Objective To investigate the nursing intervention of pregnant women with antiphespholipid syndrome(APS). Methods In experimental group 40 cases with APS positive and control group 40 cases with APS ACA-negative for comparison. Results The abortion occurred in 6 cases(15. 0%) ,2 cases of stillbirth(5.0%) ,loss of pregnancy(abortion+stillbirth) 8 cases (20. 0%) in experimental group. The abortion occurred in 2 cases (5.0%), no stillbirth in control group. The loss of pregnancy in experimental group were significantly higher than the control group (X2=9. 54, P＜0. 005 ). The rate of positive in ACA-IgG (40. 0%) after treatment lower than before treatment (52. 5 %) (X2 = 3.85, P＜0. 05). The rate of positive in ACA IgM (37. 5%) after treatment lower than before treatment(40. 0)% (X2=3.81 ,P＜0. 05 ). Conclusion The APS positive rate and the loss of pregnancy were closely related. The overall nursing intervention conld improve efficacy and reduce the complications.

Objective To investigate the efficacy to pregnant outcoule with antieardiolipin antibody(ACA) of qualitative and quantitative before treatment and after treatment in women pregnant with antiphospho-lipid syndrome (APS).Methods The heparin combined with aspirin therapy APS 40 patients before and after treatment to momtor the change of ACAIgG,IgM.Results 40 patients were treated 37 eases of live births,success rate were92.5%,the rate of pregnancy loss were3 cases(7.5%);The lever of ACA-IgG and ACA-IgM were(67.63±2.53)u and (49.40±3.64)u beforetreatment andlever of ACA-IgG and ACA-IgM were(23.87±1.54)u and(21.60±2.59)u after treatment.The lever after treatment were significandy Iower than the before treatment(P＜0.01);The level of ACA were overall downward in 40 cases after treatment by dynamic observation;The rate of positive in ACAIgG (40.0)% after treatment lower than before treatment(52.5)%(X2=3.85,P＜0.05);The rate of positive in ACA IgM(37.5)% after treatment lower than before treatment(47.5)%(X2=3.81,P＜0.05).Conclusion Hepfinar treatment combined with aspirinmay be a safe and effective method for patients with APS.

Objective To observe the preemptive analgesia effects of katamine and elonidine, and to find out the influence of preemptive on stress responses. Methods 36 patients with hysteromyoma undergone hysteromyomec-tomy were randomly assigned to three groups (n = 12 each group) :group Ⅰ , control group, without preemptive analge-sia,the patients in control group were given continous epidural analgesia with 2% lidoeaine 12 - 14ml. Group Ⅱ ,the patients were injected 0. 6mg/kg katamine into epidural analgesia 30 minutes before operation. Group Ⅲ,the patients were injected 0. 6mg/kg katamine and 1.5μg/kg clonidine into epidural analgesia 30 minutes before operation. The patients in three groups were recorded VAS score on 2h ,4h ,6h, 12h ,24h after operation, also recorded the change of epinephrine(E) and norepinephrine(NE) and sensation and movement recovery time after operation. The side effects such as dizziness nausea,vomit,and exited talking were observed during the operation. Results The VAS score were significantly different between group Ⅰ ,Ⅱ and Ⅲ. The levels of E and NE in plasma in group Ⅰ were increased more than group Ⅱ and Ⅲ within 24 hours after operation, also there is significant difference in group Ⅱ compared with group Ⅲ in T1 ,T2 ,T3. The time of sensation and movement recovery were remarkably longer in group Ⅲ com-pared with group Ⅰ and Ⅱ, showing significant difference. There were no significant difference in side effects after operation in three groups. Conclusion The preemptive analgesia of kutamine and colnidine can relieve the pain of lower abdominal surgery and stress response after operation,and it do not increase the side effects.

C-reactive protein(CRP)is the most sensitive indicator of acute phase proteins.A growing body of evidence suggests that atherosclerosis,as a main cause of cerebral infarction,is a chronic inflammtory process.The present studies have found that the CRP levels and genetic polymorphisms are associated with atherosclerosis and cerebral infarction.As compared with coronary artery disease,the association between high-sensitive CRP and ischemic stroke is more closely.This article reviews the advaces in research on the biological characteristics of CRP,the factors influencing CRP levels,the CRP levels and the correlation between genetic polymorphisms and cerebral infarction.

