Objective:To study the effects of transverse abdominis plane block (TAPB) combined with dexmedetomidine on the recovery quality after general anesthesia in cesarean section.Methods:From June 2019 to October 2020, 120 cases of cesarean section in Changsha Maternal and Child Health Hospital were randomly divided into dexmedetomidine group (Group D), transversus abdominis plane block group (group T), transversus abdominis plane block combined with dexmedetomidine (Group TD) and control group (Group C). Before anesthesia induction, local infiltration of 1% lidocaine was performed at the incision of all parturients. Propofol and rocuronium were used for induction under general anesthesia. After delivery of fetus, sufentanil and midazolam were injected intravenously, and propofol was pumped to maintain anesthesia. At the same time, dexmedetomidine was pumped into group D and TD, and normal saline was pumped into group T and C. After the posterior sheath of rectus abdominis was sutured in T group and TD group, two epidural anesthesia catheters were placed to the fascia of transverse abdominis on both sides, and 10 ml of 0.33% ropivacaine was injected respectively. The parturients were sent to postanesthesia care unit (PACU) after the operation. The time from the end of operation to the extubation of tracheal tube, heart rate (HR) and mean arterial pressure (MAP) before operation (T 1), after induction (T 2), after operation (T 3), at the time of extubation (T 4), 10 minutes after extubation (T 5) and at the time of leaving PACU (T 6) were recorded. Steward's wake-up score at T 4, T 5 and T 6, agitation during extubation (Sedation Agitation Scale, SAS score), PACU stay time and pain visual analogue scale (VAS) were recorded. Results:There was no difference in HR and MAP between the four groups at T 1, T 2, and T 3 ( P>0.05), while HR and MAP in group C at T 4, T 5 and T 6 were higher than those in the other three groups ( P<0.05). There was no significant difference in Steward′s wake-up score among the four groups ( P>0.05). The SAS score [(4.0±0.4)point], the time from the end of operation to extubation [(10.1±1.5)min] and stay time of PACU [(21±4.2)min] were the lowest in group TD than those in the other three groups ( P<0.05); the VAS score in group TD [(0.5±0.5)point] and group T [(1.1±0.4)point] were lower than that in group D [(4.1±0.3)point] and group C [(5.3±0.5)point] ( P<0.05). Conclusions:The application of general anesthesia combined with TAPB and dexmedetomidine in cesarean section may improve the quality of anesthesia recovery.

It has been preliminarily demonstrated that CIAPIN1 plays an essential role in normal tissue and is closely related to tumor formatin and development, prognosis and multiple drug resistance. CIAPIN1-based target therapy may provide a novel thinkingpathway in cancer treatment.

This article classified and compared the latest researches on the objectification of pulse diagnosis based on its theory and purpose. It introduced the significance of objectification of pulse diagnosis, which also revealed the reason that hindered its development and applications in practice. The paper has an overview of its current status and some personal reflection on this issue.

Respirator is one of medical equipment in the first-aid, the clinical risk of it is much higher than the general medical equipment and diagnostic or patient monitor equipment. As a result, the quality control of it is particularly important. Several issues of the quality control of the respirator, such as the pre -purchase technical feasibility study, acceptance and installation after arrival, respirator use and management, respirator-reported loss demonstration and cost- benefit analysis of it are discussed from the angle of clinical engineers and technical personnel.

OBJECTIVE:To investigate the status quo and tendency of the utilization of drug for bony metastasis cancer in our hospital. METHODS:The utilization of drug for bony metastasis cancer in our hospital from 2006 to 2009 was analyzed statistically. RESULTS:The total amount of the drug for bony metastasis cancer had been increasing. Pamidronate took up the first place of the consumption sum list and accounted for 80% of total consumption sum. Top one drug in the list of DDDs was domestical pamidronate. Utilization rate of disodium clodronate increased form 0.67% in 2006 to 31.68% in 2009. The order of DDC had not changed during 2006～2009. CONCLUSION:In recent year the drug for bony metastasis cancer has been rational and has become curative effect-oriented rather than price-oriented.

Objective To evaluate the value of ultrasonic elastography for diagnosis of chronic nonspecific low back pain. Methods From March to September, 2016, 32 patients diagnosed as chronic nonspecific low back pain and other 32 healthy people (controls) were measured lumbar erector spinae with ultrasonic elastography, and calculated Yang's modulus. The correlation between Yang's modulus and Visual Analogue Scale (VAS) or Japanese Orthopaedic Association (JOA) score in the patients were investigated with Pearson's analysis. Re-sults There was no significant difference in Yang's modulus between bilateral lumbar erector spinae in both the patients and the controls (t<1.849, P>0.05), but it was more in the patients than in the controls (t=9.931, P<0.001). The Yang's modulus was positively correlated with VAS score in the patients (r=0.614, P<0.001), but not with the JOA score (r=-0.243, P=0.180). Conclusion Ultrasonic elastography can be applied to differentiate low back pain from the healthy, and measure the intensity of pain.

