Objective To demonstrate that miR-483-5p and its targeted gene ERK1 involved in the regulation of proliferation and apoptosis of human granulosa cells.Methods ① The ERK1 mRNA and protein level expression were detected by PCR and Western blot after miR-483-5p overexpression in vitro normal human granular cells.De-tected the relative luciferase density after cotransfecting miR-483-5p mimics and its control respectively with wild or mutant ERK1 mRNA 3`UTR cloned luciferase report vector in granular cells.② Granular cells proliferation and ap-optosis were detected by MTT and TUNEL after transfecting miR-483-5p mimics or ERK1 siRNAs alone or simulta-neously.Results ① It showed that both ERK1 mRNA and protein in granular cells were markedly downregulated after the transfection of miR-483-5p mimics.A significant relative luciferase activity decrease were detected in the granular cells co-transfected with ERK1 wild and miR-483-5p mimics comparison with the control mimics,but not in the cells co-transfected with the ERK1 mutant and miR-483-5p mimics.② When miR-483-5p mimics and ERK1 siRNAs were alone or co-transfected into granular cells,the proliferation was inhibited while apoptosis trend was monitored to be promoted in all cases.No obvious statistic difference was shown between each other.Conclusion MiR-483-5p is involved in the regulation of the proliferation and apoptosis of human granulosa cells by directly binding to the target gene ERK1.

Objective To explore the effects of narrow-band ultraviolet B (NB-UVB)on the serum levels of thymic stromal lymphopoietin (TSLP)and interleukin-25 (IL-25), as well as on the expressions of TSLP receptor (TSLPR)and IL-25 receptor (IL-25R)mRNAs in peripheral blood mononuclear cells (PBMCs)from patients with atopic dermatitis(AD). Methods A total of 40 patients with AD and 30 healthy volunteers were enrolled in this study. All the patients were treated with NB-UVB at 0.3 - 2.5 J/cm2 thrice a week for 12 consecutive weeks. Venous blood samples were obtained from these patients before and after the treatment as well as from these healthy controls. Double-antibody sandwich enzyme-linked immunosorbent assay (ELISA)was performed to detect serum levels of TSLP and IL-25, and reverse transcription PCR(RT-PCR)to determine the mRNA expression levels of TSLPR and IL-25R in PBMCs from these subjects. The scoring atopic dermatitis (SCORAD)system developed by the European Task Force on Atopic Dermatitis was used to estimate the severity of AD, and visual analogue scale (VAS)to evaluate the degree of itch. Statistical analysis was carried out by the two-independent-sample t-test for intergroup comparisons and paired t-test for comparisons between pre- and post-treatment samples from these patients. Results After the treatment with NB-UVB, the total response rate reached 75%(30/40)in these patients, with a significant decrease in SCORAD score from 55.26 ± 10.88 before the treatment to 20.36 ± 5.12 after the treatment (t = 10.29, P < 0.05)and in VAS score from 8.20 ± 1.37 to 3.05 ± 1.02(t = 8.16, P < 0.05). Before the treatment, the patients showed a significant increase in the serum levels of TSLP(198.24 ± 29.47 ng/L vs. 120.13 ± 19.65 ng/L, t = 29.70, P < 0.05)and IL-25(160.54 ± 34.89 ng/L vs. 120.41 ± 43.07 ng/L, t = 14.65, P < 0.05), as well as in the mRNA expression levels of TSLPR (8.57 ± 1.34 vs. 1.94 ± 0.39, t =7.07, P < 0.05)and IL-25R(6.81 ± 0.50 vs. 1.48 ± 0.47, t = 18.89, P < 0.05)compared with the healthy controls. With the improvement of conditions after the treatment, a significant decrease was observed in the serum levels of TSLP (151.87 ± 14.78 ng/L, t = 18.56, P < 0.05)and IL-25(130.52 ± 29.65 ng/L, t = 9.07, P < 0.05), as well as in the mRNA expression levels of TSLPR (2.89 ± 0.53, t = 5.21, P < 0.05)and IL-25R (3.90 ± 0.37, t = 7.35, P < 0.05)in PBMCs from these patients compared with those before the treatment, and differences disappeared in all of these parameters between the patients and controls (all P > 0.05). Conclusions TSLP and IL-25 may play important roles in the development of AD, and NB-UVB may treat AD by downregulating the expressions of them and their receptors.

