Objective To investigate the safety and feasibility general anesthesia for cesarean section in term matemal.Methods Hospital in January-December 2014 admitted there are contraindications to spinal anesthesia or reject elective spinal anesthesia in term maternal 42 cases were general anesthesia.By intravenous injection of propofol 1.5-2 mg/kg and succinylcholine 1.5-2 mg/kg rapid induction,after video laryngoscopes with endotracheal intubation,immediate surgery to remove the fetus,neonates 1,5 min Apgar score.Results 42 cases of maternal disposable endotracheal intubation success rate of 100％,no regurgitation and aspiration;all fetuses removed within 10 min after induction of anesthesia,neonatal 1,5 min Apgar scores were 8 points or more,with no respiratory depression.Conclusion When patients have contraindications to spinal anesthesia or spinal anesthesia refused general anesthesia is a safe and viable alternative,as long as the rational use of anesthetics,general anesthesia for cesarean section and newborn is safe.

AIM:To explore the protective effects of atorvastatin on blood brain barrier (BBB) in cerebral is-chemia-reperfusion ( IR) injury and the potential mechanisms involved .METHODS: SD rats were divided into sham group, IR group and atorvastain group .Intraluminal suture method was used to establish cerebral IR model , and the ische-mic brain was reperfused for 72 h after the occlusion.The rats in atorvastatin group were administered with atorvastatin (20 mg? kg-1? d-1 ) by gavage once a day for 3 consecutive days after operation .At 72 h after reperfusion , neurological func-tion scores, the water content of the brain tissue , Evans blue (EB) content of ischemic hemisphere , the expression of tight junction ( TJ )-associated protein occludin and inflammation factor phosphatidylinositiol 3-kinase-p110 gamma ( PI3K-p110γ) were tested and analyzed .RESULTS: In IR group, the rats showed elevated neurological function scores ( P<0.01), brain tissue water content (P<0.01) and EB content (P<0.01), accompanied with the down-regulation of oc-cludin expression (P<0.01) and up-regulation of PI3K-p110γ(P<0.01) at 72 h after reperfusion.Compared with IR group, decreased brain edema (P<0.01) and EB leakage (P<0.01) were observed in atorvastatin group , accompanied with increased occludin expression (P<0.01) and decreased PI3K-p110γexpression (P<0.01).However, no statistical difference of the neurological function scores between the 2 groups was observed .CONCLUSION:Atorvastain attenuates cerebral IR injury , which may be associated with the inhibition of inflammatory reactions and the up -regulation of TJ-asso-ciated proteins to maintain the stability of BBB .

Objective To explore the method and effect of computer simulative model of lying-in women in the teaching of gynecological nursing. Methods We separated 171 nursing students in grade 2005 into the control group (85 students) and the experimental group (86 students). For the experimental group the teaching method of computer simulative model of lying-in women was used. For the control group we used the traditional teaching method. The effects of two teaching methods were compared. Results The examination achievement of the experimental group was more than that of the control group and 93% nursing students of grade 2005 approbated this teaching method. Conclusions Introducing computer simulative model of lying-in women into the teaching of gynecological nursing can not only improve the effect of teaching, stimulate studying interest and cultivate unity and cooperation ability.

Objective To explore the biomechanical characteristics of the pharynx in patients with aspiration after radiotherapy for nasopharyngeal carcinoma (NPC).Methods Clinical data on NPC patients with dysphagia admitted between July 2011 and June 2015 were retrospectively analyzed.Twenty-three patients were found who had received videofluoroscopic swallowing studies (VFSSs) and whose pharyngeal pressure and upper esophageal sphincter (UES) relaxing were tested using high-resolution solid-state manometry (HRM).The cases were divided into an aspiration group and a non-aspiration group according to the VFSS results.Differences in biomechanical parameters between the 2 groups when taking food of different viscosity were compared.Results Patients with aspiration had significantly higher UES residual pressure when taking thick liquids (20.1± 14.3 mmHg) and paste (18.0± 14.3 mmHg) than patients not aspirating (9.3±9.2 mmHg and 7.2±8.9 mmHg for thick liquid and paste respectively).But no significant difference in average pharyngeal pressure between the two groups was observed.Conclusion Aspiration after radiotherapy may be correlated with increased UES residual pressure.

