-β,CTGF and COL1 and inhibit the expressions of mTOR pathway downstream target protein P70S6K and 4EBP1,thus reduce lung injury atearly stage.

Objective To explore the influence of group B Streptococcus screening during pregnancy and the incidence of the ear‐ly‐onset GBS disease for newborns .Methods Totally 47 cases of pregnant women with premature rupture of membranes (PROM ) , which were GBS positive and accepted antibiotic treatment ,who were chosen as the experimental group .While 73 cases of pregnant women with premature rupture of membranes (PROM) ,which were not accept GBS screening and antibiotic treatment ,were chosen as control group .The neonatal clinical manifestations were observed .The swab specimens were collected from throat and detected of GBS by using PCR method .Results The experimental group showed no occurrence of neonatal group B streptococcal infection , dyspnea ,cyanosis and fever .Totally 7 cases of the control group had group B Streptococcus infection .Totally 2 cases had dyspnea and 2 cases had cyanosis .Totally 4 cases had fever .The neonatal research indicators of these two groups were statistically signifi‐cant differences (P<0 .05) .Conclusion The group B Streptococcus screening during pregnancy would effectively reduce the inci‐dence of neonatal infection of group B Streptococcus .

OBJECTIVE: To study the clinical efficacy of Nalmefene in the treatment of chronic type Ⅱrespiratory failure. METHODS: A total of 40 patients with chronic type Ⅱ respiratory failure were randomly divided into treatment group and the control group: the treatment group received Nalmefene (1.0 mg) plus 5% GS (250 mL) q.d by iv gtt. in addition to the routine treatment, and the control group received 1.875 g Nikethamide plus 5% GS (250 mL) q.d by iv gtt. After 5-day treatment, the clinical symptom, physical signs, adverse drug reactions, lung function testing and blood gas analysis in two groups were evaluated. RESULTS: The overall response rate was 95.0% in the treatment group vs. 60.0% in the control group(P

OBJECTIVE: To observe the clinical efficacy of Jinhua xiaocuo pill and 0.05% taiarotene cream in the treatment of acne vulgaris. METHODS: 64 patients with acne vulgaris were randomly divided into experimental group and control group according to visiting order, the cases of 2 groups were 32. Experimental group were treated with 4 g Jinhua xiaocuo pill p.o. and 0.05% taiarotene cream for external use once every evening. Control group were treated with chloramphenicol/metronidazole liniments three times a day, the treatment course of 2 groups were 6 weeks. Efficacy before and after treatment were evaluated and analyzed with SPSS 13.0 software. RESULTS: The effective rate was 93.8% for experimental group and 65.6% for control group. Significant different was noted between two groups(?2=7.169,P

Objective To explore the clinical effect and prognosis of plasma N -terminal probrain natriuret-ic peptide (NT -proBNP)and 6 min walk test performance (6 -MWT)in patients with chronic heart failure (CHF).Methods 100 patients with CHF were selected as observation group,and 50 healthy people were selected as control group.They were grouped by NYHA degree,28 cases were NYHA Ⅱ,56 cases were NYHA Ⅲ and 16 cases were NYHA Ⅳ.The plasma level of NT -proBNP,6 -MWT,left ventricular ejection fraction (LVEF),early diastolic peak mitral flow velocity to late diastolic peak mitral flow velocity (E /A)were measured.Results The plasma NT -proBNP level of CHF patients was positively correlated with NYHA degree (r =0.683,P <0.01);6 -MWT was neg-atively correlated with NYHA degree(r =-0.518,P <0.01).For CHF patients,significant correlation was observed between NT -proBNP and 6 -MWT (r =-0.789,P <0.05).Plasma NT -proBNP level was correlated with dias-tolic HF,systolic HF and mixed type heart failure (r =-0.678,P <0.01;r =-0.845,P <0.01;r =-0.759,P <0.01).Conclusion Plasma NT -proBNP,6 -MWT can serve as a marker for the detection and evaluation of heart failure.Meanwhile,the higher the NT -proBNP level,the shorter the 6 -MWT,the more serious the heart failure,the poorer the prognosis.

