Objective To explore the clinical value of total laparoscopic hysterectomy(TLH).Methods Retrospective analysis was conducted on clinical data of 38 cases of TLH(Laparoscopic Group)and 40 cases of total abdominal hysterectomy(Open Group)from November 2005 to October 2006 in our hospital,to compare operative time,intraoperative blood loss,the incidence of postoperative pyrexia,recovery time of bowel movement,and hospital stay in both groups.Results The operative time in the Laparoscopic Group(85.8?13.8)min was significantly shorter than that in the Open Group(99.3?9.3)min(t=-5.923,P=0.000).The blood loss was significantly less in the Laparoscopic Group(105.8?32.4)ml than that in the Open Group(166.0?67.4)ml(t=-4.930,P=0.000).The incidence of postoperative pyrexia was distinctively lower in the Laparoscopic Group(3 cases)than that in the Open Group(15 cases)(?2=9.270,P=0.002).The time to first flatus was significantly shorter in the Laparoscopic Group(26.2?4.2)h than that in the Open Group(40.5?4.9)h(t=-13.601,P=0.000).The postoperative hospital stay in the Laparoscopic Group(6.8?0.9)d was distinctively shorter than that in the Open Group(10.6?0.8)d(t=-19.612,P=0.000).Follow-up examination for six months showed that two cases of poor healing of incision and two cases of vaginal residual granulation in the Open Group and one case of vaginal residual granulation in Laparoscopic Group,and no other complications were found.Conclusions TLH gets the advantage over total abdominal hysterectomy.If surgeons are familiar with the laparoscopic operative skills,TLH can be an ideal procedure for hysterectomy.

0.990 0) with an average recovery ranged from 86.1% to 109.0%.The injection RSD were within 0.84%～3.1%(n=6).CONCLUSIONS:The method is successfully applied for simultaneous determination of 22 kinds of free amino acids.

Objective The pathogenesis of T2DM has not been elucidated.This study aimed to explore the association of FXR gene polymorphisms with the risk of T2DM in Eastern China population. Methods We collected 467 cases in the Health Examination Center of our hospital from January 2011 to December 2012.Ligase detection reaction was performed to test the genotypes in 240 T2DM patients and 227 controls.Unconditioned logistic regression analysis was used to explore the association of FXR gene polymorphisms with the risk of T2DM in different genetic models, after adjusting for age, sex, smoking and drinking status. Results Compared with AA genotype, GG significantly increased the risk of T2DM (P=0.017), while GA+GG approached marginal significance in association with T2DM (P=0.049) in rs1030454.For rs10860598, GA reduced the incidence of T2DM (P=0.025) compared with AA genotype, while GA+GG had marginal significance with T2DM (P=0.049).For rs11110411, CT or CT+CC could reduce the risk of T2DM compared with TT with P value of 0.016 and 0.024 respectively.Compared with AA, GA or GA+GG in rs17030270 was negative with the risk of T2DM with P value of 0.018 and 0.032 respectively. Conclusion FXR gene polymorphisms are associated with the risk of T2DM in northern Chinese Han population and the variation of FXR gene may play a role in the pathogenesis of T2DM.

American medical colleges attach great importance to the humanistic education.The rich humanities curriculum is fully integrated into the teaching practice thus the mutual penetration of medicine and the humanities is achieved.They have specific and detailed examination evaluation system and the teaching method was more practical and participatory.By contrast,nost of the medical colleges in our country neglect the humanities construction and the cultivation of medical students' humanistic spirit.The coverage of the humanities curriculum is relatively narrow and the faculty is insufficient.We should promote the development of humanistic cducation,attach importance to the construction of medical humanities,set up appropriate curriculum system,increase the investment in faculty and reform the teaching method and examination method.

Objective To investigate the potential change of cellular cholesterol efflux and the functional changes of ABCA1 on macrophages from diabetes animals. Methods High energy diet was given to golden hamster to make animal model of hyperlipidemia. Diabetes was induced by a single intraperitoneal injection of STZ (30 mg/kg). Macrophages were isolated and incubated with apoA-I or 8-br-cAMP in vitro. Cellular cholesterol content was measureal before and after treatment by HPLC. Results Intracellular cholesterol content of diabetic animals was higher than that in high energy diet and normal controls. Expression of ABCA1 mRNA was upregulated in diabetic group after incubation with apoA-I and cAMP. When macrophages were incubated with apoA-I, cholesterol efflux increased with the prolongation of incubation time.The amount of intracellular cholesterol efflux in 3 groups of animals showed the following relationship: diabetic animals exceed high energy diet fed animals, and the latter exceeds normal animals. Conclusion Intracellular lipid efflux depends mainly on the presence of extracellular apoA1 as well as membrane ABCA1 protein. The deposition of cholesterol in the macrophage of diabetic and insulin resistant animals may be related to the characteristic changes of quantity and function of apoA1 in these animals.

Objective To explain the effects of C-reactive protein(CRP) on lectin-like oxidized low density lipoprotein receptor-1 expression on THP-1 derived macrophages and the related signal transduction pathways.MethodsTHP-1 cells were differentiated into macrophages with the stimulation of PMA.THP-1 derived macrophages were incubated with CRP and co-incubated with inhibitors of NF-?B、AP-1 and MARK signal transduction pathways.The expression of LOX-1 antigen and mRNA was analyzed by ELISA and RT-PCR.Results CRP stimulated the expression of LOX-1 antigen and mRNA on macrophages in a dose-dependent manner.NF-?B inhibitor BAY11-7085 suppressed the inducible effects of CRP on LOX-1 expression.Conclusion CRP increased LOX-1 expression on THP-1 derived macrophages at transcription and post-transcription levels.The NF-?B signal transduction pathway may be involved in such process.

