Nowadays,with the introduction of the concept of minimally invasive surgery,laparoscopic surgery which occupied the mainstream operation method,vaginal surgery,and abdominal surgery were three main ways of gynecological surgery.Hysterectomy operation method as the routine operation of gynecology was changed as well.Laparoscopic hysterectomy has replaced transvaginal hysterectomy and transabdominal hysterectomy gradually.Historical development,operation indication,and advantages and disadvantages of hysterectomy are summarized in this article.

Objective To investigate the effect of delighted thinking on improving negative emotion of depression patients. Methods 100 depression patients were randomly divided into the observation group and the control group with 50 in each according to admission sequence. Both groups was executed antidepressionant drugs treatment and routine psychiatric care simultaneously. The observation group was given delighted thinking training on the basis of above treatment. The emotional recovery of two groups was observed. Results There was significant difference on facial expression, communication and limbs language after executing delighted thinking training in the observation group. And there was significant difference on scores of Hamilton depression rating scale (HAMD) at discharge. Scores of Nurses' Observation Scale during early, middle and late stage of delighted thinking training greatly improved compared with those before training. Conclusions Delighted thinking contributes to throw off negative thinking pattern of self-denial, stimulate positive passion threshold, improve depressed mood and raise treatment effect for depression patients.

Objective To evaluate the value of ultrasound in diagnosing ductal carcinoma in situ (DCIS). Methods The sonographic characteristics of 12 DCIS which were confirmed by pathology were analyzed retrospectively. Results The ultrasound image of DCIS could be divided into four types;the solid mass nodule, mammary dysplasia, mix mass nodule, the dilated duct type. Micro calcification had high incidence rate. Ultrasonic diagnosis accordance rate was 50.0 %. On molybdenum target mammograms, the tumor appeared as a cluster of calcified spots in 8 cases, and the accuracy rate of diagnosis of was 66.7 %.Conclusion There are no typical characters of DCIS in ultrasound image. However, some characteristics are suggestive and can help to differentiate them from the benign tumors, such as small nodule, irregular shape,obscure boundary, and microcalcification. When sonography combine with molybdenum target mammography,the accuracy rate of diagnosis will be improved.

Objective To analyze the ultrasonic imaging characteristics of primary breast lymphoma and their significance for diagnosis.Methods Data of ultrasonograph from 21 cases of primary breast lymphoma were reviewed, and all cases had been certificated by pathology.Results All of 21 cases with primary breast lymphoma were solid mass.The contours of 16 cases were regular, and the boundaries of 9 cases were clear.20 cases were hypoechoic masses, besides 3 cases with lower echo like liquefactive degeneration.The internal echoes of 19 cases were disorderly, part of them with hyperechoic trabs.The rear echoes of 17 cases were neither enhanced nor fading.The surrounding tissues of 19 cases were not changed.13 cases had more than 3 blood vessels on color Doppler imaging.Conclusion There are some ultrasound characteristics in primary breast lymphoma, which would be helpful in the diagnosis of primary breast lymphoma.

Objective To analyze the cognition and demand of the residency training program among clinical medical students to provide scientific basis for the promotion of this policy.Methods From May 24 to 25,2015,a self-designed questionnaire survey was conducted on 645 undergraduate clinical medical students,who came from Zhengzhou University,Xinxiang Medicine College,Henan University.Data of cognition and demand of the residency standardized training were statistically analyzed using SPSS 22.0 software.Enumeration data were analyzed by chi-square test and abnormal distribution data based on Wilcoxon rank sum test.Results 616 valid questionnaires were recovered.259 undergraduate clinical medical students (42.00％) did not quite understand the resident standardized training policy and 225 (36.50％) did not known the policy at all.Before and after clinical practice,the cognition of the residency standardized training had statistically significant difference (x2=87.596,P=0.000),the knowledge of the policy (x2=10.939,P=0.012) and the degree ascending alleviate employment pressure (x2=29.349,P=0.000) were the main influencing factors of the clinical medical students' choices after graduation.Conclusion Improving medical students' understanding of the significance of medical education after graduation,and the integration of professional degree training and residency standardization training effectively helps to promote implementation of the policy.

