Objective To investigate the clinical efficacy of Jiawei Guizhi Fuling Decoction combined with mifepristone on uterine fibroids and the changes of serum sex hormone levels in patients after treatment.MethodsForty-two patients were randomly divided into three groups: control group (42 cases) and control group (41 cases).The rats were treated with Guizhi Fuling Decoction plus mifepristone combination for three months.The control group was given only monotherapy with normal mifepristone tablets.The time of treatment was consistent with that of the study group.The levels of serum sex hormones were measured quantitatively before and after treatment.By comparing the therapeutic effect of the patients in different experimental groups and the levels of hormone Differences in evaluation between groups.ResultsThe total effective rate of 92.9% in the study group was significantly better than that in the control group (73.8%).The difference between the two groups was statistically significant (P<0.01).After treatment, the study group and the control group Uterine / tumor volume was significantly reduced, the difference was significantly different (P<0.01), compared between the two groups after treatment of uterine / tumor volume, the study group than the control group, the volume was significantly reduced, the difference was statistically significant (P<0.05).Serum levels of sex hormones: Serum levels of E2 and P were significantly lower in the study group than in the control group (P<0.05).Before and after treatment, the levels of serum E2 and P were lower in the two groups than before treatment (P<0.05).ConclusionJiawei Guizhi Fuling Decoction combined with mifepristone has a better effect on the treatment of uterine fibroids with mifepristone monotherapy, which significantly reduces the level of serum sex hormones and promotes the reduction of uterine / tumor volume after administration.It is worthy of promotion the combination of traditional Chinese and Western medicine conservative treatment of uterine fibroids means.

Objective:To share a drug treatment experience for multiple drug resistant Pseudomonas aeruginosa.Methods:A retrospective analysis of the pharmaceutical care participated by clinical pharmacist for one case of intervertebral space infection with multiple drug resistant Pseudomonas aeruginosa was carried out.Results:Pharmacists participated in the whole treatment process,made the combined antimicrobial regimen (fosfomycin + ceftazidime + ciprofloxacin),and adjusted the time sequence.As a result,satisfactory curative effect was obtained.Conclusion:The infection with multiple drug resistant Pseudomonas aeruginosa may be treated with the three-drug therapy.Clinical pharmacists can play a positive role in the treatment of complicated infections.

Objective To study the effect of different cag pathogenicity island in Helicobacter pylori ( Hp ) from Chinese patients and various kinase inhibitors on Hp induced interleukin 8 (IL 8) secretion in Chinese gastric epithelial cells. Method Chinese gastric epithelial cells(MGC 803) were cocultured with Chinese clinical cagA +cagE +, cagA +cagE -,cagA -cagE +,cagA -cagE - Hp in vitro, respectively. At the end of culture, IL 8 protein secretion was assayed by ELISA. The effect of the inhibitor of protein kinase A(PKA), C, G, protein tyrosine kinase(PTK) was analyzed on IL 8 protein secretion in gastric epithelial cells by Hp stimulation. Results cagA +cagE + Hp induced IL 8 protein secretion higher than cagA + cagE - or cagA -cagE + Hp , but cagA -cagE - Hp didn′t increase IL 8 protein secretion in gastric epithelial cells. Further studies with gastric epithelial cell showed that IL 8 protein secretion induced by cagA +cagE + Hp was blocked by the PTK inhibitor herbimycin A but not by PKA inhibitor H7, PKC inhibitor calphostin C, and PKG inhibitor KT5823. Conclusion cagA +cagE + Hp significantly increases IL 8 protein secretion and it depends on PTK activation in gastric epithelial cells.