Objective To investigate the effect of liver detoxification soup combined with compound glycyrrhizin on hepatitis-related factors in patients with chronic hepatitis B.MethodsFrom April 2014 to August 2015, 86 patients with chronic hepatitis B were enrolled in this study.Random number table was divided into observation group and control group (43 cases).The control group was given routine glycyrrhizin and other conventional (ALT), serum total bilirubin (TBil), serum albumin transferase (ALT) and serum total bilirubin (TBil) were measured before and after treatment.(HA), laminin (LN), type Ⅳ collagen (Ⅳ-C) and type Ⅲ procollagen (PCⅢ) were used to analyze the effect of hepatic fibrosis, And observe adverse reactions.ResultsThe effective rate of the observation group was 93.02% higher than that of the control group (76.74%, P<0.05).After treatment, the patients were treated with chest discomfort, emotional depression, epigastric fullness, fatigue, ALT (35.28±1.35) U/L, HA (165.25±1.44) mg/L, and the treatment group (P<0.05).After treatment, the levels of TBil (30.34±1.59)μmol/L, Alb (48.32±1.33)g/L, and the level of serum was significantly higher than that of the control group (P<0.01).The incidence of adverse reactions was 11.63% and 6.98% in the two groups.ConclusionTraditional Chinese medicine hepatectomy decoction combined with compound glycyrrhizin can effectively treat chronic hepatitis B and improve the level of serum hepatitis-related factors, and the adverse reaction is light, it is worthy of clinical application.

OBJECTIVE:To investigate the status quo and tendency of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015. METHODS:The prescriptions of breast cancer patients in 11 hospitals of Zhe-jiang province were analyzed retrospectively in respects of consumption sum,DDDs,DDC,etc. RESULTS:The consumption sum of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015 increased from 2530192.33 yuan to 6201691.54 yuan,and its proportion in total consumption sum increased from 13.93％ to 17.40％,showing in-creasing tendency. The anastrozole always took up the first place in the list of consumption sum. Tamoxifen,anastrozole and letro-zole took up the top 3 places in the list of DDDs. Goserelin took up the first place in the list of DDC. CONCLUSIONS:The pre-scription amount and consumptionsum of endocrine therapy drugs in breast cancer patients from 11 hospitals of Zhejiang province during 2010-2015 show year-on-year growth trend;and those drugs which are safe,effective,economical and convenient predomi-nate in clinic.

Objective To examine the effects of high-density lipoprotein(HDL) and lipoprotein-deficient serum(LPDS) isolated from patients with type 2 diabetes mellitus on cholesterol efflux through human skin fibroblast(HSF) and human hepatoma cell line(HepG2).Methods and Results Blood was collected from 13 patients with type 2 diabetes mellitus and 17 healthy volunteers,HDL and LPDS were isolated.Cholesterol efflux assays,RT-PCR and Western blot were performed with HSF and HepG2 cells.The HepG2 cells showed a high expression of scavenger receptor B1(SR-B1) and lack of functional ATP-binding cassette receptor A1(ABCA1) and ATP-binding cassette receptor G1(ABCG1) while HSF cells express SR-B1 at very low level and have a high expression of ABCA1 pretreated with 22-OH cholesterol.The cholesterol efflux from HepG2 cells to HDL isolated from patients with diabetes decreased significantly as compared to controls.However,cholesterol efflux from HSF cells to LPDS was not different between groups.Conclusion The function of HDL involving cholesterol efflux in type 2 diabetes mellitus was impaired while cholesterol efflux induced by LPDS from HSF cells was maintained,suggesting that HDL plays a critical role in mediation of intracellular cholesterol accumulation and progression of atherosclerosis inpatients with type 2 diabetes.

Objective To investigate the clinical values of Gemstone Spectral Imaging coronary angiography with analysis of the relationship between plaque character and angina pectoris types.Methods Two hundred cases of hospitalized patients were collected from January 2015 to December 2016 in the Department of Cardiovascular Disease,Chenzhou City First People's Hospital,who were diagnosed as coronary heart disease.According to the clinical data,stable angina pectoris (SA) and unstable angina pectoris (UA),coronary CT scan was performed for each patient to evaluate the relationship between the nature of atherosclerotic plaques and the classification of angina pectoris.SPSS 19.0 software was used for statistical analysis.Results By analyzing the correlation between SA and UA,SA calcification plaque was accounted for 63.2％,soft plaque 17.4％,mixed plaque 19.4％;UA calcification plaque was accounted for 37.5％;Soft plaque was accounted for 42.3％;and mixed plate was accounted for 20.2％.The difference was statistically significant (P ＜ 0.05).In the SA group,all of the stenotic lesions were mainly calcified plaques.There was no significant difference in the degree of severe stenosis between the different plaques in the SA group (P ＞ 0.05).In UA group,soft plaques were the main lesion of mild and moderate stenosis of coronary artery,and calcified plaques were the main stenosis in severe stenosis.There were significant differences in the degree of coronary artery stenosis between different plaques in UA group (P ＜ O.05).Conclusions The 128-slice spiral CT can accurately evaluated the relationship between the nature of coronary plaque and the type of angina pectoris,which is of great value in the early warning and angina pectoris classification of high-risk patients with coronary heart disease.