Objective To evaluate the influence of the duration of patient-controlled intravenous analgesia (PCIA)on pain and gastrointestinal function after gynecological abdominal surgery.Methods Patients who received gynecological abdominal surgery were divided into 3 groups according to using time of PCIA for 24 hours,48 hours,72 hours.There were 30 cases in each group.Pain intensity,gastrointestinal peristalsis time,anal exhaust time,getting out-of-bed time,voluntary micturition time,nausea and vomiting were compared among three groups after stopping PCIA.Results There were no significant differences in VAS score among three groups at each time point.There were no significant differences in voluntary micturition time among three groups.The anal exhaust time,getting out-of-bed time in 24-hour group were earlier than those of the other two groups,the differences were significant; The nausea and vomiting in 24-hour group were lower than the other two groups,the difference was significant.Conclusions The application of PCIA can effectively relieve acute pain 24 hours after surgery,but the effect was not obvious on pain induced by activities after 24 hours.But the side effects induced by analgesia pump(anesthetic)still work,such as vomiting,long duration of discharge,activity inconvenience.So PCIA should be stopped at right time in order to reduce complications and facilitate for recovery of patients after the surgery.

OBJECTIVE:To establish a method for the contents determination of psoralen,isopsoralen,psoralenoside and isop-soralenoside in Danzhi qing’e tablet. METHODS:HPLC performed on the column of Eclipse XDB-C18 with mobile phase of metha-nol-water(51∶49,V/V)(isocratic elution,for psoralen and isopsoralen)and acetonitrile-0.1% formic acid(12∶88,V/V)(isocratic elution,for psoralenoside and isopsoralenoside)at a flow rate of 1.0 ml/min,the detection wavelength was 246 nm,column tem-perature was 30℃,and injection volume was 10 μl. RESULTS:The linear range was 3.138-200.8 μg/ml for psoralen(r=0.999 9), 3.175-203.2μg/ml for isopsoralen(r=0.999 9),3.181-101.8μg/ml for psoralenoside(r=0.999 9)and 3.169-101.4μg/ml for isopso-ralenoside (r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 2%;limits of quantitation were 0.627 5 ng,0.635 0 ng,3.181 0 ng and 3.169 0 ng,the limits of detection were 0.251 0 ng,0.254 0 ng,1.273 0 ng and 1.268 0 ng;recoveries were 95.68%-102.80%(RSD=2.4%,n=6),95.91%-102.10%(RSD=2.3%,n=6),98.64%-99.13%(RSD=0.23%,n=6) and 100.20%-101.70%(RSD=0.69%,n=6),respectively. CONCLUSIONS:The method is simple and accurate, and can be used for the simultaneous determination of psoralen,isopsoralen,psoralenoside and isopsoralenoside in Danzhi qing’e tablet.

Objective To compare the effects of airway humidification by intermittent atomization inhalation and micro pump control on pulmonary infection after tracheotomy in elderly patients with serebral hemorrhage. Methods From February 2012 to February 2013, 46 elderly patients with heavy craniocerebral injury and tracheotomy were set as the control group, treated with intermittent atomization inhalation. From March 2013 to March 2014, 50 elderly patients with severe craniocerebral injury and tracheotomy were set as the observation group, treated with micro pump controlled continuous airway humidification. The two groups were compared in terms of the satisfaction rate and incidence of pulmonary infection. Result The satisfaction rate of the observation group was higher than that of the control group and the incidence of pulmonary infection was significantly lower than that of the control group (P<0.05). Conclusion Micro pump controlled airway humidification for elderly patients with severe craniocerebral injury can improve the airway humidification effect and reduce the incidence of pulmonary infection.

