Objective To Observe the effects of treating primary trigeminal neuralgia with modified Shaoyao-Gancao decoction and carbamazepine. Methods 76 patients with primary trigeminal neuralgia were randomly divided into a treatment group and a control group, 38 patients in each. The treatment group was treated with modified Shaoyao-Gancao decoction and carbamazepine; and the control group was treated with carbamazepine only. Clinical curative effect, pain improvements and adverse reactions were observed after the treatment and 6 week follow-up. Results The total effective rate was 89.3%and 75.5%in the treatment group and the control group respectively, the difference was statistically significant(P=0.043). The onset frequency, duration, degree of pain were all improved in both groups after the treatment and 6 week follow-up[treatment group after the treatment is (0.54±0.78), (2.15±1.73), (1.58±1.26), 6 week follow-up is (0.24±0.63), (1.36±1.03),0.86±1.95);control group after the treatment is (1.98±1.68), (3.96±1.49), (3.02±1.45), 6 week follow-up is (1.06±1.78), (1.97±1.69), (2.13±1.54), P<0.05],and the treatment group was better than the control group(P=0.040 and 0.039 respectively). Conclusion Modified Shaoyao-Gancao decoction combined carbamazepine has good clinical curative effect in treating primary trigeminal neuralgia.

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 compare and analyze the changes of CEA,CA19-9,CA72-4 in different pathologictypes of gastric cancer.Methods 93 patients with gastric cancer were divided into different groups according to the histological types,pathologic types and TNM staging.The levels of CEA,CA19-9,CA72-4 of the patients were measured,then the results were compared and analyzed.Results The level of serum tumor marker of the moderately differentiated group was obviously higher than that of well-differentiated group(P ＜ 0.05),while the level of serum tumor marker of the poorly differentiated group was obviously higher than that of moderately differentiated group (P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between the well-differentiated group,moderately differentiatedgroup and poorly differentiated group were statistically significant(F =61.433,57.882,125.547,all P ＜ 0.05).The differences of levels of CEA,CA19-9,CA72-4 between patients of TMN Ⅰ stage,TMN Ⅱ stage,TMN Ⅲ stage,TMN Ⅳstage were statistically significant(F =189.624,95.236,80.342,all P ＜ 0.05).The difference of serum tumor marker between different histological groups was not statistically significant (all P ＞ 0.05).Conclusion The concentration of serum CEA,CA19-9,CA72-4 will be higher if the gastric tumor is poorly differentiated or invades deeply,but the concentration of serum tumor has nothing to do with the histological types of the tumor.

At present,reports at home and abroad suggest a low probability of successful preservation of ovarian endocrine function after ovarian shift radiotherapy.After radiotherapy for cervical carcinoma,the ovarian function is associated with various factors,such as radiotherapy dose and method,patient's age,shift position,and concurrent chemotherapy drugs.Therefore,as for each patient,the dose to the ovarian tissue should be controlled within the individual dose limit to effectively preserve the ovarian function.

