15 oocytes group than in the ≤15 oocytes group. All parients with the acute abdmen caused by ectopic and heterotopic pregnancy had tubal factor causing infertility. The misdiagnostic rate was significantly lower of reproductive-specialty doctors than non-reproductivespecialty doctors. Conclusion Excessive oocytes induced by ovarian hyperstimulation and tubal damage were main risk factors of acute abdomen. To reduce the misdiagnosis, non-reproductive-specialty doctors should know about IVF-ET and patients should be informed about the occurrence of these procedure related complications.

Objective Less than a decade ago, ER-positive and PgR-positive diagnostic criteria decrease from 10%to 1%. Up to 20%of current immunohistochemical determinations of ER and PgR worldwide may be inaccu-rate. It is necessary to study patients whose tumors are between luminal A (LABC) and triple-negative (TNBC) breast cancer. Methods Survival analysis grouping by the level of positive hormone receptor, CK5/6 and EGFR, and en-docrine therapy was carried out in 206 patients whose tumors were junction zone between LABC and TNBC. Re-sults There were no significant differences between the low-positive (1%-9%) HR group and positive HR (10%-19%) group in overall survival (OS) and disease-free survival (DFS). There was an apparent difference between the nor-mal-like group and basal-like group in OS and DFS, and between the patients with and without endocrine therapy. There were significant differences between death and tumor progression for EGFR and CK5/6, chemotherapy, and endocrine therapy. Conclusions We conclude that EGFR and CK5/6 are better prognostic indicators than the lev-el of positive HR in patients whose tumors are junction zone at the junction zone between LABC and TNBC. En-docrine therapy can be highly beneficial to these patients regardless of the positive HR level.

Objective To investigate the effects and outcomes of four procedures for hysterectomy. Method Retrospectively, we analyzed the clinical characteristics of 756 cases who respectively received hysterectomy by total abdominohysterectomy (TAH,260 cases), modified abdominohysterectomy (MAH, 180 cases), transvaginal hysterectomy (TVH, 106 cases), or laparoscopic assisted vaginal hysterectomy (LAVH)(210 cases) and compared their effects and outcomes. Results The average operation time of TAH(98 ?23)minutes, MAH(67?18)minutes, TVH (63?19)minutes and LAVH(99?35)minutes. The average operation time of LAVH and TAH groups was significantly longer than that of TVH and MAH groups (P

Objective To explore the effects of information support on anxiety and sleeping quality of puerpera with postpartum hemorrhage. Methods A total of 120 puerpera with postpartum hemorrhage who were hospitalized and delivered in our hospital from August 2011 to August 2014 were selected. They were randomly assigned to a control group and an experimental group, with 60 in each. The control group was given regular postpartum care, and the experiment group was given information support on the basis of regular care. Sleep quality, anxiety degree and mental state of puerpera in the two groups were compared. Results SAS score in the experimental group was significantly lower than that in the control group, and the difference was statistically significant (P<0.05). The number of puerpera with normal health state and the number of puerpera with mild anxiety in the experimental group were both more than those in the control group, and the number of puerpera with moderate to severe anxiety was less than that in the control group. The differences above were all statistically significant (P<0.05). Total PSQI score in the experimental group was significantly lower than that in the control group, and the sleeping quality in the experimental group was better. All the differences above were statistically significant (P<0.05). Total SCL-90 score in the experimental group was significantly lower than that in the control group, and scores of somatization, terror, anxiety, depression and interpersonal relationship were lower than those in the control group. All the differences above were statistically significant (P<0.05). Scores of hostility, paranoid, psychoticism and OCD compared between the two groups were similar, and the differences were not statistically significant (P>0.05). Conclusion Information support for puerpera with postpartum hemorrhage is able to reduce anxiety degree, improve sleeping quality, and enhance mental state, which is beneficial for the recovery of puerpera.

