Objective To explore the impact of throughout patient-controlled epidural analgesia(PCEA) on labor progress and delivery mode. Methods We enrolled 120 nulliparous women with term cephalic singleton preg-nancies. They were divided into two groups ,throughout analgesia group(n=60):when they are in labor,we started an-algesia and continued to the end of second stage of labor. While 60 nulliparous were selected to non-analgesia group as the control group. Data were collected about duration of the first, second stage of labor, oxytocin dosage, postpartum hemorrhage,outcome of delivery, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis and the effect of epidural analgesia, etc. Results There wsa is significant difference in the duration of the first stage delivery, the utilization rates of oxytocin, delivery mode (P<0.05) ;and there was no remarkable differences in the second stage of labor process, postpartum hemorrhage, neonatal Apgar scores, umbilical cord vein and artery blood gas analysis (P>0.05) Conclusion The throughout patient-controlled epidural analgesia can shorten labor progress, cut down uterine-incision delivery and reach satisfying analgesis effect, without commidng any impact on the outcome of delivery.

Objective To investigate the clinical effect of combined treatment of children with hand foot and mouth disease Yanhuning combined with interferon, psychological intervention. Methods 80 children with HFMD in our hospital from January 2015 to March 2017 were selected,and according to the different treatment and nursing intervention divided into observation group and control group,40 cases in each groups. control group with routine nursing intervention in the observation group, interferon, interferon ,psychological nursing intervention mode of Yanhuning; the two groups of children with mental state improvement of clinical symptom, clinical resolution the treatment time and total efficiency, and the relevant data for comparative analysis. Results The psychological nursing mode of interferon Yanhuning (observation group) the clinical effect is better than that of interferon plus routine nursing intervention in children with hand foot and mouth disease (control group) the clinical effect of intervention, the psychological state of patients better than the control group, the clinical symptoms disappeared time was shorter than the control group, the total efficiency of treatment was higher than the control group, there was statistical significance the difference (P<0.05). Conclusion Children with HFMD selection effect of interferon psychological nursing intervention model of Yanhuning significantly, can effectively improve the clinical symptoms in children with mental state, fades in a short time, it is worthy of widely used intervention in children with hfmd.

Objective To evaluate operative methods and the clinical effect of closed reduction and percuta-neous locking compression titanium plate internal fixation in treatment of distal tibial fractures.Methods The clinical data of 21 patients with fracture who received closed reduction technology through the subcutaneous tunnel of fracture end,minimally invasive percutaneous treatment of tibial locking titanium plate fixation were retrospectively analyzed. Results All 21 patients were followed up from 6 to 18 months(11 months in average).All patients recovered with good healing of fracture.According to criteria of Johner -Wruhs score,the results were excellent in 12 cases,good in 6 cases,fair in 3 cases,and poor in 0 case.The excellent and good rate was 85.71%.Conclusion The method of closed reduction and percutaneous locking compression titanium plate internal fixation in treatment of distal tibial frac-tures can protect skin soft tissue,reduce the damage to the blood -supply of the fracture,promote the healing of the fracture and reduce complications.

Objective To evaluate the efficacy and toxicity of the protocol of FOLFOX4 for advanced colorectal cancer. Methods 27 patients received FOLFOX4oxaliplatin 85 mg/m2 as a 2-hour infusion on day 1 and a 2-hour infusion of LV (200 mg?m-2?d-1) followed by a 5-Fu bolus (400 mg?m-2?d-1) and 22-hour infusion (600 mg?m-2?d-1) for 2 consecutive days every 2 weeks. Four courses were carried out with an interval of one month. Results The total effective rate was 44.44 %, CR(3.70 %), PR(40.74 %). Median survival of all patients was 10.0 months. Mean Survival was 11.5 months. One year survival rate was 30.02 %. Median duration of 12 effective patients were 5.3 months. Median survival of effective patients and non-effective was 11.8 and 8.5 months respectively(P

Objective To study the effect of stromal cell-derived factor-1(SDF-1)/CXCR4 on the proliferation of CD34+ hematopoietic stem/progenitor cells(HSPCs) supported by bone marrow mesenchymal stem cells(MSCs).Methods Rat bone marrow MSCs were plated as feeder layer in long-term cultures(LTC) with bone marrow CD34+ cells in vitro.Cultures were weekly supplemented with SDF-1,anti-SDF-1 antibody,or anti-CXCR4 antibody separately for 5 weeks.The hematopoietic-supporting activity was evaluated by the number of CD34+ cells and colony forming cell(CFC).To assess the effect of SDF-1/CXCR4 on CD34+ cell proliferation cycle,killing assays were carried out and proliferation indexes were calculated.Expression of SDF-1 and CXCR4 in MSCs and CD34+ cells were determined by flow cytometry.SDF-1 in MSC-and CD34+ cell-conditioned medium was also measured by ELISA.Results The number of CD34+ cells,CFC and proliferation indexes were significantly increased in treat-ment with SDF-1(P

0.05),while the difference of dynamic HCO3-,BE in the umbilical blood gas analysis was significant statistically in the three groups(P

