ObjectiveTo compare the clinical effects of laparoscopically assisted vaginal hysterectomy (LAVH) and transabdominal hysterectomy (TAH).MethodsOne hundred and twenty-six cases operated with hysterectomy were classified into LAVH group and TAH group by random digits table with 63 cases each.The operation time,intraoperative bleeding amount,exhaust time,hospitalization time and postoperative complications were observed and compared.ResultsThe operation time,intraoperative bleeding amount,exhaust time and hospitalization time was ( 115.6 ± 13.8 ) min,(92.5 ± 11.3 ) ml,(21.8 ±4.8) d and (6.1 ± 1.7) d in LAVH group,( 82.5 ± 8.7) min,( 112.3 ± 17.8) ml,(28.9 ± 6.2) d and (9.6 ±2.2) d in TAH group,there were significant differences between two groups (P＜0.05).The incidence of incision pain,delayed wound healing,vaginal stump infection,thrombophlebitis,and gastrointestinal disorders was 9.5％(6/63),0,1.6％(1/63),0 and 7.9％(5/63) in LAVH group,which was significantly lower than that in TAH group [52.4％(33/63),7.9％(5/63),11.1％(7/63),7.9％(5/63) and 22.2％ ( 14/63 ) ] (P ＜ 0.05).ConclusionCompared with TAH,LAVH can shorten exhaust time,hospitalization time,reduce intraoperative bleeding amount,decrease complication rate,which can be further applied in clinic.

The mRNA and protein expression of thymidylate synthase (TS), thymidine phosphorylase (TP) and dihydropyrimidine dehydrogenase (DPD) and their relationship with prognosis were investigated. Real-time quantitative RT-PCR (Taqman) was used to detect the mRNA expression of TS, TP and DPD in formalin-fixed and paraffin-embedded 106 samples of epithelial ovarian cancer and 29 normal ovaries. A TATA box-binding protein (TBP) was used as an endogenous reference gene. A relationship between TS, TP, DPD expression and clinicopathologic features was investigated. The protein location and expression of TS, TP and DPD was examined in the same patients by an avidin-biotin-peroxidase immunohistochemistry. TS and TP mRNA expression levels were significantly higher in tumor group than in normal controls, with the average value of TS and TP mRNA being 6.14+/-0.62 and 0.59+/-0.06 in tumor tissue, and 0.71+/-0.14 and 0.16+/-0.04 in normal tissue, respectively. DPD mRNA expression levels were significantly lower in tumor group (0.11+/-0.02) than in normal controls (0.38+/-0.05). There was statistically significant difference in TS and TP mRNA expression levels among different pathological grades and clinical stages (P<0.05), but histological subtype was not significantly associated with TS and TP mRNA expression. DPD gene expression was not significantly associated with any clinicopathological parameters. Immunohistochemistry revealed that TP protein was mainly distributed in nucleus, and TS and DPD mainly in cytoplasm. The protein expression intensity of TS, TP and DPD was coincided with the mRNA expression levels. It was concluded that TS, TP mRNA and protein expression levels were significantly higher in epithelial ovarian cancer, and DPD mRNA and protein expression levels were significantly lower. The expression levels of TS and DPD were related to the patients' prognosis and survival. Combined gene expression levels of TS, TP and DPD represent a new variable to predict the clinical outcome in ovarian cancer. The association of TS, TP and DPD expression levels with survival suggests an importance of these genes for tumor occurrence and progression.

Objective To investigate the effect of celastrol on space learning capability and expressions of beta-amyloid (Aβ) 40 and Aβ42 in hippocampus in APPswe/PS1dE9 double transgenic mouse after partial hepatolobectomy.Methods The 3-month-old APPswe/PS1dE9 double transgenic mice (n =96) were randomly divided into three groups according to the random number table method.Surgery group (group S, partial hepatolobectomy;n =32), celastrol group (group C, injections of dimethyl sulphoxide/DMSO and celastrol for 3 days before undergoing partial hepatectomy, on the surgery day, and for a further 4 days after surgery;n =32), and DMSO group (group D, injections of DMSO for 3 days before undergoing partial hepatectomy, on the surgery day, and for a further 4 days after surgery;n =32).Eight mice were selected randomly in each group and were Morris-water maze trained for continuous 5 days.Theirs learning and memory abilities were evaluated at 1,3, 7 and 14 d after surgery, respectively.Hippocampus was collected and the changes of β40 and Aβ42 were measured by enzyme-linked immunosorbent assay (ELISA) at the time set in advance in each group.Results The average escape latency of group C was significantly shorter than groups S and D at 3, 7 and 14 d after partial hepatectomy (P ＜ 0.05).Times of passing through the platform groups S and D were significantly less than group C (P ＜ 0.05).The expressions of Aβ40/Aβ42 in group C were lower than group S and group D at 1, 3, 7 and 14 d after partial hepatectomy (P ＜ 0.05).Conclusions Through decreasing the expressions of Aβ40 and Aβ42 in hippocampus,celastrol improves the space learning capability in APPswe/PS1dE9, the double transgenic mouse after partial hepatolobectomy.

