Objective To investigate the efficacy and safety to children of different concentration ropivacaine used for braehial plexus block in upper-limb paediatfic surgery.Methods After undergoing basal anesthesia with ketamine,100 children scheduled for hand and forearm surgery were randomly allocated to receive brachial olexus block.Brachial plexus block was performed separately with 0.33% ,0.25% ,0.2% ,0.167% ropivacaine in four group.The onset time and complete time of sensory blockade of ulner nerve,medial nerve and radial nerve;duration of analgesia;satisfaction degree of nerve block and complications were recorded.Results MAP and HR in group D was higher than before anesthesia at T1,T2,T3,and was higher compared with other three groups at T1,T2 ,T3.There wasn' t significantly difference in anesthetic effect among A,B,C group and D group was the worst,compared with other three groups.The amount of ketamine and the rate of adverse reactions in D group was significantly more than that in other three groups.The time of analgesic and movement to restore was shorter than that in other three groups.Conclusion 0.25% ropivacaine was more applicable to children with anesthetized perfectly and less complication.

To observe the clinical effect of compound Yimucao oral liquid on postpartum lochiorrhea. Methods:A to-tal of 200 patients with postpartum lochiorrhea were randomly divided into the observation group ( 100 cases ) and the control group (100 cases). The patients in the observation group received 20ml compound Yimucao oral liquid three times a day for seven days, while those in the control group were given 15g Yimucao granules three times a day for seven days. After the treatment, the duration, amount, color and quality of lochia, lower abdominal pain, uterine involution and the status of postpartum infection in the two groups were compared. Results: The total effective rate in the observation (94. 0%) was higher than that in the control group(84. 0%). Compared with that in the control group, less average hemostasis time, better situation of abdominal pain, uterine involution and lower postpartum infection rate in the observation group were observed after the treatment(P<0. 05). Conclusion:Compound Yimucao oral liquid can promote the uterine involution. It’ s effective and safe in the treatment of postpartum lochirrhea.

Posterior reversible encephalopathy syndrome is a clinical imaging syndrome associated with multiple pathogenic factors.The main clinical manifestations were headache,seizures,psychotic symptoms,visual disturbance,disturbance of consciousness,etc.The parieto-occipital reversible white matter lesions are the main manifestations of the imaging.If this disease can be diagnosed and treated in time,the clinical symptoms and imaging changes of most patients can be disappeared.If the diagnosis and treatment cannot be obtained in time,it may happen some irreversible damage,serious and even life-threatening,so it is very important to strengthen the understanding,diagnosis and treatment of this disease.At present,the pathogenesis of the disease is still not clear,now reviewed its pathogenesis and imaging manifestation in order to strengthen the clinician's understanding of the disease's pathophysiological mechanism and improve the level of diagnosis.

A design of ECG monitor was presented in this paper. It is based on the latest MCU and BLE4.0 technologies and can interact with multi-platform smart devices with extra low power consumption. Besides, a clinical expansion part can realize functions including displaying the real-time ECG and heart rate curve, reading abnormal ECG signals stored in the monitor, and setting alarm threshold. These functions are suitable for follow-up use.
Electrocardiography ; instrumentation ; Equipment Design ; Heart Rate ; Humans ; Signal Processing, Computer-Assisted

Objective To explore the characteristics of cognitive impairments in euthymic patients with early-on?set or late-onset bipolar I disorder (BD-I). Methods Ninety-four with onset age less than 21 (early onset group), 41 eu?thymic patients with onset age above 35 (late onset group) and 135 normal controls with matched education and age were enrolled. Seven classical neuropsychological tests were used to assess attention, processing speed, working memory and executive functions. Results The early-onset group was significantly worse than its corresponding normal controls in 14 indexes of all tests, including digital symbol, digital span, visual graphic reproduction (c1 and c2), time of TMT-A and TMT-B, verbal fluency, number of sorting, error and preserved error in WCST, as well as total score, completed missions, planning time and executing time in TOH (P<0.05). Moreover the effect size of difference were more than 0.4 in verbal fluency, time of TMT-A and TMT-B, and executing time in TOH. Compared with its matched control group, the late-on?set group was significantly impaired in 9 indexes, including digital span, visual graphic reproduction (c1,c2 and total), time of TMT-A, number of error and preserved error in WCST, as well as total score and completed missions in TOH (P<0.05), merely two indexes of TOH with effect size more than 0.4, while the late-onset group was no significantly impaired in digital symbol, TMT-B and verbal fluency. Conclusions There are significant cognitive impairments in euthymic BD-I patients with no matter early-onset or late-onset. But it seems that the cognitive impairments in early-onset bipo?lar disorder are more extensive and serious.

