Objective To explore the relationship between the times of abortion and congenital and acquired uterine anomalies.Methods One hundred and eighty-five patients underwent diagnostic hysteroscopy following abortion were selected and diagnosed by hysteroscopy,then divided into congenital and acquired uterine abnormalities according to the morphology and the formation of uterine cavity lesions.The relationship of 1 times,2 times,equal or more than 3 times of different number of abortion and uterine congenital and acquired abnormalities were compared respectively.Results Diagnostic hysteroscopy revealed anomalies uterine cavity was 79.9％ (148/185),of them congenital uterine anomalies was 52.4％ (97/185),and acquired uterine pathologies was the most of 21.1％ (39/185),acquired uterine abnormalities was 21.1％ (39/185),and intrauterine adhesion was the most common of 11.9％ (22/185).Incidence of intrauterine adhesions of natural abortion with 1 times,2 times and 3 times or more were 7.4％ (5/68),14.1％ (11/78) and 15.4％ (6/39).Hysteroscopy showed that the detection rates of normal uterine cavity,congenital abnormalities,acquired uterine and congenital and acquired pathologies in 3 groups were 27.9％ (19/68),51.5％ (35/68),17.6％ (12/68)and 2.9％(2/68);17.9％(14/78),51.3％(40/78),24.3％(19/78) and 6.4％(5/78);10.3％(4/39),56.4％ (22/39),20.5％ (8/39) and 12.8％ (5/39),respectively,the differences were not significant (x2 =8.823,P=0.184).Conclusion Hysteroscopy is a simple and efficient tool in the early diagnosis of congenital and acquired uterine anomalies.Diagnostic hysteroscopy can be performed after the first miscarriage in order to early diagnose and treat congenital and acquired uterine pathologies.

Objective To explore the morbidity, risk factors and nursing of ventilator-associated pneumonia (VAP) in comprehensive ICU. Methods It was a retrospective survey. 98 mechanical ventilation (＞ 48 h) patients from Jan to Dec, 2009 in comprehensive ICU were reviewed using questionnaires to collect the clinical data. They were divided into the VAP and the non-VAP group. Several statistically significant risk factors were screened out with univarite analysis, then independent risk factors were determined with multiple Logistic regression. Results The morbidity of VAP was 35.7%. Univariate analysis showed that the level of APACHE Ⅱ score, duration of mechanical ventilation, whether primary lung disease, whether acid-suppressing agents, whether the semi-supine, whether accidental tube removal, oral care approach, whether attracted to subglottic were statistically significant risk factors of VAP. While multivariate Logistic regression analysis showed that the duration of mechanical ventilation, whether the semi- supine,whether attracted to subglottic were the major risk factors of VAP. Conclusions The occurrence of VAP is related with multiple factors. Application of comprehensive prevention strategies in accordance with these risk factors of VAP can reduce the morbidity of VAP effectively.

Objective To design and apply ventilator-associated pneumonia prevention checklist in ICU.Methods The ventilator-associated pneumonia prevention checklist was designed by referring to guidelines and related literature.The checklist was applied to ventilator-dependent patients.The head of nursing group evaluated prevention status of ventilator-associated pneumonia performed by nurses every day.Results After application of the checklist,the average indwelling time of tracheal catheter and the incidence of ventilator-associated pneumonia decreased among ICU patients.Conclusion Using the ventilator-associated pneumonia prevention checklist in quality management in the prevention of ventilator-associated pneumonia can shorten the average indwelling time of tracheal catheter,and reduce the incidence of ventilator-associated pneumonia,and the checklist can be promoted and applied.

Objective To study the safety and efficacy of transpedicular osteotomy en bloc lamina resection to treat thoracic spinal stenosis.Methods A retrospective study of 23 consecutive patients underwent transpedicular osteotomy en bloc lamina resection from June 2004 to December 2008,including 12 males and 11 females,with a mean age of 46 years(range,38-62 years)was conducted.The courses of diseases were 1.5 to 20 months with an average of 6.5 months.There were 18 cases caused by thoracic ossification of ligamentum flavum(OLF),4 cases caused by ossification of posterior longitudinal ligament(OPLL)and 1 case caused chondroma.Preoperative CT and MRI examinations showed that all patients got spinal cord compression.Preoperative ASIA Grade was A for 1 case,B for 3 cases,C for 7 cases and D for 13 cases.Postoperative neurological status was evaluated by ASIA grade system.Results The postoperative follow-up duration ranged from 16 to 58 months(mean 30 months).The operation time varied from 90 to 210 min,with the average of 163 min.Blood loss varied from 600 to 3200 ml,with the average of 2150 ml.Pedicle screws were used in 10 cases with T9-T12 stenosis,and dura excisions were repaired by lumbodorsal fascia in 5 cases.Cerebrospinal fluid leakage occurred in 2 cases.Postoperative ASIA grade showed that there was A for 1 case,B for 2 cases,C for 2 cases,D for 5 cases and E for 13 cases.Conclusion Transpedicular osteotomy is a good approach,which avoid sclerotic cortex and ossified ligamentum flavum,to resect en bloc lamina with with shorter operative time and less blood loss.

