[Summary] In recent years , ultrasound guidance has been widely used in local anesthesia , particularly in peripheral nerve blockage .Ultrasound guided neuraxial blockage is also making progress .Previous studies have shown that pre-puncture ultrasound scanning could provide useful information on the correct intervertebral interspace , the midline of the spine , the optimal puncture point , the appropriate angle for needle insertion , and the distance from skin to the spinal canal .In this review, the ultrasonographic techniques and image analysis , as well as its clinical use , including pre-puncture scanning and real-time guidance for spinal and epidural anesthesia , were summarized .

Objective To investigate the changes of venous cord blood nitric oxide(NO) and endotnelin-1(ET-1) levels and to find out its relationship with umbilical arteries blood flow velocities in the pregnant women with diabetes mellitus.Methods 66 cases of the pregnant women with diabetes mellitus(DM) were selected at random,including 30 diabetes mellitus complicated with pregnancies(DMP) and 36 gestational diabetes mellitus(GDM).36 cases of the normal pregnant(NP) women were selected as the control group.Venous cord blood samples were collected from all the subjects after delivery.Cord blood NO and ET-1 levels were detected by Griess assay and radioimmuno-assay respectively,and umbilical arteries blood flow velocities(S/D) were measured just before delivery.Results Compared with the control group,cord blood NO levels decreased and ET-1 levels increased and S/D increased in the DMP group significantly(P0.05).Conclusion Umbilical blood NO and ET-1 levels are abnormal in DMP,which induces the high resistance of fetal-placental circulation,and finally might cause adverse pregnancy outcomes.

SUMMARY A patient with previous L3 -4 posterior lumbar interbody fusion,pedicle screws instrumen-tation and L3 -4 decompression,was scheduled for left total hip arthroplasty.Two years ago,due to poor landmarks palpation,the patient experienced a failed lumbar puncture after multiple attempts before her-niorrhaphy.His plain radiography showed bilateral partial laminectomy at L3 -4 level,and between L3 and L4,two posterior pedicle screws connected by metal rods on both sides.This time,we used ultra-sound to locate L4 -5 interlaminar space in paramedian sagittal oblique view and identified the spine midline by transverse interlaminar view before puncture.According to this information,L4 -5 puncture point was verified and the combined spinal-epidural anesthesia was performed in a paramedian approach. After withdrawing clear cerebral spinal fluid,15 mg hyperbaric bupivicaine was injected into intrathecal space.An epidural catheter was then inserted into the epidural space.The sensory block level was fixed at T10 to S within 10 minutes.Intraoperatively,the patient received 10 mL 2% (mass fraction)lido-caine through the epidural catheter in total.The surgery was uneventful.No neurologic complication was observed after the surgery.This case report demonstrates that ultRASound imaging can provide useful in-formation for neuraxial needle placement and can be a valuable tool in managing patients with anatomical change around the spine.

Objective To investigate the possible risk factors for lead poisoning in order to prevent the lead poisoning in children.Methods One thousand and fifty-five children aged 5 months to 16 years who were outpatients in Beijing children′s hospital were chosen. Blood lead was analyzed by 3010-B lead analyzer for each child.Also the risk factors were recorded by using a standardized questionnaire.Results The mean level of blood lead was(110.1?41.9) ?g/L with the occurrence of lead poisoning (blood lead ≥100 ?g/L) at 43.51%.No difference were found in blood lead level among different age groups.Several environmental and social factors were found to be related to lead poisoning in children,such as non-balanced diet,rarely hand washing,frequent eating crisp foods,not frequency of calcium and zinc supplementation and frequency of room decoration.Conclusion Unhealthy dietary and life styles contribute to lead poisoning in children.

Objective:To optimize the ethanol extraction process of Rhizoma Corydalis and Salvia miltiorrhiza, and study the effect of comminution degree of the medicinal materials on the effective constituent. Methods:Using the alcohol concentration, alcohol vol-ume, extraction time and extraction times as the impacting factors,the content of tetrahydropalmatine and salvianolic acid as the indi-ces, the extraction process was optimized by orthogonal test of L9(34). Results:The best extraction conditions were as follows:Rhizo-ma Corydalis was crushed into coarse powder, the material / liquid ratio was 1∶6 with 75% ethanol as the extraction solvent,extracting twice with 1. 5h each. Conclusion:The extraction method is appropriate and simple,and can be used in the industrial production.

