Objective To investigate the effect of epidural anesthesia for painless labor on the birth process and newborn,and to provide a reference for the implementation of painless labor.Methods From January 2013 to January 2015 in our hospital,102 pregnant women were randomly divided into observation group and control group, 51 cases in each group.The observation group used sufentanil combined with ropivacaine for labor analgesia,and the control group received conventional natural childbirth measures for labor.Compared the two groups of maternal analge-sia effect,duration,the rate of vaginal delivery and postpartum 2 hours the amount of bleeding,and compared the two groups of fetal distress and neonatal asphyxia incidence.Results The maternal effect rate and total efficiency in the observation group were 62.75%,96.08%,which were significantly higher than those of the control group (P <0.05).In the observation group,the first birth process was (251.82 ±93.64)min,the second stage of labor was (54.72 ±2.561)min,which were significantly less than those of the control group (P <0.05 );birth rate of the observation group was 74.51%,postpartum 2 hours bleeding (227.52 ±31.73)mL,fetal distress occurred rate was 1.96%,newborn asphyxia occurrence rate was 1.96%,and compared with the control group,the differences were not statistically significant (P >0.05).Conclusion Epidural block anesthesia of painless labor can effectively relieve the pain of delivery,reduce maternal labor and the second stage of history,and has good safety of mother to child,it is worth popularization and application.

Acupuncture Therapy ; Adrenal Insufficiency ; therapy ; Adult ; Humans ; Male

Objective To investigate the effect of Yiqi Yangyin Huoxue Decoction combined with Western medicine therapy , while on this basis the observation group was combined with the on serum CRP ,TNF‐α,blood lipid and hemorheology levels in cor‐onary heart disease angina pectoris .Methods Totally 114 patients with coronary heart disease(CHD) angina pectoris were random‐ly divided into observation group (n=57) and control group (n=57) according to the random number table method .The control group was treated with Western medicine treatment ,while on this basis the observation group was combined with the therapy of Yiqi Yangyin Huoxue Decoction .The treatment cource was 4 weeks in the two groups .Serum CRP ,TNF‐α,blood lipids ,hemorheol‐ogy levels ,frequency and duration of angina pectoris attack ,efficacy of angina pectoris and ECG and adverse reactions were contras‐tively analyzed in the two groups .Results The levels of serum CRP and TNF‐αafter treatment in the two groups were decreased (P<0 .05);sthe serum levels of CRP and TNF‐α after treatment in the observation group were lower than those in the control group(P<0 .05);the TG ,TC and LDL‐C levels after treatment in the two groups were decreased (P<0 .05);the TC ,LDL‐C and TG levels after treatment in the observation group were lower than those in the control group (P<0 .05);fibrinogen ,plasma vis‐cosity and whole blood viscosityafter treatment in the two groups were decreased (P<0 .05);the fibrinogen ,plasma viscosity and whole blood viscosity after treatment in the observation group were lower than those in the control group (P<0 .05);the angina pectoris attack frequency after treatment in the two groups were reduced (P<0 .05) ,the duration was shortend (P<0 .05);but the angina pectoris attack frequency after treatment in the observation group was lower than that in the control group (P<0 .05) ,the duration was shorter than that in the control group (P<0 .05);the total effective rate of angina pectoris and ECG in the observa‐tion group was higher than that in the control group (P<0 .05) .The two groups had no serious adverse reactions during the treat‐ment process .Conclusion Yiqi Yangyin Huoxue Decoction combined with Western medicine can reduce serum CRP ,TNF‐α,blood lipid and hemorheologic levels in CHD angina pectoris ,and has remarkable curative effect with safety and reliability .

