Objective:To investigate the relationship between positive expression of multiple myeloma oncogene 1 (MUM1) and changes of endometrial endometrium in patients with repeated implantation failure (RIF).Methods:A retrospective cohort study of 62 RIF patients who attended the Center for Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University between March 2022 and May 2023 were selected. All patients were examined by perimetry, endometrial tissue was collected, and the positive expression of MUM1, vascular endothelial growth factor (VEGF), and microvessel density (MVD) were detected by immunohistochemical staining. The endometrial hemodynamics were examined by three-dimensional Doppler ultrasound, and according to the results of MUM1 expression, the patients were divided into MUM1-positive group (29 cases) and MUM1-negative group (33 cases). The endometrial thickness, endometrial blood flow vascularization index (VI), flow index (FI), vascularized blood flow index (VFI), and bilateral uterine arterial blood flow resistance index (RI), pulsatility index (PI), peak systolic velocity/peak diastolic velocity (S/D) were compared between the two groups. The expression levels of endometrial VEGF and MVD were compared between the two groups. Pearson correlation was used to explore the correlation between the expression of endometrial VEGF, MVD and endometrial blood flow VI, FI, VFI in the two groups.Results:In RIF patients, the endometrial VEGF positivity rate [31.03% (9/29)], MVD expression (16.97±3.28), and endometrial VI (1.45±0.96), FI (21.13±5.33), and VFI (0.39±0.17) in MUM1-positive group were significantly lower than those in the MUM1-negative group [the VEGF-positive rate: 36.36% (12/33), P<0.001; MVD: 33.42±7.97, P<0.001; VI: 1.91±0.56, P=0.025; FI: 23.91±5.37, P=0.045; VFI: 0.54±0.14, P=0.004]. Bilateral uterine arterial blood flow RI (0.69±0.14), PI (1.49±0.61), S/D (2.40±0.62) in MUM1-positive group was significantly higher than those in MUM1-negative group (0.54±0.15, 0.92±0.34, 1.45±0.40; all P<0.001). There was a significant positive correlation between the endometrial MVD expression level in the MUM1-positive group and endometrial blood flow of VI, FI, and VFI ( r=0.931, P<0.001; r=0.968 , P<0.001; r=0.914, P<0.001), and there was also a significant positive correlation between endometrial VEGF expression and endometrial blood flow VI, FI, and VFI ( r=0.965 , P<0.001; r=0.954, P<0.001; r=0.935, P<0.001). Conclusion:In RIF patients, the positive expression of MUM1 affects endometrial blood flow and the expression levels of VEGF and MVD, and there is a significant positive correlation between endometrial blood flow VI, FI, VFI and the expression of VEGF and MVD in the endometrium.

Objective:To investigate the relationship between positive expression of multiple myeloma oncogene 1 (MUM1) and changes of endometrial endometrium in patients with repeated implantation failure (RIF).Methods:A retrospective cohort study of 62 RIF patients who attended the Center for Reproductive Medicine of the Second Affiliated Hospital of Zhengzhou University between March 2022 and May 2023 were selected. All patients were examined by perimetry, endometrial tissue was collected, and the positive expression of MUM1, vascular endothelial growth factor (VEGF), and microvessel density (MVD) were detected by immunohistochemical staining. The endometrial hemodynamics were examined by three-dimensional Doppler ultrasound, and according to the results of MUM1 expression, the patients were divided into MUM1-positive group (29 cases) and MUM1-negative group (33 cases). The endometrial thickness, endometrial blood flow vascularization index (VI), flow index (FI), vascularized blood flow index (VFI), and bilateral uterine arterial blood flow resistance index (RI), pulsatility index (PI), peak systolic velocity/peak diastolic velocity (S/D) were compared between the two groups. The expression levels of endometrial VEGF and MVD were compared between the two groups. Pearson correlation was used to explore the correlation between the expression of endometrial VEGF, MVD and endometrial blood flow VI, FI, VFI in the two groups.Results:In RIF patients, the endometrial VEGF positivity rate [31.03% (9/29)], MVD expression (16.97±3.28), and endometrial VI (1.45±0.96), FI (21.13±5.33), and VFI (0.39±0.17) in MUM1-positive group were significantly lower than those in the MUM1-negative group [the VEGF-positive rate: 36.36% (12/33), P<0.001; MVD: 33.42±7.97, P<0.001; VI: 1.91±0.56, P=0.025; FI: 23.91±5.37, P=0.045; VFI: 0.54±0.14, P=0.004]. Bilateral uterine arterial blood flow RI (0.69±0.14), PI (1.49±0.61), S/D (2.40±0.62) in MUM1-positive group was significantly higher than those in MUM1-negative group (0.54±0.15, 0.92±0.34, 1.45±0.40; all P<0.001). There was a significant positive correlation between the endometrial MVD expression level in the MUM1-positive group and endometrial blood flow of VI, FI, and VFI ( r=0.931, P<0.001; r=0.968 , P<0.001; r=0.914, P<0.001), and there was also a significant positive correlation between endometrial VEGF expression and endometrial blood flow VI, FI, and VFI ( r=0.965 , P<0.001; r=0.954, P<0.001; r=0.935, P<0.001). Conclusion:In RIF patients, the positive expression of MUM1 affects endometrial blood flow and the expression levels of VEGF and MVD, and there is a significant positive correlation between endometrial blood flow VI, FI, VFI and the expression of VEGF and MVD in the endometrium.

