Purpose To explore the clinical value of reducing the incidence of reflux and improving patients' comfort by low pressure contrast injection during transvaginal ultrasound real time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy).Materials and Methods Data ofTVS RT-3D HyCoSy using low pressure contrast injection of 498 infertile women were analyzed.The peak pressure,the incidence of reflux and adverse reactions were recorded.Compared these parameters between bilateral tubals.Results The peak pressure in patency,partially patency and fully obstructed of bilateral tubals were (22.47±5.96) kPa,(37.24±8.83) kPa and (44.64±7.73) kPa.There was significant difference among the three groups (F=70.35,P＜0.05).Among all 498 patients,the incidence of reflux was 26.31％.The incidence in patency,partially patency and fully obstructed of bilateral tubals were 18.00％,30.21％ and 43.59％.There was significant difference among the three groups (x2=15.59,P＜0.05).Different degrees of adverse reactions were 88.96％,10.64％ and 0.4％.Conclusion By using low pressure contrast injection during HyCoSy,the incidence of reflux can be reduced and examination comfort can be improved.

Objective To estimate and optimize the dosage regimen of vancomycin and linezolid for treatment in different Gram-positive cocci infections. Methods The pharmacokinetic data of vancomycin and linezolid were collected, and the pharmacodynamics in vitro of these drugs for staphylococcus epidermidis, staphylococcus aureus, enterococcus faecalis and enterococcus faecium were analysed. The cumulative response fraction (CFR) was evaluated in different dosage regimens of two drugs against four types of bacteria. Results The regimen of 3 500 mg/d vancomycin was recommended for patients with staphylococcus epidermidis infection. The regimen of 2 500 mg/d vancomycin was recommended for patients with staphylococcus aureus infection. The regimens of 3 000 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecalis infection. The regimens of 2 500 mg/d vancomycin and 400 mg linezolid given 2 times/day were recommended for patients with enterococcus faecium infection. Conclusion In application of vancomycin and linezolid for treatment of Gram-positive cocci infections, different dosage regimens should be used in different types of infections.

Objective To study effect and its possible mechanism of total glucosides of paeony ( TGP ) on adriamycin-induced nephropathy rats.Methods Thirty male SD rats were randomly divided into normal group ( CON) , adriamycin-induced nephropathy group ( ADRN) and TGP-treated ADRN group (TGP).The rat nephropathy model was established by adriamycin injection.At the end of the 8th week after treatment, ELISA was used to detect the level of Cr and BUN.The values of 24 urine protein was determined by urinary protein kit.Masson staining was used to observe the fibrosis.RT-PCR was used to detect the mRNA levels of TLR4/NF-κB/TGF-β1 .Immunohistochemical method was used to detect the content of TLR4/NF-κB/TGF-β1.ResuIts Compared with the CON group, the level of Cr, BUN, 24 urine protein of ADRN group rised(P<0.01), the degree of fibrosis of ADRN group were aggravated(P<0.01), and the expressions of TLR4/NF-κB/TGF-β1 of ADRN group increased significantly.However, compared with ADRN group, the(P<0.01) level of Cr, BUN, 24 urine protein of TGP-treated rats reduced(P<0.01), the degree of fibrosis of TGP-treated rats eased(P<0.05), and the expressions of TLR4/NF-κB/TGF-β1 of TGP-treated rats decreased significantly.ConcIusion TGP retards the process of fibrosis and reduces the pathological damage in adriamycin-induced rats by down-regulating the expression of TLR4/NF-κB/TGF-β1 signaling.

Purpose To explore the association between ultrasound contrast agent injection volume as well as regurgitation and tubal patency. Methods SonoVue contrast agent was used for 515 cases of infertility transvaginal four-dimensional ultrasound imaging hysterosalpingography, recorded the amount of contrast agent injection, regurgitation, and compared contrast agent injection volume and regurgitation in different patency. Results The ultrasound contrast agent injection volume between bilateral patency with bilateral passable and one side patency one side passable as well as one side patency one side barrier, between one side patency one side passable and one side patency one side barrier had no significant difference (U=1467.0-4843.0, P>0.05);and it had statistical difference between any other two conditions (U=273.5-6160.0, P<0.05). The regurgitation between bilateral passable and bilateral barrier, one side passable one side barrier, between bilateral barrier and one side patency one side barrier, one side passable one side barrier, between one side patency one side passable and one side patency one side barrier had no statistical difference (U=949.5-6378.5, P>0.05), and it had statistical difference between any other two conditions (U=919.5-5126.5, P<0.05). Conclusion Ultrasound contrast agent injection volume and regurgitation in hysterosalpingography are associated with tubal patency, which can be used as objective indexes for assessing tubal patency, and provide basis for tubal patency.

Objective To analysis the expression levels of inflammatory cytokines in patients with cluster headache during headache attack period and intermittent period using antibody chips to explore the role of inflammatory cytokines in the pathogenesis of cluster headache. Methods Blood samples from 6 patients with cluster headache were collected during headache attack period and intermittent period. Samples were then centrifugated and stored at - 80 degrees refrigerator. Samples were further labeled with biotin and reacted with antibody chips against 40 major inflammatory cytokines. The target proteins were conjugated with streptomycin antibody labeled with infrared fluorescent agent, and signals were transformed to images by Licor-odyssey scanner. Results In pairwise comparisons, the levels of some inflammatory cytokines were significantly increased during attacks compared to intermittent period including interleukin-1β(44.18 vs. 68.46, P<0.05), interleukin-6(23.08 vs. 36.40, P<0.05), interleukin-8(151.87 vs. 328.12, P<0.05), interleukin-13(23.93 vs. 38.87, P<0.05), monoeyte chemoattraetant protein (454.80 vs. 725.75, P<0.05) and macrophage inflammatory protein-1β (265.08 vs. 515.74, P<0.05). Conclusion Inflammatory cytokines may play an important role in the pathogenesis of cluster headache. However, the mechanism needs further investigation.

