Objective To investigate the effect and severe adverse reactions of goserelin combined with mifepristone after operation for moderate and endometriosis laparoscopic conservative.Methods 68 cases with moderate to severe endometriosis diagnosed after laparoscopic conservative operation were randomly divided into the Gore Sherry Lin group and mifepristone group with 34 cases for 6 months of a course,regular follow-up.Clinical efficacy and adverse reaction for two groups were compared.Results The dysmenorrhea symptoms for two groups of patients have been alleviated,the efficiency rate was above 91％.The recurrence rate of the mifepristone group was higher than the goserelin group (14.71％ vs 2.94％,P ＜ 0.05).The cumulative pregnancy rate of mifepristone group was lower than the goserelin group (20.59％ vs 38.23 ％,P ＜ 0.05) discontinued for 1 years.The liver function damage of the goserelin group was significantly lower than the mifepristone group (2.94％ vs 23.53％,P ＜ 0.05).Conclusion It is more significance for using suppression of ovarian function after laparoscopic conservative operation for severe endometriosis.It can increase the pregnancy rate and decrease the recurrence rate.

Objective To investigate the levels of inflammatory cytokines in children with low absolute lymphocyte count (ALC).Methods 56 patients with low ALC as the patients group and 20 children with healthy physical examination as the control group were enrolled.Several inflammatory cytokines,namely IL-1,IL-6,IL-8 and TNF-βwere measured with enzyme linked immu-nosorbent assay(ELISA)kits.High sensitive C reactive protein(Hs-CRP)was measured by the immunoturbidimetry(ITM)kit with the automatic biochemical analyzer.Results The concentrations of IL-1,IL-6,IL-8 and TNF-βin the patients were(0.096±0.012) ng/mL,(0.118±0.026)ng/mL,(0.388 ±0.069)ng/mL and(1.256 ±0.245 )ng/mL respectively,which had no statistical differ-ences as compared with the control group(P >0.05);the concentration of HsCRP in the patients group was(5.7±2.8)mg/L,while which in the control group was(4.8±2.6)mg/L,showing no statistically significant difference between them(P >0.05).Conclusion The levels of the cytokines in low ALC patients are not increased,which may be related with the other factors.Actively using tra-ditional Chinese medicine treatment is beneficial to the recovery of disease.

The stigmatization of social system toward serious mental disorder patients is a long-standing problem,and it brings the stigma,which is prevailing throughout different patients with mental disorder.And that brought profound negative influences on the patients and their families.The patients with the stigma,they shame in social avoidance,worry about discrimination,even delay in diagnosis and treatment for various reasons,serious impact on their treatment,prognosis and quality of life.This article through the comprehensive analysis of the factors of the stigma among the patients with serious mental disorder in our country,and probes into how to reduce the stigma.

Objective To observe the effects of functional electrical stimulation (FES) based on a normal walking pattern on the lower extremity function of subjects early after cerebral infarction.Methods Twenty patients with cerebral infarction aged (59.7 ± 10.1) years (range 45-80) who were hospitalized and within 3 months (31.1 ± 19.3 days) after the onset were randomly assigned to an FES group (n =11) or a placebo stimulation group (n =9).All subjects in both groups received standard medical and rehabilitation treatment.In addition,the FES group received FES and the placebo group received sham-FES without current output.The daily stimulation and shamstimulation sessions lasted for 30 min,5 d/week for 3 weeks.All of the subjects in the two groups were assessed using the Fugl-Meyer assessment (FMA),postural assessment for stroke patients (PASS),the Berg balance scale (BBS),functional ambulation categories (FACs) and the modified Barthel index (MBI).Results After 3 weeks of treatment,FMA,PASS,BBS and MBI scores had all improved significantly compared with before treatment in both groups,but the FES group showed significantly better improvement.After treatment the average FAC results of both groups had improved,and there was no significant difference between the two groups.At the same time,the research revealed the expected significant correlations among the FMA,PASS,BBS and MBI results.Conclusion FES based on a normal walking pattern can improve lower extremity motor function early after cerebral infarction,improve balance,and improve ability in the activities of daily living.

