Objective To explore the recurrence-prevention effect of oral contraceptive and levonorgestrel-releasing intrauterine system (Mirena) after hysteroscopic endometrial polypectomy.Methods One hundred and seventy-four patients who received hysteroscopic endometrial polypectomy were enrolled in this research.The patients were informed and divided into three groups according to their selection:51 cases were given oral contraceptive since one month until 12 months after the surgery (oral contraceptive group); 60 cases were received Mirena since one month after the surgery (Mirena group) ; and 64 cases were received no treatment after the surgery (control group).The groups were followed up at 3,6,12 months after the surgery and compared the recurrence rate,menstruation,level of hemoglobin and complication rate.Results The recurrence rate in oral contraceptive group,Mirena group and control group was 3.9％(2/51),3.3％ (2/60) and 19.0％ (12/63),respectively.The recurrence rate in control group was higher than that in oral contraceptive group and Mirena group,and there was significant difference (P ＜ 0.05).The proportion of low menstruation volume in control group was lower than that in oral contraceptive group and Mirena group,and there was significant difference (P ＜ 0.05).The level of hemoglobin in control group was lower than that in oral contraceptive group and Mirena group [(124.55 ±9.33) g/L vs.(133.71 ± 11.03),(135.89 ±6.88) g/L],and there was significant difference (P ＜ 0.05).The incidence of complication in Mirena group [18.3％ (11/60)] was less than that in oral contraceptive group[35.3％(18/51)],and there was significant difference (P ＜ 0.05).Conclusions Oral contraceptive and Mirena after hysteroscopy for endometrial polys significantly decrease the recurrence rate.The complication rate of Mirena is lower and it is a safe and effective way to treat and prevent the endometrial polyp.

Objective To discuss the value of minimum systolic and diastolic peak velocity ratio(S/D) and pulse index(PI) of the umbilical artery of pregnant twins in predicting perinatal outcome.Methods Pulsed Doppler measurements of the umbilical artery were conducted in 77 cases of twin pregnancise. Perinatal outcome was compared between normal and abnormal umbilical artery S/D,PI group respectively. The rates of abnormal umbilical artery S/D,PI in monochorionic and dichorionicdich were compared. Results The rates of adverse perinatal outcome,small for gestational age(SGA),structural malformation in abnormal umbilical artery S/D group were significantly higher than those in normal umbilical artery S/D group ( P

Multidrug resistance (MDR) is one of the main reasons for failure in clinical treatment of cancer.A variety of different mechanisms involves in the occurrence and during the development of MDR.Exploiting the corresponding reversal drugs according to the mechanisms is the major route of solving MDR problems clinically.In this article,research of MDR mechanisms,at home and abroad is reviewed.

Objective To explore a method for establishing the hamster model of Clostridium difficile-associated diarrhea (CDAD)and the indicators for its evaluation.Methods Clindamycin was administered to hamsters subcutaneously (day 1),and 24 h later infected with C.difficile clinical isolates KH1 (ribotype 027,106-108 CFU/mL)or SH9 (ribotype 001 ,108-1010 CFU/mL)by gavage.Animals were observed for CDAD symptoms such as diarrhea,weight loss and death.At the end of ob-servation period (day 7 or death),the cecum was collected from each animal for histological evaluation of inflammation.Results Following a single dose of 100 mg/kg clindamycin subcutaneously,all the animals challenged with KH1 (108 CFU/mL)devel-oped diarrhea and then died within 5 days.All the hamsters challenged with SH9 (1010 CFU/mL)developed diarrhea as well but only 66.7% died at the end of observation period.Among other groups,only one or none developed diarrhea and then died. The symptoms of hamsters with diarrhea included loose stool,wet tail and weight loss.On histological examination,conges-tion,hemorrhage and neutrophil infiltration of the mucosa were observed in the hamsters died of CDAD.Conclusions We have successfully established a hamster CDAD model that allows for future investigations.

Objective To investigate wether bronchial epithelial-mesenchymal transformation (EMT)take part in airway remodling in asthmatic mice,and the effect of inhaled glucocorticoid to it. Methods Thirty BALB /c mice were randomly divided into control group(n =10),asthma group(n =10) and budesonide group(n =10).The qualitity of serum OVA-sIgE was measured to vertify asthma modle. Bronchial airway thickness collagen deposition area was analyzed by HE and Masson staining to test the level of airway remodling.ELISA was used to test the quantity of transforming growth factor(TGF)-βin bron-choalveolar lavage fluid(BALF).Immunohistochemical assay was used to observe fibroblast specific protein-1 (FSP-1 )expressing area.Western blot and realtime PCR were performed to analyze the protein and mRNA expression of E-caderin,Vimentin and FSP-1 .Results The expression of OVA-sIgE,bronchial airway thick-ness,the collagen deposition area were significantly higher in asthma group than those in control group,while the above index in BUD group were allivated compared to those in asthma group(P <0.01 ,respectively). The expression of TGF-βin BALF increased and the expression of FSP-1 located in bronchial epithlium,the quantity of E-caderin significantly decreased,and the quantity of Vimentin and FSP-1 increased by Western blot and realtime PCR in asthma group,compared to those in control group(P <0.01 ).While the level of E-caderin increased(P <0.01 ),TGF-βand Vimentin reduced partly in BUD group(P <0.05 ),and there was no differece in the level of FSP-1 between BUD group and asthma group(P >0.05).Conclusion Lung tissue EMT take part in airway remodling of asthma,which is mainly focus on bronchial epithlium.The effect of traditional inhaled budesonide can not heal the bronchial EMT in asthma.

