ObjectiveTo investigate the effect of nursing intervention on quality of life in patients undergoing total hysterectomy. Methods100 patients undergoing total hysterectomy were randomly divided into the intervention group and the control group with 50 patients in each group.The patients in the control group were given routine instruction after admission,before and after operation.The patients in the intervention group were given systematic nursing intervention on the basis of routine nursing.The quality of life three months postoperation was compared between two groups. ResultsThe quality of life in the intervention group three months after operation was better than that of the control group. ConclusionsSystematic nursing intervention for patients undergoing total hysterectomy during hospitalization can improve their postoperative quality of life.

Objective To investigate the effect of hypoxia-inducible factor-1α expression (HIF-1α) on toll-like receptor 4 (TLR4) signaling pathway-mediated rat lung ischemia-reperfusion injury (LIRI).Method Forty-five S-D rats were randomly divided into Sham group,LIRI group,LIRI+ TLR4-activated group,LIRI+ TLR4-inhibited group,LIRI + ASK1-inhibited group,LIRI + p38-inhibited group,and LIRI + HIF-1α-inhibited group.The interaction between TLR4 signaling pathway [including TLR4,myeloid differentiation factor 88 (MyD88),TIR-domain-containing adapter-inducing interferon-βTIR-domain-containing adapter-inducing interferon-β (TRIF),Apoptosis signal-regulating kinase 1 (ASK1) and p38] and HIF-1α and the role of TLR4-dependent HIF-1α in LIRI in vivo were analyzed.Result In LIRI,HIF-1α accumulation was induced in a TLR4-dependent fashion,and MyD88,but not TRIF,and activation of ASK1 and P38 were found to be critical for TLR4-mediated HIF-1α accumulation.HIF-1α protein played a critical role in TLR4-mediated lung injury of LIRI.HIF-1α up-regulated TLR4 expression in LIRI in a positive feedback manner.Conclusion We identify that HIF-1α has a damaging effect on TLR4 signaling pathway-mediated LIRI and TLR4-HIF-1 may synergistically involved in the development of LIRI.Therefore we suggest that the interaction between them may represent a novel therapeutic target for the development of novel target-based therapies of LIRI.

BACKGROUND:The thermosensitive chitosan is a kind of chitosan, its hemostatic effect, tissue compatibility andin vivo absorption need further investigations.
OBJECTIVE:To investigate the hemostasis,in vivo degradation and tissue compatibility of thermosensitive chitosan hemostatic film.
METHODS: A total of 48 Sprague-Dawley rats were randomly divided into four groups, and carried out two
experiments at the same time. (1) The incisions of the liver in three groups were covered with the thermosensitive chitosan hemostatic film, celulose hemostatic cotton and gelatin sponge, respectively. Blank control group
received no treatment. The bleeding time and bleeding amount were recorded. (2) The incisions of the quadriceps femoris muscle of rats in the above three groups were embedded with the same hemostatic materials respectively. Blank control group was not embedded. At 1, 2, 3, 4, 6 weeks, the incision tissues of the liver and the quadriceps femoris muscle were harvested for observation. After 4 weeks, the incisions were observed with hematoxylin-
eosin staining and transmission electron microscopy.
RESULTS AND CONCLUSION: The bleeding time and bleeding amount of thermosensitive chitosan hemostatic film and celulose hemostatic cotton groups were significantly lower than those of gelatin sponge and blank
control groups (P < 0.05). After 6 weeks, the thermosensitive chitosan hemostatic film was absorbed completely. After 3 weeks, the celulose hemostatic cotton was absorbed completely. After 2 weeks, the gelatin sponge was absorbed completely. The liver lobules of thermosensitive chitosan hemostatic film were complete, the liver cellwere normal structure, showing light sweling and little inflammatory cellinfiltration. Under transmission electron
microscopy, the liver cels had integral structure, cellnucleus and organeles remained intact. The muscle fibers showed complete structure and little inflammatory cellinfiltration. Under transmission electron microscopy, the muscle fibers
ranked tidily, with integral cellnucleus and organeles. The thermosensitive chitosan hemostatic film has good hemostasis effect and tissue compatibility.