Objective:To observe the effect of general anesthesia combined with serratus anterior plane block (SAPB) on the quality of life and postoperative pain of patients undergoing breast cancer surgery.Methods:The clinical data of 80 patients with breast cancer undergoing elective modified radical mastectomy admitted to the Affiliated Hospital of Guilin Medical College from January 2020 to March 2021 were retrospectively analyzed. According to different anesthesia methods, they were divided into control group and observation group, with 40 cases in each group. The control group received simple general anesthesia, while the observation group received general anesthesia combined with SAPB. The degree of postoperative pain in the two groups at 3, 6, 12 and 24 h after surgery was evaluated with the Numerical Rating Scale (NRS) score, and the postoperative recovery at 24 h after surgery and quality of life at 3 h and 6 months after surgery were evaluated with the Quality of Recovery-40 (QoR-40) score and the Short Form of Health Survey (SF-36). The serum levels of pain related cytokines[neuropeptide Y (NPY), prostaglandin E2 (PGE2), and 5-hydroxytryptamine (5-HT) ] in the two groups were compared. The complications of the two groups were recorded.Results:The NRS score in the observation group at 6 h and 12 h after operation were lower than those in the control group (all P<0.05). The QoR-40 score at 24 h after operation and SF-36 score at 6 months after operation in the observation group were higher than those in the control group (all P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P>0.05). The NPY, PGE2 and 5-HT levels of patients in the observation group were lower than those in the control group at 24 h after operation (all P<0.05). Conclusions:The use of general anesthesia combined with SAPB in modified radical mastectomy for breast cancer can alleviate postoperative pain and improve long-term quality of life, which may be related to the reduction of pain related cytokine secretion.

Objective:To investigate the expression of multiple myeloma oncogene 1 (MUM1) in patients with recurrent implantation failure (RIF) and its diagnostic value in chronic endometritis (CE).Methods:The data of 112 patients with RIF treated in the Reproductive Medicine Centre of the Second Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were collected by cohort study. All patients underwent hysteroscopy, endometrial tissue was collected and the positive expressions of MUM1 and CD138 in endometrial tissue were detected by immunohistochemistry staining; the differences in the positive expression rates of MUM1 and CD138 in endometrium were compared; the consistency of hysteroscopy combined with MUM1 and combined with CD138 immunohistochemistry staining in the diagnosis of CE was compared by Kappa test; the sensitivity of MUM1 and CD138 in diagnosing CE was compared by four-tabular method.Results:There were 55 cases of CE diagnosed by hysteroscopy in 112 patients with RIF, and the incidence was 49.11%. The positive expression rate of MUM1 was higher than that of CD138 [52.68% (59/112) vs. 41.07% (46/112), P<0.001] in endometrium of 112 RIF patients; the Kappa value of hysteroscopy combined with MUM1 and combined with CD138 immunohistochemistry staining in the diagnosis of CE was 0.794; the sensitivity and negative predictive value of endometrial MUM1 immunohistochemistry staining in the diagnosis of CE were higher than those of CD138 [100% (59/59) vs. 77.97% (46/59) and 100% (53/53) vs. 80.31% (53/66), all P<0.001]. Conclusion:In patients with RIF, hysteroscopy combined with endometrial MUM1 immunohistochemistry staining can be used as a more accurate method for diagnosing CE.

