Objective To compare the clinical effects of dydrogesterone and gestrinone on postoperative endometriosis and the rate of pregnancy in patients with infertility. Methods One hundred and fifty patients with postoperative endometriosis were enrolled in the current study who were hospitalized in fuzhou General Hospital of Nanjing Command from Jan. 2009 to Aug. 2013. They were randomly divided into dydrogesternne group(76 cases)and gestrenone groups(54 cases)based on progestogent treatment. The situation of pain symptoms improvement,the recurrence rate of 1 year,side effects and postoperative pregnancy rate were observed in order to evaluate the drug efficacy. Results There were a high rate of postoperative pain remission rate and a low recurrence rate of the two groups,and the difference was not significant( P ﹥0. 05 ). The main adverse reaction of patients in dydrogesterone group was breast pain and the incidence rate was 3. 9%( 3/76 ),while there was no breast pain in gestrinone group,and the difference was not significant( P =0. 140 ). The main adverse reaction of patients in gestrinone group was liver function damage and the incidence rate was 25. 9%(7/54),while the dydrogesterone group hadn't liver function damage,and the difference between two groups was significant( P =0. 000 ). The abnormal uterus bleeding incidence rate in dydrogesterone group was 15. 8%(12/76),higher than that of gestrinone group(13. 0%(7/54)),and the difference was significant(P=0. 038) . The serum carbohydrate antigen-125(CA-125)level in two groups were down to normal after operation,and still declined after drug treatment for 3 months. But there was no obvious change after 6 months. One year pregnancy rate of dydrogesterone pregnancy was 80%(24/30),higher than that of gestrinone group(48%,12/25),and the difference was significant( P =0. 038 ). Conclusion There is no significant difference in therapeutic effect between two groups. However,dydrogesterone therapy have no significant liver damage,and a higher postoperation pregnancy rate.

Objective To discuss the impact of nursing intervention on self- care ability and health behavior of cancer patients with indwelling PICC in order to improve their life. Methods 218 cases of cancer patients with PICC catheter were randomly divided into the intervention group (107 patients)and the control group (111 patients),the control group were treated with conventional care, the intervention group was treated with targeted cognitive intervention by the PICC nurse specialists on the basis of conventional care. Interventions included improving health knowledge, self-concept, self-care responsibility and self-care skills in four areas, the intervention lasted 3 months. A questionnaire survey was conducted before and after intervention. Self-care skills and health behavior levels were compared between the two groups. Results Self-care skills and health behavior levels of the intervention group were significantly higher thanthose of the control group after intervention. Conclusions Targeted interventions can effectively improve the self-care capacity of outpatient oncology patients with PICC catheter and improve their health behaviors.

Objective To analyze the reasons of abnormal extubation for the chemotherapy patients with PICC,and put forward preventive measures. Methods A retrospective investigation was carried out about the reasons for abnormal extubation in 583 chemotherapy patients with PICC in our hospital from December 2007 to September 2009. Results There were 63 cases of abnormal extubation in 583 patients, accounted for 10.8% of the total number. The reasons of abnormal extubation included: catheter-related infection, misplacement,prolapse, dilapidation and fracture, catheter occlusion,thrombosis and abandoning treatment. Conclusions Complications caused by PICC are the main reasons for abnormal extubation. Important care measures to prevent and deal with kinds of complications timely can reduce the incidence of abnormal extubation.

Objective:To analyze PD-L2 expression on monocytes of peripheral blood cells in systemic lupus erythematosus ( SLE) and it′s correlation with the degree of disease activity .Methods:Peripheral blood of 26 cases of SLE patiens and 38 cases of healthy controls were collected .Peripheral blood mononuclear cells ( PBMC) were isolated and realtime PCR was carried on to analyze the PD-L2 gene expression.At the same time flow cytometry was performed to analyze the CD 14 and PD-L2 expression.Results:PD-L2 was significantly up-regulated on monocytes in RA patients than in healthy controls and had correlation with the disease activity and the SLEAI score.Conclusion:These findings help to clarify the function of PD-L2,including its potential role as a biomarker for SLE .

