Objective To analyze the effect of different doses of sufentanil combined with ropivacaine in labor analgesia and its adverse events.Methods According to the digital table,90 vaginal delivery women were randomly divided into group A,groupB and group C,each group 30 cases,which all used epidural anesthesia.Group A chosen 0.5％ ropivacaine 20ml,and group B chosen 0.5％ ropivacaine tetracaine 20ml + sufentanil 5μg,and group C used 0.5％ ropivacaine 20ml + sufentanil 10μg.The visual analogue score(VAS),modified Bromage score,incidence of adverse reactions of pregnant women at different time points were compared.Results (1) At 10min,60min after medication and the cervix openning whole,the VAS scores of pregnant women in group B were significantly lower than those in group A(t =5.5089,5.9342,4.2642,all P ＜0.05),and at 10min,60min after medication,the cervix openning whole and at 1 h after medication,the VAS scores of pregnant women in group C were significantly lower than those in group A (t =13.9558,6.7654,5.2154,all P ＜ 0.05).Compared with group B,the VAS scores of pregnant women in group C at 10 min and 60 min after medication were significantly lower(t =7.4353,4.2165,3.6865,all P＜0.05).(2)The itching rate in group C (26.67％) was significantly higher than that in group B(3.33％) and group A (0) (χ2 =4.7059,7.0673,all P ＜ 0.05).Conclusion In epidural analgesia,5 μg sufentanil + 0.5 ％ ropivacaine 20ml analgesic has good effect and less adverse reactions,which can be used widely.

Objective To explore the atanalgesic effect of propofol combined with fentanyl in intravenous compound anesthesia for painless induced abortion.Methods 150 women which volurnteered to take painless induced abortion and which gestational age were 6 ～ 10 weeks were selected and randomly divided into the two groups for each 75 cases based on the method of number table.The control group were treated with propofol,while the observation group were treated with fentanyl on the basis of the control group.The mouth of the cervix relaxation expansion,blood loss and operative time was observed,and the clinical efficacy and adverse reactions of two groups were compared.Results The blood loss,operative time,mouth of the cervix relaxation expansion,total effective rate and adverse reactions in the observation group was (22.3-± 9.23) ml,(2.1 ± 0.6) h,97,33 ％,97.33 ％,1 4.67 ％,respectively,which were better than those of the control group[(36.7 ± 8.95) ml,(3.4 ± 0.8) h,69.33％,82.67％,38.67％] (t =7.365,8.163,χ2 =8.56,9.23,8.45,all P ＜0.05).Conclusion Propofol combined with fentanyl in intravenousanesthesia for painless induced abortion has an excellent analgesic effect,which is safe and easy to operate.So it is worthy of clinical application.

Objective To study the effect of remifentanil combined with propofol on sober and insulin resistance in patients after esophageal cancer radical surgery.Methods According to the digital table,63 patients with esophageal cancer were randomly divided into the control group (n =32 cases) and the observation group (n =31 cases).The control group were anesthetized through fentanyl plus propofol,while the observation group were anesthetized through remifentanil plus propofol.The level of consciousness and insulin resistance were analyzed.Results 5min after extubation,the OAAS scores of the observation group was (3.8 ± 1.6) points,which was better than that of the control group [(2.9 ± 1.3) points] (t =2.4540,P ＜ 0.05).Compared with preoperation,the insuhn resistance of the two groups were all increased after operation (all P ＜ 0.05).And the insulin resistance in the control group was higher than that in the observation group (P ＜ 0.0 5).Conclusion Remifentanil combined with propofol can improve the level of consciousness and decrease insulin resistance in patients after esophageal cancer radical surgery.

Objective To explore the value of combined determination of serum hepatic fibrosis index for evaluation on the degree of liver fibrosis in patients with chronic hepatitis B(HBV).Methods 275 patients with HBV were selected as chronic hepatitis group,which were divided into the mild chronic hepatitis group(75 cases),chronic moderate hepatitis group (72 cases),chronic severe hepatitis group (65 cases),liver cirrhosis group (63 cases) according to the severity of disease.In addition,50 healthy population were selected as the healthy control group.The four liver fibrosis indicators included serum hyaluronic acid(HA),laminin (LN),collagen type Ⅲ (PC Ⅲ),type IV collagen(IV-C) were determined by chemiluminescence immunoassay and compared among the groups,and the diagnostic results of combined different indicators were compared.Results The indexes of HA,PC Ⅲ,IV-C,LN were significantly higher than those of the healthy control group (t =2.567,2.687,2.811,2.741,all P ＜ 0.01).The hepatic fibrosis indexes were increased by with the severity and duration increased gradually (t =2.665,2.787,2.755,2.811,all P ＜ 0.01).The concentration-time curves area (AUC) of PC Ⅲ,Ⅳ-C,LN,HA were 0.680,0.825,0.716,0.826,respectively.Diagnosis value of three combination indicators in HA + PC Ⅲl + Ⅳ-C was highest.Conclusion The chemiluminescence dynamic detection of four liver fibrosis indicators is a good non-invasive detection method for guiding clinical diagnosis on the degree of liver fibrosis.

