Objective To investigate the expression of inducible nitric oxide synthase (iNOS) in human gastric carcinoma and its relationship with angiogenesis, lymph nodes metastasi s and clinical staging of gastric carcinoma. Methods The expression of iNOS in 50 patients with gastric carcinoma was studied with im munohistochemical method. Microvessel density (MVD) of human gastric carcinoma was also determined with anti-CD34 as the labelled vascular endothelial cells. Results The rate of expression of iNOS in 50 cases of gastric carcinoma was 70.0% , and MVD averaged 22.0?9.8, higher than those in the tissues around cancer (16 .2%,6.1?3.4) and normal gastric tissues (15.0%,5.5?2.6; P

OBJECTIVE:To study the effects of volatile oil of Pogostemon cablin on the expression of tight junction proteins ZO-1 and Occludin in colonic mucosal epithelial cells of rats with post-infectious irritable bowel syndrome(PI-IBS). METHODS:Rats were randomly divided into normal control group(distilled water),model group(distilled water),Trimebutine maleate tablet group(TMT,0.1 g/kg)and volatile oil of P. cablin low-dose,medium-dose and high-dose groups [2,3,4 g(crude drug)/kg] with 8 rats in each group. Except for normal control group,those groups were given colon perfusion of acetic acid to induce PI-IBS mod-el. After modeling,they were given relevant medicine intragastrically once a day for consecutive 5 days. The expression of ZO-1 and Occludin [by IOD] and their distribution were detected by immunohistochemistry. RESULTS:In normal control group,ZO-1 and Occludin evenly distributed on the top of enterocyte,manifesting as alveolate and punctiform;in model group,ZO-1 and Oc-cludin scattered on the top of enterocyte,showing uneven dyeing or fade;the distribution of ZO-1 and Occludin in volatile oil of P. cablin groups was similar to normal control group,and its dyeing was lighter than that of normal control group. IOD value of ZO-1 and Occludin in model group were lower than in normal control group(P<0.01);those of volatile oil of P. cablin high-dose group and the IOD value of ZO-1 of P. cablin medium-dose group and TMT group were higher than those of model group (P<0.05 or P<0.01). CONCLUSIONS:The volatile oil of P. cablin can up-regulate the expression of tight junction proteins ZO-1 and Occlu-din in colonic mucosal epithelial cells of rats with PI-IBS.

Objective To investigate the present situation of quality of life in the elderly residents aged more than 60 years in Zhanjiang city and to analyze its influence factors .Methods 418 elderly residents over 60 years sampled by the random sampling in Zhanjiang city were performed the questionnaire survey by using the Chinese Scale of World Health Organization QOL (WHOQOL-BREF) .Results The quality of life in the physical ,psychological and environmental fields in male residents was higher than that in the female residents ;which in the psychological and environmental fields in the high cultural level residents was higher than that in the low cultural level residents ;which in the social relations field in the high income residents was higher than that in the low in-come residents ;there were no statistical differences in the quality of life among the elderly residents with different occupations be-fore retirement and marital status ;the Logistic regression analysis showed that gender and occupation were the influence factors of quality of life self evaluation in elderly residents .Conclusion Gender ,occupation ,educational level and income level are the influ-ence factors of quality of life in elderly residents .

Objective To investigate effects of hormone replacement therapy with conjugated equine estrogen (CEE) in different doses combined with medroxyprogesterone acetate ( MPA) on mammographic density among postmenopausal women and its clinical significance. Methods Ninety eligible postmenopausal women were randomized into three groups with varied treatment continuously for one year, Croup A receiving 0.3 mg CEE with 2 mg MPA and caltrate 600 mg and vitamin D 125 U daily; Group B receiving 0. 625 mg CEE combined with 2 mg MPA and caltrate 600 mg with vitamin D 125 U daily; and Group C receiving caltrate 600 mg and vitamin D 125 U daily. Mammographic density was analyzed using Wolfe and semi-quantitative methods for all of them and compared each other one year after treatment, as well as mammographic density before and after treatment in Groups A and B. Results One year after treatment, mammogrphic density reached the highest in postmenopausal woman of Group B and the lowest in those of Group C, with significant difference among the three groups (P ＜ 0. 01) and between Groups A and C (P ＜ 0. 01) and between Groups B and C ( P ＜ 0. 05 ). Mammogrphic density with semi-quantitative method increased significantly in Group A ( P ＜ 0. 05 ) and Group B ( P ＜ 0. 01 ), respectively, after treatment as compared with that before it. Change in mammografic density before and after treatment was greater in Group B than that in Group A, but not reaching statistically significant level (P ＞ 0. 05). Conclusions Hormone replacement therapy can cause the increase of mammographic density in postmenopausal women, possibly in a dose-dependent pattern, which suggest that HRT has side effect on breast tissue and the lowest effective dose of estrogen should be selected in HRT. Mammographic density can be used as an indicator to monitor side effect of HRT on breast.

