Objective To investigate the clinical efficacy of laparoscopic myomectomy surgery and open myomectomy surgery for the patients with uterine fibroids.Methods 78 patients with uterine fibroids in our hospital were divided into observation group and control group by random serial number,and each group had 39 cases.The observation group was given laparoscopic myomectomy,while the control group was given open myomectomy surgery.The average time,average blood loss,postoperative exhaust time and average postoperative hospitalization days were compared between the two groups.Results The operative time,blood loss,postoperative exhaust time and hospital stay time of the observation group were (113.3 ± 15.1) min,(50.5 ± 27.5) ml,(19.5 ± 5.1) h and (4.6 ± 0.5) d,while those in the control group were (61.5 ± 12.7) min,(100.9 ± 35.7) ml,(37.6 ± 4.9) h and (7.7 ± 0.6) d,the differences were significant between the two groups (t =11.79,10.35,8.06,7.11,all P ＜ 0.05).Conclusion Compared with open myomectomy surgery,laparoscopic myomectomy can not only shorten the hospital stay,but also reduce the time of discharge,and it is worth to be further promoted in clinical.

At present, oncology medical student in our country has many communication problems, such as communication awareness is not strong,the lack of communication,communication is not enough self-confidence and other issues.To improve the communication ability between doctors and patients for the oncology professional medical students:it is the necessary premise for correct implementation of diagnosis and treatment, an effective way to reduce medical disputes, adapt to the demand of the development of higher medical education.And pointed out the effective ways to improve the ability of doctor-patient communication:to set up the doctor-patient communi-cation and tumor department before the internship training course;establishlisten with your heart and professional guidancemode;with teacher actively guiding; learn to empathymode; adhere to the concept of taking pa-tients as the center.

Sedation monitoring of the critically ill children must be individualized and continuous. Electroen-cephalography-derived method———bispectral index( BIS) is one of the most widely used objective sedation monitoring methods in recent years,permitting continuous monitoring. Some studies reported the correlations between BIS and the clinical scales were varing. The BIS value of 70 or so may distinguish between adequate and inadequate sedation. BIS has some unique advantages over other objective methods. Many factors may influence the right interpretation of BIS. On the whole, the researches and applications of BIS are mainly in adults, the experience is relatively less in critical ill children. This article reviews the studies of BIS in critical ill children for sedation monitoring.

The optimal bariatric surgery is still not acquired although the obesity epidemic has become a worldwide problem. The recentness studies on obesity focused on mass balance regulated by central nervous system, in which an important circuit is vagus nerve. This review provides progress on obesity mediated by vagus nerve simulation and vagal blocking.

Food intake,energy expenditure and body adiposity are homeostatically regulated.Hypothalamus and brainstem are key brain regions of the system.In the state of hunger or satiety,the neural and hormonal messages from the gut regulate energy homeostasis through reflection or direct effect on the hypothalamus and brainstem,Which is referred to as brain-gut signaling.New researches on the special physiological functions of gut hormones are expected to offer a target for anti-obesity drugs.

