Objective To investigate the clinical effect of combined therapy of left and right amlodipine in the treatment of hypertension complicated with perimenopausal syndrome. Methods 50 patients with hypertension associated with peri menopausal syndrome in our hospital from January 2015 to January 2016 were selected,and according to the different treatment and nursing intervention divided into observation group and control group,25 cases in each groups. The control group with routine nursing intervention and benazepril treatment, observation group with amlodipine and comprehensive psychological nursing intervention treatment before and after treatment in two; blood pressure, luteinizing hormone (LH), serum follicle stimulating hormone (FSH), estrogen (E2) level and the changes of anxiety and depression (SAS) (SDS) were recorded in detail, and the relevant data for comparative analysis. Results Amlodipine+comprehensive psychological nursing intervention (observation group) of peri menopausal comprehensive clinical effect is better than that of benazepril+routine nursing intervention patients with hypertension treatment (control group) clinical efficacy, clinical symptoms improved better than the control group, the difference was statistically significant (P<0.05). Conclusion Hypertension patients with perimenopausal syndrome patients choose amlodipine + comprehensive psychological nursing intervention treatment effect significantly, can effectively improve the clinical symptoms and psychological state, and is worthy of clinical application.

Objective To investigate and analyze the clinical efficacy of high dose hCG combined with psychological intervention in threatened abortion. Methods 50 patients with threatened abortion in our hospital from February 2015 to October 2016 were selected,and divided into study group and control group,25 cases in each groups. The study group for the first time the dosage of 10000U, after the dose to 5000U, use drug 2 times every week, and at the same time, the implementation of the corresponding psychological nursing intervention; patients in the control group for the first time the dosage was 2000U, after every day of medication 1 time, each time the dosage is still 2000U, to observe and compare the therapeutic effect. Results The patients in the study group, the success rate of pregnancy was significantly higher than the control group, while the patients in the study group, β -hCG and progesterone levels were significantly higher than those in the control group, while the study group after the nursing care of patients with anxiety and depression scores were significantly lower than the control group, the differences between the groups was obvious (P<0.05). Conclusion High dose hCG combined with psychological intervention in threatened abortion is more effective and effective in treatment of threatened abortion.

Objective To study the influence of Nictinamide on the endotheline(ET-1)in patienta with pulmonary arterial hypertension(PAH).Methods 66 cases of PAH were divided randomly into two groups (n=33for each):the Nictinamide treatment group and the control group.The changes of endotheline were compared before and after treatment.Results After treatment serum endotheline was significantly lower in the treatment group(P＜0.01),but there was no difference in the control group before and aftertreatment(P＞0.05).The significant difference was observed between treatment group and control group(P＜0.01).Conclusion Nictinamide will reduce the level of endothellne and confers some degree therapeutic and preventive value for PAH.

BACKGROUND: Studies have shown that mild hypertension and hypothermia both offer cerebral protection against focal cerebral ischemia,and their possible synergistic effect may provide even better neuroprotective effects.OBJECTIVE: To investigate the mechanism of cerebral protection by induced hypertension combined with mild hypothermia against focal cerebral ischemia and reperfusion, through observation of the changes in the infarct volume and blood-brain barrier(BBB) in rats.DESIGN: A randomized controlled experimental study based on experimental animals.SETTING: The departments of neurology of two university hospitals and department of dermatology in a municipal hospital.MATERIALS: The study was carried out in the Laboratory of Department of Neurology, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology and Laboratory of Department of Neurology, People' s Hospital of Wuhan University from March to July 2001. Sixty-four Wistar rats weighing 180 to 230 g were purchased from the Experimental Animal Center of People' s Hospital of Wuhan University.INTERVENTIONS: Sixty-four rats were randomly divided into control group, hypertension group, mild hypothermia group, and combined therapy group, each group consisting of 16 rats. Reperfusion was initiated after a 3-hour focal cerebral ischemia of the 16 rats, and at 2 hour during the ischemia, the rats in the hypertension and mild hypothermia group were treated with hypertension for 3 hours and mild hypothermia, respectively, and those in the combined therapy group received both treatment. The rats in the control group received no treatments for ischemia and reperfusion. Twenty-four hours later, all rats were killed for examination.MAIN OUTCOME MEASURES: The scores of neurological deficits, infarct volume and degree of BBB damage.RESULTS: The scores for neurological deficits, infarct size and volume of Even' s blue staining were 2. 12 ±0. 54, (17.65 ±4.78)%, and(56.63± 10.70) mm3, respectively, in hypertension group, and 2. 14 ±0.69,(16. 21 ± 3.79)%, and(53.52 ± 8.44) mm3 in mild hypothermia group,and 1.78 ±0. 61, (11, 31 ±3.64)%, and 38.45 ±5.25 mm3 in combined therapy group, which were all decreased significantly as compared with the control group[2.70 ±0. 64, (28.34 ±4. 13)%, and(94.87 ± 15.34) mm3].The combined therapy group had the smallest infarct size and volume of Even's blue staining among the three treatment groups( P ＜ 0.05).CONCLUSION: Hypertension and mild hypothermia may reduce the infarct volume and alleviate BBB damage during focal cerebral ischemia and reperfusion in rats, and the effects of combined treatment are more obvious.

