Objective To observe and compare the efficacy and safety of chloroprocaine and ropivacaine for epidural labor analgesia.Methods 86 cases of voluntary acceptance of maternal painless natural childbirth were selected in the study.43 cases were given chloroprocaine epidural analgesia (chloroprocaine group),and the other 43 cases were given ropivacaine epidural analgesia (ropivacaine group).The pain (VAS score),lower limb motor block degree(MBS score),fetal heart rate(FHR) and contractions duration of maternal prenatal and medication immediately after 10min,20min,40min,80min were compared between two groups.The first,second and third stage of labor and fetal output after 1 min,5min,10min Apgar score were compared.The incidence of adverse events were observed.Results In the chloroprocaine group,the 10min VAS score was (2.10 ± 1.02),which was significantly lower than (4.31 ± 1.13) in the ropivacaine group (t =4.565,P ＜ 0.05).In the chloroprocaine group,analgesia 20min MBS score was (0.24 ± 0.03),which was significantly higher than (0.11 ± 0.04) in the ropivacaine group (t =4.126,P ＜ 0.05).In the chloroprocaine group,4 cases occurred nerve injury,which was more than the ropivacaine group (1 case),the difference was statistically significant (x2 =4.263,P ＜ 0.05).Conclusion Chloroprocaine and ropivacaine for epidural labor analgesia have superior efficacy and the clinical efficacy is similar.Chloroprocaine has the advantage of quick results,but the medication about 20min time period that the drug might lead to a greater degree of lower limb motor block,and has the risk of nerve injury,pregnant women can choose according to their medication.

Objective To investigate the distribution and drug resistance of clinical common isolated bacteria from our hospital in 2013.Methods The antimicrobial susceptibility testing was carried out by using the automated systems with the MIC method and Kirby-Bauer method.The WHONET 5.6 software was adopted to conduct the data analysis according to the CLSI standard in 2013 version.Results A total of 4 168 strains of bacteria were clinically isolated in 2013,in which Gram-positive bacterial strains ac-counted for 21 .8%(907/4 168)and Gram-negative bacterial strains for 78.2%(3 261/4 168).The prevalence of methicillin-resist-ant strains in S.aureus and coagulase negative staphylococcus was 48.7% and 80.9% respectively.No staphylococcal strain with resistant and intermediate to vancomycin and linezolid was found.Penicillin-resistant S.pneumonia strain was not found.And 1 strain of vancomycin- resistant E.faecium was found.The prevalence of ESBLs - producing strains was 58.8% in E.coli and 35.8% in K.pneumonia.Non-fermentative bacilli accounted for 37.5% in all bacterial isolates.The percentage of P.aeruginosa re-sistant to imipenem and meropenem was 19.3% and 14.2% respectively,the percentage of A.baumannii resistant to imipenem and meropenem was 68.9% and 67.0% respectively.Conclusion The isolation rate of non-fermentative bacilli is increased,the drug re-sistance rate of P.aeruginosa and A.baumannii is declined than that in 2012.Strengthening the surveillance of bacterial drug resist-ance in hospital has important significance for guiding rational selection of antimicrobial agents in clinic.

Hospital-acquired pneumonia (HAP) is a very common complication in patients with neurological diseases.Its incidence and mortality are very high and result in a prolonged hospital stay and an increase in hospitalization costs.Therefore,how to effectively prevent HAP has become the focus of attention by neurologists.There are many risk factors for HAP,such as advanced age,conscious disorders,dysphagia,body position,oropharyngeal colonization,mechanical ventilation,enteral nutrition,and stress ulcer prevention drugs,etc.Clearing the risk factors for HAP and taking appropriate measures to strengthen protection may reduce the occurrence of HAP and improve the prognosis of patients.

Objective To study the efficacy of recombinant human thrombopoietin (rhTPO)for the treat-ment of chemotherapy -induced thrombocytopenia with leukemia.And to explore its security.Methods 80 thrombo-cytopenia of acute leukemia after chemotherapy were selected.All patients were randomly divided into the research group and the control group according to the single and double of order registration number in clinic,40 cases in each group.The control group was treated with recombinant human interleukin -11 (rhIL -11),the research group was applied rhTPO treatment.The platelet (PLT)level of two groups,and other indicators of change were detected,and adverse reactions were observed.Results PLT resuming maximum value of the research group was (217.4 ±52.7) ×109 /L,which was significantly higher than the control group,the difference was statistically significant (t =15.63, P <0.05).The time of PLT recovery to 100 ×109 /L of the research group after chemotherapy was (15.6 ±3.6)d, which was significantly lower than the control group,the difference was statistically significant (t =10.72,P <0.05). The adverse reactions incidence of the research group was 12.5%,lower than 35.0% of the control group,the differ-ence was statistically significant (χ2 =9.87,P <0.05).Conclusion The treatment effect of RhTPO for thrombocy-topenia of the acute leukemia after chemotherapy is better than that of rhIL -11,can significantly improve the throm-bocytopenia,and has less adverse reaction and higher security.It is worthy of clinical popularization and application.

