Objective To explore the feasibility and safety of total vaginal hysterectomy(TVH)in the treatment of high-grade squamous intraepithelial cervical lesions(HSIL)in postmenopausal women without uterine prolapse.Methods A retrospective analysis was conducted on the data of 76 patients who underwent total hysterectomy in the Department of Gynecology,Jiaxing Maternity and Child Health Care Hospital from January 2019 to December 2022.The patients were divided into vaginal group(n=35)and laparoscopic group(n=41)according to the surgical approach.The baseline characteristics,intraoperative conditions,and postoperative recurrence of two groups were compared.Results There were no statistically significant differences in the baseline characteristics,postoperative white blood cells,and postoperative complications between two groups.The operation time of vaginal group was shorter than that of laparoscopic group,the intraoperative blood loss of vaginal group was less than that of laparoscopic group,and the postoperative body temperature of vaginal group was lower than that of laparoscopic group,and the differences were statistically significant(P＜0.05).The surgical cost of vaginal group was lower than that of laparoscopic group,and the difference was statistically significant(P＜0.05).Conclusion For postmenopausal patients with non prolapsed HSIL,both vaginal and laparoscopic TVH can achieve satisfactory efficacy and prognosis.The vaginal group has the advantages of low treatment cost,short surgical time,less intraoperative bleeding,and high satisfaction.

Objective To evaluate the efficacy and safety of continuous suture and base ball suture in transumbilical single-port laparoscopic myomectomy.Methods A total of 103 underwent transumbilical single-port laparoscopic myomectomy patients in Jiaxing Maternal and Child from October 2021 to October 2023 were selected as subjects.The observation group(n=51)adopted baseball suture and the control group(n=52)adopted continuous suture.Baseline characteristics,intraoperative performance,and postoperative recovery were compared between two groups.Results The operation time in observation group patients was shorter than that in control group,and postoperative body temperature in observation group patients was lower than that in control group.Exhaust time in observation group patients was shorter than that in control group,differences were statistically significant(P＜0.05).Conclusion Transumbilical single-port laparoscopic myomectomy baseball suture is safe and feasible,with shorter operation time,less postoperative fever and faster postoperative recovery.

Objective To explore the feasibility and safety of total vaginal hysterectomy(TVH)in the treatment of high-grade squamous intraepithelial cervical lesions(HSIL)in postmenopausal women without uterine prolapse.Methods A retrospective analysis was conducted on the data of 76 patients who underwent total hysterectomy in the Department of Gynecology,Jiaxing Maternity and Child Health Care Hospital from January 2019 to December 2022.The patients were divided into vaginal group(n=35)and laparoscopic group(n=41)according to the surgical approach.The baseline characteristics,intraoperative conditions,and postoperative recurrence of two groups were compared.Results There were no statistically significant differences in the baseline characteristics,postoperative white blood cells,and postoperative complications between two groups.The operation time of vaginal group was shorter than that of laparoscopic group,the intraoperative blood loss of vaginal group was less than that of laparoscopic group,and the postoperative body temperature of vaginal group was lower than that of laparoscopic group,and the differences were statistically significant(P＜0.05).The surgical cost of vaginal group was lower than that of laparoscopic group,and the difference was statistically significant(P＜0.05).Conclusion For postmenopausal patients with non prolapsed HSIL,both vaginal and laparoscopic TVH can achieve satisfactory efficacy and prognosis.The vaginal group has the advantages of low treatment cost,short surgical time,less intraoperative bleeding,and high satisfaction.

Objective To evaluate the efficacy and safety of continuous suture and base ball suture in transumbilical single-port laparoscopic myomectomy.Methods A total of 103 underwent transumbilical single-port laparoscopic myomectomy patients in Jiaxing Maternal and Child from October 2021 to October 2023 were selected as subjects.The observation group(n=51)adopted baseball suture and the control group(n=52)adopted continuous suture.Baseline characteristics,intraoperative performance,and postoperative recovery were compared between two groups.Results The operation time in observation group patients was shorter than that in control group,and postoperative body temperature in observation group patients was lower than that in control group.Exhaust time in observation group patients was shorter than that in control group,differences were statistically significant(P＜0.05).Conclusion Transumbilical single-port laparoscopic myomectomy baseball suture is safe and feasible,with shorter operation time,less postoperative fever and faster postoperative recovery.

