Objective To investigate the effects of remifentanil patient controlled intravenous analgesia (PCIA) as a labour analgesic and the effects of neonate.Methods One hundred and thirty-five vaginal delivery primiparas were randomly divided into 3 groups: natural labor group, remifentanil l(RI) group and remifentanil Ⅱ(R Ⅱ) group,each group of 45 cases.RⅠ group and R Ⅱ group were treated with remifentanil at initial dose of 0.5 μg/kg and background dose of 0.05 μg/(kg? min) respectively.Patients in RⅠ group were treated with bolus dose of 0.2 μg/kg.Patients in R Ⅱ group were treated with bolus dose of 0.5 μg/kg.The lock time was 2 minutes.The analgesic effect of before analgesia immediate, and 5,30,60 min after analgesia were evaluated by visual analogue scale (VAS).And the oxytocin usage rate, cesarean section rate, neonatal Apgar score were assessed.The adverse drug reactions were recorded.Results After 5,30,60 min used drug , compared with natural labor group((9.52±0.32) sore, (9.58±0.27) sore, (9.53±0.28) sore) ,the VAS were decreased in the group of RⅠ((7.19±0.53) sore, (5.82±0.48) sore, (5.25±0.54) sore) and R Ⅱ (P＜0.05).Compared with RⅠ group,the VAS were decreased in the group of R Ⅱ (P＜0.05).There were no differences of oxytocin usage rate,cesarean section rate,neonatal Apgar score.In the remifentani] group, there were 2 cases of pruritus and 1 cases of vomiting;the systolic blood pressure and heart rate were in the normal physiological range after analgesia.Abnormal fetal heart rate was not found during the routine fetal heart monitoring during analgesia.Conclusion Patient-controlled intravenous analgesia with remifentanil is effective in labour analgesia and at initial dose of 0.5 μg/kg,background dose of 0.05 μg/(kg? min) and bolus dose of 0.5 μg/kg for 2 min.

Objective: To investigate relationships among Cognitive performance,cognitive styles and Neuroticism.Methods: Experimental cognitive tests were administered to 30 Highly and 30 Lowly neurotic individuals under tightened and relaxed cognitive conditions.Results: Highly and Lowly neurotic individuals did not appear any differences in total scores,but significant differences in scores of tightened-relaxed cognitive styles.Highly Neurotic individuals mostly tend to be relaxed cognitive style,and Lowly Neurotic individuals to be tightened cognitive style.Conclusion: Neuroticism does not relate with total scores of cognitive performance under tightened and relaxed cognitive condition,but with tightened-relaxed cognitive styles.

OBJECTIVE: To facilitate automatization in pharmacy of inpatient departments and promote the management level and quality of pharmaceutical service.METHODS: The transformation of operation mode and administration mode were observed after developing automatization in the inpatient pharmacy departments.RESULTS & CONCLUSIONS: The intelligent location storage and auto single-dose dispenser were combined with electronic information transmission technology to facilitate the automatization of inpatient pharmacy.The dispensing process of inpatient pharmacy is optimized and improved and standardized management of drugs is consummated.The efficiency and accuracy of the dispensing of tablets and injections are improved.Error rates of drug dispensary and costs of storage are cut down.Labor intensity and the number of staff are also reduced and the quality of pharmaceutical service in the inpatient pharmacy departments is upgraded roundly.

Objective:To investigate the efficacy of magnesium sulfate combined with labetalol on severe preeclampsia and the effects on serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), vascular endothelial growth factor (VEGF) and pregnancy associated plasma protein-A (PAPP-A).Methods:Eighty-five patients with severe preeclampsia who received treatment in Jinhua Municipal Central Hospital between January 2019 and June 2020 were included in this study. They were randomly assigned to receive treatment either with magnesium sulfate (control group, n = 42) or magnesium sulfate combined with labetalol (observation group, n = 43). Before and after treatment, 24-hour dynamic blood pressure, 24-hour urinary protein excretion and umbilical artery hemodynamics were determined. In addition, serum levels of sICAM-1, VEGF and PAPP-A were detected. Results:After treatment, 24-hour mean arterial pressure, 24-hour urine protein excretion in the control and observation groups were significantly decreased compared with before treatment. After treatment, the 24-hour mean arterial pressure [(116.45 ± 9.63) mmHg vs. (120.74 ± 9.48) mmHg] and 24-hour urine protein excretion [(1.85 ± 0.52) g vs. (2.33 ± 0.75) g] were significantly lower than those in the control group ( t = 2.069, 3.436, both P < 0.05). The umbilical artery resistance index in the control group, and the peak systolic velocity/end-diastolic velocity ratio and the umbilical artery resistance index in the observation group were significantly decreased after treatment compared with before treatment (all P < 0.05). After treatment, the peak systolic velocity/end-diastolic velocity ratio in the observation group was significantly lower than that in the control group [(2.80 ± 0.50) vs. (3.01 ± 0.45), t = 2.034, P < 0.05]. After treatment, serum sICAM-1 and PAPP-A levels were significantly decreased, and serum VEGF level was significantly increased, in each group (all P < 0.05). After treatment, serum levels of sICAM-1 [(548.52 ± 102.74) mg/L vs. (647.52 ± 124.15) mg/L, t = 4.009, P < 0.05] and PAPP-A [(111.74 ± 28.52) U/L vs. (134.24 ± 35.96) U/L, t = 3.200, P < 0.05] in the observation group were significantly lower than those in the control group, and serum VEGF level in the observation group was significantly higher than that in the control group [(32.12 ± 7.45) ng/L vs. (28.17 ± 6.23) ng/L, t =2.659, P < 0.05]. There was no significant difference in the incidence of poor pregnancy outcome between the control and study groups ( P > 0.05). Conclusion:Magnesium sulfate combined with labetalol exhibits good therapeutic effects on severe preeclampsia. The treatment method can improve umbilical artery hemodynamics, and its mechanism may be related to its effect on vascular endothelial function.