OBJECTIVE:To study the effects of indometacin on apootosis and proliferation of cervical cancer Hela cell. METH-ODS:Hela cell was cultured in vitro as study object,and cultured with 0(blank control),200,400,600,800 and 1 000 μmol/L indometacin for 24,48 and 72 h. The inhibitory rate of indometacin to the proliferation of Hela cells was detected by MTT assay. After treated with 0(blank control),400,600 and 800 μmol/L indometacin for 24 h,the change of cellular morphology was ob-served by invert microscope;cell cycle phase and apoptosis were analyzed by flow cytometry. RESUITS:Indometacin of 600, 800,1 000μmol/L could inhibit the proliferation of Hela cell,which was positively correlated to drug concentration and time. Com-pared with blank control,indometacin could induce that Hela cell transformed from polygonous to round in appearance,and result-ed in cell apoptosis and necrosis;the proportion of cells at G0/G1 phase increased,while the proportion of cells at S phase reduced;the apoptotic rate of cells raised. CONCLUSIONS:Indometacin could inhibit the proliferation of Hela cell,block cell cycle at G0/G1 phase and induce apoptosis.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) or high glucose on the toll-like receptor 4 (TLR4) expression,inflammatory cytokines and fibrotic factors in human tubular epithelial cells (HK-2),revealing the innate immune-related pathogenesis of diabetic nephropathy (DN) which may have clinical implications.Methods Three TLR4 siRNA sequences were designed and synthetized.After transfection,the most effective siRNA was selected to use for further expriments.The experiment consisted of 2 parts.Part 1:Cells were divided into three groups:normal-glucose group (NG,5.5mmol/L glucose),mannose group (M,5.5 mmol/L glucose + 19.5 mmol/L mannose),High-glucose group (HG,25 mmol/L glucose),preliminary validated the effects of high glucose and high osmotic pressure.Part 2:Cells were divided into seven groups:NG group,HG group,Ang Ⅱ group,Ang Ⅱ + negative group,HG+ negative group,Ang Ⅱ + siRNA group and HG+ siRNA group.Real time PCR was used to analyze the mRNA expression of TLR4,myeloid differentiation factor 88 (MyD88),heat shock protein 47 (HSP47).Western blotting was used to observe the protein expression of TLR4,MyD88,HSP47,NF-κB,type Ⅳ collagen (ColⅣ).ELISA was used to detect the expression of monocyte chemotactic protein-1 (MCP-1) and interleukin-6 (IL-6).Results Compared with NG group,TLR4,MyD88,HSP47 mRNA and TLR4,MyD88,NF-κB,ColⅣ,HSP47 protein were highly expressed under high glucose or Ang Ⅱconditions (P ＜ 0.01),and the expression levels of MCP-1 and IL-6 also increased significantly (P ＜ 0.01).Compared with HG or Ang Ⅱ group,the above indicators were obviously inhibited in the TLR4 siRNA groups (P＜0.01).Comparison between blank vector transfected groups and HG group as well as Ang Ⅱ group indicated no statistic significance (P ＞ 0.05).Conclusions Both Ang Ⅱ and high glucose stimulate TLR4 expression,which result in the up-regulation of inflammatory and fibrotic factors in HK-2.Specific target of TLR4 gene silencing can block the TLR4 pathway that is activated by high glucose and Ang Ⅱ,and thus reduce the inflammatory and fibtogenic factors' release.TLR4 signal is the common innate immune response pathway which induces the release of inflammatory and fibrotic factors in HK-2 under high glucose or high angiotension conditions.

Objective To investigate the role of autophagy in podocyte damage,and the intracellular mechanism of autophagy activation through passive Heymann nephritis (PHN) animal model.Methods Male Sprague-Dawley rats (n=40) were studied on day 0,2,4,7,and 21 after induction of PHN by injection of anti-Fx1A.Podocyte morphology and autophagosomes were observed by transmission electron microscopy.Podocyte numerical density was estimated by Weibel-Gomez =method.Cell apoptosis was detected by TUNEL assay and caspase-3 immunohistochemical staining.Expressions of autophagy markers and endoplasmic reticulum stress (ERS)-associated proteins were analyzed by Western blotting.Results (1) In PHN rats,immunohistochemical staining showed that C5b-9 deposited along glomerular basement membrane on day 4 to day 21.Small subepithelial electron -dense deposits and a part of foot process fusion were detected in the glomerulus of PHN rats on day 4 by transmission electron microscope,and podocyte damage was aggravated on day 21.Furthermore,compared with control,the urinary protein levels of PHN rats began to increase on day 3,and reached the top on day 21 [(50.6±6.0) mg/24 h].(2) The number of podocytes significantly decreased in PHN rats compared with control group on day 21(P ＜ 0.05).(3) In PHN rats,apoptotic podocytes were found by caspase-3 immunohistochemical staining and TUNEL assay on day 21.(4) The expression of autophagy marker LC3 Ⅱ was markedly increased on day 7 and 21,but down-regulated on day 21 compared with day 7.Moreover,accumulated autophagosomes in podocytes were detected on day 7 and 21 by transmission electron microscope.(5) The level of GRP78 was significantly increased on day 2 and 7 but reduced to baseline on day 21.At the same time,the downstream pathways (ATF6α,p-PERK and p-JNK) of unfolded protein response were also up-regulated in the early process of PHN and down-regulated later.Conclusions Autophagy is an important way to protect against immunemediated podocyte injury in membranous nephropathy.Autophagy activation is mainly related to endoplasmic reticulum stress induced by complement attack.This provides an important basis for a thorough understanding of the role of autophagy in the process of podocyte damage and the pathogenesis of membranous nephropathy.