Objective:To study the relationship between gingival thickness(GT)and the underlying alveolar bone thickness(BT)in maxillary anterior region and the distance from cemento-enamel junction(CEJ)to alveolar crest.Methods:30 young volunteers with healthy gingiva were included.GT was measured at 2mm below the CEJ,buccal BT were measured at 3 locations:2,4 and 6 mm below the alveolar crest respectively,the distance from CEJ to alveolar crest were measured by CBCT and clinical direct measure respectively. Results:The correlation coefficient (r)values between GT and BT at 2,4 and 6 mm below alveolar crest were 0.493,0.383 and 0.342 (P <0.001 )respectively,the r value between GT and the distance from CEJ to alveolar crest was -0.21 3(P <0.01 ).No statistically significant difference was observed between CBCT and clinical measurements(t =-0.521 ,P =0.603).Conclusion:There is positive correlation between GT and BT at 2,4 and 6 mm below alveolar crest and negative relation between GT and the distance from CEJ to alveolar crest.

Objective To evaluate the differences of clinical features,neuroimaging,angiography and laboratory findings between different stroke subtypes according to TOAST criteria in elderly patients.Methods 91 patients (aged ≥ 80 years) with acute ischemic stroke were retrospectively reviewed in Departement of Neurology from April 2009 to August 2010.Subtypes of ischemic stroke were analyzed according to the classification of TOAST.Risk factors,clinical manifestations,complications,prognosis,neuroimaging,cerebrovascular lesions,and laboratory findings of different TOAST subtypes were compared.Results Large-artery atherosclerosis (LAA) (34/91) was the most common cause of acute ischemic stroke in elderly patients,and most criminal lesions (25/34) located at the intracranial arteries.In the LAA group,patients with intracranial (25/34) or extracranial (12/34) occlusive diseases were more than those in other groups.Patients with cardioembolism (CE) had lower lipid levels.In the CE group,patients with poor shortterm prognosis (7/15) were more than in the LAA or small-artery occlusion (SAO) group,and patients with severe cerebral edema (4/15) were more than those in other groups.In patients of the SAO group,complications occurred infrequently (4/20),and none had poor short-term prognosis.Conclusions There were some differences among different TOAST subtypes in clinical features,neuroimaging,cerebrovascular diseases,and laboratory findings.The clinical significance of our findings needs to be explored further.

Abstract: Malaria is one of the deadliest vector-borne infectious diseases in Africa, seriously endangering human life and health. Among them, cerebral malaria (CM) has a higher morbidity and mortality rate in children, with clinical manifestations primarily involving neurological symptoms, and comprehensive treatment mainly using artemisinin derivatives. When children with cerebral malaria are complicated by congenital heart disease and induce acute hypoxic attacks, the diagnosis and treatment face great difficulties in the absence of effective examination and monitoring treatments. Similar cases have rarely been reported at home and abroad. The paper summarizes and reports a case of a child with cerebral malaria combined with cyanotic congenital heart disease, treated during an aid mission to Africa, who was improved and discharged from the hospital after receiving multidisciplinary anti-malarial, intracranial pressure lowering, neurotrophic and symptomatic supportive treatment. This paper also discusses the diagnosis and treatment process of this child under difficult conditions, combined with current literature reports, in hopes of providing a reference for clinical treatment.