Objective To explore the effect of araloside on the proliferation and apoptosis of HeLa cells.Methods Human cervical cancer cell line HeLa was cultured in vitro,the experiment was divided into 4 groups as follows:blank group,araloside trea-ted groups(50,100,200 μg/mL).Normal saline and araloside (50,100,200 μg/mL)were gave,respectively.24,48 and 72 hours lat-er,the cells were collected.Cell proliferation was detected by MTT,cell apoptosis was determined by flow cytometry,the expression of pAkt1,pIкBα,NF-κB (p65),Bcl-2 and Caspase-3 were evaluated by western blot.Results Araloside obviously inhibited the pro-liferation and increased the apoptosis level of HeLa cells in a time-dose dependent manner.Moreover,Araloside significantly de-creased the phosphorylation of Akt1 and IκBα,reduced the expression of NF-κB(p65)and Bcl-2,whereas obviously increased Caspase-3 content.Conclusion Araloside could inhibit the proliferation and promote the apoptosis of HeLa cells via suppressing Akt/NF-кB signaling pathway.

Objective To explore the inhibition role of araloside on cervical cancer HeLa cell proliferation and migration to reveal the molecular mechanism of NF-κB in HeLa cell in the process of tumor suppression.Methods The in vitro cultured cervical cancer HeLa cell line served as the research object.The experiment was divided into the control group and araloside(200 μg/mL) treatment group(observation group).The change of proliferation and migration ability after 48 h were observed in the two groups.Western blot was used to detect the expression of NF-κB molecule and change of autophagy involved protein Beclin 1 and LC3B.Results Araloside could significantly inhibit the proliferation and migration of HeLa cells and the NF-κB signaling pathway,and promoted the expression of autophagy related molecule Beclin 1,Atg 5 and LC3B.Conclusion Araloside could inhibit the NF-κB signaling pathways,thus induces autophagy occurrence and influences the proliferation and migration of cervical cancer HeLa cells.

Objective To obtain a lasting and purified cell line of vascular smooth muscle cells (VSMCs) by primary culture, and to provide these test materials related research. Methods The primary and transfer culture was done by tissue - piece inoculationand trypsin digestion,respectively. The cells were frozen in liquid nitrogen,and cultured cells were identified by phase contrast microscopy and immunohistochemical SP kit. Results 85% of inoculated tissue pieces survived. More than 90% of VSMCs regrew in transfered culture. The frozen cells could recover their proliferation by several culture transfers. The VSMCs showed the typical "peak and valley" characteristics under microscopy. Immunohistochemical staining with antibody against SM - a - actin expression in these cells was positive. Conclusion The tissue - piece inoculation is a simple method for obtaining satisfactory VSMCs in short term.

We describe the prenatal diagnosis and postnatal follow-up of a fetus with a pericallosal lipoma diagnosed by MRI. The pregnant woman was admitted to Zhongnan Hospital of Wuhan University in February 2019. MRI examinations with multiple sequences and imaging methods were performed prenatally at 31 +6 and 38 +3 weeks of gestation, and at two days and three months postnatally. The MRI images showed that the corpus callosum was normal and the lesion was located around the corpus callosum, with high signal intensity on T1 weighted imaging, medium-to-high signal intensity on T2 weighted imaging, and low signal intensity on fat suppression sequence. No abnormal blood vessels were found on susceptibility-weighted imaging and time-of-flight magnetic resonance angiography sequences. Based on the prenatal and postnatal MRI findings, the tumor was clinically diagnosed as a pericallosal lipoma.

The application of biological technology and the deepening of tumor research have effectively improved the level of tumor diagnosis, treatment and clinical outcome prediction. However, the specific mechanisms of tumorigenesis and development are still unclear, and tumor drug resistance has also become an urgent problem that needs to be solved to improve the clinical outcome of patients. Considerable studies have shown that the extrachromosomal DNA (ecDNA) can promote tumorigenesis, development and drug resistance. EcDNA is a looser, rounded form of DNA with unique genetic properties that carry specific genes and regulatory elements. This paper will discuss the biological characteristics, tumor-promoting mechanisms and drug resistance-facilitating of ecDNA.

Objective To investigate the value of brain natriuretic peptide (BNP) detection in the diagnosis and treatment of heart failure patients with normal ejection fraction.Methods Totally 78 elderly patient were selected in our hospital,with left ventricular ejection fraction (LVEF) ≥45 ％,among which 52 cases of patients were consistent of heart failure criteria (heart failure group),27 cases with normal left ventricular diastolic function as control group.The echocardiographic indices of diastolic function and the change of the concentration of BNP were compared.Results As compared with heart failure group,BNP concentration (108.7 ± 32.2) ng/L vs.(190.3 ± 41.5) ng/L,left ventricular posterior wall thickness (11.3 ± 1.7) mm vs.(13.6 ± 1.4) mm,left ventricular mass index (119.3±10.2)g/m2 vs.(130.7±8.9)g/m2 were elevated in heart failure group (all P＜0.01).Conclusions BNP detection can be used for a diagnosis of heart failure as a simple and easy method.The BNP and ultrasound heart beat graph combination can improve heart failure diagnostic accuracywith normal ejection fraction in elderly patients.