Objective To investigate ultrasonographic features,clinical and histopathologic characteristics of hydrometra in the elderly women.Methods Hysteroscopy endometrial biopsy,dilation and curettage (D&C) and Tao Brush were selectively performed for the endometrial cytologic and histopathologic diagnosis according to the depth of the hydrometra investigated by transvaginal sonography,endometrial thickness and high-risk factors of carcinoma of endometrium in 72 elderly women with hydrometra.Results Among 72 elderly women with hydrometra,9 cases (12.5％) were examined by hysteroscopy,51 cases (70.8％) by D&C and 12 cases (16.7％) by endometrial cytology along with D&C.Histopathologic examination revealed that there were 7 (9.72％) cases with endometrial carcinoma,2 cases (2.8％) with atypical endometrial hyperplasia,6 cases (5.6％) with endometrial benign lesion,14 cases(19.4％)with pyometra and the other 43 cases (59.7％) with normal and simple hydrometra.Conclusions Transvaginal sonography in combination with endometrial cytology are beneficial for screening of endometrial disorders or for drainage of hydrometra in elderly women,decreasing invasive examinations such as D&C.

To construct “developmental assessment” in the course of emergency nursing and inten-sive care nursing by applying the combination of formative assessment and summative evaluation, the com-bination of qualitative assessment and quantitative assessment and the incorporation of self-assessment and other evaluation. Specifically, this project contains investigation activity (accounting for 10%), operating activity (10%), checking on work attendance and homework evaluation (15%), reflection activity (15%), comprehensive design experiment evaluation (20%) and theoretical evaluation (30%). Process evaluation and self-evaluation are highlighted, especially feedback and improvement after evaluation. Through multi stage and multi form evaluation, the goal of emergency and critical care professional education has been achieved, which has promoted the development of student nurses' quality and overall development.

Objective:To study the effect of Rhizoma Coptidis apozem on expression of AMP-activated protein kinase(AMPK) in skeletal muscle of metabolic syndrome rats. Methods:The models were established by administering high fat diet. Rats were randomly divided into five group: normal control group, metabriolic syndome group, Rhizoma Coptidis apozem group, Berberine group, Metformin group. To estimate insulin resistance by euglycemic hyperinsulinemic glucose clamp(GC) tecchnique. To estimate expression of AMPK by using Western blot. Results: Compared with metabolic syndrome group, Rhizoma Coptidis apozem group had higher M-value, lower wet weight of innards fat, and higher protein level of p-AMPK-?. Conclusion: Rhizoma Coptidis apozem can improve insulin resistance, decrease innards fat, and regulate up expression of AMPK.

Objective To study the effects of benzyl propionate nandrolone (BPN ) on the nicotinamide phosphoribosyl transferase (Nampt), insulin receptor substeate-2 (IRS-2 )and pancreatic duodenal homeobox-1 (PDX-1)expressions, cell cycle changes as well as insulin secretion in pancreatic islet cell NIT-1 lines, and to explore the influence of BPN in the Nampte xpression in NIT-1 cells and insulin signaling molecules in high glucose oxidation stress.Methods The NIT-1 cells were cultured with different concentrations (5.6,11.1,16.7,and 27.6 mmol·L-1)of glucose,then they were treated with 10 mg·L-1 BPN for 48 h with no BPN treatment as corresponding control groups.The expression levels of Nampt,IRS-2,and PDX-1 were tested by Western blotting assay.The changes of cell cycle were determined by FCM and the cell insulin secretion levels were measured with radioimmunoassay.Results Compared with corresponding control groups,the expression levels of Nampt,IRS-2, and PDX-1 proteins in the NIT-1 cells in various BPM groups were increased (P<0.05 or P<0.01).The G0/G1 phase arrest was relieved (P<0.01)when the cells was cultured in low glucose (5.6 mmol·L-1 )condition,and the G2/M block was remitted significantly in high glucose (27.6 mmol·L-1 )condition (P<0.01),furthermore, the cell insulin secretion was promoted compared with control groups except 1 1.1 mmol· L-1 glucose group (P<0.01).Conclusion BPN can promote the expression levels of Nampt,ISR-2 and PDX-1 proteins in NIT-1 cells. There is close relationship between the Nampt expression in NIT-1 cells and insulin signaling pathway and BPN prevents the cells from insulin resistance.

