Objective To discuss the effect of levonorgestrel-releasing intrauterine system (LNG-IUS) in ovarian endometriosis after laparoscopic operation.Methods One hundred and fifty patients with ovarian endometriosis were treated by placement of LNG-IUS after laparoscopic operation (study group).The therapeutic effect and adverse reaction were observed.Fifty patients with ovarian endometriosis only treated by orally gestrinone were as control group.The rate of recurrence was compared.Results After placement of LNG-IUS for 3,6,12 months,the thickness of endometrium in study group was significantly thinner [(6.02 ± 1.84),(5.68 ± 1.38),(4.04 ± 1.24) mm vs.(7.85 ± 1.62) mm],the amount of menorrhea and the scores of visual analogue scale (VAS) was significantly decreased [(48.29 ± 7.04),(32.64 ± 6.09),(19.74 ± 4.78) ml vs.(65.63 ± 7.83) ml,(35.74 ± 16.34),(20.54 ± 12.29),(13.79 ± 10.38) scores vs.(78.13 ± 15.69) scores],there was significantly difference compared with that before treatment (P ＜ 0.05).After placement of LNG-IUS for 3 months,the menstrual period in study group was significandy longer than that before treatment [(9.42 ± 3.75) d vs.(6.69 ± 2.83) d],and after placement of LNG-IUS for 12 months,the menstrual period in study group [(4.53 ± 1.37) d] was significantly shorter than that before eatment (P ＜ 0.05).In study group,the menstrual cycle had no significant difference among different time point (P ＞0.05).In follow-up period,the adverse reaction in study group was mainly intermenstrual bleeding,and the rate of intermenstrual bleeding was gradually decreased (P ＜ 0.05).Others adverse reaction was rare,and the incidence rate was gradually decreased.The rate of recurrence in study group was significandy lower than that in control group [14.7％(22/150) vs.30.0％(15/50)](P＜0.05).Conclusion Placement of LNG-IUS after laparoscopic operation can reduce symptoms and signs,and can play important role in preventing recurrence.

AIM:To identify intragenic mutation loci of the BEST-1 gene with congenital vitelliform macular dystrophy by molecular genetic analysis at one family in Northeast China.
METHODS: Genomic DNA was extracted from peripheral leukocyte of 2 patients and 5 healthy members in the family with vitelliform macular dystrophy and 100 normal controls. Ten exon sequences of BEST - 1 amplified by polymerase chain reaction ( PCR ) were made direct DNA sequencing to define the gene mutation loci and compared with gene screening performed on 100 normal controls.
RESULTS: After the direct DNA sequencing, no mutation loci was found in all the patients of this family with vitelliform macular dystrophy.
CONCLUSION:There is no mutation in the exons of BEST-1 gene causing disease genes in this family.

Twenty-seven male SD rats were assigned to 3 groups: control, obese, and obese with diabetes groups. Serum corticosterone was determined and euglycemic-hyperinsulinemic clamp was carried out. Expressions of liver X receptor ( LXR), 11 β-hydroxysteroid dehydrogenase 1 ( 11 β-HSD1 ), and glucocorticoid receptor (GR) were determined by real-time PCR. Both groups of obese rats were insulin-resistant, with up-regulated LXR mRNA and down-regulated 11 β-HSD1 mRNA( both P＜0.05 ).

Objective To investigate the mechanism of liver X receptor(LXR)signal pathway in regulating glucose metabolism by observing the variety of LXR expression and its impacts on regulating the mRNA expression of PEPCK and GCK, the key enzyme of hepatic glucose metabolism in various glucose metabolic status in rats. Methods SD rats were chosen and divided into four groups:the CON group, the induced DM group, the OB group, and the induced OB+DM group. For each group of rats, body weight, blood glucose, serum triglycerides, and cholesterol were measured. Then the rats were sacrificed and the livers were collected and studied. Real-time PGR was used to measure the expressions of LXR mRNA, PEPCK mRNA, and GCK mRNA in the livers. Finally, the Western Blot assay was used to measure the liver LXR protein expression. Results The expression of LXR mRNA was significantly higher in DM,OB, and OB+DM groups than in CON group(P＜0.05).The Western blot results showed that the levels of protein were in accordance with the mRNA expression. Comparing to the CON and the OB groups, the PEPCK mRNA expression of the OB+DM and the DM groups was significantly higher, while the GCK mRNA expression of these two groups was significantly lower(P＜0.05). Comparing to the CON group, the PEPCK mRNA expression of the OB group was significantly lower, while the GCK mRNA expression of OB group was significantly higher(P＜0.05).Conclusions During non-diabetic phase, LXR could act as a protective receptor for glucose metabolism and keep glucose homeostasis by regulating the key enzymes of the hepatic glucose metabolism. While in the diabetic phase, the protective receptor LXR failed to reverse the change of the related enzymes caused by insulin deficiency, and finally the plasma glucose level was raised.

Perioperative nutrition support may be required when the synthesis and utilization of nutrients become disordered due to gastrointestinal abnormalities and trauma anesthesia. Proper nutrition support can reduce or prevent malnutrition, and thus facilitate the recovery and lower complications and case-fatality rate.

Objective To assess the psychometric properties of the Chinese version of Family Man-agement Measure (FaMM). Methods FaMM was translated into Chinese and distributed to 330 caregivers whose children had chronic diseases to fill the questionnaire. Results Cronhach's alpha coefficient for the subscales ranged from 0.52 to 0.86, indicating acceptable internal consistency. The content validity index was 0.84. Construct validity was supported by significant correlation between FaMM and FAD and CBCL,Pearson correlation coefficient ranged from 0.11 to 0.38. The relationship among them accorded with the expected trends of Family Management Style Framework. The result of factor analysis indicated 9 factors explaining 60.08% variance. Conclusions The psychometric property of the Chinese version of FaMM was acceptable and it could be regarded as a reliable and valid instrument to measure the family response of Chinese families whose children had chronic diseases.

