Objective:To investigate the relationship among happiness, resilience, optimistic intelligence quotient and perceived social support in patients with advanced gynecological cancer.Methods:A total of 269 patients with advanced gynecological cancer from January 2018 to January 2019 in three top three hospitals in Shanghai were selected as subjects by convenient sampling.The basic information questionnaire, Memorial University of New-foundland scale of happiness, Connor-Davidson Resilience Scale simplified Chinese version, Optimistic Intelligence Quotient Questionnaire and Perceived Social Support Scale were used to investigate.Results:The score of happiness was (32.45±6.37), the score of resilience was (30.64±8.78),the score of optimistic intelligence quotient was (62.74±12.49) and the score of perceived social support was (68.14±4.25) in patients with advanced gynecological cancer. Linear regression equation analysis showed that happiness and optimistic intelligence quotient × happiness had significant predictive effect on resilience ( β values were 0.547, 0.016, P < 0.05), optimistic intelligence quotient had no significant predictive effect on resilience ( P>0.05), and optimistic intelligence quotient, happiness, resilience, optimistic intelligence quotient×happiness had significant predictive effect on perceived social support ( β values were 0.015-0.251, P<0.01). Happiness could regulate the direct path and the first half of the mediating effect of resilience between perceived social support and optimistic intelligence quotient. According to Johnson-Neyman's analysis, the boundary value of the moderating effect of happiness between optimistic intelligence quotient and resilience was 26.19, and the boundary value of the moderating effect of happiness between optimistic intelligence quotient and perceived social support was 22.08. Conclusions:There is a positive correlation between optimistic intelligence quotient and perceived social support in patients with advanced gynecological cancer. Resilience can play a significant mediating role between optimistic intelligence quotient and perceived social support under the regulation of happiness, which can provide corresponding psychological intervention for patients with advanced gynecological cancer.

Objective To explore the clinical application value of blood routine examination in judgment of the activity of inflammatory bowel diseases.Methods 102 patients with inflammatory bowel disease were selected as the main research objects,60 healthy persons in the same period were selected as the control group,all of the subjects were received routine testing of blood,C-reactive protein and erythrocyte sedimentation rate,and the relationships between disease and blood routine indexes were compared.Results In UC group,the PLT,WBC RDW index levels of remission were higher than those of the control group,the differences were statistically significant(t =6.75,8.21,5.73,all P ＜0.05).In patients with UC,the HGB,HCTand MPV index levels were lower than those in the remission patients and the control group,the differences were statistically significant(t =8.12,11.03,6.72,9.35,10.23,8.71,all P ＜0.05).But the PLT index was higher than that of patients in remission,the RDW and WBC indexes were higher than those in the control group and the remission period,there were statistically significant differences (t =7.59,8.51,6.03,all P ＜ 0.05).The routine blood indexes of the relief patients of CD group had significant differences compared with the control group(t =6.17,7.29,9.01,10.35,8.27,7.69,8.01,9.91,allP ＜ 0.05),the HCT,MCV,HGB and MPV indexes were lower than those of the control group,the differences were statistically significant (t =9.01,10.35,8.27,9.9i,all P ＜ 0.05),the WBC,PLT,N and RDW indexes were higher than those of the control group,the differences were statistically significant (t =6.17,7.29,7.69,8.01,all P ＜ 0.05).In UC group,the HGB,HCT,MCV and MPV indexes were lower than those in the remission patients and the control group,there were statistically significant differences(t =8.19,6.97,7.53,9.02,all P ＜ 0.05).But the PLT,RDW,WBC and N indexes were higher than those in the remission patients and the control group,the differences were statistically significant (t =9.81,7.94,8.36,7.61,P ＜ 0.05).In the active patients of CD group,the WBC and N indexes were significantly higher than those of UC group,the differences were statistically significant (t =8.15,9.07,all P ＜ 0.05).In the remission patients of CD group,the PLT index was significandy higher than that in the remission patients of UC group,the difference was statistically significant (t =10.35,P ＜ 0.05).Conclusion Indexes of blood routine has obvious significance in activity of inflammatory bowel disease,and it is significant correlation with inflammation index,which can be used as one of the routine clinical method to determine the activity of inflammatory bowel diseases.

