Objective To investigate the clinical efficacy of uterine incision diverticulum type repair after cesarean section treated by laparoscopy and transvaginal combined with repair in.order to provide the reference for the clinical operation scheme selection.Methods Fifty-two patients who underwent uterine incision diverticulum type repair after cesarean section in the Second People's Hospital of Jingzhou were randomly divided into observation group and control group with 26 cases in each.Patients in the observation group were treated with laparoscopy combined with repair treatment,and patients in the control group were treated with transvaginal repair treatment.The operation periods,cut bleeding volume,postoperative anal exhaust time for the first time,postoperative highest temperature and length of hospital stay were recorded to evaluate the repair and uterine diverticula recovery at 3 months after operation.Results The operation periods in the observation group was (119.91 ± 35.73) min,longer than that in the control group ((62.32 ± 31.83) min ; t =3.514,P ＜0.05).There were on significant differences between two groups in terms of the amount of bleeding,anal discharge first time,the highest postoperative temperature and contrast after a few days in hospital (P＞ 0.05).After treatment,the observation group menstrual recovery rate was 84.62％ and 88.46％ in the control group.The differences were not statistically significant (x2 =1.14,1.76,P ＞ 0.05).Conclusion Laparoscopy hemiorrhaphy and transvaginal repair are effective treatment for uterine incision diverticulum after caesarean operation.The corresponding treatment plan can be made according to the patient's condition.

Objective To study the effect of candesartan (Can) on the LPS‐induced proinflammatory cytokines release in VSMCs ,and to explore the role of TLR4‐mediated signaling pathway in this process .Methods Rat VSMCs were primarily cul‐tured ,and the effect of different concentrations of Can on VSMCs activity was observed by M TT assay .The cells were divided into 5 groups :A(control) ,B(LPS intervention) ,C(LPS + 10 - 7 mol/L Can) ,D(LPS + 10 - 7 mol/L Can ) and E (LPS + Can 10 - 5 mol/L Can) .mRNA and protein levels of Toll‐like receptor‐4(TLR4) ,myeloid differentiation primary response gene 88(Myd88)and nu‐clear factor‐κB(NF‐κB) nuclear translocation were determined by real‐time PCR and Western blot ,respectively ;IL‐1β and TNF‐αconcentration were detected by ELISA .The production of intercellular reactive oxygen species(iROS) was measured by the DCFH‐DA assay .Pretreating VSMCs with the inhibitors against TLR4 ,NADPH oxidase ,and NF‐κB ,or a combination with candesartan and these inhibitors ,and then the expression of IL‐1β and TNF‐α was measured by ELISA .Results Can in the concentration range of 10 - 8 - 10 - 3 mol/L had no significant effect onVSMCs activity .Compared with th control group ,Can could effectively inhibit LPS‐induced VSMCs ,IL‐1β and TNF‐α release ,decreased the mRNA and protein expression of TLR4 ,Myd88 ,reduced the produc‐tion of iROS ,inhibited the NF‐κB(p65) nuclear translocation with a concentration‐dependent manner(P< 0 .05) .Anti‐TLR4 anti‐body ,DPI ,and PDTC all inhibited LPS‐induced inflammatory cytokines release in VSMCs ,and the combination of Can and these blockers showed stronger anti‐inflammatory effect .Conclusion Can can decrease the releaseof inflammatory cytokines IL‐1β and TNF‐α in VSMCs stimulated by LPS ,which is realized by inhibiting the signaling pathway of TLR4/Myd88‐iROS‐NF‐κB .

OBJECTIVE: To establish a chemical pattern recognition method for Panax notoginseng (P. notoginseng) and classify the main root, rhizome, and rootlet. METHODS: The fingerprints of P. notoginseng samples in three different parts were established based on HPLC method. The similarity was calculated by the Similarity Evaluation System of Chromatographic Fingerprints of Traditional Chinese Medicine (2012 edition). The pattern recognition were carried out by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). RESULTS: The HPLC fingerprint common pattern of 35 batches of P. notoginseng samples was established. Similarity values were in the range of 0.994 to 1.000, which indicated that similarity analysis could not classify them. The established PCA model could only identify the rhizome, besides PLS-DA can completely identify the three parts of P. notoginseng. Seven characteristic peaks, such as ginsenoside Rg1, ginsenosides Rb1 were screened as biomarkers. CONCLUSION: The combination of HPLC fingerprint and chemical pattern recognition could provide a comprehensive reference for the quality control and quality evaluation of P. notoginseng.