Objective To investigate telomere length and cellular DNA content in different gastric lesion mucosa, and their relation with gastric mucosal carcinogenesis. Methods Telomere length were determined by southern hybridization. Cellular DNA content was detected by flow cytometry. Results Telomere length in intestinal metaplasia (IM) grade 2 was significantly shorter than that in normal gastric, IM grade 0 or grade 1. Telemere length of gastric carcinoma cells was the shortest in all of the biopsy specimens. Telomere length ratio in patients of corresponding surrounding nontumorous tissues with IM grade 2 was the largest in 45 resected gastric carcinoma. In flow cytometry, The aneuploid of gastric carcinoma (n=18), chronic atrophic gastritis (CAG) contained IM grade 2 (n=8), grade 1 (n=40), grade 0 (n=20), chronic superficial gastritis (CSG n=46) and normal gastric mucosa (n=10) was 33.3%,12.5%,10.0%,0.0%,0.0% and 0.0%, rspectively, in all of the biopsy specimens. In 45 resected gastric carcinoma specimens, Telomere length of 18 aneuploid was significantly shorter than that of 27 diploid. Furthermore reverse correlation was observed between telomere length and the DNA index in 18 aneuploid. Conclusions Telomere length were shortened as normal mucosa changed into intestinal metaplasia and more into gastric cancer. The normal and CSG mucosa shows no aneuploid. The positivity of DNA aneuploid tends to increase with the progression of intestinal metaplasia. In addition, telomere length and the DNA index show a reverse correlation. It is speculated that the shorter the telomere length the more amplificative activity the DNA. Telomere length and increased DNA index may be a predictor of stomach carcinogenesis.

Objective To investigate the nutrition status and quality of life(QOL)in the perioperative patients with laryngeal cancer and to analyze the effect of nutrition status on quality of life.Methods Sixty-six patients with laryngeal cancer were surveyed respectively by self-designed general situation questionnaire,nutritional risk srcreening 2002(NRS2002)and European organization for research and treatment of cancer quality of life core questionnaire(EORTC QLQ-C30).The impact of nutritional status on QOL was analyzed by the multiple linear regression analysis.Results The total score of nutritional risk of perioperative patients with laryngeal cancer was 3.53±1.51 and the incidence of nutritional risk was 28.79%.The nutrition status influenced on QOL, physiological function,cognitive function and pain area(P<0.05).Conclusion Nurses should assess the nutritional status of the patients and correct malnutrition without delay in order to improve the physical function and QOL of the patients.

OBJECTIVE:To evaluate the rationality of cefoxitin use in our hospital. METHODS:Evaluation index and evalua-tion criteria were established on the basis of DUE. The relative weight of evaluation index were calculated by using attribute-based AHM weight method,and the gas between medical orders and complete rational ones were evaluated by using TOPSIS processing method. The proportion of rational medical orders were calculated to evaluate the rationality of drug use. RESULTS:Among 116 medical records,there were 19%reasonable medical orders(including 4.3%complete reasonable medical orders,5 cases),50%ba-sically reasonable medical orders(58 cases)and 31% unreasonable medical orders(36 cases). CONCLUSIONS:It is reasonable and feasible to use AHM weighted TOPSIS method to evaluate the rationality of cefoxitin. The utilization of cefoxitin in our hospital is basically reasonable,but there are still many problems.

Objective To explore the relationship between serum adiponectin (APN) concentration and insulin resistance(IR) in elderly pregnancy patients(GDM) with gestational diabetes mellitus.Methods Data of 120 cases of elderly pregnancy patients with gestational diabetes mellitus admitted from Jan.2011 to Dec.2016 were retrospective analyzed.The relationship between serum APN concentration and IR was assayed.Healthy subjects and normal pregnancy patients in our Department were taken as the control.Results The concentration of APN was lower while the CysC,BNP,IGF1,IGF2 and IGFIR were higher in elderly pregnancy patients with gestational diabetes mellitus than those in the control group with a significant difference (P＜0.05).At the same time,Spearman analysis results showed that the serum APN was negatively related with IR while CysC,BNP,IGF1,IGF2 and IGFIR were positively related with IR (P＜0.05).Conclusion Theserumconcentrationofadiponectin and visfatin were negatively related with insulin resistance in elderly pregnancy patients with GDM.