Objective To study the feasibility and care mode of remote fetal monitoring at primary hospital. Methods A questionnaire survey was administered to 71 hospitals of different levels in Jiangsu province.Question-naire content included human resources status of midwifery,the remote fetal monitoring system and its clinical applica-tion;anonymous questionnaire survey was conducted to 130 maternal women by random cluster sampling;investigation of remote fetal monitoring device type,operation mode,clinical usage and existing problems was done through the doc-ument retrieval of VIP and Wanfang data platform.Results In grade Ⅱhospital,obstetricians sufficient and insuffi-cient were 10 cases (24.39%),31 cases(75.6%),respectively,and in grade Ⅲ hospital were 8 cases (61.53%), 5 cases (38.46%),respectively,there was statistically significant difference between grade Ⅱ and grade Ⅲ hospital (χ2 =4.572,P <0.05);In grade Ⅱ and grade Ⅲ hospital midwives were obviously insufficient,but there was no sta-tistically significant difference between grade Ⅱ and grade Ⅲ hospital(χ2 =0.219,P >0.05).Different cultural lev-el,place of residence,occupation of maternal demand for the development of remote fetal monitoring were urgent and higher degree of acceptance,but the cognition was not comprehensive,college degree or above,technical personnel and urban pregnant women that their need for remote fetal monitoring were the most urgent.There were significant differ-ences(all P <0.01).The use of remote fetal monitoring equipment was mostly at tertiary hospital nationwide.3G net-work way to transfer data had short time and small scope.Conclusion The existing monitoring system and service mode can not meet the requirements of the implementation of remote fetal monitoring,medical personnel professional quality and maternal comprehensive quality are the main influencing factors.The primary hospitals should actively pro-mote the application of remote fetal monitoring,maternal health care services and health education should arouse the attention of the whole society.

Objective To determine the pathological mechanism of gastrolithiasis formation in vitro and the effects of pectinase on gastrolithiasis. Methods The test in vitro was divided randomly into two groups:(1) Haws and persimmons(25g respectively) were chewed and put into two clean containers filled with fresh gastric juice.(2) Wine containing 30% alcohol(50ml) was added to the container. Each group included 4 collections.All two groups were placed in 37℃ calorstat box to observe the course and time of gastrolith formation. After gastrolith formation, 2g pectinase was added to the container and observed the decomposition of pectinase to gastrolith and the time was recorded. The effects of pectinase on 54 patients with gastrolithiasis were also investigated. Results The mean time of haws juice coagulation and persimmons was 23 minutes and 25 minutes respectively in the group without wine; but in the group with wine, the mean time of haws juice coagulation and persimmons was 14 minutes and 19 minutes respectively. After adding pectinase, the mean time of clot initiated decomposition was about 17 minutes in both groups, but complete decomposition needed 34 minutes. All the 54 patients with gastrolithiasis who received pectinase were cured.The gastrolith disappeared 6 hours after taking pectinase confirmed by barium meal examination. Conclusions Haws and/or persimmons mixed with gastric juice could induce gastrolith formation. The effects of pectinase on patients with haws or persimmons gastrolithiasis are good, this therapeutic procedure is simple, and the gastrolith resolves quickly.Pectinase may be widely used in the treatment of gastrolithiasis.

