Objective To evaluate the impact of bilateral ovariectomy in post-menopausal women by comparison of climacteric symptoms before and after operation. Methods Post-menopausal women who received hysterectomy with concurrent bilateral ovariectomy on benign uterine indications were recruited.Climacteric symptoms before and after operation were accessed by a questionaire including modified Kupperman Index.Comparison was made after grouping the patients into early menopause group,whose menopausal period was no more than 5 years,and late menopause group,whose menopausal period was more than 5 years. Results Among a total of 95 individuals,8 had normal,46 had mild,34 had moderatc,and the other 7 had severe Kupperman Index scores before operation,while 5 had normal,28 had mild,48 had moderate,and the other 14 had severe Kupperman Index scores after operation,with more moderate and severe climacteric symptoms after operation than before operation(P<0.05).Women of early menopause group had higher total Kupperman Index scores and symptom scores of sweating,insomnia,depression,fatigue and headache than those of late menopause group before operation(P<0.05).Women of early menopause group had significantly higher Kupperman Index scores after operation than before operation(23.93±7.53 vs 17.63±8.07,P<0.05).However,there was no significant difference in total Kupperman Index scores in women of late menopause group before and after operation. Conclusion Bilateral ovariectomy may affect the climacteric symptoms in post-menopausal women,especially in early menopausal period.

Objective To investigate the effects of ethinylestradiol and cyproterone acetate tablets(Diane-35)on endocrine metabolism in non-obese women with polycystic ovary syndrome(PCOS). Methods Fifty-three non-obese patients with PCOS were assigned to the 6-month treatment with Diane-35.Body mass index(BMI),waist to hip ratio(WHR),F-G score and acne score were recorded before treatment and at the end of the third and sixth cycle after treatment.Serum total testosterone,follicle stimulating hormone(FSH),luteinizing hormone(LH),LH/FSH,fast plasma glucose,fast insulin and insulin resistance index(HOMA-IR)were obtained at early follicular phase and at the end of the third and sixth month.Results There was no significant change in BMI and WHR after treatment.Compared with those before treatment.F-G score,acne score,serum total testosterone,LH and LH/FSH were significantly decreased at two time points after treatment (P<0.05).BMI and HOMA-IR in patients with insulin resistance were significantly higher at the end of the sixth cycle after treatment than those before treatment(P<0.05). Conclusion Diane-35 can improve hyperandrogenism in non-obese patients with PCOS.However,Diane-35 may aggravate insulin resistance in those with insulin resistance.

BACKGROUND:Few reports are found about the effect of ovariectomized rats' bone histomorphometry parameters using non-destructive dynamic loading system.OBJECTIVE:To observe the effect of different loads situations on the bone histomorphometry parameters in ovariectomized rats.DESIGN,TIME AND SETTING:A controlled observation on the bone histomorphometry was performed in the Biomedical Engineering Laboratory of Jilin University from April 2007 to August 2007.MATERIALS:A total of 35 9-month-old Sprague-Dawley female rats were randomly divided into five groups,including sham operation group,ovariectomized (OVX) control group,OVX loading 1 N group,OVX loading 2 N group,OVX loading 4 N group.There were 7 rats in each group.METHODS:Rats in OVX control group and castration load group were processed into bilateral OVX on the back. The sham operation group only underwent the excision of fat tissues on back,and then sutured. After castration for 1 week,rats were loaded with non-destructive dynamic loading system in the two sides of the tibia,15 minutes a day. The mechanical loads would continue for 4 weeks and the loads were 1N,2N and 4N.MAIN OUTCOME MEASURES:Changes of proximal tibia bone histomorphometry parameters.RESULTS:The area,number and thickness of trabecular bone in OVX loading group were all higher than OVX control group (P＜0.05,P＜0.01).The trabecular bone area and thickness in OVX 4 N and OVX 2 N groups were significantly higher than OVX control group (P ＜ 0.001).There was a downward trend of trabecular separation in OVX 4 N group compared with OVX control group (P ＜ 0.05). With the increasing loads,there was an increasing trend of the area,number and thickness of trabecular bone,which were close to sham-operated group. The trabecular separation was declined. Single fluorescent labeled surface and double fluorescent labeled surfaces in sham operated group were all lower than that in OVX control group. With the increase in loads,the single fluorescent labeled surface,double fluorescent labeled surface,interlabeled width and mineral apposition rate had been shown to increase. The OVX 2 N and OVX 4 N groups exhibited a remarkably higher level of mineral apposition rate than OVX control group (P ＜ 0.05).CONCLUSION:With the increase in load at the range of 1-4 N,all parameters of bone histomorphometry improve in the OVX rats,the bone microstrcture is greatly ameliorated,bone mass loss is reduced and the process of osteoporosis is delayed.

