Objective To explore the feasibility of reducing induction dose of remifentanil,deepening anesthesia and intubation after umbilical removal and its effect on maternal,neonatal and anesthesiologists during cesarean section.Methods Thirty cases of ASA Ⅰ-Ⅱ scheduled for elective cesarean section were divided into three groups according random digits table method with 10 cases each.The induction dose of remifentanil was 1.0,1.5,1.0 μ g/kg in group Ⅰ,group Ⅱ,group Ⅲ.Group Ⅰ and group 11 received routine procedure after induction of anesthesia,intubation,while group Ⅲ received anesthesia umbilical removal.Systolic pressure (SBP),diastolic pressure (DBP) and heart rate (HR) were recorded before induction of anesthesia,skin incision and immediately intubation.And the fetal childbirth time,intubation time and neonatal Apgar score at 1,5,10 min were recorded.Results Three anesthesia procedures could meet the requirements of cesarean section.The SBP,DBP and HR at skin incision in group Ⅰ and group Ⅲ were significantly higher than those at before induction of anesthesia [group Ⅰ:(136.5 ±9.7) mm Hg (1 mm Hg=0.133 kPa) vs.(113.5 ±7.8) mm Hg,(96.5 ±9.1) mm Hg vs.(74.2 ±6.0)mm Hg,(98.5 ± 8.7) times/min vs.(81.2 ± 8.4) times/min; group Ⅲ:(138.1 ± 11.4) mm Hg vs.(118.7 ±9.9) mm Hg,(90.1 ±9.9) mm Hg vs.(77.3 ±7.9) mm Hg,(100.3 ±9.0) times/min vs.(81.7 ±9.2)times/min],there were statistical differences (P ＜ 0.05).The SBP,DBP and HR at immediately intubation in group Ⅲ were significantly lower than those in group Ⅰ andgroup Ⅱ [(97.6±10.1)mmHgvs.(138.9±11.2) and (130.1 ± 4.5) mm Hg,(80.1 ± 5.5) mm Hg vs.(97.7 ± 8.9) and (82.0 ± 8.6) mm Hg,(80.4 ±7.8) times/min vs.(99.3 ± 12.2) and (95.9 ± 9.6) times/min],there were statstical differences (P ＜ 0.05).There was no statistical difference in fetal childbirth time among the 3 groups (P＞ 0.05).The neonatal Apgar score at 1 min in group Ⅱ was significantly lower than that in group Ⅰ and group Ⅲ [(7.4 ± 0.9) scores vs.(8.8 ± 0.6),(8.9 ± 0.6) scores],there was statistical difference (P ＜ 0.05).The intubation time in group Ⅲ was significantly longer than that in group Ⅰ andgroup Ⅱ [(8.5±l.8) min vs.(3.0±0.5),(2.8±0.6)min],there was statistical difference (P＜ 0.05),but the intubation time in group Ⅲ was completed within 10 min.Conclusions Using the protocol of remifentanil 1.0 p g/kg induction,midazolam 2 mg,fentanyl 0.2 mg deepening after the umbilical removal can effectively avoid the effect of remifentanil on neonatal 1 min Apgar score,decrease the intubation stress with no effect on anesthesiologists.This method is simple,method of anesthesia for elective cesarean section.

ObjectiveTo evaluate the role of serum IgM, IgG and IgA anticardiolipin antibody (ACA) isotypes in the diagnosis of systemic lupus erythematosus (SLE), and their association with lupus nephritis (LN) in children.Methods One hundred and sixteen hospitalized SLE pediatric patients were selected between April 2005 and October 2013. The clinical data were collected and analyzed.Results There were 20 males and 96 females among 116 SLE patients. The positive rate of ACA-IgG, ACA-IgM and ACA-IgA was 37.1%, 35.3%, 26.7% respectively, without signiifcant difference between each other (P>0.05). Among 116 SLE patients, 75 cases had LN and 41 cases had no LN. The positive rates of ACA-IgM and ACA-IgA were not sig-niifcantly different between cases with and without LN (P>0.05). Cases with LN (42.7%) had higher ACA-IgG positive rate than cases without LN (22.0%) (P=0.026). The occurrence of LN and the positive rate of ACA isotypes were not signiifcantly different between genders (P>0.05).Conclusions The different isotypes of ACA have the same signiifcance in the diagnosis of SLE. The detection of ACA-IgG helps diagnose the LN complicated with SLE.