Objective:To study the changes and significance of Th17 and Treg cells as well as their associated cytokines in pe-ripheral blood of patients with chronic hepatitis C and cirrhosis in order to investigate their role in the pathogenesis of chronic hepatitis C and hepatitis C cirrhosis. Methods:Flow cytometry and ELSIA assay were used to detect the expression ratio of Th17 and Treg cells and the serum levels of IL-10,TGF-β,IL-6 and IL-17 in peripheral blood of healthy human and patients with chronic hepatitis C and hepatitis C cirrhosis. Than we analyzed the differences of the above detection index between the healthy and patients with chronic hepatitis C and hepatitis C cirrhosis. Results:The expression ratio of Th17 cells (1. 33%±0. 30%) in peripheral blood of patients with chronic hepatitis C and IL-6[(8. 10±2. 42)ng/L] and IL-17[(16. 70±4. 73)ng/L] serum levels were significantly higher than those in the healthy (Th17:1. 14%±0. 19%) and IL-6[(1. 72±6. 70)ng/L],IL-17[(12. 29±1. 88)ng/L],P<0. 05;The expression ratio of Treg cells in peripheral blood of patients with hepatitis C cirrhosis and chronic hepatitis C patients was significantly higher than that in the healthy (6. 21%±0. 76%,5. 89%±0. 85% vs 5. 51%±0. 59% ),P<0. 05,The ratio of Th17/Treg in patients with cirrhosis was significantly lower than that in patients with chronic hepatitis C and the healthy(0. 19±0. 02 vs 0. 22±0. 03,0. 21±0. 03),P<0. 05;the levels of IL-1[(16. 21±3. 76)ng/L] and TGF-β[(5. 15±0. 83)ng/L] in peripheral blood of patients with hepatitis C cirrhosis were significantly higher than those in chronic hepatitis C[(14. 36±2. 78)ng/L;(4. 47±0. 87)ng/L] and the healthy[(14. 01±3. 01)ng/L;(4. 43±0. 98)ng/L)],P<0. 05. Conclusion:Th17 and Treg cells and their related cytokines involved in the process of chronicity of hepatitis C and cirrhosis,Th17 and Treg cells and their related cytokines in the treatment and prevention of chronicity of hepatitis C and cirrhosis may have important significance.

The anoikis resistance confers the ability of cancer cells to survive and metastasize in the blood circulation without adhesion,but its effect and mechanism in intrahepatic and distant metastasis of hepatocellular carcinoma has not been fully elucidated.Recent studies have shown that certain factors or drugs may inhibit anoikis of hepatoma cells through some signaling pathways.These signaling pathways are not completely separated,they are interconnected to promote metastasis of hepatocellular carcinoma.Liver is the metabolic center of many substances,and many related factors can promote metastasis of hepatocellular carcinoma through inhibiting anoikis.In this review,we summarized the signaling pathways of anoikis resistance of hepatocellular carcinoma.

Objective:To investigate the prevention effect of nurse-led peer support system on the postpartum posttraumatic stress disorder of primipara.Methods:A total of 74 cases of primipara were randomly divided into experimental group ( n=37) and control group ( n=37). The control group received routine nursing. The experimental group received nurse-led peer support intervention. The postpartum depression and postpartum posttraumatic stress disorder was assessed by using Edinburgh postnatal depression scale (EPDS) and impact of event scale-revised (IES-R) before and after intervention. Results:Before intervention, the socre of EPDS and IES-R was no statistical difference between experimental group and control group ( P>0.05). After intervention, the scores of EPDS and IES-R were significantly decreased in the experiment group [(5.41 ± 0.49) pionts, (16.56 ± 1.36) pionts] compared to the control group [(16.56 ± 1.36) pionts, (19.01 ± 1.98) pionts], the difference was statistically significant ( P<0.05). Conclusion:Nurse-led peer support system can alliviate postpartum depression and posttraumatic stress disorder status and promote the psychological health of primipara.

Objective:To investigate the effect of attention and interpretation therapy on sleep dysfunction and quality of life in perimenopausal syndrome patients.Methods:From August 2018 to January 2020, a total of 76 patients with perimenopausal syndrome were divided into experimental group (38 cases) and control group (38 cases) according to the random number table method. Two groups recieved routine therapy and nursing care, on the basis of this, the experimental group was given attention and interpretation therapy for 10 weeks. Before intervention and after 10 weeks of intervention, the effects were assessed by Pittsburgh Sleep Quality Index (PSQI) and Menopause-Specific Quality of Life (MENQOL), respectively.Results:There was no significant difference in the score of PSQI, MENQOL before intervention between the two groups ( P>0.05). After intervention, the sleep quality, sleep duration, sleep efficiency scores and total PSQI scores were 0.79±0.10, 1.48±0.23, 1.11±0.22, 9.70±0.59; in addition, the vasomotor symptoms, psychological symptoms, somatic symptoms and total MENQOL scores were 3.06±0.81, 2.06±0.81, 2.50±0.51, 2.63±0.39 in the experimental group, significanlty lower than those in the control group (1.03±0.22, 1.85±0.33, 1.25±0.28, 10.59±0.66, 3.69±0.95, 2.83±0.77, 2.92±0.94, 3.18±0.53), the differences were statistically significant ( t values were 2.306-6.021, P<0.05). Conclusions:Attention and interpretation therapy can effectively alliviate sleep dysfunction and improve quality of life of perimenopausal syndrome patients.