Objective To study the clinical value of combined detection of D-dimer,PT,FIB and Cyc-C in the patients with nephrotic syndrome(NS) complicating thromboembolism.Methods Sixty-five patients with clinically diagnosed NS(observation group) in the Huangshi Municipal Central Hospital from April 2013 to March 2016 were selected and divided into the non-thromboembolism group(group A,45 cases) and thromboembolism group(group B,20 cases).Contemporaneous 43 individuals undergoing physical examination served as the control group(group C).The levels of Cys-C and 24 h urine protein were tested by the electrochemical luminescence method;meanwhile PT,FIB and D-dimmer levels were detected by the nephelometry method.Their changes in the patients with NS complicating thromboembolism were observed.Results The levels of Cys-C,24 h urine protein and D-dimer in the observation group were significantly higher than those in the control group (P＜0.01).The difference of PT and FIB levels were not statistically significant(P＞0.05);the D-dimer and Cys-C levels in the observation B group was significantly higher than that in the observation A group(P＜0.05),moreover the D-dimer level was positively correlated with Cys-C.Conclusion D-dimer and Cys-C can be used as the predictive factors of thromboembolism occurrence in NS patients.

Objective To evaluate the effect of mouse nerve growth factor on fracture healing.Methods Cochrane library, Pubmed, EMbase, CNKI,VIP,Wanfang Data and CBM were searched for the randomized controlled trials(RCTs)of mouse nerve growth factor on fracture healing from the date of establishment of the databases to May 2014.Three independent rese archers evaluated the included studies using GRADE,according to recommend classification method of GRADE system by three researchers,crtical evaluated and data extracted of the quality of the included studies,which conform to the quality standard of RCT was analyzed by Meta analysis.The extracted data were analyzed by RevMan 5.0 and GRAED proiler.Results A total 5 trials were discovered and all of these were in Chinese.Compared with conventional treatment was improved a lot[MD =-8.74,95%CI( -9.79,-7.68),P<0.0001].However, adverse drug reaction in patients with mouse nerve growth factor were increased[OR =14.66,95%CI(1.89, 113.99),P=0.01].The both outcomes were low quality in the GRADE system.Conclusion Mouse nerve growth factor can improve fracture healing and the side effects will also increase.

10.3969/j.issn.1000-8179.2013.12.004

Objective To systematically review articles about therapeutic drug monitoring of vancomycin in Chinese adults, so as to provide a reference of vancomycin trough concentrations for clinical evidence-based medicine.Methods Literature concerning vancomycin therapeutic drug monitoring were electronically retrieved in, CBM, Wanfang data, CNKI and Vip.Furthermore, the articles written in English by Chinese author in PubMed, EMbase were included.All the data were searched from inception of the database or network to Aug.2014.Two reviews independently screened literature according to the inclusion and exclusion criteria, and assessed the quality of literature using the Combieg and NOS.Analyzing the types of studies, the number of therapeutic monitoring of vancomycin, trough serum concentration, clinical outcome and renal function.Results A total of 35 studies including 32 cross-sectional studies and 3 cohort studies were included, all studies were observational studies.3099 patients with 5206 blood concentrations monitoring results were eligible for final analyses in all 32 cross-sectional studies.The rates of trough serum concentration in 5-15 mg/L was 53.6%.Compared with the trough concentrations between 5 and 15 mg/L, clinical cure rate was no significant difference in the trough concentrations of over 15μg/mL.However, the incidence rate was significantly reduced in renal toxicity in 5-15 mg/L trough serum concentration.Conclusions For adults, trough serum concentration of vancomycin should adopt the 5-15 mg/L in China.However, considering lack of high-level evidence, so it needs to be studied further.