Objective To explore the effect and mechanism of adenosine A2A receptor(A2AR)on lipopolysac-charide(LPS)-induced inflammatory injury of Caco-2 intestinal epithelial cells.Methods Caco-2 cells were di-vided into control group,LPS group(treated with 10 μg/ml LPS for 12 h),A2AR agonist(CGS21680)group(pretreated with 50 nmol/L CGS21680 for 10 min),CGS21680+LPS group(pretreated with 50 nmol/L CGS21680 for 10 min,treated with 10 μg/ml LPS for 12 h),cell viability was determined using CCK-8 assay,the secretion levels of tumor necrosis factor-α(TNF-α),interleukin-1 β(IL-1 β)and interleukin-6(IL-6)in cell su-pernatant of each group were determined using ELISA.mRNA expression levels of TNF-α,IL-1 β and IL-6 in cells of each group were detected by real-time fluorescence quantitative PCR,the protein expression levels of microtubule associated light chain protein 3(LC3)-Ⅱ/LC3-Ⅰ and autophagy associated protein(Beclin1)in cells of each group were analyzed using Western blot analysis.Caco-2 cells were then divided into control group,LPS group(pretreated with 50 nmol/L CGS21680 for 10 min),CGS21680+LPS group(pretreated with 50 nmol/L CGS21680 for 10 min,treated with 10 μg/ml LPS for 12 h),CGS21680+LPS+Rapa group(pretreated with 50 nmol/L CGS21680 for 10 min,treated with 10 μg/ml LPS and 5 μmol/L Rapa for 12 h),cell viability was deter-mined using CCK-8 assay,the secretion levels of TNF-α,IL-1 β and IL-6 in cell supernatant of each group were determined using ELISA.Results Compared with the control group,the viability of Caco-2 cells in LPS group sig-nificantly decreased(P＜0.05),the levels of TNF-α,IL-1 β and IL-6 in supernatant significantly increased(P＜0.05),the mRNA relative expressions of TNF-α,IL-1β,IL-6 in cells significantly increased(P＜0.05),the LC3-Ⅱ/LC3-Ⅰ ratio and the relative expression of Beclin1 protein were significantly up-regulated(P＜0.05).Compared with LPS group,the viability of Caco-2 cells in CGS21680+LPS group significantly increased(P＜0.05),the levels of TNF-α,IL-1 β and IL-6 in supernatant significantly decreased(P＜0.05),the mRNA rela-tive expression levels of TNF-α,IL-1β,IL-6 in cells were significantly down-regulated(P＜0.05),and the ratio of LC3-Ⅱ/LC3-Ⅰ and the relative expression of Beclin1 protein were significantly down-regulated(P＜0.05).In addition,compared with CGS21680+LPS group,the viability of Caco-2 cells in CGS21680+LPS+Rapa group significantly decreased(P＜0.05),and the levels of TNF-α,IL-1 β and IL-6 in the supernatant also significantly increased(P＜0.05).Conclusion A2 AR agonist can reduce the inflammatory injury of Caco-2 intestinal epithe-lial cells induced by LPS and improve cell viability,which may be related to its inhibition of autophagy.

AMP-activated protein kinase(AMPK)is a conserved energy sensor that plays roles in diverse biological processes via phosphorylating various substrates.Emerging studies have demon-strated the regulatory roles of AMPK in DNA repair,but the underlying mechanisms remain to be fully understood.Herein,using mass spectrometry-based proteomic technologies,we systematically investigate the regulatory network of AMPK in DNA damage response(DDR).Our system-wide phosphoproteome study uncovers a variety of newly-identified potential substrates involved in diverse biological processes,whereas our system-wide histone modification analysis reveals a link between AMPK and histone acetylation.Together with these findings,we discover that AMPK pro-motes apoptosis by phosphorylating apoptosis-stimulating of p53 protein 2(ASPP2)in an irradia-tion(IR)-dependent manner and regulates histone acetylation by phosphorylating histone deacetylase 9(HDAC9)in an IR-independent manner.Besides,we reveal that disrupting the his-tone acetylation by the bromodomain BRD4 inhibitor JQ-1 enhances the sensitivity of AMPK-deficient cells to IR.Therefore,our study has provided a resource to investigate the interplay between phosphorylation and histone acetylation underlying the regulatory network of AMPK,which could be beneficial to understand the exact role of AMPK in DDR.