Objective: To investigate the health literacy and its influencing factors among residents in areas out of poverty in Kunming City, so as to provide insights into formulating health education strategies. Methods: A total of 1 916 permanent residents at ages of 15 to 69 years were sampled in three areas out of poverty in Kunming City using the multi-stage stratified random sampling method and probability proportionate to size sampling method from August to October, 2020. Health literacy was investigated using the Questionnaire on the Health Literacy among Chinese Residents, the level of health literacy was analyzed and weighted by the population of the China's Seventh National Population Census. Factors affecting health literacy among residents in areas out of poverty were identified using a multivariable logistic regression model. Results: A total of 1 916 questionnaires were allocated, and 1 908 valid questionnaires were recovered, with an effective recovery rate of 99.58%. The respondents included 997 men (52.25%) and 911 women (47.75%), and had a mean age of (45.58±14.28) years. The level of health literacy was 21.38%. Multivariable logistic regression analysis identified age (15 to 24 years, OR=5.087, 95%CI: 1.573-16.450; 25 to 34 years, OR=6.016, 95%CI: 1.991-18.183; 35 to 44 years, OR=7.526, 95%CI: 2.541-22.289; 45 to 54 years, OR=4.800, 95%CI: 1.640-14.050), educational level (junior high school, OR=5.333, 95%CI: 3.100-9.175; high school/vocational high school/technical secondary school, OR=19.895, 95%CI: 10.418-37.966; college or above, OR=27.580, 95%CI: 12.349-61.597) as factors affecting health literacy among residents in areas out of poverty in Kunming City. Conclusion The level of health literacy is 21.38% among residents in areas out of poverty in Kunming City, and age and educational level are associated factors.

Objective To investigate whether endoscopic nasobiliary drainage (ENBD) after endoscopic stone extraction could reduce post-operative complications.Methods Retrospective analysis of 697 patients with extrahepatic duct stones undergoing ERCP treatment was pedormed.They were assigned to ENBD group (n =538) and control group (n =159).Post-operative complications including pancreatitis,cholangitis and bleeding were observed and compared.Results There were no significant differences in incidence of pancreatitis and bleeding between 2 groups.Incidence of cholangitis in ENBD group was significantly lower than that in control group (1.3％ vs.3.8％,P ＜ 0.05).Conclusion ENBD after endoscopic stone extraction could reduce the incidence of postoperative cholangitis.

ObjectiveTo evaluate the feasibility and safety of endoscopic intraductal radiofrequency ablation (RFA) for unresectable malignant biliary strictures.MethodsA total of 12 patients with malignant biliary obstructions,who were unsuitable for surgical resection,were prospectively selected for this study.During ERCP,when successful biliary cannulation achieved,a bipolar radiofrequency probe was introduced into bile duct over a guidewire.RFA was given to the tumor lesion under fluoroscopy,followed by stent placement.The patients were closely observed and followed up after the procedure.ResultsSuccessful RFA was achieved in all patients before stents insertion ( plastic and metal stents in 6 respectively,additional pancreatic stents were given to 3).Mild complications of cholangitis and pancreatitis occurred in 1 patient respectively,which were cured with short-term management.Jaundice was promptly controlled in 7 patients (58.3％ ).During the mean follow-up duration of 3.4 (range 0.5-5.5) months,one patient died of cardiocerebral accident and others survived without obvious disconffort.The 1- month and 3- month stent patency was 100％ (12/12) and 80％ (8/10),respectively.ConclusionIt is technically feasible and safe to perform endoscopic intraductal RFA for the palliation of biliary malignancies.The short-term outcome is satisfying,however,long-term result and the better therapeutic schedule need further evaluation.

