Objective To study the efficacy and side effects of methotrexate with different protocols in the treatment of ectopic pregnancy (EP). Methods Total of 648 patients who had EP and were treated only with MTX were analysed.Patients were divided into six groups according to protocol: Group 1,100 mg intravenously( IV); Group 2,100 mg, IV, followed by citrovorum factor; Group 3, 20 mg, IV every day for five days; Group 4, 20 mg intramusculary (IM) every day for five days; Group 5, 75 mg,IV; Group 6, 75 mg, IM.Results The rates of repeated MTX injection in group1～6 because of inadequate decrease of hCG were 23.3%,25.0%,21.4%,20.6%,24.4% and 22.4% respectively .Success rates were 87.4%,85.4%,90.5%,92.6%,86.3% and 91.4% respectively.Rates of liver dysfunction were 10.3%,8.3%,64.3%,69.1%,8.7% and 31.0%.Conclusion Single-dose of 75mg MTX IV injection may be the best regimen in the treatment of EP because of the same efficacy but the least side effects.

Accurate placement of pedicle screws is a key factor of spinal surgery. Investigation of a new real-time intra-operative monitoring method is an important area of clinical application research which makes a contribution to planting pedicle screw accurately. Porcine spines were chosen as experimental objects. The changes of reduced scattering coefficient (μ'(s)) along normal puncture path, medial perforation path and lateral perforation path were measured and studied. A conclusion is drawn that there are two distinct peaks throughout the puncture process, appearing at the junction of cancellous bone and cortical bone, at the beginning and at the end, respectively. The reduced scattering coefficient is proved to be a good monitoring factor which can identify whether the screw is about to reach the critical position of the spine puncture. Moreover, the variation provides an important reference for spinal surgical navigation process.
Animals ; Biomedical Research ; Bone Screws ; Monitoring, Intraoperative ; Punctures ; Spectroscopy, Near-Infrared ; Spine ; surgery ; Surgery, Computer-Assisted ; Swine

Objective To estabhsh a rat portacaval shunt model of portal vein arterialization (PVA)by using right renal artery,andtoinvestigateitsinfluence on portal velnpressure,liver funciton and hepatic pathology.Method Forty-three Sprague-Dawley rats were assigned to PVA group(33 rats)and control group(10 rats).Portal pressure,liver function and pathological changes were evaluated at day 2,2 weeks and 2 months after surgery,respectively.Results The experimental model was successfully established in 30 out of 33(91%)rats.At day 2,2 weeks and 2 months after the operation,the portal pressure increased significanfly(P<0.05)compared with the control group,but no significant differences were found in the senrum level of alanine amlnotransferase,total bilirubin,total bile acid and creatinine.There were no patholgiccal changes from day 2 to 2 weeks after surgery,only postoperative expanslon of the sinusoidal snace was found on 2 months after surgery.Conclusion The rat model of PVA by renal artery was successfully established with the hand-suture mierosurgical techniques.The portal vein pressure maintained at a high level after PVA,meanwhile,no negative effect was found on the liver function and hepatic histological structure changes.

