Objective To investigate clinical effects differences of ropivacaine combined with two doses of sufentanil on labor analgesia.Methods300 lying-in women with painless childbirth in the period from January 2016 to December 2016 in department of obstetrics in Deqing hospital of traditional Chinese medicine were chosen and randomly divided into two groups including A group (150 cases) with ropivacaine combined with conventional doses of sufentanil for 7.5μg and B group (150 cases) with ropivacaine combined with low doses of sufentanil for 2.5μg;the block onset time of sensory and motor, arrival time at the maximum block level, modified Bromage score, Apgar score, VAS score at different time points and adverse reaction rate of both groups were compared.ResultsTwo groups of maternal sensory and motor block work time and reach the highest block plane comparative differences had no statistical significance.The modified Bromage score of B group were significant better than A group(P<0.05).The adverse reaction rate of B group were significant lower than A group(P<0.05).ConclusionCompared with conventional dosage sufentanil, luo pp paid in combination with low dose used in epidural sufentanil analgesia can obviously reduce the working time, improve the quality of anesthesia and reduce the incidence of adverse reactions, is suitable for clinicians to choose application.

Objective To study the diagnostic value of the golgi protein 73 (GP73) combined with alpha‐fetoprotein (AFP) ,α‐L‐fucosidase (AFU) andα‐antitrypsin(α‐AT) detection in primary hepatic carcinoma(PHC) .Methods 100 patients with PHC ,100 patients with hepatitis and cirrhosis ,and 100 healthy people hospitalized in the hospital from October 2011 to May 2013 were en‐rolled in the study .Serum AFP levels were detected by using Beckman DxI800 chemiluminescent analyzer ,serum AFU ,α‐AT levels were detected by using Beckman DxC800 automatic biochemical analyzer ,and GP73 levels were measured by using enzyme‐linked immunosorbent GP73 quantitative detection kits .Results In patients with PHC and patients with hepatitis and cirrhosis ,serum GP73 ,AFP ,AFU ,α‐AT levels were significantly higher than healthy people(P<0 .05) .In patients with PHC ,GP73 ,AFP ,AFU ,α‐AT levels were significantly higher than those in patients with hepatitis and cirrhosis(P<0 .05) .The sensitivities of single serum GP73 ,AFP ,AFU ,α‐AT detection were 75% ,72% ,23% ,67% respectively and specificity were 95% ,95% ,100% ,97% respective‐ly .The sensitivity and specificity of the 4 tumor markers′combined detection were 99% and 100% .The sensitivity of combined de‐tection was significantly different from single detection(P<0 .05) .Conclusion GP73 ,AFP ,AFU ,α‐AT may improve the diagnostic efficiency of primary liver cancer .

Objective To study the influence of combined spinal-epidural anesthesia on perioperative coagulation function,RAAS activity and postoperative analgesia effect in parturients with cesarean section.Methods One hundred and eighteen parturients of cesarean section in our hospital from June 2013 to January 2016 were collected and divided into the observation group and control group according to the random number table method,59 cases in each group.The observation group received the combined spinal-epidural anesthesia and the control group received epidural anesthesia.The coagulation function indicators on preoperative 1 d (T0),at 10 min before operation end(T1) and postoperative 6 h (T2) were detected by adopting the automatic blood coagulation analyzer,the renin angiotensin aldosterone system (RAAS) function indices were detectd by radioimmunoassay.The pain indicators at postoperative 6 h(T2),12 h (T3) were detected by the pain threshold test instrument.Results The levels of prothrombin time(PT),activated partial thromboplastin time (APTT) and thrombin time (TT) at T1 and T2 in the observation group were significantly higher than those in the control group,while the PTA level was lower than that in the control group(P<0.05);serum RAAS indices such as (renin),angiotensin Ⅱ(ANG II) aldosterone(ALD) in the observation group were lower than those in the control group(P<0.05).The VAS score at T2,T3 in the observation group was lower than that in the control group,while the pain threshold and pain tolerance threshold levels in the observation group were higher than those in the control group(P<0.05).Conclusion Combined spinal-epidural anesthesia can reduce the blood coagulation and RAAS activation caused by cesarean section trauma,and the effect of postoperative analgesia is more significant.

