Adult ; Cervical Intraepithelial Neoplasia ; diagnosis ; surgery ; Electrosurgery ; methods ; Female ; Humans ; Middle Aged ; Uterine Cervical Neoplasms ; diagnosis ; surgery

OBJECTIVE:To observe the efficacy and safety of eprosartan in the treatment of hypertensive patients with coro-nary heart disease. METHODS:160 hypertensive patients with coronary heart disease randomly divided into observation group and control group. All patients were given aspirin,nitroglycerin,low molecular weight heparin,statins and other conventional treat-ment;control group was additioanlly given 50 mg Losartan potassium tablet,orally,once a day. Observation group was additional-ly given 600 mg Eprosartan tablet,orally,once a day. The treatment course for both groups was 6 months. Clinical efficacy,sit-ting systolic blood pressure and diastolic blood pressure,alanine aminotransferase(ALT),aspartate aminotransferase(AST),urea (UREA),creatinine(Cr),uric acid(UA),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C),the Mini-Mental status (MMSE) scale and activities of daily living (ADL) scale scores before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:There was no signifi-cant difference in the total effective rate between 2 groups(P>0.05). After treatment,the sitting systolic blood pressure and diastol-ic blood pressure,MMSE and ADL scale scores in 2 groups were significantly lower than before,and sitting systolic blood pres-sure in observation group was lower than control group,the differences were statistically significant(P<0.05),and there were no significant differences in sitting diastolic blood pressure,MMSE and ADL scale scores between 2 groups(P>0.05),and no signifi-cant differences in ALT,AST,UREA,Cr,UA,TC,TG,HDL-C and LDL-C between 2 groups before and after treatment(P>0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Eprosartan can effectively reduce sitting systol-ic blood pressure in hypertensive patients with coronary heart disease,and improve cognitive function,with good safety.

OBJECTIVE:To study the effects and mechanism of propranolol on the myocardial abnormal electrophysiology sta-tion in diabetic model rats. METHODS:SD rats were randomly divided into normal control(normal saline)group,diabetic(nor-mal saline)group,PD98059(ERK inhibitor,10 mg/kg)group and propranolol low-dose,medium-dose and high-dose(1,20,50 mg/kg)groups,with 8 rats in each group. Except for normal control group,rats were given alloxan(20 mg/kg)intravenously via tail vein to induce diabetic model. They were given relevant medicine intragastrically,once a day,for consecutive 42 days. The car-diac index,electrocardiogram and action potential durations (APD) of rats were analyzed;the expression of TNF-α,IL-2,IL-6 and IL-10 protein in serum were detected,and the expression of Ras,Raf,ERK kinase(MEK)and ERK1/2 in myocardial tissue were detected. RESULTS:Compared with normal control group,cardiac index increased in diabetes group;heart rate decreased;QT interval and APD were prolonged;the relative expression of TNF-α,IL-2,IL-6,IL-10,Ras,Raf,MEK and ERK1/2 protein increased (P<0.01). Compared with diabetes group,cardiac index decreased in propranolol medium-dose and high-dose groups and PD98059 group,heart rate increased,QT interval and APD were shortened;the relative expression of TNF-α,IL-2,IL-6, IL-10,Ras,Raf,MEK and ERK1/2 protein decreased(P<0.05 or P<0.01). CONCLUSIONS:Propranolol can improve myocar-dial abnormal electrophysiology station of diabetic model rats by down-regulating inflammatory reactions in serum and inhibiting the activation of MEK/ERK signaling pathway.

Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

Background Neuroglobin (Ngb) is a newly discovered member of globin superfamily.It is thought to regulate cell survival under hypoxia or oxidative stress condition.Ngb is expressed at a high level in retinal neuron,suggesting that retina may be one of important functional sites of Ngb.Objective The aim of this study was to investigate the protective role of endogenous Ngb on retina ganglion cells (RGCs) following chronic high intraocular pressure(IOP)in mice and the underlying mechanisms.Methods This study included the in vitro and in vivo experiment.RGCs derived from adult C57BL/6J wild type(WT) mice and Ngb-transgenic(Ngb-Tg) mice which cultivated by our laboratory were incubated with 5.0,7.5,10.0 mmol/L glutamic acid for 3 days.RGCs survival rate was calculated for the ration of dead and survival cells using a double labeling kit to evaluate the influence of Ngb on RGCs survival rate in the addition of glutamic acid.Chronic ocular hypertension models were established by injection of fluorescent microballon(MB) (10 μm)into the anterior chamber of WT mice and Ngb-Tg mice,The mice were divided into WT control group(n=18),Ngb-Tg control group(n=30),WT+MB single injection group(n=38),Ngb-Tg+MB single injection group (n =38),WT+MB twice injection group (n =6) and Ngb-Tg + twice injection group (n=6).In addition,WT+PBS injection group (n =6) and Ngb-Tg+ PBS injection group (n =6) were designed as negative controls to identify if it can affect IOP or not.The mice were sacrificed on 0 day(control group),3 days and 1,4,8 weeks followed the MB anterior chamber injection.Real-time PCR,Western blot and immunoytochemistry were used respectively for the analysis of the expressions of Ngb mRNA and protein in mouse retina,and the survival rates of RGCs were compared between the two types mice.Dihydroethidium (DHE) in retina was detected after cardiac perfusion and ATP level in mouse retina homogenate was analyzed.Results The RGCs survival rate was significantly higher in Ngb mice compared with WT mice in 5.0,7.5 and 10.0 mmol/L glutamic acid treatcd groups (t =2.810,3.020,3.110,P＜ 0.01).IOP of WT+ MB single injection group and Ngb-Tg+ MB single injection group were elevated in comparison with the WT control group and WT+PBS injection group and the high IOP remained for 4 weeks.Ngb level was raised in the WT+MB single injection group on the third day following injection,but the Ngb concentration remained a high level in the Ngb-Tg mice during the period of the experiment duration.The RGCs apoptosis rate was elevated both in the WT mice and Ngb-Tg mice 1,4,8 weeks after injection of MB,however,the cell apoptosis rate was higher in WT mice than that of Ngb-Tg mice(P＜0.05).DHE content in retina in the Ngb-Tg+MB single injection group was significantly lower than that in the WT+MB single injection group (t =3.212,P=0.008),and ATP content in retina was elevated in the Ngb-Tg+MB single injection group compared with WT+MB single injection group(t =2.864,P＜0.01).Conclusions It is suggested that Ngb might be a neuroprotective molecules against RGCs death by decreasing oxidative stress and improving mitochondria function.

Objective To investigate the features of epileptic seizures and eletroencepalogram (EEG) in patients with mitochondrial myopathy encephalopathy,lactic acidosis and stroke-like episodes (MELAS).Methods Forty-four patients with MELAS were diagnosed at the First Hospital of Peking University from November 2007 to August 2013.EEG and head MRI were performed on all patients.The types of epileptic seizure and EEG changes were compared between patients in and outside stroke-like episodes.Results Epileptic seizures occurred in 39 of 44 patients (88.6％) with MELAS,while multitype epileptic seizures were presented in 26 cases (66.7％).In stroke-like episodes,22 patients presented with partial seizures,30 with generalized seizures and 17 with status epilepticus.In nonstroke-like episodes,7 patients presented with partial seizures,14 with generalized seizures and 2 with status epilepticus.The frequency of partial seizures,generalized tonic-clonic seizures,status epilepticus were 47.7％ (21/44),68.2％ (30/44),38.6％ (17/44) in stroke-like episodes and 13.6％ (6/44),27.3％ (12/44),4.5％ (2/44) in nonstroke-like episodes,which have statistical significance (x2 =12.022,14.758,15.103;P =0.001,0.000,0.000,respectively).Abnormal EEGs appeared in all patients.The rates of slow alpha frequency,diffuse δ or θ wave,epileptic discharges were 6.8％ (3/44),43.2％ (19/44),25.0％(11/44) in stroke-like episodes and 31.8％ (14/44),59.1％ (26/44),22.7％ (10/44) in nonstroke-like episodes,respectively.Slow alpha frequency were significantly different between patients in and outside stroke-like episodes (x2 =8.822,P =0.003).Conclusions Epileptic seizures with different types are more common during stroke-like episodes in patients with MELAS.While the rates of epileptic discharges are also common outside the stroke-like episodes.