Objective To analyze the hemodynamic changes of cerebral arteries in patients with chronic extracranial internal carotid artery occlusion (EICAO).Methods Ninety-six patients with chronic unilateral EICAO who were admitted to Kailuan General Hospital from September 2012 to December 2015 were selected as the case group (EICAO group),and 30 volunteers were selected as the control group.Color transcranial Doppler ultrasonography was used to detect the anterior communicating artery (ACOA) of the grade Ⅰ collateral circulation,the posterior communicating artery (PCOA),the ocular artery of the grade Ⅱ collateral circulation,and the pial collateral branch.Circulation rate and cerebral hemodynamic parameters:(Mean blood flow velocity (Vm) and pulsatility index).Results In the left and right EICAO groups,the opening rates of collateral circulation at grade Ⅰ were 86.96％ (40/46),96.00％ (48/50) and 78.26％ (36/46) and 88.00％ (44/50) respectively.There were significant differences in the opening rates of collateral circulation at grade Ⅰ between the two groups (x2 =4.114,P =0.043).There was no significant difference in the opening rates of collateral circulation at grade Ⅱ between the two groups (x2 =3.544,P =0.060).The left and right sides of EICAO group were compared with the same side of control group.The Vm of the common carotid artery (left side of the EICAO group (24.08 ± 9.25) cm/s),left side of the control group (32.52±3.28) cm/s,P＜0.01);right side of the EICAO group (22.20±5.51) cm/s),right side of the control group(31.58±3.35) cm/s,P＜0.01)) and the end-carotid artery end stage (TICA) The pulsation index (left side of left EICAO group (0.78 ±0.17),left side of control group (0.92±0.08),P ＜0.01);right side of right EICAO group (0.75 ± 0.19),right side of control group (0.91 ± 0.10),P ＜0.01),Vm of middle cerebral artery (MCA) (left side of left EICAO group(40.29 ±20.61) cm/s,left side of control group(55.72 ±5.60) cm/s,right side of EICAO;The right side of group (37.10±19.70) cm/s),the right side of control group (53.70±6.28) cm/s,P＜0.01),the pulsation index of MCA (left side of left EICAO group(0.74±0.19),left side of control group(0.87±0.10),P＜0.01;right side of right EICAO group (0.69±0.23),right side of control group:(0.90 ± 0.08),P ＜ 0.01).There were significant differences.NIHSS score of neurological impairment:normal 17.39％ (8/46),mild 39.13％ (18/46),moderate 30.44％ (14/46),moderate severe 13.04％ (6/46) in left EICAO group,and normal 18.00％ (9/50),mild 54.00％ (27/50),moderate 24.00％ (12/50),moderate severe 4.00％ (2/50) in right EICAO group.There was no significant difference between the two groups (P =0.178).Conclusion The ipsilateral common carotid artery and its distal middle cerebral artery in patients with chronic unilateral internal carotid artery occlusionshow hypoperfusion of hemodynamics,accompanied by neurological impairment.

Objective: To investigate the effect of ELMOD2 over-expression on the malignant biological behaviors of gastric cancer MGC803 cells, and to study its related molecular mechanism. Methods: GV141-ELMOD2 expression vector was transfected into human gastric cancer MGC803 cells. The mRNA and protein expressions of ELMOD2 were detected by Real-time fluorescent quantitative PCR and WB, respectively. The cell proliferation ability was detected by CCK-8 method. Apoptosis rate was detected by flow cytometry. The cell migration ability was detected by Transwell method. The protein expressions of PCNA, BAX and Bcl-2 and Vimentin were detected by WB. Results:After transfection of ELMOD2 expression vector, the mRNAand protein expressions of ELMOD2 were significantly increased in MGC803 cells (P<0.05). Further studies showed that over-expression of ELMOD2 increased the proliferation and migration ability but reduced the apoptosis rate of MGC803 cells significantly (P<0.05 or P<0.01). The protein levels of PCNA, Vimentin and Bcl-2 in MGC803 cells increased, while the protein level of BAX decreased (P<0.05 or P<0.01). Conclusion: Over-expression of ELMOD2 can promote the proliferation and migration of MGC803 cells and inhibit cell apoptosis. These effects may be achieved by increasing the protein level of PCNA, Vimentin and Bcl-2, and reducing the protein level of BAX.