Objective To investigate the incidence of occult pancreatobiliary reflux and to evaluate its relation to gallbladder epithelial dysplasia and cancer. Methods From July 2006 to Feb 2008,956 cases underwent selective biliary procedure or preoperative endoscopic retrograde cholangiopanereatography (ERCP), bile was collected and amylase was measured. All removed gallbladders were pathologically examined for dysplasia and cancer. Results Occult pancreatobihary reflux was found in 75 of 754 patients in this study, with an incidence of 9. 9%. The biliary amylase values in the patients with occult pancreatobiliary reflux and in controls were 7701±20 378 IU/L and 16±51 IU/L, respectively ( P <0. 01 ).Gallbladder dysplasia and cancer were found in 31.0% and 3.4% of the patients with occult pancreatobiliaryreflux, respectively, and both were higher than those in the patients without pancreatobiliary reflux ( P <0. 05). In the patients with occult pancreatobiliary reflux, the biliary amylase level with gallbladder dysplasia or cancer was 2388 ± 2745 IU/L and was higher than those without gallbladder dysplasia or cancer (P < 0. 01 ). Conclusions With an incidence of 9.9% in patients of normal pancreatobiliary junction,the occult pancreatobihary reflux may contribute to the pathogenesis of gallbladder epithelial dysplasia and cancer.

BACKGROUND:The use of mesenchymal stem cels in the field of tissue engineering for osteoarticular injury repair is a very promising tool since these cels are readily expandable and able to differentiate into chondrocytes. Abundant evidence suggests that microRNAs play critical roles in chondrogenic differentiation of mesenchymal stem cels.
OBJECTIVE:To observe the chondrogenic effect of human bone marrow mesenchymal stem cels transfected with lentiviral vectors bearing miR-221-3p/222-3p inhibition, thereby provding new strategies for cartilage injury.
METHODS: miRNA microarray technology was applied to detect microRNAs expression profiles at three different stages of chondrogenic differentiation induction after transforming growth factor-β3 treatment and verified by real-time fluorescence quantitative PCR (RT-qPCR). Human bone marrow mesenchymal stem cels were infected with lentivirus bearing miR-221-3p/222-3p inhibition. After co-suppressing the expression of miR-221/222-3p, cel counting kit-8 was used to determine the cel proliferation, the differentiation of bone marrow mesenchymal stem cels towards chondrocytes was verified by type II colagen protein expression through immunohistochemistry and glycosaminoglycan accumulation was also elevated by sarranine O staining. RT-PCR was used to detect type II colagen and aggrecan mRNA expression at 21 days of chondrogenic induction.
RESULTS AND CONCLUSION: The expression of miR-221-3p/222-3p was inhibited after Lv-miR221-3p/222-3p inhibition co-transfected into bone marrow mesenchymal stem cels. microRNA microarray and RT-qPCR results showed that the expression of miR-221-3p/222-3p was declined significantly at the anaphase of chondrogenic differentiation. The expression levels of chondrogenic markers, Aggrecan and type II colagen were significantly increased in the miR-221-3p/222-3p inhibition group and cel proliferation was also inhibited significantly compared with non-transduced cels or transduced with the empty lentiviral vector group. miR-221-3p/222-3p knockdown in bone marrow mesenchymal stem cels could inhibit proliferation but promote chondrogenic differentiation of bone marrow mesenchymal stem cels.

Objective To evaluate the relationship between plasma cystatin C concentration (PcyC) and coronary artery diseases (CAD). Method A total of 126 subjects with CAD evidenced by coronary angiography admitted from April 2007 to March 2009 were divided into three groups: stable angina pectoris (SAPs, n = 34),unstable angina pectoris (UAPs, n = 56) and acute myocardial infarction (AMIs, n = 36), according to the diag-nostic criteria of CAD set by WHO. Another 34 subjects without CAD were taken as controls. There were no statis-tical differences in demographics among four groups. Serum lipids profile, uric acid (UA), PcyC and high-sensi-tive C-reactive protein (hs-CRP) were determined. And in the meantime, all patients were followed up for six months and adverse cardiovascular events were recorded. Comparisons were made between groups with a number of independent-sample t -tests. Data were processed with analysis of variance to test the differences in means among four groups, and the means were compared with chi-square test. Statistical significance was established at a P val-ue of less than 0.05. Results Cystatin C levels were significantly higher in UAPs than that in SAPs and in controls (P < 0.05), but were much lower than that in AMIs (P < 0.05). And much higher concentration of hs-CRP was found in UAPs (P < 0.05) and in AMIs (P < 0.01). Cystatin C was positively and significantly corre-lated with age, hs-CRP, WBC, creatinine and UA (r > 0, P < 0.05), whereas a significantly negative correla-tion with high-density lipoprotein cholesterol was found (r = - 0.227, P < 0.05). These coefficients were obvi-ously high for creatinine (r = + 0. 612), and WBC (r = + 0.459). During the period of six-month follow-up, 26 patients with adverse cardiovascular events were found, and had significantly higher cystatin C levels than 22 con-trols at admission (P < 0.01). Conclusions Cystatin C plays a pivotal role in the course of CAD, and the PcyC is a strong predictor for the risk of cardiovascular events.

