Objective To observe the application effects of postoperative analgesia of ultrasound guided transverses abdominis plane (TAP) block in patients undergoing hysterectomy.Methods 50 patients with hysterectomy under general anesthesia were selected,and they were randomly divided into two groups according to the digital table,25 cases in each group.The patients of group A were injected with 0.45% ropivacaine mesylate 20mL in ultrasound guided bilateral TAP after the end of surgery before extubation,the patients of group B were injected with the same amount of normal saline in ultrasound guided bilateral TAP block.Postoperative patient-controlled intravenous analgesia with sufentanil was provided to all patients.The VAS score of the two groups after operation,the postoperative dosage of sufentanil in 24h and pressing times of analgesia pump,and the satisfaction of patients with postoperative analgesia,and adverse reactions were observed.Results The VAS scores of 2h of group A (0.96±0.74)points vs.group B (1.88±0.73)points (t=4.45);The VAS scores of 4h of group A (1.52±0.65)points vs.group B (2.24±0.72)points (t=3.69);The VAS scores of 8h of group A (1.88±0.44)points vs.group B (2.68±0.56)points (t=5.64);The VAS scores of 12h of group A (2.24±0.52)points vs.group B (2.96±0.54)points (t=4.80);The VAS scores of 24h of group A (2.44±0.51)points vs.group B (3.24±0.44)points (t=5.99);there were statistically significant differences(all P=0.00).The postoperative dosage of sufentanil in 24h[group A (51.60±1.02)μg vs.group B (55.46±1.37)μg,t=11.30,P=0.00],the pressing times of analgesia pump[group A (7.20±2.04)times vs.group B (14.92±2.74)times,t=11.30,P=0.00],the satisfaction of patients with postoperative analgesia[group A (9.20±0.71)points vs.group B (7.52±0.77)points],t=8.03,P=0.00].There were 2 cases of postoperative nausea and vomiting in group B,and 8 cases in group A,the difference was statistically significant(x2=4.50,P=0.03).Conclusion The application of postoperative analgesia of ultrasound guided TAP block in patients undergoing hysterectomy can reduce postoperative intravenous analgesic drug usage,reduce the incidence of adverse reactions induced by drugs,improve patients' comfort and satisfaction,it is suitable for clinical application.

The tissue engineering technology that developed in the 1980s brings a hope for the regeneration of human organs. It is feasible to construct by-pass vessels, which have no immune resistance but are capable of anticoagulation. At present, a huge number of researches have provided the necessary basis for the construction. However, there are still some difficulties on the points of induction and proliferation of endothelial cells, development of new materials for scaffold and co-culture of seed cells in scaffold. These difficulties have become the bottle neck of tissue engineered blood vessels. The tissue engineering vessels are nowadays absent in clinical practice. With the progress in researches of tissue engineering, it is strongly believed that human organs and tissues can be constructed using tissue engineering technology, thus satisfying the donors of organ transplantation.

Subacute and chronic cerebrovascular occlusion is an uncommon but an important cause for ischemic stroke.The main pathogenic mechanism is local hemodynamic disorder.Theoretically,the improvement of hemodynamic disorder can reduce the incidence of stroke as well as improve the prognosis.At present,there is still controversy over the optimal therapeutic plan.With the rapid development of interventional techniques,considerable progresses have been made in the endovascular treatment for subacute and chronic cerebrovascular occlusion,although some shortcomings still exist.This article aims to make a comprehensive review about the subacute and chronic cerebrovascular occlusion,focusing on its definition,damage,clinical status of its treatment,imaging evaluation,technical points of endovascular therapy,and procedure-related complications.

Objective:To observe and investigate the effects of real-time dynamic glucose monitoring, continuous subcutaneous insulin infusion combined with Carelink management software analysis on blood glucose control in newly diagnosed type 2 diabetic patients.Methods: 64 cases of patients with newly diagnosed with type 2 diabetes were selected from our hospital, and randomly divided into observation group and control group. The observation group were treated by real-time dynamic blood sugar monitoring and continuous subcutaneous insulin infusion joint Carelink management software analysis system, while the control group by continuous subcutaneous insulin infusion in combination with the real-time dynamic blood sugar monitoring. We compared serum C peptide, the rise of serum insulin levels and the decrease of blood glucose after ten days of treatment. At the same time, insulin resistance index (HOMA - IRI) and hypoglycemic events were compared between the two groups.Results: After treatment, the decrease range of blood glucose, postprandial blood glucose and HOMA-IRI in the observation group were significantly better than those in the control group (t=4.362,t=3.254,t=4.289; P<0.05). At the same time, the increase range of elevated fasting insulin, postprandial insulin, fasting C peptide and sugar after C peptide in the observation group were significantly better than those in the control group (t=3.712,t=4.115,t=3.831,t=3.889;P<0.05). The standard number of days of the blood glucose in the control group were significantly higher than those in the observation group (t=4.583,P<0.05).Conclusion: For patients with type 2 diabetes treated by real-time continuous glucose monitoring and continuous treatment of infusion combined with subcutaneous insulin Carelink management software can effectively reduce blood glucose, improve the insulin resistance of patients, reduce hypoglycemia and increased insulin sensitivity, meanwhile also can better protect the islet beta cell function.