Objective To observe the clinical effects by endoscopic implantation of accurate and slow-release particles for advanced esophageal carcinoma. Methods Under endoscopy, we dividing the whole focus into several layers by each 1.0 cm and implanting one slow-release particles (about 10 mg) in each point whose interval is 1.0 cm. One course of treatment includes three-time implantation and each treatment needs four weeks, by the way the details depend on the state of illness. In this research, all of patients complete the treatment smoothly. By comparing the patients’ situation before treatment, three-month treatment and six-month treatment, which include the remission of clinical symptom, the changing of focus area, the improvement of swallow function, untoward effect and life quality, et al. Results The results show several test indexes changed a lot. When treated for 3 months and 6 months, the levels of focus area and swallow difficulty classification were decreased significantly (P < 0.05) as compared with those before treatment; but the patients’ life quality didn’t have significant statistical difference (P > 0.05), by the way there isn’t individual difference appearing because of a little short of testing time and a few of samples. In addition, the WBC had a significant statistical difference between before treatment and three-month treatment (P < 0.05), and the ratio of complication didn’t have a significant change. Conclusions Endoscopic implantation of 5-Fu slow-release particles for the treatment of advanced esophageal carcinoma is a safety, high efficacy, low toxic and good tolerant palliative treatment.

Objective To investigate the effect of metformin on osteogenic and adipogenic differentiation of primary bone marrow mesenchymal stem cells. Methods Bone marrow mesenchymal stem cells were isolated and purified from the rat bone marrow by adherent method, the cells from passage 3-4 were used in our experiments. At 90% confluence, the medium was removed and the cells were cultured in osteogenic medium with or without 10 μmol/L metformin, medium was changed every two or three days. At days 7, 14, and 21, the cells were collected, osteogenic differentiation was evaluated by measuring Runt-related transcription factor 2, alkaline phosphatase, collagen type Ⅰ and osteocalcin using real-time PCR; ALP activity was also evaluated by p-nitrophenyl phosphate as the substrate and normalized to total protein content; At day 21, mineralization nodules in the extracellular matrix of bone marrow mesenchymal stem cells were stained using Alizarin red staining. Differentiation of adipocytes were induced in adipogenic medium for 14 days with or without 10 μmol/L metformin, then the cells were collected for detecting the transcription activity of PPARγ and CAAT/enhanced-binding protein α, lipid droplets in adipocytes were measured by oil red O staining. Results In the metformin group, alkaline phosphatase activity was higher, osteoblast markers were up-regulated(all P＜0.05), and the calcium nodules were more, while the adipocyte markers are down-regulated by about 70%, and lipid droplets were less than the group without metformin. Conclusion Metformin can effectively promote the differentiation of bone marrow mesenchymal stem cells to osteoblasts, while inhibit the differentiation to adipocytes.

AIM:Toinvestigatetheeffectsofcalcitoningene-relatedpeptide(CGRP)onmyocardinexpres-sion and phenotypic switch in vascular smooth muscle cells ( VSMCs) .METHODS:VSMCs were obtained by aortic tissue adherent culture and treated with angiotensin Ⅱ( AngⅡ) , AngⅡ+CGRP or AngⅡ+CGRP +CGRP8-37 .The protein expression of myocardin and the phenotypic proteins of the VSMCs was detected by Western blot .RESULTS:The expres-sion of myocardin in cultured VSMCs showed downregulation along with time expansion .The protein level of myocardin was higher at 48 h and 72 h than that at baseline in the cultured VSMCs (P<0.05).However, the myocardin was lower at 48 h and 72 h than that at baseline after treatment with CGRP in cultured VSMCs (P<0.05).Furthermore, at 48 h in cul-tured VSMCs, the myocardin decreased along with α-smooth muscle actin (α-SMA) (P<0.05), and osteopontin (OPN) increased (P<0.05) in AngⅡ group compared with control group .After treatment with CGRP, the levels of myocardin andα-SMA become higher ( P <0.05 ) but OPN was lower ( P <0.05 ) in CGRP group than those in AngⅡ group. CGRP8-37 abrogated CGRP-induced increase in myocardin and α-SMA and decrease in OPN in CGRP 8-37 group compared with CGRP group .CONCLUSION: CGRP may regulate the phenotypic switch of the VSMCs and maintain the cells in contractile phenotype through the upregulation of myocardin protein , which may be accomplished by the combination of CGRP and its receptor .