Objective Toevaluate the postgraduates'satisfaction toAlma Mater's education of Peking University Health Science Center from 1998 to 2008.Methods Twenty to thirty percent of postgraduates who graduated from PUHSC and obtained domestic employment were selected and a questionnaire survey was conducted.Correspondence analysis was applied to intuitively show the relation of some variables.Results Postgraduates were satisfied with the education of PUHSC.The moral education,vocational ethics and teaching management of PUHSC was excellent.The campus life,society practice activities,administrative management and logistics service of PUHSC need to be improved.Methodology courses,foreign language courses,professional courses and writing courses should be reinforced during the education.Conclusion The postgraduates were satisfied with Alma Mater's education.It was pointed that postgraduate education of PUHSC was adapted to social needs.

Objective To evaluate the effect and potential risks of two types of materials ( taitanum versus polylevolactic acid,PLLA) screws on fixation of distal tibiofibular syndesmosis by a prospective randomized comparative clinical study.Methods From January 2007 to May 2008,48 patients with ankle fractures combined with a verified syndesmotic rupture were randomly allocated to receive either bioabsorbable PLLA (n =28 ) or titanium (n =20) screw fixation.The patients were assessed in aspects of radiography,function recovery and complication during follow-up.Results The total followup rate was 98％.The demographic information of the two groups showed no statistical difference ( P ＞0.05).After 1-2 years of follow-up,the indexes including Baird score,total score,and Baird grade were not statistically different between the two groups ( P ＞ 0.05).At the end of follow-up,there was significant difference in regard of joint motion between the injured and uninjured ankle in both groups ( P ＜0.05).Moderate rejection occurred in two patients and tibiofibular heterotopic ossification in two in PLLA group.Conclusions There is no significant difference between the bioabsorbable and metallic screws with regard to ankle function recovery,but the bioabsorbable screw fixation can avoid a second operation for taking out the screw.However,the complication risk of the bioabsorbable screws should not be ignored,such as rejection reaction,heterotopic ossification.

Objective To compare the contrast enhancement effects of SonoVue and Sonazoid in rabbit liver at ultrasonic frequency of 7 MHz using various mechanical index(MI) and dosage. Methods Eight rabbits were bolus injected with different contrast agents:for SonoVue(0. 06 ml/kg,0. 12 ml/kg) ,MI ranging 0. 10 - 0. 55; while Sonazoid (0. 045 ml/kg, 0. 09 ml/kg) , MI ranging 0. 19 - 0. 98. Quantitative analysis of ultrasonography was done using video-intensity analysis system, and peak intensity (PI) was compared. Results With the same frequency, in SonoVue group, for both dosage groups, PI reached maximum at MI = 0. 15 ( P <0. 05) ; with the same MI, PI of the high dosage group was higher ( P < 0. 05). In Sonazoid group,for both dosage groups,PI reached maximum at MI = 0. 40( P <0. 05) ; with the same MI,PI of the high dose group was higher ( P <0. 05). Conclusions The optimistic ultrasonographic conditions provided to SonoVue and Sonazoid are different. Dosage of contrast agents, MI and frequency need to be concerned.

