Objective To investigate the clinical effect of intravenous infusion of dextral metomidine and the analgesia of epidural injection.MethodsAccording to the different ways of labor analgesia will be selected in January 2015 to January 2017 in our hospital childbirth puerpera 120 cases are grouped into: the control group with regular continuous epidural analgesia injection way, observation group with intravenous infusion set beauty holds the mi + right regularity discontinuous epidural analgesic injection mode;Record two groups of patients with various experiment data, and will make an analysis of data obtained, conclusion intravenous infusion set right beauty holds the mi joint regularity the clinical effect of continuous epidural labor analgesia injection.ResultsIntravenous right beauty holds the mi + regularity discontinuous epidural injection way for puerpera childbirth analgesia effect is superior to the pure regularity discontinuous epidural injection way analgesia effect, compare the difference between groups was statistically significant (P<0.05).Conclusionpregnant women choosing to analgesia vein infusion set beauty holds the mi + right regularity discontinuous epidural analgesic injection way, clinical analgesic effect is good, will not cause great influence to own and maternal newborn, worth clinical widely used for childbirth analgesia.

With the improvement of people's living standard and changes of their lifestyle, the incidence of coronary artery disease (CAD) has increased quite significantly, which has attracted great concern. Examination methods for CAD are more and more advanced, while the cost of inspection is rising. As a traditional test, the exercise treadmill test (ETT) is convenient, safe, and cheap. ETT can be conducted in almost every hospital as it doesn't need advanced equipments. The values of some new evaluation indexes for diagnosis and prognosis of CAD are reviewed in this article.

SHP-1 is the protein tyrosine phosphatase which is mainly expressed in the cytoplasm of hematopoietic-derived cells,and it is the key factor to change the levels of intracellular phosphorylation.SHP-1 can generate different intracellular signals in different cells,and it can play various functions.

BACKGROUND: The exact pathogenesis of osteoarthritis is unclear. Studies have shown that macrophages in synovial tissue are involved in sliding-inflammation response and the production of cartilage matrix degradation enzyme. OBJECTIVE: Based on the important role of synovial macrophages in osteoarthritis, to review and summarize the major research achievements and important research methods in this field, laying a foundation for future research on synovial macrophages. METHODS: The first author used computer to search relevant literatures included in PubMed and VIP from 1999 to 2019. The search terms were “osteoarthritis, synovitis, synovial macrophages” in English and Chineserespectively. Manual screening was conducted according to the inclusion criteria, and irrelevant, repetitive and obsolete articles were excluded. Finally, 46 eligible articles were included.RESULTS AND CONCLUSION: There is an inflammatory response in the synovial tissue, and the severity of synovitis is closely related to osteoarthritis symptoms and progression. A large number of macrophages with different activation states are infiltrated in the synovial tissues of osteoarthritis patients at different stages. M1 macrophages are the main subgroup of macrophages involved in the production, cartilage degradation and osteophyte formation of osteoarthritis inflammatory factors, while M2 macrophages have a protective effect on osteoarthritis by secreting anti-inflammatory factors. Inhibiting the differentiation of macrophages into M1 type and promoting their M2 type differentiation can alleviate the pathological changes of osteoarthritis and delay the progression of osteoarthritis. It may be an effective method to treat osteoarthritis by regulating the polarization state of synovial macrophages.

The acetabular fractures are technically challenging due to the deep location in the pelvis and low degree of exposure.Although the classic ilioinguinal approach could treat most anterior acetabulum fractures,the limited surgical field and difficulty in exposure is the main obstacle surgeons should overcome.Various approaches including extended approaches and combined anterior and posterior approaches ensure adequate exposure,but high rate of complications impede it from clinical use.The Stoppa approach has been favored by the orthopedic surgeons in recent years for the minimized surgical dissection and good exposure.It allows for extensive visualization of the pelvic brim and direct manipulation of quadrilateral plate.This approach is indicated in all anterior column and wall fractures,combined anterior column and posterior hemi-transverse fractures,selected both-column fractures,transverse and T-fractures.The utilization of the Stoppa approach developed along with the evolution of the relevant theory of acetabular fractures in the past years.The development such as the precise measurement of “safe zone” and the application of new apparatus could do great help in decreasing the complications and improving the surgical results.This article summarizes the relevant literatures and provides a review of the advances in the Stoppa approach in acetabular fractures.

