Objective To investigate the causes of failure of manually rotating fetal head technology and its delivery outcomes.Methods One hundred and Ninety-eight cases with persistent occipito transverse position or persistent occipitoposterior position admitted to our hospital form January 2008 to December 2010 were enrolled as our subjects.According to the result of manually rotating fetal head technology,these patients were divided into the success group (126 cases) and the failure group (72 cases).The information related to delivery was recorded.Results The proportion of fetal weight ≥ 3500 g in the failure group was 76.4％ (55/72),higher than that of the success group(31.7％ (40/126)),and there has statistic significant difference (x2 =30.177,P =0.001).The proportion of uterine inertia in the failure group(58.3％ (42/72)) was higher than that of the success group(38.1％ (48/126)),and there has statistic significant difference (x2 =7.569,P =0.006).The proportion of critical or low-grade narrow birth canal in the failure group(38.9％ (28/72)) was significantly higher than that of the success group (23.8％ (30/126)),and there has statistic significant difference (x2 =5.030,P =0.002).The proportion of the improper time for manually rotating fetal head (opening of cervix was less than 6 cm,and fetal head was above ischial spine and opening of cervix was 8-10 cm,fetal head reach to more than 2 cm lower of ischial spine) in the failure group was 61.1％ (44/72),which was significantly higher than that of the success group (38.9 ％ (49/126)),and there has statistic significant difference (x2 =9.084,P =0.003).The proportion of maternal and neonatal complications (postpartum hemorrhage,puerperal morbidity,fetal distress,neonatal asphyxia) in the failure group were significantly higher than those of the success group (x2 =9.586,P =0.002 ; x2 =9.334,P =0.002 ; x2 =5.910,P =0.015 ; x2 =5.240,P =0.022).The proportion of cesarean section in the failure group(72.2％ (52/72)) was significantly higher than that of the success group(34.1％ (43/126)),and there has statistic significant difference(x2 =26.641,P =0.001).Conclusion The manually rotating fetal head technology can transform from dystocia to normal delivery and decrease the rate of cesarean section.It is necessary to prevent and deal with the failure causes of manually rotating fetal head technology.And it must be cautious to perform the follow-up correction and trial production after the failure of previous correction.

ObjectiveTo explore the influence of cognitive behavioral intervention on hospitalized patients with schizophrenia.Methods100 hospitalized schizophrenia patients were randomly divided into experimental group and the control group.Routine treatment given to the patients in the control group and cognitive behavioral intervention was applied to the patients at the same time based on routine treatment in experimental group.The patients were assessed with the mini-mental state examination( MMSE),activities of daily living(ADL) and WHO battery of cognitive assessment instrument(WHO-BCAI) pre-and post-cognitive behavioral intervention.ResultsThe expenrentcl geoup and ntrol group before and after the intervention the average MMSE score was(21.8 ± 3.9),(24.4 ± 4.7 ),(21.5 ±3.4),(22.9 ±3.8) ;ADL score an average of(28.8 ±7.9),(25.1 ±4.5),(27.9 ±7.1),(25.2 ±4.8) (t =6.89,11.13,all P ＜ 0.05 ) ; cognitive function in the auditory vocabulary learning,language skills,visual identification,the connection test and cancellation tests were different ( P ＜ 0.05 or P ＜ 0.01 ).ConclusionCognitive behavioral intervention had positive influence on cognitive function in hospitalized patients with schizophrenia.

The blood brain barrier(BBB) is a barrier system between the blood and brain tissue,which can maintain relatively stable of internal environment in the central nervous system (CNS).Cerebral hypoxiaischemia and other conditions can lead to the change of the permeability of BBB.This paper reviews the latest research for the structural basis and function of BBB,and for the scope,time and mechanism of the change of BBB structure and function during hypoxic-ischemic brain injury.This theory in the regulation of BBB may play an important role in the treatment of hypoxic-ischemic brain injury and underlying diseases of CNS.

