Objective To study the effect of anticholinesterase agents on acantholysis in pemphigus vulgaris (PV) by using a mouse model.Methods Fifty-five neonatal BALB/c mice were divided into four groups:model group injected subcutaneously with the sera of patients with PV (n =15),pyridostigmine bromide group (n =15) and neostigmine methylsulfate group (n =15) subcutaneously injected with pyridostignine bromide and neostigmine methylsulfate respectively,in addition to the sera of PV patients,control group subcutaneously injected with sodium chloride physiological solution (n =10).The effect of anticholinesterase agents on acantholysis in PV was evaluated in terms of clinical presentation,histopathological manifestations and direct immunofluorescence findings.Results The injection of sera from PV patients induced characteristic changes of PV in neonatal BALB/c mice in the model group.The degree of acantholysis in the model group was higher than that in the pyridostigmine bromide group (H =21.584,P ＜ 0.001) and neostigmine methylsulfate group (H =20.641,P ＜ 0.001).No changes were observed in the control group.Conclusion Anticholinesterase agents can reduce the degree of acantholysis in the mouse model of PV.

AIM To investigate the curative effects of Kuntai Capsules (Coptidis Rhizoma,Scutellariae Radix,Asini Corii Colla,etc.) on rat model for primary ovarian insufficiency (POI) caused by 4-vinylcyclohexene diepoxide (VCD).METHODS Seventy-five weaned 21-day old rats were divided equally into five groups randomly:control group,model group,low-,medium-,and high-dosage Kuntain group.Except the control group was given sesame oil rats,other four groups were given intraperitoneal injection of VCD solution.According to vaginal smear of rats,eight rats in each group were selected,the levels of FSH (follicle-stimulating hormone),LH (leuteinizing hormone),E2 (estradiol) and AMH (anti-Mullerian hormone) were measured,and morphological changes of ovary and uterus were observed.RESULTS Compared to the control group,FSH level in rats' serum of the model group significantly increased while AMH and E2 levels significantly decreased,and LH level rose;Kuntai Capsules significantly decreased FSH level while increased AMH level;The wet weight of rats' ovary in the model group was lighter than that in the control group.The ovary weight of Kuntai Capsules low-dosage group was increased;the number of follicles at all levels and corpora lutea of rats in the model group were decreased.After the treatment with Kuntai Capsules,the number of follicles at all levels and corpora lutea were increased;light microscopy manifested decreased uterine glands of the tube wall,reduced glandular cavity.After the treatment with Kuntai Capsules,the number of uterine glands increased and the gland cavity expanded.CONCLUSION Kuntai Capsules may slowdown the functional decline rate of ovarian.

Objective To investigate the climacteric symptoms and depressive related factors of climacteric females in gynecology outpatients and inpatients,to provide evidence for effective health promotion.Methods 416 climacteric women were investigated by using improved menopause Kuppermen Scales and Center for Epidemiological Studies Depression (CES-D).The results underwent analysis.Results There were 93.99％ of patients suffering from climacteric syndrome,49.52％ with depression symptom.The main factors of climacteric syndrome were eating breakfast according to the timetable every day,nutritionally balanced diet,controlling of salt intake,regular body exercises and to maintain a proper body weight.Factors related to depression symptoms were sore breasts,constipation,dry skin,lower abdominal pain.The correlation between climacteric syndrome and depressive symptom was significant.Conclusions The main influencing factor of climacteric syndrome was healthy lifestyle.The climacteric syndrome increases the risk of depressive symptoms.