Objective To investigate the prevention effects of antithrombotic pressure pump combined with graduated compression stockings (GCS) on incidence of postoperative lower extremity deep venous thrombosis (LEDVT) in breast cancer patients. Methods A total of 363 cases of breast cancer patients after operation were divided into routine care group (124 cases) according to the method of random number table, pressure group (127 cases) and combined treatment group (112 cases). The routine care group received conventional LEDVT ankle pump exercises. The pressure group used GCS besides the routine intervention. The combined group received GCS and antithrombotic pressure pump besides the routine intervention. Then the levels of thrombosis markers, D-dimers,platelets, and incidences of LEDVT were examined in the three groups. Results Before operation, no significant differences between the levels of prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT), fibrinogen, plasma D-dimer and platelets (P>0.05). After operation, the levels of PT, APTT, TT, fibrinogen, plasma D-dimer and platelets in three groups were (10.22 ± 0.76) s, (27.24 ± 3.68) s, (14.60 ± 0.88) s, (2.94 ± 0.59) mg/L, (0.31 ± 0.21) mg/L, (288.48 ± 71.29) × 109/L, (10.73 ± 0.79) s, (27.35 ± 2.54) s, (14.71± 1.76) s, (4.12±1.09) mg/L, (0.46±0.38) mg/L, (284.26±70.98) ×109/L and (11.11±0.64) s、(28.52± 2.74) s, (14.33± 1.02) s, (4.42±1.20) mg/L, (0.35±0.33) mg/L, (258.79±62.35) ×109/L, respectively. There was significant difference among these groups (F=5.71-87.31, P<0.01). The differences on PT, APTT, fibrinogen and D-dimers between combined treatment group and routine care group were statistically significant (P<0.05). The differences on PT, fibrinogen and platelets between combined treatment group and pressure group were statistically significant (P<0.05). The differences on PT, APTT, fibrinogen and D-dimers between routine care group and pressure group were statistically significant (P<0.05). Through one months of follow-up, the incidence of LEDVT in routine care group, pressure group and combined treatment group were 12.10％(15/124),3.15％(4/127),0.89％(1/112), respectively. There was significant difference among these groups (χ2=16.279,P<0.01). Conclusions The application of antithrombotic pressure pump combined with GCS significantly improves the postoperative hypercoagulable states in breast cancer patients. The combined treatment reduces the incidence of LEDVT without bleeding risk. Therefore, antithrombotic pressure pump combined with GCS is recommended for clinical use in the postoperative breast cancer patients.

Objective:To explore the relationship between the quality of professional life and depression tendency of nurses.Methods:From November 2018 to January 2019, 242 nurses from some third-class A hospitals were randomly selected as the subjects. The Quality of Professional Life Scale of Nurses were used to evaluate the status of nurses' professional life quality, and the depression state of nurses was measured by Self Rating Depression Scale, and the relationship between them was analyzed.Results:The total score of professional life of nurses was (156.86±26.60) , including family work balance (24.60±4.73) , working environment (77.30±14.78) , workload (36.34±6.11) and social environment (18.62±4.21) . The total score of depression tendency of nurses was (43.76±9.50) , the overall depression tendency rate was 64.46% (156/242) , and the incidence rates of moderate and severe depression tendency were 23.55% (57/242) and 10.74% (26/242) , respectively. There was negative correlation between the total score of professional quality of life and each dimension score with depression tendency ( P<0.05) ; Multiple linear regression analysis showed that high quality of professional life was the protective factor of depression tendency of nurses ( P<0.001) . Conclusion:The quality of professional life of nurses is related to depression tendency, and the high quality of professional life is not prone to depression.