With the ventilator associated lung injury (VALI) atracting more and more attention,lung protective ventilation strategy (LPVS) has gradually been applied to clinical practice.Obese patients are at higher risk in VALI for laparoscopic surgery,mechanical ventilation induced atelectasis is an important reason for low oxygen in intraoperative and postoperativen procedure.In laparoscopic surgery,high abdominal pressure causes the elevation of diaphragm,and increases airway pressure.The excessive pressure increases the amount of alveolar dead space and airway pressure,reduces lung compliance,and increases the possibility of barotrauma and colotrauma.In addition,carbon dioxide pnenmoperitoneum indces hypercapnia.Both of them influence the recovery of postoperative lung function.To optimize intraoperative management and improve the prognosis of patients with general anesthesia,the application of LPVS attracts more attention,including small tidal volume,positive end-expiratory pressure,and recruitment maneuvers,etc.However,LVPS may also cause lung injury.This article is a review on the application of LPVS in laparoscopic surgery of obese patients.

Objective:To investigate the inhibitory effect of 4'-methylether-scutellarein(4-MS),an extract from Verbena officinalis,on human choriocarcinoma JAR cell line and the possible mechanism.Methods:JAR cells were exposed to 4'-methylether-scutellarein of different concentrations for 48 h.MTT assay was used to examine the anti-proliferative effect of 4'-methylether-scutellarein.Flow cytometry was used to investigate the apoptosis and the changes of cell cycle.AO/EB double staining was applied to discriminate the apoptotic cells from dead ones.The changes of Survivin,p38-MAPK and Caspase 3 mRNA expressions were detected by RT-PCR in JAR cells treated with 4-MS.Furthermore,Western blotting assay was used to determine Survivin protein expression,phosphorylation level of p38 and Caspase 3 in JAR cells before and after 4-MS treatment.Results:4-MS inhibited the proliferation of JAR cells in a dose- and time-dependent manner(P

Objective To study the adverse effect of omethoate on DNA in mouse sperm cells in vivo. Single cell gel electrophoresiss (SCGE) or comet assay was used to observe the damage of DNA. Methods 40 male kunming mice were randomly divided into 4 groups and were treated with omethoate by gavage at 0 mg/kg, 0.5 mg/kg, 1 mg/kg and 2 mg/kg respectively, once a day for 35 consecutive days. Results The movement and density of sperms decreased as the dose of omethoate increased, the length of comet tails in group of 1 mg/kg and group of 2 mg/kg was much longer than that in the control, the other indexes of comet assay also showed significant DNA damage. Conclusion Omethoate exposure can induce DNA damage in the sperm cells of male mice.

Purpose:To study LPS induced iNOS mRNA expression and NO production by murine peritoneal macrophages, and their relationship with cytotoxic function of activated macrophages.Methods:LPS induced iNOS mRNA expression, production of NO and effects of activated macrophages on anti tumor were investigated separately by RT PCR, nitrate reductase method and 3HTdR incorporation.Results:LPS can upregulates iNOS mRNA expression in a dose dependent manner. L NIL(specific inhibitors of iNOS) pretreatment significantly reduced cytotoxic effect on the proliferation of HL 60 cells, but had little effect on the K562 tumor target cells on condition that NO production is sufficiently inhibited. Conclusions:LPS can effectively induce iNOS mRNA expression and NO production in murine peritoneal macrophages. NO is one of the important effector molecules in unspecific immunity of activated macrophages, but it plays different roles in cytotoxic effects of macrophages on different target tumor cells.