Objective:To observe the changes of somatosensory evoked potential (SEP) in the upper limbs of patients with acute middle cerebral artery (MCA) cerebral infarction, and to explore its relationship with neurological impairment.Methods:From January 2015 to December 2016, 62 patients with 38 cases of male and 24 women of cerebral infarction who were treated in the department of neurology, Kailuan General Hospital were selected for a retrospectively prospective cohort study, including 38 males and 24 females.aged (66.7 ± 10.9) years old and ranging from 33.0 to 85.0 years old.According to the side of cerebral infarction, 37 cases were divided into left MCA group and 25 cases into right MCA group.During the 48 hours of admission, the electromyography evoked potential meter was used to detect the upper limb SEP, and the peak latency, amplitude and electrical activity waveform of the cerebral cortex potentials N20, P25 and N35 were recorded.Results:The results of SEP in the contralateral limbs of the left and right MCA cerebral infarction group were as follows: 1 case (2.70%) and 5 cases (20.00%) of normal median nerve; 36 cases (97.30%) and 20 cases (80.00%) of abnormality.The ratio of median nerve abnormalities in the group was statistically significant (χ 2=12.577, P<0.001). The ulnar nerve was normal in 3 cases (8.11%), 4 cases (16.00%); 34 cases (91.89%) and 21 cases (84.00%) were abnormal.There was no statistically significant difference between the two groups (χ 2=2.320, P=0.128). The peak latency and/or amplitude of each peak decreased in 34 groups (60.71%) and 33 cases (60.00%) of the ulnar nerve; the waveform of electrical activity disappeared, 22 cases (39.29%) of median nerve and 22 cases of ulnar nerve (40.00%). The peak latency and/or amplitude decreased, the electrical activity waveform disappeared, and the median nerve and ulnar nerve were compared, and the difference was not statistically significant (χ 2=0.021, P=0.885). The National Institue of Health Storke Scale(NIHSS) scores of left and right MCA cerebral infarction group were 34 (91.89%) and 19 (76.00%) respectively.Among them, the disappearance of electrical activity waveform were 18 cases (52.94%) and 4 cases (21.05%)of median nerve; 18 cases (52.94%) and 4 cases (21.05%) of ulnar nerve.The SEP electrical activity waveform disappeared in patients with moderate or higher neurological impairment, and the median nerve and ulnar nerve were statistically significant (χ 2=20.613, 20.613, all P<0.001). Conclusion:The median nerve and ulnar nerve SEP of the contralateral upper limb, which is dominated by the acute middle cerebral artery cerebral infarction, were abnormally changed.The main manifestations were that the latency of each peak of N20, P25 and N35 was prolonged and/or the amplitude was significantly decreased, and the waveform of SEP electrical activity disappeared.In addition, the disappearance of SEP wave activities only occurred in moderate and above neurological damage

ObjectiveTo observe the clinical effect of modified Yinqiaosan combined with antibiotics in the treatment of acute tonsillitis in children with wind-heat invading lung syndrome. MethodA total of 96 children with acute tonsillitis of wind-heat invading the lung syndrome were randomized into control group and observation group. The control group was treated with routine antibiotics， and the observation group was treated with modified Yinqiaosan and antibiotics for 7 days. The scores of major symptoms （sore throat， erythmatous throat， dysphagia， erythmatous tonsils and suppuration） and minor symptoms （fever， cough， stool， and tongue） and the levels of inflammation- and immune-related indexes ［white blood cell （WBC）， C-reactive protein （CRP）， serum amyloid A （SAA）， interleukin-6 （IL-6）， and interferon-γ （IFN-γ）］ were compared between two groups. ResultThe data of 92 children were statistically analyzed： 45 in the observation group and 47 cases in the control group. The total clinical effective rate of the observation group was 95.56%， as compared with the 93.62% of the control group. After treatment， the scores of major symptoms in the observation group were lower than those in the control group （P<0.05）， and the scores of cough， defecation， and tongue in the observation group were lower than those in the control group （P<0.05）. The levels of inflammation- and immune-related indexes after treatment in the observation group were lower than those before treatment （P<0.05）. Except IFN-γ， the levels of the inflammation- and immune-related indexes in the control group were lower than those before treatment （P<0.05）. After treatment， the levels of SAA and IL-6 in the observation group were lower than those in the control group （P<0.05）. ConclusionModified Yinqiaosan combined with antibiotics can significantly reduce the expression of SAA and IL-6 in the treatment of children with acute tonsillitis， thereby alleviating inflammation and clinical symptoms and improving prognosis.