Objective To investigate the pain-relieving effectiveness of persistent epidural anesthesia and its influence on mothers and infants.Methods 40 pregnant women without any obstetric complications and anesthetic contraindications were selected as the observation group,and persistent epidural anesthesia were applied when the cervicis opened to be larger than 3cm.40 cases with similar obstetric conditions were regarded as the control group without using any anesthesia.We compared the degree of labor pain,duration,delivery mode,the incidence of postpartum hemorrhage,intrauterine distress,neonatal asphyxia between the two groups.Results There were significantly difference in the rate of oxytocin utilization,vaginal delivery and the time of stageⅡ labor.There were no obvious difference in the active phase of labor course,the incidence of cesarean birth,intrauterine distress,neonatal asphyxia and postpartum hemorrhage between the two groups.Conclusions The results indicate that epidural anesthesia could affect the length of stageⅡ labor time and have merits of simple,obvious analgetic effect,but inflecencing delivery mode,therefore it to be improve.

Objective To investigate whether intrauterine hypoxia and ischemia can produce long-time effects or NOSI can prevent these damages. Methods Fetal rat intrauterine distress model was constructed. The rats were divided into the normal group, hypoxia and ischemia reperfnsion group and treatment group. Pupa were given to surrogate mothers and the ability of learning and memory at 40 day of age after delivery were examined. Then the water maze test was performed to detect the space learning ability and memory function of rats, and the changing of synaptophysin levels in hippocampns were detected by immunohistochemical staining. Result Behavioral results show that fetal distress produces cognitive impairment demonstrated by Morris water maze performance including a higher escape latency score and a de-creased cross platform time. The COD of Syp positive immunoreactive product in hippocampus were less decreased than that in the normal group or NOSI group. But the behavioral results and the COD of synaptophysin had no difference between normal group and NOSI group. Conclusions Fetal distress produced cognitive impairment and led to the decreasing of synaptophysin in hippocampns. Effective measure can relieve these damages.

Objective To identify significantly differentially expression of rat by genes chip,try to find out the initiating factors and molecular mechanisms that oxidative stress originate or strengthen the steriod-induced necrosis of femoral head(SINFH).Methods Twenty Wistar rats were dived into experimental group and control group randomly.The rats were injected intraperitoneally whith endotoxin,and then injected intramuscularly with high-dose methylprednisolone or saline in experimental group and control group respectively.The mRNA was extracted from the femoral head of rats inevery group,and the cDNA probes were obtained by inverse transcript,and then carried out microarray detection.The quantitative RT-PCR was used to confirm the results of the microarray.Results Histopathological findings revealed that the experimental group rats had femoral head necrosis,trabecular bone disorders,thinning,bone cell necrosis,and the rate of empty lacunae increased,and in control group no femoral head osteonecrosis was found.Total of 27 differentially expressed genes were found,and of which 4 genes(COX6A2,COX4I2,SOD3,and DUSP1)were significantly different.The expression of these 4 genes were down-regulated.The functions of these four genes involved in inhibition of reactive oxygen species(ROS)generation,accelerated removal of ROS and protection tissue from oxidative damage and so on.Conclusion The expression of oxidative stress-related genes in SINFH of rats exist change.COX6A2,COX4I2,SOD3,and DUSP1 are key genes in process of oxidative stress originate or strengthen the SINFH.

Objective To investigate the formation and special cell biological behavior of osteoclasts.Methods The live-cell imaging technology was adopted to consecutively and dynamically observe the whole process of multinuclear osteoclast formation induced by RANKL and M-CSF from rat peripheral blood monocyte.Meanwhile,the inverted phase contrast microscopy,TRAP staining,and scanning electron microscopy were also applied to identify the osteoclast.Results After 2-week cultivation,a great number of apocytes were found by the inverted phase contrast microscopy,and most apocytes and monocytes had positive reaction after TRAP staining.Moreover,many bone resorption lacunae in which osteoclasts were perhrming bone resorption function could be found in the bone slice under the scanning electron microscope.Live-cell imaging observation showed that the multinuclear osteoclasts were generated through self-fusion of monocytes,fusion of monocytes and apocytes,as well as fusion between apocytes.All fusion processes occurred under the condition of cell adherence.Time-lapse Microcinematography observation showed diverse shapes of osteoclasts and the cell division of multinuclear osteoclasts.Conclusion Rat peripheral blood monocyte can develop into osteoclast under induction of RANKL and M-CSF.Osteoclast can form gigantic apocyte via various types of cell fusion to increase its nucleus number and cell volume,vary its shape,and increase the area of plasma membrane.On the other hand,osteoclast can decrease its cell volume and nucleus number via cell division to adapt the needs of local morphology,biomechanics and bone resorption dynamics.It suggests that this non-mitosis cell division is a special cell biological behavior of osteoclast,which may be the basis of exerting its function and improving bone resorption efficiency.

