Objective To observe the therapeutic effect of transvaginal repair of uterine diverticula after cesarean section.Methods The clinical data of 12 patients underwent transvaginal repair (group A) with uterine incision diverticulum treatment were retrospectively analyzed.13 cases underwent transabdominal repair of the uterine incision diverticulum were selected as group B.The operation time,intraoperative bleeding volume,postoperative exhaust time,hospital stay and the next days of menstrual period were compared between the two groups.Results In group A,the operation time was 48 min,the amount of bleeding was 30 ml,postoperative exhaust time was 9 h,the length of hospital stay was 4.5 d,the next time menstruation was 3-5 days,Those of group B were 120 min,120 ml,16 h,7.8 d and 3-5 d.The differences of operation time,bleeding volume,postoperative exhaust time,hospitalization days between the two groups were significant(P ＜ 0.05).There was no statistically significant difference between the two groups in the days of the next menstrual period (P ＞ 0.05).Conclusion The effect of transvaginal,transabdominal repair on uterine diverticula formation after cesarean section is clear,but the transvaginal operation can shorten the operation time,reduce intraoperative bleeding volume,shorten postoperative exhaust time and decrease the hospitalization days,thus reduce the cost of hospitalization.

ObjectiveTo observe the clinical effect of Danshenyin on chronic atrophic gastritis and explore the mechanism. MethodA total of 152 patients with chronic atrophic gastritis who were treated in Xining No. 1 People's Hospital were selected and randomized into control group （76 cases） and observation group （76 cases）. The control group was given conventional western medicine treatment， and the observation group was given Danshenyin （oral）. The treatment lasted 8 weeks for both groups. The clinical effect， traditional Chinese medicine （TCM） syndrome score， and pathological score of gastric mucosa were compared between two groups. The content of pepsinogenⅠ （PGⅠ）， pepsinogenⅡ （PGⅡ）， proinflammatory cytokines ［soluble interleukin-2 receptor （sIL-2R）， tumor necrosis factor-α （TNF-α）］， and gastric mucosa-proteting factors ［prostaglandin E₂ （PGE₂）， calcitonin gene-related peptide （CGRP）］ was determined， and the adverse reactions and recurrence rates were recorded. ResultThe effective rate （91.18%， 62/68） in the observation group was higher than that （7.61%， 52/67） in the control group （χ²=4.727， P<0.05）. The TCM syndrome score in the observation group was lower than that in the control group （P<0.05）. Compared with the control group， the observation group showed low pathological scores of glandular atrophy and intestinal metaplasia and dysplasia （P<0.05）. The observation group had higher serum PGⅠ content and PGⅠ/PGⅡ value and lower PGⅡ content than the control group （P<0.05）. The content of sIL-2R and TNF-α decreased （P<0.05） and that of PGE₂ and CGRP increased （P<0.05） in the observation group as compared with those in the control group. The incidence of adverse reactions in the observation group was 7.35% （5/68）， as compared with the 14.93% （10/67） in the control group. The recurrence rates in the 6-month and 12-month follow-up in the observation group were lower than those in the control group， but the difference was not statistically significant （Fisher's exact test）. ConclusionDanshenyin shows satisfactory effect in relieving TCM syndrome， regulating PG secretion， and improving gastric mucosal lesions in the treatment of chronic atrophic gastritis. The mechanism is the likelihood that it modulates sIL-2R， TNF-α， PGE₂， and CGRP to alleviate inflammatory damage of gastric mucosa and protect gastric mucosa. The medicine is safe and reduces the recurrence of chronic atrophic gastritis.