Objective: To investigate the rate of depression among Beijing residents aged 55 or above. Methods: 2660 Beijing residents aged 55 or above in a cohort study of year 2000 were followed and screened with CES-D. Demographic data, information of health status and activity of daily living were also collected. Results: The rate of depression in this cohort was 13.5% (360/2660), the rate of men was 9.6%, that of women was 17.4%, women had significantly higher rate than men. The rate of depression of residents in rural area was much higher than that of urban area (20.9% vs. 7.4%), the illiterate resident had higher rate of depression than those with at least primary education (20% vs. 8.7%). Residents above 75 or below that had no difference in rate of depression. Depression had close relation with poor health status and disability in activity of daily living. Conclusion:The rate of depression is higher in women and in residents of rural area or in those illiterate. Depression is closely related to poor health status and disability in daily living.

Objective To investigate the feasability of resorbable porcine-derived, xenogeneic aortas acelullar tissue matrix (ACTM) to be used as scaffold for cervical esophageal defect repair in a dog model. Methods Esophageal segmental defect measuring 5cm in length were created by surgical resection in 6 mature Chinese mongrel health dogs, then the defect were repaired with aorta acelullar tissue matrix (ACTM). The animals were kept alive for periods. The healing process was observed. Results There no death after perioperative period, one dog had anastomotic leakage. one dog was died of esophagus rupture as the result of esophageal dilation. Submucosal tissue regeneration and abundant neovascularization were found at 2 weeks. The squamous epithelium covered the most part of grafts surface in dogs killed after 4 weeks. 12 weeks later the squamous epithelium comprising 8 to 12 layers, both esophageal glands and muscle tissue were found. The graft material itself was mostly absorbed and could not be identified by naked eyes in the dogs killed after 12 weeks. Conclusion ACTM show promise as an ideal treatment option for esophageal repair.

Objective:To utilize MRI and plain films to observe the changes of soft tissue structures in patients with developmental dysplasia of the hip (DDH) after closed reduction, and explore the concentric reduction rate, the "docking" rate and the femoral head necrosis rate after reduction.Methods:Retrospective analysis of unilateral completely dislocated DDH patients with closed reduction and spica casting in our hospital from October 2012 to July 2018. MRI was performed on the day of closed reduction and every 2-3 months after operation. Pelvic plain films were performed before operation and follow-up. The labro-chondral complex (LCC) of the hip was divided into 4 types on MRI images, and the reliability and repeatability of LCC classification were evaluated by intra-class correlation coefficient. Trend chi-square test or Fisher exact probability method was used to analyze the variation of thickening rate of ligamentum teres, transverse ligaments and pulvinar during MRI follow-up, and the difference of cartilaginous acetabular head index was evaluated by analysis of variance of repeated measurements or Mann-Whitney U test. The concentric reduction rate of the femoral head after performing closed reduction, the "docking" rate of the femoral headwhen the cast was changed for the last time were analyzed, and the necrosis rate of the femoral head were followed up for 18 months or more after reduction.Results:A total of 63 DDH patients (63 hips) with closed reduction were included. Intra-class correlation coefficient of LCC classification was 0.84 between observers (95%CI: 0.74-0.91) and 0.94 within observers (95%CI: 0.90-0.97) . Most LCC classifications were type 4 on the day of CR (93.7%, 59/63) , and return to normal (type 1 classifications) at the second follow-up (50.9%, 28/55). ligamentum teres, transverse ligaments and pulvinar were hypertrophic (94.5%-100%) on the day of CR, and decreased to 10.9%-12.7% at the second follow-up, which had statistically differences ( χ2=88.6; χ2=86.4; χ2=97.9, P<0.05). The cartilaginous acetabular head index was 68.1±12.1 on the day of CR, and increased to 84.4±7.0 at the second follow-up, which had statistically difference ( Z=-3.15, P=0.002). 58.7% femoral heads were "docking", 8.6% femoral head had necrosis. Conclusion:The abnormal soft tissue structures in the hip joint mostly recovered gradually after closed reduction, and 60% femoral heads could be docked, the short-term risk of the femoral head necrosis was low.

Objective To study the long-term results of using an autologous vascularized pedicled flap of gastric tissues in the repair of traumatic bile duct strictures.Methods From 2002 to 2016,38 patients with traumatic bile duct strictures underwent repair using an autologous vascularized pedicled flap of stomach tissues.The postoperative morbidity,mortality,long-term clinical results,liver function and the rate of biliary stricture recurrence were studied.Results The overall complication rate was 18.4％ (7/38).A delay in healing of the incision wound occurred in 4 patients,biliary fistula in 2,and ascites in 1.Two patients died of malignant tumor.The median follow-up was 92 (61 ～ 107) months and the follow-up rate was 100％.Excellent results were obtained in 97.2％ (35/36) of patients.Abnormal liver function was detected in 1 patient which improved with treatment using choleretic drugs.The remaining 35 patients had normal liver functions with absence of abdominal pain.Conclusions To repair traumatic bile duct strictures using an autologous vascularized pedicled flap of stomach tissues was safe and reliable,and good long-term outcomes are available.