Objective To investigate the effects of dexmedetomidine preconditioning on ischemia-reperfusion(I/R) injury to isolated rat hearts.Methods Twenty-four male Wistar rats weighing 230-260 g were anesthetized with intraperitoneal 10％ chloral hydrate 400 mg/kg and heparin 500 IU/kg.Their hearts were excised and perfnsed in a Langendorff apparatus with K-H solution saturated with 95％O2-5％CO2 at 37 ℃.Twenty-four isolated rat hearts were randomly divided into 3 groups after 10 min of equilibration(n =8 each):group I/R,dexmedetomidine 0.23,2.30 ng/ml preconditioning group (groups D I,D Ⅱ ).In group I/R,the hearts were perfused continuously for another 30 min.In groups D Ⅰ and D Ⅱ,the hearts were perfused with K-H solution containing dexmedetomidine 0.23,2.30 ng/ml for 20 min followed by 10 min washout before ischemia.All hearts were subjected to 30 min of global ischemia followed by 120 min of reperfusion with K-H solution.The activities of creatine kinase(CK) and lactate dehydrogenase(LDH) in coronary effluent were measured at the end of 10 min equilibration(balance),and at 5,30,60 and 120 min of reperfusion.Myocardial tissues were obtained at the end of reperfusion for determination of the activity of SOD and the content of MDA.Results Compared with group I/R,the CK and LDH activities in coronary effluent and MDA content in myocardium were significantly decreased,the SOD activity was significantly increased in groups D I and D Ⅱ ( P ＜ 0.05).Compared with group D Ⅰ,the CK and LDH activities in coronary effluent and MDA content in myocardium were significantly decreased,the SOD activity was significantly in group DⅡ ( P ＜ 0.05).Conclusion Dexmedetomidine preconditioning can attenuate myocardial I/R injury in a concentration-dependent manner in rats.

Objective To observe the effect of catgut embedding(CE) at "Shimen"(CV 5) on the endometrial receptivity,pinopodes expression of the endometrial surface and leukaemia inhibitory factor(LIF) immunoactivity during periimplantation period.Methods Thirty Kunming mice were randomly divided into control,CE of "Shimen"(CV 5,CE-CV 5) and medication groups(n=10/group).For mice of CE-CV 5 group,a piece of catgut was embedded into the subcutaneous tissue of "Shimen"(CV 5) on the day when the vagina-discharged epistom was found(pregnancy day 1,Pd 1).On Pd 4,mifepristone(0.1 mL,diluted in propylene glycol) was subcutaneously injected into CV 5 in rats of medication group.The expression of endometrial pinopodes(sampled on Pd 5) was observed by scanning electron microscopy.The immunoactivity of LIF of the endometrium was detected by immunohistochemistry.Results Compared with control group,the mean optical density(OD) values of LIF in CE-CV 5 and medication groups decreased significantly(P0.05).Electronic microscopic observation showed 1) abundant mature pinopodes on the endometrial surface,with a large number of well-stacked ecphyma in control group;2) fewer pinopodes and well-arranged smooth epithelial cells on the endometrial surface in catgut embedding group;and 3) no pinopodes found in the endometrium of medication group.Conclusion Catgut embedding at "Shimen"(CV 5) can suppress the establishment of the mouse endometrial receptivity,which is possibly related to its effect in inhibiting the expression of endometrial pinopodes and LIF.

