Objective To investigate the effect and safety of combined spinal-epidural analgesia (CSEA) with different doses of ropivacaine during labor. Methods One hundred ASA Ⅰ -Ⅱ full term primigravidae were randomly divided into 5 groups: group Rl (n =20), R2 (n =21), R3 (n = 21), group Y ( n = 19) and group C ( n = 20) . When the external cervical os was dilated to 3-4cm lumbar puncture was performed at L2-3 or L3-4 with a special CSE needle. 0.75% ropivacaine 0.33ml (2.5mg), 0.5ml (3.75mg) or 0.67ml (5mg) was added to 5% glucose with a total volume of 2.5ml and injected into subarachnoid space in group R1, R2 and R3 respectively. When subarachnoid block was wearing off, patient controlled-epidural analgesia (PCEA) with 0.175% ropivacaine was started (background infusion 6ml/h, bolus 2ml, lock-out time 15min) . In group Y patients received only PCEA with 0.175% ropivacaine and in group C patients received neither CSEA nor PCEA and served as control. Level of pain (VAS scores), degree of motor block (modified Bromage scores), Apgar scores and neurological and adaptive capacity scores (NACS), the progress of labor, the amount of ropivacaine used and side effects were recorded and compared. Blood samples were taken from umbilical vein for blood gas analysis immediately after delivery. Results Demographic data were comparable between groups and there were no significant differences in the progress of labor, Apgar score, NACS and blood gases of umbilical venous blood between groups. The onset of analgesia was significantly faster in group R1, R2 and R3 than that ingroup Y(P

Spread into regional lymph node is the major route of metastasis in cervical cancer.Although lymph node status is not involved in the International Federation of Gynecology and Obstetrics stagingsystem of uterine cervical cancer,the presence or absence of lymph node metastasis provides important information for prognosis and treatment.In this review,we have attempted to focus on the incidence and patterns of lymph node metastasis,and the issues surrounding surgical assessment of lymph nodes.In addition,the preoperative prediction of lymph node status,as well as the intraoperative assessment by sentinel nodes will be reviewed.Finally,lymph node micrometastasis also will be discussed.

Objective: To investigate whether endothelial progenitor cells (EPCs) involved in the early healing process of aneurysms with flow diverting stents and the mechanisms. Methods: Five clean rabbits were chosen to prepare the animal model of aneurysm on the right carotid artery. After EPCs were cultured autologously, they were double labeled by Hoechst 33342 and carboxyfluorescein diacetate succinimidylester (CFSE). The aneurysms of rabbits were treated using flow diverting stents. The labeled EPCs were retransfused autologously via veins. EPCs involving in the intimai repair of aneurysms were observed with Cell tracking technology after 2 weeks. In combination of scanning electron microscopy, pathology and immunohistochemistry, EPCs involving in the process of intimal repair were analyzed. Results: Circled digit oneTwo weeks after simple flow diverting stents treatment, the rabbits were reexamined. Their aneurysms did not visualized completely (5/5). The aneurysms were obliferated completely, and the aneurysm necks were covered with neointima. Circled digit twoHoechst33342 and CFSE double-labeled positive cells were found in aneurysm sections. In the aneurysm sections of 2 experimental animals (2/5) , the positive cells were in the neointima. Circled digit threeScanning electron microscopy and immunohistochemistry results suggested that only a few amount of endothelial cells repaired the intimai surface. Conclusion: EPCs involved in the process of early intimal healing of aneurysms.

The metabolism study of radiolabeled drugs plays an important role in the development of new drugs. It provides information on drug absorption, metabolism, tissue distribution and excretion, and plays an irreplaceable role in the metabolite safety evaluation and mass balance of new drugs. The new guidance draft on clinical trials of radiolabeled drugs recently released by the US FDA puts forward higher standards and has been widely concerned by the industry. In recent years, in the research and development of new drugs in China, ¹⁴C labeled drugs have been used to carry out clinical metabolism studies, which has overcome key technical bottlenecks and accumulated experience. This paper summarizes the above research progress, analyzes the existing problems, and preliminarily looks forward to the future technological development and application.