AIM To observe Arg-Glu*ss activity of antiplatelet and anticoagulation in rats and to further explore its mechanism. METHODS Twenty four male sprague dewley rats were divided into three groups randomly (eight rats in each group).Each group was orally given Arg-Glu (61 4 mg?kg -1 ?d -1 ), ASA (36 mg?kg -1 ?d -1 ) and equal placebo solution respectively.Eight days later all rats were given anesthesia and blood was taken from abdominal aorta with a plastic catheter, then the indexes related to blood hemodynamics,coagulation and blood fibrinolysis were measured. Twenty four SD rats were treated in the same way mentioned above. Platelet aggregation was measured by turbidimetric method. Plasma level of cyclic GMP and prostacyclin was evaluated by radioimmunoassay and nitric oxide by spectrophotometric determination. Common carotid artery-external jugular vein bypass was established in another 24 rats, and the weight of wet thrombus was measured with high sensitive electrical scale. RESULTS In group of Arg-Glu, statistically significance decrease versus placebo group was observed on blood apparent viscosity, reduced viscosity, hematocrit and plasma viscosity, increase versus placebo was also observed on blood reciprocal calcium time, activated partial thromboplastin time and prothrombin time ( P 0 05). Platelet aggregation activation decreased compared with placebo 〔(0 75%?3.62%) vs (32 8%?6 62%) P 0 05)〕. CONCLUSION Arg-Glu with its properties of antiplatelet、anticoagulation and improvement of blood rheology status in rats could be regarded as one antiplatelet drug and one NO precursor .Its mechanism of action was thought to be by Arg-NO-cGMP metabolism pathway while other mechanism might be involved.

Objective To report a family with lipoid proteinosis (LP) from Shandong province and to analyze mutations in the extracellular matrix protein 1 (ECM1) gene in this family.Methods Eight members in a threegeneration family with LP were clinically investigated,and two patients were identified to suffer from LP,including the proband (Ⅲ 1) and her mother (Ⅱ 2).Both of the patients presented with papules on the palpebral margin,short and thick lingual frenum,and hoarseness.Indirect laryngoscopy showed infiltrating and thickening of the vocal cord.Pathological examination of lesions on the palpebral margin and laryngeal mucosa revealed deposits of hyaline-like material in the dermis,which was strongly positive for periodic acid-Schiff (PAS) staining and resistant to diastase digestion.The pathological diagnosis was LP.Blood samples were collected from all the family members and 100 ethnically matched,unrelated and unaffected Chinese human controls followed by DNA extraction.PCR and sequencing were performed to detect the ECM1 gene,and nested PCR followed by agarose gel electrophoresis to analyze mutations in the coding region of the ECM1 gene.Results Both of the two patients were compound heterozygotes.Three missense mutations,incluing p.P169T,p.A44T and p.R392W,were found in the ECM1 gene of the affected mother,with p.P169T in one allele and p.A44T as well as p.R392W in the other.The girl patient inheried the missence mutation p.P169T from her mother and a synonymous mutation c.879G ＞ A from her father (Ⅱ 1).Nested PCR showed that the c.978G ＞ A mutation generated a splice-acceptor site AG,which leaded to a splicing defect.Conclusion A novel synonymous splice-acceptor site mutation c.879G ＞ A in the ECM1 gene is identified in the family with LP.

Objective To study the effects of transcranial magnetic stimulation (TMS) on learning and memory, and angiogenesis and the dendritic structure of hippocampal CA3 pyramidal neurons after cerebral infarction. Methods Forty-eight male Sprague-Dawley rats were divided into a sham operated group, a model group and a TMS group (n = 16). Rat models of focal cerebral infarction were established with unilateral middle cerebral artery (MCA) suture occlusion in the model and TMS groups. The rats of the TMS group were given 4 weeks of TMS treatment beginning 1 day after the infarction (2 times per day, 30 pulses per time). Their learning and memory abilities were tested with a Y-maze. Angiogenesis and the dendritic structure of their hippocampal CA3 pyramidal neurons were detected after 4 weeks. Results Compared with the model group, learning and memory improved significantly in the TMS group. The average microvessel density of the hippocampus in the TMS group was significantly more than in the model group. The total length of apical dendrites of hippocampal CA3 pyramidal neurons in TMS group was significantly longer than in the model group. Conclusions The improved learning and memory observed following TMS treatment are likely to be related to changes in angiogenesis, the dendritic.structure of the hippocampal CA3 pyramidal neurons, and enhanced synaptic plasticity.

Objective To investigate blood plasma melatonin level in night-shift nurses and explore the relationship of blood plasma melatonin level with nervous system symptom (insomnia、anxiety、depression). Methods ELISA were used for detection of blood plasma melatonin level in 80 night-shift nurses of different age group. Results Blood plasma melatonin level of shift work nurses (36to40、41to45 yearold) were significant lower than the corresponding age group of the control group, the nervous system symptom of these age group night-shift nurses correlated to melatonin level of melatonin. Conclusions Blood plasma level of melatonin have a close relation to nervous system symptom(insomnia、anxietydepression).

