Objective:To compare the training effect between the laparoscopic simulated uterine model (LSUM) with multi-angle suture and the traditional surgical model and to identify a laparoscopic model more suitable for gynecological resident training.Methods:Forty-eight residents who were trained in Sir Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine from February 2021 to February 2023 were selected. They were trained in batches, with each batch randomly divided into two groups of the same size. The observation group was trained with the traditional surgical model and general surgical videos, while the experimental group was trained with a self-developed LSUM with multi-angle suture and corresponding surgical videos. Finally, the two groups were compared for the assessment results, and a questionnaire survey was conducted in the experimental group. The statistical software SPSS 20.0 was used for t-test or chi-square test of the results. Results:There were no significant differences between the two groups in age, gender distribution, education level, and clinical experience. In theoretical assessment results, no significant difference was shown between the experimental group and the observation group [(82.63±3.93) vs. (85.00±6.15), P>0.05]. In skill assessment results, there was no significant difference between the two groups in the anterior wall assessment [(83.08±4.47) vs. (82.79±3.58), P=0.804]. However, in the assessment of the lateral and posterior walls, the proficiency, accuracy, and degree of coordination between two hands of the experimental group were better than those of the observation group, with the total score being significantly different [(64.13±3.34) vs. (46.75±3.50), (62.25±4.41) vs. (45.00±2.89), P<0.001]. In the questionnaire survey, the experimental group had a high degree of satisfaction with the LSUM and thought that the highly simulated model was beneficial to their training. Conclusions:Compared with the traditional surgical model, the LSUM with multi-angle suture can effectively improve the operation level of residents, which provides a new idea for the laparoscopic simulation training of gynecological residents in the future.

Objective:To investigate the predictive effect of perioperative depression and anxiety symptoms in breast cancer patients on the fear of cancer recurrence.Methods:A total of 194 patients with breast cancer during perioperative period from May 2019 to May 2020 in Qilu Hospital of Shandong University were selected. The depression, anxiety and fear of cancer recurrence were investigated by the general information questionnaire, the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9) and the Fear of Progression Questionnaire-Short Form (FOR-Q-SF) at admission and two weeks after surgery, respectively.Results:Perioperative depression and anxiety symptoms of breast cancer patients were significant predictors of fear of cancer recurrence ( B value was 2.325, OR value was 10.22, P<0.05; B value was 2.570, OR value was 13.07, P<0.05), and patients with depression and anxiety symptoms after surgery were at higher risk of fear of cancer recurrence ( OR values were 7.653-25.403, P<0.01). Conclusions:For breast cancer patients with negative emotions and fear of disease progression, it is necessary to help them improve their psychological coping ability, encouraging patients to actively cooperate with follow-up treatment, improving the prognosis, and improving their overall quality of life.

Objective:To explore the relationship between the quality of professional life and depression tendency of nurses.Methods:From November 2018 to January 2019, 242 nurses from some third-class A hospitals were randomly selected as the subjects. The Quality of Professional Life Scale of Nurses were used to evaluate the status of nurses' professional life quality, and the depression state of nurses was measured by Self Rating Depression Scale, and the relationship between them was analyzed.Results:The total score of professional life of nurses was (156.86±26.60) , including family work balance (24.60±4.73) , working environment (77.30±14.78) , workload (36.34±6.11) and social environment (18.62±4.21) . The total score of depression tendency of nurses was (43.76±9.50) , the overall depression tendency rate was 64.46% (156/242) , and the incidence rates of moderate and severe depression tendency were 23.55% (57/242) and 10.74% (26/242) , respectively. There was negative correlation between the total score of professional quality of life and each dimension score with depression tendency ( P<0.05) ; Multiple linear regression analysis showed that high quality of professional life was the protective factor of depression tendency of nurses ( P<0.001) . Conclusion:The quality of professional life of nurses is related to depression tendency, and the high quality of professional life is not prone to depression.

Objective:To explore the relationship between the quality of professional life and depression tendency of nurses.Methods:From November 2018 to January 2019, 242 nurses from some third-class A hospitals were randomly selected as the subjects. The Quality of Professional Life Scale of Nurses were used to evaluate the status of nurses' professional life quality, and the depression state of nurses was measured by Self Rating Depression Scale, and the relationship between them was analyzed.Results:The total score of professional life of nurses was (156.86±26.60) , including family work balance (24.60±4.73) , working environment (77.30±14.78) , workload (36.34±6.11) and social environment (18.62±4.21) . The total score of depression tendency of nurses was (43.76±9.50) , the overall depression tendency rate was 64.46% (156/242) , and the incidence rates of moderate and severe depression tendency were 23.55% (57/242) and 10.74% (26/242) , respectively. There was negative correlation between the total score of professional quality of life and each dimension score with depression tendency ( P<0.05) ; Multiple linear regression analysis showed that high quality of professional life was the protective factor of depression tendency of nurses ( P<0.001) . Conclusion:The quality of professional life of nurses is related to depression tendency, and the high quality of professional life is not prone to depression.

