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.

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.

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.

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.

Humans ; Non-alcoholic Fatty Liver Disease ; diagnosis ; therapy

ObjectiveTo investigate the effect of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.MethodsNinety-six ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr weighing 50-80 kg undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate short-term sleep quality in hospital.The patients were divided into 4 groups according to the types of preoperative sleep disturbance ( n =24 each):group Ⅰ no sleep disturbance;group Ⅱ long-term sleep disturbance; group Ⅲ acute short-term sleep disturbance; group Ⅳ long-term + acute short-term sleep disturbance.Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with iv infusion of remifentanil and propofol.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 30-35 nun Hg.Controlled hypoteasion was performed with nicardipine,MAP was maintained at 50-70 mm Hg and HR at 60-90 bpm during operation.The patients received iv flurbiprofen 50 mg at 15 min before the end of operation for postoperative analgesia.When VAS score was more than 3 during the fnrst 6 h after operation,flurbiprofen 50 mg was given iv as rescue analgesic.ResultsThe incidence of rescue analgesic administered after operation was significantly larger in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesic administered during the first 6 h after operation between groups Ⅱ and Ⅲ.ConclusionPreoperative sleep disturbance has adverse effect on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

Objective To evaluate the bridging role of non-bioartificial liver for patients with chronic severe hepatitis B awaiting liver transplantation. Methods The non-bioartificial liver support was used to treat 9 hepatitis B patients with advanced stage liver failure waiting for liver donor in order to correct physiological disturbances and bridge to orthotopic liver transplantation (OLT). Results When the patients were treated with non-bioartificial liver support, the concentrations of serum total bilirubin and total bile acid were decreased dramatically (P

Objective:To observe the effect of Fufang Congrong Yizhi Capsule on myristoylated alanine-rich C-kinase substrate (MARCKS) mRNA level in hippocampus of old dementia rats induced by ?-amyloid(1-40). Methods: Animals were divided randomly into young group, old group, sham operation group, model group, western medicine group and Chinese medicine group. Model, western and Chinese medicine groups received ?-amyloid (1-40) intracerebroventrical injection to build dementia animal model, and then Chinese and westein medicine groups received Fufang Congrong Yizhi Capsule and donepezil for 14 days, respectively. To observe changes of behavior and MARCKS mRNA under the effect of Chinese and western medicine by Morris test and RT-PCR test. Results: Learning and memory function of Chinese and western medicine groups were better than that of model group. MARCKS mRNA of model group was increased significantly, that of Chinese medicine group was decreased compared with model group. Conclusion: Fufang Congrong Yizhi Capsule can reduce the level of MARCKS mRNA in hippocampus of old dementia rats caused by ?-amyloid(1-40), through which it can improve the learning and memory function of the dementia old rats.