Objective To observe the effects of central exudative chorioretinopathy(central exudative chorioretinopathy,CEC)treated with blood-activating and stasis-removing Chinese medicines.Methods All 339 cases of central exudative chorioretinopathy with 346 infected eyes were randomly recruited into a treatment group(176 cases with 181 infected eyes)and a control group(163 cases with 165 infected eyes).The treatment group was treated with traditional Chinese medicine by dialectical combination of syndrome and disease,while the control group was treated with conventional treatment.Results The corrected visual acuity was 0.01～1.2 in the treatment group.Of all 181 eyes in 176 patients,76 eyes were cured(41.98%),85 eyes were improved(46.96%),and 20 eyes were ineffective(11.6%),with a total effective rate being 88.94%.BY contrast,in the control group,of all 165 eyes in 163 patients,62 eyes were cured(37.57%),67 eyes were improved(40.60%),and 36 eyes were ineffective(21.83%),with a total effective rate being 78.17%.There was significant difference in the total effective difference between the two groups(U=2.05693,P＜0.05).FFA and OCT were reexamined for the patients in the treatment group three menths after the treatment.The results showed that fluorescein leakage and choroidal neovascularization(choroid al neovascularisation,CNV)lesions disappeared in 76 eyes;fluorescein leakage and CNV lesions relieved in 85 Eyes;fluorescein leakage still existed in 12 eyes;and sear formed in 8 eyes.Conclusion Blood-circulating and stasis-removing Chinese medicines have good effects in promoting subhyaloid hemorrhage and exudation,eliminating retinal oedema,and improving eyesight.

Objective: To investigate the changes of PERK, Runx2, osterix, RANKL and OPG in bone tissue of the female rats with experimental postmenopausal osteoporosis (PMOP) before and after treatment, and to elucidate the role of PERK signaling pathway in PMOP. Methods: The ovariectomized rats were reproduced to osteoporosis models. A total of 45 rats were divided into normal control group (the rats didn' t receive any treatment, n=15), osteoporosis group (the rats were ovariectomized, n=15) and osteoporosis treatment group (the ovariectomized rats were injected with estrogen through caudal vein, n=15). The changes of serum collagen I (Col I), alkaline phosphatase (ALP) and osteocalcin (OCN) of the rats in various groups were observed. Three months after feeding, the femoral shaft of the rats in various groups were taken for pathological section. The gene expression levels of PERK, ATF4, Runx2, osterix, RANKL and OPG in bone tissue of the rats in various groups were detected by RT-PCR; the protein expression levels of PERK, ATF4, Runx2, osterix, RANKL and OPG were detected by Western blotting method. Results: Compared with control group, the levels of serum Col I, ALP and OCN in the rats in osteoporosis group were significantly decreased (P<0.05 or P<0.01); compared with osteoporosis group, the levels of serum Col I, ALP and OCN of the rats in osteoporosis treatment group were significantly increased (P<0.01). Compared with control group, the gene expression levels of PERK, ATF4, Runx2 and osterix in bone tissue of the rats in osteoporosis group were significantly decreased (P<0.01), and the gene expression level of RANKL was increased (P<0.01); compared with osteoporosis group, the gene expression levels of PERK, ATF4 Runx2 and osterix in bone tissue of the rats in osteoporosis treatment group were significantly increased (P<0.01), and the gene expression level of RANKL was significantly decreased (P< 0.01). Compared with control group, the protein expression levels of PERK, Runx2 and osterix in bone tissue of the rats in osteoporosis group were significantly decreased (P<0.05 or P<0.01), and the protein expression level of RANKL were increased (P<0.05 or P<0.01); compared with osteoporosis group, the protein expression levels of PERK, Runx2 and osterix in bone tissue of the rats in osteoporosis treatment group were significantly increased (P<0.05 or P<0.01), and the protein expression level of RANKL was significantly decreased (P< 0.01). The HE staining results showed that compared with control group, the bone resorption pits in bone tissue of the rats in osteoporosis group became large with the increased bone absorption, which caused bone loss; compared with osteoporosis group, the resorption in bone tissue of the rats in osteoporosis treatment group was decreased, and the bone structure returned to normal. Conclusion: After the female rats are ovariectomized and injected with estrogen, the expression trends of PERK and osteoblast transcription factors Runx2 and osterix are consistent, in contrast with the osteoclast transcription factor RANKL expression, suggesting that the osteoblast function is reduced and it is related to the decreased expression of PERK in PMOP onset.