Objective To evaluate the efficacy of intravenous immunoglobulin (IVIG) in the treatment of severe EV71 infection in children.Methods The clinical data of children with severe EV71 infection,who admitted in our hospital from January 2010 to November 2012 were retrospectively analyzed.According to the time of admission and treatment principles,the patients were divided into the 2010 group and the 2012 group.The patients of the 2010 group routinely received IVIG treatment,but patients in the 2012 group received IVIG treatment in serious condition.The obvious effective rate,effective rate,ineffective rate,the incidence rate of critically ill and mortality of the two groups were compared.Results There were no significant differences in the obvious effective rate (86.0％ and 85.2％),effective rate (9.6％ and 11.8％),ineffective rate (4.4％ and 3.0％),the incidence rate of critically ill (4.0％ and 2.2％) between the two groups (x2 =0.011,1.269,1.657,3.304,all P ＞ 0.05).The mortality of the 2010 group (2.8％) was higher than that of the 2012 group (0.6％)(x2 =8.213,P ＜0.05).Conclusion IVIG has no effect on patients with severe EV71 infection,and is not recommended.

Objective To observe the effect of Tongsaimai Tablets on the leptomeningeal collateral circulation established after acute cerebral infarction by TCD.Methods 50 patients with acute cerebral infarction were randomly divided into control group (received conventional treatment) and treatment group (received Tongsainai Tablets three times a day,1.75g each time,on the basis of conventional treatment).The leptomeningeal collateral circulation of the two groups were observed after 6 months.Results The factors which may affect the leptomeningeal collateral circulation,such as age,the prevalence of hypertension and hyperlipidemia,original compensatory status of cerebral artery between the two groups had no statistically significant differences.The open rate of leptomeningeal collateral circulation in the treatment group was 64.00％,which was significantly higher than that of the control group(32.00％)(P =0.024).Conclusion Tongsaimai Tablets can promote the formation of leptomeningeal collateral circulation in patients with acute cerebral infarction.

Objective To investigate the effect of Orthodontic traction and porcelain in the treatment of anterior teeth subgingival quit.Methods 63 patients with anterior teeth subgingival quit were randomly assigned into observation group and control group,the control group were treated with conventional processing methods,the observation group were treated with orthodontic traction and porcelain repair nethod.the efficient and general treatment were compared.Results In the observation group,there were 12 cases cured,17 cases effective,2 cases ineffective,the total effective rate was 93.55％ (29/31) ; in the control group,there were 9 cases cured,14 cases effective,9 cases ineffctive,the total effective rate was 71.88％ (23/32).There were significantly difference between two groups (x2 =5.1323,P =0.0235).Tooth loose degrees,gingival condition and periodontal status and treatment of bone resorption rates of the observation group were 93.55％,93.55％,100.00％ and 96.77％,significantly higher than the control(71.88％,68.75％,71.88％,75.00％),the differences were statistically significant (all P ＜ 0.05).Crown retention between the two groups showed no significant difference between cases (P ＞ 0.05).Conclusion orthodontictraction has good effect in the treatment of former porcelain subgingival root pruning.

Objective To explore the clinical effect of dental implants surgery alveolar ridge bone deficiency treating with nano crystal collagen base bone and hydroxy soda lime.Methods To choose dental implants surgery patients who had dental implants surgery alveolar ridge bone deficiency treating with nano crystal collagen base bone and hydroxy soda lime as the research object,according to the admission they were randomly divided into nanometer crystal collagen base bone group and hydroxy soda lime group,and the clinical effect of the two metheds was comparatively analyzed.Results The cure rate of the bone-grafting group was obviously higher than the hydroxyapatite group(P ＜0.05).The average width alveolar ridge after bone incremental of hydroxyapatite group and bone-grafting group compared with preoperation were all increased significantly(P ＜0.01),but the two groups after treating comparison had no significant differences (P ＞ 0.05).Conclusion The clinical effect of dental implants art alveolar ridge bone mass insufficient treating with bone-grafting is satisfied,and the further research is worth clinical promotion.

Objective To discuss the etiological factor,clinical situation,diagnosis and therapy of early postoperative inflammatory small bowel obstruction.Methods The clinical data of fifty cases with early postoperative inflammatory small bowel obstruction were analyzed retrospectively.Results 44 cases were cured in a mean period of 10.3 days with non-operative therapy.Six cases received operation including 4 cases enterolysis and 2 cases section intestinal resection.Infection of incisional wound occurred in 2 case and long time diarrhoea and malnutrition occurred in 2 case.Conclusion Early postoperative inflammatory small bowel obstruction mainly occurs in about 1-2 weeks after operation and is related to extensive operation and insult.Early postoperative inflammatory small bowel obstruction has typical signs and symptoms of bowel obstrurtion.If conservative therapy isnt effective or strangulation of bowel occurs,operation should be adopted and operation style should be simple and effective.

Objective To study the diagnostic value of prenatal ultrasound in fetal cardiovascular malformations.Methods 4 152 cases of pregnant women received prenatal ultrasound were slected in the study.The accuracy of prenatal ultrasound diagnosis was confirmed by follow-up.Results In 4 152 cases of pregnant women,24 cases of fetal cardiovascular malformations were detected,incidence rate of 5.78 per thousand,the follow-up confirmed 19 cases,3 cases refused an autopsy,2 cases were lost.The diagnostic accuracy reached 79.17％.Conclusion Prenatal ultrasound for diagnosis fetal cardiovascular malformations has high diagnostic accuracy,which may achieve clinical early diagnosis and early intervention,help control birth defects.