Objective To explore the relationship between health-related media information and career decision making self-efficacy of nursing undergraduates,and the mediation effect of psychological needs and trust between above two variables. Methods Totally 548 nursing undergraduates were investigated using basic properties of health-related media information questionnaire,health-related media information of trust and psychological needs questionnaire and Career Decision Making Self-efficacy Scale. Results Health-related media information and health-related media information of trust and psychological needs could predict mental disability directly (P<0.05). Health-related media information of trust and psychological needs played a mediating role between health-related media information and career decision making self- efficacy,and the total effect and the indirect effect of two separate intermediary variables were significant,and contribution rate of 50.31%. By confirmatory factor analysis, structural equation model were:χ2/degree of freedom (χ2/df)=4.225, goodness of fit index=0.933, adjusted goodness of fit index =0.902, root mean square error of approximation =0.070. Conclusions Nursing school administrators should pay close attention to the mediating roles of health-related media information of trust and psychological needs,and develop specific interventions systematic on the basis of a comprehensive assessment,so as to improve nursing students career decision-making self-efficacy levels.

Objective To explore the effect of shRNA silenced aromatic hydrocarbon receptor (AHR) on WNT signaling path-way during the differentiation of P19 cells into cardiac myocytes. Methods The eukaryotic expression vector of mouse AHR gene was designed and constructed. The interference plasmid was transfected into P19 cell and the positive stains to AHR gene silencing were screened by G418. The mRNA expression of important genes GSK3βandβ-catenin were evaluated by real-time fluorescent quantita-tive PCR during the differentiation of P19 cells. Results The constructed AHR-shRNA plasmid significantly inhibited the expression of AHR gene. Along with the differentiation of P19 cell into cardiac myocytes, in the interference group the expression ofβ-catenin gene was lower whereas the expression of GSK3βgene was elevated than those of control group with significant differences (all P<0.01). Conclusions The interference of AHR gene expression can regulate WNT signaling pathway in the development of heart.

Objective To investigate the clinical application of multiplex allele-specific PCR assays for simultaneous detection of the mitochondrial 12S rRNA A1555G and C1494T mutations associated with aminoglycoside-induced hearing impairment.Methods Three standard plasmids of different genotypes (wild-type, A1555G mutant and C1494T mutant) were constructed for templates and allele-specific primers aiming directly at wild-type and mutant of mitochondrial DNA nt1555 and nt1494 were designed for developing a multiplex allele-specific PCR technique to detect the A1555G and C1494T mutations.Then the method was applied to clinical screening of 138 non-syndromic hearing loss subjects and confirmed by DNA sequencing.Results Multiplex allele-specific PCR was successfully applied to the detection of A1555G and C1494T mutations in a cohort of 138 Han Chinese genetically unrelated hearing-loss subjects.Finally, 11(7.97%) unrelated affected subjects harbored the A1555G and C1494T mutations in the 12S rRNA gene(10 cases for A1555G and 1 cases for C1494T), which was well consistent with results of DNA sequencing [7.97%(11/138), Kappa=1.000, P＜0.01].Conclusion This study indicates that the multiplex allele-specific PCR assay is useful, convenient and reliable in the detection of the A1555G and C1494T mutations, which could identify the subjects at risk and effectively prevent of aminoglycoside-induced hearing loss.

Shanghai East Hospital has built a general practice residency training information system based on "Internet +" technology since 2017. This training system effectively promoted the training quality, improved the clinical and research ability of general practitioners, and strengthened the supervision of the training. It has improved the training satisfaction, increased passing rate of national medical licensing examination and graduation comprehensive examination of trainees. This training system can largely break the time and space limitations, and has strong replicability. It may provide reference to optimize the general practice standardized residency training for other institutions.

Objective To explore the clinical application of blood perfusion quantitatively by contrastenhanced ultrasonography(CEUS) to grade cerebral gliomas during operation. Methods Thirty-one patients with cerebral gliomas were examined by CEUS with Sonoliver software during operation. Maximum intensity (IMAX), time to peak (TTP), rising time (RT) and mean transit time(mTT) of the regions of interest (ROIs) of normal brain tissue and high- and low-grade gliomas were respectively determined and comparatively analyzed. Results Fifteen high-grade gliomas and sixteen low-grade gliomas were postoperatively confirmed by pathologic results. The administration of contrast agent led to higher echo enhancement in cerebral gliomas than normal brain tissues in all cases. The TTP of high- and low-grade gliomas were significantly shorter than that of normal cerebral tissues ( P ＜0.05) ,and the mTT was longer than that of normal brain tissue( P ＜0. 05). There was significant differences of IMAX and TTP between high- and low-grade gliomas(P ＜0.05), but there was no significant difference of RT and mTT between the two groups ( P ＞0.05). Conclusions CEUS with quantitative analysis software on blood perfusion of the tumors can provide valuable information to grade cerebral gliomas.