Objective:To explore the relationship between the quality of professional life and depression tendency of nurses.Methods:From November 2018 to January 2019, 242 nurses from some third-class A hospitals were randomly selected as the subjects. The Quality of Professional Life Scale of Nurses were used to evaluate the status of nurses' professional life quality, and the depression state of nurses was measured by Self Rating Depression Scale, and the relationship between them was analyzed.Results:The total score of professional life of nurses was (156.86±26.60) , including family work balance (24.60±4.73) , working environment (77.30±14.78) , workload (36.34±6.11) and social environment (18.62±4.21) . The total score of depression tendency of nurses was (43.76±9.50) , the overall depression tendency rate was 64.46% (156/242) , and the incidence rates of moderate and severe depression tendency were 23.55% (57/242) and 10.74% (26/242) , respectively. There was negative correlation between the total score of professional quality of life and each dimension score with depression tendency ( P<0.05) ; Multiple linear regression analysis showed that high quality of professional life was the protective factor of depression tendency of nurses ( P<0.001) . Conclusion:The quality of professional life of nurses is related to depression tendency, and the high quality of professional life is not prone to depression.

Objective:To evaluate the efficacy and safety of Chinese medicine Jianpi Antai formula in infertile women undergoing in vitro fertilization-embryo transfer(IVF-ET).Methods:A total of 300 infertile women who underwent 2 frozen embryo transfer procedures at the Reproductive Medicine Center,Sir Run Run Shaw Hospital were included in the study.The participants were randomly divided into study group and control group.The study group received routine medication plus the Jianpi Antai formula during the period of embryo transfer,while the control group received routine medication only.The general condition,embryo implantation rate,clinical pregnancy rate,live birth rate,and the blood routine and liver and kidney function were evaluated and compared between two groups.Results:There were 277 cases who completed the study,including 134 in the study group and 143 in the control group.The embryo implantation rate(68.7%vs.55.9%),the clinical pregnancy rate(56.7%vs.44.8%)and the live birth rate(50.7%vs.37.8%)in the study group were all higher than those in the control group(all P＜0.05).Subgroup analysis revealed that in patients of advanced age(≥35 years)and those with decreased ovarian reserve function(anti-Müllerian hormone＜1.68 ng/mL),the embryo implantation rate,clinical pregnancy rate,and live birth rate in the study group were all higher than those in the control group(all P＜0.05).During the follow-up period,there were no abnormalities in the basic vital signs of both groups,and no adverse events were reported.Conclusion:Jianpi Antai formula can safely improve the embryo implantation rate in infertile women undergoing IVF-ET,reduce the embryo miscarriage rate,increase the live birth rate as well as improve the clinical outcomes.

Standardized training of residents is an important measure to cultivate medical talent.Hysteroscopy is an important teaching content in the standardized training of obstetrics and gynecology residents.A variety of teaching and training methods has been employed in department of obstetrics and gynecology in Sir Run Run Shaw Hospital affiliated to School of Medicine of Zhejiang University including theory teaching,teaching rounds,PBL,trainee training,one to one training,skill assessment to improve the quality of the standardized training and the practical ability of the residents.

Ovarian tissue cryopreservation and transplantation is the only way to preserve fertility for female cancer patients in prepubertal ages and those who cannot delay radiotherapy or chemotherapy.However,the success rate of cryopreservation and transplantation of ovarian tissue is still low at present due to the risk of ischemia and hypoxia of the grafted tissues.Abnormal activation of primordial follicles and ischemia-reperfusion injury after blood supply recovery also cause massive loss of follicles in grafted ovarian tissues.Various studies have explored the use of different drugs to reduce the damage of follicles during freezing and transplantation as well as to extend the duration of endocrine and reproductive function in patients with ovarian transplantation.For example,melatonin,N-acetylcysteine,erythropoietin or other antioxidants have been used to reduce oxidative stress;mesenchymal stem cells derived from different tissues,basic fibroblast growth factor,vascular endothelial growth factor,angiopoietin 2 and gonadotropin have been used to promote revascularization;anti-Müllerian hormone and rapamycin have been used to reduce abnormal activation of primordial follicles.This article reviews the research progress on the main mechanisms of follicle loss after ovarian tissue transplantation,including hypoxia,ischemia-reperfusion injury and associated cell death,and abnormal activation of follicles.The methods for reducing follicle loss in grafted ovarian tissues are further explored to provide a reference for improving the efficiency of ovarian tissue cryopreservation and transplantation.