Objective To investigate the efficacy and safety of ultrasound-guided polyglycol in patients with scar pregnancy. Methods Thirty-six patients with scarring treated in Third People's Hospital of Hangzhou from November 2014 to November 2016 were selected as subjects. All patients underwent ultrasound-guided polyglycol administration. The results were analyzed and analyzed. The results were analyzed. Gonadotropin (β-HCG) returned to normal time and the occurrence of adverse symptoms. Results The average recovery time, treatment cost, average recovery time and adverse reaction rate of blood β-HCG in the study group were lower than those in the control group, the difference was statistically significant (P<0.05). Conclusion The effect of ultrasound on the injection of polyphenols in patients with scar pregnancy is safe, feasible and easy to be accepted by patients and their families. It has clinical significance.

Objective To discuss the effectiveness of implementation of blending learning in teaching of Fundamental of Nursing.Methods 234 nursing undergraduates were divided into the experimental group and the control group.The experimental group adopted blending learning method,while the control group used traditional teaching method.The final term exam and technical test results were compared between two groups.Results Students' practice scores in the experimental group were higher than those of the control group.In the experimental group,about 90.2％ undergraduates accessed learning resources through online teaching platform,82.4％ students considered that their nursing skills improved and 78.4％ students thought that their self-learning capacity strengthened.Conclusions Blending learning gives students a potential time,environment and recourse to learn.By integrating in-class and after-class studying,undergraduates' self-learning ability and nursing skills improved.

ObjectiveTo investigate the clinical effect of nape acupuncture on post-stroke dysphagia by a meta-analysis.Method Domestic literature on clinical randomized controlled trials of nape acupuncture treatment of post-stroke dysphagia published from Jun. 2004 to Jun. 2014 were obtained by a computer search ofChina National Knowledge Internet(CNKI), Wanfang Data medical information system (WF), VIP information resource system (VIP) and Chinese Biomedical Literature Database (CBM) combined with a manual search of Jinan University library journal database. Literature inclusion and exclusion criteria were established to extract data and the qualities of the included studies were assessed using a Jadad rating scale. A meta-analysis was made using the software ReviewManager 5.2.ResultA total of 17 articles were included with 1158 patients. The results of meta-analysis showed that there were statistically significant differences in the total efficacy rate [OR=3.99, 95%CI(2.83, 5.63),P<0.00001] and the cure rate[OR=2.67, 95%CI(2.03, 3.53),P<0.00001] between the nape acupuncture and control groups.ConclusionNape acupuncture has clinically a good therapeutic effect on post-stroke dysphagia. Multi-center, large-sample and high-quality studies are still needed for validation because the qualities of the included articles are lower, which is one of the factors influencing the assessment.

Objective To analyze the correlation between the tubular gastric width and the anti gastroesophageal reflux after esophageal cancer operation,and to provide reference for the choice of surgical methods in treatment of esophageal cancer.Methods Selected 60 patients who received radical surgery for esophageal carcinoma combined with gastric tube reconstruction surgery in our hospital from January 2015 to October 2015,and divided them into two groups according to the way of stomach tube anastomosis (cervical anastomosis,thoracic anastomosis) and different width of gastric tube (greater than or equal to or less than 3 cm).Namely:cervical anastomosis + greater than or equal to 3 cm group(14 cases),cervical anastomosis + less than 3 cm group(15 cases),thoracic anastomosis + greater than or equal to 3 cm group(15 cases) and thoracic anastomosis + less than 3 cm group(16 cases).All patients recieved esophageal pH monitoring for 3 days continuously from the 11 th day after operation.The monitoring indicators include:number of reflux,accumulation time of pH ＜ 4,whether there were clinical symptoms (heartburn,chest pain,pharyngeal foreign body sensation,cough,asthma,etc.) after surgery,and the frequency and time of these clinical symptoms appeared.All the patients were given endoscopic examination at the 14th days postoperatively.Observed the esophageal mucosa of patients and conducted histopathological grading of gastric mucosal inflammation.And then made a correlation analysis of gastric tube width and esophageal mucosal inflammation grade among all the patients with reflux symptoms.Results The cumulative time and number of reflux,incidence rate of clinical symptoms,and pH values less than 4 were significantly different(P ＜ 0.05).The cumulative time and number of reflux,incidence rate of clinical symptoms,and pH values less than 4 in the cervical anastomosis + less than 3 cm group were significantly lower than that in the other 3 groups(P ＜ 0.05),with statistical significance between different groups of endoscopic esophageal mucosa inflammation grade difference (P ＜ 0.05).Esophageal mucosal inflammation grading in patients of the cervical anastomosis + less than 3 cm group was the lightest.It showed a linear correlation between the gastric tube width and esophageal mucosal inflammation grading in patients with reflux symptoms.Conclusion Postoperative gastroesophageal reflux is closely related to stomach esophagus width after resection of esophageal carcinoma with tubular stomach reconstruction of stomach esophagus,because it is unable to control gastric tube width to the appropriate range.And it should be strengthened in patients with reflux related indicators for monitoring,so as to take measures to prevent gastroesophageal reflux as soon as possible to improve the prognosis of patients with quality.

