Objective To discuss the diagnosis and management for lower uterine segment pregnancy.Methods Clinical data of 6 cases of lower uterine segment pregnancy between January 2005 and February 2006 were retrospectively analyzed.Results Five patients had a history of caesarean section,while another one had undergone repeated pregnancy.Uterine artery embolization(UAE) in combination with methotrexate(MTX) injection was carried out in 2 cases,and uterine artery embolization only,MTX injection only,and total hysterectomy were employed in 1 case,1 case,and 2 cases,respectively.Conclusions Previous caesarean section and repeated pregnancy are risk factors of the occurrence of lower uterine segment pregnancy.Uterine artery embolization in combination with methotrexate injection is a safe and reliable management option.

Objective To explore effect of two methods for treating extravasation of venous indwelling needles.Methods A total of 96 patients with extravasation at transfusion were randomly divided into experiment and control groups with 48 cases in each group. Magnesium sulfate wet packing was used in the control group and external application of potato chips in the experiment group.The two groups were compared in terms of time for curative effect to occur and time for recovery.Result The time for curative effect to occur and time for recovery in the experiment group were both significantly shorter than those of the control group.Conclusion External application of potato chips is effective in reducing extravasation during venous transfusion.It is simple and free from side effects.

Objective:To investigate the effect of pidotimod on the expressions of IL-2 and IL-10 of patients with genital herpes(GH) and obverse its curative effect and quality of life of the patients.Mehtods:45 cases of outpatients with GH were selected as experimental group wich were given pidotimod orally 0.8g per day for 3 months.Observe the curative effect and value the quality of life before and 3 months after and 6 months after the treatment respectively.Detect the change of the expressions of IL-2 and IL-10 of the blood plasma of the GH patients.Select 30 healthy people as control group.Results:The recurrence rate of the experimental group during 1-3 month,4-6 month,7-9 month after treatment were 60.0%、42.2%and 22.2%respectively.The scores of quality of life and the total evaluation of quality of life itself (G1) and health condition(G4) at 3 and 6 month after treatment rising significantly than before treatment,and it is more obviously at 6 months after treatment than 3 months after treatment.Before treatment,the level of IL-2 of experimental group is significantly lower than that of control group,while the level of IL-10 of the experimental group is significantly higher than that of control group.3 and 6 months after treatment,the level of IL-2 rising significantly,while the level of IL- 10 reducing significantly.The change is more obviously at 6 months after treatment than 3 month after treatment either in the IL-2 rising or the IL-10 reducing.Conclusion:There is cellular immune function disorder in the GH patients.Pidotimod has a certain curative effect on the GH patients.It can reduce the recurrence rate of GH and improve the quality of life of the patients.Maybe it can enhance the cellular immune function of the body through rising the level of IL-2 and reducing the level of IL-10.

Objective To summarize the perioperative nursing care of the elderly patients with hip fracture.Methods There were 95 elderly patients with hip fractures admitted to hospital and received the fixation of artificial joint replacement and preoperative and postoperative nursing care from June 2010 to September 2013.Results Ninety-five patients were recovered and discharged from the hospital. They had stayed the hospital for 11 to 28 days and the average time was(17.5±2.5)d.One patient had developed pneumonia after surgery and one patient had incision infection.After treatment both patients were cured.Conclusions When the elderly patients with hip fracture stayed in the hospital,the nurses should give them good care.The nurses should provide them with mental care based on their psychological and physiological characteristics,help the patients to prevent the complications,guide the patients through rehabilitation training,enhance daily living and promote the patients’health as soon as possible.

OBJECTIVE To avoid the hospital(infection) in the dental surgery operating room.METHODS The(international) ISO quality standard was applied to establish the quality control the hospital infection.RESULTS The quality control for the hospital infection was guaranteed in the dental surgery operating room,and the items (observed) were in the allowance of the legislations for the hospital infection.Zero case of hospital infection(happened.) CONCLUSIONS It is useful for the hospital infection administration in the dental surgery operating room to apply the international ISO quality standard.

The records of 10 consecutive cases that sustaining traumatic CCF were retrospectively reviewed.The age of cases ranged from 18 to 55 years old, and all of them were complicated with fracture of orbit and base of skull.The causes of injuries, the characteristics of ocular manifestations,the findings in CT or cerebral angiography, and methods of treatment of CCF were analysed. The results showed that 9 cases were cured by operation (90%). The cavernous sinus fistulae were closed. The ocular signs such as exophthalmos, vascular murmur in eyelid and conjunctival swelling disappeared.One case had remaining exophthalmos.Nine patients who were cured were followed up for 6 months to 10 years.No ocular signs recurred in all cases. In 2 cases there were mild complications.It suggested that the pulsating exophthalmos,vessel murmur in eyelid and marked conjunctival vessel dilatation were the characteristics of ocular manifestations in CCF. Endovascular embolization with detachable balloon or spring coil is currently the treatment of choice and it is efficacious and safe in traumatic CCF.

