Objective To observe the application effects of postoperative analgesia of ultrasound guided transverses abdominis plane (TAP) block in patients undergoing hysterectomy.Methods 50 patients with hysterectomy under general anesthesia were selected,and they were randomly divided into two groups according to the digital table,25 cases in each group.The patients of group A were injected with 0.45% ropivacaine mesylate 20mL in ultrasound guided bilateral TAP after the end of surgery before extubation,the patients of group B were injected with the same amount of normal saline in ultrasound guided bilateral TAP block.Postoperative patient-controlled intravenous analgesia with sufentanil was provided to all patients.The VAS score of the two groups after operation,the postoperative dosage of sufentanil in 24h and pressing times of analgesia pump,and the satisfaction of patients with postoperative analgesia,and adverse reactions were observed.Results The VAS scores of 2h of group A (0.96±0.74)points vs.group B (1.88±0.73)points (t=4.45);The VAS scores of 4h of group A (1.52±0.65)points vs.group B (2.24±0.72)points (t=3.69);The VAS scores of 8h of group A (1.88±0.44)points vs.group B (2.68±0.56)points (t=5.64);The VAS scores of 12h of group A (2.24±0.52)points vs.group B (2.96±0.54)points (t=4.80);The VAS scores of 24h of group A (2.44±0.51)points vs.group B (3.24±0.44)points (t=5.99);there were statistically significant differences(all P=0.00).The postoperative dosage of sufentanil in 24h[group A (51.60±1.02)μg vs.group B (55.46±1.37)μg,t=11.30,P=0.00],the pressing times of analgesia pump[group A (7.20±2.04)times vs.group B (14.92±2.74)times,t=11.30,P=0.00],the satisfaction of patients with postoperative analgesia[group A (9.20±0.71)points vs.group B (7.52±0.77)points],t=8.03,P=0.00].There were 2 cases of postoperative nausea and vomiting in group B,and 8 cases in group A,the difference was statistically significant(x2=4.50,P=0.03).Conclusion The application of postoperative analgesia of ultrasound guided TAP block in patients undergoing hysterectomy can reduce postoperative intravenous analgesic drug usage,reduce the incidence of adverse reactions induced by drugs,improve patients' comfort and satisfaction,it is suitable for clinical application.

The tissue engineering technology that developed in the 1980s brings a hope for the regeneration of human organs. It is feasible to construct by-pass vessels, which have no immune resistance but are capable of anticoagulation. At present, a huge number of researches have provided the necessary basis for the construction. However, there are still some difficulties on the points of induction and proliferation of endothelial cells, development of new materials for scaffold and co-culture of seed cells in scaffold. These difficulties have become the bottle neck of tissue engineered blood vessels. The tissue engineering vessels are nowadays absent in clinical practice. With the progress in researches of tissue engineering, it is strongly believed that human organs and tissues can be constructed using tissue engineering technology, thus satisfying the donors of organ transplantation.

Objective:To observe and investigate the effects of real-time dynamic glucose monitoring, continuous subcutaneous insulin infusion combined with Carelink management software analysis on blood glucose control in newly diagnosed type 2 diabetic patients.Methods: 64 cases of patients with newly diagnosed with type 2 diabetes were selected from our hospital, and randomly divided into observation group and control group. The observation group were treated by real-time dynamic blood sugar monitoring and continuous subcutaneous insulin infusion joint Carelink management software analysis system, while the control group by continuous subcutaneous insulin infusion in combination with the real-time dynamic blood sugar monitoring. We compared serum C peptide, the rise of serum insulin levels and the decrease of blood glucose after ten days of treatment. At the same time, insulin resistance index (HOMA - IRI) and hypoglycemic events were compared between the two groups.Results: After treatment, the decrease range of blood glucose, postprandial blood glucose and HOMA-IRI in the observation group were significantly better than those in the control group (t=4.362,t=3.254,t=4.289; P<0.05). At the same time, the increase range of elevated fasting insulin, postprandial insulin, fasting C peptide and sugar after C peptide in the observation group were significantly better than those in the control group (t=3.712,t=4.115,t=3.831,t=3.889;P<0.05). The standard number of days of the blood glucose in the control group were significantly higher than those in the observation group (t=4.583,P<0.05).Conclusion: For patients with type 2 diabetes treated by real-time continuous glucose monitoring and continuous treatment of infusion combined with subcutaneous insulin Carelink management software can effectively reduce blood glucose, improve the insulin resistance of patients, reduce hypoglycemia and increased insulin sensitivity, meanwhile also can better protect the islet beta cell function.