Objective To investigate the relationship between the C-reactive protein (CRP) and nonalcoholic fatty liver disease (NAFLD) prevalence.Methods In this study,63,486 workers who had participated in the Kailuan health examination from July 2012 to October 2013 and without history of drinking,myocardial infarction,stroke and cancer and without data incomplete were recruited.The observation population was divided into three groups according to the levels of CRP at baseline:group 1 (＜ 1 mg/L),group 2 (1-3 mg/ L) and group 3 (＞3 mg/L).The prevalence of NAFLD among three groups was observed.Multiple logistic regression was used to calculated relationship between the CRP and NAFLD prevalence.Results The prevalence of NAFLD in group 1,group 2 and group 3 were 26.9％,42.1％ and 49.3％,respectively,and the differences were significant (x2=2 192.31,P ＜ 0.01).Logistic model showed that after adjustment for age,gender,waist circumference and other confounders,the association between CRP and NAFLD was strong and the OR value (95％ CI) among the group 1,group 2 and group 3 were 1.00,1.49 (1.42-1.56),1.54 (1.45 -1.64),respectively.Conclusion CRP is independently associated with the nonalcoholic fatty liver disease.

Objective To discuss postoperative curative effect comparison of goserelin and gestrinone on endometriosis (EMT). Methods A total of 75 cases of patients with EMT, who were given EMT cystectomy of under laparoscopy, were divided into observation group (n=37 cases) and control group (n=38 cases) in accordance with different treatment meth-ods. The patients in observation group were given 3.6 mg goserelin by subcutaneous injection within 1 week upon the operation, once for every 4 weeks, for 6 times, while the patients in control group were given 2.5 mg gestrinone through the mouth within 1 week upon the operation, twice for every week for 48 times. According to the 2-year following-ups after treatment, the curative effect, reoccurrence rates, occurrence rates of untoward effect and pregnancy rates of pa-tients in two groups were observed. Results According to the 2-year following-ups after treatment, 4 and 2 cases of patients were lost to follow up, and after comparing the loss ratios of follow-up of patients in two groups, no statistical differences were appeared (χ2=0.15, P>0.05). The total efficiency of patients in observation group was much higher than that in control group, while the reoccurrence rate was much lower than that in control group (χ2=3.85, P<0.05). 9 and 6 cases of untoward effect were appeared in control group and observation group respectively, with light symptom, and after comparing the occurrence rates of untoward effect, no statistical differences were appeared (χ2=0.88,P>0.05). The suc-cessful pregnancy rate of patients in observation group after 2-year withdrawal of drugs was much higher than that in control group (χ2=4.69, P<0.05). Conclusion Compared with gestrinone, goserelin has more favorable postoperative cura-tive effect on EMT, which can obviously reduce the postoperative reoccurrence rate, and raise the successful pregnancy rate and higher security.

Objective To evaluate the technical feasibility and safety of endoscopic retrograde catheterization of gallbladder (ERCG) and endoscopic transpapillary gallbladder stenting (ETGS) for gallbladder diseases.Methods Patients who underwent ERCG and ETGS in Eastern Hepatobiliary Hospital from January 2010 to June 2016 were enrolled to this retrospective study.The superselection time of cystic duct,the catheterization time of gallbladder,postoperative symptoms and complications were analyzed.Results A total of 10 patients were enrolled to this study,including 2 cases of acute calculous cholecystitis,4 cases of percutaneous transhepatic gallbladder drainage (PTGBD) and 4 cases of cholecystocholedocholithiasis.The success rates of ERCG and ETGS were 100％.Symptoms were relieved in all patients and PTGBD catheter was removed after ETGS.The mean times of ERCG and ETGS were 10.2 ± 6.9 min and 17.0 ± 8.0 min respectively.The mean times of ERCG were 18.5±4.9 min,13.0±3.6 min and 3.3± 1.3 min,respectively (F=18.86,P =0.002).The mean times of ETGS were 25.5±4.9 min,21.0± 4.7 min and 8.8 ± 1.0 min,respectively (F =18.04,P =0.002).Complications included 1 case of cholangitis and 1 case of hyperamylasemia.Cholangitis was relieved after anti-inflammatory treatment.No acute pancreatitis,bleeding,perforation or procedure-related death occurred.Conclusion ERCG and ETGS are safe and feasible,which can play important roles in the treatment of specific gallbladder diseases or gallbladder with bile duct diseases.