Objective To investigate the influencing factors of pain during ultrasound-guided puncture sclerotherapy in the treatment of ovarian chocolate cyst(OEC).Methods A retrospective cohort study was conducted on 209 OEC patients undergoing ultrasound-guided puncture sclerotherapy in our department from September 2021 to September 2023.Demographic data,medical history and surgical information were collected.According to surgical approach,they were divided into transabdominal surgery group(n=57)and transvaginal surgery group(n=152).Pain scores were assessed at 5 surgical time points:needle insertion,irrigation,displacement,sclerosis,and needle withdrawal.Pain scores were compared between the 2 groups at each surgical moment.According to the pain scores at the moments of needle insertion and replacement,the patients were divided into the no/mild pain group(pain score ≤ 3)and the moderate/severe pain group(pain score ≥4),and the related factors of the incidence of moderate/severe pain were analyzed.Results There was no statistical difference in intraoperative pain between different surgical approaches(transabdominal/transvaginal)in treating OEC under the guidance of ultrasound.At the moment of needle insertion,significantly higher incidence of moderate/severe pain was observed in the patients with a body mass index(BMI)＞23.9 kg/m2 than those with BMI ≤23.9 kg/m2,and those with a history of dysmenorrhea than those without(P＜0.05).At the time point of displacement,BMI and history of dysmenorrhea had no correlation with the incidence of moderate/severe pain.Age,obstetric history,mode of delivery,time of menarche,menstrual volume,history of pelvic surgery,history of combined adenomyosis,size of cysts,duration of surgery,and surgical approach had no notable impacts on intraoperative pain.Conclusion Different surgical approaches for ultrasound-guided puncture sclerotherapy of OEC have no effect on pain levels at various surgical moments.From the aspect of humanistic care,transabdominal puncture should be preferred.During needle insertion and displacement,particular attention should be given to the overweight patients and those with a history of dysmenorrhea,and appropriate pain intervention measures should be formulated.

Objective To observe the efficacy and safety of flumatinib conversion in chronic myelogenous leukemia-chronicphase(CML-CP)patients with suboptimal TKI response or intolerance.Methods Patients who did not have the best response or intolerance to first-line imatinib,dasatinib,and nilotinib and switched to flumatinib(600 mg/d)from February 2020 to August 2022 were collected from 5 hospitals from Chongqing and affiliated hospitals of North Sichuan Medical College.The efficacy and safety of flumatinib were observed.The optimal response rate,major molecular response(MMR),cumulative complete cytogenetic response(CCyR)rate,cumulative MMR rate,cumulative deep molecular response(DMR),progression-free survival(PFS),event-free survival(EFS)and adverse reactions in 3,6 and 12 months after treatment were observed and analyzed.Results A total of 100 patients with CML-CP were enrolled,with a median follow-up of 18(3～36)months.The optimal response rate was 92.6％(88/95),94.4％(85/90)and 92.9％(79/85)respectively,at 3,6 and 12 months after treatment.Till August 20,2023,the cumulative CCyR and MMR rate was 98.0％(98/100)and 81.9％(77/94),respectively,the median time to reach CCyR and MMR was 3 months,and cumulative DMR rate was 51.0％(51/100).PFS rate was 100.0％(100/100)and 1-year EFS rate was 85.6％(75/90).The most common non-hematologic adverse reactions of flumatinib were diarrhea and abdominal pain(7.0％),followed by renal dysfunction(6.0％)and musculoskeletal pain(2.0％).The main hematologic adverse reactions were thrombocytopenia(12.0％),anemia(6.0％)and leukopenia(2.0％).Conclusion Flumatinib has better MMR and DMR and is well tolerated in CML-CP patients with TKI resistance or intolerance.

AIM:To investigate the effect of calcitonin gene related peptide(CGRP)on the expression of cyclic AMP response element binding protein(CREB)and phosphorylated-CREB in rat parietal cortex during focal cerebral ischemia/reperfusion(I/R).METHODS:Focal cerebral ischemia/reperfusion model was induced by occlusion of the right middle cerebral artery using the intraluminal suture method.The expressions of CREB and phospho-CREB in the parietal cortex in different groups(sham group,focal cerebral ischemia/reperfusion group and CGRP group)were detected with immunohistochemistry and Western blotting,and the positive products were analyzed by image analysis system.RESULTS:There was definite expression of CREB in right parietal cortex in sham group,while it was lesser in I/R group than that in sham group,but it became more in CGRP group than that in I/R group(P

Objective To investigate expressional pattern of the Connexin 43 in atrial myocytes of ventricular septal defect children. Methods The expressional role of the Connexin 43 in atrial myocytes of ventricular septal defect children were observed and determinated by immunohistochemistry and digital image analysis technology. Results 1.The Connexin 43 granules of 1-3 year-old-group normal children were mainly distributed on cell side surface,which took on beening spot-,belt-or chain-shaped,but seldom at intercalated disks. The Connexin 43 of 7-16 year-old-group normal children were abundantly distributed on cell side surface and intercalated disks. 2.The Connexin 43 of 1-3 year-old-group ventricular septal defect children were not noly distributed on cell side surface but could be detected at intercalated disks and cytoplasm,a few granules were irregular in arrangement.The Connexin 43 of 7-16 year-old-group ventricular septal defect children were distributed on cell side surface and in cytoplasm but seldom existed at intercalated disks,and arranged in irregular order. 3.The experimental results showed insignificant difference in the expressional amount of the Connexin 43 in atrial myocytes between the ventricular septal defect children and normal children. Conclusion The Cx 43 distributional pattern in atrial myocytes of ventricular septal defect children was changed,but its expressional amount was indistinct,which suggested that ventricular septal defect affected only the Cx43 expressional pattern.