Objective To evaluate the efficacy and side-effects of the levonorgestrel-releasing intrauterine device (Mirena) in the treatment of dysfunctional uterine bleeding .Methods 45 cases of dysfunctional uterine bleeding diagnosed by pathology were installed with Mirena.The endometrial thickness by ultrasound hemoglobulin increase and pathologic changes of endometria were recorded before and 24 months after the installation.ResultsThe endometrial thickness before and after the insertion of Mirena were(15.6 ±4.2) mm and (3.2 ± 1.3)mmrespectively (P ＜ 0.01) .Six months after the insertion of Mirena, patients' hemoglobulin was significantly increased from (97.6 ± 8.2)g/L to (123.7 ± 8.1)g/L (U = 2.26, P ＜ 0.05) .After the installation of Mirena, patient experienced metrorrhagia.Conclusions Mirena is a device providing effective and continual therapy for dysfunctional uterine bleeding .It can not only significantly reduce the menstrual blood loss but also reverse the complex hyperplasia effectively.

Objective:To investigate biomechanical changes of mandible in the impact injure simulated by finite element method (FEM).Methods:Mimics and Comsol software were used to build a FEM of human craniofacial bone based on CT scan data of a normal adult.LS-DYNA and Hypermesh software were used to simulate the impact with different quality,velocity and angulation pro-duced injures of human mandible,the biomechanical parameters of the mandible in the impact injury process were analysed.Results:A FEMof human maxillofacial bone was established,and the dynamic process of different impact force produced damage was simula-ted.Mandibular chin,angle and condylar neck was the stress concentrated area in the process of mandible injury.There was higher stress peak at the site which was closer to the impact position,the stress peak arrival time was also earlier.When the impactor with the same quality,the bigger the velocity,the greater the stress peak.When the impactor with the same velocity,the bigger the quali-ty,the greater the stress peak.When the impactor with the same velocity and quality,there was greater stress peak under the impact to mandible from angulation of 0 degree.Stress transfered to the surrounding bone from the impact position radially and gradually re-duced.The bone area with small cross-section was prone to high stress and more serious damage.Conclusion:The quality,the ve-locity,the impact angle and the impact site are the factors affecting the severity of impact injury.

Streptozotocin-induced diabetic rats were treated with resveratrol for 12 weeks.Compared with group of diabetic rats without treatment,the levels of urine albumin,serum creatinine,and blood urea nitrogen were significantly decreased and pathological changes in kidney were improved in treatment group ( P＜0.05 ).The mRNA expressions of FoxO1 and catalase were higher and FoxO1 phosphorylation level in diabetic rats treated with resveratrol was lower than that in diabetic rats without treatment (P＜0.05),suggesting that resveratrol may protect the kidneys of diabetic rats via regulating expression of FoxO1.

Objective To improve the treatment of abnormal calcium-phosphorus metabolism in hemodialysis patients, and observe its influence on the quality of life. Methods Implemented the kidney Disease Outcomes Quality Initiative (K/DOQI) clinical practice guidelines for bone metabolism and disease in hemodialysis patients, improved the treatment of abnormal calcium-phesphoms metabolism in hemodialysis patients. After 1 year, the values were compared between before and after application of K/DOQI guidelines, including albumin-adjusted serum calcium, phosphorus, calcium × phosphorus (Ca × P) product, and intact parathyroid hormone (iPTH) and their achieved target range rates. The quality of life were evaluated by using the kidney disease questionnaire (KDQ). Results One year later, the levels of serum calcium, phosphorus, Ca × P product, and iPTH were all decreased (P<0.01 or <0.05) compared with before the application of K/DOQI guidelines. The percentage of patients fell within the guideline range were as follows: 74.42% (32/43), calcium; 62.79%(27/43), phosphorus; 55.81%(24/43), Ca × P product; 60.47%(26/43), iPTH; 25.58%(11/43), all four criteria, higher than before (P<0.01 or <0.05). The scores of KDQ in global indices and symptom scores of physical symptoms, fatigue, depression, relationships with others and frustration dimension were also all increased (P<0.01). Conclusion The state of calcium-phospberns metabolism in hemodialysis patients is improved, the quality of life is also enhanced.

In the process of teaching southern Asia students in medical biochemistry,teaching mode has been actively explored.Sufficient preparation before class,applying nimble teaching style,emphasis on communication with foreign students and searching for effective review and examination system will receive the satisfactory results.

Objective To introduce an effective nursing practice for patients with Grave's ophthalmopathy(GO) undergoing endoscopic trans-ethmoid orbital decompression(ETOD). Methods The treatment and nursing experience of 31 cases (57 eyes) undergoing orbital decompression through endoscopic trans-ethmoid approach were reviewed and analyzed. Results Three months after operation, exophthalmos was corrected in all 31 cases (57 eyes) with satisfying result, and the visual acuity was improved in all 9 cases (16 eyes),who complained of visual loss preoperatively. At the 3-months' review, 2 patients presented diplopia on the primary eye position due to newly on-set global displacement. Conclusions Advanced treatment and careful nursing are very important to improve the surgical safety and decrease the complications.