This study was aimed to observe the intervention effect of oxidation/antioxidation at different time point among mice induced by lipopolysaccharide (LPS) and bleomycin. It provided experimental basis for the establishment of chronic obstructive pulmonary disease (COPD) animal model with qi-deficiency and phlegm-obstructing pattern with inducers mentioned above. A total of 96 mice were randomly divided into the normal control group, bleomycin group, and LPS group, with 32 mice in each group. In the bleomycin group and LPS group, 40 μL of nasal drops were given with bleomycin at the concentration of 3.75 μg/μL or LPS at the concentration of 5 μg/μL, respectively to establish the COPD animal model with qi-deficiency and phlegm-obstructing pattern. On the 1st day, 7th day, 14th day and 28th day after the model establishment, the general status and activities of mice were recorded. And traditional Chinese medicine (TCM) signs such as skin color of the four limbs, skin color under the tongue and color of the tail were also collected when the animal model was sacrificed. At each time point, 8 mice were sacrificed. The lung tissues were removed. And the contents of GSH, MDA, SOD and T-AOC were detected in the homogenate of lung tissues. The results showed that compared with the normal control group, mice in the bleomycin group had slightly dull eyes, dry hair without burnish, upright and fluffy hair, dark purple skin color of the auricle and four claws, tiredness, inactivity, occasional cough, asthma or rapid breathing. The GSH content of lung tissues on the 7th day, 14th day and 28th day was obviously reduced (P< 0.05, or P< 0.01). The MDA, SOD and T-AOC contents on the 1st day, 7th day, 14th day and 28th day were obviously reduced (P< 0.05, or P< 0.01). Compared with the normal control group, mice in the LPS group had slightly dull eyes, soft hair with slight burnish, pale red skin color of the auricle and four claws, tiredness; some mice preferred to gather. Contents of GSH and SOD in lung tissues on the 1st day and 7th day were obviously reduced (P< 0.05, or P< 0.01). Contents of MDA and T-AOC on the 1st day, 7th day and 14th day were obviously reduced (P < 0.05, or P < 0.01). It was concluded that obvious oxidation/antioxidation imbalance started on the 7th day in lung tissues of mice in the bleomycin group. It reduced later on. And the oxidation/antioxidation imbalance continued until the end of the model establishment. Obvious oxidation/antioxidation imbalance started on the 1st day in lung tissues of mice in the LPS group. However, this oxidation/antioxidation imbalance was adjusted back to normal level through time.

Objective To evaluate the safety and efficacy of Prolift pelvic reconstructive surgery for advanced pelvic organ prolapse in elderly patients,and to investigate its impact on pelvic floor function and sexual function.Methods Totally 42 patients aged 60-79 years with advanced pelvic organ prolapse [Pelvic Organ Prolapse Quantification (POP-Q) stage Ⅲ,n=30; POP-Q Ⅳ,n=12)were selected in this study.All patients underwent total Prolift procedure,and were followed up at month 1 and 6 after operation.Operation time,bleeding volume and postoperative complications were recorded.The impact of total Prolift procedure on pelvic floor function in patients were assessed by pelvic floor distress inventory short form 20 (PFDI-20),the pelvic floor incontinence questionnaire 7 (PFIQ-7) and the pelvic organ prolapsed and incontinence sexual quality questionnaire 31 (PISQ-31).Results The operative time was (35-78) minutes[mean time:(42±25) minutes].Bleeding volume was (50 300) ml [mean volume:(137±58) ml].No bladder injury,rectum injury and postoperative complications were observed.All patients were cured,and no one recurred.The scores of PFDI-20 and PFIQ-7 were decreased in patients after sugery at 1 and 6-month follow-up as compared with beforesugery (4.5±1.4,0 vs.47.9±12.2; 7.8±4.3,0 vs.76.3±17.9,respectively,all P＜0.01).There were no significant differences in scores of PFIQ-7 between before and after sugery at 1-and 6-months follow-up (52.3±4.3 vs.49.8±6.3,51.1±6.5,P＞0.05).Conclusions Prolift pelvic reconstructive surgery is an safe and effective treatment for advanced pelvic organ prolapse,which can significantly improve quality of life in elderly patients.