Objective To study the effects of semaphorin 5A (SEMA5A) gene silencing by lentivirus?mediated short hairpin RNA(shRNA)on biological activity of malignant melanoma cell line A375. Methods Two pairs of interference sequences for SEMA5A gene(shRNA1 and A375?shRNA2)and a pair of control interference sequences were designed to build lentiviral vectors, which were then transfected into HEK293T cells to gain lentivirus. A375 cells were divided into three groups:experimental group(A375?shRNA1 and A375?shRNA2 cells)transfected with the lentivirus containing shRNA1 or shRNA2, negative control group (A375?con cells) transfected with that containing the control shRNA, and blank control group(A375 cells)receiving no transfection. The A375 cells with stable knockdown of SEMA5A gene expression were screened by puromycin. Subsequently, reverse transcription?PCR and Western?blot analysis were performed to detect mRNA and protein expressions of Semaphorin 5A in these cells, and methyl thiazolyl tetrazolium(MTT)assay was applied to evaluate the growth of cells. The scratch assay and invasion assay were conducted to estimate migration and invasion ability of cells. Results The lentivirus containing the SEMA5A?targeting shRNAs or control shRNA was successfully transfected into A375 cells, and stably transfected cells were gained after puromycin selection. The expressions of semaphorin 5A mRNA and protein in the A375?shRNA2 cells were significantly reduced compared with those in the A375?con and A375 cells(all P < 0.05). MTT assay showed that the growth of A375?shRNA2 cells was significantly slower than that of A375?con and A375 cells(both P<0.05), while there was no significant difference in the growth rate between A375?con and A375 cells(P>0.05). The scratch assay showed that there was no obvious cell migration into the scratch in the experiment group, whereas the scratch was almost covered by cells in the negative control group and blank control group. The invasion assay showed that the number of A375?shRNA2 cells passing through the Transwell chamber was significantly smaller than that of A375 and A375?con cells(both P<0.05), while there was no significant difference between that of A375 and A375?con cells(P > 0.05). Conclusion The silencing of SEMA5A gene by lentivirus?mediated shRNA could effectively down?regulate the expression of semaphorin 5A, and inhibit the growth, invasion and migration of A375 cells.

Objective To discover regularities behind critical values in an effort to provide scientific evidences for a better critical value report system.Methods Collection, analysis and statistical assessments for critical value items and ranges appropriate for the hospital Results The occurrence rate of critical values is found to be 0.14%.By means of clinical evaluation, statistic analysis and reference to literature and clinical specialists, the clinical labs revised the ranges of PO2, GLU, PT and APTT, and added ALT, MYO, CTnl and K+ , GLU, BILl for newborns, and canceled AMY.All of these changes were put in practice upon approval of the Medical Department of the hospital Conclusion Regular evaluation and continuous improvement of the critical value report system may help with saving lives, improving quality of care of the labs and doctors" diagnosis as well

Objective To investigate the effect of the clinical teaching model based on the miniclinical evaluation exercise (Mini-CEX) scale in Department of General Surgery,and to provide a reference for improving the quality of clinical teaching in Department of General Surgery.Methods A total of 82 nursing interns in Department of General Surgery from June 2016 to June 2018 were enrolled,among whom 41 undergraduates in 2016 were enrolled as control group and 41 undergraduates in 2017 were enrolled as intervention group.The undergraduates in the control group were taught with the traditional clinical teaching method,and those in the intervention group were taught with the clinical teaching model based on the Mini-CEX scale.The two groups were compared in terms of department examination results,score of the Mini-CEX scale,and quality assessment score of clinical nursing teaching,in order to evaluate the teaching quality in Department of General Surgery.Results Compared with the control group,the intervention group had significantly higher department examination score [(96.56 ± 4.23) vs.(90.42 ± 5.12)] and total score of Mini-CEX scale [(5.22 ± 0.45) vs.(4.01 ± 1.03)].The intervention group had a significantly higher excellent rate than the control group (P＜0.05).The intervention group also had a significantly higher quality assessment score of clinical nursing teaching than the control group [(98.34 ± 6.12) vs.(92.45 ± 5.16)].Conclusion The clinical teaching model based on the Mini-CEX scale can improve the quality of teaching and clinical teaching skills in department of general surgery and thus improve the clinical skills and comprehensive quality of nursing interns.