Objective To evaluate the feasibility of laparoscopic cholangiotomy for radical excision of upper cholangiocarcinoma. Methods Four trocars were placed at the umbilical area, right upper and lower abdomen, and below the xiphoid. A 3 cm incision was made at the left upper abdomen for Roux-en-Y jejunojejunostomy. The gallbladder, inferior segment of the left medial liver, and the middle-upper segment of the bile duct were resected. And then the tumor and the adjacent 1 cm bile duct were excised. Afterwards, the proper hepatic artery, portal vein, and the surrounding connective tissues and lymph nodes were removed. Finally, the bile-jejunum Roux-en-Y anastomosis was performed. Results The hepatic duct bifurcation was involved by the cholangiocarcinoma in all the 4 cases. The diameter of the tumor was 1-1.5 cm. The resection of the inferior segment of the left medial liver and middle and upper segments of the bile duct, and dissection of the lymph nodes at the hepatic porta were completed successfully. The operation was accomplished in all the cases with an operation time of 270, 255, 270, and 230 mins, and the intraoperative blood loss was 500, 400, 300, and 400 ml, respectively. Postoperative pathological examination showed highly differentiated adenocarcinoma in all the cases. Cases 2 and 3 developed bile leakage after the operation and were cured 20 or 15 days later. In all the cases, the jaundice disappeared after the operation. Their appetite recovered, and the body weight was increased by 3, 3.5, 2, and 2 kg, respectively. Conclusions Upper cholangiocarcinoma can be radically excised by using laparoscopy. The resection of cholangiocarcinoma and part of liver tissues, dissection of surrounding connective tissues and lymph nodes, and bile duct reconstruction can be accomplished under a laparoscope. Thus,we consider that laparoscopic cholangiotomy is feasible for radical excision of upper cholangiocarcinoma.

Through the integration of multiple types of information use hospital data resources to provide effective practice parameters for the hospital management decisions.Mainly includes the following aspects:First,the management of personnel files,personnel files to achieve the secure sharing of information and knowledge management in the information dossier on the basis of improving the efficiency of hospital management and scientific personnel.Secondly,the clinical aspects of digital information using the extended use of information technology to achieve information sharing medical imaging information systems and the medical doctors on the PACS station,nurse station systems,and computer management system,library networking integration and other modern IT networking,re sources to achieve the hospital image information sharing.In addition,play the role of information in the files of clinical teaching hospitals in major events,to carry out medical treatment,teaching,scientific research system for clinical teaching staff provide a basis.To enhance the scientific decisionmaking of the hospital management.

Objective To assess effects of the different retention time and temperature of the tumescent fluid on surgical blood loss in tumescent liposuction.Methods 20 patients with localized fat deposits received tumescent liposuction and the blood loss were calculated and compared between two treated groups.Results The mean surgical blood loss in 20 patients was (50.27± 18.56) ml with range (21.42-77.26) ml.The blood loss in liposuction with 0.5 hour retention and no retention of tumescent fluids was (19.89±7.52) ml and (26.25±12.07) ml,respectively; the blood loss in liposuction with heated (37℃) and non-heated tumescent fluid (23℃) was (28.60±6.07) ml and (29.93±9.06) ml,respectively.Conclusions A half hour retention of tumescent fluid in subcutaneous tissue after injection could reduce the surgical blood loss and the blood loss amount does not increase in the usage of a pre-heated tumescent fluid.

Objective To examine the effect of intrathecal administration of nerve growth factor (NGF)on healing of tibial shaft fracture in rats. Methotis Forty-eight adult male SD rats were randomized into 2 equal groups.In the experiment group,2.5 S mNGF was injected into the intrathecal space at the L1 level of spinal cord for 2 weeks(1 μg/day),while the control were treated with normal saline of the same amount.After injection,the animals in both groups were sacrificed respectively at days 7,14,21 and 28 for all X-ray evaluation on the bone callus and an immunohistochemistry assay on related dorsal root ganglia (DRG)and osteotylus. Results The immunoreactivity of calcitonin gene-related peptide(CGRP)and substance P(SP)in DRG and osteotylus was significantly hisher in the NGF group than in the saline-treated controls.X-ray CValuation of osteotylus 21 to 28 days after fracture scored lower in the NGF group than in the controls but the healing process was enhanced in the former.A hisher proportion of cartilage was found in the NGF group than in the controls,and the reconstruction of callus was promoted. Conclusion Stimulating the release of sensory neuropeptides in the rat spinal cord and enhancing the immunoreactivity of CGRP and SP in DRG and callus.NGF Can result in accelerated fracture healing.

?Objective:To investigate the behavior of absorbable coral hydroxyapatite (Interpore 500R) as bone tissue engineering scaffold. Methods: Marrow stromal stem cells harvested from legally aborted human fetus were cultured in DMEM containing 100 ml/L fetal boving serum and induced to differentiate towards osteoblasts.Then the cells were seeded onto absorbable coral hydroxyapatite , then the composite was implanted subcultaneously into the back of nude mice .Cell materia attachement was observed with scanning electron microscope,type I collegen secretion was studied with laser confocal microscope and new bone formation was studied histologicaley. Results: The cells could adhere to absorbable coral hydroxyapatite and secrete collagen I.Mature bone tissue was found in the implanted composite 40 day after transplantation. Conclusion: Absorbable coral hydroxyapatite Interpore 500R is a favorable bone tissue engineering scaffold.