Objective To observe the effect of electroacupuncture(EA) on the hippocampal expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in rats with vascular dementia(VD),so as to find out the underlying mo lecular mechanisms of EA in treating VD.Methods Thirty-two Wistar rats were randomly divided into a shamoperation group,a model group,a sham-acupuncture group,and an EA group (8 in each group).Permanent bilateral common carotid artery occlusion was performed to model vascular dementia in the model group,the shamacupuncture group and the EA group,while exposure but no occlusion of the bilateral common carotid were performed in the sham-operating group.Novel object recognition test was adopted to prove the establishment of VD rat model.All the rats were kept in an immobilization apparatus while receiving treatments.EA was applied ontoBaihui (GV20) and Zusanli (ST36) in EA group for 30 min,once daily for 7 days.Sham-acupuncture group were treated with needles inserted 0.5 mm superficially.And the sham-operation group and the model group were only immobilized.The protein expression of GluA1,pGluA1,CaMK Ⅱ and pCaMK Ⅱ in hippocampal tissue was detected by western blotting.Results The expression of GluA1 in the model group (1.216 ± 0.102) was significantly less than in the sham-operating group (1.918 ± 0.137) (P ＜ 0.05).The expression of GluA1 in the EA group (1.653 ± 0.169) was significantly higher than in the model group (1.216 ± 0.102) and in sham-acupuncture group (1.231 ±0.188) (P＜0.05).The expression of CaMKⅡ in the model group (1.516±0.392) was less than in the sham-operating group (2.187 ± 0.231) (P ＜ 0.05).The expression of CaMK Ⅱ in the EA group (2.733 ±0.387) was significantly higher than in the model group (1.516 ±0.392) and sham-acupuncture group (1.493 ±0.205) (P＜0.05).The expression ofpGluA1 in the model group (1.502 ±0.419) was less than in the sham-operating group (2.253 ± 0.244) (P ＜ 0.05).The expression of pGluA1 in the EA group (2.382 ± 0.308) was significantly higher than in the model group (1.502 ± 0.419) and the sham-acupuncture group (1.498 ± 0.223) (P ＜ 0.05).The expression of pCaMK Ⅱ in the model group (0.394 ± 0.227) was less than in the sham-operating group (0.667 ±0.175) (P＜0.05).The expression ofpCaMKⅡ in the EA group (1.189± 0.346) was significantly higher than in the model group (0.394 ± 0.227) and the sham-acupuncture group (0.408 ± 0.231) (P ＜ 0.05).Conclusion EA can enhance the protein expression and phosporylation of GluA1 and CaMK Ⅱ,causing silent synapses transforming into functional synapses,and consequently,long term potentiation was facilitated and cognitive impairment was improved by EA.

OBJECTIVETo observe the clinical efficacy on cognitive impairment after traumatic brain injury (TBD treated with acupuncture and cognitive training.

METHODSSixty patients were randomized into an observation group and a control group, 30 cases in each one, and 5 cases of them were dropped out due to the earlier discharge. Finally, there were 28 cases in the observation group and 27 cases in the control group. In the control group, the cognitive training and conventional treatment were applied. In the observation group, on the basis of the treatment as the control group, acupuncture was applied to Baihui (GV 20), Fengchi (GB 20), Geshu (BL 17) and Fenglong (ST 40), once a day, for 4 weeks totally. The mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) were adopted to evaluate the cognitive function in the patients of post-TBI cognitive impairment.

RESULTS(1) After treatment, the total score in MMSE and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<0. 05). Except for the score of immediate recall, the score in MMSE and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05). (2)After treatment, the total score in MoCA and the score of each item were increased significantly as compared with those before treatment in the two groups (all P<. 05). Except for the score of nomenclature item, the total score in MoCA and the score of each of the other items were increased significantly in the observation group as compared with those in the control group after treatment (all P<0. 05).

CONCLUSIONBoth the simple cognitive training and the combined therapy of acupuncture and cognitive training improve MMSE and MoCA scores and relieve the cognitive impairment induced by TBI. But the combined therapy achieves the much better efficacy.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Brain Injuries ; psychology ; therapy ; Cognition ; Cognition Disorders ; psychology ; therapy ; Cognitive Therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

Objective To investigate the treatment of symptomatic patent ductus arteriosus (PDA) in very low birth weight preterm infants. Methods From January 1, 2008 to December 31, 2010, 78 very low birth weight preterm infants (birth weight＜1500 g) were diagnosed as symptomatic PDA. Among which, 42 cases administered orally with indomethacin (0.2 mg/kg, every 12 hrs for three times) were taken as treatment group, while five cases in this group who failed to indomethacin treatment were interrupted with video-assisted thoracoscopic surgery. And 36 cases who did not receive treatment for ductus arteriosus were taken as control group. The clinical outcomes, complications and prognosis of these patients were observed. Results There were no significant differences between the gentle percentage, gestational age, diameter of ductus arteriosus, rate of complicated with heart failure, sepsis, neonatal respiratory distress syndrome and intraventricular hemorrhage of two groups (P>0.05, respectively). The ductus arteriosus closed in 33 patients of treatment group (78.6%) and in nine patients of control group (25.0%)(χ2=22.39,P=0.000). There were no significant differences in serum creatinine level and platelet count between before and after the treatment in treatment group(P>0.05). Compared with control group, the treatment group had lower incidence of intraventricular hemorrhage (z=1.167, P=0.030), shorter duration of oxygen therapy [(8.0±5.5) d vs (13.3±9.3) d, t=2.225, P=0.032] and shorter hospital stay [(39.0±7.7) d vs (43.6±10.6) d, t=2.229, P=0.029]; while the incidence of bronchopulmonary dysplasia and necrotizing enterocolitis were similar (P>0.05). The five cases of PDA who received video-assisted thoracoscopic surgery were successfully interrupted with no residual shunt left, while three of them had lung infections and one had pleural effusion, but no pneumothorax and infant death associated with surgery occurred. Conclusions Symptomatic PDA of very low birth weight preterm infants should be treated actively. Oral indomethacin was an effective and safe method to cure the PDA in these infants. Surgical ligation under video-assisted thoracoscopic surgery after failure of indomethacin treatment might be a good option.