ObjectiveTo study the diagnostic value of serum type IV collagen(IV-C) in hepatic fibrosis. MethodsSerum IV-C levels were detected by using radioimmunoassay(RIA) and were compared with serum type Ⅲ procollagen(PCⅢ ) levels in normal controls(NC) and patients with chronic liver diseases. ResultsSerum IV-C and PCⅢ levels in patients with chronic liver diseases were all much higher than those in NC(P < 0.01, totally). Serum IV-C level in severe chronic hepa titis(CH) group was significantly higher than those in mild and median CH groups (P<0.01 total ly), and that in active liver cirrhosis(LC) group was significantly higher than that in static LC group (P＜0.05). There were significant positive correlation between serum IV-C level and serum PcⅢ level both in CH group and in LC group ( in CH γ=0.7023, in LC γ=0. 5878, P＜0. 001).Conclusion Serum IV-C level could reflect the activity of hepatic fibrogenesis.

A total of 17 hip joint lesion patients (24 hips) combined with ankylosing spondylitis and severe osteoporosis from March 1996 to March 2003.They.received autologous impaction bone graft and cementless total hip replacement.They were 20-52 years old,averagely 35 years.Harris score and X-ray method were used to evaluate clinical outcomes.A total of 17 patients (24 hips) were followed up for 36-120 months,averagely 87 months.Harris score increased from averagely 34 points (preoperation) to averagely 86.4 points (postoperation),resulting in an excellent and good rate of 87.5%.Radiograph showed that femoral prosthesis was closely fixed to proximal segment of the femur,without prosthetic infection or dislocation.One hip suffered from 5-mm prosthetic subsidence within 1 year following replacement,and no further subsidence following over 5-year follow up.The prosthesis showed good contact to sclerotin,without loose.It is suggested that bone mass has great effects on cementtess prosthetic replacement.Autologous impaction bone graft for bone remodeling provides a good method for total hip replacement in patients combined with ankylosing spondylitis and severe osteoporosis.The clinical outcome is satisfactory.

To investigate the correlation between cerebral infarction and carotid atherosclerosis.Methods:Bilateral carotid atherosclerotic plaques,intima-media thickness (IMT),and stiffness coefficient (β) in 60 patients with cerebral infarction were detected by high-frequency color Doppler imaging,and they were compared with the control group (n=60).Results:The detection rate of plaque in the cerebral infarction group was significantly higher than that in the control group (90% vs 28%,P<0.005); the constituent ratio of soft plaques in the cerebral infarction group was significantly higher than that in the control group (P <0.01),and the constituent ratio of flat and hard plaques was significantly lower than that in the control group (P<0.005); IMT and β values in the cerebral infarction group were significantly higher than those in the control group (P<0.01).Furthermore,IMT had significant positive correlation with β values (P<0.01).Conclusions:Carotid atherosclerosis is closely correlated with cerebral infarction.

Subclavian artery occlusion is a common peripheral artery occlusion disease of various causes,with incidence of 1.9％.The most common symptoms are dizziness,ataxia,and hemiplegia that are caused by subclavian steal syndrome.Surgery is the only therapeutic method for symptomatic patients.Open surgery remains an important role despite of the rapid progress in endovascular surgery.Main surgical method includes carotid-subclavian transposition (CST),carotid-subclavian bypass (CSB) and axillary-axillary bypass.Each one is suitable for different lesions and anatomies.Both the effectiveness and safety have been testified.

Objective To discuss the effects of high-fluoride intake and iodine-deficiency on thyroid glands of pregnant mice and their offspring. Methods 200 mg/ L sodium fluoride solution was supplied ad.lib. for the adult female Kunming mice before pregnancy and during pregnancy with iodine-sufficiency and iodine-deficiency. The morphological changes and functions of thyroid glands and the body weights of the pregnant mice and their offspring were observed and measured. Results Under the condition of iodine-sufficiency, significantly higher levels of blood T4 in pregnant mice exposed to high-dose fluoride and their offspring were observed compared with those of control group. Significantly heavier body weights were found in 18 d-pregnant mice and 7 d-old offspring compared with those of control group (P

Objective To evaluate the value of color Doppler flow imaging(CDFI) in the diagonosis of placental site trophoblastic tumor(PSTT). Methods After being examined by transvaginal CDFI, four of six patients underwent curettage and two of them had hysterectomy and attached by chemical treatment. All the patients were verified to have a PSTT by pathology. Results The image of PSTT in CDFI included different size at different site, low resistence index (RI) of vessel around the lesion, and absence of vessel in the lesion. Conclusions The characteristic image in CDFI is helpful to the diagnosis of PSTT.