Objective To explore the effect of chitosan on vascular smooth muscle cells inhibited proliferation from rabbit arteriovenous fistula and its mechanisms.Methods Established rabbit fistula model on carotid arteryinternal jugular vein.After 1 month cultured VSMCs with primary culture by tissue-pieces inoculation.Cultured VSMCs were divided into three groups:①normal control group.②FBS-treated group:cell were treated with 5％,10％,20％ for 48 h,respectively; established the model of rabbit VSMCs proliferation.③chitosan-treated group:VSMCs cultured with 20％ FBS were exposed to different doses of chitosan(10,100,500,1000,2000μg/ml) for 48 h.And VSMCs were treated for different time (0,12,24,48 h) with Chitosan 1000 μg/ml.Expression levels of PCNA and TLR4/ NF-κB were detected by Western blotting.RT-PCR were applied to measure the mRNA expression of PCNA and TLR4.The protein levels of TLR4 and NF-κB were detected by immunofluorescence.Results Compared with low concentration serum group,FBS-treated VSMCs exhibited a increase in mRNA and protein expression of PCNA and TLR4.FBS-induced protein expression of PCNA and TLR4/NF-κB were reduced by chitosan.Also mRNA expression of PCNA and TLR4 were reduced.They were dependent on concentration and time.In rabbit VSMCs TLR4 was mainly expressed in the cytoplasm and NF-κB expressed mainly in the nucleus.Compared with normal control group,TLR4 and NF-κB protein expression were significantly decreased by chitosan.Conclusion High concentration serum induced VSMCs proliferation.Chitosan can inhibit the proliferation of rabbit VSMCs.It is speculated that the mechanism may be related to the expression of TLR4 receptor activation,reducing expression of downstream factor MyD88 and NF-κB.It is suggest that chitosan can become potential new drugs of arteriovenous fistula prevention of intimal hyperplasia.

One hundred and thirty patients with esophageal carcinoma were randomly asigned into two groups:62 cases received thoracoscopic esophagectomy (TE group) and 68 cases received open thoracic esophagectomy group (OE group).All patients underwent lymph nodes dissection along bilateral recurrent laryngeal nerve.Compared with OE group,TE group had a less blood loss during the lymph nodes dissection (P ＜ 0.05) and a lower incidence of pulmonary infection (P ＜ 0.05).There were no significant differences in the number of dissected lymph nodes,dissection time,incidence of temporary hoarseness,permanent hoarseness and mechanical ventilation for respiratory failure between two groups (P ＞ 0.05).The study suggests that lymph nodes dissection along bilateral recurrent laryngeal nerve can be succesfully completed by thoracoscopic esophagestomy,and it has the advantage of less intraoperative blood loss and lower incidence of pulmonary infection,compared to open thoracic surgery.

Objective To observe the effectiveness and mechanism of Xiaoyao San (Xiaoyao Powder for Soothing Liver and Relieving Depression) in improving depression-like behavior of rats. Methods Male Wistar rats were randomized into normal group, model group, Xiaoyao San (1.9 g·kg-1·d-1) group, and fluoxetine (2 mg·kg-1·d-1) group. The rats were exposed to chronic unpredictable mild stress ( CUMS) to induce rat depression-like behavior. Field test was performed for the observation of effect of Xiaoyao San on rat depression-like behavior, Luminex liquid chip system was applied to detect the serum cytokines, and the amount and size of rat hepatic sinusoidal endothelial window were examined under electron microscope, and hepatic indoleamine 2, 3-dioxygenase ( IDO) and tryptophan 2, 3 -dioxygenaes ( TDO) expression levels were detected by immunohistochemical and Western blot methods. Results Xiaoyao San showed obvious effect on increasing sugar water consumption, the number of crossing the blocks and erection frequency in rats, decreasing serum levels of tumor necrosis factor alpha ( TNF-α) and interleukin 6 ( IL-6) , increasing the amount of hepatic sinusoidal endothelial window, promoting hepatic sinusoidal endothelial vascularization, and reducing TDO and IDO expression ( P<0.05 or P<0.01). Conclusion Xiaoyao San exerts obvious effect on improving rat depression-like behaviors, and the mechanism is probably related with the decrease of inflammatory factors, inhibition of IDO pathway, and improvement of hepatic sinusoidal endothelial function.