Amino Acid Metabolism, Inborn Errors ; blood ; diagnosis ; Female ; Humans ; Infant ; Methylmalonic Acid ; blood

Objective To explore the significance of CRP in the diagnosis and treatment of pediatric diseases. Methods The highest CRP value and the total number of white blood cells of hospitalized children during hospitalization were detected ,divided into 6 groups according to the level. To compare the relationship among the total number of WBC,CRP and PCT of each group in the infectious diseases and compare the changes of the total number of WBC and CRP before and after treatment. Results CRP and serum procalcitonin (PCT) was positively correlated (P ＜ 0.01), but a large part of white blood cells did not associate with the PCT. In total white blood cells of 6 groups,3 groups had no statistically significant changes before and after treatment, while the CRP abnormal changes of 5 groups before and after treatment was statistically significant(P ＜0.05). Conclusion CRP was not only as the initial identification of indicators of the children with bacterial infections and viral infections,but also reflected the severity of inflammation. CRP should be used as a routine examination of outpatient with fever, associated with the analysis of the white blood cell could play an important role in reducing the abuse of antibiotics.

Objective To explore the clinical application of improved thoracic closed drainage tube vacuum aspiration in treatment of elderly patients with trachea foreign body.Methods 32 elderly patients with trachea foreign body were divided evenly into group A and group B.Group A received treatment of improved thoracic closed drainage tube aspiration,while group B received treatment of bronchoscopy.One-time success rate of removing foreign body,operation duration,length of stay and occurrence of complications were compared between group A and group B.Results One-time success rate of removing foreign body in group A was significantly higher than group B (100.00％ vs 81.25 ％,x2 =6.720,P ＜ 0.05) ;operation time of group A was (1.79 ± 1.25)min,which was significantly shorter than (13.18 ± 4.37) min of group B (t =4.31,P ＜ 0.05).Conclusion The clinical effect of improved thoracic closed drainage tube vacuum aapiration in treatment of elderly patients with trachea foreign body was positive and better than treatment with bronchoscopy,it is worthy of clinical application.

Objective To assess the effect of levothyroxine , lipoic acid and their combination therapy on improving the cognitive deficit and on the level of oxidative stress in the serum and hippocampus tissue of adult hypothyroid rast .Methods Fifty male SD rats were randomly divided into five groups:normal group , hypothyroidism group [ propylthioaracil ( PTU ) group], the levothyroxine sodium (L-T4) treatment group (PTU +L-T4 group), the lipoid acid(LA) treatment group (PTU+LA group), and the two-drug combination group (PTU+LT-4+LA group).After 8 weeks of treatment, the learn-ing and memory abilities of the rats were evaluated by Morris Water Maze ( MWM ) .The content of malondialdehyde ( MDA) and the activities of superoxide dismutase ( SOD) in the serum and hippocampus were respectively measured using thiobarbituric acid ,and xanthine-xanthine oxidase methods .Results Compared with the normal group , the escape latency was longer(P<0.01), the MDA level was increased and the SOD activity was decreased in the serum and hippocampus in the PTU group (P<0.001).Compared with PTU group, the SOD activity was increased and the MDA level was decreased in the PTU +L-T4 group, PTU +LA group and PTU +L-T4 +LA group(P<0.05).There was significant difference in MWM test score .Conclusion The L-T4 and LA combination therapy can significantly improve the cognitive function of hypothyroid rats.

Background and purpose:We have already reported viral macrophage inflammatory protein-Ⅱcan induce surface chemokine receptor CXCR4 internalizated.Based on the diverse biological functions of SDF-1?/ CXCR4,this study was to investigate the effect of SDF-1?on invasion and metastasis of human breast carcinoma MCF-7 cells.Methods:MCF-7 cell's ability of invasion,metastasis and anoikis were used as end points.The invasive ability was measured by the number of cells that were able to penetrate polycarbonates coated with matrigel.The metastastatic ability was analyzed by Transwell chamber.The anoikis ability was detected by FCM.Results:SDF- 1?+MCF-7 cells formed long and abundant pseudopodia,and only few filopodia were detectable in MCF-7 cells.It was shown that adhesive and metastasis capability of MCF-7 cells was enhanced with SDF-1?cocultured(P