Total 1350 subjects were selected by cluster random sampling from Chongwen District and Shijingshan District in Beijing with a populations of 100 000.Chongwen District represented a typical urban district and Shijingshan represtnted a newly extended urban district.Qualified investigators conducted face-to-face survey using the uniform questionnaire and measurement, dealing with the knowledge, attitude and behavior for risk factors of stroke in two districts.The results showed:in Chongwen District, the awareness rates of "the diagnostic criteria of hypertension", "antihypertensive drugs can lower the risk of cardiocerebral vascular disease", and "criteria for obesity" were 71.3%, 87.3% and 22.9% respectively,which were significantly higher than those in Shijingshan District.The awareness rate of "bad temper may increase the risk of cardiocerebral vascular disease" was lower in the Chongwen District.There were no significant differences in attitude between two districts.In Chongwen District the level of three risk factors (smoking and obesity) was significantly lower than Shijingshan, but action of self-examination was also significantly lower.Generally, there was higher level in health knowledge and lower level of risk factors in Chongwen District.The hypertension-related knowledge and behavior was not entirely consistent.It is necessary to transform knowledge into behavioral changes or intervention of risk factors in population with high awareness like Chongwen District.

Objective: To evaluate whether simultaneous vaccination with live attenuated polio vaccine affects the immunogenicity of live attenuated rotavirus (RV) vaccine. Methods: Rotarix produced by GlaxoSmithKline was used as the research object. Two doses of Rotarix were orally administered on day 0 and month 1, and oral live attenuated polio vaccine (OPV) was administered on day 0, month 1 and month 2 according to the national vaccination plan. Healthy infants aged 6 to 16 weeks were randomly divided into two groups: interval vaccination group (Rotarix and OPV were vaccinated on different days) and simultaneous vaccination group (Rotarix and OPV were vaccinated on the same day). Serum samples were collected on day 0, month 2 and month 12, and serum RV-IgA was measured by enzyme linked immunosorbent assay. Statistical analysis was performed to evaluate whether there were statistical differences in the seroconversion rate and level distribution of RV-IgA between the two groups. Results: The seroconversion rate of serum RV-IgA in month 2 was 73.84% in the interval vaccination and 63.95% in the simultaneous vaccination group, and the difference between them was statistically significant (P<0.05). The geometric mean concentrations (GMC) of RV-IgA were 97 EU/ml and 90 EU/ml, respectively (P>0.05). Compared with the simultaneous vaccination group, the seroconversion rate and GMC of serum RV-IgA in month 12 were higher in the interval vaccination group, and the differences were statistically significant (P<0.05). Conclusions Simultaneous vaccination with live attenuated polio vaccine would affect the immune response of live attenuated rotavirus vaccine, especially the maintenance of RV-IgA antibody level.

The application of tyrosine kinase inhibitor (TKI), a target therapy of chronic myeloid leukemia (CML), has greatly improved the prognosis of patients with CML. However, uninterrupted treatment with TKI affects the quality of life and aggravates the economic burden of patients. Achieving treatment-free remission (TFR) has become the current research direction of CML treatment. This paper reviews the relevant foreign literature on the discontinuation of TKI in recent years.