Community health service is an effective measure to relieve the difficult medical services and expensive medical cost problem,but community inhabitants in Chongqing make little use of community health service.The actual cause is that people s degree of trust in community health service is low.In view of existing situation,this article analyzes the various factors that influence community residents' degree of trust in community health service and puts forward corresponding policy proposal.

Subacute and chronic cerebrovascular occlusion is an uncommon but an important cause for ischemic stroke.The main pathogenic mechanism is local hemodynamic disorder.Theoretically,the improvement of hemodynamic disorder can reduce the incidence of stroke as well as improve the prognosis.At present,there is still controversy over the optimal therapeutic plan.With the rapid development of interventional techniques,considerable progresses have been made in the endovascular treatment for subacute and chronic cerebrovascular occlusion,although some shortcomings still exist.This article aims to make a comprehensive review about the subacute and chronic cerebrovascular occlusion,focusing on its definition,damage,clinical status of its treatment,imaging evaluation,technical points of endovascular therapy,and procedure-related complications.

A total of 17 hip joint lesion patients (24 hips) combined with ankylosing spondylitis and severe osteoporosis from March 1996 to March 2003.They.received autologous impaction bone graft and cementless total hip replacement.They were 20-52 years old,averagely 35 years.Harris score and X-ray method were used to evaluate clinical outcomes.A total of 17 patients (24 hips) were followed up for 36-120 months,averagely 87 months.Harris score increased from averagely 34 points (preoperation) to averagely 86.4 points (postoperation),resulting in an excellent and good rate of 87.5%.Radiograph showed that femoral prosthesis was closely fixed to proximal segment of the femur,without prosthetic infection or dislocation.One hip suffered from 5-mm prosthetic subsidence within 1 year following replacement,and no further subsidence following over 5-year follow up.The prosthesis showed good contact to sclerotin,without loose.It is suggested that bone mass has great effects on cementtess prosthetic replacement.Autologous impaction bone graft for bone remodeling provides a good method for total hip replacement in patients combined with ankylosing spondylitis and severe osteoporosis.The clinical outcome is satisfactory.

To investigate the correlation between cerebral infarction and carotid atherosclerosis.Methods:Bilateral carotid atherosclerotic plaques,intima-media thickness (IMT),and stiffness coefficient (β) in 60 patients with cerebral infarction were detected by high-frequency color Doppler imaging,and they were compared with the control group (n=60).Results:The detection rate of plaque in the cerebral infarction group was significantly higher than that in the control group (90% vs 28%,P<0.005); the constituent ratio of soft plaques in the cerebral infarction group was significantly higher than that in the control group (P <0.01),and the constituent ratio of flat and hard plaques was significantly lower than that in the control group (P<0.005); IMT and β values in the cerebral infarction group were significantly higher than those in the control group (P<0.01).Furthermore,IMT had significant positive correlation with β values (P<0.01).Conclusions:Carotid atherosclerosis is closely correlated with cerebral infarction.

Tumor-derived heat shock protein-peptide complex 96 (HSPPC-96) containing tumor antigenic peptides can elicit po-tent tumor-specific and protective immunity. Autologous HSPPC-96 vaccine has been shown to effectively prolong recurrence-free sur-vival and increase the overall survival of many tumors, thereby suggesting extensive future applications. However, as an autologous tu-mor-derived individual vaccine, the development of HSPPC-96 vaccine is challenged by the lack of an adequate autologous tumor, lim-ited efficacy for advanced-stage cancer, etc. This paper summarized the progress, future perspectives, and challenges in the clinical de-velopment of HSPPC-96 vaccine immunotherapy.

Tumor markers for early diagnosis of cancer is an important auxiliary mean,which for early tumor detection,monitoring and for judging curative effect of treatment regimens play important role.Clinical method for early diagnosis on ovarian cancer is the detection of serum CA125,however,its precision and specificity for early diagnosis are not enough.It has been found that in the development period of the patients with ovarian cancer,SMRP and CA125 is co-expression.This article reviews the value of serum mesothelin on diagnosis of epithelial ovarian cancer to provide reference on early diagnosis and treatment.

The fetal inlfammatory response syndrome (FIRS) is a subclinical condition characterized by systemic acti-vation of the fetal innate immune system with a large number of pro-inlfammatory cytokines released. FIRS is the fetal coun-terpart of the systemic inlfammatory response syndrome (SIRS) described in adults. Intrauterine infection is the most common reason of FIRS. FIRS has been implicated as a cause of preterm labor, preterm white matter injury, bronchopulmonary dyspla-sia (BPD) and necrotizing enterocolitis (NEC).