OBJECTIVETo explore the impacts on the fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture and motor imagery.

METHODSSixty-two cases of flaccid paralysis of upper extremity in stroke were randomized into an observation group (30 cases) and a control group (32 cases). In the control group, the conventional western medication and the passive movement of the extremity were applied. Additionally, the penetrating needling technique was used at the head points [penetrating needling from Baihui (GV 20) to Taiyang (EX-HN 5)] and the local affected extremity [penetrating needling from Jianyu (LI 15) to Binao (LI1 14), from Quchi (LI 11) to Shaohai (HT 3), from Waiguan (TE 5) to Neiguan (PC 6), etc]. The needles were retained for 30 min. In the observation group, on the basic treatment as the control group, during the needle retaining, the motor imagery therapy was supplemented. The treatment was given once a day, 5 treatments a week, for 4 weeks totally in the either group. The scores in the action research arm test (ARAT) and the modified Fugl-Meyer assessment (FMA) were recorded at the moment of enrollment, in 2 and 4 weeks of treatment, in the 6th and 8th weeks, as well as after 90 days separately.

RESULTS(1) ARAT score: since the 2nd week, ARAT scores in the observation group were all improved significantly as compared with those in the control group at the each time points (all P<0. 05). In the observation group, the scores were improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, the score in the 2nd week was not different significantly as compared with that before treatment (P>0. 05), but the scores at the rest time points were improved significantly in the pair comparison (all P<0. 05); (2) FMA score: in the 2nd week and on the 90th day, FMA score in the observation group was higher significantly than those in the control group (both P < 0. 05). In the observation group, the scores were all improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, except that in comparison between the 90th day and the 8th week (P>0. 05), the results were all P<0. 05 at the rest time points.

CONCLUSIONThe early intervention of the combined therapy of acupuncture and motor imagery effectively promotes the recovery of the coordination function and the fine movement of upper extremity, especially the improvements of the fine movement in stroke at flaccid paralysis stage. The efficacy is better than the single acupuncture treatment.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Imagery (Psychotherapy) ; Imagination ; Male ; Middle Aged ; Motor Activity ; Paraplegia ; etiology ; physiopathology ; psychology ; therapy ; Stroke ; complications ; therapy ; Upper Extremity ; physiopathology

Objective To develop a multiplex sequence-specific PCR assay for simultaneous screening of 5 types of JAK2 mutations and investigate its clinical application value. Methods Multiplex sequence-specific PCR assay for simultaneous screening of JAK2 V617F, K539L (include 2 types of gene mutations), N542-E543del and E543-D544del mutations were developed. 115 patients with myeloproliferative diseases (MPD) including 61 polycythemia vera (PV) cases, 43 essential thrombocythemia (ET) cases and 11 primary myelofibrosis (MF) cases were analyzed. Results The assay can screen the 5 types of JAK2 mutations efficiently. The detection sensitivity is 1% for JAK2 V617F mutation and 0.1% for the other mutations. JAK2 V617F mutation and JAK2 exon12 mutation were detected in 56 and 3 of the 61 PV samples, respectively. 27 of the 43 ET samples and 6 of the 11 MF samples were JAK2 V617F positive, but no JAK2 exon12 mutation was found in both groups. The 3 cases carrying JAK2 exon12 mutation had the clinical feature of erythrocytosis and erythropoietin-independent erythroid colony formation but without apparent leukocytosis, thrombocytosis and splenectasis. Conclusion The assay can simultaneously screen 5 types of JAK2 mutations with high sensitivity and thus lead to an increased detection rate.