Objective To investigate the residual functions in the hepatic lobe with deprivation of bile duct by observation of histomorphological and functional changes in the hepatic cells in a rat model. Methods The right hepatic bile ducts of rats were obstructed with cyanoacrylate and then ligated two weeks after the left and caudate lobes were removed. The lobus quadratus hepatis served as self-control with or without portal vein ligation. The venous blood from individualized liver lobe was examined and histological observation was done to examine the histomorphological and functional changes in the hepatic cells. Results Compared to the controls of both sham operation and untreated lobe, the hepatic lobe with bile ducts deprived did not undergo atrophy significantly with few ultrastructural changes. The hepatocytes of the hepatic lobe with bile duct deprived contained plenty of mitochondria, ribosomes and rough endoplasmic reticulum when observed under transmission electron microscope (TEM). The results of periodic acid-Schiff staining revealed normal glycogen metabolism in the hepatic cells. No significant decrease was detected in the serum albumin and fibrinogen concentrations by examination of blood collected from vein of this liver lobe with deprivation of bile ducts. Conclusions The liver lobes with bile ducts deprived retain most of the liver functions such as protein synthesis and nutrition metabolism, and show no atrophy during the observation period. It is suggested that the hepatic lobes with bile duct deprived still possess the value of preservation. The present study has founded a theoretic basis for remaining the remaining liver lobes with bile duct deprived or ligated in some emergency and specific clinical situations.

The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P < 0.000 010 and electrocardiogram curative effect (OR = 2.21; 95% CI; [1.83, 2.68]; P < 0.000 010. Funnel figure seemed that there was publication bias. The current limited evidence showed that when compared with the control group, treatment group was superior in improving patients with angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.
Adjuvants, Pharmaceutic ; Adult ; Aged ; Angina Pectoris ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; Electrocardiography ; Female ; Heart ; physiopathology ; Humans ; Injections ; Male ; Middle Aged ; Randomized Controlled Trials as Topic

Objective To understand the correct sexual health knowledge and source of sexual information among college students in Kunming, and provide the practical suggestions for students' sexual education. Methods A self-administered questionnaire survey was conducted among 950 students chosen from 5 universities in Kunming by cluster multistage sampling. Results The college students' health knowledge accuracy has certain significant differences between men and women, living urban and rural, inside and outside the province, and the Han and other nationalities. The most conversation partner discussing sex for the first time is their companion. Students get sex knowledge most in junior high school, and the school is the most important way to get these knowledge. Conclusion Sexual health knowledge education should be balanced between boys and girls, rural area students and minority students' knowledge of sexual health should be strengthened, and make them have a correct understanding onsex. In addition, strengthen the familysex knowledgeis also important.

