Objective To change the traditional disposal of the third stage of labor, we exsanguinate the placental blood from the maternal termination of umbilical cord after delivery, then the pressure of placental sinus decrease rapidly, the vessels contract, the placenta seperate from the uterine wall and expuse quickly, the third stage of labor is shortened and postpartum bleeding amount is decreased. Methods We chose 200 cases of vaginal delivery puerperants from October 2004 to August 2005 in our hospital as the test group (group A), 100 cases of vaginal delivery puerperants in the same period as the control group (group B). The statistics of the third stage of labor and the postpartum bleeding amount is made so as to evaluate and analyse the effect. Results In group A, the third stage of labor is obviously shortened and the postpartum hemorrhage is obviously reduced. There is singnificant difference between the two groups (P

Objective To find out the correlation of elderly blood pressure variability and heart and cerebrovascular diseases.Methods 133 cases of non-hypertensive elderly accepted the 24 hour ambulatory blood pressure monitoring,the 24 hours,day,night systolic blood pressure variability and diastolic blood pressure variation were analyzed,and incidence of coronary heart disease,arrhythmia,hyperlipidemia were investigated according to the degree of variation.Results The incidence of arrhythmia,coronary heart disease and hyperlipidemia of the elderly which 24 hours,day,night systolic blood pressure variation standard deviation or diastolic blood pressure variation standard deviation were greater than the upper limit of normsl were significantly higher than the elderly whose value within the normal range ( P ＜ 0.05 or P ＜ 0.01 ).Conclusion Elderly non-hypertensive blood pressure variability and cardiovascular and cerebrovascular diseases have significant contact,blood pressure variability can be as important risk factors which determine the pathogenesis and prognosis of cardiovascular disease in this population.

Botulinum neurotoxin(BoNT) is the most lethal biotoxin known to mankind. It inhibits acetylcholinerelease from the cholinergic nerve ending by cleavage of SNARE proteins, followed by neuromuscular blockadeand paralysis. Gangliosides are considered to act as a first receptor of BoNT with low affinity.Then the membranebound gangliosides-BoNT complex moves laterally to reach and bind the toxin specific protein receptor,synaptotagmin, with a high affinity constant. At last the gangliosides-BoNT-synaptotagmin complex undergoesreceptor-mediated endocytosis. This double-receptors theory is widely accepted. The research data are summarizedand reviewed.

Objective To investigate clinical features,pathogen distribution and prognostic risk factors of candidemia in patients from non-intensive care unit (ICU) wards.Methods Seventy two patients with blood culture-confirmed candidemia were admitted in non-ICU wards in the First Affiliated Hospital of Zhejiang University during January 1 st 2011 and January 31 th 2014.The clinical data of patients,including clinical features,pathogen distribution,treatment and prognosis were retrospectively analyzed.The risk factors for the infection and the fatality of patients were assessed by chi-square test,Fisher exact probability test and multivariate Logistic regression analysis.Results Among 72 patients with candidemia,29 (40.28％) were related to Candida albicans and 43 (59.72％) were related to non-Candida albicans.Univariate analysis showed that elderly people (x2 =6.109,P ＜ 0.05),male (x2 =5.258,P ＜ 0.05),solid tumor (x2 =7.186,P ＜ 0.01),parenteral nutrition (x2 =6.512,P ＜ 0.05),surgery within 30 d (x2 =4.284,P ＜ 0.05),indwelling gastric tube (x2 =4.164,P ＜ 0.05),and indwelling urethral catheter (x2 =3.952,P ＜ 0.05) were risk factors of Candida albicans-related candidemia;while patients with hematologic malignancies (P ＜ 0.0l) and neutropenia (P ＜ 0.05) were prone to non-Candida albicansrelated candidemia.Fourteen cases died within 28 days from the diagnosis of candidemia with an overall 28-d fatality rate of 19.44％.Multivariate Logistic regression analysis indicated that septic shock(OR:84.818,95％ confidential interval:3.560-2020.567,P ＜ 0.01)and acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score (OR:1.252,95％ confidential interval:1.035-1.515,P ＜ 0.05) were independent risk factors of death,while removal or replacement of central venous catheter (OR:0.002,95 ％ confidential interval:0-0.135,P ＜ 0.01) was a protective factor.Conclusions There are more non-Candida albicans-related candidemia than Candida albicans-related candidemia in non-ICU wards.Patients with high APACHE Ⅱ score and septic shock usually have poor prognosis,while removal or replacement of central venous catheter may improve the prognosis.