ObjectiveTo study the role and mechanism of low-dose aspirin with IFN-α in inhibiting growth and metastasis of hepatocellular carcinoma (HCC).MethodsMHCC97L cells were cultured and a metastatic model of human HCC was established by orthotopic implantation of histologically intact human HCC tissue into the liver of nude (nu/nu) mice.After administration of different doses of Aspirin and IFN-α for 40 days,the mice bearing xenografts in liver were killed,and the tumor volume and lung metastasis were evaluated.Cell proliferation and MMP-2 activity were measured by MTT and gelatin zymography,respectively.The expressions of VEGF and MMP-2 were measured by western blot and ELISA.ResultsCompared to the control group,there were no significant differences in the high-dose Aspirin [45 mg/(kg · d)] treated group regarding tumor volume [(1.89 ±0.88) cm3 vs (3.12±0.85) cm3,P＞0.05] and incidence of lung metastases (58.3％ vs 66.7％,P＞0.05),but the tumor volume and incidence of lung metastasis were significantly inhibited in the highdose IFN-α group [1.5 × 107/(kg · d)],the high-dose IFN-α combined with high-dose Aspirin group,and the low-dose IFN-α [7.5 × 106 / (kg · d) ] combined with low-dose Aspirin [15 mg/(kg · d] group (P＜0.05).2 mmol/L Aspirin did not inhibit the proliferation of MHCC97 cells (P＞0.05),but inhibited the activities and expressions of MMP-2 and VEGF.Low-dose IFN-α combined with low-dose Aspirin significantly decreased the expressions of MMP-2 and VEGF in nude mice (P＜0.05).ConclusionLow-dose Aspirin combined with low-dose IFN-α significantly inhibited the growth and metastasis of HCC through suppressing the expressions of MMP-2 and VEGF.

BACKGROUND:A preliminary experiment developed a double-chamber stirred bioreactor which can carry out osteogenic and cartilage induction at the same time.
OBJECTIVE:To explore the effects of double-chamber stirred bioreactor on the repair of goat knee cartilage defects with tissue-engineered cartilage.
METHODS:Twelve goats were selected to make bilateral femoral condyle osteochondral defects models and randomized to three groups:experimental group, implanted with the composites ofβ-tricalcium phosphate and bone marrow mesenchymal stem cells that were subjected to 2-week chondrogenic and osteogenic induction simultaneously in the double-chamber stirred bioreactor under mechanical stimulation;control group, implanted with the composites ofβ-tricalcium phosphate and bone marrow mesenchymal stem cells that were subjected to 2-week chondrogenic and osteogenic induction simultaneously in the double-chamber stirred bioreactor;blank control group, without treatment. After 12 and 24 weeks of implantation, general observation, Masson staining, II col agen immunohistochemical staining and histological scoring were performed.
RESULTS AND CONCLUSION:In the experimental and control groups, new cartilage tissue and bone tissue were visible, but the experimental group showed better repair effects than the control group (P<0.05). The blank control group had no cartilage formation. These findings indicate that under the mechanical stimulation by the double-chamber stirred bioreactor in vitro, the repair effect of tissue-engineered osteochondral complex on knee joint cartilage defects can be improved.