Objective To explore the feasibility of quantitative hemodynamics measurement of inferior vena cava (IVC) in healthy volunteers with phase-contrast sequence on 3.0 T MR system (3.0 T PC-MRI),and to evaluate the relationship between IVC lumen area,blood flow,and velocity.Methods Fifty healthy adult volunteers prospective underwent IVC PC-MRI at 3.0 T MR system.All volunteers were from our hospital for the routine chest or abdomen examinations,no heart disease and lung disease always,heart rate,blood pressure,electrocardiogram was in normal range,no abnormalities were found in clinical and abdominal imaging examinations,and IVC disease was excluded by ultrasonic examination.The area (A),mean velocity (MV),mean flux (MF),regurgitant fraction (RF) and time-flow curve of upper and middle segments of IVC during one cardiac cycle were observed.Independent samples t test was used to compare IVC lumen area and blood flow,velocity between different genders,different age groups (18 to 30 years old group,more than 30 years old group) and different phase velocity encoding value of IVC middle segment,one-way ANOVA was used to compare different phase velocity encoding value of IVC upper segment [(60,80,100)cm/s].Pearson correlation coefficient and regression equation were used to evaluate the relationships between area,blood flow,and velocity.Results Among 50 patients with successful completion of the examination,significant difference was found in A,MV,MF and RF between the different IVC segments.MF of the IVC middle segment were (37.94 ± 7.32) and (33.68 ± 6.65) ml/s in male (n =24) and female (n =26),respectively ; significant difference was found in different genders (t =2.49,P =0.017).MF of upper segment and middle segments of IVC were (54.89 ± 10.98)and (38.29 ± 7.54)ml/s in 18 to 30 years old group(n =27),while MF of upper segment and the middle of IVC were (44.96 ± 8.49) and (32.65 ± 5.59) ml/s in older than 30 years old group (n =23) with significant difference(t =3.34,2.15,P ＜ 0.01).Peak positive velocity were (55.36 ± 6.30),(61.30 ± 12.42),(62.55 ± 13.09) cnm/s in different phase velocities (60,80 and 100 cm/s),while peak negative velocity (PNV) were (42.37 ± 19.18),(32.79 ± 24.67),(24.61 ± 21.20) cm/s with significant differences (F =4.258,7.794,P ＜ 0.05).The overall image quality was good for quantitative measurement between different phase velocity encoding values of upper segment and the middle IVC (image evaluation are greater than or equal to 3,11 patients were three points,24 patients were four points,15 patients five points).The relation between the PC flow image of IVC and the cardiac cycle was sine wave,the area and the velocity of upper and middle segments of IVC was negative (r =-0.466 and-0.765,P ＜ 0.01),and no linear correlation between the area and the flow of upper and middle segments of IVC (r =0.259,0.046,P ＞ 0.05).There were slight reverse flow during systolic and diastolic cycle.Conclusion The area,flow and velocity of IVC can be rapidly,accurately and noninvasive measured with PC-MRI,and different ages,different genders and different anatomical parts of IVC had obvious hemodynamic differences.

Objective To investigate the effect of sodium valproate in suppression of cell proliferation and arrest of cell cycle of in human hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988.Methods Hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988 were inoculated on the culture plate,cultured in the DMEM medium,they were intervened with sodium valproate in concentration of 0.2 mmol/L (0.2 mmol/L group),1.0 mmol/L (1.0 mmol/L group),5.0 mmol/L (5.0 mmol/L group) and dimethyl sulfoxide (control group) for 48 h respectively.Absorbance was measured by enzymelinked immunosorbentassay equipment,and inhibition ratio was calculated.Cell cycle was detected by flow cytometry.Results The absorbance of hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988 in 5.0 mmol/L group were significantly lower than those in control group and 0.2 mmol/L group (0.569 ±0.059 vs.0.706 ±0.033 and 0.760 ±0.020,2.068 ±0.178 vs.2.793 ±0.144 and 2.663 ± 0.078,P ＜ 0.05),the absorbance of pancreatic cancer cell line PaTu8988 in 1.0 mmol/L group (2.432 ± 0.084) was significantly lower than that in control group and 0.2 mmol/L group (P ＜ 0.05).With the sodium valproate concentration increased,inhibition rate of tumor cell increased gradually,the inhibition rate of hepatoma cell line SMMOL/LC-7721 and pancreatic cancer cell line PaTu8988 in 5.0 mmol/L group was 23.5％ and 25.9％ respectively.Compared with control group,with the sodium valproate concentration increased in 0.2,1.0,5.0 mmol/L group,the proportion of G1 phase cell increased gradually in hepatoma cell line SMMOL/LC-7721 [(49.25 ± 1.63)％,(65.26 ± 2.34)％,(83.13 ± 1.78)％ vs.(49.22 ± 4.35)％],the proportion of S phase cell decreased gradually [(26.84 ± 2.30)％,(17.76 ± 3.90)％,(3.38 ± 0.65)％ vs.(29.21 ± 2.35)％],cell cycle showed G1 phase arrest,there was significant difference (P ＜ 0.05).Compared with control group and 0.2 mmol/L group,the proportion of G2 phase cell increased in pancreatic cancer cell line PaTu8988 in 1.0 and 5.0 mmol/L group [(26.80 ± 1.50)％,(36.58 ± 3.78)％ vs.(12.00 ± 4.62)％,(16.54 ± 2.26)％],cell cycleshowed G2 phase arrest,there was significant difference (P ＜ 0.05).Conclusion Sodium valproate mightsignificantly suppress the cell proliferation in hepatoma cell line SMMOL/LC-7721 and pancreatic cancercell line PaTu8988 and induce cell cycle arrest,it is clinically promising antitumor drug.