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.

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 .

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

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.

Objective To explore the relationship between Nestin expression level and prognosis in osteosarcoma,and to provide a new idea for treatment.Methods Thirty patient with osteosarcoma who had received treatment were included this study according to the criteria.HE staining was applied to evaluate the response to chemotherapy,meanwhile immunohistochemistry was applied to evaluate Nestin expression levels before and after chemotherapy.Kaplan Meier survival curve was drawn to analyze the outcomes.Results The response of chemotherapy was good in 17 patients and poor in 13.24 cases were strongly positive in Nestin staining,five were weakly positive,and one was negative.The expression level of Nestin in osteosarcona was correlated to the chemotherapy response and prognosis (P ＜ 0.05),while higher level of Nestin expression referred to poorer response of chemotherapy and lower overall survival rate.Conclusions The expression level of Nestin in osteosarcoma tissue is associated with the effect of chemotherapy and prognosis;higher expression level of Nestin indicates poorer prognosis and efficacy of chemotherapy.

Objective To explore the significance of using cytologic and RT-PCR methods to examine(peritoneal) washings and peritoneal tissues of gastric cancer patients in prediction of peritoneal micrometastasis.Methods The peritoneal washings of 38 patients with gastric cancer and 5 patients with benign gastric(lesions) were collected and,at the same time,a small amount of omentum and peritoneum were removed for control.CEAmRNA expression of free cells in peritoneal washings were detected by RT-PCR method and(also) cytology of the washings were performed.Results The CEAmRNA expression rate of peritoneal washings and peritoneal tissues were 36.8%(14/38) and 39.5%(15/38)respectively.Both were more(sensitive) than that of cytologic examination 26.3%(10/38).TNM staging,depth of invasion,lymph node metastasis,and serosal involvement were related to the expression rate of CEAmRNA.Conclusions mRNA of CEA is more sensitive and specific than cytologic examination for detecting free cancer cells in peritoneal cavity.It is an effective method for detecting peritoneal micrometastases in gastric cancer patient.

Objective To summarize the characteristics of epidemiology,clinic and radiography of mycoplasma pneumoniae pneumonia(MPP) in children.Methods Two hundred and one MPP patients were selected as our subjects who hospitalized in Kailuan General Hospital Affiliated to Hebei United University from Jan.to Dec.2013.All clinical data were recorded.Results Of 412 children with pneumonia,201 children were developed MPP(48.97％).There was significant difference among different age groups regarding of MPP incidence rate(x2 =62.04,P ＜ 0.05),and the highest incidence was in school-age group(71.59％).There was significant difference among the different month,and the MPP cases were more occurred at January,July,September,October and November.The main clinical manifestations were cough (201cases,100％),fever(136 cases,67.66％),moist rales (168 cases,83.58％),breathing (58 casses,28.86％).And parts of children (23.38％) were complicated with extra pulmonary symptoms.The blood WBC of most MPP patients were without obvious increase and blood WBC of 136 cases(67.66％) was less than 10 × 109/L.The cases with hsCRP (＜ 5 mg/L or-10 mg/L) accounted for 36.32％ or 22.39％.Imaging examination results showed that 64 cases were with bronchovascular shadow,73 cases with spot and schistic shadow,64 cases with lobar pneumonia and 3 cases with pleural effusion.Conclusion Clinicians sholud make the early diagnosis and treatment of MPP based on epidemiology,clinical and image comprehensive characteristics of MPP.