Objective:To explore the clinical outcome of measured resection combined with gap balancing technique in total knee arthroplasty (TKA).Methods:From January 2016 to October 2017, 61 cases of varus knee joint flexion deformity were applied the procedure of measured resection combined with gap balancing technique in primary total knee arthroplasty, including 24 male and 37 female; the average age was 66.80±8.2 years old (range from 60 to 78 years old). All patients underwent antero-medial incision of knee joint,medial parapatellar approach and posterior stabilized prosthesis. Measurement osteotomy technique was used to localize osteotomy. Gap balancing technique was vitrificated flexion and extension. Operation time, surgical blood loss and osteotomy volume were recorded. Radiographic evaluation included alignment of lower extremity, knee joint linedistance, tibiofemoral joint angle, rotation angle of femoral prothesis and posterior condylar offset (PCO). Joint functions were assessed including KSS scores, ROM and patient satisfaction.Results:The average operation time was 54±12 min (range from 45 to 65 min). The average postoperative drainage was 140±26 ml (range from 120 to 180 ml). The difference in hemoglobin values were 22±8.5 g/L(range from 20 to 30 g/L) between preoperative and postoperative 5 days. The lateral proximal tibial bone mass was 10.2±1.5 mm (range from 9.2 to 11.5 mm). The lateral distal femoral bone mass was 9.1±1.5 mm (range from 8.8 to 10 mm). The bone mass of posterior lateral condyle of femur was 8.6±1.5 mm (range from 7.8 to 10 mm). The bone mass of posterior medial condyle of femur was 9.2±1.2 mm (range from 8.6 to 10 mm), compared with the bone mass of posterior lateral condyle of femur, and the difference was statistically significant ( t=2.44, P=0.006). The intraoperative angle between osteotomy line of gap balanced osteotomy technique (line B) and connecting line of screw hole in measure osteotomy (line A) was 1.15°±0.47° (range from 1.02° to 2°). The external rotation angle was27.8%, the internal rotation angle was72.2%. There was no significant difference between preoperative knee joint line distance 40.55±4.32 mm and postoperative knee prosthesis joint line distance 40.99±3.86 mm. Postoperative knee straight and bent-knee 90° stress X-ray demonstrated that medial-lateral tibiofemoral joint angle showed no significant difference ( P >0.05). Cross-sectional CT of knee joint post operation, rotation angle of femoral prosthesis ≤±2°. Most of them were mainly concentrated in the internal rotation angle. There was no significant difference between preoperative PCO 31.55±3.18 mm and postoperative PCO 31.55±3.18 mm ( P>0.05). The KSS score and patient satisfaction score post operationwere significantly higher than those preoperation. The KSS score and patient satisfaction score at 3 months after operation were 89.2±9.4 points and 7.2±2.6 points, which were higher than that at 1 month after operation (78.0±3.5 points and 5.2±1.8 points), with statistically significant differences ( t=1.897, P=0.026; t=1.753, P=0.038). The KSS score was above 90 at 6 months after operation. The knee ROM after 1 month (94.7°±10.6°) had no statistical significance compared with that preoperation (91.9°±12.5°) ( t=1.286, P=0.245). The knee ROM at 3 months after surgery (105.8°±14.7°) was significantly higher than that before operation (91.9°±12.5°) ( t=1.924, P=0.041). There was no significant difference between the scores of the follow-up time points and those of 3 months after operation ( P >0.05). Conclusion:TKA were performed by using measured resection combined with gap balancing technique. Not only can good alignment of lower extremity be restored, but also flexion-extension gap balance can be obtained. Equal osteotomy with less soft tissue release. There are better ROM of knee and KSS functional scores in the early postoperative period. However, it is easy to cause femoral pseudointernal rotation.

OBJECTIVE: To study the effect of intranasal glucosteroid on the expression of PKC, Bcl-2 and Bax in nasal polyps. METHOD: The expression of PKC, Bcl-2 protein and Bax were detected with immunohistochemistry in nasal polyps from the patients (n=16) pre and post treated for 4 weeks with intranasal glucosteroid. And which compared with normal mucous membrane of inferior turbinate concha. RESULT: The PKC and Bcl-2 protein expressed significantly higher in the pretreated patients (P < 0.01), which were significant reduced in the post treated patients compared with pretreated ones. The expression of Bax protein significantly higher in the post treated patients (P < 0.05). CONCLUSION Our findings indicated that abnormal expression of apoptosis related genes in nasal polyps tissues might play an important role in the occurrence and progression of nasal polyps. The treatment of intranasal glucosteroid may regulate the expression of apoptosis related genes.
Administration, Intranasal ; Adolescent ; Adult ; Aged ; Female ; Glucocorticoids ; pharmacology ; therapeutic use ; Humans ; Male ; Middle Aged ; Nasal Polyps ; drug therapy ; metabolism ; Protein Kinase C ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Young Adult ; bcl-2-Associated X Protein ; metabolism