Objective To investigate the correlation between immediate postoperative platelet count with liver failure after partial hepatectomy in patients with hepatocellular carcinoma.Methods The clinical data of 71 patients with hepatocellular carcinoma who underwent liver resection at the Hepatopancreatobiliary Surgery Department of Nanjing Drum Tower Hospital from July 2013 to August 2015 were retrospectively analyzed.The clinical diagnosis was confirmed by pathology of the resected specimens.Based on postoperative platelet count within 2 h,the patients were divided into the low platelet count (PLT ＜ 100 × 109/L) group (n =24,33.8％) and the normal platelet count (PLT ≥ 100 × 109/L) group (n =47,66.2％).The correlations between immediate postoperative platelet count with serum indexes including serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil) and direct bilirubin (DBil) were analyzed,and the incidences of posthepatectomy liver failure was also evaluated in these two groups.Results There was no re-operation and perioperative death in this study.Among the 71 patients,25 patients (35.2％) developed postoperative complications (grade Ⅰ to Ⅲ),and 8 patients (11.3％) suffered from postoperative liver failure (grade A).When compared with the normal platelet count group,the low platelet count group had significantly increased risks of postoperative liver failure (29.2％ vs 2.1％,X2 =11.618,P ＜ 0.05),increased postoperative peaks of ALT,AST,TBil and DBil levels [(462.5 ±135.7)U/L vs (307.9 ± 192.6) U/L,(440.0 ± 163.3) U/L vs (265.8 ± 155.8) U/L,(29.5 ±9.1) μmol/L vs (17.9 ±8.8) μ mol/L,t =3.507,4.385,5.129,P ＜0.05,respectively] and longer normalization time of liver function.Multiple Logistic regression analyses revealed that an immediate postoperative low platelet count was an independent risk factor of posthepatectomy liver failure.Conclusions The platelet count was associated with the incidence of postoperative liver failure after partial liver resection in patients with hepatocellular carcinoma.Patients with an immediate postoperative low platelet count suffered from a high incidence of posthepatectomy liver failure and delayed liver function recovery.

Objective To evaluate the effect of duloxetine on the expression of Toll?like receptor 4 (TLR4) in the spinal dorsal horn in a rat model of diabetic neuropathic pain (DNP). Methods Type 2 di?abetes mellitus was induced by high?fat and high?sucrose diet and intraperitoneal streptozotocin ( STZ) 35 mg∕kg in male Sprague?Dawley rats, aged 2 months, weighing 180-220 g. Seventy?five rats with type 2 di?abetes mellitus were randomly divided into 5 groups ( n=15 each ) using a random number table: group DNP, DNP + normal saline group (group DNP+NS), and DNP + duloxetine 5, 10 and 20 mg∕kg groups (DNP+D5, DNP+D10, DNP+D20 groups). Another normal 15 rats were selected and served as control group ( group C) . Duloxetine 5, 10 and 20 mg∕kg were injected intraperitoneally once a day for 14 consecu?tive days starting from 15 days after administration of STZ in DNP+D5 , DNP+D10 and DNP+D20 groups, respectively. The equal volume of normal saline was given instead in group DNP+NS. The mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency ( TWL) were measured on the day before STZ administration and 14, 17, 21 and 28 days after STZ administration. After the last measurement of pain threshold, the L4?6 segments of the spinal cord were removed for determination of the expression of
TLR4 by immuno?histochemistry and Western blot. Results Compared with group C, the MWT was signif?icantly decreased, TWL was shortened, and the expression of TLR4 was up?regulated in DNP, DNP+D5, DNP+D10 and DNP+D20 groups (P<0?05). Compared with group DNP, the MWT was significantly in?creased, TWL was prolonged, and the expression of TLR4 was down?regulated in DNP+D5 , DNP+D10 and DNP+D2 0 groups ( P<0?05) , and no significant changes were found in the parameters mentioned above in group DNP+NS ( P>0?05) . Conclusion The mechanism by which duloxetine attenuates DNP is related to down?regulated expression of TLR4 in the spinal dorsal horn of rats.

Objective To study the clinical efficacy of the injection Salvia (freeze-dried, abbr: Salvia powder needle), with fallopian tube recanalization on the treatment of oviduct obstructive infertility. Methods One hundred and ninety-five patients of oviduct obstructive infertility were enrolled in this study and divided into drug group and control group. Salpingography with modified catheter, recanalization and perfusion operation were performed in both two groups. Salvia powder, gentamicin, α-ACT and dexamethasone were injected into test group, while Gentamicin, α-ACT and dexamethasone were injected into control group. Recanalization rate of fallopian tube, rate of intrauterine gestation and rate of ectopic pregancancy were measured and compared between two groups. Results Twelve months after operation, recanalization of fallopian tube of test group and control group was 94.39% and 85.87%, respectively. Twenty-four months after operation, intrauterine gestation rate of test group and control group was 50.00% and 35.71%, respectively. Conclusion Salvia powder combined with modified recanalization operation is helpful to improve the rate of intrauterine gestation.