Objective:To study the mechanism of metastasis associated lung adenocarcinoma transcript 1 (MALAT1) targeting microRNA-142-3p (miR-142-3p) in ovarian cancer chemotherapy resistance.Methods:A total of 80 ovarian cancer tissues and paired normal tissues were collected in Shaanxi Provincial People′s Hospital from February 2016 to February 2019. The relative expression levels of MALAT1 and miR-142-3p in ovarian cancer tissues and paired normal tissues were detected by real-time fluorescence quantitative polymerase chain reaction (PCR), and the correlation between MALAT1 and miR-142-3p was analyzed. The effects of abnormal expressions of MALAT1 and miR-142-3p on proliferation and chemotherapy sensitivity of 5-fluorouracil (5-FU) and cisplatin of ovarian cancer Hey cells were verified by CCK-8 assay. Dual luciferase reporter gene experiment was used to detect the targeted relationship between miR-142-3p and MALAT1 (Hey cells were divided into four groups: MALAT1 wt, MALAT1 wt+ miR-142-3p mimic, MALAT1 mut, MALAT1 mut+ miR-142-3p mimic). RNA immunoprecipitation assay was use to confirm the binding site of MALAT1 and miR-142-3p.Results:In the ovarian cancer tissues and paired normal tissues, the relative expression levels of MALAT1 were 0.000 52 (0.002 56) and 0.000 47 (0.000 89), with a statistically significant difference ( Z=2.365, P=0.018); the relative expression levels of miR-142-3p were 0.001 19 (0.002 69) and 0.001 61 (0.008 48), with a statistically significant difference ( Z=2.935, P=0.003). The relative expression level of MALAT1 was negatively correlated with miR-142-3p in the ovarian cancer tissues ( r=-0.474, P<0.001). The relative expression level of miR-142-3p in the miR-142-3p mock group was statistically lower than that of MALAT1+ miR-142-3p mimic group (0.004 18±0.001 24 vs. 0.006 51±0.000 28; t=3.174, P=0.017). The relative fluorescence concentrations of MALAT1 wt group and MALAT1 wt+ miR-142-3p mimic group were 2.27±0.86 and 31.10±6.05 respectively, with a statistically significant difference ( t=8.172, P<0.001). After 48, 72 and 96 hours of ovarian cancer Hey cells being transfected with MALAT1 overexpression plasmid, the absorbance ( A) values of cells in the MALAT1 overexpression group were significantly greater than those in the control group (0.522±0.021 vs. 0.433±0.021; 0.644±0.012 vs. 0.544±0.051; 0.887±0.055 vs. 0.698±0.042), with statistically significant differences (all P<0.05). After MALAT1 being overexpressed in Hey cells, at 0.10 ng/μl concentration of 5-FU, the proliferation rate of cells in the overexpression group was significantly faster than that in the control group (0.615±0.036 vs. 0.506±0.042; t=4.432, P=0.002), and the cells at 1.00, 10.00, 100.00 ng/μl concentrations of 5-FU showed the same trends (all P<0.05). At 0.01 ng/μl concentration of cisplatin, the proliferation rate of cells in the overexpression group was significantly faster than that in the control group (0.777±0.015 vs. 0.733±0.039; t=2.355, P=0.023), and the cells at 0.10, 1.00, 10.00, 100.00 ng/μl concentrations of cisplatin showed the same trends (all P<0.05). After miR-142-3p being overexpressed in Hey cells, at 0.10 ng/μl concentration of 5-FU, the proliferation rate of cells in the overexpression group was significantly slower than that in the control group (0.512±0.051 vs. 0.744±0.119; t=4.028, P=0.004), and the cells at 1.00, 10.00, 100.00 ng/μl concentrations of 5-FU showed the same trends (all P<0.05). At 0.10 ng/μl concentration of cisplatin, the proliferation rate of cells in the overexpression group was significantly slower than that in the control group (0.520±0.043 vs. 0.674±0.096; t=3.441, P=0.009), and the cells at 1.00, 10.00, 100.00 ng/μl concentrations of cisplatin showed the same trends (all P<0.05). After ovarian cancer Hey cells being treated with 0.10, 1.00, 10.00, 100.00 ng/μl concentrations of 5-FU and cisplatin, the proliferation rates of cells in the MALAT1 overexpression group, MALAT1+ miR-142-3p group and control group showed statistically significant differences (all P<0.05). Further pairwise comparisons revealed that the proliferation rates of cells in the MALAT1+ miR-142-3p group were significantly slower than those in the MALAT1 overexpression group (all P<0.05). Conclusion:MALAT1 can reduce the sensitivity of ovarian cancer cells to 5-FU and cisplatin by targeted miR-142-3p, leading to chemotherapy resistance of ovarian cancer.

Objective:To screen the neutralizing epitope of enterovirus 71 (EV71) and determine the specific minimum amino acid sequence that triggers immunity for providing a theoretical basis for the development of synthetic peptide vaccines.Methods:EV71 neutralizing antibody-specific binding clones were panned and sequenced using a phage display random 12-peptide library to obtain the key sequences of neutralizing epitopes. A series of peptides containing the key sequences with N-terminal acetylation (AC) and C-terminal linking to Keyhole limpet hemocyanin (KLH) were synthesized. Serum samples were collected after immunizing mice with the modified peptides. Then the immunogenicity of the peptides and the neutralizing activity of serum samples were analyzed by Western blot, ELISA and neutralization test.Results:After three rounds of panning, cloning and sequencing, KQEKDL was identified as the key motif. The serum samples collected from the mice immunized with the modified series of peptides containing key motifs had different degrees of binding ability to EV71 and VP1 protein. The serum samples of mice immunized the synthetic peptide containing only the minimum key motif (AC-KQEKDL-KLH) had the strongest response to the other three peptides and EV71 and the highest neutralizing titer.Conclusions:The EV71 neutralizing epitope was successfully screened using the phage display random peptide library. The key motif of KQEKDL might be the specific minimum amino acid sequence that triggered the immune system. This study provides a theoretical basis for better understanding the immune response mechanism, evaluating the immunogenicity of the antigens and further research and development of polypeptide vaccines.