OBJECTIVE:To observe the efficacy and safety of Compound yimucao oral liquid combined with oxytocin in the prevention of postpartum hemorrhage and promotion of uterine involution for puerpera of vaginal delivery. METHODS:240 preg-nants with natural childbirth of vaginal delivery were randomly divided into control group and observation group. Control group was injected oxytocin 20 U in buttock after delivery. Observation group was additionally treated with Compound yimucao oral liquid 20 ml,tid for consecutive 2 weeks. Postpartum vaginal bleeding,uterine involution and incidence of adverse reactions in 2 groups were observed. RESULTS:Compared with control group,postpartum hemorrhage volume after delivery 2-24 h,incidence of post-partum hemorrhage,uterus size,uterine hemorrhage and lochia duration in postpartum 42 d in observation group were significantly better than control group,the differences were statistically significant(P<0.05);there were no significant differences in the hemor-rhage postpartum volume after delivery 1 h and 1-2 h and fundal height in postpartum 42 d in 2 groups(P>0.05). There were no fever,rash,nausea and other obvious adverse reactions in 2 groups. CONCLUSIONS:Compound yimucao oral liquid combined with oxytocin can obviously decrease the postpartum bleeding and promote uterine involution,with good safety.

Objective To explore the clinical outcomes of treating unstable intertrochanteric fractures with proximal femoral locking plate (PFLP) in the elderly patients.Methods From January 2010 to June 2015,380 elderly patients with unstable intertrochanteric fracture were treated with PFLP and successfully followed up at our department.They were 171 men and 209 women,from 60 to 89 years of age (average,68.7 years).By AO classification,there were 58 cases of AO31-A2.2,87 ones of 31-A2.3,130 ones of 31-A3.1,63 ones of 31-A3.2,and 42 ones of 31-A3.3.Operation time,incision length,length of hospital stay,fracture healing time,postoperative complications and hip joint Harris scores were recorded.Results This cohort was followed up for an average of 13.3 months (range,from 8 to 21 months).Their operation time averaged 53.2 min,X-ray exposure 12.2 times,intraoperative blood loss 92.7 mL,incision length 12.6 cm,postoperative drainage volume 54.7 mL,and length of hospital stay 9.2 days.Pulmonary infection was observed in 3 cases,fixation loosening in 8,fixation breakage in 2,hip varus in 9,and fracture nonunion in 4,yielding a total complication rate of 6.8％ (26/380).No operative incision infection was observed.The average fracture healing time was 11.8 weeks (range,from 7 to 48 weeks) after operation.The average Harris score one year postoperation for the 380 patients was 86.3 ± 6.1,significantly higher than the preoperative value (43.6±4.4) (P ＜0.05).There were 96 excellent,231 good,42 fair and 11 poor cases,giving an excellent to good rate of 86.1％.Conclusion Since PFLP has advantages of limited invasion,blood loss and complications,a high rate of fracture healing,and good functional recovery of the hip,it may be a good treatment for unstable intertrochanteric fractures in the elderly patients.

ObjectiveTo explore the potential value of diffusion weighted imaging(DWI) in the clinical diagnosis of soft-tissue tumors.MethodsDiffusion-weighted MRI was performed in 48 histologically proven soft-tissue tumor cases using diffusion-weighted spin-echo sequences.Of the 48 soft-tissue tumor cases,there were 28 cases of sarcoma and 20 cases of benign tumor.The apparent diffusion coefficient(ADC) values of a large region with no necrosis,scar tissue,hemorrhage or calcification representing the lesion were measured.ADC values of benign tumors,malignant tumors and normal muscles were compared.ResultsThe ADC value of the malignant tumors (0.95 ± 0.31 )× 10-3mm2/s was significantly lower than that of benign lesions( 1.87 ±0.66) × 10-3mm2/s and muscles( 1.62 ±0.50) × 10 -3mm2/s.There was no significant difference in ADC value between benign lesions and muscles.Sensitivity(75％ ) and specificity(89％ ) were obtained when the ADC value was 1.38 × 10-3mm2/s in the differentiation of benign and malignant tumors.ConclusionDiffusion-weighted MRI had potential value in differentiating benign softtissue tumors from malignant ones.