OBJECTIVE To investigate the effect of prenatal nicotine exposure on cardiac ejection function and myocardial fibrosis of the offspring of rats.METHODS Pregnant rats were sc given nicotine 6.0 mg· kg-1,once daily for 17 d.The body mass and heart mass of the offspring were detected at the 21th day of gestation,and 15 and 90 d after birth.Heart rate of 90 d offspring was recorded by ECG,and cardiac functions were detected by Doppler ultrasonography,including cardiac output (CO),stroke volume (SV),ejection fraction (EF),left ventricular long axis shortening fraction (FS),interventricular septum diastolic diameter (IVSd) and left ventricular posterior wall diastolic diameter (LVPWd).The myocardial ultrastructure was detected under an electron microscope.Masson staining was used to detect the myocardial collagen fiber deposition.The level of collagen protein type Ⅰ in heart tissue was detected by radioimmunoassay.RESULTS Compared with control group,prenatal nicotine exposure resulted in a decrease of heart mass and body mass in groups of 21 d fetal rats and 15 d offspring(P＜0.05,P＜0.01),but had no effect on the 90 d offspring.Compared with the normal control group,the heart rate of 90 d offspring increased [366+10 vs (418+10) min-1] (P＜0.05),CO,FS and EF decreased (P＜0.01),and IVSd and LVPWd increased (P＜0.05,P＜0.01).Electron microscopy revealed that in the heart of nicotine 90 d offspring,myocardial fiber arrangement was loosened and confused,while extracellular matrix increased.Masson staining showed collagen deposited in the myocardium.The level of collagen type Ⅰ in heart tissue increased [0.59±0.09 vs (0.40±0.05) tμg·g-1 tissue] (P＜0.01).CONCLUSION Prenatal nicotine exposure induces the increased level of cardiac collagen type Ⅰ,myocardial fibrosis and decrease of cardiac ejection function in adult offspring,which may lead to increased susceptibility to cardiovascular diseases.

Objective Primary renal mucosa associated lymphoid tissue lymphoma (MALT lymphoma)is very rare,here dis-cuss the clinical pathological characteristics and diagnosis,differential diagnosis of primary renal MALT lymphoma.Methods A case of primary renal MALT lymphoma was assayed for clinical and histopathological morphology,an well as immuno-histochemical staining,then reviewed the relevant literature.Results The clinical and imaging characteristics of renal lym-phoma lack of specific performance,the tissue section of the kidney biopsy showed diffuse infiltration of small lymphocytes. The small lymphocytes were centrocytes-like,monocytes-like,and plasma cell differentiation was recognized.Lymphoepithe-lial lesions were scattered.Follicular implanted phenomenon could been seen.Immunohistochemically result:the tumor cells were positive for CD20,PAX-5,CD79αand MUM-1,but negative for CD3,CD5,CD45RO,bcl-2,CD10,bcl-6 and CyclinD1. CD2 1 showed damage FDC network,positive for Kappa,negative for lambda,and it showed monoclonal phenotype,the Ki-6 7 index was about 35%.Final pathology diagnosis was primary renal MALT lymphoma.Conclusion Primary renal MALT lymphoma is very rare,the clinical manifestations and imaging characteristic of renal lymphoma are non-specific and misdiag-nosis frequently occurs in clinical practice,definite diagnosis depends on pathological examination,immunohistochemical stai-ning is helpful to differential diagnosis.

