Objective:To study the effect of leuprolide preoperative used in the patients with uterine fibroids .Methods:Totally 70 patients with uterine fibroids were divided into the observation group and the control group with 35 ones in each.The 35 patients in the control group were with laparoscopic myomectomy , and those in the observation group was given leuprolide , 3.75 mg per time, once in a month for 3 months, and then undergone laparoscopic myomectomy .The serum hormone levels , menstruation situation and fi-broids and uterus volume changes in the observation group were observed and compared before the treatment and after the 3-month leu-prolide treatment .The situation during the operation and after the operation , and the recurrence rate of uterine fibroids between the two groups were compared .Results:After the pretreatment of leuprolide , the levels of luteinizing hormone ( LH) , follicle-stimulating hor-mone (FSH) and serum estradiol (E2) in the observation group were significantly lower than those before the treatment (P<0.05), and the menstrual blood volume , uterine volume and fibroid volume were significantly lower than those before the treatment , and the differences were statistically significant (P<0.05).The blood loss during the operation and pelvic drainage of the observation group were significantly lower than those of the control group , and the ambulation time and length of hospital stay of the observation group were significantly shorter than those of the control group with statistically significant differences (P<0.05).Conclusion:Leuprolide preoperative used in the patients with uterine fibroids can significantly reduce serum hormone levels and fibroid volume , which are ben-eficial to myomectomy with smaller surgery invasion and better prognosis .

Objective To investigate the effect of tourniquet modified strapping on venipuncture in tumor patients.Methods 120 tumor patients whose veins were exposed hard in radiotherapy department from October 2016 to March 2017, randomly divided into the control group and the observation group equally.The control group was treated with the traditional single strapping tourniquet to have venipuncture and the observation group with tourniquet modified strapping.Results The venous filling degree, the success rate of first puncture, and the satisfaction of the patients in the observation group were significantly higher than those in the control group (P<0.05).Conclusion The use of tourniquet modified strapping in tumor patients whose veins were exposed hard can significantly improve the venous filling degree, the success rate of puncture, the satisfaction of patients and the quality of nursing service, and thus it is worthy of clinical promotion.

Objective To study the clinical effect and safety of Dinoprostone suppositories for cervical ripening and labor induction.Methods 50 primiparas with sinsle cephalic term pregnancy.cervical Bishop score≤6 points,with vaginal delivery conditions,no previous uterine scar or prostaglandin allergies or other contraindications were randomly divided into two groups:the dinoprostone suppositories group(observation group)and the sulfuric pula group(control group).The primiparas were administered sulfuric pula keto 200mg/day via intravenous injection for 3 days.Bishop score was assayed in both groups before treatment and 6h.12h after treatment to compare the effect of cervical ripening,labor rates,the total time of labor,mode of delivery,postpartum hemorrhage,neonatal outcomes and adverse reactions.Results Cervical scores were(3.85±0.72)point and(6.79±0.63)point in the observation group 6h and 12h after administration,which were significantly higher than those of control group[(2.85±0.41)point,(4.26±0.52)point](t=6.034,15.485,all P＜0.05).Labor rates of 12h and 24h in the observation group were signitlcandy higher than control group.There Was no significant difference between two groups of neonatal outcomes and postpartum hemorrhage.Conclusion Dinoprostone suppositories sas safe and effective for cervical ripening and labor induction,without adverse effects on mothers and children.