Objective: To investigate the effect of resilience on fear of cancer recurrence in breast cancer patients and to find the specific role of perceived social support between them. Methods: From April 2018 to January 2019, we invited 456 breast cancer patients hospitalized in the Department of Breast surgery in Qilu Hospital of Shandong University in Jinan to participate in the study and to finish a questionnaire survey which including the general information questionnaire, Chinese version of the Fear of Progression Questionnaire-Short Form, The Connor-Davidson Resilience Scale and Perceived Social Support Scale. Results: The average score of fear of cancer recurrence in breast cancer patients was (41.5±7.7), and 85.99% (313/364) of the patients′ score was clinically significant (total score ≥ 34). Resilience could negatively predict the fear of cancer recurrence (β=-0.240 P < 0.01). Perceived social support is the moderation between resilience and fear of cancer recurrence (β=-0.179, P<0.01). Conclusions The level of resilience could affect the level of fear of cancer recurrence in breast cancer patients, and the increase in the level of perceived social support could enhance the effect of resilience on the fear of cancer recurrence, thus further reducing the level of patient′s fear of recurrence.

Objective To investigate the prevention effects of antithrombotic pressure pump combined with graduated compression stockings (GCS) on incidence of postoperative lower extremity deep venous thrombosis (LEDVT) in breast cancer patients. Methods A total of 363 cases of breast cancer patients after operation were divided into routine care group (124 cases) according to the method of random number table, pressure group (127 cases) and combined treatment group (112 cases). The routine care group received conventional LEDVT ankle pump exercises. The pressure group used GCS besides the routine intervention. The combined group received GCS and antithrombotic pressure pump besides the routine intervention. Then the levels of thrombosis markers, D-dimers,platelets, and incidences of LEDVT were examined in the three groups. Results Before operation, no significant differences between the levels of prothrombin time (PT), activated partial prothrombin time (APTT), thrombin time (TT), fibrinogen, plasma D-dimer and platelets (P>0.05). After operation, the levels of PT, APTT, TT, fibrinogen, plasma D-dimer and platelets in three groups were (10.22 ± 0.76) s, (27.24 ± 3.68) s, (14.60 ± 0.88) s, (2.94 ± 0.59) mg/L, (0.31 ± 0.21) mg/L, (288.48 ± 71.29) × 109/L, (10.73 ± 0.79) s, (27.35 ± 2.54) s, (14.71± 1.76) s, (4.12±1.09) mg/L, (0.46±0.38) mg/L, (284.26±70.98) ×109/L and (11.11±0.64) s、(28.52± 2.74) s, (14.33± 1.02) s, (4.42±1.20) mg/L, (0.35±0.33) mg/L, (258.79±62.35) ×109/L, respectively. There was significant difference among these groups (F=5.71-87.31, P<0.01). The differences on PT, APTT, fibrinogen and D-dimers between combined treatment group and routine care group were statistically significant (P<0.05). The differences on PT, fibrinogen and platelets between combined treatment group and pressure group were statistically significant (P<0.05). The differences on PT, APTT, fibrinogen and D-dimers between routine care group and pressure group were statistically significant (P<0.05). Through one months of follow-up, the incidence of LEDVT in routine care group, pressure group and combined treatment group were 12.10％(15/124),3.15％(4/127),0.89％(1/112), respectively. There was significant difference among these groups (χ2=16.279,P<0.01). Conclusions The application of antithrombotic pressure pump combined with GCS significantly improves the postoperative hypercoagulable states in breast cancer patients. The combined treatment reduces the incidence of LEDVT without bleeding risk. Therefore, antithrombotic pressure pump combined with GCS is recommended for clinical use in the postoperative breast cancer patients.

Objective To exam the quality of life of the caregivers of patients with breast cancer, to explore their related factors, including medical characteristics of the patients, demographic characteristics of the caregivers, relationship with the patients, social support and psychological resilience, and to test the mediating and moderating roles of psychological resilience between social support and quality of life. Methods A total of 179 hospitalized patients diagnosed with breast cancer were recruited in Qilu Hospital of Shandong University. The self-designed demographic questionnaire, Medical Outcome Study 12-Item Short Form Health Survey,Version 2(SF-12V2), Perceived Social Support Scale(PSSS), and 10-item Connor-Davidson Resilience Scale(CD-RISC-10) were used to collect information about demographic characteristics and measure the quality of life, perceived social support and psychological resilience of the caregivers. The factors affecting the quality of life of the caregivers were analyzed by multiple linear regression analysis, and the mediating and regulating effects of mental resilience on social support and mental health were analyzed. Results The age of the caregivers was negatively correlated with the physical health (P=0.010). The score of the body health of the family members of the middle and late stage cancer patients was lower than that of the family members in the early stage (P=0.003). There was a positive correlation between friend support and resilience and mental health (P<0.01). Resilience played a moderating role and mediating role in the relationship between friend support and mental health. Conclusions Attention should be paid to the quality of life of caregivers in patients with breast cancer. The medical staff should provide more social support for the caregivers, and should pay more attention to improve the psychological resilience of the caregivers, guide them to better cope with the burden and pressure of care, and improve their mental health with half the effort.

