ObjectiveTo discuss the effect of health education pathways in old patients undergoing laparoscopic cholecystectomy. Methods62 old patients undergoing iaparoscopic cholecystectomy were divided into the control group and the observation group, each group included 31 patients. The control group used the traditional method of health education, and the observation group adopted health education pathways. The satisfaction degree of patients with nursing and incidence of postoperative complication were compared between the two groups using χ2 test and t test. ResultsThe satisfaction degree of patients with nursing was higher and incidence of postoperative complication was lower in the observation group com-pared with those of the control group. ConclusionsHealth education clinical pathway can raise the edu-cation ability of nurses, increase the satisfaction degree of patients, reduce the complications and improve the serf- guard ability of the old people.

Objective To compare the therapeutic effects of two different intervention methods in the treatment of Navelbine leakage.Methods 40 cases with Navelbine leakage were collected and randomly divided into the control group and the observation group in equal number.Local block therapy in earlier period was used in the control group,and non-local block therapy was adopted in the observation group.Then the therapeutic effects of the two methods were compared.Results The differences of effect between the observation group and the control group were significant.Conclusions Local medicine injection in earlier period,wet compress and microwave physiotherapy after 24 hours is more effective than the local block in earlier period in the treatment of Navelbine leakage.It may shorten the time of pain and detumesccnce obviously,so it is worth popularizing clinically.

With the concepts of minimal invasive surgery and precision medicine embedding deeply in modern medicine, traditional clinical treatment strategies are constantly updated due to the rapid progression of medical research. Systematic dissection of the regional lymph nodes is a key component in the surgical therapy of gynecologic malignancies, however it may result in a series of complications, such as lower extremity lymphedema, deep venous thrombosis, immune disorders and so on, which seriously impact the patients' quality of life. The necessity of systematic lymphadenectomy and the extent of lymph nodes resection have always been one of the most controversial issues in gynecologic oncology. In recent years, the extensive application of sentinel lymph node (SLN) technology has been increasingly used in the treatment of gynecologic malignancies, which may provide important guidance on this issue. This article reviews the clinical application status, detection methods, detection efficiency, and current controversies regarding SLN mapping and biopsy in cervical cancer, endometrial cancer, ovarian cancer and vulvar cancer, discussing the application value of SLN technology in gynecologic oncology.

Objective To investigate clinical value of three-dimensional transvaginal sonography (3D-TVS) in the diagnosis of septate uterus and the relationship between its parameters and adverse pregnancy.Methods From Mar.2010 to Sept.2011,73 patients (aged 23-35 years) with septate uterus who were diagnosed by 3D-TVS in Fujian Province Maternal and Child Health Hospital were enrolled in this retrospective study.The septum width,septum angle,septum length and the length of remaining uterine cavity were measured among the patients with subseptate uterus,and then,the distortion rate was calculated.The hysteroscopic surgery was used as the gold standard,and the diagnostic titer of 3D-TVS in the diagnosis of septate uterus was determined.Receiver operating characteristic curve (ROC) were plotted to evaluate the diagnostic titer of uterine parameters measured by 3D-TVS in predicting the adverse pregnancy outcome among patients with subseptate uterus.Univariate logistic regression was used to analyze the effectiveness of uterine parameters on adverse pregnancy outcome.Results Using hysteroscopic surgery as the gold standard,the coincidence rate of diagnosis of septate uterus by 3D-TVS was 94％ (69/73).Among the patients with septate uterus,25％ (17/69)were complete septate uterus,75％ (52/69) were subseptate uterus.Among patients with subseptate uterus,the septum length [(2.2 ± 0.6) cm] and distortion rate in patients with adverse pregnancy(0.60 ± 0.10)were significantly higher than those without adverse pregnancy [(1.5 ±0.6) cm,0.43 ±0.13,both P ＜0.05].However,no significant difference in the width,angle and length of septum were observed between the two groups (P ＞ 0.05).The area under ROC curve (AUC) of septum length and distortion rate in determining adverse pregnancy were 0.833 (95％ CI:0.721-0.944) and 0.800 (95％ CI:0.671-0.929),respectively.The optimal cutoff point of septum length was 1.94 cm,with the sensitivity was 74.3％ and the specificity was 76.5％ ; the optimal cutoff point of distortion rate was 0.48,with the sensitivity was 77.1％ and the specificity was 76.5％.The expectation morbidity ratio of adverse pregnancy was 2.717,3.067 and 0.514 by every adding level of septum length,distortion rate,and length of remaining uterine cavity,respectively.Conclusions 3D-TVS showed high accuracy in diagnosis of septate uterus.The septum length and distortion rate may predict the risk of adverse pregnancy,and the value of them can be used for screening adverse pregnancy in clinical practice.