Objective To investigate the value of IL-27,IL-29 and miRNA-497 in HER-2 positive radioactive particles combined targeted therapy. Methods Sixty-one elderly inpatients with HER-2 positive gastric cancer ascites in the Gaoming District People's Hospital, Wuchuan Municipal People's Hospital and Zhejiang Provincial Tumor Hospital were divided into the two groups. The treatment group(n= 31) was treated by the radioactive particles+ targeted drug Trastuzumab(initial dose 8 mg/kg, maintenance dose 66 mg/kg, once per 3 weeks) for 6 weeks; the control group(30 cases) was treated by targeted drug Trastuzumab (initial dose 8 mg/kg,maintenance dose 6 mg/kg, once per 3 weeks) for 6 weeks. The levels of ascites IL-27,IL-29 and miRNA-497 in the radioactive partcles combined targeted therapy group and control group were detected. Results The levels of ascites IL-27, IL-29 and miRNA-497 after treatment in the treatment group were significantly decreased compared with those before treatment and in the control group,the effective remission rate in the treatment group was 74. 19%, which was higher than 36.67% in the control group, the average median survival time in the treatment group was 155 d, which washigher than 72 d in the control group, the difference was statistically significant. Conclusion IL-27 ,IL-29 and miRNA-497 has the significance of curative effect evaluation and prognosis judgment in the radioactive particles combined targeted therapy for the patients with HER 2 positive gastric cance.

Objective To study the impact factors on prognosis of patients with gallbladder adenocarcinoma after surgery.Methods The clinicopathological data of 1 285 patients who underwent surgery and were histologically confirmed to have gallbladder adenocarcinoma from 2004 to 2014 was extracted from the SEER database of US National Cancer Institute.Life table was used to calculate the survival rate.Kaplan-Meier was used to construct the survival curves.Univariate and Cox multivariate regression analysis were applied to evaluate the prognostic factors.The univariate analysis was evaluated by the log-rank x2 test.Results The median survival of 1 285 patients with gallbladder adenocarcinoma was 32 months.The 1-,3-and 5-year survival rates were 77.5％,46.8％ and 36.5％,respectively.The 5-year survival rates of stage Ⅰ,Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB were 72.7％,63.2％,24.6％,20.5％,0 and 5.1％,respectively.The median survival of stage ⅢA,ⅢB,ⅣA and ⅣB were 22 months,19 months,12 months and 16 months,respectively.The differences were statistically significant (P ＜ O.05).Univariate analysis showed that sex,age,degree of differentiation,tumor size,T staging,N staging,number of lymph nodes detected,lymph node metastasis rate,location of lymph node metastasis,and American Joint Commission on cancer (AJCC) staging were significantly associated with prognosis (P ＜ 0.05).There was no significant differences among race and marital status with prognosis (P ＞ 0.05).Multivariate Cox regression analysis showed that sex (male),age (≥ 65 years),degree of differentiation,T staging,number of lymph nodes detected (＜ 4)and AJCC staging were independent risk factors affecting prognosis of patients with gallbladder adenocarcinoma (P ＜ 0.05).Conclusions With increase in AJCC staging,the survival rates in patients with gallbladder adenocarcinoma after surgery decreased gradually.Parameters including sex,age,T staging,number of lymph nodes detected and AJCC staging were independent factors affecting prognosis of patients with gallbladder adenocarcinoma after surgery.

OBJECTIVE: To optimize water extraction technology of Feng-Moutan Cortex. METHODS: L9 (34) orthogonal design was used to optimize soaking time, solid-liquid ratio, extraction time and extraction times in water extraction technology of Feng-Moutan Cortex using comprehensive scores for the peak area percentage and extract yield of 8 ingredients in Feng-Moutan Cortex as gallic acid, paeoniflorin, catechin, paeoniflorin, benzoic acid, benzoyloxypaeoniflorin, benzoylpaeoniflorin and paeonol after normalization as indexes. Verification test was conducted. RESULTS: The optimal water extraction technology was that 20-fold water, soaking for 1 h, extracting twice, 2 h each time. Results of verification test showed that comprehensive scores of 3 times of tests were 65. 98, 68. 85 and 69. 25, respectively. RSDs of each index were lower than 5％ (n=3). CONCLUSIONS: Established comprehensive scoring method can reflect the relative contents of effective components in Feng-Moutan Cortex comprehen- sively, so that optimized extraction technology is reasonable and feasible.