Objective To investigate the relationship between the expression ofα1-antichymot-rypsin (α1-ACT)in plasma and postoperative cognitive dysfunction(POCD).Methods The cognitive function of 64 patients undergoing operation under general anesthesia was evaluated by a battery of cognitive assessment instruments(BCAI)and the levels ofα1-ACT were measured at the time 1 d pre-operatively and 7 d and 3 months postoperatively.The patients were randomly divided into two groups:30 patients in ulinastatin group (group U)were injected with 10 000 U/kg ulinastatin,which was dissolved in 100 ml saline,within 20 min at the time of 30 minutes before induction;while control group (group C)were injected with the same volume saline.Results There was no significant differ-ence between the expression of α1-antichymotrypsin in patients with POCD and in control patients at the time before operation.Compared with control patients,the levels of α1-ACT in patients with POCD at the time of 7 d and 3 months postoperation were significantly higher (P <0.05).The levels of α1-ACT at 7 d postoperation were significantly higher than that preoperatively in both groups (P <0.05).The incidence of POCD in group U were significantly lower than that in group C,at the time of 7 d and 3 months after surgery (P <0.05).Conclusion POCD is associated with high expression of plasma α1-ACT.

Objective To conduct an empirical analysis of constitutes and changes of type 2 diabetes patients′ hospitalization expenses and find out the differences and influencing factors so as to provide hospitals and related departments with the decision basis of controlling medical costs, arranging medical resources and optimizing systems.Methods Information of type 2 diabetes patients who had been admitted to a certain first-class grade one hospital in Ningxia from 2013 to 2016 were collected and categorized.Hospitalization costs and influencing factors of the patients were comprehensively analyzed through descriptive statistics, variance analysis and regression analysis.Results The medicine and examination costs as the constitutes of hospitalization expenses were too high.Gender, length of stay, age and diabetic complications were main contributory factors of type 2 diabetes patients′ hospitalization expenses.Conclusion The costs of hospitalization of patients with type 2 diabetes are unreasonable and need to optimize.Type 2 diabetes patients′ hospitalization expenses should be effectively controlled and medical resources should be reasonably used through standardizing treatment behavior, shortening length of stay, intensifying publicity and education, enhancing prevention and reinforcing follow-ups, expanding health insurance coverage and upgrading its level.

Purpose To compare the CT features of hepatic metastases of gastro-entero-pancreatic adenocarcinomas with and without neuroendocrine differentiation [NED(+) and NED(-)] and to explore the value of CT features in differentiation of the two groups.Material and Methods From January 2009 to December 2015,abdominal CT scans of 17 pathologically proved cases of NED(+) gastro-entero-pancreatic adenocarcinomas with hepatic metastases and 34 pathologically proved cases of NED(-) hepatic metastases with sex,age and primary site matched were retrospectively reviewed.CT features including hepatic metastases number,size,distribution,shape and enhancement were assessed,as well as presence of lymphadenopathy or ascites.Differences of CT features between the two groups were analyzed.Results Compared with NED(-) group,hepatic metastases of NED(+) group more frequently demonstrated a peripheral enhancement on artery phase (94.1％ vs.44.1％,P＜0.05),and more washout on portal venous phase (41.2％ vs.5.9％,P＜0.05),while hepatic metastases of NED(--) group showed more plateau type (91.2％ vs.58.8％).There was no significant difference of other findings between the two groups (P＞0.05).Logistic regression revealed that enhancement area in hepatic artery phase and enhancement changes in portal venous phase were independent factors for differential diagnosis (P＜0.05).The area under the ROC curve of combining the two features was 0.811 (P＜0.05).Conclusion There are some different CT enhancement features between NED(+) and NED(-) hepatic metastases of gastro-entero-pancreatic adenocarcinomas,which are helpful in differential diagnosis.