OBJECTIVETo analyze and compare vaginal microbiomes in healthy women at child-bearing ages and patients with bacterial vaginosis (BV).

METHODSA total of 74 vaginal swabs of the vaginal fornix were collected from 37 BV patients and 37 healthy women. BV status was assessed according to Amsels clinical criteria for all the subjects and confirmed using Gram-stain criteria (Nugent scores). Genomic DNA of the samples was extracted for amplifying the 16S rRNA V6 hypervariable region by PCR and pyrosequencing by Illumina. BIPES, UCHIME, TSC and GAST were employed to analyze the information of the species from the samples.

RESULTSLactobacillus was the predominant species in healthy women (more than 95%), including mainly L. iners and L. crispatus, with a small quantity of Gardnerella, Granulicatella, Streptococcus, Prevotella, Escherichia and other genus. The α diversity was significantly increased in 30 BV patients (P<0.001), and β diversity also changed obviously shown by decreased Lactobacillus (varying from 45% to 1%, consisting mainly of L. iners) or even absence Lactobacillus in 6 cases, with increased relative abundance of Gardnerella, Prevotella, Granulicatella, Anaerococcus, Parvimonas, Peptoniphilus.harei, Peptostreptococcus, and Dialister. Different from previous data, 7 BV cases showed a predominance of the rare species L.gasseri and L.acidophilus (75% to 50%).

CONCLUSIONLactobacillus is the predominant vaginal species in healthy women (mainly L. iners and L. crispatus) co-existing with many other bacteria and a variety of microorganisms. Lactobacillus is significantly decreased and even absent in most of BV patients, and some cases show the predominance of the rare species L.gasseri and L.acidophilus.

Adult ; Case-Control Studies ; DNA, Bacterial ; genetics ; Female ; Humans ; Microbiological Techniques ; Microbiota ; Middle Aged ; RNA, Ribosomal, 16S ; genetics ; Reagent Kits, Diagnostic ; Vagina ; microbiology ; Vaginosis, Bacterial ; microbiology ; Young Adult

Objective:To explore the feasibility of deep learning technology for renal artery recognition in retroperitoneal laparoscopic renal surgery videos.Methods:From January 2020 to July 2021, the video data of 87 cases of laparoscopic retroperitoneal nephrectomy, including radical nephrectomy, partial nephrectomy, and hemiurorectomy, were retrospectively analyzed. Two urological surgeons screened video clips containing renal arteries. After frame extraction, annotation, review, and proofreading, the labeled targets were divided into training set and test set by the random number table in a ratio of 4∶1. The training set was used to train the neural network model. The test set was used to test the ability of the neural network to identify the renal artery in scenes with different difficulties, which was uniformly transmitted to the YOLOv3 convolutional neural network model for training. According to the opinion of two senior doctors, the test set was divided into high, medium, and low discrimination of renal artery and surrounding tissue. High identification means a clean renal artery and a large exposed area. For middle recognition degree, the renal artery had a certain degree of blood immersion, and the exposed area was medium. Low identification means that the exposed area of the renal artery was small, often located at the edge of the lens, and the blood immersion was severe, which may lead to lens blurring. In the surgical video, the annotator annotated the renal artery truth box frame by frame. After normalization and preprocessing, all images were input into the neural network model for training. The neural network output the renal artery prediction box, and if the overlap ratio (IOU) with the true value box was higher than the set threshold, it was judged that the prediction was correct. The neural network test results of the test set were recorded, and the sensitivity and accuracy were calculated according to IOU.Results:In the training set, 1 149 targets of 13 videos had high recognition degree, 1 891 targets of 17 videos had medium recognition degree, and 349 targets of 18 videos had low recognition degree. In the test set, 267 targets in 9 videos had high recognition degree, 519 targets in 11 videos had medium recognition degree, and 349 targets in 18 videos had low recognition degree. When the IOU threshold was 0.1, the sensitivity and accuracy were 52.78% and 82.50%, respectively. When the IOU threshold was 0.5, the sensitivity and accuracy were 37.80% and 59.10%, respectively. When the IOU threshold was 0.1, the sensitivity and accuracy of high, medium and low recognition groups were 89.14% and 87.82%, 45.86% and 78.03%, 32.95%, and 76.67%, respectively. The frame rate of the YOLOv3 algorithm in real-time surgery video was ≥15 frames/second. The false detection rate and missed detection rate of neural network for renal artery identification in laparoscopic renal surgery video were 47.22% and 17.49%, respectively (IOU=0.1). The leading causes of false detection were similar tissue and reflective light. The main reasons for missed detection were image blurring, blood dipping, dark light, fascia interference, or instrument occlusion, etc.Conclusions:Deep learning-based renal artery recognition technology is feasible. It may assist the surgeon in quickly identifying and protecting the renal artery during the operation and improving the safety of surgery.