Standardized training of residents is an important measure to cultivate medical talent.Hysteroscopy is an important teaching content in the standardized training of obstetrics and gynecology residents.A variety of teaching and training methods has been employed in department of obstetrics and gynecology in Sir Run Run Shaw Hospital affiliated to School of Medicine of Zhejiang University including theory teaching,teaching rounds,PBL,trainee training,one to one training,skill assessment to improve the quality of the standardized training and the practical ability of the residents.

Whether and how garlic-derived -allylmercaptocysteine (SAMC) inhibits hepatocellular carcinoma (HCC) is largely unknown. In the current study, the role of low-density lipoprotein receptor (LDLR)-related protein 6 (LRP6) in HCC progression and the anti-HCC mechanism of SAMC was examined in clinical sample, cell model and xenograft/orthotopic mouse models. We demonstrated that SAMC inhibited cell proliferation and tumorigenesis, while induced apoptosis of human HCC cells without influencing normal hepatocytes. SAMC directly interacted with Wnt-pathway co-receptor LRP6 on the cell membrane. LRP6 was frequently over-expressed in the tumor tissue of human HCC patients (66.7% of 48 patients) and its over-expression only correlated with the over-expression of -catenin, but not with age, gender, tumor size, stage and metastasis. Deficiency or over-expression of LRP6 in hepatoma cells could partly mimic or counteract the anti-tumor properties of SAMC, respectively. administration of SAMC significantly suppressed the growth of Huh-7 xenograft/orthotopic HCC tumor without causing undesirable side effects. In addition, stable down-regulation of LRP6 in Huh-7 facilitated the anti-HCC effects of SAMC. In conclusion, LRP6 can be a potential therapeutic target of HCC. SAMC is a promising specific anti-tumor agent for treating HCC subtypes with Wnt activation at the hepatoma cell surface.

Objective To assess the caregiver's needs of patients with breast cancer and their related factors. Methods By purposive sampling,caregivers of hospitalized patients with breast cancer were recruited and completed the Comprehensive Needs Assessment Tool for Cancer Caregivers(CNAT-C),9 items Patient Health Questionnaire(PHQ-9),Generalized Anxiety Disorder-7(GAD-7)to assess their demographic characteristics,needs,depression and anxiety. Results A total of 82 caregivers completed the questionnaires.The most unmet need was health-care staff,followed by information,hospital facilities and services, practical support, family/social support, health and psychological problems and religious/spiritual support.The domain with the highest prevalence of unmet needs was healthcare staff(69.5%,57/82),followed by information/education(48.8%,40/82).The score of domains of health and psychological problems,hospital facilities and services was(6.42±5.73),(10.52±4.84)points in female caregivers,and (2.84±2.52),(7.41±5.39)points in male caregivers,there was significant difference(t=2.83,2.47,P<0.01 or 0.05). Caregivers with high school or lower education reported higher needs in health staff domain than caregivers with higher education: (19.70 ± 5.72) points vs. (16.77 ± 7.38) points, t=2.02, P=0.046. Caregivers who were unmarried had higher needs in domain of religious/spiritual support than married caregivers:(2.86±2.27)points vs.(1.56±0.18)points,t=2.99,P=0.004.Caregivers who were religious had higher needs in domain of religious/spiritual support than caregivers who were not:(2.63±1.92)points vs. (0.93 ± 0.61) points, t=2.78, P=0.007). Caregivers who were from rural area reported higher needs in domain of practical support than those from city: (6.48 ± 4.82) points vs. (4.19 ± 1.35) points, t=2.00, P=0.049. The total score of caregiver needs was positively correlated with depression (r =0.44, P < 0.01), anxiety(r=0.41,P<0.01),in addition to the medical staff and the other dimensions of depression(r=0.28-0.46, P < 0.05), anxiety (r=0.22-0.51, P < 0.05) were positively correlated. Conclusions The most unmet needs of caregivers of patients with breast cancer were health-care staff, followed by information, and hospital facilities and services. More attention should be paid on caregivers who were female, with lower education,unmarried,religious,from rural area and reported depression and anxiety.