Objective To maintain the good psychological state of new nurses, stabilize nursing troop and improve nursing quality, we investigate the work pressure source and mental health of new nurses and analyze the correlation among work pressure, mental resilience and mental health. Methods According to the principle of convenience sampling,a total of 116 new nurses who get the job less than one year in the first hospital of Jilin university were investigated using the method of questionnaire survey. The Conner Davidson Resilience Scale (CD-RISC), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were involved in the questionnaire. Results Mental resilience scores of new nurses were (63.73±15.11), the scores of anxiety and depression were (34.49±6.45) and (35.59±7.24). Work pressure was negatively correlated with mental resilience (P<0.01) and positively correlated with anxiety and depression (P<0.01). New nurses worried about making mistakes in the work accounted for 89.42 percents (93/104), which was the highest score in the stress source. Conclusions New nurses have good mental resilience and psychological health level, but work pressure has certain impact on mental resilience and mental health. Hospital managers should take active measures which include reducing pressure and improving the ability to help the new nurses through the adaptation as soon as possible.

Replenishing the insulin-producing β cell mass is considered to be a hot topic in the field of diabetes treatment.It has long been known that pancreatic β cells are generated primarily by self-duplication in adults.However,insulin resistance can induce dramatic compensatory β cell mass expansion in the pancreas.Therefore,it is of great value to investigate the etiology and pathogenesis of β cell proliferation under insulin resistance.The recent study has shown that betatrophin,a protein secreted by the liver,modulates β cell growth in response to insulin resistance.We published one article in Diabetes Care titledIncreased circulating levels of betatrophin in newly diagnosed type 2 diabetic patientsto elaborate the relationship between diabetes and betatrophin.

Objective To investigate the risk factors and prognosis of perioperative myocardial infarction in the patients undergoing noncardiac surgery. Methods Clinical data of 562 patients who had accepted non-cardiac surgery was collected and retrospectively analyzed. The risk factors, treatments and outcomes of all these patients were recorded and analyzed. Results A total of 19 out of the 562 patients had perioperative myocardial infarction ( PMI) . The incidence was 3. 4% . The mean occurrence time was (43. 5 ± 12. 7)h after operation. Eleven PMI patients (11 ∕ 19) were non-ST-segment elevation myocardial infarction and eight patients (8 ∕ 19) were ST-segment elevation myocardial infarction. Thirteen PMI patients were left coronary artery occlusion and six patients were right coronary artery occlusion. Advanced age, history of myocardial infarction, unstable angina, change of ST-T segment on electrocardiography (ECG), multivessel diseases, diabetes,hypertension,and high risk non-cardiac surgery were the risk factors of PMI and positively correlated to PMI. Sixteen PMI (16 ∕ 19) patients accepted PCI treatment and three patients (3 ∕ 19) accepted drug conservative treatment. Two patients had unstable angina attack after treatment and one patient had arrhythmia. The heart function in two patients decreased by one or more than one class within the follow up of 1 year. No patient had recurrent acute myocardial infarction or deceased during follow-up. Conclusions Many factors could lead to PMI. Making preoperative assessment, recognizing patients of high risks and dealing with patients who had PMI in time was necessary.

Objective To study the effectiveness of microwave ablation in treating HCC.Methods A total of 98 nodules in 56 cases of HCC were treated via appropriate puncture approach ac-cording to the volume, amount and site of tumor nodules. Results Only 1 patient failed to finish treatment since he could not suffer the pain. The other 55 patients finished without a hitch. Clinical and imaging findings were analyzed for change of physiology. Conclusion The microwave ablation is effective for the treatment of HCC. Such therapy can be important supplement of direct surgical man-agement. Its effect mainly depends on accurate puncture approach and enough diametric range. Mean-while, reasonable puncturing method should be selected.