The recurrent laryngeal nerves of 16 dogs were sectioned to paralyze the vocal cord on the left side. The ansa hypoglossi nerve was cut on the same side, its proximal end was implanted into the thyroarytenoid (TA) muscle belly on the left side in six animals. It was anastomosed with the adductor branch of the recurrent larygeal nerve on the left side in five animals and the other five didn't receive reinnervated operations. After a period of five to six months, the operated areas were reexplored. The excitability values of the implanted nerve, anastomosed proximal and distal nerves, right recurrent laryngeal nerve, normal TA muscle, reinnervated TA muscle and denervated TA muscle were tested respectively in 16 dogs. The results indicated that the excitability values of the implanted and anastomosed nerves were equivalent to those of the normal nerves and were significantly higher than those of the reinnervated muscle which were equivalent to those of the normal muscle. The excitability values of the denervated TA muscles were lowest.

Objective To understand the prevalence and cause of eye diseases in the middle and old aged population in community was of important significance for the prevention and treatment of relevant diseases.The present study attempts to survey the prevalence of common eye diseases and conditions of blindness and low vision in 50 years and older population in community of Beijing.MethodsThis was an ophthalmologic epidemiology survey.The 2 833 target population was included and registered in Western Chang'an street community in door-to-door and questionnaire manner between October,2006-October,2007.Multiple factors,such as demography,general conditions,lifestyles,education degree,economical status,medical status and the awareness of relevant ophthalmic knowledge of participants were recorded and evaluated.Relevant eye examinations including uncorrected visual acuity,pinhole visual acuity,non-contact intraocular pressure test,slit-lamp,funduscopy and optometry examinations were performed in Beijing No.2 Hospital by trained ophthalmologists.Blindness and low vision were evaluated based on WHO criteria.The causes of leading-blindness and low vision were analyzed.Oral informed consent was obtained from all of the subjects.Results2 410 individuals of 2 833≥50-year-old participants received complete surveys according to the designed process in this study with an examined rate of 85.07%.The incidence of blindness and low vision in examinees was 0.79% and 5.64% respectively.The positive factors related to blindness and low vision appeared to be age,education and an awareness of relevant ophthalmic knowledge (χ~2=26.62,18.28,21.32,P＜0.001).The primary causes of blindness in examined population,in order,were cataract,glaucoma and retinopathy,and those of low vision were cataracts,refractive error and diabetic retinopathy.ConclusionIt is emphasized that early prevention and treatment for cataract,glaucoma,diabetic retinopathy and refractive errors can reduce the prevalence of blindness and low vision in people over 50 years in the Western Chang'an street community of Beijing.

Objectives To evaluate the preliminary effectiveness,investigate the clinical methods and prevent the complications of the epiphysis preservation operation by using custom-made prosthesis in children with distal femoral osteosarcomas.Methods Between August 2012 and July 2013,3 patients (from 8 to 14 years old) who were diagnosed of osteosarcoma underwent tumor segmental resection and epiphysis preservation operation and reconstruction with custom-made prosthesis.Patients were assigned neoadjuvant chemotherapy 1 to 2 cycles.The effect of neoadjuvant chemotherapy was then evaluated by X-ray,CT and MRI.Patients were determined the disease field by MRI,customized prosthesis by computer and had surgery of tumor segmental resection and reconstruction with custom-made prosthesis.All individuals were given appropriate functional exercise after operation,standard chemotherapy after incision healing one week,and long-time follow-ups.Results The operation times were 3 hours,4 hours and 6 hours.The bleeding losses during operation were 300 ml,500 ml and 2200 ml,respectively.The functional scores according to the scoring system of the Musculoskeletal Tumor Society (MSTS) after 12-24 months follow-ups were 24,26 and 13,respectively.And excellent functional results were obtained in short-time follow-ups.1 patient had prosthesis infection and amputation was taken after failing in conservative treatment.Unequal lengths of both lower extremities in 2 patients were less than 2 cm.Conclusion For the pediatric distal femoral osteosarcomas that has surgical indications,a new theory and therapy idea on combination of epiphysis preservation operation with custom-made prosthesis and neoadjuvant chemotherapy and standardized postoperative chemotherapy is suggested.And it has advantages of effective curative effect,easy operation,short operative time and quick recovery.However,long-term outcomes of complications should be observed further.