Objective:To investigate the expression of multiple myeloma oncogene 1 (MUM1) in patients with recurrent implantation failure (RIF) and its diagnostic value in chronic endometritis (CE).Methods:The data of 112 patients with RIF treated in the Reproductive Medicine Centre of the Second Affiliated Hospital of Zhengzhou University from October 2019 to October 2021 were collected by cohort study. All patients underwent hysteroscopy, endometrial tissue was collected and the positive expressions of MUM1 and CD138 in endometrial tissue were detected by immunohistochemistry staining; the differences in the positive expression rates of MUM1 and CD138 in endometrium were compared; the consistency of hysteroscopy combined with MUM1 and combined with CD138 immunohistochemistry staining in the diagnosis of CE was compared by Kappa test; the sensitivity of MUM1 and CD138 in diagnosing CE was compared by four-tabular method.Results:There were 55 cases of CE diagnosed by hysteroscopy in 112 patients with RIF, and the incidence was 49.11%. The positive expression rate of MUM1 was higher than that of CD138 [52.68% (59/112) vs. 41.07% (46/112), P<0.001] in endometrium of 112 RIF patients; the Kappa value of hysteroscopy combined with MUM1 and combined with CD138 immunohistochemistry staining in the diagnosis of CE was 0.794; the sensitivity and negative predictive value of endometrial MUM1 immunohistochemistry staining in the diagnosis of CE were higher than those of CD138 [100% (59/59) vs. 77.97% (46/59) and 100% (53/53) vs. 80.31% (53/66), all P<0.001]. Conclusion:In patients with RIF, hysteroscopy combined with endometrial MUM1 immunohistochemistry staining can be used as a more accurate method for diagnosing CE.

Objective:To explore the role of comprehensive first aid skills training in improving medical students' comprehensive first aid ability.Methods:Eighty-seven medical students were enrolled in this study, and received the training of comprehensive first aid skills developed by the emergency medicine teaching and research section of our hospital. The scores of individual first aid ability, emergency handling ability, team cooperation ability, organization and coordination ability and communication ability before and after the training were analyzed. At the same time, a questionnaire survey was conducted among students to understand their evaluation and recognition of the training. SPSS 10.0 was used for t test. Results:After the training, the total score of comprehensive first aid ability was increased significantly [(73.55±3.89) vs. (63.53±3.06)], and the scores of emergency handling ability [(10.11±1.43) vs. (8.01±1.16)], team cooperation ability [(11.38±1.21) vs. (8.15±0.99)], organization and coordination ability [(10.68±1.17) vs. (8.15±0.99)] and communication ability [(9.64±1.31) vs. (7.55±1.08)] were also significantly increased ( P<0.05). However, there was no significant difference in the scores of individual first aid ability mastery before and after training. In all, 80.46%-96.55% of the students think that the training of comprehensive first aid skills is conducive to the improvement of their comprehensive first aid ability, and all of the students are willing to use this training in the future. Conclusion:Comprehensive first aid skill training is beneficial to improve medical students' comprehensive first aid ability.