Objective To explore the mechanisms of apoptosis induced by arsenic trioxide and amifostine in human acute promyelocytic leukemia cell lines HL-60 in vitro.Methods HL-60 cells were treated with different concentrations of arsenic trioxide alone and combined with amifostine.The inhibitory ratio of the ceils were measured by MTT assay.and the expression of Survivin Was detected by semiquantitate RT-PCR.Results Proliferation of HL-60 cells exposed to arsenic trioxide dwpped down with increasing dose of the dmg and this effect Was significantly hisher when arsenic trioxide Was used in combination with amifostine.Furthermore.there was a more significant decrease in Survivin expression in HL-60 cells treated with arsenic trioxide in combination with amifostine as compared to the cells treated only with arsenic trioxide.Conclusion Arsenic trioxide induced HL-60 cells to undergo apoptosis by downregulating the expression of Survivin. Amifostine enhanced the sensitivity of HL-60 cells to arsenic trioxide by downregulating the expression of Survivin,thus promoting apoptosis effect.

Objective: To analyze the epidemiological characteristics of hospitalized children with burn in Ningbo from 2013 to 2018,and to provide evidence for developing intervention strategies. Methods: The pediatric burn cases,discharged from the Ningbo Women & Children's Hospital from 2013 to 2018,were registered using the Ningbo Hospitalized Injury Monitoring Report Card,and their distributions of time,places,groups,involved body parts and prognosis were analyzed. Results: There were 3 862 pediatric burn inpatients included in this study,with 2 977（77.08%）cases aged 1-3 years and 2 532（65.65%）nonlocal cases. About 898（23.25%）cases occurred during 9:00-12:00 a.m. and 1 833（47.46%）cases occurred during 17:00- 21:00 p.m. Burns predominantly occurred at home,with 3 810（98.65%）cases. The top three body regions involved were multiple regions,lower limbs and upper limbs with 1 820（47.13%）,835（21.62%）and 541 cases（14.01%）. The proportions of involving multiple regions declined with age（Psingle<0.05）. The proportion of involving multiple regions in nonlocal children was higher than that of local children（P<0.05）. Conclusion Burn is one of the leading causes of child injury-related hospitalization in Ningbo. Home is the main burn scene. Nonlocal and 1-3 year-old children were especially at high risk of burns.

We analyzed genetic evolution characteristics of avian influenza A (H7N9) virus isolated in Zhaoqing,China,2014-2016.Nucleic acid were extracted and sequenced from 17 samples of H7N9 positive cases in Zhaoqing.Genetic characteristics of homology and important amino acid sites were analyzed by using BioEdit5.0 and MEGA6.0.The evolutionary trees were constructed by Neighbor-Joining and the referenced sequences were downloaded from GenBank,Eight nucleic acid fragments from 7 strains of H7N9 viruses were successfully generated.The highest homology was found in HA gene with A/chicken/Dongguan/695/2014(H7N9),and NA gene with A/chicken/Dongguan/1075/2014(H7N9).The internal genes were high homology with avian H7N9 and H9N2 virus from Dongguan and Shenzhen in Guangdong,China.The HA and NA genes were directly evolved in the Pearl River Delta evolution branch with the H7N9 sequences from the cities of Dongguan,Guangzhou and Shenzhen,while the sequences from the provinces of Anhui,Zhejiang,and Jiangsu were in the Yangtze River Delta evolution branch.There were 2 alkaline amino acids in cleavage site of HA,2 mutations (G186V and Q226L) in the crucial sites related with the receptor of HA protein,1 mutation (E627K) in PB2 protein,and 1 drug resistance mutation (S31N) in M2 protein.And no evidence of neuraminidase resistance in NA protein was found.In conclusion,the H7N9 virus for human infection in Zhaoqing may originate from avian H7N9 and H9N2 viruses,which circulated in the Pearl River Delta region of Guangdong from 2013 to 2014.The mutations of G186V,Q226L and E627 K might be related with high susceptibility to human beings.