Objective To compare the serum estradiol level of gouty patients with healthy controls and to investigate whether estradiol upregulatesthe expression of the uric acid transporter ATP-binding cassette superfamily member 2 (ABCG2) of human renal tubular epithelial cells (HK-2)..Methods Serum of 16 male gout patients and 16 male healthy controls and their estradiol level were assessed with ELISA.The HK-2 cells wer cultured with different concentrations of estradiol for 24 hours or 48 hours.mRNA expression of ABCG2 was assessed by quantitative polymerase chain reaction (qPCR).HK-2 cells were cultured with estradiol or estradiol and inhibitor of PI3K/Akt pathway LY294002.mRNA expression of ABCG2 was assessed by qPCR,while the Akt,p-Ser473-Akt,p-Thr308-Akt and ABCG2 expression were investigated by Western blot.Data was analyzed using either the one-way analysis of variance or the t test.Results The level of serum uric acid in gout patients was [(547±18) μmol/L],which was significantly higher than that of healthy controls [(344±12) μmol/L),t=-5.395,P＜0.01].The level of estradiol in gout patients was (45±6) μmol/L,which was significantly lower than that of healthy controls [(100±8) μmol/L,t=9.375,P＜0.01].The mRNA expression of ABCG2 of 10-4 mol/L estradiol group was elevated after 24 hours or 48 hours (t=3.168,t=3.990;P＜0.01).In the group of co-stimulation withestradiol and LY294002,the ABCG2,p-Ser473-Akt and p-Thr308-Akt expression were down regulated compared to the estradiol group.Conclusion There is a significant correlation between serum estradiol and uric acid.Estradiol inducesthe expression of ABCG2 of HK-2 cells by activating PI3K/Akt pathway.

Objective To investigate the effete of chitosan on rabbit carotid artery internal jugular vein fistula intimal hyperplasia and its regulation on TLR4/NF-κB signaling.Methods A total of 28 New Zealand white rabbits were randomly divided into the control group(n=4),the model group(n=12) and the chitosan group(n=12).Model group and chitosan group rabbits were established respectively carotid artery internal jugular vein fistula models.After AVF surgery,chitosan was smeared on venous blood vessels and anastomosis.After 4,6 and 8 weeks,the rabbits were separately sacrificed and the AVF venous vascular tissues were taken.The pathological changes of AVF venous vascular tissue in each group were observed.The changes of α-SMA were detected by immunohistochemistry method.The mRNA expressions of PCNA and TLR4 in the tissues were measured by Real-time PCR.At the same time,the protein expressions of PCNA,TLR4,MyD88 and NF-κB were detected by Western blotting.The experimental data were processed by two-factor analysis of variance in statistics.Results (1) After 4 weeks,vascular intimal was thicked in mdel group.In intimal hyperplasia,α-SMA was staining,and then proliferation of vascular smooth muscle cell was significant.As time increasing,more intimal hyperplasia shown obviously,the expression of α-SMA significantly increased.Compared with model group,chitosan group significantly reduced the degree of intimal hyperplasia,the level of α-SMA was significantly decreased,vascular smooth muscle cell proliferation was also extraordinarily decreased.(2) Compared with control group,the expression levels of PCNA,TLR4,MyD88 and NF-κB increased with time.The indices of Chitosan group were markedly higher than control group,but significantly lower than model groups.Conclusion Chitosan can inhibit the proliferation of rabbit VSMCs.The mechanism may be concerned in down regulating TLR4-mediated signaling pathway,reducing the possibility of intimal hyperplasia of rabbit AVF venous blood vessels.