Objective: To investigate the clinical efficacy of needling Danzhong(CV 17) in the treatment of postpartum hypogalactia and provide clinical evidence for indications of the point. Methods: A multi-centre single-blind randomized controlled trial was carried out. Two hundred and seventy-six puerperal women with postpartum hypogalactia were randomly allocated into acupuncture group and herb group, and respectively treated for three consecutive days. The degree of mammary fullness, the amount of milk secreted, prolactin, baby weight, the frequency and volume of artificial feeding, the number of infant urination events, and the duration of baby crying were observed. The clinical curative effects on postpartum hypogalactia were compared. Results: Hypogalactia was effectively treated in both acupuncture and herb groups. There were statistically significant differences in degree of mammary fullness, amount of milk secreted, baby weight, the frequency and amount of artificial feeding, and the number of infant urination events between pretreatment and post-treatment, but no difference between the two groups. There was no significant difference in prolactin in the acupuncture group and there was a difference in prolactin in the herb group between pretreatment and posttreatment. Conclusion: Needling Danzhong(CV 17) can effectively promote lactation.

A major barrier to the use of antimicrobial peptides as antibiotics is the toxicity or ability to lyse eukaryotic cells. In this study, a 26-residue amphipathic α-helical antimicrobial peptide A12L/A20L (Ac-KWKSFLKTFKSLKKTVLHTLLKAISS-amide) was used as the framework to design a series of D- and L-diastereomeric peptides and study the relationships of helicity and biological activities of α-helical antimicrobial peptides. Peptide helicity was measured by circular dichroism spectroscopy and demonstrated to correlate with the hydrophobicity of peptides and the numbers of D-amino acid substitutions. Therapeutic index was used to evaluate the selectivity of peptides against prokaryotic cells. By introducing D-amino acids to replace the original L-amino acids on the non-polar face or the polar face of the helix, the hemolytic activity of peptide analogs have been significantly reduced. Compared to the parent peptide, the therapeutic indices were improved of 44-fold and 22-fold against Gram-negative and Gram-positive bacteria, respectively. In addition, D- and L-diastereomeric peptides exhibited lower interaction with zwitterionic eukaryotic membrane and showed the significant membrane damaging effect to bacterial cells. Helicity was proved to play a crucial role on peptide specificity and biological activities. By simply replacing the hydrophobic or the hydrophilic amino acid residues on the non-polar or the polar face of these amphipathic derivatives of the parent peptide with D-amino acids, we demonstrated that this method could have excellent potential for the rational design of antimicrobial peptides with enhanced specificity.
Anti-Infective Agents ; chemistry ; pharmacology ; Circular Dichroism ; Drug Design ; Erythrocytes ; drug effects ; Gram-Negative Bacteria ; drug effects ; Gram-Positive Bacteria ; drug effects ; Hemolysis ; drug effects ; Humans ; Peptide Fragments ; chemistry ; pharmacology ; Protein Structure, Secondary ; Structure-Activity Relationship ; Substrate Specificity