Objective To explore the clinical value of 3.0T nuclear magnetic resonance susceptibility weighted imaging in diagnosis of neonatal hypoxic ischemic encephalopathy,thus to provide guidance for the clinical.Methods From December 10,2015 to December 10,2017,100 cases of neonatal hypoxic ischemic encephalopathy (observation group) and 100 cases of normal newborns in Lishui People's Hospital during the same period accepted health examination (control group) were selected in the research.All the cases received 3.0T magnetic resonance susceptibility weighted imaging,the diagnostic value of 3.0T MR susceptibility weighted imaging was observed.Results The ADC value of the observation group[(0.00 1 13 ± 0.000 01)mm2/s] was significantly lower than that in the control group[(0.001 98 ±0.000 02)mm2/s] (P ＜0.05).The neonatal ADC value of the mild group[(0.001 21 ± 0.000 01)mm2/s] was significantly higher than that in the moderate group[(0.001 12 ± 0.000 02)mm2/s] and the severe group[(0.001 02 ± 0.000 03)mm2/s] (P ＜ 0.05).ADC value was positively correlated with neonatal hypoxic ischemic encephalopathy,namely,the lower the ADC value,the more serious the neonatal hypoxic ischemic encephalopathy.The fractional anisotropy value and relative anisotropy value of newborn babies in the observation group were significantly higher than those in the control group (all P ＜ 0.05).Conclusion For neonatal hypoxic ischemic encephalopathy patients,3.0T nuclear magnetic resonance susceptibility weighted imaging in the diagnosis is feasible,it can help the clinician to analyze the disease,and has positive significance to carry out the treatment.

In medical clinical study, the researchers and the ethics committee members' personal economic in-terests and responsibilities conflicts may produce damage to experimental research and the subjects, may make the study being questioned the authenticity and the objectivity of clinical trial results, also damage to the subjects' rights and interests and damage the credibility of hospital. In order to prevent the happening of the conflict, put forward the strategies:strengthen legislation construction, improve the treatment method, set up a conflict of interest com-mittee, adhere to the principle of open, review and restriction to the personnel, regularly organize researchers and ethics committee members attend the training.

Objective To explore the risk factors affecting prognosis of invasive fungal infection .Methods The clinical data of 208 hospitalized patients diagnosed with invasive fungal infection in Sun Yat-sen memorial hospital from 2007 to 2011 were reviewed . The factors affecting prognosis were determined by univariate and logistic regression analysis .Results The fatality rate of adult inpa-tient with invasive fungal infection was 21%.The univariate analysis showed that difference of seven indicators was significant between the survive group and death group:advanced age (over 60 years old), hospitalization time,fasting plasma glucose level, hypoalbumin-emia, using more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome ( MODS) .Binary logistic regression showed that the difference of five indicators was significant between the two groups:advanced age (over 60 years old), hypoalbuminemia, using more than two kinds of broad spectrum antibiotic for more than two weeks, kinds of invasive operations , and multiple organ dysfunction syndrome .Conclusions The indicators such as advanced age (over 60 years old), hypoalbuminemia, the use of more than two kinds of broad spectrum antibiotic for more than two weeks , kinds of invasive operations , and multiple organ dysfunction syndrome might be independent risk factors of death in patients with invasive fungal infection.Early medical intervention should be made in clinical work , in order to reduce fatality rate of patients with invasive fungal in-fection.