Objective To explore the effect of compound lidocaine cream and/or psychotherapy in preventing the catheter-related bladder discomfort (CRBD) of male patients with operation under general anesthesia. Methods Eighty male patients undergoing selective upper abdomen operation were selected, and the patients were divided into 4 groups by random digits table method with 20 cases each:control group (C group), compound lidocaine cream group (L group), psychotherapy group (B group) and compound lidocaine cream combined with psychotherapy group (LB group). The incidence of CRBD after extubation, dosage of fentanyl and the number of patients who need flurbiprofen axetil to relief the pain of CRBD were compared among the 4 groups. Results The incidence of no CRBD after operation in LB group was significantly higher than that in C, L and B group: 90%(18/20) vs. 15%(3/20), 60%(12/20) and 50% (10/20), and there were statistical differences (P<0.05). The incidence of mild CRBD in LB group was significantly lower than that in C, L and B group:10%(2/20) vs. 45%(9/20), 35%(7/20) and 40% (8/20), and there were statistical differences (P<0.05). There were no statistical differences in dosage of fentanyl among the 4 groups (P>0.05). The rate of patients who need flurbiprofen axetil to relief the pain of CRBD in C group was significantly higher than that in L, B and LB group: 40%(8/20) vs. 5%(1/20), 10%(2/20) and 0, and there were statistical differences (P<0.05). Conclusions Both the means of compound lidocaine cream and psychotherapy can reduce the incidence of CRBD. However, the method of compound lidocaine cream combined with psychotherapy is able to basically avoid the occurrence of CRBD, and it is worth spreading in clinic.

Objective To evaluate the expression of ? opioid receptor of the knee joint synovium tissue in patients with chronic inflammation. Methods The patients were divided into inflammatory group and control group(n=25 for both). Those who were allocated to the inflammatory group were diagnosed as osteoarthritis by arthroscopy, and in the control group, the patients were having dislocation of patella and took internal fixation with arthroscopy. The synovium tissues were harvested from suprapateller bursa, articulation vestibule, intercondylar fossa and articulation metacele. The synovium were taken to measure ? opioid receptor by immunohistochemistry and RT-PCR in both groups. Results Immunohistochemical and RT-PCR results revealed that the expression of mRNA and the optical density (OD) of immunoreaction of ?-opioid receptor in the knee synovium tissue in the chronic inflammation group were significantly higher than those in the control group (P0.05). Conclusion The expression of ? opioid receptor of the knee joint synovium tissue in chronic inflammation was significantly up-regulated. It may play a partial role in the peripheral mechanism of morphine.

BACKGROUND: Evidence from in vitro study indicates that bone marrow stromal cells and undifferentiated mesenchymal cells can different into chondrocytes.OBJECTIVE: To observe the morphological changes of red bone marrow and periosteum allograft and its capability of chondrogenesis after transplantation in rabbits for repair of articular cartilage defects.DESIGN: Randomized controlled experiment with rabbits.SETTING: Department of Human AnatomY, Medical College of Yanbian University.MATERIALS: Fourteen Chinese rabbits of either sex with body mass of (2.15±0.30) kg.METHODS: This experiment was carried out in the Department of Human Anatomy, Medical College of Yanbian University between April 2001 and February 2002. Full thickness articular cartilage defect of 3.0 mm×6.0 mm was produced in the rabbits on the patellar surface of the femur in the 28knee joints, which were then randomized to receive either transplantation with autologous red bone marrow and periosteum graft into the bone defect (20 knees) or no grafts (8 knees). The morphological changes of graft were evaluated 7 days and 2, 4, 8, and 12 weeks after the operation by gross,optical microscopic, and electron microscopic observations with also assistance of image analysis.drocyte area of two groups.RESULTS: In the 12th week after the operation, the morphology, distribution and arrangement of the regenerated tissues were similar to normal cartilage in the knees with graft transplantation, and the regenerated tissues grew to be integrated with the surrounding normal cartilage with obscure boundary between them. But the boundary between the bone defect and surrounding normal cartilage was clearly observed in the ungrafted knees,and most of the defect was replaced by fibroblasts and collagen fibers with only some small chondrocytes seen in the superficial layer. Microscopic observation in the 4th week revealed the presence of chondrocytes in the superficial layer of the graft, and imaging analysis displayed greater single cell surface in the grafted than in the ungrafted knees in the 4th, 8th and 12th weeks [(248.70±16.62) vs (168.23 ±6.14) μm2, (267.79±28.88) vs (172.93±17.18) μm2, (175.75±13.24) vs (145.35±13.54) μm2, P ＜ 0.05].CONCLUSION: The chondrogenesis in autologous complex tissue graft of red bone marrow and periosteum occurs 8 weeks after the operation, and the morphology, distribution and arrangement of the newly generated cells are similar to that of the normal cartilage, with good mutual compatibility and complementarity in the regeneration activity between the two graft tissues.