Colorectal cancer(CRC)ranks the third in incidence and mortality rate among human tumors. Tumor relapse,me?tastasis and drug resistance remain the main obstacle to the success of CRC treatments. Compared to traditional chemotherapy ,target therapy seems to treat tumors in more precise and rational fashion with good response and often less toxic side-effect. Although target agents provide hope for more effective therapy,recent clinical studies have shown only modest benefit from target therapy similar to tra?ditional chemotherapy. Primary and secondary resistance to target agents is still observed and contributes to CRC treatment failure. The review summarizes research progress in the mechanism of drug resistance to target therapy in CRC treatment.

Objective To investigate the effect of dynamic regulation of negative pressure values in vacuum sealing drainage (VSD) on healing of soft tissue wounds.Methods From January 2013 to December 2015,115 patients were treated at our institute for open soft tissue defects of Gustilo-Anderson type ⅢaⅢc.They were 69 males and 46 females,aged from 17 to 76 years (average,44.7 years).They were divided into 4 groups to be subjected to different negative pressure values.Group A (n =29) was subjected to negative pressure values from-40 to-20 kPa,group B (n =29) to values from-80 to-60 kPa,group C (n =29) to values from-40 to-20 kPa for the first 72 hours followed by values from-80 to-60 kPa,and group D (n =28) to values from-60 to-80 kPa for the first 72 hours followed by values from-40 to -20 kPa.The 4 groups were compared in terms of drainage volume,wound shrinking,cleaning time,healing time and complications.Results The drainage volumes on the 7th day in groups B and D (4.89 ± 0.66 mL/cm2 and 4.33 ± 0.96 mL/cm2) were significantly higher than those in groups A and C (2.90 ± 0.67 mL/cm2 and 2.99 ±0.56 mL/cm2);the wound shrinking areas on the 14th day in groups B and D (14.16 ± 1.77 cm2 and 13.84 ± 1.65 cm2) were significantly larger than in groups A and C (12.57 ± 1.92 cm2 and 10.95 ± 1.37 cm2) (P ＜ 0.05).The cleaning time in group A was significantly longer than in the other 3 groups (P ＜ 0.05).The healing time in groups A and C was longer than in groups B and D (P ＜ 0.05).The incidences of pain in groups B and C were significantly higher than in groups A and D (P ＜ 0.05).The incidences of infection and blocking in group A were higher than in the other 3 groups (P ＜ 0.05).Conclusion Dynamic regulation of negative pressure values from-80 to-60 kPa for the first 72 hours followed by values from-40 to-20 kPa is an optimal choice for VSD management of soft tissue defects due to adequate drainage,obvious wound shrinking,quick cleaning and healing,and limited complications.

Objective To evaluate the association between isotretinoin pharmacokinetic parameters and CYP2B6 (cytochrome p-450) gene polymorphisms. Methods Blood samples were collected at different time points from 21 healthy male volunteers who received a single 40-rng oral dose of isotretinoin. High performance liquid chromatography-electrospray ionization mass spectrometry (LC-MS) was used for the quantification of isotretinoin in plasma samples which were standardized by dosage and body weight. PCR and restriction fragment length polymorphism (RFLP) analysis were performed to detect the G516T mutation in exon 4 as well as A785G mutation in exon 5 of CYP2B6 gene in these subjects. Results There was an obvious genetic linkage imbalance in exon 4 and 5 of CYP2B6 gene among these volunteers. In the case of CYP2B6*4 allele,3 (14.29%) people were CYP2B6*4/*4 homozygotes, 6 (28.57%) CYP2B6*1/*4 heterozygotes, and 12 (57.14%) CYP2B6*1/*1 wild-type homogygotes, while as far as CYP2B6*6 allele was concerned, 3 (14.29%)people were CYP2B6*6/*6 homozygotes, 5 (23.81%) CYP2B6*1/*6 heterozygotes, and 13 (61.90%)CYP2B6*1/*1 wild-type homozygotes. The reaction half-time (t1/2) and mean residence time (MRT) of isotretinoin were longer in volunteers carrying wild-type CYP2B6*4 allele than those of CYP2B6*4/*4 homozygotes (both P ＜ 0.05 ), while no significant difference was observed in maximum concentration (Cmax), peak time (Tmax) or area under the plasma concentration time (AUC) between the two groups of volunteers. There was no statistical difference in any of the above parameters between subjects carrying wild type CYP2B6*6 allele and those of CYP2B6 *6/*6 homozygotes (all P ＞ 0.05 ). Conclusions The mutation of CYP2B6*4 allele ia relevant to the metabolism of isotretinoin, which seems to be more rapid in CYP2B6*4/*4 homozygotes.

