Objective To compare the clinical effect about hysteroscope and laparotomy in patients with submucous uterine myoma. Methods Eighty-four patients with submucous uterine myoma were randomly divided into control group(n=42)and observation group(n=42). The patients in the control group were given laparotomy treatment,while in the observation group were given hysteroscope treatment. The intraoperative and postoperative conditions between the two groups were recorded and compared. Results The operation time, intraoperatve blood volume,postoperative anal exhaust time,postoperative pain intensity( judged by VAS)and hospital stays periods in observation group were(52. 5 ± 9. 6)min,(84. 6 ± 16. 7)ml,(21. 5 ± 3. 6)h,(3. 6 ± 1. 4)scores and(5. 4 ± 1. 8)d,significant lower than those in control group((72. 6 ± 13. 4)min,(116. 8 ± 28. 4)ml,(29. 8 ± 5. 4)h,(1. 8 ± 0. 5)scores,(9. 6 ± 2. 4)d),and the differences were significant( t=5. 468,4. 263,4. 438,6. 283;P =0. 006,0. 018,0. 024,0. 001,0. 002 ). While the hospitalization costs in observation group was(7394. 9 ± 1164. 8)yuan,higher than that of the control group((5 428. 9 ± 824. 5) yuan;t=4. 647,P=0. 036). There were no statistical significant in terms of recurrence rate between the two groups( 20. 5% vs. 19. 6%;χ2 = 0. 236,P = 0. 637 ). Conclusion Treatment of hysteroscope surgery on submucosal myoma of uterus has the advantages of small trauma and quick recovery and it is an ideal surgical method for uterine myoma.

Objective To discuss the effect of psychological and behavioral intervention on sleep quality and self efficacy in patients with type 2 diabetes mellitus complicated with sleep disorder.Methods 80 patients with type 2 diabetes mellitus complicated with sleep disorder in our hospital were divided into control group (with 40 cases) and intervention group (with 40 cases)according to the random digital table method.The control group were given routine nursing,while the intervention group were given psychological and behavioral intervention based on the control group.The changes of sleep quality and self efficacy,scores of anxiety and depression and fasting blood glucose before and after intervention were compared between the two groups.Results The differences in the scores of PSQI and GESE were not statistically significant between the control group and the intervention group before intervention (P >0.05),which were significantly improved after intervention[(8.26 ±1.32)points,(29.65 ±3.01)points;(5.62 ± 1.03)points,(34.24 ±4.15)points;t =15.386,10.502,28.087,14.751,all P <0.05],and the scores in the inter-vention group were better than those in the control group (t =9.972,5.663,both P <0.05).There were not obvious differences in the scores of SAS and SDS between the control group and the intervention group before intervention(all P >0.05),which were significantly decreased after intervention[(41.24 ±3.21)points,(42.52 ±3.01 )points;(32.36 ±2.12)points,(34.24 ±4.15)points;t =19.674,12.550,27.589,19.546,all P <0.05)],and the scores in the intervention group were significantly lower than those in the control group (t =14.599,10.215,both P <0.05).There was no obvious difference in fasting blood glucose between the two groups before intervention (P >0.05),which were significantly decreased after intervention[(8.76 ±1.06)mmol/L,(6.25 ±1.32)mmol/L,t =3.646,8.955,all P <0.05],and the level in the intervention group was significantly lower than that in the control group (t =9.377,P <0.05).Conclusion The psychological and behavioral intervention can effectively improve the
sleep quality of patients with type 2 diabetes mellitus complicated with sleep disorder,improve the self efficacy,and relieve anxiety and other negative emotions,then decrease the fasting blood glucose level,which has promotion value in the clinical nursing.

Objective To develop a computer-auto-controlling and analysis system for Tail suspension .Methods Combining the advantage of computer science , engineering and animal behavior into tail suspension test .The “energy”index was developed .The system was validated with antidepressants such as imipramine and paroxetine .Results The measuring principle is based on the energy developed by mice trying to escape from their suspension .During the test, the movements of the mice are analyzed in terms of force , energy and power developed over time .Each mouse issuspended by the tail using adhesive tape to a hook connected to a tail test sensor .The tail test sensor fixed to suspension bar picks up all movements of the mouse and transmits these to a signal regulation unit and transmission circuit , which amplify , filter and digitalizes the signals.The signals are displayed visually in waveform .Activity time, immobility time, energy are continuously updated .The correlation coefficient of “immobility time” collected by computer and manpower was 0.94. Using this system, both imipramine and paroxetine could decreased the immobility time and paroxetine could increased the energy induced by mice ( both P <0.01 ) .Conclusion A stable computer-auto-controlling and analysis system for Tail suspension was established and could be used to screen the antidepressants .