Physical activity is limited in maintenance hemodialysis (MHD) patients, and higher level of physical activity may result in less risk of death, milder depression or ahypnosis, less fatigue and better quality of life. Physical activity may relate with many factors. MHD patients may be benefited from exercise to improve the physical activity, mainly with aerobic exercise and resistance training during hemodialysis. Nurses can do more in health education and direction of exercise for MHD patients.

Objective To investigate the effects of respiratory training on motor function in patients with acute stroke. Methods From 2012 to 2014, 80 patients with acute stroke were randomly assigned into treatment group and control group equally. The control group re-ceived routine rehabilitation training, while the treatment group received respiratory training in addition. All the patients were assessed with Fugl-Meyer Assessment (FMA) and modified Bathel Index (MBI) before and eight weeks after treatment. Results The scores of FMA and MBI improved more in the treatment group than in the control group (t>3.938, P<0.001) after treatment. Conclusion Respiratory training may promote the recovery of motor function in acute stroke patients.

Objective To investigate the efficacy and safety of low-dose ammonia sulfur-sulfur-resistant treatment.Methods 120 patients with initial depression were randomly divided into a group(40 cases), the estercalyptrin group(40)and the drug group(40).The treatment was treated by the treatment of the ammonia sulfonate, 20 mg/d, 20 mg/d, and 20 mg/d of escitaloplan tablet.The clinical efficacy and response scale(TESS)was evaluated with the Hamilton depression scale(TESS)in the treatment of 1, 2, 4 and 8 over the weekend.Results Three groups showed significant improvement(P<0.01)during the 8th weekend of treatment of the HAMD scores.Grade 1 and 2 weekend, combined treatment group compared with single drug group score had significant difference(P<0.01), and the contrast between the single drug groups had no significant difference, 4 score over the weekend, and comparison between the three way were significant differences(P<0.05), 8 scores over the weekend, and share with escitalopram phthalein general group is no difference, but tolbutamide will benefit group compared with the other two groups had significant difference(P<0.01).Conclusion Small doses of tolbutamide will benefit has antidepressant effect, but the long-term curative effect of treatment is better than the amount of escitalopram citalopram, and share small doses of escitalopram citalopram tolbutamide will benefit can obviously accelerate the antidepressant treatment work.

The treatment of vascular malformations has been a difficult clinical subject. At present, the main therapeutic methods include embolization/sclerotherapy, surgical excision, laser treatment, etc. However, it is often difficult to obtain a satisfactory clinical effect. As it can induce the vascular endothelial denudation resulting in protein degeneration, ethanol embolization can obtain the effect of complete obliteration of the diseased vascular lumen. Although ethanol embolization of vascular malformations has already achieved satisfactory clinical effect, the fear of cardiac and pulmonary accidents has limited the application of this technique in clinical practice. This paper aims to make a comprehensive review concerning the effect of ethanol embolization for vascular malformations on the cardiopulmonary functions.

Objective To investigate the effects of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.Methods Ninety-six ASA Ⅰ or Ⅱ patients of both sexes (aged 20-60 years and weighing 50-80 kg) undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate the long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate the short-term sleep quality in hospital.The patients were divided into four groups according to the types of preoperative sleep disturbance (n =24 each):no sleep disturbance (group Ⅰ),long-term sleep disturbance (group Ⅱ),acute short-term sleep disturbance (group Ⅲ),and long-term + acute short-term sleep disturbance (group Ⅳ).Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with intravenous infusion of remifentanil and propofol.Then the patients received endotracheal intubation and mechanical ventilation.The end-tidal pressure of carbon dioxide was maintained at 30-35 mm Hg.Controlled hypotension was performed with nicardipine,and the mean arterial blood pressure was maintained at 50-70 mm Hg and heart rate at 60-90 bpm during operation.The patients received intravenous injection of flurbiprofen 50 mg 15 minutes before the end of operation for postoperative analgesia.When the visual analogue scale score was more than 3 during the first 6 hours after operation,flurbiprofen 50 mg was given intravenously as rescue analgesia.Results The incidence of rescue analgesia administered after operation was significantly greater in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and greater in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesia administered during the first 6 hours after operation between groups Ⅱ and Ⅲ.Conclusion Preoperative sleep disturbance has adverse effects on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Nowadays people feared to be infected with HIV extremely,and despised the persons who had bad behaviors susceptible to HIV,for the severe harm to the health by AIDS and secret route of transmission of HIV.So it resulted in some special problems of ethics for discriminations by normal and hostilities by HIV infectious people. Therefore it was key to adopt strategy of tolerance, and to treat the HIV infectious people justly, respectfully that was effective to prevent and treat AIDS. Under the principle of vantage,AIDS patients,HIV infectious people,high-risk groups, general people and medical workers could cooperated with each other,and to preclude the ethics differences with tolerance.By evoling the consciousness of respecting privilege of health,exciting social feeling of moralities and responsibility of the public,we cna raise the effect of preventing and treating of AIDS,and keep the prevalence of AIDS within limits.