Objective: To investigate the application value of real-time virtual sonography(RVS)in the diagnosis and treatment of complicated hepatolithiasis. Methods: The retrospective and descriptive study was conducted. The clinical data of 10 patients with complicated hepatolithiasis who were admitted to Hunan Provincial People′s Hospital between October 2017 and March 2018 were collected. There were 3 males and 7 females, aged from 40 to 69 years, with an average age of 57 years. Patients received abdominal color Doppler ultrasound examination, magnetic resonance cholangiopancreatography, and upper abdominal spiral computed tomography (CT) thinly scanning + enhanced examination. Data of CT examination were imported into RVS. RVS was used to locate hepatolithiasis, relationship between stones and vessels, anatomy of bile ducts and vessels in hepatic hilus. Surgical methods included RVS-guided hilar cholangiotomy, biliary stricturoplasty, bilateral hepatojejunostomy, hepatic segmentectomy (lobectomy), and hepatolithotomy. Observation indicators: (1) surgical and postoperative situations; (2) typical case analysis; (3) follow-up. Follow-up using outpatient examination was performed to detect residual stones up to June 2019. Measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers. Results: (1) Surgical and postoperative situations: 10 patients underwent RVS-guided surgeries successfully for complicated hepatolithiasis, with successful match in RVS (difference between CT images and ultrosound images <2 mm). No residual stone was identified by choledochoscope during operation. The operation time and volume of intraoperative blood loss were 285 minutes (range, 210-360 minutes) and 200 mL (range, 100-600 mL), respectively. No blood transfusion was needed during the operations. The duration of hospital stay was 20.5 days (range, 14.0-29.0 days). There was no perioperative death. One patient had postoperative biliary leakage and abdominal infection, and was cured after conservative treatment. (2) Typical case analysis: the tenth patient, female, 60 years old, was diagnosed with complicated hepatolithiasis, and was prepared to undergo hepatolithotomy+ quadrate lobectomy and hilar cholangioplasty+ bilateral hepatojejunostomy. Preoperative CT images and intraoperative color Doppler ultrasound images of the patient were fused and matched on the sagittal section of the portal vein and the cross section of the right branch of portal vein, and stones and important vessels were marked on the images. After accurate positioning, a curette was used to remove the stones. Removal of biliary stones through hepatic parenchyma and peripheral dilated bile ducts was conducted at the site where stones obviously existed. After the stones were removed, the intrahepatic bile duct and hilar bile duct merged. The left end of the bile duct split was confirmed by real-time ultrasound. After location of portal vein was determined by ultrasound, vascular plastic surgery was perfomed to avoid stenosis. (3) Follow-up: 10 patients were followed up for 6-12 months, with a median follow-up time of 8 months. One of 10 patients was suspected residual stones at the right peripheral hepatic anterior lobe by postoperative angiography at 2 months after surgery, and was not removed stones by choledochoscope. The patient had no recurrent symptoms after T-tube removal. The other 9 patients had no residual stones. Conclusion RVS applied in complicated hepatolithiasis is helpful for the precise intraoperative diagnosis, and the surgical treatment can be safe and effective.

Objective:To investigate the influence of cognitive-behavior therapy on the psychological status of family members of terminal cancer patients. Method:A total of 60 families of terminal cancer patients were selected and randomly divided into observation group (30 cases) and control group (30 cases). The observation group was treated with cognitive-behavior therapy, while the control group was given general supportive psychological care. The Hamilton Depression Scale ( HAMD) , Hamilton Anxiety Scale ( HAMA) and Pittsburgh Sleep Quality Index ( PSQL) were used to evaluate the family members of the two groups of patients before and after the intervention. Results: Before the intervention, there was no statistical significance difference in the scores of HAMA, HAMD and PSQI between the two groups (P>0. 05). After the intervention, the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those before the intervention ( P <0 . 05 ); and the scores of HAMA, HAMD and PSQI in the observation group were significantly lower than those in the control group ( P<0 . 05 ) . Conclusion:Cognitive-behavior therapy can significantly improve the negative emotions of depression, anxiety and sleep disorder among family members of terminal tumor patients.

Objective To establish an animal model of SM by equal toxicity dose(1LD50)-induced acute pulmonary injury in rats and compare the differences of inflammatory factor and protein expression. Methods Rats were randomly divided into five groups. ELISA and immunohistochemical methods were measured. Results Serum INF-γ and IL-23 levels in the intraperitoneal SM group were increased compared with the tracheal SM group;there were also significant differences in serum IL-4 levels between the two groups. In the alveolar septum , the positive expression ratios of NF-Kβ1,NF-Kβp65,ERK,JNK,and p38MAPK in the intraperitoneal SM group were increased compared with the tracheal SM group. Conclusion Using SM (1LD50),There are significantly higher serum inflammatory factor levels and protein-related expression in the alveolar septum of rats intraperitoneally injected with SM compared with those administered SM by intratracheal instillation. The results suggest that pulmonary inflammatory reactions associated with SM are dependent on the route of exposure.

The beginning of TCM acupuncture in New Zealand dates back to the middle of 19th century. After self-improvement for more than 100 years, TCM acupuncture has gained a considerable development. From the perspective of history and current situation, the development of acupuncture in New Zealand was elaborated in this article; in addition, the sustainable development of acupuncture was discussed from the perspective of education and training. In New Zealand, the TCM acupuncture and dry needling have played a dominant role in acupuncture treatments, which are practiced by TCM practitioners and physical therapists. The TCM acupuncture is widely applied in department of internal medicine, surgery, gynecology, and pediatrics, etc., while the dry needling is li-mited for traumatology and pain disorder. Therefore, including TCM acupuncture into the public medical and educational system in New Zealand should be an essential policy of Ministry of Health to provide welfare for the people.