Objective: To study on in vitro release of tetanus toxoid contained in polylactide microsp heres and the influence of additives on the drug release. Methods: Some parameters affecting the rate of release were asse ssed during the in vitro experiments lasted 84 days: (1)the molecular mass of the poly mers , (2)the protein loading of the microspheres, (3)the particle sizes, (4)co-enca p sulation of additives. Results: The polylactide microspheres con taining tetanus toxoid presented considerable sustained release effect. Release kinetics of the microspheres fitted in with zero order equations. The rate of release was shown to dep end on the four parameters mentioned above. Conclusion: The poly lactide microsph eres investigated may be prospective for the development of controlled release v accines.

Objective To provide references for enhancing the connection between the need of society and the training mode of in-service postgraduates who major in health service management by analyzing the existing and potential in-service postgraduates' potential trainingwishes andexpectations.Methods Questionnaire surveys,which involved basic information,motivations and aspirations on the advanced studies,understandings and suggestions on the cultivating mode,were conducted among in-service postgraduates(Grade 2010 through Grade 2012) who major in health service management in BUCM and staffs in the departments of corresponding postgraduates.Data including 128 validated questionnaires were analyzed using descriptive statistics in excel.Results The data indicated that further education was welcomed by 87 in-service postgraduates(85.3％ of the survey samples),who had astrong willing to further study.Specifically,the following tendencies were obtained:interdisciplinary training combining research and practice was approved by 71 in-service postgraduates (55.5％ of the samples); career-oriented talent training mode was accepted by 90 in-service postgraduates(70.2％ of the samples); 79 in-service postgraduates (61.7％ of the samples) believed courses should include both theory and practice educations; flexible educational system was welcomed by 77 in-service postgraduates(60.0％ of the samples) ; 61(47.7％) in-service postgraduates wished to attend class on week-ends while 45 (35.0％) wished to attend class in evenings; group instruction method was recommended by 73(57.0％) in-service postgraduates; 104(81.3％) believed double-tutors system should be applied to academic dissertation,and the academic dissertation could be all kinds of research papers such as investigation report,which was approved by 97 (75.6％) in-service postgraduates.Conclusions Through the above analysis,it can be validated that education on in-service postgraduates who major in health service management is worthy of further development.Finally,colleges and universities are suggested to optimize the training mode in four aspects including training objective,curriculum provi-sion,teaching methods and graduation thesis.

Objective To investigate the effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome(NSTE -ACS).Methods 195 patients with NSTE -ACS were divided into ST segment elevation in lead aVR group(n =54 cases)and non -ST segment elevation in lead aVR group(n =141 ) according to ST segment elevation in lead on admission;clinical data,laboratory index and coronary artery lesion were recorded,and major adverse cardiac (MACE)in hospitalization time were also recorded.Results Compared with non -ST segment elevation in the lead aVR group,the heart rate of ST segment elevation in the lead aVR group was faster[(85.4 ±12.0)beats per minute vs.(79.3 ±13.2)beats per minute,t =2.959,P <0.05],systolic blood pressure and diastolic blood pressure were higher[(145.0 ±20.3)mmHg vs.(136.0 ±19.4)mmHg,t =2.874,P <0.05];NT -proBNP[(743.9 ±125.8)pg/mL vs.(416.4 ±95.3)pg/mL,t =19.625,P <0.05],cTnI[(3.4 ± 1.0)ng/mL vs.(1.2 ±0.4)ng/mL,t =21.994,P <0.05],CK -MB[(31.5 ±9.8)ng/mL vs.(19.8 ±6.5)ng/mL, t =9.682,P <0.05]were higher (P <0.05);LVEF were lower[(50.1 ±5.2)% vs.(53.8 ±5.7)%,t =4.153, P <0.05];the rate and amplitude of low ST segment in outside lead aVR also was higher[(9.5 ±3.8)mm vs. (7.4 ±2.8)mm,t =4.224,P <0.05];the rate of left main and three -vessel disease in ST segment elevation in lead aVR group were higher (P <0.05).Compared with non -MECE group,proportion of ST segment elevation in lead AVR on admission was higher (P <0.05).Logistic regression analysis showed that heart rate(OR =1.472),NT -proBNP(OR =1.732),cTnI(OR =1.893),left main coronary artery(OR =2.478)and three -vessel disease (OR =2.310)were risk for ST segment elevation in lead AVR(P <0.05).Logistic regression analysis also showed that ST segment elevation in lead AVR were risk for MACE(OR =1.474).Conclusion ST segment elevation in lead AVR has close relationship with large area of myocardial ischemia,and patients prognosis is poorer,which may be independ-ent risk factor for the recent outcomes of patients with NSTE -ACS.Early record of the change in the case of aVR lead ECG ST segment NSTE -ACS patients is of important value in evaluation of the condition and prognosis.

Bile reflux gastritis (BRG)has been recognized as a chemical gastropathy due to excessive duodenogastric reflux (DGR).Abnormalities in pyloric anatomic structure,as well as antropyloric and duodenal dysmotility are considered to be implicated in the occurrence of pathologic DGR.Bile acid may induce apoptosis of gastric mucosal cells,and high concentration of bile acid plays a crucial role in the induction of intestinal metaplasia in stomach.In this review article, advances in study on BRG,including the mechanisms of DGR,the pathogenic effect of bile acid on gastric mucosa,and the diagnosis and treatment of BRG were summarized.