Objective To investigate fluoride-induced inflammation and nuclear factor-κB (NF-κB) signaling pathway in cultured human acute monocytic leukemia cells (THP-1).Methods In vitro cultured THP-1 cells were used as a model of microglia.After cultured with different concentrations of [0 (negative control group),10,50,100,500,1 000 and 5 000 μmol/L] sodium fluoride (NaF) for 48 h,the survival of cells was detected by CCK8.THP-1 cells were divided into 3 groups:control group,low dose and high dose fluoride groups according to the results of CCK8 assay,and then treated with different concentrations of sodium fluoride (0,500,5 000 μmol/L) for 48 h,concentrations of inflammatory cytokines,such as Interleukin-lβ (IL-1β) and tumor necrosis factor-α (TNF-α) were measured by enzyme linked immunosorbent assay (ELISA) in THP-1 mononuclear cell culture medium.The protein levels of IκBα,phospho-NF-κB p65 and phospho-IκB-α were detected by Western blotting.Results THP-1 cells were treated with different concentrations of sodium fluoride (500,1 000,5 000 μ mol/L) for 48 h.Fluoride group THP-1 cell survival rate [(73.21 ± 3.67)％,(31.40 ± 4.56)％,(0.40 ± 0.24)％] was lower than that of the negative control group [(100.00 ± 0.00)％,all P ＜ 0.01].Compared to the control groups [(0.36 ± 0.07),(31.07 ± 0.81)ng/L],significant increases of the inflammatory cytokines IL-1β [(1.42 ± 0.79),(19.47 ± 2.90)ng/L] and TNF-α [(61.06 ± 2.20),(172.72 ± 2.29)ng/L] were detected in culture medium in low-fluoride and high fluoride groups,respectively.Interestingly,compared to the control groups [(100.00 ± 5.48)％,(100.00 ± 14.82)％],significant increases of phospho-NF-κB p65 [(113.71 ± 8.99)％,(134.74 ± 1.93)％] and phospho-IκB-α [(152.61 ± 14.16)％,(176.91 ± 7.95)％] were observed in both low-fluoride and high fluoride groups.Meanwhile,the protein level of IκBα in high fluoride group [(63.53 ± 9.67)％] was significantly lower than that of the control group [(100.00 ± 10.99)％,P ＜ 0.01].Furthermore,significant positive correlation was detected between increased IL-1β,TNF-α and phospho-NF-κB p65 (r =0.74,0.72,all P ＜ 0.05).Conclusions Excessive fluoride can induce microglial cells to release inflammatory cytokines and activate nuclear factor-κB signaling pathway.The release of inflammatory cytokines and activation of the signaling pathway may be one of the mechanisms of the damage of the central nervous system caused by sodium fluoride.

Objective This study assesses the influence of rizatriptan on calcitonin gene-related peptide (CGRP),proenkephalin (PENK) and cholecystokinin (CCK) mRNA expressions in the trigeminal ganglia of a rat migraine model and investigates the possible mechanisms by which triptans treat migraine.Methods A total of 24 rats were randomly divided into four groups:normal control group (A),migraine model group(B),rizatriptan control group (C) and rizatriptan treatment group(D).Groups C and D were intragastrically perfused with rizatriptan,1 mg/kg per day.After 7 days,nitroglycerin was subcutaneously injected into the buttocks of the groups B and D to induce migraine.Two hours after nitroglycerin injection,the trigeminal ganglia was isolated.CGRP,PENK and CCK mRNA expressions in the trigeminal ganglia were determined using SYBR Green Ⅰ real-time quantitative PCR.Results The copy number of CGRP mRNA (× 107) in 200 ng total RNA of each group was 0.05 ±0.01,1.30 ±0.52,0.23 ±0.12,0.43 ±0.33 ; The copy number of PENK mRNA (× 103) in 200 ng total RNA of each group was 3.30 ± 1.65,0.34 ±0.14,3.91 ± 2.44,0.71 ± 0.13.The copy number of CGRP mRNA in the trigeminal ganglia of group B was significantly higher than that of group A (q =7.854,P ＜ 0.05) ; CGRP mRNA expressions were significantly lower in the trigeminal ganglia of rats in group D compared with group B (q =5.458,P ＜0.05).Compared with group A,PENK mRNA expressions in the trigeminal ganglia of rats were significantly lower in group B (q =4.478,P ＜ 0.05).PENK mRNA expressions were significantly higher in trigeminal ganglia of rats in group C compared with group D (q =4.838,P ＜ 0.05).CCK mRNA expression in trigeminal ganglia of rats was similar among groups.Conelusions Rizatriptan can decrease the expressions of CGRP in the trigeminal ganglia of the migraine rats and exhibits neurogenic inflammation triggered by CGRP.PENK expressions decrease in the trigeminal ganglia of the migraine rats,weaken the analgesic effects of enkephalin.