Objective To analyze the main causes of early neonatal death in Qingdao Women &Children's Hospital in the latest 10 years.Methods The medical records of early neonatal death in the Qingdao Women&Children’s Hospital from January 2002 through December 201 1 were analyzed.Results A total of 16 314 neonates were available to study,and 525 of them died.The mortality of early neonatal death within a week after birth was 77.71% (408 cases),including 214 premature infants and 194 mature infants.A comparison of mortality between the first 5-year and the second 5-year showed that the underlying trend of mortality was downward (P <0.05 ).The mortalities of early neonatal death within 1 day,3 days, and 4-7 days after birth were 1 10 cases (27.00%),192 cases (47.06%),and 106 cases (25.98%), respectively,and most of the neonates died within 3 days after birth;and the number of severe neonates died within 24 hours was higher than that in other two groups (P <0.01).The leading causes of early neonatal death in 10 years were:preterm birth-related factors (97 cases,23.78%),severe asphyxia (91 cases, 22.3%),congenital malformations (66 cases,16.2%).From 2002 to 2006,the top three main causes of early newborn death were severe asphyxia,congenital malformations and acute respiratory distress syndrome (ARDS),whereas from 2007 to 2011,the leading causes of death were ARDS,severe asphyxia,and congenital malformations.In comparison of early neonatal death between different gestational ages,preterm infants’death occurred mainly in 32 weeks,accounting for 26.72%.Conclusions In our hospital,the early neonatal mortality was decreased in the latest 10 years,and majority of deaths occurred within 3 days after berth,and preterm infants’death occurred mainly in 32 weeks.The leading causes of overall early neonatal death in order of frequency were premature birth,severe asphyxia and congenital malformations,but in later 5 years this order of leading causes changed.

Objective:To investgate the ease effects of local injection of ursolic acid both on orthodontic tooth movement distance and tooth root resorption in the rats, and to clarify its mechanism.Methods:Ninety-six male Wistar rats were used to establish models of orthodontic tooth movement.After the successful establishment of models,all the model rats were randomly divided into 0 (control group),0.5,1.0 and 2.0 mmol·L-1 ursolic acid groups (n=24).The rats were locally injected with different doses of ursolic acid into the palatal submucosal area adjacent to the right upper first molar ,once per 3 d,each time 50μL.The rats were respectively sacrificed on the days 1,3,5,7,10,14,21 and 28,then the distances of tooth movement were measured.HE staining was used to observe the morphologic changes of the root tissue of rats.Results:The tooth movement distances of rats in control,0.5,1.0,and 2.0 mmol· L-1 ursolic acid groups were increased with the prolongation of time (P<0.01).Compared with control group,the tooth movement distances of rats in 0.5 mmol·L-1 ursolic acid group 3,7,14,21 and 28 d after forcing had statistical significance (P<0.05 or P<0.01 );the tooth movement distances of rats in 1.0 and 2.0 mmol· L-1 ursolic acid groups 1 d after treatment had no statistical significance (P>0.05),but at the other time points,the tooth movement distances of rats had statistical significance (P<0.01).The tooth movement distances of rats had statistical significance between 0.5,1.0 and 2.0 mmol·L-1 ursolic acid groups 5,7,10,14,21 and 28 d after forcing (P<0.05 or P<0.01).The morphological results showed that the resorption pits were found on the surface of tooth root with the prolongation of loading time;in addition,with the increasing of the doses of ursolic acid, the absorption of root surface was relieved. Conclusion:Local injection of ursolic acid at the doses of 0.5,1.0 and 2.0 mmol·L-1 can reduce the distance of orthodontic tooth movement in the rats, and the distance of tooth movement in the rats is reduced with the increasing of its doses,and ursolic acid has the ease effect on the orthodoutic tooth root resorption.