Objective: To explore the influence of metacognitive group intervention on resilience of college students with social anxiety disorder. Methods: Forty-eight college students with social anxiety disorder were randomized into two groups. The control group (24 patients) received systemic desensitization, and the experiment group (24 patients) received metacognitive group psychological intervention. Social anxiety score, mental health and resilience score were compared before and after intervention of two groups. Results: The total scores of SCL-90 and the sub-scores of each dimension were significantly decreased after intervention, especially among the experiment group (P<0.05). No significant difference were found in the total score of SCL-90 and the scores of each factor at the last follow-up and after intervention in the experiment group (P>0.05). For control group, the total scores of SCL-90 and sub-scores of each dimension increased at the last follow-up compared with after intervention. Compared with before intervention, the LSAS and HAMA scores of the two groups significantly decreased, and the ER 89 score increased (P<0.05). There were no significant differences in the LSAS, HAMA, and ER 89 scores at the last follow-up and after intervention in the experiment group (P>0.05). For control group, the LSAS and HAMA scores at the last follow-up increased, and the ER 89 score decreased compared with after intervention (P<0.05). The LSAS and HAMA scores in the experiment group were significantly lower, and the ER 89 score was significantly higher, than those of the control group after intervention and at the last follow-up (P<0.05). Conclusion Metacognitive group psychological intervention can effectively improve resilience among college students with social anxiety disorder, helps reducing anxiety symptoms and promote social self-confidence and initiative.

Objective To study the radiation injury of rat C6 glioma cell line by high resolution,1 H-nuclear magnetic resonance (1 H NMR) spectroscopy,and to preliminarily investigate its mechanism.Methods Metabolite concentrations in C6 cells were determined by 1 H NMR spectroscopy.Comet assay was used to evaluate DNA damage.Flow cytometry was used to determine the cell cycle and apoptosis rate.Colony-forming assay was used to measure the colony-forming rate and preliminarily investigate the mechanism of radiation injury.The resuhs were analyzed by one-way analysis of variance and Pearson correlation analysis.Results With the increase in radiation dose from 0 Gy to 1,5,10,and 15 Gy,DNA damage was enhanced in a dose-dependent manner (P=0.000-0.690);the percentage of cells in G1 phase increased (P =0.026-0.749);the apoptosis rate significantly increased (all P =0.000);the colony-forming rate significantly declined (P =0.000-0.004);the Lac/Cr ratio significantly decreased (P =0.000-0.015),which had a negative linear correlation with DNA damage parameters (tail length,r=-0.971;％DNA in the tail,r =-0.998;tail moment,r =-0.995) and apoptosis rate (r =0.978).Conclusions 1 H NMR spectroscopy reveals that the change in the Lac/Cr ratio is associated with injury and apoptosis of C6 cells after radiation.1 H NMR spectroscopy has the potential to predict radiation injury of glioma.

Objective To improve the in vivo analgesic activity of acacetin and find leads for the development of new drugs, novel acacetin derivatives containing alkyl amide groups with different length of carbon chain were designed and synthesized according to the molecular structure of the active hit compound found in our previous work. Methods Using apigenin as the initial chemical ma-terial,the acacetin was synthesized through 3 steps,then the target compounds were prepared by conjugating hydroxy group of acace-tin at position 7 with bromoalkyl amides. The analgesic activity of the target compounds was evaluated by acetic acid writhing model of mice. Results and Conclusion Novel acacetin alkyl amide derivatives showed more potent analgesic activities than that of clinical medicine diclofenac,which could be used as leads for further development of new drugs.

Objective To evaluate the efficacy of high resolution MR T2WI combined with DWI in evaluation of pathological complete response after neoadjuvant therapy in rectal cancer.Methods Totally 364 patients with locally advanced rectal cancer who recieved neoadjuvant therapy and radical surgery,underwent MR scanning before and after neoadjuvant therapy,were enrolled in this study.The diagnostic efficacy of high resolution MR T2WI and high resolution MR T2WI combined with DWI in evaluation on pathological complete response after neoadjuvant therapy in rectal cancer were compared.Results Finally 49 cases were demonstrated pathologic complete response.Accuracy,sensitivity,specificity,positive predictive value and negative predictive value of high resolution MR T2WI and high resolution MR T2WI combined with DWI in predicting on pathological complete response after neoadjuvant therapy were 82.69％ (301/364),40.82％ (20/49),89.21％ (281/315),37.04％ (20/54),90.65％ (281/310)and 87.36％ (318/364),65.31％ (32/49),90.79％ (286/315),52.46％ (32/61),94.39％ (286/303),respectively.Sensitivity had statiatical significant difference between two methods (x2 =4.96,P=0.03).Conclusion Compared with high-resolution T2WI,the combination of DWI and high-resolution T2WI can improve the diagnostic efficacy in evaluation of pathologic complete response of locally advanced rectal cancer.