Objective:To study the cytotoxicity to tumor cells P815,H22 and B16 in vitro and the treatment effect of mice spleenocytes activated by lymphokine IL-2 and Tremella Polysaccharide,and their effects on main viscerals.Methods:The cytotoxicity of spleenocytes activated by lymphokine IL-2 or IL-2 and Tremella Polysaccharide to P815,H22 and B16 was detected by ?-scintillation counter after 2 hours.Subcutaneous injection of the above-mentioned spleenocytes to the local area of jepatocarcinoma of mice,one injection every two days,5 times totally.To examine tumor weight,size,histological changes and morphological changes in main viscerals.Results:The significantly cytotoxicity to tumor cells of spleenocytes activated by IL-2 and Tremella Polysaccharide was observed.To B16,the cytotoxicity of activated spleenocytes was the strongest.To H22,the cytotoxicity of activated spleenocytes was stronger and to P815,the cytotoxicity was the weakest,the cytotoxicity of TP-LAK cells was significantly stronger than that of LAK cells( P

Objective:To explore the effects of sitagliptin phosphate combined with metformin on blood glucose control and microinflammation in patients with type 2 diabetes.Methods:One hundred patients with newly diagnosed type 2 diabetes who were treated in the First Affiliated Hospital of Xingtai Medical College from March 2017 to March 2019 were randomly divided into observation group (50 cases) and control group (50 cases). The observation group was treated with sitagliptin phosphate combined with metformin for 8 weeks, while the control group was treated with metformin for 8 weeks. The changes of fasting blood-glucose (FBG) and blood glucose 2 h after meal (2 h-PBG ) in the two groups before and after treatment were observed, and the standard time of FBG and 2 h-PBG in the two groups were statistically analyzed. The levels of interleukin(IL)-1, IL-6 and high-sensitivity C-reactive protein (hS-CRP) were compared between the two groups before and after treatment.Results:After treatment, the levels of FBG and 2 h-PBG in the observation group were significantly lower than those in the control group: (6.32 ± 0.83) mmol/L vs. (7.21 ± 1.03) mmol/L, (8.61 ± 1.26) mmol/L vs. (9.63 ± 1.12) mmol/L, and the standard time of FBG and 2 h-PBG in the observation group were significantly shorter than those in the control group: (3.11 ± 0.86) weeks vs. (4.53 ± 1.31) weeks, (3.26 ± 0.36) weeks vs. (9.63 ± 1.12) weeks, and the differences were statisticlly significant ( P<0.05). After treatment, the serum levels of IL-1, IL-6 and hs-CRP in the observation group were significantly lower than those in the control group: (22.86 ± 4.07) ng/L vs. (35.13 ± 5.92) ng/L, (5.93 ± 0.84) ng/L vs. (9.67 ± 1.11) ng/L, (2.12 ± 0.25) ng/L vs. (3.57 ± 0.48) ng/L, and the differences were statistically significants ( P<0.05). Conclusions:Sitagliptin phosphate combined with metformin in the treatment of type 2 diabetes patients can rapidly and effectively control blood glucose and improve the state of microinflammation in patients.

ObjectiveTo explore the differences of patients with mild cognitive impairment (MCI) and normal elderly individuals in neuropsychology and ApoE genotype polymorphism.Methods23 patients with MCI and 28 normal controls were examined with the neuropsychological test and ApoE phenotypes. The neuropsychological test included mini-mental state examination (MMSE), activities of daily living scale (ADL), Preffer outpatient disability questionnair (POD), Fuld object memory evaluation (FOM), rapid verbal retrieve (RVR), digit span (DS), logical memory (LM), Geometry figures, clock drawing test (CDT), delayed recall, clinical dementia rating scale (CDR), global deterioration scale (GDS), Hachinski ischaemic scale (HIS) and center for epidemiological studies-depression scale (CES-D).ResultsMCI cases achieved significantly lower scores than healthy elderly in all cognitive function measures (P<0.05～0.001)except ADL,POD performance and naming, especially in logical memory and semantic memory, similar with the earlier period of AD. The ApoE genotype polymorphism examination showed that the rate of ApoE epsilon 4 allele carry in MCI patients was around 10 times to that in normal controls.ConclusionIndividuals with MCI appear to be at an increased risk of developing AD. Susceptible neuropsychological marker binding other biomarker, e.g. ApoE, can raise the sensibility and specificity in early diagnosis of AD.