Objective To explore the influence of different reconstruction modes with time?weighted respiratory phases on the internal tumor volume ( ITV) of solitary pulmonary lesion ( SPL) , and to evaluate the feasibilities of 8 and 4 equal time?weighted respiratory phases in 4DCT simulation. Methods 24 patients with SPL underwent 4D scanning. Images were reconstructed with 10, 8 and 4 equal time?weighted phases of the respiratory cycles, respectively. Gross tumor volumes ( GTVs ) were delineated on the three sets of reconstructed images and fused into ITVs, which were ITV10 , ITV8 and ITV4 respectively. The differences of volumes, centroid of the ITVs and motions of GTV centroids in three?dimensional directions were compared. Statistical analysis was performed using the Friedman M test. Results The volumes of ITV10 , ITV8 and ITV4 were (9.09±12?29) cm3,(9.10±12?47) cm3 and (8.98±12?61) cm3(P=0?001), respectively. There were no differences between the volumes of ITV10 and ITV8 after the Bonferroni correction ( P=0?721) , while the opposite between those of ITV10 and ITV4 ( P=0?002 ) . The differences of centroid positions of ITV10, ITV8 and ITV4 in x?, y?and z?axes were all less than 1 mm ((12.22±7?71),(12.23± 7?71),(12.22±7?71),Px =0?668);(43.30±29?38),(43.30±29?40),(43.31±29?39),Py =0?643;(5.66±3?67),(5.66±3?67),(5.66±3?67),Pz=0?878), similar to the motions of GTV centroids in three reconstructed modes ((0.69±0?56),(0.69±0?68),(0.79±0?51) mm,Px=0?356;(3.13±3?78),(3.13± 4?05),(3.19±4?06) mm,Py =0?978;(1.18±1?31),(1.03±1?32),(1.16±1?34) mm,Pz=0?302). Conclusions There were no differences in volumes, centroid positions and motions between ITV10 and ITV8 . The quantity of reconstruction images and GTV delineations according to 8 time?weighted phases were both less than conventional 10 phases. 8 time?weighted respiratory phases mode was feasible in 4DCT simulation for SPL.

Objective To evaluate the efficacy and safety of paclitaxel plus cisplatin combination in treatment patients with advanced or metastatic squamous-cell carcinoma of the esophagus(ESCC).Methods Twenty-five patients with advanced or metastatic ESCC received paclitaxel 175mg/m2 by 3-hour infusion on day 1 and cisplatin 25mg/m2 by infusion on day 1 ～ 3.3 weeks as one cycle.Results Twenty-four patients were eligible to be evaluated the efficacy and safety.The overall response rate was 45.8％ with complete and partial response rates of 4.1％ and 41.7％,respectively.The median survival time of all patients was 11 months(95％ CI:8.35 ～ 13.65 months).There was significant difference in the median overall survival between the patients who had showed response versus those who had not(P =0.022).Median survival was 12.5 months(95％ CI:9.11 ～ 15.90 months) and 8 months(95％CI:5.50 -9.50 months),respectively.The 1-year survival probability was 37.3％.The most common toxicities were leukopenia,neutropenia,thrombocytopenia and alopecia.Conclusion The effect of paclitaxel and cisplatin which seems beneficial as first-line therapy in advanced squamous-cell carcinoma of the esophagus had a high effective rate with acceptable toxicity.

Objective:To observe the efficacy of polyene phosphatidyl choline combined with Hugan tablets in the treatment of drug-induced liver injury. Methods:Totally 80 cases of drug-induced liver injury were randomly divided into the observation group (40 cases )and the control group(40 cases). The observation group was given polyene phosphatidyl choline injections 697. 5mg+5%glucose injections 250ml,ivd,qd,combined with Hugan tablets 1. 44g,po,tid,the control group was given polyene phosphatidyl choline injections 697. 5mg+5%glucose injections 250ml,ivd,qd,and the symptomatic treatment in the two groups was the same. The two groups were treated for 20d. Alanine aminotransferase ( ALT), aspartate aminotransferase ( AST), total bilirubin ( TBIL), glutamyl transpeptidase(GGT) and alkaline phosphatase(ALP)were detected respectively before and after the treatment, and the therapeutic effects were compared between the two groups. Results: After the treatment,the total effective rate in the observation group was 97. 5%,which was significantly higher than that in the control group(P <0. 01),Symptoms,signs and biochemical indices in the two groups were improved obviously. The decrease of ALT,AST and GGT in the observation group after the treatment was obviously lower than that in the control group(P<0. 05). Conclusion: Polyene phosphatidylcholine injections combined with Hugan tablets in the treatment of liver injury is better than polyene phosphatidyl choline, which is worthy of clinical application.

OBJECTIVE:To investigate the use of prophylactic use of antibiotics for special diagnosis and treatment in our hos-pital,and to provide reference for rational use of antibiotics. METHODS:The patients receiving special diagnosis and treatment were collected from our hospital during Jan.-Aug. 2016. The prophylactic application of antibiotics was analyzed statistically. RE-SULTS:Among 149 included patients,there were 62 cases of prophylactic use of antibiotics with utilization rate of 41.61％. Among 62 patients receiving antibiotics,5 cases were given medicine orally and others were via injection. Nine categories 18 types of antibiotics were used,involving 69 times;cephalosporin were used in 49 times(71.01％),among which top 3 types in the list of use sequence were cefodizime,cefotetan and cefazolin;prophylactic use of antibiotics was not found in angiography(including coronary artery) and stent implantation. Utilization rate of antibiotics for other diagnosis and treatment was more than 50％. The prophylactic use of antibiotics was complex in ureteroscopy and cystoscopy,shock wave lithotripsy;the selection of drug types started from the high level. There were 59 cases of single drug(95.16％)and 3 cases of two-drug(4.84％). Total of 41 cases were given medicine 0.5-2 h before surgery or at the beginning of anaesthesia (66.13％). Medication time of 18 cases was ≤24 h (29.03％);that of 11 cases was >24-48 h(17.74％). CONCLUSIONS:The prophylactic use of antibiotics is relatively standard in angiography(including coronary artery),stent implantation and implantation of peritoneal dialysis tube in our hospital. There are some problems during special diagnosis and treatment,such as the indication of drug delivery is not strict;the selection of drug types starts from the high level;medication timing is not suitable;medication course is excessively long.