Objective To investigate the diagnostic value of serum anti-Müllerian hormone combined with sex hormones for polycystic ovary syndrome ( PCOS).Methods The serum levels of anti-Müllerian hormone ( AMH), testosterone ( T), luteinizing hormone ( LH), follicle-stimulating hormone (FSH) and the estradiol ( E2) were measured by electrochemiluminescence method in 82 patients with PCOS and 60 controls. The sensitivities, specificities and the areas under the receiver operating characteristic curves ( ROC-AUC) of the indicators and their combination for diagnosis of PCOS were compared by chi-square test and Z test separately.The correlations of serum AMH levels with age and sex hormones levels were analyzed separately by Spearman correlation analysis .Results The levels of serum AMH, T, LH and LH/FSH ratio in patients with PCOS were obviously higher than those in controls (62.19 pmol/L vs 27.63 pmol/L, 1.39 nmol/L vs 0.88 nmol/L, 12.72 IU/L vs 6.44 IU/L, 2.17 vs 1.17, U＝592.00, 1 096.00, 1 233.50, 1 134.00, all P＜0.01).The sensitivity of AMH (80.5%, 66/82) for diagnosis of PCOS was higher than that of LH (62.2%, 51/82) and LH/FSH ratio (54.9%, 45/82, χ2＝5.6, 13.79, all P＜0.05), but no significant difference was found when comparing with T (72%, 59/82, χ2＝1.71, P＞0.05 ) .The sensitivity of AMH ( 80.5%, 66/82 ) increased when combined with T (89.0%, 73/82), LH (87.8%, 72/82) and T+LH (95.10%, 78/82, χ2＝5.14, 4.17, 10.08, all P＜0.05), but no significant change by the combination of AMH +LH/FSH (85.4%, 70/82, χ2＝2.25, P＞0.05) .The specificity of AMH (80%, 48/60) for diagnosis of PCOS was no significant difference compared with that of T (71.7%, 43/60), LH (85%, 51/60), and LH/FSH ratio (91.7%, 55/60) (χ2＝3.20, 0.36, 2.77, all P＞0.05) .Also no increase when combined with T (71.7%, 43/60), LH (73.3%, 44/60), LH/FSH (75%, 45/60) and T +LH (66.7%, 40/60, χ2＝3.20, 2.25, 1.33, 3.38, all P＞0.05).The ROC-AUC of multiple indicators for diagnosis of PCOS were compared , AMH (0.880) was higher than T, LH and LH/FSH ratio (0.778, 0.760, 0.778, Z＝2.12, 2.46, 2.12, all P＜0.05), but no significant differences were found comparing with AMH and the combination of AMH +T, AMH+LH, AMH+LH/FSH and AMH+T+LH (0.892, 0.897, 0.898, 0.902, Z＝0.31, 0.45, 0.48, 0.59, all P＞0.05).Serum AMH levels were positively correlated with T , LH levels and LH/FSH ratio (r＝0.258, 0.241, 0.290, all P＜0.05), but not correlated with age in PCOS group (r＝-0.178, P＞0.05).In the control group, AMH levels had no correlations with T, LH levels and LH/FSH ratio (r＝0.025, 0.104, 0.111, P＞0.05), while negatively correlated with age (r＝-0.307, P＜0.05).The cutoff value of AMH for diagnosis of PCOS decreased with age .Conclusions The sensitivity of AMH for diagnosis of PCOS was higher than that of LH and LH /FSH ratio, and the sensitivity could be further improved by the combination with T or /and LH without reducing the specificity .Age-stratified cut-off values of AMH were better for accurate diagnosis of PCOS.

Objective To explore the establishment of a two-way referral system for the treatment of cervical diseases within a medical alliance. The two-way referral system was introduced to reduce the morbidity and mortality of cervical cancer through better management of patients'who have tested positive for cervical disease, screening effectively for early diagnosis and treatment of cervical precancerous lesions, and providing early interventions for cervical cancer patients. Methods The control group consisted of 2, 515 patients who had screened positive for cervical disease between January 2018 and December 2018 at one of four community health service centers that were not within the medical alliance. The experimental group consisted of 2, 384 patients who had screened positive for cervical disease at one of four community health service centers in the medical alliance. The control group was treated using the original management mode;the experimental group's treatment was managed within the two-way referral system, which included standardized screening, referral, follow-up, health education, and professional training. The hospital visit rates, time intervals from diagnosis to the start of interventions, detection rates, and treatment rates were observed for both groups of women. Results The hospital visit rates, detection rates, and treatment rates were higher for those in the experimental group than the control group. The time interval from receiving a diagnosis to the first hospital visit was (16.9±11.5) days for patients in the experimental group and (25.7±20.9)days for those in the control group. The difference was a statistically significant (-0.05). Conclusion The management of cases in a two-way referral system within a medical alliance facilitates patients receiving earlier diagnosis and treatment for cervical pre-cancerous lesions and malignant tumors. Such efficiency improvements may reduce morbidity and mortality as well as help control medical costs, all of which have long-term economic and social significance.