Objective To evaluate and compare the advantages and disadvantages and the clinical application between transvaginal abdominal hysterectomy(TAH)and laparoscopically assisted vaginal hysterectomy(LAVH)on the benign lesions of non-prolapsed uterus.Methods 400 patients with benign lesions of non-prolapsed uterus were divided into two groups,TAH group(202 cases)and LAVH group(198 cases).The effects of clinical treatment of the two groups were compared.Results There were significant differentces between the two groups in operation time,the blood loss,passage of gas by anus,return to normal activities,and overall cost of treatment.However,after 1to 3 months follow-up,all patients were good in terms of outcome.Conclusion Different surgical patterns of hysterectomy had their distinctive advantages.The key point of a successful operation Was to avoid complications of the operation.

Objective To observe the effect of drug edible of herbal medicine granule on vascular endothelial function in patients with coronary heart disease(CHD).Methods A total of 200 cases featuring with cardiovascular blood stasis were chosen from patients who were diagnosed with CHD in Zhengzhou hospital of traditional Chinese medicine from January 2015 to January 2016.All cases were divided into observation group(n=98)and control group(n=102).The observation group was given Xin bao drug edible of herbal medicine granule and conventional drugs,and the control group was given conventional drugs.After 8 weeks of observation,the levels of endothelin(ET-1),nitric oxide(NO)and angiotensin Ⅱ(AngⅡ)were measured by enzyme-linked immunosorbent assay(ELISA).The serum levels of total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL),and TCM clinical symptom score were compared between the two groups.Results The level of TC of the control group was decreased after treatment(P<0.05);the levels of TC,TG and LDL in the observation group were lower than those in the control group(P<0.05).After treatment,the levels of NO,ET-1,Ang-Ⅱ and FMD in the observation group were significantly different from those before treatment(P<0.05).The levels of NO and FMD in the observation group were higher than those in the control group,and the levels of ET-1 and Ang-Ⅱ were lower than those in the control group(P<0.05).After treatment,the scores of TCM clinical symptoms in the observation group were lower than those before treatment(P<0.05).Compared with the control group,the total score of palpitations,the times of shortness of breath and clinical symptoms were lower than those in the observation group(P<0.05).Conclusion Xin bao drug edible of herbal medicine granule could relieve coronary heart disease blood stasis type of patients with vascular tension,reduce its endothelial cell damage and improve its clinical symptoms.

Objective To synthesize H.pylori bacterial ghosts (BG) and loaded with adriamycin.The cytotoxic effects in gastric cancer cell line were also observed.MethodsThe lysis plasmid was introduced into H.pylori by bacterial conjugation. H.pylori BG were produced by inducing H.pylori lysis at 42 ℃.After suspension and centrifuge, H.pylori BG were loaded with adriamycin.The adriamycin loading quantity was measured with spectrophotometry.The cytotoxic effects of H.pylori BG-adriamycin in gastric cancer cell line SGC7901 were evaluated with MTT assay.ResultsH.pylori BG were successfully synthesized and loaded with adriamycin.The loading quantity of adriamycin was 70.4 μg/mg.H.pylori BG were seen to be adsorbed and internalized by gastric cancer cells under confocal microscope, which distributed on the surface or cytoplasmic of SGC7901 cell line. Carried Adriamycin was delivered into gastric cancer cell line and mainly accumulated in the nucleus.IC50 of SGC7901 to H.pylori BG-adriamycin was 0.32 ± 0.15 by MTT assay, which was significantly lower than that to free adriamycin (0.44 ±0.15, P＜0.05).Conclusions The proliferation of gastric cancer cells were effectively inhibited by H.pylori BG-adriamycin.H.pylori BG are expected to be ideal carrier for anti-gastric cancer medicine.