Objective To detect the plasma concentration of tacrolimus and the survival time of rats after small-volume liver transplantation,and to investigate the criteria for immunological rejection after small-volume liver transplantation.Methods Lewis rats and Brown Norway rats were used to establish a small volume and normal liver volume transplantation model,which were divided into 7 groups:whole liver transplantation group (WI),small volume allogeneic liver transplantation group (SI),and whole liver allograft group (WA),small volume allogeneic liver transplantation group (SA),whole liver allograft immunotherapy group (WAT),small volume allogeneic liver transplantation immunotherapy group (SAT),small volume allogeneic liver transplantation immunotherapy modulation group (SATa).Morphological and functional changes of liver tissue were studied postoperatively,AST and tacrolimus plasma concentrations were detected,and survival was recorded.Results Compared with the WA group,the inflammatory cells infiltrated in the portal area of the SA group,the inflammatory changes of the sinusoidal endothelial cells,and the proportion of TCRpositive lymphocytes increased.Four days after transplantation,peripheral blood tests showed that CD4+CD25+ double positive lymphocytes were significantly lower in the allograft group than in the allograft group,and the positive expression rate in the SA group (0.6％) was significantly lower than that in the WA group (1.8％).The differences were statistically significant (P＜0.05).In the SAT group,the blood concentration of tacrolimus was significantly higher than that in the WAT group at each time point (P＜0.05).The blood concentration of tacrolimus in the SATa group was relatively stable,and the plasma concentration of the SATa group was stable.And AST was significantly lower than the SAT group,the differences were statistically significant (P＜0.05).Compared with WAT group,the proliferation and apoptosis rate of hepatocytes in SAT group and SATa group were significantly increased.The proliferation of hepatocytes in SATa group was significantly higher than that in SAT group (P＜0.05).Survival analysis showed that the cumulative survival rate of the WA group was 85.7％,which was significantly higher than that of the SAT group (28.6％).The difference was statistically significant (P＜0.05).The cumulative survival rate of the SATa group was 51.7％.The survival time of WAt group was (57.4±25.0) days,SAT group was (28.0±29.10) days,SATa group was (39.7± 29.0) days,which were longer than untreated groups.The ratio of proliferation to apoptosis (PRA) increased with increasing time of tacrolimus.Regardless of blood concentration,tacrolimus plasma concentration was positively correlated with AST (R =0.758,P＜0.05),indicating RPA was inversely correlated with AST (R=-0.962,P＜0.05).Conclusion The use of tacrolimus significantly prolonged the survival time of small-volume allogeneic liver transplantation rats.Adjusting the amount of tacrolimus under the guidance of tacrolimus plasma concentration and AST serum value equation TD =-0.494TC-0.0035AST+ 260.487 to make the blood concentration relatively stable,it can further extend the allogeneic liver transplantation rat time to live.