ObjectiveTo compare the clinical efficacies of acupuncture, auricular point sticking, and the combination of the two methods in treating primary dysmenorrhea by using randomized controlled method, for selecting the optimal treatment in treating primary dysmenorrhea, and to explore the nursing care method for primarydysmenorrhea from the perspective of Chinese medicine. MethodNinety patients with primary dysmenorrhea were randomized into an acupuncture group of 30 cases (group A), an auricular point sticking group of 30 cases (group B), and a combined group of acupuncture plus auricular point sticking of 30 cases (group C). The patients were given treatment 7 d ahead of the menstrual period, a menstrual cycle as a treatment course, totally for 3 courses. The pain score and clinical efficacies were observed and compared among the three groups for statistical analyses.Result The pain scores were significantly changed in the three groups after intervention (P<0.05), there were significant differences in comparing the pain scores among the three groups after intervention (P<0.05), group A and C were superior to group B (P<0.05), and group C was superior to group A (P<0.05). The total effective rate was 96.7% in group A, versus 93.3% in group B and 100.0%in group C, and the rank-sum test showed thatZ=7.675,P=0.022 (P<0.05).ConclusionThe three treatment methods are all effective in treating primary dysmenorrhea, while combining acupuncture and auricular point sticking can approach the optimal effect.

Objective To explore the method of studing the note-taking teaching management under the mode of tutor management for the new nurses and to furthermore complete the goal of clinical teaching management. Methods 24 new nurses received the training in the general surgery department and the ches separtment were chosen. They were divided into the experiment group and the control group according to the clinical teaching nurses' ability of note-taking teaching and management in different period, with 12 cases in each group. The control group adopted the stage-separated teaching method. The study note was graduately completed under the central teaching, instruetion and unified planing in the teaching research section. The experiment group adopted the stage-separated goal teaching method, and conducted one to one responsibility management and instruction system between the teaching nurses and the new nurses. The teaching research section applied the formative evaluation in the first stage (teacher teaching stage), and gave the intervention to the new nurses' mode resulted by studing note. Results There were statistical meanings in the total articles and average article for per person of notes and average article for per pelpson of little notes before and after the intervention(P<0.01).The total averatge article for per person of studying note and the articles for per person of large and little notes achieved the management goal. Conclusions The reasonable combination of tutor teaching method and the conventional teaching method produces the stage-separated goal teaching management mode in the operation room, and achieves a good clinical effect.

Objective To give full play to the nurses in the supply department in teaching management, improve teaching model of the supply department. Methods To collect and analyze 43 patients' informations about training for equipment arrangement in our hospital from 2009. 6 to 2010. 5. Results All nurses met the standard of clinical quality evaluation in training period, new employees got the average score of (9.91 ±0. 12). Conclusions Instructing teacher plays a key role in equipment arrangement teaching, and effectively promote their professional level.

Objective To investigate safety managements of surgical instruments employed for the minimally invasive surgery through link management so as to guarantee surgery safety. Methods All procedure managements for surgical instruments were performed, such as distribution after sterilization, surgical use,takeover after the surgery for 1 910 cases from July to December 2009 in our hospital. All the surgical instruments involved in the surgery included thoracoscopes, laparoscope, uteroscope, ventriculoscope and surgical robots. We organized management training of surgical instruments for medical staff, filed out management procedures,enhanced their consciousness of safety management, controlled the key link for quality control, performed gap management, handled the existing problems and improved management quality. Results The safety procedure management of surgical instruments was performed for the 1 910 cases, which insured that the surgery could go smoothly. Conclusions Safety management measures are established on the basis of the information traced from surgical use, takeover after the surgery, cleaning, sorting, inspection for surgical instruments so that oversight over its management could be effectively avoided, making its clinical effects more obvious.