Objective To study the effects of bone marrow mesenchymal stem cells transplantation on functional recovery of the injured rats spinal cord.Methods MSCs labeled with Brdu were transplanted into rats model of spinal cord half-transection injury.The open-field BBB scoring system was employed to evaluate behavioral changes.MSCs' survival after transplantation was identified by BrdU immunohisto chemistry.We observed the reconstruction of neuronal circuits by HRP coloration.The recovery of transduction function after spinal injury was examined by cortex somatosensory evoked potential (CSEP).Results Treated rats generally showed better functional recovery than control rats after operation.BrdU-positive cells could be found in the spinal cord injury site one week after transplantation.At two months after transplantation, HRP-positive cells could be found at rostral of the spinal cord injury site of treated rats, but not be found in control.CSEP could be evoked at treated rats from two months after transplantation,but not in controls.Conclusion MSCs may survive in the spinal cord injury site via local injection immediately after spinal cord injury, and may promote regeneration of the injured axons.

BackgroundThe mental health problems of employees in administrative organs and public institutions are highly valued. However， there is a lack of understanding regarding the mental health status of employees in provincial and municipal administrative organs and public institutions in Qinghai region. ObjectiveTo analyze the anxiety and depression of employees in provincial and municipal administrative organs and public institutions in Qinghai region， so as to provide references for promoting their mental health and intervening in psychological problems. MethodsFrom October 23 to 28， 2022， a total of 3 096 employees in provincial and municipal administrative organs and public institutions in Qinghai region were enrolled using stratified cluster sampling technique， and were assessed using Self-rating Anxiety Scale （SAS） and Self-rating Depression Scale （SDS）. ResultsA total of 1797 （58.04%） employees in municipal and above administrative organs and public institutions in Qinghai region completed a valid questionnaire survey. Depressive symptoms were noted in 579 （32.22%）. SDS scores yielded statistical difference among the selected employees of different ethnicities， types of job positions and educational levels （F=9.074， 101.488， 4.477， P<0.01）， and the severity of depressive symptoms also demonstrated statistical difference among the selected employees with different ethnicities， educational levels and types of job positions （H=49.196， 17.028， 160.848， P<0.01）. Anxiety symptoms were detected in 711 （39.57%） employees. SAS scores exhibited statistical difference among the employees with different genders， ages， ethnicities， educational levels， marital status and types of job positions （t=-4.571， F=6.648， 3.950， 5.243， 12.008， 22.253， P<0.01）. Statistical differences were also illustrated in the severity of anxiety symptoms among the selected employees with different ages， genders， ethnicities， educational levels， marital status and types of job positions （H=24.361， -3.788， 28.365， 24.268， 25.976， 56.204， P<0.01）. ConclusionAbout one-third of employees in municipal and above administrative organs and public institutions in Qinghai region may have symptoms of depression and anxiety. The depression symptoms are more severe among Tibetan people， those with low education levels and ordinary civil servants. The anxiety symptoms are more severe among employees aged 30 and below， those with low education levels， unmarried and those in technical positions ［Funded by 2020 Guiding Plan Project for the Health System of Qinghai Province （number， 2020-wjzdx-71）］

Objective:To observe the effect of syndrome differentiation and treatment with Wandaitang on symptoms, quality of life and function of immunologic after operation of endometrial carcinoma (EC), in order to discuss the mechanism of action according to regulation of microenvironment of EC. Method:The 109 patients were divided into control group (54 cases) and observation group (55 cases) by random number table. Patients in control group got radiotherapy and/or chemotherapy according to different stages after operation. Patients in observation group were additionally given syndrome differentiation and treatment with Wandaitang, 1 dose/day. And a course of treatment was 3 months. Before and after treatment, symptoms, sign, functional assessment of cancer therapy-general (FACT-G) were scored. And levels of T lymphocyte subsets (CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺), natural killer cell (NK), vascular endothelial growth factor (VEGF), transforming growth factor-β (TGF-β), insulin-like growth factor-1(IGF-1), interleukin-17 (IL-17) and IL-10 were detected. Result:After treatment, the scores of symptoms, signs and total scores of the patients in the observation group were lower than the control group (P<0.01).The scores of each dimension and total score of FACT-G scale in the observation group were higher than those in the control group(P<0.01). After treatment, NK, CD3 ⁺, CD4 ⁺ and CD4 ⁺/CD8 ⁺ in the observation group were higher than those in the control group(P<0.01),lower than the control group(P<0.01). After treatment, the serum levels of VEGF, TGF-β, IGF-1, IL-17 and IL-10 in the observation group were lower than those in the control group. Conclusion:Wandaitang can ameliorate clinical symptoms, improve quality of life of patients and immune function of organism, regulate multiple cytokines, change the tumor microenvironment of endometrial carcinoma.