Objective To observe the preventive and therapeutic effect of Baimai Ointment on stoke,and explore the principle of promoting blood circulation and removing blood stasis.Method By dermal administration,the crude drug contents of Baimai Ointment given to rats were 0.075,0.150,and 0.300 g/kg respectively.Focal cerebral ischemic model was induced by the middle cerebral artery occlusion (MCAO),and the preventive and therapeutic effect of Baimai Ointment was evaluated.The degree of hematoma absorption in rats was measured to observe the effect on promoting blood circulation and removing blood stasis of Baimai Ointmnent.The acute blood stasis model and carotid thrombosis model were established in rats to study the effects on blood viscosity and thrombosis time.Results Baimai Ointment had no significant prevent effect on stroke in rats.It effectively improved behavior coordination in stroke model rats.It also significantly decreased the area of hematoma on rats,speeded up the repairment of local demage.After administration of Baimai Ointment,blood viscosity of blood stasis model rats was obviously decreased,while thrombosis time was effectively prolonged on carotid thrombosis model.Conclusion Baimai Ointment can significantly improve the behavior coordination in stroke model rats,plays a significant role in treatment,but no significant preventive effect,a preliminary study shows that the possible therapeutic principles may be promoting blood circulation and removing blood stasis.

Objective To investigate the effect of exogenous apelin-13 on oxidative stress, myocardial inflammatory cytokines and apoptosis in diabetic model rats.Methods A total of 40 male Wistar rats were randomly divided into 2 groups: normal control group (NC, n=8) and experimental group (EX, n=32).Diabetes was induced by feeding with high-sugary and high-fat diet for 8 weeks and a single intraperitoneal injection of streptozotocin (STZ) (30 mg/kg).The wellestablished 28 diabetic model rats were then randomly divided into 2 subgroups: model group (DM, n =14) and apelin-13 administration group (AP, n =14).The rats in AP group were given intraperitoneal administration of apelin-13 at a single dose of 0.1 μtmol · kg-1 · d-1 for 10 weeks, while NC group and DM group were given 0.9％ NaCl in the same way.All rats were sacrificed at the end of the week 10.Blood hydrogen peroxide (H2O2), nitric oxide (NO) and malonaldehyde (MDA) were measured by colorimetry, and superoxide dismutase (SOD) was measured by enzyme-linked immunosorbent assay (ELISA).The expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in rat myocardium were detected by immunohistochemistry.Masson staining was used to observe the myocardial fibrosis in rats of different groups.Cardiomyocyte apoptosis was determined by TUNEL.Results (1) Compared with NC groups, DM group showed that MDA, H2O2 and NO were significantly increased, while SOD was significantly decreased (F=22.400, 6.230, 4.267 and 8.901, all P＜0.0167).There was a statistically significant difference in the levels of MDA, H2O2,SOD between DM group and AP group.(2) The expression of TNF-α and IL-6 was significantly higher inDMgroup than inNCgroup (0.0599±0.0208 vs.0.0076±0.0031, F=35.139;0.0503±0.0243 vs.0.0071± 0.0024, F=15.946, both P＜0.0167).After 10 weeks of apelin-13 administration, the levels of inflammatory cytokines were significantly decreased in AP group than in DM group.(3) The myocardial apoptosis and fibrosis were significantly increased in DM group than in NCgroup [0.0293±0.0061 vs.0.0030-t-0.0013 and 0.0708±0.0420 vs.0.0013±0.0003, F=84.930 and 19.420, both P＜0.0167].The myocardial apoptosis and fibrosis were significantly decreased in AP group than in DM group (both P＜0.0167).Conclusions To some extent, apelin13 reduces the levels of oxidative stress and myocardial inflammation reaction in type 2 diabetes.Moreover, it may play a vital role in the improvement of myocardial apoptosis and fibrosis.

Objective To investigate the effect of angina treated with Danhong injection plus nitroglycerin injection.Methods A total of 108 patients with angina were randomly divided into a treatment group (56cases) and a control group (52 cases).The control group was treated by conventional therapy (injected nitroglycerin injection lOmg added in normal sodium 48ml by venous pumping within 8 hours,once daily for 10 days);on the base of the conventional therapy,the treatment group treated with additional danhong injection (30ml,added in 5% glucose injection 250ml,iv,q.d.,once daily for ten days).Observe changes of electrocardiography and physical signs before and after the therapy.Results The total effective rate of the treatment group is 92.84%,contrasting 82.68% in the control group (P＜0.05).Conclusion It is effective to treat angina with Danhong injection plus nitroglycerin injection.