OBJECTIVE: To explore the circadian distribution of premature ventricular contractions (PVCs) in patients with viral myocarditis (VM) according to the theory of chronomedicine in traditional Chinese medicine (TCM) in order to find out the scientific evidence for a reasonable administration time. METHODS: Two hundred and forty patients with VM were enrolled and electrocardiograms were examined for all by Holter monitor. The circadian distribution of PVCs was evaluated according to the theory of chronomedicine of TCM about time periods corresponding to five zang viscera. RESULTS: PVCs mostly happened in periods of 3:00-5:00, 5:00-7:00, 7:00-9:00 and 9:00-11:00, in which 5:00-7:00 was the most serious time. Less PVCs happened in periods of 17:00-19:00, 19:00-21:00 and 21:00-23:00. The frequency of PVCs in midnight also increased with aging. The time periods of the frequency peak of PVCs in patients with different syndromes were also different. In patients with syndrome of pathogenic heat invading heart (PHIH), the PVCs mostly appeared in midday. In patients with syndrome of flaring of fire due to yin-deficiency (FFYD), the PVCs were most serious in daytime and aggravated at noon. And in patients with syndrome of insufficiency of heart-qi and yang (IHQY), the PVCs mostly happened in early morning or midnight. CONCLUSION: There was a manifest regulation of the pathological circadian rhythm of PVCs in patients with VM. The circadian distributions of PVCs were variable in patients with different syndromes. Therefore the theory of chronomedicine of TCM may be used to guide the treatment based on syndrome differentiation.

Objective To investigate the effects of recombinant human erythropeietin(rh-EPO)on Bid mRNA and caspase-3 activity in the brain after hypoxic-ischemic brain damage(HIBD)in neonatal rats and the possible mechanism of the neuroprotective effect of rh-EPO.Methods Ninety 7 day old male SD rats weighing 12-18 g were randomly divided into 3 groups(n=30 each):group Ⅰ sham operation(S);group Ⅱ hypoxia-ischemia group(HI)and group Ⅲ rh-EPO.The animals were anesthetized with ether.Left common carotid artery was ligated with 4-0 silk and 3 days later the animals were placed in a 2 L airtisht vessel filled with 8%O2-92%N2 at 2-3 L/min for 2 h in group Ⅱ and Ⅲ.rh-EPO 3 000 IU/kg in 4 ml/kg normal saline(NS)was administered intraperitoneally after induction of hypoxia-ischemia(HI)in group Ⅲ while in group Ⅱ NS 4 ml/kg was given IP instead.Six animals in each group were killed at 6,12,24,48 and 72 h(T1-5)respectively after IP NS or rh-EPO.Their brains were removed for determination of Bid mRNA expression(by RT-PCR)and caspase-3 activity(by colorimetric method).Results The expression of Bid mRNA was up-regulated and caspase-3 activity was significantly increased in the brain at T1-5 in HIBD group(group Ⅱ)as compared with sham operation group.rh-EPO administration significantly reduced the increase in Bid mRNA expression and caspase-3 activity in the brain induced by hypoxia-ischemia.The expression of Bid mRNA was positively correlated with the caspase-3 activity.Conclusion rh-EPO has protective effects on the brain against hypoxia and ischemia by decreasing the expression of Bid mRNA and caspase-3 activity in the brain.

Objective To compare the influences of general anesthesia and intra spinal anesthesia on circulation, respiration, body temperature and anesthesia-related complications in patients undergoing percutaneous nephrolithotomy (PCNL), and assess the effectiveness and safety of both anesthesia. Methods Forty ASA Ⅰ - Ⅱ patients elective for PCNL surgery were divided into two groups by random digits table with 20 cases each:group Ⅰ (endotracheal general anesthesia) and group Ⅱ (intra spinal anesthesia). The temperature, heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation (SpO2) values and postoperative shivering, nausea, vomiting, back discomfort and the incidence of sore throat were observed and recorded. Results The anesthesia was stable, there were no changes in MAP, HR at different time in group Ⅰ . The anesthesia in group Ⅱ was effective, MAP at 15 min after anesthesia,and HR,MAP after lithotomy position and prone position were obviously changed in group Ⅱ compared with those before anesthesia and group Ⅰ (P ＜ 0.05 ). The temperature at 30,60,90, 120 min after anesthesia decreased compared with that before anesthesia in two groups (P ＜ 0.05 ), and the temperature at 30,60 min after anesthesia in group Ⅰ [(35.8 ±0.6), (34.8 ± 0.5)℃] was lower than that in group Ⅱ [(36.2 ± 0.6),(35.6 ± 0.5)℃](P＜ 0.05).During recovery,complications such as shivering, nausea,sore throat, back discomfort occurred to some extent, of which the incidence of shivering was the highest. Conclusion Both of two anesthesia are applicable to PCNL. When intra spinal anesthesia is used,the life indicators of patients need to be observed and general anesthesia is preferable for the obesity,less physical and the old with poorly compensatory function.