Objective This report aims to assess the exposure risk of aflatoxin B1 in edible vegetable oil in Guangxi.Methods By using margin of exposure (MOE),the report analyzes the dietary exposure of aflatoxin B1 in edible vegetable oil with the data from contamination survey and dietary intake survey.Results For the vegetable oil sample,the content of aflatoxin B1 was between 0.50-320.00 μg/kg.The detection rate of peanut oil was 78.08％ (114/146) which was higher than other vegetable oil,and the exceeding rate was 31.51％ (46/146).For peanut oil,the average content was 30.80 μg/kg,the dietary exposure of the population was 17.30 ng/kg BW,and the MOE was 18.For the prepackaged peanut oil samples,the average content of aflatoxin B1 was 6.33 μg/kg,which was below the limit.While for the bulk peanut oil,the average content of AFB1 was 41.50 μg/kg,which was more than 1.08 times of the limit,and the dietary exposure was 25.59 ng/kg BW.The MOE of bulk peanut oil was 12,1/8 of the prepackaged peanut oil.Conclusion Food safety regulators should pay more attention to bulk peanut oil products,the priority in the risk management measures.At the same time,related department should also promote healthy education for the residents.

Objective:To investigate dermoscopic features of childhood vulvar lichen sclerosus.Methods:From January 2019 to May 2021, 79 female children with vulvar lichen sclerosus were collected from Kunming Children′s Hospital, and their dermoscopic features at first and return visits were analyzed retrospectively.Results:Among the 79 female children with vulvar lichen sclerosus, their age ranged from 2.4 to 12 years, the age at onset was 5.6 ± 2.12 years, the course of disease was 14.23 ± 12.36 months, and 30 children received regular follow-up and treatment. Among 329 skin lesions at the first visit, characteristic vascular shapes were observed in 149 (45.3%) , including linear vessels in 129, punctate vessels in 25, coiled vessels in 19, and hairpin-like vessels in 12; degenerative structures and pigment abnormalities were seen in 207 (62.92%) , including bluish-gray pigmented structures in 136, brown pigmented structures in 51, pepper-like patterns in 15, etc.; yellowish-white structureless areas were found in 280 (85.1%) , follicular keratotic plugs in 97 (29.5%) , and reddish-violet globules and patches in 66 (20%) . Among 238 skin lesions at the return visit, characteristic vascular shapes were observed in 100 (42%) , including linear vessels in 87, dendritic vessels in 21 and punctate vessels in 4, and no hairpin-like vessels were observed; degenerative structures and pigment abnormalities were seen in 154 (64.70%) , including brown pigmented structures in 93, bluish-gray pigmented structures in 57, and pepper-like patterns in 4; yellowish-white structureless areas were found in 165 (69.3%) , follicular keratotic plugs in 62 (26.1%) , and reddish-violet globules and patches in 8 (3.4%) . The prevalence rates of bluish-gray pigmented structures, yellowish-white structureless areas, reddish-violet globules and patches, punctate vessels, hairpin-like vessels, and coiled vessels in the skin lesions were all significantly lower at the return visit than at the first visit (all P < 0.05) , while the prevalence rate of the brown pigmented structure was significantly higher at the return visit than at the first visit ( P < 0.05) . Conclusion:Under a dermoscope, yellowish-white structureless areas are a highly specific characteristic of childhood vulvar lichen sclerosus, and therapeutic effect can be monitored by observing changes in dermoscopic features, including brown pigmented structures, bluish-gray pigmented structures, yellowish-white structureless areas, reddish-violet globules and patches, and vascular structures. Dermoscopy shows favorable application value in auxiliary diagnosis and follow-up observation of childhood vulvar lichen sclerosus.

Objective To investigate the current status of job satisfaction,stressful events and self-efficacy among nurses in cancer hospital,and explore correlation among job satisfaction,stressful events and self-efficacy.Methods Totally 260 nurses from Zhejiang Cancer Hospital were inquired by Minnesota satisfaction questionnaire,inventory of stressful events,and general self-efficacy scale.Descriptive analysis and Pearson correlation analysis were adopted to analyze the data.Results A total of 260 questionnaires were given out,while 246 valid questionnaires returned,and the effective rate was 94.6％.The total average scores of job satisfaction,stressful events and self-efficacy were (3.41 ± 0.45),(117.72 ± 18.92) and (2.50 ± 0.44).There was a significant negative correlation between overall satisfaction and stressful event (r =-0.458,P＜0.001).However,satisfaction were positively correlated with self-efficacy (r =0.257,P =0.020).Conclusions Job satisfaction among nurses of cancer hospital is higher than data of previous studies,but the overall self-efficacy is still low,and most of them is in the middle-high stressful events.Managers can improve nurses' job satisfaction by reducing occupational stress and increasing self-efficacy.That might reduce dimission rate,and maintain the stability of care team.