Objective To investigate perceptions of patient safety culture(PSC) among nurses in tertiary hospitals in Kunming. Methods Totally 2629 nurses were recruited by convenience sampling method from 7 tertiary hospi-tals in Kunming between July 2015 to January 2016. Hospital Survey on Patient Safety Culture (HSOPS) was used to assess PSC. Results The top three superior dimensions of PSC were Organizational Learning-Continuous Im-provement(86.60%),Teamwork within Hospital Units(83.34%) and Feedback and Communication about Error(75.98%). The last three inferior dimensions of PSC wereNonpunitive response to error(23.74%),Staffing(33.71%) and Teamwork across hospital units(49.45%). There were significant differences in certain items among nurses with different educational level,academic title,working hour per week(P<0.05). Conclusion Establishing nonpunitive re-sponse culture,reasonably arranging staffing and working hours,and encouraging nurses with high educational level and title to play their full role,are critical measures to improve patient safety culture in hospital.

Objective To explore the expression and the pathomechanism of folate receptor alpha(FRα) and CA125 in the development and progression of endometrial carcinoma.Methods Sixty samples of endometrial carcinoma tissues,46 samples of endometrial hyperplasia tissues and 10 normal endometrial tissues were collected in the study.Immunohistochemical methods were used to detect the expression of Frαand CA125 in all tissues.The expressions of FRα and CA125 and their correlation with clinicopathological characteristics were analyzed.Results FRα was positively expressed in 93.9％ of the endometrial carcinoma tissues,with a strongly positive rate of 65.0％,which was significantly higher than that in endometrial hyperplasia tissues and normal endometrial tissues (P ＜ 0.05).The highly expressed FRαin endometrial carcinoma tissues was associated with age,FIGO stage and histologic types (P ＜ 0.05),while no statistical significance was found between the high expression of FRαand myometrial invasion.The expression of FRα in endometrial atypical hyperplasia was higher than that in other hyperplasia subgroups.The expression of CA125 in endometrial carcinoma tissues and endometrial hyperplasia tissues were both higher than that in normal endometrial tissues (P ＜ 0.05).Conclusion FRα may play an important role in the carcinogenesis and progression of endometrial carcinoma,and act as a target of therapy and a kind of assessment for prognosis in endometrial carcinoma.CA125 may be involved in the development of endometrial lesions and further researches are needed to confirm a physiological mechanism between FRA and CA125 in carcinogenesis of endometrial carcinoma.

Objective To develop a 3D finite element model for the human craniomaxillofacial region in an attempt to offer basis to the research of simulation of craniomaxillofacial injury.Methods A healthy adult male was submitted to head CT scan, and the data was imported into the Mimics 15.0 software for threshold segmentation and 3D reconstruction according to the classifications of bone tissue, skin tissue and subcutaneous tissue.The reconstruction data was imported into 3D reverse software Geomagic Studio 2012, and the images were optimized and the 3D model was generated.The three parts of the model were fitted according to the actual proportion using the 3D control software Solidworks 14.0, and then the boundary conditions were derived.Hypermesh 12.0 finite element processing software was used to build the volume mesh, and the model was established.Each layer of the model was given to the material parameters, and the simulation conditions were provided to test the model.Results This model was completely composed of volume meshes, including 214,250 hexahedral meshes and 411,920 nodes.This model can clearly show the stress distribution, the trend of fracture line, the displacement of fracture block of soft and hard tissue during the simulation, and the results are consistent with clinical practice.Conclusion A three-dimentional finite element model with good performance is established, which can be used for biomechamics simulation analysis of multiple sites on the head or the whole structure, and has a certain significance in clinical and scientific research.

Objective To explore biological characteristics of chondrogenic differentiation of human periosteum-derived cells and the role of BMP4 in chondrogenic differentiation of these cells.Methods From October 2009 to September 2012,periosteum was obtained from tibia of patients undergoing leg amputation surgery,and isolated periosteum-derived cells by tissue culture method.Cells were cultured in DMEM/F12 containing 10％ fetal bovine serum,and morphology of cells were observed under inverted microscope.Periosteum-derived cells growth and the effect of BMP4 on cells growth examined by cell count using trypan blue,and cells growth curve was made.Experiment was divided into control group,chondrogenic differentiation group and BMP4 group,cells were expanded and differentiated in the presence or absence of BMP4 and complete medium.Then toluidine and immunohistochemical staining analyzed proteoglycan and collagenⅡ expression of these cells after 14 and 21 days.The expression of aggrecan,collagen Ⅱ and SOX9 mRNA of these cells using real-time PCR.Results (1) Periosteumderived cells adhered to growth in vitro,the shape of cell presented fibroblast-like morphology changing into polygonal after 1 week and round cell formation after 2 weeks chondrrogenic differemtiation.Growth curve showed that the passage 3 and 9 cells had similar reproductive activity.The passage 3 cells were positive for CD90 (21.07％) and CD105 (25.84％).(2)Toluidine bule staining and type Ⅱ collagen immunohistochemical staining showed BMP4 group (40.29 ± 4.29,56.74 ± 5.12) and chondrogenic differentiated group (19.27 ± 3.71,38.31 ± 4.25) ccould secrete proteoglycan and collagen Ⅱ,control group were negative (10.24 ± 1.21,15.28 ± 2.23),BMP4 group were significantly than chondrogenic differentiated group.(3) The expression of aggrecan,collagen Ⅱ and SOX9 mRNA of BMP4 group(25.76 ±0.57,6.48 ±0.48,2.91 ±0.18)were significantly higher than that of control group(2.37 ±0.24,1.12 ± 0.31,1.07 ± 0.22)and chondrogenic differentiated group(11.12 ± 0.38,2.24 ± 0.41,1.54 ± 0.35)using real-time PCR.Conclusion Periosteum-derived cells have strong proliferative,and have good potentials of differentiating into chondroblasts like mesenchymal stem cells.BMP4 can promote chondrogenic differentiation of periosteum-derived cells in vitro cultures.