Objective To compare the advantages and disadvantages of the amplification refractory mutation system -polymerase chain reaction (ARMS-PCR) with restriction fragment length polymorphism polymerase chain reaction(RFLP-PCR) technology, then explore its application in detection and analysis of single nucleotide polymorphism (SNP). Methods By using ARMS-PCR and RFLP-PCR the polymorphisms of the MMP-2 in cervical cancer and the normal-control group were analyzed. The research sites were-1306 C/T.The final result was verified by DNA sequencing. Results The results of amplified used ARMS-PCR showed that the genotypes of the SNP site in MMP-2 gene promoter were CC, CT, TT, and the DNA fragments were corresponding with the results of DNA sequencing. Conclusion ARMS-PCR technology has the advantages of lower cost time-saving simple operation and reliable results, while has a high value for research of SNP.

Objective To investigate the differences in psychological problems and behaviors between asth-matic and nonasthmatic children,and to evaluate the psychological interventions. Methods Behaviors and psycholog-ical actions were investigated in the 126 children with asthma and 126 healthy children, after psychological interven-tions of 3 and 6 months,the effects were evaluated in 28 asthmatic children. Results Behavioral and psychological problems were more prevalent in asthmatics than nonasthmaties, psychological and behavioral problems were different in asthmatic children of different severity and gender, psychological and behavioral interventions as well as drug ther-apy have beneficial effects on controlling of asthmatic symptoms and improving the pulmonary function, it could cor-rect and cure the bad behavioral and psychological problems and improve the quality of life. Conclusion Asthma contributes to the development of behavioral and psychological problems in children. Psychological and behavioral in-tervention in children with asthma has many positive effects on controlling the symptoms and improving the pul-monary function,it could correct and cure the bad behavioral and psychological problems and improve the quality of life.

Objective To explore the effects of homocysteine (Hcy) on neural stem cell (NSC) proliferation and the mRNA expression level of Notch1 and Hes1 related Notch signaling pathway from neonatal rats in vitro. Methods NSCs from neonatal rats were cultured by serum-free culture method in vitro. Cells were divided into four groups: control group (Hcy-C), low dose Hcy (Hcy-L) group, middle dose Hcy (Hcy-M) group and high dose Hcy (Hcy-H) group. NSCs were iden- tified by immunofluorescent staining using the antibodies against Nestin, β-tubulin Ⅲ and GFAP. The proliferation ability of NSCs was detected by MTT. The mRNA expressions of Notch1 and Hes1 were detected by Real-time PCR. Results In the serum free suspension medium, neurospheres that consisted of a great number of nestin-positive cells were found. β-tu- bulin Ⅲ positive neurons and GFAP positive astrocytes were detected by immunofluorescence staining on the 6 th day of cell induction. MTT assay showed that the cell viability was significantly lower in three Hcy treatment groups than those of con- trol group (P ＜ 0.05). And the effect of concentration-dependent was observed. The results of RT-PCR showed that mRNA expression of Hes1 was significantly lower in three Hcy treatment groups than that in control group (P ＜ 0.05). The mRNA ex- pression of Notch1 was significantly lower in Hcy-H group than that of other three groups (P ＜ 0.05). The mRNA expression of Notch1 was significantly lower in Hcy-M group than that of Hcy-L group and control group (P ＜ 0.05). Conclusion Hcy could inhibit the proliferation of NSCs by down-regulating mRNA expression levels of Notch1 and Hes1 genes related to Notch signal pathway.