Objective To discuss the influence of nursing intervention on psychological state and glu-cose control of patients with diabetes mellitns before and after intensive treatment of insulin pump. Methods 120 patients who were going to receive intensive treatment of insulin pump were divided into the control group and the observation group with 60 patients in each group by simple random method.The two groups both re-ceivecl routine nursing. The observation group was given psychological intervention along with health education by application of progressive dominant content education method. The psychological state and glucose control of the two groups were compared by χ2 test and t test. Results The score of health knowledge and satisfaction degree with health education in the observation group were higher than those of the control group.The score of anxiety and depression in the observation group decreased more significantly and satisfaction rate of glucose control was higher than that of the control group after 14 days of insulin pump treatment. Conclusions Health education to patients with intensive treatment of insulin pump by application of progressive dominant content education method can make patients to master health knowledge easily.Psychological intervention can alleviate the negative emotion of these patients and facilitate better effect of insulin pump treatment.

Objective To investigate the feasibility, indications, operating technique and the clinical value of laparoscopeic surgery for ectopic pregnancy with prior history of obstetric and gynecologic operations. Methods 82 ectopic pregnancy patients with prior history of the obstetric and gynecologic operation were subjected to laparoscopic surgery. Among them, 60 patients had undergone prior obstetric and gynecologic operation only once, 21 patients had undergone twice, and the remaining one had undergone obstetric and gynecologic operation three times. The laparoscopic operation was completed in different ways as follows: puncture and injection of drug under laparoscopy, salpingectomy, resection of pregnancy in oviduct, removal of embryo through incision of oviduct under laparoscope, suction removal of embryo from oviduct, and new technique for pregnant surgery at interstitial portion. Results Of these 82 patients undergoing laparoscopic surgery, 73 cases had adhesion in different degree, and the adhesion rate was 89.0% (73/82). In the 60 patients with history of one operation, pelvic peritoneal adhesion was found in 51 patients, the adhesion rate was 85.0%. All 22 patients with two prior operations had pelvic peritoneal adhesion, and the rate was 100.0%. The laparoscopic surgery was successful in 70 cases. The rate of success was 85.4%, while in 12 patients, the operation was changed into laparectomy due to dense adhesion, and the rate was 14.6%. Of these 12 patients, in 5 of them there was endometriosis, in 6 patients chronic pelvic inflammation was found, 9 patients had a surgical history for ectopic pregnancy, 2 patients with the history of caesarean section, and one patient had a history of complicated gynecologic operation. Complications included colonic injury in one patient with ectopic pregnancy, and the operation was changed to laparotomy. Injury to the ureter happened in one patient. The operation time for laparoscopic surgery was 30-180 min. Conclusions The laparoscopic operation is an effective procedure and it has become a routine procedure for ectopic pregnancy with prior history of obstetric and gynecologic operation. Because of chronic pelvic inflammation and endometriosis, it is difficult to perform laparoscopic surgery successfully, and laparotomy should be anticipated at all time.

A PCR assay used for detection and quantification of Neotyphodium lolii in tissues of the grass Lolium perenne L. was developed. Compared with the Microscopic analysis of stained tissues, this method was more accurate. For quantitative applications, real time PCR was used to quantify Neotyphodium lolii in Lolium perenne L.. The results showed that there were some variations between different individuals, but no variance existed between different tillers from the same plant. Thus it can be concluded that fungal content in the plant is not only associated with species/variety specific, but also with the genotype of the host plant as well.

1.0 ?10 7 copies/ml than those with lower HBV DNA levels both in combination group and lamivudine group (52.0% vs 25.8%, P= 0.04; 63.2% vs 28.6%, P= 0.03). Necro-inflammatory activity, fibrosis and the expression of HBV DNA showed no correlation with response rate in combination group. Among those who had higher levels of HBV DNA expression, seroconversion rate in combination group is higher than that in lamivudine group (46.2% vs 9.5%, P= 0.03). Conclusions The efficacy of combination therapy appeared to be better in patients with at least moderately elevated baseline ALT, high level of HBV DNA as well as HBV DNA expression in hepatocytes. Combination therapy may delay or diminish the development of YMDD mutation-related resistance to lamivudine.