Objectives To investigate the effects of Apelin 13 on myocardial metabolism in diabetic rats.Methods A total of 40 male Wister rats were randomly divided into normal control group (NC,n=8) and experimental group (n =32).Diabetic rats model were induced by high-sugar and high-fat diet combined with low-dose intraperitoneal injection of streptozotocin (STZ).The wellestablished 28 diabetic model rats were randomly divided into diabetic model group (DM,n=14) and apelin-13 treated group (n=14).In the Apelin-13 group,diabetic rats were administered Apelin-13 [0.1 μmol/(kg · d)]by intraperitoneal injection for 10 weeks,while the control group and diabetic model group were given an equal volume of 0.9％ NaCl.At the end of the 10th week,all rats were sacrificed after fasting glucose measurement.Levels of serum free fatty acids (FFA) and myocardial FFA were measured by ELISA.Expression of myocardial glucose transporter member 4 (GLUT4) were detected by immunohistochemistry.The mRNA expressions of myocardial PPARα,CD36 and CPT-1 were detected by real-time fluorescence quantitative PCR.Results Fasting blood glucose,serum FFA and myocardial FFA were significantly higher in DM group than in NC group (all P＜ 0.05).The level of plasma glucose and myocardial FFA were significant lower(P＞0.05) in Apelin-13 treated group than in DM group;but serum FFA was not significantly lower(P＜0.05).The mRNA expressions of PPARα,CD36,CPT-1 in cardiac myocyte were higher in DM group and Apelin-13 treated group than in control(P＜0.05),and lower in Apelin-13 treated group than in DM group(P＜ 0.05).The expression of myocardial GLUT4 was significantly lower in DM group(1.138±0.316)and in Apelin-13-treated group (4.631 ± 1.832) than in NC group(9.132 ± 2.156),(F=65.507,P＜ 0.05),and higher in Apelin-13-treated group than in DM group(P＜0.05).Conclusions Apelin-13 increases myocardial expression of GLUT4,improves utilization of FFA,and it can effectively reduce the expression of PPARα,CD36 and CPT-1.Therefore,it may play a vital role in the improvement of myocardial metabolism in diabetic rats.

This paper is to investigate the effect of ischemic preconditioning on cardiac function in the hyperlipidemic rats.The alterations of LVSP,(d p /d t ) max , GSH Px, SOD and MDA were measured in ischemia/reperfusion group, ischemic preconditoning group and control group with in vitro myocardial ischemic precondioning model. The level of LVSP, (d p /d t ) max , GSH Px and SOD was significantly higher in the preconditoning group than that in the ischemia/reperfusion group, and these values were close to those in the control group. The area of contraction component in P cycle was higher and the amount of MDA was lower, whereas the level of LVSP, (d p /d t ) max declined significantly in ischemia/reperfusion group.It is suggested that ischemic preconditoning in hyperlipidemic rats can reduce cardiac functional impairment due to ischemia/reperfusion injury, and may have myocardial protective effects.

Objective To study the diagnostic value of endoscopic retrograde cholangiopancreatography (ERCP) combined with intraductal ultrasonography (IDUS) for bile duct stricture diseases.Methods The results of endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography,intraductal uhrasonography,bile duct brushing cytology,the liquid-based cytology and the histopathological examination were analyzed retrospectively.The final diagnosis was made based on clinical data,histopathology and follow-up results(≥4 months).Results Twenty-one patients were diagnosed as having malignant biliary diseases,including 9 biliary tract carcinoma,4 duodenal papilla carcinoma,4 pancreatic cancer infiltrated common bile duct,4 cancer of the liver infiltrated common bile duct ; 15 were diagnosed as having benign biliary diseases,including 9 bile duct stones,4 liver fluke disease,lbile duct inflammatory stenosis,1 bile duct stricture caused by external compression.The accuracy rate of the EUS,ERCP,IDUS and ERCP + IDUS in the differential diagnosis of the bile duct stricture disease were 77.8％,88.9％,91.7％ and 94.4％,respectively.The accuracy rates of IDUS,ERCP,ERCP combined with IDUS were significantly higher than that of EUS (P ＜ 0.05).The sensitivity,specificity,positive predictive value and negative predictive value of ERCP combined with IDUS were 95.2％,93.3％,95.2％ and 93.3％ respectively which were higher than those of EUS,ERCP and IDUS.After the bile duct brushing cytology and the liquid-based cytology or histopathological examination,19 patients were diagnosed as having malignant biliary diseases,17 were benign biliary diseases.The sensitivity,specificity and accuracy of the procedures for malignant bile duct stricture disease were 90.5％,100.0％,94.4％ respectively.Conclusion ERCP combined with IDUS can improve the diagnostic accuracy.The diagnostic positive rate will be higher with the help of ERCP,IDUS and targeted brush.

Objective To construct and implement the nursing quality information feedback system based on QUACERS model and control theory, and discuss its application effect and the problems that should be paid attention to and to provide operational cases and practical basis for nursing quality management. Methods Through literature review and expert consultation, the framework and content of nursing quality information feedback system were set up and implemented. The changes of the nursing quality and the repeated occurrence of nursing problems were evaluated before (2013) and after (2015) the implementation of this project. And in December 2015, a self-made questionnaire was conducted among the nurses in the hospital to evaluate the importance of the feedback and it′s effect of improving the nursing quality. And evaluate the timeliness and effectiveness of different feedback forms. Results 1 120 and 1 136 nurses were followed-up in 2013 and 2015 respectively. The scores of human resource management, clinical nursing service and nursing safety management were higher than before, and the repeated occurrence of nursing problems was lower than before. A total of 450 questionnaires were distributed, 438 copies were collected, the effective recovery rate was 97.33%. Ratings for the importance of each item was from 3.37 to 4.57. Ratings for the effect of improving the quality of care was 3.79 to 4.39. The percentage of quality information received by nurses was more than 95%, and the average score of feedback timeliness was 4.29 to 4.53. Conclusions Quality information feedback system based on QUACERS model can cover multiple dimensions of quality management, and it was conducive to obtaining comprehensive information;Combined with multiple feedback forms can improve the effect of information feedback.