Background:It is commonly recommended that patients should refrain from driving for 24 hours after sedation for endoscopy,however,this recommendation has been queried recently. Aims:To investigate the effect of sedation on early postoperative cognitive function in patients undergoing endoscopy. Methods:One hundred adult patients undergoing sedative esophagogastroduodenoscopy ( EGD ) were randomly recruited, and another 100 adult patients undergoing conventional EGD were served as controls. All patients had an education level more than 9 years. Cognitive function was assessed by number connection test-A( NCT-A),number cancellation test and digit symbol test( DST)before propofol sedation or the beginning of endoscopic procedure and was reassessed when the discharge criteria were met. If the results obtained were inferior to those before EGD,a third assessment was taken 30 minutes later until the results recovered or being superior to the baseline levels. Results:All patients completed the first and second assessment,and 124 patients had taken the third assessment. When the discharge criteria were met,result of number cancellation test was inferior to that before EGD in sedation group( P =0. 000 ). Furthermore,the results were analyzed by grouping with age,number cancellation test in young patients and NCT-A in elderly patients were inferior to that before EGD,respectively(P=0. 000 and P =0. 025 ). In control group,none of the results were inferior to those before EGD. The results of the third assessment recovered or being superior to the baseline levels. Conclusions:Early postoperative cognitive dysfunction at discharge is common in patients undergoing endoscopy using propofol sedation,but the impairment will recover by a prolonged staying calm before discharge. The optimal time for discharge and resuming driving remains to be further studied.

OBJECTIVE:To study the lifespan effect of ethyl acetate extract from Polygonum multiflora(EPM)on caenorhab-ditis elegans,and to investigate its anti-aging effect. METHODS:EPM low-concentration,medium-concentration and high- concen-tration groups(25,37.5,50 mg/L,calculated by crude drug)and blank group(0 mg/L)were established to investigate the effects of EPM on the lifespan of caenorhabditis elegans. EPM group(37.5 mg/L)and blank group(0 mg/L)were established to perform re-productive test,acute heat stress test and acute oxidative stress test of caenorhabditis elegans. The effects of EPM on reproductive capacity and pressure stress of caenorhabditis elegans were investigated. RESULTS:The lifespan test,average lifespan of cae-norhabditis elegans in EPM low-concentration,medium-concentration and high-concentration groups were prolonged significantly, compared to blank group(P<0.05 or P<0.01),especially in EPM medium-concentration group. In reproductive test,the number of offspring of caenorhabditis elegans in EPM group on the second and third day were increased significantly,compared to blank group (P<0.05). In acute heat stress test and acute oxidative stress test,average survival time of caenorhabditis elegans in EPM group was prolonged significantly(P<0.05). CONCLUSIONS:37.5 mg/L EPM can retard the aging process of caenorhabditis ele-gans and doesn’t damage the reproductive capacity.

Objective:To evaluate the relationship between chemokine CXC-ligand 16 (CXCL16) and natural killer T cells during renal fibrosis in mice with acute kidney injury (AKI).Methods:Twenty-four healthy male C57BL/6 mice, aged 8-10 weeks, weighing 20-30 g, were divided into 4 groups ( n=6 each) using a random number table method: control group (group C), AKI group, control+ rCXCL16 group (group C-rCXCL16) and AKI+ rCXCL16 group.In AKI-rCXCL16 and AKI groups, folic acid 250 mg/kg was intraperitoneally injected to induce AKI in anesthetized mice, and rCXCL16 0.1 mg/kg and the equal volume of solution were intraperitoneally injected, respectively, at 3, 6, 9 and 12 days after injection of folic acid.The equal volume of solution and rCXCL16 were intraperitoneally injected at the corresponding time points in group C and group C-rCXCL16, respectively.The orbital blood samples were taken on day 14 after injection of folic acid for determination of the serum blood urea nitrogen (BUN) and creatinine (Cr) concentrations.The renal tissues were obtained for measurement of the renal fibrosis size (using Sirius red staining and Masson staining), for determination of the expression of fibronectin (FN), collagen-Ⅲ (Col-Ⅲ) and α-smooth muscle actin (α-SMA) (by immunofluorescence) and expression of interleukin-4 (IL-4), mannose receptor (CD206) and arginase 1 (Arg-1) mRNA (by real-time polymerase chain reaction), and for evaluation of the ratio of CD1d Tetramer + -IL-4 + cells (by flow cytometry). Results:Compared with group C, the serum BUN and Cr concentrations were significantly increased, the renal fibrosis size was increased, the expression of IL-4, CD206, Arg-1 mRNA, FN, Col-Ⅲ and α-SMA was up-regulated, and the ratio of CD1d Tetramer + -IL-4 + cells was increased in AKI and AKI-rCXCL16 groups ( P<0.05), and no significant change was found in the parameters mentioned above in group C-rCXCL16 ( P>0.05). Compared with group AKI, the serum BUN and Cr concentrations were significantly increased, the renal fibrosis size was increased, the expression of IL-4, CD206, Arg-1 mRNA, FN, Col-Ⅲ and α-SMA was up-regulated, and the ratio of CD1d Tetramer + -IL-4 + cells was increased in group AKI-rCXCL16 ( P<0.05). Conclusion:The mechanism by which CXCL16 is involved in the process of renal fibrosis is related to the recruitment of natural killer T cells secreting IL-4 which regulates macrophage M2 polarization in mice with AKI.