Objective:To investigate the body composition and sarcopenia in patients with stable chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors.Methods:A total of 220 patients with stable COPD were enrolled in the study from China-Japan Friendship Hospital during July 2018 to December 2019; 220 age and sex-matched healthy subjects (control group 1) and 220 healthy young adults aged 20-40 years (control group 2) were enrolled from the community. The body composition was measured by bioelectrical impedance method. The demographic characteristics, disease conditions, living background and other related factors were collected by questionnaire. T test or one-way ANOVA were used for comparison between groups, and non parametric test was used for non normal distribution data.Results:Compared with the control group 1 and control group 2, the body fat rate ( Z=-10.037, t=-8.411), the fat free mass index ( Z=-8.165, t=-7.856), and appendicular skeletal muscle index (ASMI) ( t=-7.158, t=-11.989) were significantly lower in stable COPD patients ( P<0.05). Among 220 patients with stable COPD, 51 (23.2%) were diagnosed as sarcopenia; the prevalence of sarcopenia was 18.3% (24/131) in men and 30.3% (27/89) in women (χ2=4.297, P=0.038). The decreased ASMI and grip strength in COPD patients with sarcopenia were significantly associated with age≥75 (χ2= 15.746, F= 14.048), female sex ( Z=5.805, t=2.672), low income ( Z=-4.291, t=-4.789), Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade Ⅳ (χ2=22.644, F=3.905), Modified British Medical Research Council (mMRC) Dyspnea Scale grade 4 (χ2=12.475, F=4.369), not receiving systematic health education ( Z=-4.239, Z=-2.474), no exercise (χ2=14.786, F=3.402), insufficient nutrition intake (χ2=40.531, F=10.529). The range of 6-min walking distance was (110-268) m, that was even shorter for patients with mMRC dyspnea scale grade 4 ( F=3.468, P<0.05). Conclusion:The impairment of body composition is common in COPD patients, which will further affect the body function. It is suggested that the routine evaluation of COPD should include the measurement of body composition.

Objective: To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR). Methods: Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed. Results: The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes. Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.

Objective To investigate the predictors of early neurological deterioration (END) in patients with acute ischemic stroke (AIS). Methods From January 2015 to April 2018, patients with AIS without receiving thrombolytic therapy and endovascular treatment admitted to the Department of Neurology, the First Affiliated Hospital of Nanjing Medical University were collected retrospectively. END was defined as National Institutes of Health Stroke Scale (NIHSS) score increased by ≥2 within 7 days after onset from baseline. The baseline clinical data, imaging examinations, and laboratory findings were compared in patients of the END group and the non-END group. Multivariate logistic regression analysis was used to determine the independent predictors of END. Results A total of 652 patients with AIS were enrolled,including 437 males (67. 0％). There were 247 patients (37. 9％) in the END group and 405 (62. 1％) in the non-END group. There were significant differences in low-density lipoprotein cholesterol, fasting blood glucose, homocysteine, lipoprotein (a), neutrophil percentage, and NIHSS scores between the 2 groups (all P < 0. 05). There were significant differences in the proportion of severity of stroke, serious lesion of the guilty vessels, watershed infarction, etiologic classification of stroke, Oxfordshire Community Stroke Projects classification, and taking statins before onset between the 2 groups (all P < 0. 05 ). Multivariate logistic regression analysis showed that lipoprotein (a) (odds ratio [OR] 1. 001, 95％ confidence interval [CI] 1. 000-1. 002; P = 0. 021), total anterior circulation infarcts (OR 3. 842, 95％CI 1. 383-10. 671; P =0. 003), and partial anterior circulation infarcts (OR 2. 642, 95％CI 1. 486-4. 695; P = 0. 001) were the independent risk factors for END, and prior statin use was an independent protective factor of END (OR 0. 222, 95％CI 0. 072-0. 679; P = 0. 008). Conclusion Lipoprotein (a), total anterior circulation infarcts, and partial anterior circulation infarcts were the independent risk factors for END. Taking statins before onset was an independent protective factor of END.