Objective To assess the quality of life and its influencing factors in ellerly patients with advanced cancer.Methods The quality of life was evaluated with EORTC QLQ-C30 scale Chinese version in 103 elderly patients with advanced cancer in a hospital outpatient clinic of Beijing from July 2013 to July 2014.The overall health,physical function,role function,cognitive function,emotional function,social function and individual symptoms score were assessed.The general information and clinical data of patients were analyzed.Results The general score of quality of life in elderly advanced cancer patients was (35.77 ± 21.98).In the domain of function the role functional score was the lowest (36.60 ± 27.97);in the domain of symptoms the tired score was the highest(50.82 ± 30.16),the score of appetite loss was the highest in individual symptoms (39.78 ± 24.32).Educational level,marital status,living condition,medical insurance and the number of comorbidities were correlated with overall health in elderly patients with advanced cancer (P ＜ 0.05).Multiple linear regression analysis showed that the educational level (t =2.447,P ＜ 0.05),marital status (t =2.118,P ＜ 0.05),medical insurance (t =3.770,P ＜ 0.05) and overall health status were positively correlated with the quality of life scores;and number of eomorbidities (t =-7.157,P ＜ 0.05) was negatively associated with the overall quality of life.Conclusion The quality of life was generally poor in elderly patients with advanced cancer;and educational level,marital status,medical insurance,comorbidities are important influencing factors.

Objective To explore the function of MDA on diabetic nephropathy .Methods Glomerular mesangial cells ( GMC) were pretreated with MDA at a final concentrations of 0μmol/L, 1μmol/L, 5μmol/L, 10μmol/L and 50 μmol/L.MTT assay was used to examine the viability of GMC ) .AnnexinV-FITC was used to evaluate effect of MDA on cell apoptosis .RT-PCR and western blot were used to analyze the expression of Nrf 2, HO-1 andγGCL.Results MDA treatment inhibited GMC viability in a dose-dependent manner .MDA at the concentration of more than 5 μmol/L induced mass production of ROS in GMC ( P<0.05 ) .In addition , antioxygen of tBHQ may relieve MDA-induced reduction of cell viability .MDA inhibited the expression of HO-1 , γGCLand Nrf2 ( P <0.05 ) .Conclusions MDA inhibites GMC viability and promotes the cell apoptosis by ROS production through in-hibiting Nrf2/HO-1-γGCL.

Objective To investigate the impact of daily life ability, self-efficacy and social support on post-stroke depression. Methods This was a cross-sectional questionnaire survey. A convenience sample of stroke patients from neurology department was created. Data were collected from patients about their level of daily life ability, self-efficacy, social support and depression measured. Inferential statistics multiple regression analysis was used to estimate the relationships between the predictors and post-stroke depression. Results A total of 144 (96.00%) of 150 stroke patients completed the questionnaires. The level of depression was 14.19 ± 9.25 with 25.00% (36/144) of incidence of post-stroke depression. Self-efficacy scored 40.45 ± 11.41, social support scored 28.34 ± 8.02, which negatively predicted depression (r=-0.834 and-0.736, P<0.01 respectively). Self-efficacy had the most significant impact on depression (t=-6.433, P < 0.01), however, the impact from daily life ability scored 76.74 ± 22.12, which had not statistically significant impact on depression (t=-1.773, P=0.083). Conclusions During treatment and nursing management of post-stroke depression, attention should be paid to the psychiatric variable such as self-efficacy and social support.

ObjectiveTo study the expression of vascular endothelial growth factor (VEGF) and aquaporin 1 (AQP1) in the synovium of rheumatoid arthritis (RA) patients,and their correlation with angiogenesis.MethodsThe expression of VEGF and AQP1 in the synovial tissue was detected with immunohistoehemistry in 7 patients with RA,12 patients with osteoarthritis (OA).The expression of VEGF and AQP1 positive cells and vessels was scored,and the correlation of positive cells with vessels was analyzed.Rank-sum test and Spearman's correlation analysis were used for statistical analysis.ResultsThe expression of VEGF positive cells was significantly correlated with vessels in the synovium of RA group(rs=0.971,P＜0.01 ).No significant correlation was found between VEGF positive cells and vessels in synovium of the OA group (rs=0.235,P=0.462).There was no evident difference in the expression of VEGF positive cells between RA and OA group (Z=-0.390,P=0.711 ).The expressions of AQP1 positive cells were significantly correlated with vessels in the synovium of RA group (rs=0.828,P=0.022).No significant correlation was found between AQP1 positive cells and vessels in the synovium of OA group (rs=0.396,P=0.203).There was no notable difference in the expression of AQP1 positive cells between RA and OA group (Z=-0.302,P=0.773).The expressions of VEGF positive cells were significantly correlated with AQP1 positive cells in RA group (rs=0.891,P=0.007).No significant correlation was found between VEGF positive cells and AQP1 positive cells in OA group (rs=0.338,P=0.283).ConclusionThe expressions of VEGF and AQP1 are significantly correlated with angiogenesis in the synovium of RA,and they play an important role in the pathology of RA.Moreover,there may be synergistic effect between VEGF and AQP1 in RA.