OBJECTIVE: To study the molecular pathogenesis of SLC26A4 mutations associated with inner ear malformations including large vestibular aqueduct syndrome (LVAS), Mondini dysplasia and inner ear malformations but not accompanied with LVAS. METHOD: DNA sample and clinical material were obtained from 14 sporadic LVAS probands, six Mondini dysplasia probands and seven inner ear malformations excluding IVAS probands. SLC26A4 gene mutation was analyzed by direct sequencing for its 20 coding exons. GJB2 gene and also mt12SrRNA were analyzed by direct sequencing. RESULT: In 14 cases of LVAS, two mutations were detected in 12 patients (85.7%, either homozygous or compound heterozygous mutations), and one mutation was found in two patients (14.3%). In six cases of Mondini dysplasia, two mutations were detected in all of patients (100%). No mutation could be found in the seven cases of other inner ear abnormalities not accompanied with LVAS. No pathogenic mutation was detected in all of these 27 probands in GJB2 gene and mt12SrRNA 1555/1494T. CONCLUSION We have shown that LVAS and Mondini dysplasia closely correlate with SLC26A4 gene. No mutation was detected in seven probands of inner ear malformations not accompanied with LVAS. We should study the molecular pathogenesis of this disease in depth.
Adolescent ; Adult ; Child ; Child, Preschool ; Connexins ; Ear, Inner ; abnormalities ; Exons ; Female ; Genome ; Humans ; Infant ; Male ; Membrane Transport Proteins ; genetics ; Mutation ; Sulfate Transporters ; Syndrome ; Vestibular Aqueduct ; abnormalities ; Young Adult

Objective: To understand the depression of nurses in the maternity and child care hospital and in order to provide references for improving the physical and mental health of nurses. Methods: A total of 679 nurses from 14 departments of a provincial maternity and child health care hospital in June 2017 were selected as the subjects to investigate the depression of nurses by questionnaire. Results: The total rate of depression was 40% in this group and the average standard of SDS was (49.45+12.02) , which was higher than the norm in our country and the difference was statistically significant (P<0.01) . The average standard of SDS for nurses in different departments was higher than the norm in our country except the women's health caredepartment. The differences of the depression in age、the age for nurse、monthly income、night shift frequency、children's status、the work feelings and family support were statistically significant (The values of 2 are 12.908、9.953、10.316、19.422、11.246、41.672 and 61.434, P<0.05) . Multivariate Logistics Regression Analysis showed age、family income、night shift frequency、the work feelings、family support were risk factors of depression among nurses, by 26-35 years of age、the monthly income less than 6 000 yuan、night shift frequency (less than 5~6 days) , dislike work、family support for work in general and no support. Conclusion The rate of depression among nurses in provincial maternity and child health care hospital is high. Hospital departments should attach great importance to the psychological problems of nurses and give psychological intervention in order to improve the mental health level of nurses.

Objective To understand the status quo of midwives' core competency in Fujian Province and analyze its influencing factors.Methods A total of 374 midwives from 13 hospitals in Fujian Province were surveyed by the midwife core competency scale.Results The average score of midwives' core competency were(3.96±0.54).The scores of vocational literacy,postnatal care skills and health care skills during pregnancy were relatively high.The scores of public health care knowledge,public health care skills and women's health knowledge were relatively low.The scores of core competence for junior,senior and expert abilities for midwives were (4.03±0.55),(3.78±0.59)and (3.54±0.75),respectively.In seven dimensions,the scores for skills were all higher than those for knowledge.Multivariate stepwise regression analysis showed that years of working,hospital grade,marital status and form of employment were influencing factors of midwives' core competency (P＜0.05).Conclusion The core competence of midwives in 13 hospitals in Fujian Province was generally at the middle level.The junior ability was satisfactory,and the senior and expert abilities should be improved.Midwives who were newly employed,working in primary institutes,non-institution personnels should be paid more attention in order to promote midwives' core competency holistically.

