Objective To investigate the expression of neive growth factor (NGF) in the ectopic endometrium in adenomyosis patients,and explore the relationship between NGF expression and innervation or pain scales.Methods From Mar.2009 to Oct.2009,45 adenomyosis patients undergoing hysterectomy in Obstetrics and Gynecology Hospital of Fudan University were enrolled in this study,which were classified into 33 cases in pain group and 12 cases in non-pain group based on symptom.The degree of dysmenoreal,chronic pelvic pain and dyspareunia was evaluated by visual analogue scale,including no pain,mild to moderate pain and severe pain group.In the mean time,26 patients with leiomyoma or cervical intraepithelial neoplasia Ⅲ (CIN Ⅲ)undergoing hysterectomy were defined as control group.Ectopic endometrium from experimental group and eutopic endometrium from control group were collected in the surgery.The expression of NGF was examined by immunohistochemistry.The density of protein gene product (PGP)9.5 positive nerve fibers was detected by immuno-fluorescence.Results The NGF level and the density of PGP 9.5 positive nerve fibers in adenomyosis pain group (0.25 ± 0.08,16 ± 8) were higher than adenomyosis painless (0.19 ± 0.05,P =0.007 ; 11 ± 5,P =0.018) and control group (0.18 ± 0.05,P =0.000;9 ± 4,P =0.000).The NGF level and the density of PGP9.5 positive nerve fibers in severe dysmenorrheal group(0.29 ± 0.07,19 ± 10) were higher than mild to moderate dysmenorrheal (0.22 ± 0.07,P =0.018 ; 13 ± 4,P =0.035) and painless group (0.18 ± 0.05,P =0.000 ; 11 ± 5,P =0.006) of adenomyosis patients.There was no difference of NGF level and the density of PGP 9.5 positive nerve fibers in chronic pelvic pain group and no chronic pelvic pain group of adenomyosis patients,so was dyspareunia group and no dyspareunia group.Conclusion The increased NGF level of adenomyosis nodules and improving innervation might be involved in the mechanism of adenomyosis related pain.

Objective To investigate the relationship between insulin resistance and endogenous androgens at early and late phase of postmenopause.Methods A total of 105 women with early postmenopause (≤5 years since menopause) and 107 women with late postmenopause (≥ 10 years since menopause) were enrolled in this study.In the mean time,those women were classified into normal weight [body mass index (BMI),BMI ＜24 kg/m2] group and overweight (BMI≥24 kg/m2) group.Sex hormonebinding globulin (SHBG),testosterone (T),dehydroepiandrosterone-sulfate (DHEA-S),fasting blood glucose(FBG),fasting insulin (FINS)levels were measured and then calculated free androgen index(FAI) and homeostatic model assessment of insulin resistance (HOMA-IR).The relationship between sex hormones and insulin resistance was analyzed by partial correlation and multiple linear regression analyses.Results Compared to early postmenopausal women,late postmenopausal women had higher FINS [(7.9 ± 6.6) mU/L versus (6.6 ±4.0) mU/L] and HOMA-IR(2.1 ± 1.9 versus 1.7 ± 1.1),but they had lower DHEA-S [(0.9 ± 0.5) mg/L versus (1.1 ± 0.5) mg/L,all P ＜ 0.05)].Both in early postmenopausal and late postmenopausal groups,overweight women had higher HOMA-IR (early group,2.2 ± 1.0 versus 1.2 ±0.9 ; late group,2.8 ± 2.6 versus 1.6±1.1)and FINS early group[(6.9±2.9) mU/L versus (4.6±2.0) mU/L] ;late group [(10.2 ± 9.3) mU/L versus (6.4 ± 3.6) mU/L] than those at women with normal weight group(all P ＜ 0.05).In early postmenopausal group,overweight women had lower SHBG [(52 ±37) nmol/L versus (71 ±37) nmol/L] and higher FAI(2.5 ±2.1) versus (1.3 ± 1.1) than those at normal weight women group(all P ＜ 0.05).In late postmenopausal group,overweight women had higher DHEA-S (1.0 ± 0.5) mg/L versus (0.8 ± 0.4) mg/L (P ＜ 0.05).The analyses suggested that in early postmenopausal group,SHBG was correlated negatively with FINS and HOMA-IR (β =-0.386,P ＜ 0.05 ;β =-0.553,P ＜0.05),DHEA-S was correlated positively with FBG (β =0.348,P ＜ 0.05) in early postmenopausal group.FAI was correlated positively with FBG in late postmenopausal group (β =0.505,P ＜ 0.05).Conclusions The increased androgenic activities are associated with insulin resistance after of menopause.These correlations are different at different stages of postmenopause,which SHBG levels correlate with high risk of insulin resistance and DHEA-S levels correlates with high blood glucose levels at early postmenopause and FAI correlates with high blood glucose levels at late postmenopause.