Objective To explore the relationship of GFAP, NDKA and PARK7 serum concentrations of patients with IS, and their diagnose and prognosis value in IS. MethodsThe serum concentrations of GFAP, NDKA and PARK7 were detected in 37 IS patients, 28 ICH patients and and 30 healthy persons by ELISA. These indexes of patients were detected in 12 hours, 3 d and 14th day after onset of ischemic stroke. Their neurological injury status were also evaluated by MESSS at corresponding time points, and their activities of daily living were evaluated by BI at 14 d discharge from hospitaL At the same time, the diagnostic efficiency was analysed for IS using the three biomarkers and the combined detection. ResultsIn IS group, the serum concentrations of GFAP in 12 hours, 3rd and 14th day after onset were (5. 49 ±2. 25 )μg,/L, (5. 17 ± 2. 29) μg/L and (5. 96 ± 2.39 ) μg/L, respectively. The serum concentrations of NDKA were 9. 15(6.28 -12.79) μg/L, 9. 13(6.31 - 12.23) μg/L, 9.31(6.40 - 11.83) μg/L respectively,and the serum concentrations of PARK7 were (32. 71 ±6. 34 ) μg/L, (31.23 ±6. 04) μg/L, (32. 79 ±6. 94) μg/L respectively. The serum levels of GFAP, NDKA and PARK were respectively (4. 62 ± 1. 56)μg/L, 4. 24(3. 30 -5. 61 ) μg/L, ( 14. 25 +2. 65) μg/L in healthy control group. The levels in IS groups were remarkably increased compared with the healthy control group except the level of GFAP in the 3rd day (t = 1. 129, P＞0. 05). The levels in other time points were significantly different between patients group and healthy control. t value of GFAP were respectively 2. 642, 1. 870,P＜0. 05; Z value of NDKA were 6. 173, 6.100, 6.278,P ＜0. 01; t value of PARK7 were 14.964, 15.367,16.060, P ＜0. 01. The specificity and sensitivity of the individual detection for diagnosis of IS was 46. 7％ (14/30) and 81.1％( 30/37 ) for GFAP, 90. 0％ ( 27/30 ) and 78.4％ ( 29/37 ) for NDKA, 96. 7％ (29/30) and 97.3％ ( 36/37 )for PARK7. The specificity and sensitivity for combined detection of 3 biomarkers was 96. 7％ (29/30) and 100％ (37/37). The combined detection achieved better specificity and sensitivity. Moreover, the risk of IS with higher level GFAP was 1. 3 times that of the controls ( OR = 1. 300, P = 0. 044 ). The risk of higher NDKA was 1.7 times higher( OR = 1. 668, P = 0. 036 ). The risk of higher PARK7 was 1.8 times higher (OR = 1. 809, P =0. 005 ). The serum levels of GFAP were significantly different between IS and ICH in 12 h(t= 4.097, P=0.000). The serum concentrations of GFAP, NDKA and PARK7 were positively correlated with MESSS score at different time points. In IS, r value were 0. 534, 0. 482, 0. 357 , P ＜ 0. 05at less than 12 h; r value were 0.433, 0.487, 0. 299,P value were 0. 007, 0. 002, 0.073 at 3 d;r value were 0. 394, 0. 200, 0. 084,P value were 0.016, 0. 236, 0.620 at 14 d. And the serum levels of GFAP,NDKA and PARK7 were negatively correlated with BI score at 14th day, r value were -0. 430, -0. 321,-0.076,P value were 0.044,0.050,0.657. Conclusions The concentrations of GFAP, NDKA and PARK7 in serum are closely related with IS. The increased seruro levels of these indexes are risk factors in IS. The detection of these indexes could be helpful for the early diagnosis, timely treatment and prognosis assessment for IS.

Objective To analyze the adult hemophagocytic syndrome' s pathogeny,clinical features,prognostic factors and therapeutic options.Methods 18 cases of adult hemophagocytic syndrome were analyzed,the Kaplan-Meier analysis was used to investigate the total survival rate,and 17 clinical pathological factors and clinical treatment methods which may influence survival were analyzed by Log-rank test in the univariate analysis.Results In this group of patients,EBV infection and malignant lymphoma were the most common initiating diseases.The most common clinical features were peripheral cytopenia in two or three lineages (100 ％),fever (83 ％),splenomegaly (78 ％),swollen lymph nodes (56 ％).The mortality rates as high as 66.7 ％.The median survival time was 7.4 weeks.One-way ANOVA results showed that the initial symptoms as fever (P =0.039),age ＞ 30 years old (P =0.031),enlargement of the liver (P =0.041),Hb ＜ 100 g/L and Ph ＜ 50 g/L (P =0.039) were relevant prognostic factors.Conclusion Adult hemophagocytic syndrome patients with fever as the initial symptoms,age ＞ 30 years old,liver enlargement,Hb ＜ 100 g/L,Plt ＜ 50 g/L indicates poor prognosis,thus these patients having HPS risk factors should be given active chemotherapy and supportive therapy.