Objective:To explore the clinical effects of intramuscular injection of oryzanol for 5 and 10 days in the treatment of menopausal syndrome.Methods:This study adopts a case-control study method.Twenty patients with menopausal syndrome admitted to Peking Union Medical College Hospital from July 2021 to March 2022 were selected and randomly divided into a control group and an observation group using a random number table method, with 10 patients in each group. The control group was given intramuscular injection of oryzanol once a day for 5 consecutive days on the basis of routine health education; On the basis of routine health education, the observation group was given intramuscular injection of oryzanol once a day for 10 consecutive days. Two groups of patients completed a total of 6 visits before treatment and on days 5, 10, 30, 60, and 90 of treatment. Baseline survey was conducted to record the basic information of patients, including demography data, menstruation, past history, surgical history, drug allergy and the main symptoms of climacteric syndrome, and the baseline hormone level of patients was detected. Compare the menopausal symptoms by modified K-score, Pittsburgh sleep quality index (PSQI) score, menopausal specific quality of life (MENQOL) score, post treatment injection site pain by visual analog score (VAS), and observe adverse reactions during treatment between the two groups of patients at each visit time point.The measurement data conforming to the normal distribution is expressed in xˉ± s. The comparison between the two groups is performed by t test, and the change trend of the two groups at each time point is compared by repeated measurement analysis of variance; The measurement data that do not conform to the normal distribution are represented by M( Q1, Q3), and the Kruskal Wallis test is used for comparison between groups; Counting data is represented by examples(%), Fisher's exact probability method is used for inter group comparison, and Wilcoxon rank sum test is used for rank data comparison. Results:The body mass of the control group was higher than that of the observation group [(62.50±11.88) kg vs (52.90±4.28) kg, t=2.40, P=0.027]. There was no statistical difference between the two groups in other demography data and previous history, sex hormone levels, menopausal symptoms, and menstrual conditions (all P>0.05). Compared with the baseline, the modified K-score, PSQI score, and MENQOL vascular dilation and contraction, psychological state, physiological state, and sexual life scores of the two groups of patients on the 5th, 10th, 30th, 60th, and 90th day of treatment were significantly reduced, and showed a gradually decreasing trend with the extension of observation time (the values in Group F were 36.37, 12.40, 18.69, 24.73, 40.77, and 18.39, respectively, P<0.001), but there was no statistically significant difference between the groups (all P>0.05). After treatment, the VAS score of the control group was 1 point in 2 cases, 2 points in 4 cases, and 3 points in 4 cases; The VAS score of the observation group was 1 in 4 cases, 2 in 3 cases, and 3, 5, and 6 in 1 case each. There was no statistically significant difference in VAS scores between the two groups ( Z=0.43, P=0.664), and no adverse events or serious adverse events were observed during the treatment period. Conclusions:Intramuscular injection of oryzanol injection for 5 and 10 days can improve menopausal symptoms, improve sleep quality and overall quality of life in patients with menopausal syndrome, and the overall effect is similar.

Objective:To explore the significance of 99Tc m-sulfur colloid lymphoscintigraphy in the diagnosis of lower limb lymphedema after gynecological tumor surgery. Methods:The clinical data of patients with lower limb lymphedema after gynecological tumor surgery in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 2015 to October 2019 were retrospectively analyzed. 99Tc m-sulfur colloid lymphoscintigraphy was performed in all patients. The results of lymphatic vessel imaging, lymph node imaging and their combination in the diagnosis of lower limb lymphedema were analyzed. The diagnostic efficacy of lymphatic vessel imaging alone, lymph node imaging alone and their combination was evaluated by the receiver operating characteristic (ROC) curve and the area under the curve (AUC), and the Youden index, sensitivity and specificity were calculated. Results:Among the 100 lower limbs of 50 patients, 56 limbs had lymphedema and 44 limbs had no obvious edema. When diagnosis was based on abnormal lymphatic vessel imaging alone, among 56 lower limbs with lymphedema, lower limbs lymphatic vessel imaging was positive in 38 (67.9%) and negative in 18 (32.1%); among 44 lower limbs without obvious edema, lower limbs lymphatic vessel imaging was positive in 6 (13.6%) and negative in 38 (86.4%); the sensitivity was 67.9%, the specificity was 86.4%, and the Youden index was 0.543. When diagnosis was based on abnormal lymph node imaging alone, among 56 lower limbs with lymphedema, lower limbs lymph node imaging was positive in 42 (75.0%) and negative in 14 (25.0%); among 44 lower limbs without obvious edema, lower limbs lymph node imaging was positive in 13 (29.5%) and negative in 31 (70.5%); the sensitivity was 75.0%, the specificity was 70.5%, and the Youden index was 0.455. When diagnosis was based on the combination of lymphatic vessel imaging and lymph node imaging, among 56 lower limbs with lymphedema, lymphatic vessel imaging and lymph node imaging were positive in 48 (85.7%) and negative in 8 (14.3%); among 44 lower limbs without obvious edema, lymphatic vessel imaging and lymph node imaging were positive in 14 (31.8%) and negative in 30 (68.2%); the sensitivity was 85.7%, the specificity was 68.2%, and the Youden index was 0.539. The AUC for the combined diagnosis of lymphatic vessel imaging and lymph node imaging was 0.781, the AUC for the diagnosis of abnormal lymphatic vessel imaging was 0.771, and the AUC for the diagnosis of abnormal lymph node imaging was 0.739 (all P < 0.01). Conclusions:99Tc m-sulfur colloid lymphoscintigraphy is of great help in the diagnosis of lower limb lymphedema after operation of gynecological tumors. The combination of lymph node imaging and lymphatic vessel imaging is more effective in the diagnosis of lower limb lymphedema.