AIM:To explore the influence of exogenous hydrogen sulfide ( H2 S) on coagulation and fibrinoly-sis in ferric chloride ( FeCl3 )-induced mouse carotid artery thrombosis .METHODS: The mice were divided into sham control group, model group, different concentrations (12.5, 25 and 50μmol/kg) of sodium hydrosulfide (NaHS, H2S do-nor) groups and 30 mg/kg clopidogrel ( positive control ) group.Intraperitoneal injection of NaHS at different concentra-tions and oral administration of clopidogrel bisulfate were performed for 3 d prior to FeCl 3-induced carotid artery thrombo-sis.The frozen sections of the carotid artery were collected to perform HE staining , and the thrombus pattern and the chan-ges of vascular pathology were observed .The thrombus was weighed to calculate thrombosis inhibitory rate .Prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , fibrinogen ( FIB) and fibrinogen degradation product ( FDP) in the mice were also measured by a coagulometer .The plasma levels of thromboxane B 2 ( TXB2 ) , 6-keto-prostaglandin F 1α(6-keto-PGF1α) and plasminogen activator inhibitor (PAI) were detected by ELISA.RESULTS: Compared with model group, NaHS dose-dependently inhibited the formation of carotid artery thrombus .NaHS treatment reduced the contents of TXB2 and PAI, and recovered 6-keto-PGF1αcontent in thrombosis model group .In NaHS treatment groups , 6-keto-PGF1α/TXB2 and thrombus weight was negatively correlated .NaHS treatment prolonged PT and APTT , reduced the content of FIB, but increased the level of FDP in thrombosis model group .CONCLUSION:Hydrogen sulfide prevents FeCl 3-induced carotid artery thrombosis by inhibiting coagulation and activating fibrinolysis .

Objective To investigate the serum anti-HBc level in patients with different natural history of chronic hepatitis B virus (HBV) infection and cirrhosis,and its clinical value for distinguishing the natural history statue.Methods A total of 160 patients with chronic HBV infection from March 2015 to June 2016 were enrolled,and they were divided into immune tolerance group (n=43),HBeAg-positive chronic hepatitis B (CHB) group (n=37),inactive carrier group (n=39) and HBeAg-negative CHB group (n=41).A total of 44 patients with HBeAg-positive cirrhosis and 46 patients with HBeAg-negative cirrhosis were enrolled too.The general conditions data were collected,and HBsAg,HBeAg,anti-HBc,HBV DNA load and HBV genotype were detected.The associations between anti-HBc level and clinical parameters were analyzed,and the diagnostic value of anti-HBc for distinguishing different natural histories was analyzed.Results The anti-HBc levels in different natural history from high to low were as following: HBeAg-positive CHB group (4.22±0.68)log10 IU/mL,HBeAg-negative CHB group (3.89±0.88)log10 IU/mL,inactive carrier group (3.07±0.68)log10 IU/mL and immune tolerance group (2.88±0.82)log10 IU/mL.The anti-HBc levels in HBeAg-positive and HBeAg-negative cirrhosis patients were (3.04±0.82) and (3.15±0.86) log10 IU/mL,respectively.In HBeAg-positive CHB group,the anti-HBc was positively associated with ALT (r=0.353,P=0.032) and AST (r=0.421,P=0.009).In HBeAg-negative CHB group,the anti-HBc was positively associated with HBV DNA (r=0.343,P=0.028),ALT (r=0.458,P=0.003) and AST (r=0.495,P=0.001).The AUC of anti-HBc used to distinguish immune tolerance from HBeAg-positive CHB was 0.903,and the AUC used to distinguish inactive carrier from HBeAg-negative CHB was 0.833.Conclusion Anti-HBc levels in different natural history of chronic HBV infection are significantly different,and anti-HBc could be used to distinguish the natural history statue of chronic HBV infection with a higher diagnostic value than HBsAg.