Objective:To investigate the protective effects of Elabela(ELA) on the renal injury of db/db mice and its possible mechanism.Methods:Sixteen eight-week-old male db/db mice were intraperitoneally injected with ELA(5 mg·kg -1·day -1) or equivalent normal saline( n=8) for 8 weeks. Eight age-matched male db/m mice received equivalent normal saline injection as normal control. At the end of the experiment, blood and urine samples were obtained for HbA 1C and urinary albumin/creatinine(ACR) measurements. Immunohistochemistry was used to observe the expression of ELA. Histopathological changes in kidney tissue were observed by HE staining and Masson staining. The levels of collagen type Ⅳ(Col-Ⅳ) and transforming growth factor-β1(TGF-β1) as well as Yes-associated protein(YAP) phosphorylation in kidney tissue were examined by western blot. Results:Immunohistochemistry results showed that ELA expression was decreased in the renal tissue of db/db mice as compared with that of db/m mice( P<0.05). After ELA treatment, ACR and blood pressure were markedly decreased in db/db mice( P<0.05), but without significant changes in the body weight and HbA 1C. Renal tubular epithelial cells edema, basement membrane thickening, and increased collagen fiber in db/db were improved by ELA administration. Compared with db/m mice, the levels of TGF-β1 and Col-Ⅳ expression, as well as YAP phosphorylation were significantly increased in renal tissue of db/db mice(0.98±0.08 vs 0.68±0.10, 1.10±0.14 vs 0.51±0.08, 3.38±0.72 vs 0.81±0.13, all P<0.05), which were down-regulated after ELA administration(0.80±0.06, 0.51±0.05, 2.21±0.22, all P<0.05). Conclusion:ELA may improve the renal injury of db/db mice by regulating the signaling pathway of YAP, thereby delaying the development of diabetic nephropathy.

Epithelial-mesenchymal transition (EMT) is a complex transformation process and plays an important role in the invasion of cancer cells. The morphological transformation in cancer cells are accompanied by various cellular processes such as alterations in cell adhesion, cell matrix degradation, changes in epithelial markers and mesenchymal markers. Mucin (MUC) is widely distributed in epithelial cells of various tissues and organs and plays an important role in EMT. Meanwhile, MUC also can mediate signal transduction and cell adhesion, participate in tumor invasion and metastasis. This article reviewed the advances in research on EMT and MUC in tumors.

Objective To analyze the complications of radical vaginal hysterectomy in patients with locally bulky cervical cancer.Methods All 258 patients of early cervical cancer (stage Ⅰ A2-Ⅱ A) selected in our hospital during the period of June 2011 to June 2016 undergoing radical vaginal hysterectomy and laparoscopic pelvic lymph node dissection were analyzed.All cases were divided into observation (locally bulky) and control (conventional) groups.Comparison analysis was performed for complications of the two groups and the influence of neoadjuvant chemotherapy on the complications of local bulky patients.Results The incidence of complications in the observation group was 26 cases (27.9％),higher than that in the control group of 28 cases (17.0％),the difference was statistically significant (P ＜ 0.05).The incidence of bladder injury (5 cases vs 2 cases) in observation group was significantly higher than that in control group (P ＜ 0.05).For patients with locally bulky early cervical cancer,the incidence rate of complications of the neoadjuvant chemotherapy group (15.8％) was significantly lower than the simple operation group (36.4％) (P ＜ 0.05).The incidence rate of ureteral injury in neoadjuvant chemotherapy group (0 cases vs 6 cases) was significantly lower than that in simple operation group (P ＜ 0.05).Conclusions Early cervical cancer patients with locally bulky (stage Ⅰ B2/ 1Ⅱ A2) had higher incidence of complications of radical vaginal hysterectomy,and neoadjuvant chemotherapy can reduce the incidence of surgical complications.

Objective:To analyze the efficacy and safety of targeted drug apatinib combined with tegafur, gimeracil and oteracil capsules (TS-1) in the second-line treatment of advanced gastric mucinous adenocarcinoma. Methods: Totally 48 patients with ad-vanced gastric mucinous adenocarcinoma treated with the second-line regimen were randomly divided into the control group and the treatment group with 24 ones in each. The control group received the chemotherapy of TS-1, and the treatment group received apatinib additionally. The adverse reactions and objective effects were observed. Results:The objective response rate (ORR) was 54. 1% and 33. 3% in the treatment and the control group, respectively. The disease control rate (DCR) was 83. 3% and 54. 2% in the treatment and the control group, respectively. There were significant differences on ORR and DCR in both groups(P<0. 05), while no statisti-cal difference was shown in the adverse reactions (P>0. 05) between the two groups. Conclusion:Apatinib combined with TS-1 ex-hibits evident short-term therapeutic effect on advanced gastric mucinous adenocarcinoma, and the adverse reactions can be tolerated.