Objective To evaluate the clinical effect of itraconazole in prevention of invasive fungal infections in allogeneic hema-topoietic stem cell transplantion .Methods In this retrospective study ,110 patients receiving allogeneic hematopoietic stem cell transplants were administed itraconazole or fluconazole for prevention of fungal infection .The occurrence and prognosis of invasive fungal infection ,and the side effect of both pyrroles were observed .Results Proven and probable invasive fungal infections occurred in 5 of 69 itraconazole recipients(7 .2% ) and in 8 of 41 fluconazole recipients(19 .5% ) during the first 180 days after transplanta-tion ,the difference had statistical significance(P<0 .05) .The fatality rate related to fungal infection had no statistical difference be-tween the two groups(2 .9% vs .7 .3% ) .The occurrence of itraconazole adverse reactions were more than fluconazole (26 .9% vs . 7 .0% ) ,and both itraconazole and fluconazole were well tolerated .Conclusion Itraconazole significantly reduces the incidence of inva-sive fungal infection in the patients receiving allogeneic hematopoietic stem cell transplants ,and it is a effective and safe prophylaxis .

Objective: To investigate the incidence and influencing factors of falls among the elderly in Ningbo City, Zhejiang Province, so as to provide the basis for developing effective prevention strategies. Methods: The residents aged 60 years and above in Haishu District and Yuyao City of Ningbo City were selected by the multi-stage cluster random sampling method from June to October 2022. Demographic information, fall incidence in the past year, history of disease and self-rated health were collected through questionnaire surveys. Incidence of falls was descriptively analyzed, and factors affecting falls were identified using a multivariable logistic regression model stratified by gender and age. Results: A total of 1 275 elderly people were surveyed, including 635 men and 640 women. The median age was 72.00 (interquartile range, 13.00) years. In the past year, 158 residents fell, accounting for 12.39%. Additionally, 14 individuals experienced two or more falls, accounting for 8.86%. The incidence of falls was 14.69% in women, which was higher than the 10.08% in men (P<0.05). The incidence of falls was 14.86% in the elderly over 70 years, which was higher than the 9.39% in those aged 60 to 70 years (P<0.05). Multivariable logistic regression showed that the educational level (primary school and above, OR=0.501, 95%CI: 0.301-0.836), heart disease (present, OR=1.996, 95%CI: 1.076-3.703), and self-rated health status (good, OR=0.529, 95%CI: 0.319-0.875) were factors affecting falls in women; educational level (primary school and above, OR=0.514, 95%CI: 0.285-0.928) and self-rated health status (good, OR=0.456, 95%CI: 0.253-0.824) were factors affecting falls in residents aged 60 to 70 years. Conclusion Fall risk among the elderly is associated with gender, age, heart disease, educational level and self-rated health status, and the influencing factors for falls vary in different genders and ages.