National Teaching Contests of young teachers from medical colleges in China has been held for several years. Experiences obtained from participating and observing the contest have shown that the teaching ability and quality of young teachers have been dramatically improved over these years. But there are a few problems worthy of attention. First, up-to-date progress in scientific research should be intro-duced to the class in proper way. Applying the scientific material mechanically or overgeneralizing individual findings should be avoided in this process. Secondly, the teachers should strengthen the cultivation of criti-cal thinking and dialectical way of thinking, to enable students to use critical thinking, the integrated point of view to analyze and solve the problem. Thirdly, teaching should also focus on humanistic education, and through the infiltration of human content in the classroom, imperceptibly affect students. Finally, young teachers can give full play to their advantages of rapid learning and to use internet as a platform for the reform of teaching methods to promote the interaction between teachers and students, enriching their class-room.

Objective To explore the application value of Carbon Nanoparticles followed by microscale Methylthioninum Chloride in sentinel lymph node biopsy for breast cancer.Methods Two hundred and eight breast cancer patients were selected in the First Affiliated Hospital of Zhengzhou University during recent two years who performed sentinel lymph node biopsy.They were randomly divided into five groups according to different lymphatic tracer injected:Sequential group (A group,128 patients),Carbon Nanoparticles group (B group,44 patients) and Methylthioninum Chloride group (C group,36 patients).According to different Methylthioninum Chloride doses,sequential groups were randomly divided into low dose group (A1 group,48 patients),middle dose group (A2 group,42 patients),high dose group (A3 group,38 patients),If sentinel lymph nodes were negative no longer performed axillary lymph nodes dissection.Receive the five groups statistics of detection rate,the condition of lymphatic tracer,the incidence of local skin irritation and so on.Results (1) The detection rate of A,B and C three groups had no obvious difference.The incidence of lymphatic tracer dyed not ideal in B group was higher than A and B two groups,the incidence of local skin stimulation in C group was higher than A and B two groups.(2) A1,A2,A3,three groups had no difference of the detection rate and lymphatic tracer,but the incidence of local skin stimulation in A3 group is higher than A1,A2 two groups.3.5 groups of SLN detection rate had no relationship with patients' age,BMI,tumor size,tumor location,tumor molecular classification factors (P ＞ 0.05).Conclusions Carbon Nanoparticles followed by microscale Methyhhioninum Chloride detection rate was similar with two separate application,but can reduce the lymphatic vessels not developing situation when used Carbon Nanoparticles alone and reduce the local irritation caused by large dose of Methylthioninum Chloride,so it can be a good choice of SLNB in clinical.

OBJECTIVE: To observe the protective effect of Huaxia shallot preparation on human umbilical vein endothelial cell (HUVEC) injury induced by oxidized low density lipoprotein (Ox-LDL) in vitro. METHODS: Ox-LDL was prepared and identified, and HUVECs were cultured. After 2-hour intervention of different drugs and 24-hour following intervention of Ox-LDL, the number of HUVECs was observed by phase contrast optical microscope and the activity of the HUVECs was observed by methyl thiazolyl tetrazolium (MTT) technique. Superoxide dismutase (SOD) activity and nitric oxide (NO) content were assayed by respective kit. The protein expressions and mRNA levels of peroxisome proliferators activated receptor gamma(PPAR-gamma) and endothelial nitric oxide synthase (eNOS) were measured by western blot technique and reverse transcription polymerase chain reaction (RT-PCR). RESULTS: Ox-LDL could increase the apoptosis rate of the HUVECs and decrease the NO release as compared with the blank control group (P<0.05). These effects induced by Ox-LDL were all significantly inhibited by Huaxia shallot preparation. It could up-regulate the protein expressions and mRNA levels of PPAR-gamma and eNOS significantly (P<0.05). Huaxia shallot preparation could decrease the apoptosis rate of the HUVECs. CONCLUSION: Ox-LDL may be involved in the initiation and progression of atherosclerosis by injuring the endothelial cells directly and may cause the endothelial dysfunction. Huaxia shallot preparation can protect against Ox-LDL induced endothelial cell injury by up-regulating the protein expressions and mRNA levels of PPAR-gamma and eNOS. It suggests that Huaxia shallot preparation may play a role in the prevention and treatment of cardiovascular disease.