Objective To review the clinical features of chronic daily headache (CDH).Methods The clinical data of 128 patients with chronic daily headache,including general condition,characteristics of headache,concomitant symptom and disability were analyzed retrospectively.The features of primary chronic daily headache (PCDH) and medication over-dose headache (MOH) were compared.Results Among 128 cases females accounted for 79.7％ with an average age of 45.2 years and 88 patients were associated with drug overdose.The symptoms included nausea (68/128),photophobia (75/128),phonophobia (102/ 128),depression (77/128) and irritability (93/128),sleep disorders (94/128),dizziness (75/128),emotional irritability(58/128) and depression(21/128).The migraine disability assessment questionnaire and headache impact test-6 scores showed that disability was resulted from the severe degree of headache in 62.2％ (51/82) and 73.2％ (82/112) of CDH patients respectively.Compared with PCDH patients,the MOH patients had older age (t =2.59,P =0.011),longer duration (t =2.48,P =0.015) and severer degree of headache(t =5.58,P =0.018),and chronic migraine (t =11.95.P =0.001) was the most common primary headache type.Conclusions Most CDH patients are middle-aged women,with moderate to severe pain,usually complicated with depression,dysphoria and asomnia.Chronic daily headache patients are commonly associated with drug overdose.

ObjectiveTo explore activity characteristics of diverse autonomic nervous system of armymen with different mental quality levels during dread emotion processes.MethodsMental Quality Questionnaire of Armymen was used to select participants.The activities of the diverse autonomic nervous system of armymen withdifferent mental quality levels during dread emotion processes were discussed by physiological - psychological experiments.Results ( 1 ) Under neutral condition blood volume pulse (BPV) is greater in low mental quality group( ( -0.87 ±0.64)mm Hg) than in high( -0.28 ±0.24)mm Hg).(2) During dread emotion processes the normalized low frequency spectral component(LF) and skin conductance (SC) are greater in low mental quality group ( (6.54 ± 2.96) nU),(0.78 ± 0.11 ) umho) than in moderate ( ( 1.32 ± 1.25 ) nU,( (0.22 ± 0.15 ) umho) and high ((3.51 ±2.28 )nU,((0.30 ±0.12) umho).(3) During dread emotion processes the recovery time of HR and the average recovery time of skin conductance( SC ),skin temperature( ST),blood volume pulse(BVP) and HR are greater in low mental quality ( 61.58 ± 35.66 ) s,( 36.78 ± 18.58 ) s ) than in high ( ( 22.36 ± 6.87 ) s,(56.87 ± 23.98 ) s).(4) In emotional arousal,and low mental quality (0.88 ± 2.54 ) in neutral conditions change their arousal'was significantly greater than the middle (0.57 ± 2.88) and high psychological quality group (0.15 ± 1.87) ; Low mental quality group (2.17 ±2.39) under the conditions of pleasure in the dread was significantlygreater than the middle ( 1.87 ± 1.45 ) and high psychological quality group ( 1.24 ± 1.66).ConclusionThe findings indicate that armymen with low mental quality is more likely to show corresponding physiological arousal and alert status in face of the neutral or weak emotional stimuli.When facing dread emotional stimuli,they would show stronger physiological arousal mainly basing on the excitement of sympathetic nerve system,and such statuswould last much longer to bring about more fierce pain experience.

Objective To analyze the clinical characteristics of infective endoearditis complicated with intracranial hemorrhage.Methods The clinical characteristics,brain CT and MRI results and prognosis of 7 patients with infective endocarditis and intracranial hemorrhage admitted between January 1991 and May 2015 were retrospectively analyzed.Results All seven patients presented varying degrees of fever,cardiac murmur and neurological symptoms.The continuous fever lasted from 21 d to 227 d (average 91 d).Mitral valve (4 cases) and aortic valve (3 cases) were the most common affected ones.The brain CT or MRI scan presented intracranial hemorrhage in 6 cases.More than 2 hemorrhage locations were found in 5 patients and parietal lobe was most common one (4 cases).All patients were treated with antimicrobial agents and three patients underwent valve replacement surgery.Three patients were cured and another 2 died due to fatal hemorrhage.Conclusions Patients with long fever history and ineffective antimicrobial treatment are prone to intracranial hemorrhage.Brain CT or MRI scan need be performed in infective endocardits when neurological symptoms are present,and brain angiography should be also considered if necessary.