Objective To compare the clinical efficacies of Qin’s scalp eight-needle acupuncture versus conventional scalp acupuncture in treating cancer pain. Method Sixty cancer pain patients with clinically or pathologically diagnosed malignant tumors were allocated, using a random number table, to a treatment (Qin’s scalp eight-needle acupuncture) group of 30 cases and a control (conventional scalp acupuncture) group of 30 cases. The treatment group received Qin’s scalp eight-needle acupuncture at selected points every other day and the control group, conventional scalp acupuncture every other day. One course of treatment consisted of 10 days. Result Cancer pain was relieved, analgesic dosage decreased, adverse reactions to analgesics reduced and quality of life raised significantly in the treatment group compared with the control group. Conclusion Qin’s scalp eight-needle acupuncture is effective in treating cancer pain.

Objective:To investigate the effect of the completion time of initial 30 mL/kg fluid resuscitation on the prognosis of patients with septic shock.Methods:An observational study was conducted. The inpatients with septic shock admitted to intensive care unit (ICU) of Northern Jiangsu People's Hospital, Affiliated Hospital of Yangzhou University and Jiangdu People's Hospital from October 1st, 2018 to September 30th, 2020 were enrolled. The general data including gender, age, body mass index (BMI), patient source, site of infection, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score and arterial blood lactic acid (Lac) at ICU admission, fluid resuscitation dose, completion time of initial 30 mL/kg fluid resuscitation, mechanical ventilation, incidence of acute kidney injury (AKI), continuous renal replacement therapy (CRRT), length of ICU stay and 28-day mortality. The relationship between the completion time of initial 30 mL/kg fluid resuscitation and ΔSOFA score (the difference between SOFA score 3 hours of fluid resuscitation and initial SOFA score) was analyzed. In addition, according to the completion time (T) of initial 30 mL/kg fluid resuscitation, the patients were divided into T ≤ 1 hour group, 1 hour < T≤2 hours group, 2 hours < T≤3 hours group and T > 3 hours group, and the observation parameters among the groups were compared.Results:① A total of 131 patients were enrolled, including 94 males and 37 females with an average age of (68.3±15.0) years old. The median APACHE Ⅱ score was 27 (21, 34), the median of initial SOFA score was 12 (10, 14), the median of initial Lac was 5.0 (3.4, 7.1) mmol/L, and the most common source of infection was lung, with a total of 87 patients (66.41%). The completion time of initial 30 mL/kg fluid resuscitation and ΔSOFA score fitted the Logistic curve ( Y = -1.062 6 X2+4.407 9 X+0.961 8), which suggested that the early or late completion time of initial fluid resuscitation had adverse effects on the prognosis of patients with septic shock.② There was no significant difference in infection site, initial APACHE Ⅱ score, initial Lac, and initial SOFA score among different completion time of initial 30 mL/kg fluid resuscitation groups. The respiratory support rate, the incidence of AKI and the ratio of CRRT in the T ≤1 hour group were significantly higher than those in the 1 hour < T≤2 hours group, 2 hours < T≤3 hours group and T > 3 hours group (respiratory support rate: 78.57% vs. 75.51%, 42.86%, 75.00%; incidence of AKI: 57.14% vs. 20.41%, 21.43%, 50.00%; ratio of CRRT: 35.71% vs. 0%, 7.14%, 16.67%), the differences among the groups were statistically significant (all P < 0.05). The 28-day mortality was the highest in the T ≤ 1 hour group (64.29%), and the lowest in the 1 hour < T ≤2 hours group (22.45%), 35.71% in the 2 hours < T ≤ 3 hours group, 33.33% in the T > 3 hours, and the difference among the groups was statistically significant ( P < 0.01). Conclusions:Completion of initial 30 mL/kg fluid resuscitation in 1-2 hours after septic shock may reduce the 28-day mortality and improve organ dysfunction, and initial fluid resuscitation prematurely or too late may increase 28-day mortality. But further research and verification are needed.