Background A virtual reality simulator provides a novel training model for improving surgical skills in a variety of fields.They can simulate a variety of surgical scenarios to improve the overall skills required for endoscopic operations,and also record the operative process of trainees in real-time and allow for objective evaluation.At present,some simulators for transurethral resection of the prostate (TURP) are available.The utility of virtual reality simulators in training of transurethral prostatectomy was investigated.Methods Thirty-eight urologists were randomly selected to take part in a simulation based training of TURP using the TURPSimTM system.Pre and post-training global rate scale (GRS) scores and objective parameters recorded by the simulator were assessed.Then,questionnaires were filled out.Results Compared with baseline levels,the GRS scores of trainees increased (18.0±4.0 vs.12.4±4.2,P＜0.001),while the rate of capsule resection (26.3％±0.6％ vs.21.2％±0.4％,P ＜0.001),amount of blood loss ((125.8±86.3) ml vs.(83.7±41.6) ml,P ＜0.001),external sphincter injury (3.6±2.9 vs.2.0±2.0,P ＜0.001)decreased significantly after training.Most trainees were satisfied with the simulator based training and believed that the simulator accurately mimicked actual surgical procedures and could help improve their surgical skills.Conclusions As a new method of training on transurethral prostatectomy skills,training of TURP using a virtual simulator can help urologists improve their surgical skills and safety.Therefore,the application of the TURPSimTM system in education and training of urologic surgery is warranted.

Objective: To investigate the trends in mortality of malignant tumors in Ningbo City, Zhejiang Province from 2002 to 2022, so as to provide the evidence for formulating malignant tumor control strategies in Ningbo City. Methods The data regarding the mortality of malignant tumors in Ningbo City from 2002 to 2022 were collected through the Ningbo Municipal Death Cause Monitoring System, and the crude mortality and age-specific mortality of malignant tumors were calculated in Ningbo City. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010 (Chinese-standardized mortality) and the world standard population in 1960 (world-standardized mortality). The trends in mortality of malignant tumors were evaluated with annual percent change (APC) and average annual percent change (AAPC). Methods: The data regarding the mortality of malignant tumors in Ningbo City from 2002 to 2022 were collected through the Ningbo Municipal Death Cause Monitoring System, and the crude mortality and age-specific mortality of malignant tumors were calculated in Ningbo City. The mortality of malignant tumors was standardized by the population of the sixth National Population Census in China in 2010 (Chinese-standardized mortality) and the world standard population in 1960 (world-standardized mortality). The trends in mortality of malignant tumors were evaluated with annual percent change (APC) and average annual percent change (AAPC). Results: The crude mortality of malignant tumors was 186.43/105 to 221.24/105 in Ningbo City from 2002 to 2022, which showed a tendency towards a rise (AAPC=0.76%), and both the Chinese- (AAPC=-2.64%) and world-standardized mortality (AAPC=-2.74%) appeared a tendency towards a decline (all P<0.05). The world-standardized mortality of malignant tumors presented three changes in Ningbo City from 2002 to 2022, with a more remarkable decline from 2011 to 2018 (APC=-3.53%) than from 2002 to 2011 (APC=-2.10%) and from 2018 to 2022 (APC=-2.00%) (all P<0.05). The annual decline in mortality of malignant tumors was higher in men (Chinese-standardized mortality: AAPC=-2.68%; world-standardized mortality: AAPC=-2.75%) than in women (Chinese-standardized mortality: AAPC=-2.45%; world-standardized mortality: AAPC=-2.57%), and higher in urban areas (Chinese-standardized mortality: AAPC=-2.85%; world-standardized mortality: AAPC=-2.92%) than in rural areas (Chinese-standardized mortality: AAPC=-2.45%; world-standardized mortality: AAPC=-2.57%) (all P<0.05). The mortality of malignant tumors appeared a tendency towards a rise with age in Ningbo City, with the highest mortality in residents at ages of 85 years and older (1 447.13/105). Death from malignant tumors were responsible for 31.86% of all causes of death in Ningbo City, and the five most common causes of cancer death included lung cancer, liver cancer, gastric cancer, colorectal cancer and esophageal cancer. In addition, the world-standardized mortality of pancreatic cancer (AAPC=3.92%), prostate cancer (AAPC=4.71%), and cervical cancer (AAPC=1.60%) appeared a tendency towards a rise in Ningbo City (all P<0.05). Conclusions The crude mortality of malignant tumors appeared a tendency towards a rise in Ningbo City from 2002 to 2022, while the standardized mortality showed a tendency towards a decline. Management of malignant tumors should be given a high priority among men and rural residents, and lung cancer, liver cancer, gastric cancer, colorectal cancer and esophageal cancer should be emphasized.