Objective To investigate the clinical,endoscopic and pathologic features in the differential diagnosis between Crohn' s disease (CD) and intestinal tuberculosis (ITB).Methods The complete clinical data of 107 patients with CD and 69 patients with ITB in our hospital from January 2011 to January 2012 were retrospectively analyzed.The diagnostic value of the clinical and endoscopic scoring system was evaluated.Results CD occurred mainly in male.The salient features of CD included long duration of disease high incidence of colectomy.Comparing with patients with ITB,patients with CD have more cases of diarrhea,hematochezia,abdominal mass,intestinal obstruction,intestinal hemorrhage,perianal lesions,and extraintestinal manifestations (all P ＜ 0.05).It's more frequent to have positive results of anti-Saccharomyces cerevisiae antibody (ASCA),perinuclear antineutrophil cytoplasmic antibody (pANCA) and fecal occult blood in CD patients,as well as low albumin,high C-reactive protein (CRP),elevated platelet count and hematocrit (P ＜ 0.05 or P ＜ 0.01).The salient features of ITB included low fever,night sweats,active parenteral tuberculosis,increased erythrocyte sedimentation rate (ESR),chest X-ray abnormalities,the positive PPD (purified protein derivatives tuberculin) and T-SPOT (P ＜ 0.05 or P ＜0.01).Based on the imaging,CD often involved the small intestine,such as the intestinal stricture and abdominal abscess (P ＜ 0.05),while mesenteric lymphadenopathy was more common in ITB (P ＜ 0.05).The endoscopic examination showed that some patterns of disease involvement such as fissure-shape ulcer [41.12％ (44/107) vs 5.80％ (4/69)],cobblestone sign [15.89％ (17/107) vs 4.35％ (3/69)],lesions over four segment [24.30％ (26/107) vs 7.25％ (5/69)],rectum involvement [17.76％ (19/107) vs 5.80％ (4/69)],ileocecal valve stenosis [21.50％ (23/107) vs 8.70％ (6/69)] and mucosal bridge [5.61％ (6/107) vs 0(0/69)] were more frequent in CD patients than those in ITB patients(P ＜ 0.01 or P ＜0.05).However circular ulcers[37.68％ (26/69) vs 9.35％ (10/107)],rat-bite-like ulcers[24.64％ (17/69) vs 12.15％ (13/107)],persistent open ileocecal valves [39.13％ (27/69) vs 19.63％ (21/107)],tuberous and polypoid lesions [36.23％ (25/69) vs 20.56％ (22/107),37.68％ (26/69) vs 22.43％ (24/107)] were more common in ITB (P ＜ 0.01 or P ＜ 0.05).In terms of pathological findings,certain characteristic features such as transmural inflammation [5.61％ (6/107) vs 0 (0/69)],fissure-liked ulcers [14.02％ (15/107) vs 4.35％ (3/69)],non-caseous granulomas [5.61％ (6/107) vs 0(0/69)],lymphoid hyperplasia [16.82％ (18/107) vs 5.80％ (4/69)] and crypt abscess [9.35％ (10/107) vs 1.45％ (1/69)] were more common in CD than those in ITB(P ＜ 0.05).According to the clinical and endoscopic scoring system,the positive diagnostic rate of CD was 50.47 ％ (54/107)and of ITB was 66.67 ％ (46/69) (P ＜ 0.05).Conclusions The differential diagnosis between CD and ITB should be considered carefully based on clinical,endoscopic,pathological characteristics.The clinical and endoscopic scoring system may contribute to distinguish CD and ITB.