Objective To evaluate the efficacy of ultrasound-guided anterior quadratus lumborum block combined with general anesthesia for laparoscopic radical resection of rectal carcinoma. Methods A total of 80 patients of both sexes, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 40-64 yr, scheduled for elective laparoscopic radical resection of rectal carcinoma, were divided into 2 groups ( n=40 each) using a random number table method: anterior quadratus lumborum block combined with general anesthesia group ( group QG) and general anesthesia group ( group G) . In group QG, anteri-or quadratus lumborum block was performed with 0. 33％ ropivacaine 25 ml and dexamethasone 5 mg under ultrasound guidance before operation, and the same procedure was performed on the other side. Combined intravenous-inhalational anesthesia was applied, propofol 3-5μg∕ml and remifentanil 3-5 ng∕ml were given by target-controlled infusion, and cisatracurium was intermittently injected in two groups. Patient-controlled intravenous analgesia with sufentanil 2μg∕kg was used for postoperative analgesia. The analgesic pump was set up to deliver a 2 ml bolus dose with a 15-min lockout interval. Bruggrmann comfort scale ( BCS) scores were recorded at 1, 6, 12, 24 and 48 h after operation ( T1-5 ) . Tramadol was used for rescue analgesic after operation. The consumption of remifentanil and sufentanil, requirement for tramadol, occurrence of adverse reactions and patients' satisfaction with postoperative analgesia were recorded. The emergence time, first ambulation time, time to first flatus∕poo and length of hospital stay were also recorded. The develop-ment of anterior quadratus lumborum block-related complications was recorded. Results Compared with group G, BCS scores were significantly increased at T4,5 , the consumption of remifentanil, requirement for tramadol and incidence of nausea and vomiting were decreased, patients' satisfaction with postoperative an-algesia was increased, and the emergence time, first ambulation time, time to first flatus∕poo and length of hospital stay were shortened in group QG (P<0. 05). Conclusion Ultrasound-guided anterior quadratus lumborum block combined with general anesthesia can reduce the consumption of opioids in the perioperative period and is helpful in improving outcomes when used for laparoscopic radical resection of rectal carcinoma.

In recent years,psoriatic arthritis has become a major problem in the medical field,with cases gradually increasing in China,and it is still incurable.Here,we summarize the pathogenesis and clinical characteristics of currently available animal models of psoriatic arthritis based on Chinese and Western medical evidence.Literature in line with this topic was collated and summarized.The etiology and pathogenesis according to Chinese and Western medicine of existing psoriatic arthritis models were given agreement scores;the diagnostic criteria of Chinese and Western medicine were compared;and the models'characteristics and degree of agreement with clinical observations were assessed.This study found that the human leukocyte antigen transgenic mouse model,the multiple hybridization transgenic mouse model,and the mannan-induced mouse model had the highest agreement scores.As psoriatic arthritis is more common in Europe,methods for the preparation of animal models have been mostly imported from abroad,and very few animal models have the characteristics of Chinese medicine;therefore,the model fitness scores of Western diagnoses were higher than those of Chinese diagnoses as a whole.We hope to leverage the unique diagnosis and treatment method of Chinese medicine further to improve the types of psoriatic arthritis animal models available.This study provides a basis for the construction of improved animal models of psoriatic arthritis with combined traditional Chinese and Western medicine characteristics.