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 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.

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 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 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 investigate effect of the venom peptide liquor on adjunctive arthritis (AA) in mice .Methods The male Kunming mice were randomly divided into 6 groups ,named as the control group ,model group ,positive control group(1 mg/kg dex-amethason) ,wine group(10 mL/kg) ,low dosage of venom peptide liquor group(8 .3 mL/kg) and high dosage of venom peptide liq-uor group(33 .2 mL/kg);the right toes ,ankle diameter and whole body weight were measured at 7-day intervals ;the spleen index , serum level of circulating immune complexes(CIC) were determined after the thirty-fourth day when the mice was put to death .Re-sults The level of CIC in AA mice decreased significantly (P<0 .05) ,the decrease of spleen index and the reduction of toe and an-kle swelling in the low dose group were significant(P<0 .01) .Conclusion The venom peptide liquor exhibited apparent inhibitory effect on AA in mice .

Objective To investigate the clinical and pathologic features of small gastrointestinal stromal tumors (small GISTs,d ＜ 2.0 cm).Methods Medical records of 95 patients undergoing surgery (endoscopic surgery,thoracoscopic/laparoscropic surgery and open surgery)and diagnosed as having GISTs by pathology and immunohistochemistry in Nanfang hospital from October 2003 to June 2014 were retrospectively analyzed.Based on clinical and pathological results,correlation analyses between risk factors for endoscopic ultrasonography(EUS) and Mitotic count(MI),clinicopathologic parameter and NIH risk classification were performed.Results Among 95 cases (104 lesions),88 were single,while 7 were multiple;81.7％ (85/104) small GISTs arose from stomach,including 87.1％ (74/85)in middle-upper stomach;5 cases (5.3％) presented calcification of different degrees,3 cases(3.2％) presented local necrosis and 2 cases (2.1％) with arrangement of epithelioid cells;88 cases (92.6％) were very low grade of NIH risk classification,6 cases (6.3％) were intermediate risk and 1 case(1.1％) was high risk.Positive rates of CD34 and CD117 were 95.8％ (91/95) and 96.8％ (92/95) respectively.The risk factors (border,mucosal surface,echo and heterogeneity) of EUS had no correlation with mitotic count(P＞0.05).The correlation analysis between clinicopathologic features and NIH risk classification revealed tumors more than 1.5 cm had a striking correlation with NIH risk classification (P＜ 0.05).Conclusion Most small GISTs,single or multiple,located at middle-upper stomach,were of very low or low risk,and have a favorable prognosis.But it has worse biological behavior and a higher grade risk when the diameter is more than 1.5 cm,intervention should be recommended.

Objective To study the effect of ursolic acid (UA) intervention on hepatocyte apoptosis induced by TGF-β1 and its potential mechanism.Methods Primary hepatocytes were extracted from healthy SD rats by in situ perfusion,cultured for 12-24h,then randomly divided into the following groups:blank control group,UA control group (UA 25μmol/L),TGF-β1 group (TGF-β1 2.5ng/ml),UA intervention group (UA 25μmol/L and TGF-β1 2.5ng/ml),DPI intervention group (DPI 0.5μmol/L and TGF-β1 2.5ng/ml).Each group was treated with drugs for corresponding time and their proliferation and apoptosis were detected by flow cytometry,the expression of CD95 (Fas) mRNA was analyzed by RT-qPCR,the expression of protein CD95 and membrane translocation of NADPH oxidase (NOX) subunit p47Phox were analyzed by Western blotting,and the reactive oxygen species (ROS) generation in primary hepatocytes was analyzed with reactive oxygen detection kit.Results UA intervention at 30min before TGF-β1 stimulating hepatocytes markedly reduced hepatocyte apoptosis (63.97 ± 3.19 vs 80.53 ± 1.56,P＜0.01) and promoted hepatocyte proliferation (18.67 ± 1.60 vs 10.83 ± 2.03,P＜0.01).UA intervention notably down-regulated the expressions of CD95 mRNA and protein (1.28 ± 0.15 vs 2.40 ± 0.25,P＜0.01;1.05 ± 0.15 vs 1.37 ± 0.18,P＜0.05),restrained membrane translocation of p47phox (1.13 ± 0.12 vs 1.76 ± 0.22,P＜0.01),and decreased ROS level in primary hepatocytes induced by TGF-β1 (2.12 ± 0.45 vs 3.23 ± 0.53,P＜0.01).Conclusion The mechanism of UA inhibiting hepatocyte apoptosis induced by TGF-β1 is likely to be that UA intervention reduced hepatocyte apoptosis by inhibiting NOX activation and decrease generation of ROS so as to down-regulate expression of CD95 in hepatocytes.

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.