Objective:To evaluate the short-term and long-term efficacy of Jingui Shenqiwan combined with three-stage syndrome differentiation on osteoporotic vertebral compression fractures (OVCFs) after operation, and its regulatory effect on biomarkers of bone metabolism. Method:One hundred and thirty-five patients were randomly divided into control group (67 cases) and observation group (68 cases) by random number table. A total of 58 patients in control group completed the treatment (4 patients were exfoliated, 2 patients were lost to follow-up, 3 patients were eliminated); and 60 patients in observation group completed the treatment (3 patients were exfoliated, 2 patients were lost to follow-up, 3 patients were eliminated). Both groups patients were given calcitonin injection through intramuscular injection, 20 u/time, 1 time/week, for 12 weeks, calcium carbonate D3 chewable tablets (Ⅱ), 1 tablet/time, 2 times/day, and alendronate sodium tablets, 70 mg/time, 1 time/week. Patients in control group got Bushen Jiangu capsule, 4 grains/time, 3 times/day. And patients in observation group got modified Jingui Shenqiwan combined with fracture three-stage symptom differentiation, 1 dose/day. The courses of treatment in the two groups were 24 weeks, and a 24 week follow-up was provided. Before the operation and at the 12^th and 24^th week after operation, the short-term efficacy indexes, such as back pain, lumbar function, traditional Chinese medicine （TCM） syndromes and complications, were recorded. And the long-term efficacy indexes, such as recovery of responsible vertebral body, lumbar function, bone density and quality of life and incidence of 48 week re-fracture, were also recorded. Before and after operation, levels of bone alkaline phosphatase (BALP), osteocalcin (BGP), tartrate resistant acid phosphatase-5b (TRAP-5b), type I collagen carboxy terminal prepeptide (PICP), type I collagen cross-linked C-terminal peptide (β-CTX) and N-MID-OT were detected, and the safety was evaluated. Result:The comprehensive efficacy in observation group was superior to that in control group (Z=2.026, P<0.05). At the 12^th and 24^th week after operation, scores of back pain, lumbar function and TCM syndromes were all lower than those in control group (P<0.01), and score of lumbar function at the 48^th week after operation was also lower than that in control group (P<0.01). Bone density was higher than that in control group at the 24^th and 48^th week after operation, and score of quality of life was lower than that in control group (P<0.01). At the 24^th and 48^th week after operation, Cobb angles were less than those in control group, and heights of responsible centrums (anterior, central, posterior) were higher than those in control group. Cumulative incidence of complications in control group was 51.72% (30/58), which was higher than 26.67% (16/60) in control group (χ2=7.784, P<0.01). The levels of BGP were higher than those in observation group at the 24^th and 48^th week after operation, and the levels of BALP, TRAP-5b, PICP, β-CTX and N-MID-OT were all lower than those in control group (P<0.01). And there was no side effect relating to Jingui Shenqiwan. Conclusion:Modified Jingui Shenqiwan combined with fracture three-stage symptom differentiation can reduce the symptoms of back pain and promote the recovery of lumbar function, with a significant short-term comprehensive efficacy. In the long term, it can improve the strength of responsible centrums, restore the anatomical structure of injured centrums, increase the bone density of centrums, further improve the lumbar function, reduce the occurrence of complications, regulate the markers of bone metabolism, and improve osteoporosis.