Forty two resident general practitioners (GPs) attending obstetrics and gynecology course in Beijing Hospital were divided into trial group and control group with 21 in each group. The 2-hour study content uterine fibroids was taught by the same teacher. For control group the traditional classroom teaching mode was used, while for the trial group the WeChat-based flipped classroom model was used. The teaching effectiveness was evaluated by means of paper examination, critical examination and questionnaire survey. The average scores and the clinical reasoning scores of trial were significantly higher than those of control group [(90.5±3.4) vs. (82.5±4.2) points and (94.5±1.5) vs. (84.5±2.0) points; t=4.28, P<0.05 and t=5.01, P<0.05, respectively]. Compared with the control group, the trial group presented more learning interest, higher learning efficiency and self-learning ability; and also the ability of expression and communication was improved, the ability of teamwork and the ability of analyzing and solving problems was enhanced more markedly in trial group (all P<0.05). The result indicates that WeChat-based flipped classroom teaching model can improve the learning efficiency in general practice residency training.

Objective To analyze the characteristics and the related risk factors of the contractility of pelvic floor muscles in old women with pelvic floor dysfunction(PFD).Methods A cohort of 125 elderly patients with symptoms of pelvic floor dysfunction,including 60 of postpartum urinary incontinence(SUI)and 65 of pelvic organ prolapse(POP),were recruited.60 women volunteers with normal pelvic floor function were recruited as a control group.A questionnaire survey was conducted to record the general situation of the subjects.The pelvic floor muscle strength was determined by the methods of electromyography and pressure feedback recording.Results The body mass index,the average number of delivery,newborn baby's body weight were significantly higher in the SUI and POP group than in control group,with statistically significant difference(F=5.29,6.27,5.26,P=0.007,0.003,0.008),but without statistically significant difference between SUI and POP groups (P =0.674,0.554,0.578).The rapid contractility value was significant lower in SUI group than in POP and control groups(all P＜0.01),and the sustained contractility value was significant lower in POP group than in SUI and control groups(all P＜0.01).Conclusions The postpartum pelvic floor dysfunction may be correlated with BMI,vaginal delivery rate,the average number of delivery,newborn baby's body weight and a history of increased abdominal pressure.The postpartum pelvic floor dysfunction may be associated with the declined contractility of pelvic floor muscle,among which the POP may be associated with class Ⅰ muscle and the SUI with class Ⅱ muscle.

AIM To observe the protective effects of mangiferin on the inflammatory injury and expression of the inflammatory factor in the cerebral tissue of spontaneously hypertensive rats and on MCP-1/CCR2 signal pathway.METHODS Forty spontaneously hypertensive rats were randomly divided into model,benazepril [10 mg/(kg · d)] and mangiferin high,middle and low dose [40,20,10 mg/(kg · d)] groups and other eight rats of same week age served as control group.After consecutive intragastric administration for eight weeks,morphology of the rats' cerebral tissue was observed;their levels of ICAM-1,IL-6 and TNF-α in cerebral tissue were determined by ELISA;their expressions of MCP-1 and CCR2 protein in brain tissue of rats were detected by immunohistochemistry and Western blot and the detection of mRNA expressions of MCP-1 and CCR2 in cerebral tissue of rats were carried out by RT-PCR.RESULTS Compared with the model group,the blood pressure of mangiferin in each dosage group decreased slightly,but there was no significant statistical difference.In the control group and the model group,there was no obvious morphological change in the cerebral tissue.The morphology of rats in the benazepril group,each dose of mangiferin group were all normal.The contents of IL-6,TNF-α,ICAM-1 and MCP1,CCR2 protein and mRNA expression were significantly decreased in the cerebral tissues of spontaneously hypertensive rats.CONCLUSION Mangiferin has obvious anti-inflammatory effects on inflammatory reaction in spontaneously hypertensive rats,its mechanism may be related to inhibiting the expression of MCP/CCR2 signaling pathway.