OBJECTIVE:To explore the establishment of DUE criteria for the evaluation of glucocorticoids(GCs)use in oncol-ogy department of our hospital,and to evaluate the rationality of glucocorticoid use. METHODS:DUE criteria for GCs in our hos-pital was established preliminary,and used to evaluate medication indication,medication course,medication results,etc. Medical records of 300 patients receiving GCs were collected from oncology department of our hospital during Apr. to Dec. in 2013(before intervention)and Jun. 2014 to Mar. 2015(after intervention)via hospital information system. The application of GCs was evaluat-ed. RESULTS:Pexamethasone sodium phosphate injection was used most frequently in our hospital(82.34%),followed by Dexa-methasone acetate tablet(15.33%)and prednisone asetate tablets(2.33%). The mest common purpose of GCs use in oncology de-partment of our hospital is radiotherapy and chemotherapy induced vomiting prevention and treatment(55.55% of total case),fol-lowed by anti-inflammatory therapy(14.19%)and chemotheraphy drug pretreatment(12.76%). After intervention,rational use of GCs for tumor had been improved greatly,and the rate of unqualified drug dosage and medication course decreased from 6.87% to 3.95%,and that of decreased from 3.58% to 2.74%. CONCLUSIONS:The establishment of DUE criteria and continuous criteria improvement during clinical rational drug use guidance can promote rational use of GCs in oncology department.

Objective:To investigate the correlation between preeclampsia and thyroid dysfunction in pregnancy.Methods:107 early pregnant women with preeclampsia admitted to our hospital from Jan. 2017 to Jan. 2020 were all enrolled (observation group) . The observation group were in 6-34 gestational weeks, with an average parity of (1.67±0.35) times. In addition, 100 cases of normal pregnant women in the same period were selected as the control group. The control group were in 6-34 gestational weeks, with an average parity of (1.61±0.31) times. The two groups were compared at early, mid and late pregnancy in terms of thyroid function, and the correlation of preeclampsia and abnormal thyroid function was analyzed.Results:1. TSH levels in the observation group were (1.92±1.24) , (2.07±0.82) , and (2.30±1.23) mU/L in the first trimester, second trimester and third trimester, respectively, showing an upward trend. The difference between the two groups was statistically significant ( P=0.024) . FT4 levels of the observation group in the first trimester, second trimester and third trimester were (0.80±0.26) , (0.60±0.34) and (0.59±0.32) pmol/L, respectively, showing a decreased trend and the difference was statistically significant compared with those of the control group ( P=0.012) . 2. The incidence of hypothyroidism, TPOAb positive and reduced free tetraiodothyronine in the observation group was significantly higher than that in the control group ( P=0.001, 0.023, 0.005) . There was no significant difference in the incidence of hyperthyroidism or subclinical hypothyroidism between the two groups ( P=0.169, 0.846) . 3. Correlation analysis showed that preeclampsia was related to hypothyroidism, normal thyroid function with TPOAb positive and reduced free tetraiodothyronine ( P=0.000, 0.000, 0.000) . Conclusions:There are changes in thyroid function in pregnant women with preeclampsia. Hypothyroidism, positive TPOAb and reduced free tetraiodothyronine are closely related to the onset of preeclampsia.

Neurotrophic keratopathy (NK) is a degenerative disease in which damage to the corneal nerves leads to corneal hypoesthesia and even blindness.Traditional NK treatments aim at supporting corneal healing and preventing progression of corneal damage.In recent years, corneal neurotization has made some progress in NK.Compared with traditional treatment, it can not only solve the problem of corneal nerve defect, and avoid the subsequent keratopathy, but also significantly restore corneal sensitivity, corneal epithelium and vision.Corneal neurotization surgery methods are mainly divided into direct corneal neurotization (DCN) and inderect corneal neurotization (ICN).At present, this surgical method has gradually been used clinically, and has achieved satisfactory effects on unilateral NK caused by herpes virus and neuroma, as well as bilateral NK.However, it is little known about the surgical treatment of NK caused by dry eye, diabetes, and chronic glaucoma.In the future, multi-center prospective randomized studies can be conducted to further improve the treatment of NK with other causes.This article introduces this new surgical technique from three aspects, the specific surgical procedures of corneal neurotization, the selection of surgical methods, and the timing of the operation.