Objective To explore the efficacy of proximal femur locking plate(PFLP) for the treatment of unstable femoral intertrochanteric fractures in elderly patients.Methods Data of 120 cases of patients with unstable femoral intertrochanteric fractures who were treated by PFLP were retrospectively analyzed.There were 56 males and 64 were females,aging from 62 to 78 year-old (average,69.4 year-old).85 cases were left hip,and 35 cases right hip.According to AO fracture classification,there were 12 cases of A2.2,23 A2.3,34 A3.1,29 A3.2,and 22 A3.3.According to Evans intertrochanteric fractures classification:there were 93 cases of type Ⅲ,19 type Ⅳ,and 8 type Ⅴ.Operation time,length of hospital stay,fracture healing time,postoperative complications and hip joint Harris scores were recorded.Results All patients were followed up for 8-14 months (average,12.4 months).Their operating time were 51-80 min (average,63.1 min);X-ray exposure were 8-15 times (average,11.6 times);intraoperative blood loss were 70-120 ml (average,92.7 ml);postoperative drainage volume were 50-100 ml (average,61.7 ml),and length of hospital stay were 7-14 d (average,10.2 days).The healing time ranged from 12 to 32 weeks (20.4 weeks average).14 cases had delayed union,and healing time was 8-10 months.In addition,4 cases had deep vein thrombosis (after thrombolysis therapy the vein was recanalized);2 had internal fixation broken,who were then treated with PFNA Ⅱ,and bone healed after 6 months;5 had hip varus,who were then treated via hip replacement,and no hip prosthesis fracture were found.No other complications occurred in the remaining patients.At the latest follow-up,according to Harris hip score:there were 38 cases with excellent results,71 good,9 fair,and 2 poor,and the rate of excellent and good was 90.8％ (109/120).Conclusion PFLP for the treatment of unstable femoral intertrochanteric fractures has advantages of less invasion,less complication,reliable fixation and high fracture healing rate,thus it is suitable for unstable intertrochanteric fractures in elderly patients.

Objective To study the effect of hypothemah on the early inflammatory reaction in acute lung injury induced by intestinal ischemia-repeffusion(IlR)in rabbits.Method Seventy-two healthy rabbits provided by Peking Union Medical Colege Hospital Anhnal center were randomly divided into four groups(n=18 pergroup):(1)normothermia control group (rectal temperature 37-38 C;sham group);(2)normothermia IlR group(rectal temperature 37-38 C);(3)mild hypothermia HR group(rectal temperature 32-35℃);and (4)moderate hypothermia IIR group(rectal temperature 28-31.9C).Acute lung injury was induced by claIllp.ithe superiornteric artery(SMA)for 1 hour and declamping the SMA for 6 hours.Hypothermia WaS induced by surface cooling.Before and 2.4 and 6 hours after IIR,the Olasmlevels o,IL-,IL-6 and IL10 were measured.All rabbits were killed 6 hours after IIR and water content in lung tissue Wttk'assessed.Iaght mieropic examination was performed tbr morphological assessment of the hmg.The data were analyzed by AN()VA.Statistical significance wag dned as a P of<0.05.Results In the IIR groups,the plasma levels ofTHE-a.IL-l,IL-6 and IL-10 and lung water were increased.There Was evidence of acute lung injury from morphologi-cal assessment of the lung.The acute lung injury induced by IIR was improved by hypethennia.Mild hypothermia Was similar to moderate hypothermia for the treatment of acute lung injury induced by IIR.ConclusiotMild hy-pothermia and moderate hypothermia Can significantly improve acute lung injury induced by IIR in rabbits.Mild hypothea had similar efficacy to moderate hypothermia for the treatment of acute lung injury induced by IIR.