Humans ; Hypopharyngeal Neoplasms ; Hypopharynx ; pathology ; Male ; Middle Aged ; Neoplasms, Muscle Tissue

Objective To evaluate short-term fowllow-up results of castable ceramic-IPS Empress Ⅱ onlays in restoring severe tooth defects with low occlusogingival dimension from clinical aspects.Methods 41 units of the onlay were fabricated and applied in 37 patients,who were divided into experimental group and control group.The experimental group were restored with IPS EmpressⅡcastable ceramic onlay which was bonded by a dual-cure adhesive system.The control group were restored with mental onlay which was bonded by glass-ionomer cements.All these cases were followed at 6 and 12 months after cementation of the restorations.Metewands were established to evaluate its clinical effects.Results Onlay made from IPS Empress Ⅱ castable ceramic demonstrated natural and esthetical appearance.In addition,proximal contact,retention and marginal fit of the restorations were good.No gingivitis was found.Conclusion The reliability of onlay made from IPS Empress Ⅱ castable ceramic is greatly improved due to the strengthening effects of the lithium disilicate structures.In addition,the better esthetics compared to resin filling technique makes it a comparatively ideal all-ceramic system for onlays.

BACKGROUND: In the past, a lot of researches used one-time lead level in umbilical cord blood at birth for investigations,however, one-time lead level in umbilical cord blood at birth can not represent lead caused cumu lative injury to neonatal nervous system during the whole period of preg nancy. Lead in meconium is mainly from digestive juice secreted by fetal alimentary tract, exfoliative epithelia from neonatal intestinal tract and am niotic fluid and sebum cutaneum swallowed by fetus, which is excreted from the very start of pregnancy to 24 hours after birth of neonates and re flects the lead deposit in neonatal intestinal tract during the whole period of pregnancy. OBJECTIVE: To explore the relationship between neurobehavioral devel opment in neonates with intrauterine exposure to lead at low level and the lead level in umbilical cord blood (CBPb) and meconium (MPb). DESIGN: Take lead levels in umbilical cord blood and meconium as neonatal intrauterine exposure indicators and scores of neonatal neurobe havioral development as effect indicators, and descriptive analysis is used to evaluate the correlativity. SETTING: Wuhan University of Science and Technology; Laboratory of Occupation Disease and Epidemiology, Tongji Medical College, Huazhong University of Science and Technology; Wuhan First Metallurgical Con struction Company Hospital for Workers and Staff. PARTICIPANTS: A total of 103 cases of full-term and healthy neonates were selected as objects of observation. The neonates were born in Depart ment of Gynecology and Obstetrics, Wuhan First Metallurgical Constrction Company Hospital, Qingshan District of New Industrial District of Wuhan from January to October 1999. Their parents were agreed to participate in the study and filled in the questionnaire, and provided neonatal meconium and performed neonatal tests on schedule. METHODS: ① Collection and assay of sample: 5 mL umbilical cord blood were collected and reserved in refrigerator at -4 ℃. Meconium with in 24 hours after birth, with dry weight between 5 to 10 g was collected, the lead levels in umbilical cord blood and meconium were assayed with the method of graphite furnace atomic absorption spectroscopy. ② Group ing: The neonates were divided into two groups with high and low-exposure to lead based on the cutoff value of CBPb of 0.483 μmol/L and MPb of 127.78 mg/kg. ③ Neonatal neurobehavioral development examination: Neonatal neurobehavioral development examination method was used for examination 3 days before delivery. Meanwhile, self-designed questionnaire was used to conduct a survey in puerperas. MAIN OUTCOME MEASURES: ① Lead levels in neonatal umbilical cord blood and meconium. ② Scores of neurobehavioral development of neonates with different lead levels of umbilical cord blood and meconium. RESULTS: All the 103 cases of neonates entered results analysis. ①There was significant difference only in scores of neonatal behavioral neurological assessment (NBNA) and biological visual and auditory orientation reaction (BVAOR)between groups with high and low-exposure to lead in umbilical cord blood (P ＜ 0.05). However, there was no rank correlativity between lead level in umbilical cord blood and scores of NBNA,non-biological auditory orientation reaction (NBAOR), non-biological visual orientation reaction (NBVOR) and biological visual and auditory orientation reaction (NBVOR). ②here was significant difference in scores of NBNA,NBAOR, NBVOR and BVAOR between groups with high and low-exposure to lead in meconium (P ＜ 0.05-0.01). The lead level in meconium clearly correlated reversely with scores of NBNA, NBVOR and BVAOR.CONCLUSION: Lead level in meconium is more sensitively related to the scores of neonatal neurobehavioral development, which could be used as indicator for lead deposit in the fetal body during the period of pregnancy.