Objective The aim of this article is to research the radical mastoidectomy and primary tympanoplasty to attain radical cure of the mastoid focus as well as rebuilding the sound- conducting structure of the tympanic cavity to improve the audition. Method The autobone and temporal fascia were taken as the transplants after the radical mastoidectomy under microscopy, and then to carry out the operation of Portmann｀ s tempanoplasty of 2nd and 3rd types of 2nd class.Result Non of the cholesteatoma was relapsed after follow- up for 1～ 4 years.The efficiency rate of tympanoplasty is of 89.47% .The average audition increased was 19 dB HL. Conclussion Radical operation for cholesteatoma should be associated with tympanoplasty if having condition. We recommend that the opening tympanoplasty should be used, and use autobone as a artificial auditory ossicles.

The IL-8 and MMP-7 genes participate in the carcinogenesis of many malignancies, but the role of both genes in cervical cancer is not fully elucidated. The aim of this study was to determine the frequency of IL-8 and MMP-7 gene mutations and to assess their effects on the risk of early stage cervical cancer and lymph node metastasis. The clinical stage and histological grade of cervical cancer were also studied. The peripheral blood from the patients with early stage cervical cancers and normal controls was collected and the DNA was extracted. The incidence of IL-8 and MMP-7 gene mutations was assessed by using tetra-primer amplification refractory mutation system polymerase chain reaction (ARMS PCR) and restriction fragment length polymorphism (RFLP). The data were statistically analyzed by x2 test. The results showed that: (1) The genotype frequency of IL-8 -251AT and TT was significantly higher in the cervical cancer group than in the normal control group (OR=2.290 and 2.619 respectively, P=0.001), and it was also higher in the lymphatic metastasis group than that without metastasis (OR=2.917, P=0.035); (2) The frequency of MMP-7 -181G/G genotype was significantly higher in the cervical cancer group and in the lymphatic metastasis group (P<0.05); (3) The incidence of IL-8 mutation was two times higher in IIa cervical cancer group than in Ib1 and Ib2 cervical cancer group (P=0.006). For the MMP-7 gene, there was statistically significant difference in the incidence of mutation between the Ib1, Ib2 and the IIa (P=0.000); (4) Different histological types and different grades of cervical cancer had different incidence of mutations, statistically. It was suggested that there was significant difference in the genotype of IL-8 -251TT and MMP-7 -181GG polymorphism between the cervical cancer group and the lymph node metastasis group. Moreover, individuals with IL-8 T allele or MMP-7 G allele carriers were at significantly higher risk of cervical cancer, particularly the early (IIa) and medium, poorly differentiated cervical cancer (G2+G3).

Objective To explore the value of prenatal ultrasound,autopsy and vascular cast in diagnosis of right atrial isomerism(RAI).Methods Forty cases diagnosed as RAI by prenatal ultrasound from May 2012 to May 2017 were analyzed.And the results of autopsy and vascular cast after odinopoeia were compared,then up the characteristics of RAI were summed.The feature of venous drainage was the point.Results For all the 40 cases,the relative position of magenblase,the cross section of aortaventralis, the cross section of inferior vena cava and umbilical vein were lost"C"shape view.In intracardiac anomalies magenblase and cardiac apex on the different sides accounted for 77.5%,the atrioventricular septal defect accounted for 67.5%,the right ventricle double outlet accounted for 65.0%,and pulmonary artery stenosis accounted for 52.5%.The major finding of venous drainage were:bilateral superior vena cava accounted for 52.5%,left inferior vena cava accounted for 60.0%,abnormal hepatic venous drainage accounted for 20.0%,pulmonary vein co-antrum accounted for 45.0%.Three cases of cardiac malformation and 4 cases of abnormal pulmonary venous drainage were misdiagnosed,and 4 cases of abnormal hepatic venous drainage were missed by prenatal ultrasound.Conclusions RAI always combines distinctive cardiac malformations and abnormal venous drainage.Prenatal ultrasound has significant diagnostic value.It's important to have further understanding about RAI through the feedback of autopsy and vascular cast.