OBJECTIVE:To study the clinical pharmacokinetics of Midazolam.METHODS:Fourteen patients undergoing general anesthesia with Midazolam in combination with remifentanil and isoflurane were enrolled in our study.The midazolam was administered by constant-rate infusion of 20 ?g?kg-1?min-1 for 20 min.The sampling of radial artery blood samples(3 mL/sample)were schedule before the infusion and at 1,3,5,7,10,15 and 20 min after the initiation of infusion and at 5,15,30,45 min and 1,2,4,6,12,18,24 h following the completion of midazolam.The plasma midazolam concentrations were determined by RP-HPLC.The pharmacokinetic analysis was performed using DAS2.1.1 program.RESULTS:The concentration-time curves of midazolam were best described by a simple three-compartment open model in which the weight coefficient was 1 and the typical pharmacokinetics parameters of midazolam were as follows:t1/2?=9.584 2 min,t1/2?=85.367 7 min,t1/2?=339.736 5 min,V1(the distribution volume of central compartment)=0.182 1 L?kg-1,CL=119.434 4 mL?h-1?kg-1,K10=0.045 8 min-1,K12=0.086 3 min-1,K21=0.017 5 min-1,K13=0.013 3 min-1,K31=0.002 4 min-1.CONCLUSION:t1/2?,t1/2?,t1/2? and CL were in line with those reported in the literature abroad,but V1 is on the lower side and it is easy for the medication to reach a balance.However,the rapid clearance of midazolam is more in line with the pharmacokinetic parameters of the Chinese subjects.

Objective To investigate the feasibility and superiority of enteral-intestinal nutrition after opera- tion of replacement of esophagus with stomach.Methods 62 elderly patients with cancer of esophageal were radom- ly divided into early enteral-intestinal nutrition(EEN) group and total parenteral nutrition(TPN) group,the average cost of hospitalization,recovery situation,postoperative bodyweight,liver function,nutritional status were compared between the two groups.Results The average cost in the early enteral-intestinal nutrition group was less than that in the parenteral nutrition group,the bodyweight in two group were declined and the level of lactate dehydrogenase (LDH) were increased after operation,the level of transferring ferroprotein was lower in TPN group after operation than that in the EEN group(P

Objective To construct pEGFP-N1-TGF-β1 recombinant plasmid and transfect it into primary cultured neonatal piglet type Ⅱ alveolar epithelium cell (AEC-Ⅱ) by using lipofectamine 2000,in order to provide basis of methodology for producing recombinant plasmids for transplantation of transfected AEC-Ⅱ into ALI/ARDS animal model lungs.Methods PCR primers were designed to amplify the human TGF-β1 cDNA fragment from plasmid.XhoI and EcoRI were used for double digesting the empty plasmid pEGFP-N1 and cDNA fragment of human TGF-β1.Then the products of double enzyme digestion by using T4 DNA ligase were connected and transformed into DH5α and cultured over night for 16 hours.The structure of recombinant plasmid was identified by using PCR and base sequencing to verify the correctness of pEGFP-N1-TGF-β1 recombinant plasmid.It was then transfected into primarily cultured AEC-Ⅱ by lipofectamine2000 mediated transfection and cultured for another 48 hour.Plasmid DNA (pEGFP-N1-TGF-β1 recombinant plasmid) and lipofectamine 2000 were added into serum-free DMEM respectively,then DNA suspension and Lipofectamine 2000 suspension were blended together and added into cells.After 24-48 hours later,the expression level of enhanced green fluorescent protein (EGFP) was evaluated under fluorescence microscope.Results The structure of vector was verified as pEGFP-N1-TGF-β1 recombinant plasmid by using PCR and base sequencing.Green fluorescence found in some cells showed that the pEGFP-N1-TGF-β1 recombinant plasmids had been successfully transfected into primary cultured AEC-Ⅱ,however,the transfection efficiency still need tobe further improved such as repeating the transfection procedure once again or using adenovirus mediated transfection method to improve the efficiceny and to transplant the cells into animal lungs eventually.Conclusions pEGFP-N1-TGF-β1 recombinant plasmid was successfully constructed and,for the first time,transfected into primarily cultured AEC-Ⅱ of newborn piglets.This established method should be useful for investigation of therapeutic effect and outcomes of lung with experimental acute lung injury.