Objective: To observe the incidence of unreasonable use of high beam at nighttime among motor vehicle drivers, so as to provide the evidence for the prevention and control of road traffic injury. Methods: Four roads into city and five urban roads were selected in Yongkang of Zhejiang Province. An automatic recording system was used to collect the unreasonable use of high beam among motor vehicle drivers on the selected roads from 19:00 to 5:00 on Monday, Wednesday, Friday and Sunday during a week in July 2020. The regression tree model was used to analyze the relationship of the unreasonable use of high beam with road, time and traffic flow. Results: A total of 89 989 motor vehicles were observed, and 2 419 motor vehicle drivers had unreasonable use of high beam, with an incidence rate of 2.69%. The incidence rate of the unreasonable use of high beam was 3.14% in the roads into city, which was higher than 2.30% in the urban roads ( P<0.05 ). The incidence rates of the unreasonable use of high beam in the roads into city and in the urban roads were 5.15% and 2.90% on Wednesday, which were higher than those on Monday ( 2.89% and 2.34% ), Friday ( 2.90% and 1.92% ) and Sunday (2.06% and 2.12%). The highest incidence rate of the unreasonable use of high beam in the roads into city was 6.07% between 4:00 and 5:00, and in the urban roads was 4.50% between 2:00 and 3:00. The results of regression tree classification analysis showed that the highest incidence rate was 8.13% on the roads into city in the east, west and south directions, and on the urban roads in the east and north directions with less than 317 vehicles per hour on Wednesday. Conclusion It is more likely for motor vehicle drivers to use high beams unreasonably at nighttime on the roads into city with less traffic flow.

Objective To construct the standard nursing path index for perioperative enhanced recovery of patients after thoracoscopic lobectomy, and to provide theoretical basis for providing high quality nursing services for patients after thoracoscopic lobectomy. Methods Based on evidence-based medicine, systematic literature review and expert group meetings were organized to form the first draft of standard nursing pathway index for perioperative enhanced recovery of thoracoscopic lobectomy. Through Delphi method, 55 thoracic surgery medical and nursing experts were consulted for two rounds, and the structure and entries of the first draft were revised. Finally, a set of perioperative enhanced recovery standard nursing path index was formed. Results The recovery rate of the two rounds of expert consultation questionnaire were both 100%. The authoritative coefficients of experts in the two rounds were 0.855 and 0.874, and the coordination coefficients Kendall's W were 0.35 and 0.44, respectively. The standard nursing path index of perioperative enhanced recovery after thoracoscopic lobectomy included 4 dimensions (preoperative baseline assessment, preoperative preparation, intraoperative nursing intervention, postoperative nursing intervention), 25 items. Conclusions In this study, experts' enthusiasm and authority are high, opinions are well coordinated, the results are reliable, and the indexes can better meet the actual needs of patients, which can provide a basis for the next step to carry out perioperative enhanced recovery nursing practice for patients undergoing thoracoscopic lobectomy.

With the aging population in China,health issues among the elderly are becoming increasingly prominent,leading to a rapidly growing demand for health interventions for the elderly.Exergames are one of the important emerging methods in the field of health interventions for the elderly,widely used and yielding positive results.While research on exergames is well-established abroad,it is still in its infancy in China,lacking reports on the types,interaction forms,intervention content,application status,and effectiveness of exergames.Exergames are suitable for widespread use among the elderly in China,and there is a need to accelerate the development and application of exergames in the field of health interventions for the elderly in China.

One of the important causes of developmental epileptic encephalopathy (DEE) is the mutation of ion channel genes, including the mutation of the CACNA1E gene. CACNA1E-related DEE cases were first reported in 2018.The mutation types include new missense mutations, nonsense mutations and frameshift mutations, but the correlation between mutation sites and types with the phenotype of DEE is not clear.This review aims to summarize the reported CACNA1E-related DEE cases, and explore the correlation between the clinical phenotype of CACNA1E-related DEE and gene mutation sites and mutation types.Meanwhile, possible pathogenesis of CACNA1E-related DEE and the progress of drug intervention were reviewed to provide references for the diagnosis and precise treatment of DEE.