AIM: To explore the role of clinical pharmacists in the establishment of standardized cancer pain management ward in our hospital. METHODS: Information of hospitalized patients with cancer pain admitted to the oncology department from January to June 2018 and from July to December 2018 was retrospectively collected and was allocated as the control group and the intervention group, respectively. A total of 114 patients were included in the study, including 58 in the control group and 56 in the intervention group. General information included gender, age, body mass index, tumor type, KPS score, NRS score, etc was collected. There was no statistical difference of the baseline value. The analgesic effect before and after clinical pharmacists' participation was compared. RESULTS: The pain score in the intervention group was significantly lower than that in the control group (P<0.05), the number of pain occurence in the intervention group was significantly lower than that in the control group (P<0.05), and the total incidence of adverse reactions in the intervention group was significantly lower than that in the control group (P<0.05), and KPS score in the intervention group was significantly higher than that in the control group (P<0.05). CONCLUSION: Participant of clinical pharmacists in the diagnosis and treatment of standardized cancer pain ward elevates the standardized treatment level of cancer pain and improves the life qualityof cancer patients.

Objective To explore the effects of cAMP response element binding protein ( CREB) on taxol-induced cell cycle arrest in HeLa cells .Methods MTT assay was used to determine the optimal concentration and treatment time . PCR method was used to construct the recombinant plasmid pCI neo /CREB( PN) and site-directed mutagenesis recombinant plasmid pCI neo/CREB-M(PM).Cell cycle was assayed by flow cytometry .Expressions of pCREB, CREB, cyclins and CDKs were assayed by Western blotting .Results The effective conditions of taxol treatment on HeLa cells were 0.1μmol/L for 24 hours.After cells were treated with 0.1μmol/L taxol, G2/M phase was arrested in a time-dependent manner , accomplished with the decrease of cyclin A , a significant increase of cyclin B1, D1 and phosphorylated CREB (pCREB) protein expression, whereas, no marked changes were observed in cyclin E , CDK1, CDK2, CDK4 and CREB expressions. However, combinantion of PM and taxol treatment significantly reduced taxol-induced G2/M phase arrest, and reversed the effect of taxol-decreased cyclin A, increased cyclin B1 and D1 expression.Conclusion Tanscription factor CREB-mediated specific cyclins play a pivotal role in taxol-induced G 2/M arrest in HeLa cells .

Objective To investigate the role of spo0A gene in growth and sporulation of Clostridium difficile clinical isolates. Methods ClosTron gene knock-out system was used to knock out the spo0A gene of C. difficile strain C25. Bacterial growth curve was plotted by measuring D600 with spectrophotometer in different phases of bacterial growth. Malachite green staining technique was used to count the number of vegetative cells and spores under optical microscope. The sporulation rate was calculated. Results The spo0A mutant and its C25 parental strain showed similar patterns of growth. However, after knock-out of spo0A gene, an asporogenous phenotype was built, while the parental strain could produce spores as usual.Conclusions The spo0A gene plays a key role in sporulation but not growth of C. difficile strain.

Objective:To explore the efforts of applying mindfulness stress reduction therapy in alleviating stress reactions and burnout among head nurses in the context of the Coronavirus disease 2019 (COVID-19).Methods:This was a quasi experimental study. In June 2021, 109 head nurses with mild or above burnout measured by Maslach Burnout Inventory (MBI) from 12 hospitals in Zhangjiagang City were selected as the research objects to implement mindfulness-based stress reduction therapy for 8 weeks, and the scores of the Five Facet Mindfulness Question-naire (FFMQ), Stress Response Questionnaire (SRQ) and MBI of the head nurses were compared before and after the intervention.Results:The five dimensions of observation, description, perceived action, non-judgment, and non-response and the total scores of the FFMQ were (26.28 ± 1.32), (26.94 ± 1.29), (25.49 ± 0.99), (25.45 ± 1.05), (23.48 ± 1.01), and (127.63 ± 3.78) of the post-intervention, which were higher than the pre-intervention scores of (25.04 ± 1.37), (25.04 ± 1.37), (25.37 ± 1.18), (24.15 ± 1.00), (24.09 ± 0.98), (22.26 ± 1.04), and (120.90 ± 4.06), with statistically significant differences ( t values were -39.21- -15.36, all P<0.01). The three dimensions of emotional, somatic, and behavioral responses and total scores of the post-intervention SRQ were (27.70 ± 6.12), (20.75 ± 4.20), (15.19 ± 3.11), and (65.99 ± 12.43), respectively, lower than the pre-intervention scores of (29.19 ± 6.91), (21.86 ± 5.20), (16.48 ± 4.16), and (70.12 ± 15.97), with statistically significant differences ( t values were 5.70-9.33, all P<0.01); the scores of dimensions of emotional exhaustion and depersonalization in post-intervention MBI were (26.24 ± 4.60) and (5.96 ± 1.25), lower than the pre-intervention scores of (29.66 ± 6.02) and (6.90 ± 1.59). The post-intervention scores of personal fulfillment (32.37 ± 5.02), higher than the pre-intervention scores of (28.60 ± 6.04), all with statistically significant differences ( t=15.36, 13.50, -9.65, all P<0.01). Conclusions:The implementation of mindfulness stress reduction therapy for the head nurses can relieve their work pressure due to the prevention and control of the COVID-19 epidemic, reshape their healthy psychology, and reduce job burnout.

The morbidity and mortality of pancreatic cancer are increasing year by year, and the risk of venous thromboembolism (VTE) in patients with pancreatic cancer is significantly increased, especially in the local advanced stage, metastatic stage and chemotherapy period. The patient's condition is often complicated by VTE events, which further increases the risk of death. This article reviews the latest literature, discusses the occurrence, development and clinical outcome of VTE in patients with pancreatic cancer, and introduces the research progress of pancreatic cancer VTE from the perspective of epidemiology, pathophysiology, clinical manifestations, prevention and treatment strategies.