Purpose　To observe the changes of dynorphin-like immunoreactivities of neurons in some rat brain nuclei that are related to analgesia following exogenous administration of melatonin.　Methods　The experimental rats were divided into two groups, injected intraperitoneally with melatonin 110 mg/kg and with vehicle, respectively. One hour after the injection, the rat brain was processed for coronal sections. The sections were stained with immunohistochemical ABC technique. The integral optical density (IOD) of the stained section was measured by the computer-assisted image processing technique.　Results　Dynorphin-like immunoreactivities in the supraoptic nucleus and nucleus raphe dorsalis showed obvious reduction following the single injection of melatonin.IOD values in the above nuclei were decreased significantly (P<0.01) with the melatonin treatment. In the paraventricular nucleus of hypothalamus, periaqueductal gray and nucleus raphe magnus, there was no difference (P>0.05) about the IOD values between melatonin-treated group and vehicle-treated group.　Conclusions　Melatonin may result in the decrease of dynorphin content in the supraoptic nucleus and nucleus raphe dorsalis.

Objective To explore the effects of daidzein (DA) on the expressions of estrogen receptors (ER) and peroxisome proliferator-activated recepor γ (PPARγ) in osteoblasts and the influence of estrogen on these effects.Methods A mouse osteoblastic cell line MC3T3-E1 cultured in α-MEM containing 2％ FBS was treated by 0.1 and 10 μmol/L DA.ER antagonist ICI182780 and PPARγ antagonist GW9662 in 0.1 μmol/L was added as required,and an equivalent amount of phosphate buffer solution (PBS) was used as control.For the study on estrogen effect,the cells were treated by DA in the serum-free medium with or without 10 nmol/L 17β-estradiol (E2).The expressions of ERa,ERβ and PPARγ were determined by real-time RT-PCR and Western blot analysis,respectively.Results DA inhibited ER,expression but stimulated PPARγ expression in the cells at the concentration of 0.1 and 10 μmol/L.The down-regulation of ERα by DA could be blocked by ICI182780,whereas the up-regulation of PPARγ could be repressed by GW9662 in transcription levels.Furthermore,the inhibitory effect of DA on ERβ expression was markedly enhanced,while its stimulatory effect on PPARγ expression was almost lost in serum-free medium with 10 nmol/L 17βestradiol as determined by real-time RT-PCR.Conclusions Besides its direct roles in ERs and PPARγ mediated gene transcriptions,DA could exert indirect effect on cellular pharmacological responses by altering ER and PPARγ expressions.The predominant influence on receptors expression probably involved in the time-related biphasic effects of DA on osteogenesis,which was supposedly influenced by estrogen level.

Objective To study the perioperative comprehensive rapid rehabilitation care for single hole thoracoscopic lobectomypatients.Methods Clinical data of 68 cases with single-hole thoracoscopic lung resection were retrospectively analyzed, and were randomly divided into observation group(n=34) and control group(n=34), given perioperative rapid rehabilitation comprehensive nursing and routine nursing, respectively.Results Observation group had lower incidence rate and higher nursing satisfaction, and there were no died patients and all 68 patients were recovered after actively symptomatic treatment and careful nursing.Conclusion Single hole thoracoscopic pulmonary lobectomy is featured by relieving pain, shorten treatment courses, rapid recovery and shorter hospitalization time.

Objective To study the perioperative comprehensive rapid rehabilitation care for single hole thoracoscopic lobectomypatients.Methods Clinical data of 68 cases with single-hole thoracoscopic lung resection were retrospectively analyzed, and were randomly divided into observation group(n=34) and control group(n=34), given perioperative rapid rehabilitation comprehensive nursing and routine nursing, respectively.Results Observation group had lower incidence rate and higher nursing satisfaction, and there were no died patients and all 68 patients were recovered after actively symptomatic treatment and careful nursing.Conclusion Single hole thoracoscopic pulmonary lobectomy is featured by relieving pain, shorten treatment courses, rapid recovery and shorter hospitalization time.

Objective To explore the application effect of teach-learn-do integration teaching mode on the course of ‘Fundamental nursing technique’ teaching. Methods We randomly selected one class from each of two 2011 grade and 2012 grade classes as control group and another two classes as experimental group. The students in the experimental group underwent reform teaching method comparing with traditional teaching method used in the control group. In the experimental classes, we reduced the rate of theory and increased the the practice, used the self-written teach-learn-do material, built up double-teaching team, utilized diverse teaching methods. The students in the control group were taken the learning of theory first and then practice this traditional teaching mode. After the course, the theory and skill assessment had been evaluated and compared between two groups. Results The scores of two classes in the experimental group acquired (90. 46 ± 5. 65) score, (87. 41 ± 5. 37) score better than (88. 46 ± 6. 35), (85. 53 ± 6. 45) of the control group, the skill scores (89. 52 ± 2. 30), (88. 48 ± 2. 48) in the experimental group compared with (88. 61 ± 2. 01), (87. 06 ± 3.66) in the control group (t =2. 327, 2. 983, 2. 296, 3. 412;P <0. 05). Conclusions Teach-learn-do teaching method can effectively resolve the gap between theory and practice, enhance the teaching quality of‘Fundamental nursing technique’ , and is adapt the teaching of ‘Fundamental Nursing Technique’ .