Objective: To investigate the risk factors of anastomotic leakage (AL) after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy and construct a nomogram prediction model. Methods: This study was a retrospective case-control study that collected and reviewed the clinicopathological data of 359 patients who underwent laparoscopic surgery from January 2012 to January 2018, including 202 patients from the Department of General Surgery, Nanfang Hospital of Southern Medical University and 157 patients from the Department of Gastrointestinal Surgery of Fujian Provincial Cancer Hospital. Inclusion criteria: (1) age ≥ 18 years old; (2) diagnosis as rectal cancer by biopsy before treatment; (3) distance from tumor to anus within 12 cm; (4) locally advanced stage (T3-T4 or N+) diagnosed by imaging (CT, MRI, PET or ultrasound); (5) standardized neoadjuvant therapy followed by laparoscopic radical operation. Exclusion criteria: (1) previous history of colorectal cancer surgery; (2) short-term or incomplete standardized neoadjuvant therapy; (3) Miles, Hartmann, emergency surgery, palliative resection; (4) conversion to open surgery. Clinicopathological data, including age, gender, body mass index (BMI), preoperative albumin, distance from tumor to anus, operation hospital, American Society of Anesthesiologists score (ASA score), operation time, T stage, N stage, M stage, TNM stage, pathological complete response (pCR) were analyzed with univariate analysis to identify predictors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. Then, incorporated predictors of AL, which were screened by multivariate logistic regression, were plotted by the "rms" package in R software to establish a nomogram model. According to the scale of the nomogram of each risk factor, the total score could be obtained by adding each single score, then the corresponding probability of postoperative AL could be acquired. The area under ROC curve (AUC) was used to evaluate the predictive ability of each risk factor and nomogram on model. AUC > 0.75 indicated that the model had good predictive ability. The Bootstrap method (1000 bootstrapping resamples) was applied as internal verification to show the robustness of the model. The discrimination of the nomogram was determined by calculating the average consistency index (C-index) whose rage was 0.5 to 1.0. Higher C-index indicated better consistency with actual risk. The calibration curve was used to assess the calibration of prediction model. The Hosmer-Lemeshow test yielding a non-significant statistic (P>0.05) suggested no departure from the perfect fit. Results: Of 359 cases, 224 were male, 135 were female, 189 were ≥ 55 years old, 98 had a BMI > 24 kg/m², 176 had preoperative albumin ≤ 40 g/L, 128 had distance from tumor to anus ≤ 5 cm, 257 were TNM 0-II stage, 102 were TNM III-IV stage, and 84 achieved pCR after neoadjuvant therapy. The incidence of postoperative AL was 9.5% (34/359). Univariate analysis showed that gender, preoperative albumin and distance from tumor to the anus were associated with postoperative AL (All P<0.05). Multivariate logistic regression analysis revealed that male (OR=2.480, 95% CI: 1.012-6.077, P=0.047), preoperative albumin ≤40 g/L (OR=5.319, 95% CI: 2.106-13.433, P<0.001) and distance from tumor to anus ≤ 5 cm (OR=4.339, 95% CI: 1.990-9.458, P<0.001) were significant independent risk factors for postoperative AL. According to these results, a nomogram prediction model was constructed. The male was for 55 points, the preoperative albumin ≤ 40 g/L was for 100 points, and the distance from tumor to the anus ≤ 5 cm was for 88 points. Adding all the points of each risk factor, the corresponding probability of total score would indicated the morbidity of postoperative AL predicted by this nomogram modal. The AUC of the nomogram was 0.792 (95% CI: 0.729-0.856), and the C-index was 0.792 after internal verification. The calibration curve showed that the predictive results were well correlated with the actual results (P=0.562). Conclusions Male, preoperative albumin ≤ 40 g/L and distance from tumor to the anus ≤ 5 cm are independent risk factors for AL after laparoscopic surgery in rectal cancer patient with neoadjuvant therapy. The nomogram prediction model is helpful to predict the probability of AL after surgery.