Objective To observe and study the clinical efficacy of laparoscopy combined with hysteroscopy in treatment of obstruction of fallopian tube.Methods 72 cases of patients who were treated for fallopian tubal obstruction were selected as the research object,and they were randomly by simple randomization divided into two groups,the observation group and the control group,with 36 cases in each group.The hysteroscopic treatment was used in the control group,hysteroscopy combined with laparoscopy were treated in the observation group.Then operation effect and 1 years after surgery in pregnancy of the two groups were compared.Results In the control group,70 fallo-pian tube had 56 successful recanalization with the recanalization rate of 80%.At 3 months after operation it blocked 8,restenosis rate was 14.2%.In the observation group,68 fallopian tube had 62 successful recanalization with the recanalization rate of 91.1%,and at 3 months after operation it blocked 10,restenosis rate 16.2%.The recanalization rate in the observation group was significantly higher than that of the hysteroscopy wire group(χ2 =6.231,P <0.05). The restenosis rate was no significant difference between the two groups(P >0.05).The control group of 14 cases with intrauterine pregnancy,the pregnancy rate was 38.9%,1 cases of tubal pregnancy,the pregnancy rate was 2.7%.24 cases of pregnancy with intrauterine in the observation group,the pregnancy rate was 66.7%,2 cases of tubal pregnancy,the pregnancy rate was 5.4%.The intrauterine pregnancy rate in the observation group was signifi-cantly higher than that of the hysteroscopy group,there was significant difference(χ2 =5.568,P <0.05),fallopian tube pregnancy rate was no significant difference between the two groups(P >0.05 ).Conclusion Hysteroscopy combined with laparoscopy in treatment of fallopian tubal obstruction can make up for the deficiency of hysteroscopic treatment alone,it can greatly improve the fallopian tube recanalization rate and pregnancy rate after operation,it is worthy for clinical application.

Objective To investigate the effect of S100A8/A9 protein complex on the surface morphology and the F-actin network in human cervical carcinoma cell line,CasKi cells.Methods After being cultured with 20 ?g/ml S100A8/A9 protein complex,the cell skeleton of the CasKi cells were observed under a confocal scanning fluorescence microscope by staining the F-actin network.Atomic force microscopy(AFM) was employed to reveal the change of ultrastructure of the cell surface in vivo.ResultsAfter being cultured with the S100A8/A9 protein complex for 24 hours,the F-actin network disorder was revealed.Most of the F-actins distributed peripherally.The OD value of the F-actin decreased significantly from 92.42?5.16 to 57.67?3.70 after been treated with the S100A8/A9(t=5.268,P=0.000).The AFM showed a withdrawing morphology with reduced pseudopodia and destruction of stress fibers. Conclusion S100A8/A9 protein complex can change the ultrastructure of the surface of CasKi cells and its stress fibers by re-distributing of the F-actin in the cells.

Objective Based on the health standards for arsenic in drinking water recommended by WHO (0.01 mg/L) and adopted by decentralized rural water supply in China (0.05 mg/L), to explore the conditions of arsenic metabolism and levels of methylation in population consuming drinking water with different concentrations of arsenic. Methods Three hundred and forty-eight adults in Shanxi exposed to different concentrations of arsenic(≥0.05 mg/L, ≥0.01-0.05) in arsenic species , TAs , first methylation ratio (FMR) and SMR in lower exposure group and the control group. In higher exposure group, the FMR of adults aged over 60 years was significantly higher than that in groups of 18-39 years old and 40-49 years old (P0.05). Conclusion In higher exposure group, the 2nd reaction of the metabolic pathway is more active in female than that in male, and arsenic methylation capacity of the higher age group arise. No significant effects of gender and age on arsenic methylation capacity is found among population exposed to drinking water with lower level of arsenic.

Objective To study the effect of personalized enteral nutrition support in patients with laryngeal carcinoma after operation .Methods From June 2010 to April 2013 , 62 cases of laryngeal cancer patients received individualized enteral nutrition support as A group , and others 42 cases of laryngeal carcinoma after operation received commodity nutrition from January 2008 to May 2010 as B group.Then, nutrition index such as weight, prealbumin, albumin, total protein and so on, and complications, average hospitalization days, nutrition related costs , and time of wound stitches out between the two groups were detected and recorded respectively before operation , 7 th day and 14 th day after operation .Results Nutritional indexes in A group were significantly improved than those in B group , as well as the average hospitalization days , nutrition related costs , stitches out of the wound time between A group and B group , and the difference was statistically significant ( t=-12.900,-36.011,-13.762,respectively;P<0.05).Conclusions Personalized enteral nutrition support is one of the important means to promote the rehabilitation of postoperative patients with laryngeal carcinoma of nasal feeding homogenate , and self-made enteral nutrition is safe and effective , economic and simple , fewer complications , more in line with human physiological needs , and it is worthy of clinical application .

Objective To study the effect of full course nursing combined with rehabilitation nursing training on the rehabilitation of senile patients with cerebrovascular accidents.Methods A total of 120 elderly patients with cerebrovascular accidents in our hospital were divided into two groups.The control group was given rehabilitation nursing training.Combination group was given the whole course nursing combined with rehabilitation training.After 6 months of nursing,World Health Organization's Quality of Life Scale (WHOQOL-BREF),the scores of clinical nerve function defect (NIIHSS),and the clinical outcomes of two groups were compared.Results There was no significant difference in environmental score between the two groups (P ＞ 0.05).The total score of WHOQOL-BREF in the combined group was significantly than that of the control group(81.12 ± 11.53 vs.74.11 ± 11.16,P ＜0.01).There were no significant difference between the two groups in facial paralysis scores and upper limb strength scores (P ＞ 0.05).The total neurological deficit score of the combined group was significantly lower than that in the control group (18.48 ± 6.51 vs.24.50 ± 6.75,P ＜0.01).The total effective rate of the control group was significantly lower than that of the combined group (90.00％ vs.76.67％,P ＜ 0.01).Conclusion Full course nursing combined with rehabilitation training can significantly improve the quality of life and reduce neurological impairment in elderly patients with cerebrovascular accident,and thereby improve their clinical efficacy.