Objective To evaluate the relationship between intestinal metaplasia (IM) and helicobacter pylori infection in elderly patients with chronic gastritis. Methods The patients over 60 years old and diagnosed as chronic gastritis by endoscopy from January 2008 to December 2009 were divided into two groups by pathological appearance. One group was chronic gastritis with IM (IM group), the other was chronic gastritis without IM (NIM group). The infection of helicobacter pylori, activity of inflammation, atrophy of gland, and folliculus lymphaticus in gastric mucosa were observed. Results The infection of helicobacter pylori, infiltration of neutrophil and atrophy ratio of gland were significantly higher in IM group than in NIM group (52.7% vs. 37.3%, 35.5% vs.24.0 %, 36.6 % vs. 3.5%, x2 = 10. 677, 7.641, 95. 606; P = 0. 001, 0. 006, 0. 000, respectively).There was no statistical difference in presentation of folliculus lymphaticus between IM group and NIM group (x2 = 0.003, P=0. 957). The infiltration of neutrophil and presentation of folliculus lymphaticus were significantly higher in helicobacter pylori positive patients than in helicobacter pylori negative patients (45.8% vs. 14.8%, 42.6% vs. 4.2%, both P=0.000). Conclusions The appearance of IM seems to be related with helicobacter pylori infection, activity inflammation and atrophy of gland. The presentation of folliculus lymphaticus seems to be closely related with helicobacter pylori infection. The eradication treatment of helicobacter pylori infection in the elderly chronic gastritis patients should be strengthened.

OBJECTIVE To investigate the characteristic of distribution and the change in drug resistance of Enterococcus in hospital to provide reference for clinical therapy.METHODS The distribution and drug resistance of 99 strains of enterococci isolated from various clinical specimens of the infections from 2002 to 2005 were retrospectively analyzed.RESULTS The Gram-positive cocci isolated from clinical specimens in our hospital accounted for 34.2%,enterococci accounted for 3.0%,and they showed an increasing tendency in recent years.Among 99 strains of enterococci,the most organism was Enterococcus faecalis(62.6%),the second was E.faecium(25.2%).The main localities from where the enterococci isolated were respiratory tract(36.3%),then blood origin(20.2%) and urinary tract(18.8%).Enterococci strains were resistant to multiple antibiotics,but sensitive to piperacillin/tazobactam,nitrofurantoin,rifampicin and vancomycin.The resistance rates of E.faecium to penicillin,piperacillin,piperacillin/tazobactam,ciprofloxacin and vancomycin were significantly higher than that of E.faecalis, but contrary to tetracycline.Compared with the drug resistance rates of E.faecalis to penicillin,gentamicin,high level gentamicin,tetracycline,ciprofloxacin,ceftazidime and vancomycin in 2002,they were significantly increased in 2005(P

Objective To observe the analgesic effect of ultrasound-guided and nerve stimulator after artificial total knee athroplasty(TKA).Methods Forty elective cases receiving TKA under gen-eral anesthesia were randomly allocated into the ultrasound group (group C)and stimulator group (group S).The time for nerve block,onset time and complications were recorded in both groups. Results Compared to group S,the time for nerve block and onset time was significantly shortened in group C (P <0.05).There was no statistical difference in times of pressing analgesic pump and VAS score in postoperative 48 h.One patient suffered from nerve injury and two underwent vascular dam-age and hematoma in group S,while no complication was found in group C.Conclusion Compared to nerve stimulator,ultrasound-guided continuous femoral nerve block(CFNB)may reduce nerve block time and onset time and decrease complications,so that to increase safety of CFNB.