Objective:To observe the effects of the Increasing-Energy and Renewing-Wisdom granule on vascular dementia(VD) patients. Methods:42 VD patients were divided randomly into 2 groups. The patients in treatment group administered the Iincreasing-Energy and Renewing-Wisdom granule. The patients in control group administered piracetam. All the patients were treated for 3 months. Results: The patients' scores of HDS, MMSE, Wechsler (order), MQ in the treatment group were higher than those before the study (P

Objective To investigate the expression pattern of Th1 and Th2 in patients with pulmonary tuberculosis including sputum positive pulmonary tuberculosis and coinfection with human immunodeficiency viruses(HIV), and its relation to disease severity.Methods The expression pattern of CD4+T lymphocytes, Th1 and Th2 cells in peripheral blood samples from sputum positive pulmonary tuberculosis patients, coinfection with HIV patients and healthy controls were studied by flow cytometry.Results The expression of CD4+ T lymphocytes and Th1 cells in sputum positive pulmonary tuberculosis patients were significantly lower than that in healthy group(31.22?9.80)%,(9.78?3.09)% vs (43.77?10.78)%,(25.26?4.73)%; The expression of Th2 cells in culture positive pulmonary tuberculosis patients was significantly higher than that in healthy group(18.65?3.49)% vs(10.15?2.60)%; The Th2 level in severe pulmonary tuberculosis patients was significantly higher than that in the medium and mild patients(21.70?2.67)% vs (14.87?1.66)% ,(17.48?2.06)%, while the CD4+T lymphocytes and Th1 levels were significantly lower; The CD4+ T lymphocytes and Th2 cells levels in pulmonary tuberculosis patients coinfection with HIV were lower than that in tuberculosis patients without HIV coinfection(21.88?3.71)%,(8.79?2.28)% vs (31.22?9.80)%,(18.65?3.49)%.Compared with the healthy group, Th1 cells level in pulmonary tuberculosis patients with or without coinfection of HIV were lower(25.21?4.73)% vs (9.39?2.65)%,(9.78?3.09)%.Conclusion Patients with sputum positive pulmonary tuberculosis showed lower expression of Th1 and higher expression of Th2,This profile was correlated with disease severity.Patients with pulmonary tuberculosis and HIV coinfection showed both of lower expression of Th1 without enhancement of the type 2 response.

Objective To improve the identification of rush pneumoconiosis.Methods To analyze 47 cases of rush pneumoconiosis treated in our hospital from 2003 May to 2008 December.Results The male occupied 74% of 47 patients.The average age of onset was 34.2 ranging from 26.1 to 42.3.78.7% patiets presented with cough,sputum production,chest pain and dyspnea.4.2% patiets had PaO2 45 mmHg.85.1% patients' chest X-ray and CT images showed nodule shadows,interstitial fibrosis and ground glass attenuation.42.6% patients had restrictive ventilation disorders,2.1% obstrutive ventilation disorders 4.2% mixed ventilation disorders,and 74.5% decreased diffusing capacities.Through fiberoptic bronchoscopy,carbon sediment were seen on the 10% patients' bronchial walls,and bronchial lumen were distorted and stiff.Chronic inflammaion increased,macrophages and fibre tissues,and 21.2% dust cells were seen in pathology.All patients were treated according to their clinic symptoms.Conclusion Rush-mat dust was the main cause of rush pneumoconiosis,there were no special ways to cure this disease,prevention was the key to eliminate rush pneumoconiosis.

Objective To investigate the eitect oi Yiqi Fuzhi Granule in improving learning and memory of rats with mul- ti-infarct dementia (MID). Methods MID rat models were established by embolus injection through the common carotid artery. Effects of Yiqi Fuzhi Granule(24. 84 g/kg, 12.42 g/kg, 6.21 g/kg, ig)on rat learning and memory and cerebral structure were observed. Results Yiqi Fuzhi Granule could obviously increase the scores of maze test and protect cerebral tissue from damage of multi-infarction rats. Conclusion Yiqi Fuzhi Granule has good effect in improving intellect and treating dementia.

Objective To evaluate the safety of CT guided percutaneous lung biopsy in the elderly,and to analyze the risk factors for its complications.Methods Totally 204 elderly patients aged ≥65 years underwent transthoracic needle biopsy under CT guidance.Clinical data,complication and its risk factors were analyzed retrospectively.Results The complications included pneumothorax accounting for 15.2％ (31/204),hemoptysis 21.6％ (44/204),and no mortality was found.Logistic regression analysis showed that needle path ≥5.00 cm,lesion size ≤2.00 cm and emphysema around the lesion were the independent risk factors for postoperative pneumothorax (OR=4.05,2.54 and 3.97,all P＜0.05).Meanwhile,the enhancement degree by CT ＞40 HU,needle path ≥5.00 cm and lesion size ≤2.00 cm were the independent risk factors for postoperative bleeding (OR=2.27,2.82 and 2.33,all P＜0.05) in elderly patients undergoing lung biopsy.The sensitivity and specificity for postoperative pneumothorax and bleeding obtained by forecasting equation were 87.1％ and 49.1％,54.5％ and 80.8％ respectively.Conclusions The length of needle path,lesion size and emphysema around the lesion are correlated with pneumothroax,and length of needle path,lesion size and the CT enhancement degree are correlated with bleeding after percutaneous lung biopsy in the elderly.

0 05 by ? 2 test). The rats in intravenous groups (10 6,10 7) and in intratumoral group had significant prolonged survival (compared with control group, P