OBJECTIVE:To observe therapeutic efficacy and safety of Leonurus artemisia injection combined with carboprost tromethamine for preventing postpartum hemorrhage (PPH) of pregnant women after cesarean section. METHODS:177 pregnant women undergoing cesarean section were randomly divided into control group(87 cases)and observation group(90 cases). Preg-nant women of both groups received cesarean section. Control group was given intramuscular injection of oxytocin 20 U in uterine muscle wall above the incision after the foetus parturition,and given intravenous dripping of oxytocin 20 U added into 0.9% sodi-um chloride 250 mL;4 h after the operation,the pregnant women received intramuscular injection of oxytocin 10 U,every 12 hours,for 3 days. Observation group was given intramuscular injection of L. artemisia injection 2 mL and Carboprost tromethamine injection 1 mL in uterine incision after the foetus parturition;4 h after the operation,the pregnant women received intramuscular in-jection of L. artemisia injection 2 mL and Carboprost tromethamine injection 1 mL,and then give L. artemisia injectien 2 mL,ev-ery 12 hours,for 3 days. Clinical efficacies of 2 groups were observed as well as blood loss during operation,2 h after operation and 24 h after operation,the amount of hemoglobin(Hb)before operation and 24 h after operation,height of uterine fundus 3,7 d after operation,the occurrence of ADR. RESULTS:The total response rate of observation group was significantly higher than that of control group;blood loss during operation,2 h after operation and 24 h after operation,height of uterine fundus 3,7 d af-ter operation were also significantly than control group,with statistical significance(P<0.05). There was no statistical significance in Hb of pregnant women between 2 groups before operation(P>0.05). 24 h after operation,Hb of pregnant women in control group was significantly lower than before operation and observation group,with statistical significance(P<0.05);there was no sta-tistical significance in Hb of observation group between before operation and 24 h after operation(P>0.05). There was no statisti-cal significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:L. artemisia injection combined with car-boprost tromethamine shows significant therapeutic efficacy for PPH of pregnant women underwent cesarean section,can signifi-cantly reduce intraoperative and postoperative blood loss,accelerates the recovery of uterus without increasing the rate of ADR.

Objective:To investigate the clinical value of ankle-brachial index (ABI) in evaluating vascular cognitive dysfunction (VCI) in the elderly.Methods:According to the mini mental state examination (MMSE) and Montreal cognitive assessment (MoCA), 200 elderly inpatients from May 2016 to February 2018 in our hospital were selected. MoCA scale was used to evaluate the cognitive function of the patients. The patients were divided into cognitive dysfunction group ( n=110) and cognitive normal group ( n=90). The clinical data of the two groups were analyzed and compared. The correlation between ABI and MMSE, MOCA and clinical indicators was observed. The receiver operating characteristic (ROC) curve of ABI value to the predictive value of VCI in the elderly was drawn. Results:⑴ There was no significant difference between the two groups in terms of gender, the first fasting blood glucose value in hospital and the situation of diabetes, hypertension and hyperlipidemia ( P>0.05); there was significant difference in age, low-density lipoprotein cholesterol (LDL-C) level, history of small cerebral vessels and ABI between the two groups ( P<0.05). ⑵ Logistic regression analysis showed that ABI was the related factor of VCI in the elderly ( P<0.01). ⑶ Pearson correlation analysis showed that MMSE score was positively correlated with ABI ( r=0.887, P<0.01), MOCA score was positively correlated with ABI ( r=0.843, P<0.01). ⑷ The area under ROC curve of ABI prediction value for VCI in the elderly was (0.965±0.01) [95% CI (0.945, 0.985), P<0.01]. When ABI ≤0.9, the sensitivity and specificity were 88.2%, 91.1% respectively; the accuracy and the yordan index were 89.5% and 0.793. Conclusions:⑴ ABI is an influencing factor of VCI in the elderly and is positively correlated with the severity of cognitive impairment in patients. ⑵ ABI has a high predictive value for VCI of the elderly, and ABI≤0.9 can be used as an early warning factor for VCI of the elderly.