Objective To discuss clinical efficacy of patients treated with surgical treatment for posttraumatic elbow stiffness combined with pain.Methods From January 2011 to December 2014,release treatment was performed on 32 cases of posttraumatic contracture of the elbow combined with pain by operation.There were 22 males and 10 females,at average age of 39 years(range from 18 to 65 years).25 cases of these patients with mild-to-moderate pain got a simple elbow release operation.There were 4 cases of severe pain patients complicated with elbow dislocation,after fully release the elbows,reduction was performed under the direct;Both elbow arthrolysis and dermal transplantation interval type elbow arthroplasty were performed in 3 cases of severe pain patients which had severe osteoarthritis.A total of 26 patients were installed hinged external fixator after operation for early functional exercise.Results All patients were followed up for an average time of 14 months(from 12 to 18 months).All patients were significantly improved in the range of elbow and pain symptoms.Postoperative joint function improvement:2 patients with severe stiffness improved to moderate stiffness,19 patients with moderate or severe stiffness improved to mild stiffness,and the remaining of 11 cases without stiffness,The improvement rate was 100％.Postoperative pain:6 cases of moderate or severe pain relieved for mild pain,26 patients pain disappeared,the pain relief rate was 100％.Mayo elbow performance score were evaluated before and after surgery.Preoperative score:the results were good in 6 cases,fair in 14 cases and poorin 12 cases;postoperative score:excellent in 20 cases,good in 8 cases and fair in 4 cases,the good rate is 87.5 ％.The difference between preoperation and postoperation was statistically significant (P＜0.05).Conclusion Elbow arthrolysis combined external fixation is beneficial to early functional rehabilitation and restoring the flexion and extension function of stiff elbow,at the same time,the pain caused by stale dislocation or arthritis of elbow can also get good effect.

Objective: To evaluate the disinfection efficacy of peracetic acid disinfectant (type Ⅲ ) on gastrointestinal endoscopy. Methods: Endoscopes were disinfected respectively by 2% glutaraldehyde (GA group) and peracetic acid disinfectant (type Ⅲ ) (PAA group) according to the process by the 2016 version of "Regulation for cleaning and disinfection technique of flexible endoscope" , and then samples were collected through biopsy channel at the specified steps. The bacterial count and pathogenic bacteria of these samples were detected. Hepatitis B virus surface antigen (HBsAg), hepatitis C virus (HCV) antibody and Treponemia pallidum antibody (TP-Ab) were detected by chemiluminesent microparticle immunoassay (CMIA) in the PAA group. The PAA group were continuously sampled for 5 days. Results: A total of 56 gastroscopes and 16 colonoscopes were disinfected in the GA group, and 46 gastroscopes and 15 colonoscopes were disinfected in the PAA group. Compared with pre-disinfection, the bacterial count was both significantly reduced in the two groups after disinfection (P<0.05). The qualified rate of gastroscopes disinfection and total qualified rate of the PAA group were higher than those of the GA group [the qualified rate of gastroscopes: 97.83% (45/46) VS 92.86% (52/56), P>0.05; total qualified rate: 98.36% (60/61) VS 94.44% (68/72), P>0.05]. The qualified rate of colonoscopes in the two groups were both 100.00% (15/15, 16/16). After disinfecting by peracetic acid disinfectant (Type Ⅲ), HBsAg, anti-HCV and TP-Ab were negative. There were no significant differences on colonies number at different steps in a 5-day continuous sampling (P>0.05). Conclusion Peracetic acid disinfectant (type Ⅲ) can provide a satisfied disinfectant effect, and be applied in clinic to meet the requests of high-level disinfection for gastrointestinal endoscopy.