Objective To investigate the effect of long non-coding RNA F19 (lncRNA F19) on secondary brain injury following traumatic brain injury (TBI) in mice. Methods (1) A total of 96 C57BL/6J male wild-type mice were divided into sham group, sham+control lentivirus group, sham+F19 lentivirus group, TBI group, TBI+control lentivirus group and TBI+F19 lentivirus group according to the random number table. Each group consisted of two subgroups of 1 day and 3 days after TBI, with eight mice per subgroup. The expression and silence efficiency of lncRNA F19 were detected. ( 2 ) A total of 96 C57BL/6J male wild-type mice were divided into sham group, TBI+control lentivirus group and TBI + F19 lentivirus group according to the random number table. Each group consisted of two subgroups of 1 day and 3 days after TBI, with 16 mice per subgroup. The effect of lncRNA F19 on neuronal apoptosis after TBI was recorded. The mice TBI model was established using the controlled cortical damage method (CCI). The lncRNA F19 lentivirus or control lentivirus were administrated by intracerebroventricular injection 5 days before injury. The expressions of lncRNA F19 ( 2 -ΔΔct ) were detected by real-time quantitative PCR ( qRT-PCR ) at 1 day and 3 days after injury. The Toll-like receptor 4 (TLR4), B lymphocyte tumor-2 (Bcl-2) and Bcl-2 related protein (Bax) expressions were detected by Western blot. The TUNEL was used to detect apoptosis around the traumatic lesions. Results From the first day after injury, both in the sham operation and TBI groups, the control lentivirus had no effect on the level of lncRAN F19 (P >0. 05). One day after injury, compared with sham +control lentivirus group, the levels of lncRNA F19 in sham + F19 lentivirus group were significantly decreased (0. 07 ± 0. 07:0. 93 ± 0. 17);compared with TBI+control lentivirus group, levels of lncRNA F19 in TBI+F19 lentivirus group were significantly decreased (2. 91 ± 1. 18:0. 52 ± 0. 32) (P<0. 05). There were significantly lower protein levels of TLR4 (0. 51 ± 0. 13:0. 66 ± 0. 15), Bax (0. 45 ± 0. 06:0. 67 ± 0. 16), lower TUNEL-positive neurons ratio [(23. 55 ± 6. 85)％ : (31. 58 ± 7. 52)％], but higher protein levels of Bcl-2 (0. 76 ± 0. 16:0. 47 ± 0. 12) in TBI+F19 lentivirus group compared with the TBI+ control lentivirus group (P <0.05). Three days after injury, compared with sham + control lentivirus group, levels of lncRNA F19 in sham+F19 lentivirus group were significantly decreased (0. 11 ± 0. 09:0. 96 ± 0. 09); compared with TBI+control lentivirus group, levels of lncRNA F19 in TBI+F19 lentivirus group were significantly decreased (0. 54 ± 0. 24:3. 39 ± 0. 90) (P <0. 05). There were significantly lower protein levels of TLR4 (0. 60 ± 0. 20):(0. 85 ± 0. 09)], lower Bax (0. 60 ± 0. 12:0. 88 ±0. 21), lower TUNEL-positive neurons ratio [(29. 10 ± 7. 37)％ :(39. 22 ± 10. 64)％], but higher protein levels of Bcl-2 (0. 66 ± 0. 12:0. 35 ± 0. 16) in TBI+F19 lentivirus group compared with the TBI+control lentivirus group (P<0. 05). Conclusion Inhibition of lncRNA F19 can significantly reduce the TLR4-induced neuronal apoptosis in cortex after TBI in mice and alleviate reduce the secondary brain injury.