Objective To study the effect of full course nursing combined with rehabilitation nursing training on the rehabilitation of senile patients with cerebrovascular accidents.Methods A total of 120 elderly patients with cerebrovascular accidents in our hospital were divided into two groups.The control group was given rehabilitation nursing training.Combination group was given the whole course nursing combined with rehabilitation training.After 6 months of nursing,World Health Organization's Quality of Life Scale (WHOQOL-BREF),the scores of clinical nerve function defect (NIIHSS),and the clinical outcomes of two groups were compared.Results There was no significant difference in environmental score between the two groups (P ＞ 0.05).The total score of WHOQOL-BREF in the combined group was significantly than that of the control group(81.12 ± 11.53 vs.74.11 ± 11.16,P ＜0.01).There were no significant difference between the two groups in facial paralysis scores and upper limb strength scores (P ＞ 0.05).The total neurological deficit score of the combined group was significantly lower than that in the control group (18.48 ± 6.51 vs.24.50 ± 6.75,P ＜0.01).The total effective rate of the control group was significantly lower than that of the combined group (90.00％ vs.76.67％,P ＜ 0.01).Conclusion Full course nursing combined with rehabilitation training can significantly improve the quality of life and reduce neurological impairment in elderly patients with cerebrovascular accident,and thereby improve their clinical efficacy.

Objective:To investigate the prognostic value of proprotein convertase subtilisin/kexin type 9 (PCSK9) and blood lipid indexes in patients with sepsis.Methods:Patients with sepsis or septic shock who were ≥ 18 years old and met the Sepsis-3.0 diagnostic criteria admitted to the department of critical care medicine of Binzhou Medical University Hospital from January to October 2021 were enrolled. Healthy adults at the same period were selected as healthy control group. Baseline characteristics, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) and sequential organ failure assessment (SOFA) score were recorded. Venous blood samples were collected within 24 hours after diagnosis, and serum PCSK9 was determined by enzyme-linked immunosorbent assay (ELISA) at 1, 3 days and 5 days. Meanwhile, high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglyceride (TG) and lipoprotein A were detected. The differences of each index between sepsis group (28-day death group and survival group) and healthy control group were compared. Meanwhile, the indexes of patients with different severity and 28-day prognosis in sepsis group were compared. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the predictive value of PCSK9 and blood lipid for the prognosis of sepsis. Multivariate Logistic regression was used to analyze the influencing factors for the prognosis of sepsis, and the Kaplan-Meier survival curve at 28th day was drawn.Results:There were 50 patients in sepsis group (including 19 patients with sepsis, 31 patients with septic shock) and 27 patients in healthy control group. In the sepsis group, 19 patients died and 31 patients survived within 28 days. The serum PCSK9 in the sepsis group was significantly higher than that in the healthy control group [μg/L: 223.09 (198.47, 250.82) vs. 188.00 (165.27, 214.90), P < 0.01], and HDL-C, LDL-C, TC and lipoprotein A were significantly lower than those in the healthy control group [HDL-C (mmol/L): 0.82±0.35 vs. 1.45±0.24, LDL-C (mmol/L): 1.53 (1.14, 2.47) vs. 2.89 (2.55, 3.19), TC (mmol/L): 2.03 (1.39, 2.84) vs. 4.24 (3.90, 4.71), lipoprotein A (g/L): 8.80 (5.66, 17.56) vs. 27.03 (14.79, 27.03), all P < 0.01]. PCSK9 in the sepsis death group was higher than that in the survival group [μg/L: 249.58 (214.90, 315.77) vs. 207.01 (181.50, 244.95), P < 0.01], and the HDL-C, LDL-C and TC were lower than those in the survival group [HDL-C (mmol/L): 0.64±0.35 vs. 0.93±0.30, LDL-C (mmol/L): 1.32±0.64 vs. 2.08±0.94, TC (mmol/L): 1.39 (1.01, 2.23) vs. 2.69 (1.72, 3.81), all P < 0.01]. With the progression of the disease, the PCSK9 in the sepsis death group and the survival group was significantly lower than that within 1 day of diagnosis (all P < 0.05). ROC curve analysis showed that PCSK9 had higher predictive value of 28-day death than HDL-C, LDL-C, TC [area under ROC curve (AUC) and 95% confidence interval (95% CI): 0.748 (0.611-0.885) vs. 0.710 (0.552-0.868), 0.721 (0.575-0.867), 0.702 (0.550-0.854)]. Multivariate Logistic regression analysis showed that PCSK9 was an independent risk factor affecting the 28-day prognosis of sepsis (β value was 1.014, P = 0.020). Kaplan-Meier survival curve analysis showed that when PCSK9 ≥ 208.97 μg/L, with the increase of PCSK9, the 28-day survival rate of sepsis patients decreased significantly. Conclusions:PCSK9, HDL-C, LDL-C and TC can all predict the 28-day prognosis of patients with sepsis. The prognostic value of PCSK9 is the highest. PCSK9 is an independent risk factor affecting the prognosis of sepsis. In the early stage of the disease, PCSK9 may have a good predictive value for the prognosis of sepsis. When PCSK9 ≥ 208.97 μg/L, the 28-day survival rate decreased significantly.