Objective To investigate why benign, paroxysmal positional vertigo (BPPV) recurs.Methods Three hundred persons diagnosed with BPPV who had been treated at Tongji Hospital of Huazhong University of Science and Technology between April 2012 and April 2014 were given a telephone follow-up at least one year after their manual repositioning treatment.The respondents were divided into a healthy group and a recurrence group according to whether they said their vertigo had recurred.The age and gender distributions of the two groups were compared, along with their underlying diseases and living-related factors.Causes of the recurrence were then hypothesized.Results Single factor analysis and binary logistic regression analysis showed that overwork, an age over 45, travelling frequently, long use of computers, sleep disorders, oral intake of calcium tablets, posterior circulation ischemia and hyperlipidemia were all closely related to the BPPV recurrence.Age over 45 showed the strongest correlation.Conclusion Aging is the greatest risk factor for the recurrence of BPPV.Posterior circulation ischemia, hyperlipidemia, overwork, sleep disorders, long use of computers and being on business frequently are also predictors of relapse.

OBJECTIVE:To observe the bleeding,therapeutic efficacy and ADR of patients with acute cerebral infarction (ACI) treated by alteplase intravenous thrombolysis. METHODS:140 ACI patients were randomly divided into group A and B with 70 cases in each group. Group A was give alteplase 0.6 mg/kg for intravenous thrombolytic therapy,and group B was given al-teplase 0.9 mg/kg for intravenous thrombolytic therapy. The bleeding after thrombolysis,bleeding time,therapeutic efficacy and ADR were compared between 2 groups. RESULTS:The incidence of Subcutaneous ecchymosis,gingival bleeding,bleeding of di-gestive tract and intracranial hemorrhage of group A were 4.29%,2.86%,2.86% and 2.86%;those of group B were 14.29%, 12.86%,11.43% and 11.43%;the bleeding time of those symptomsin 2 groups were(6.04±0.75)and(7.22±0.56)h、(24.63± 10.24)and(35.22±9.87)min、(3.04±0.11)and(4.08±0.25)h、(3.12±0.48)和(4.53±0.66)h respectirely,with statistical signifi-cance(P<0.05). There was no statistical significance in therapeutic efficacy and ADR between 2 groups after treatment(P>0.05). CONCLUSIONS:The bleeding should be monitored strictly when ACI patients receive alteplase intravenous thrombolysis,and low-dose alteplase thrombolysis can ultimately reduce the incidence of bleeding.

AIM: The purpose of this study was to observe the morphological features of neuroendocrine cells(NECs),their proliferation and apoptosis in ovarian epithelial tumors,and to discuss their biological and clinical significance.METHODS: 79 specimens of ovarian epithelial tumor samples were collected,of them 20 benign,18 boderline,41 milignant tumors,and 22 normal ovaries were investigated immunohistochemically.Chromogranin A was used to detect NECs and their proliferation and apoptosis were examined by double-label staining of chromogranin A and Ki67 or TUNEL.RESULTS: The positive rate of CgA,distribution and staining intensity in ovarian epithelial tumors were higher than those in normal ovary.NECs showed various shapes with neuronoid protuberances stretching to the neighboring cells or basement membrane.Occasionally,they might touch together.No TUNEL positive coexpression in all NECs was observed by double-label staining,but some NECs were coexpressed with Ki67.CONCLUSION: NECs of ovarian epithelial tumors like cancer cells showed a proliferation,but no apoptosis.Their secretion might promote their neighboring non-NECs to proliferate and prevent them from apoptosis.

ObjectiveTo investigate the risk factors associated with macrovascular disease in patients with newly-diagnosed type 2 diabetes. MethodsAccording to arterial intima-media thickness(IMT)measured by color duplex ultrasonography,232 cases of newly-diagnosed type 2 diabetic patients were divided into two groups:one group were 95 cases with macrovascular disease(MD),and the other group were 137 cases without macrovascular disease (non-MD).Then various clinical data between the two groups were compared and the correlated risk factors for macrovascular disease were analyzed. Results (1)95 patients(40.9%)showed macrovascular disease in 232 patients.(2)Age,BMI,SI,systolic blood pressure,diastolic blood pressure,TC,LDL-C,CRP and 24h UmAlb were significantly higher in MD group compared with those in non-MD group(all P＜0.05);But ISI was significantly lower in MD group compared with that in non-MD group(P＜0.05).(3)Pearson correlation analysis showed that risk factors were old age,BMI,smoking,higher systolic blood pressure,higher diastolic blood pressure,TC,LDL-C,CRP and microalbuminuria. ConclusionMacrovascular disease was related to many factors.It was important to control some risk factors earlier for preventing the happening and progress of macrovascular disease.