Objective To explore the application effect of epidural labor analgesia for primipara.Methods 176 labor primipara were divided into observation group and control group by digital table.The control group was given non-drug labor analgesia,the observation group was given epidural labor analgesia.The analgesic effects of the two groups of childbirth way were recorded.Results After the intervention,in the observation group,the anxiety self-assessment rating scale,depression self rating scale score were (42.65 ±1.87)points,(45.76 ±3.05)points, which in the control group were (46.34 ±3.88)points,(51.93 ±4.95)points,there were statistically significant differences between the two groups(t=8.036,9.954,all P<0.05).In the observation group,the activematernal plasma cortisol,the first stages of VAS score,the second labor VAS score,the third labor VAS score were (31.06 ± 3.67)nmol/L,(1.88 ±0.45)points,(3.54 ±1.32)points,(2.43 ±1.19)points,which in the control group were (38.76 ±5.22)nmol/L,(2.78 ±0.96)points,(4.86 ±3.15)points,(3.85 ±2.21)points,there were statistically significant differences between the two groups(t=11.319,7.963,3.625,7.963,all P<0.05).In the observation group,the maternal postpartum haemorrhage amount,episiotomy rate,neonatal asphyxia rate were (186.71 ± 32.18)mL,14.78%,1.14%,which in the control group were (254.82 ±45.96)mL,35.23%,7.95%,there were statistically significant differences between the two groups(t=11.387,χ2 =9.818,4.714,all P<0.05).Conclusion Epidural labor analgesia application in primipara can reduce maternal negative psychological stress,relieve labor pain degree,reduce episiotomy rate and postpartum hemorrhage occurs,improve and outcomes and improve maternal and child safety,it is worth popularization and application in clinic.

Objective Study the effect of transvaginal bitths in term pregnant women with less amniotic fluid B-mode ultrasonography suggested on neonatal and find the correct approach. Methods The maternity outcome of 166 pregnant women with less amniotic B-mode ultrasonography suggested fluid was compared with that of 187 term pregnant women with normal amniotic fluid.Results There was no significant difference on severe meconium stained amniotic fluid and the rate of neonatal asphyxin between two groups.Conclusion Transvaginal biths can be tried in term pregnant women with less amniotic fluid B-mode ultrasonography suggested under the intensive care.

Objective To explore the effect and value of sufentanyl combined with different concentrations of ropivacaine in labor analgesia.Methods 120 analgesia childbirth pregnant women were divided into 3 groups(group A 0.5g/L,group B 1.0g/L,group C 2.0g/L)by random number table method,40 cases in each group,they were giv-en sufentanyl combined with different concentrations of ropivacaine in labor analgesia.The labor analgesia effect of three groups of pregnant women was recorded.Results The postpartum 2 h blood loss and total labor time of group A were (147.55 ±25.39)mL and (727.54 ±56.38)min,which of group B were (131.03 ±18.73)mL,(573.53 ± 40.09)min,which of group C were (120.03 ±14.84)mL,(493.82 ±34.51)min,there were statistically significant differences among the three groups(F =3.342 7,7.551 7,all P <0.05).The VAS pain score,oxygen partial pressure and CO2 partial pressure of group A were (3.15 ±1.14)points,(17.11 ±1.43)mmHg,(52.73 ±2.59)mmHg, which of group B were (2.01 ±0.76)points,(18.24 ±2.03)mmHg,(50.01 ±1.68)mmHg,which of group C were (1.51 ±0.35)points,(19.41 ±2.76)mmHg,(47.21 ±1.02)mmHg,there were statistically significant differences among the three groups(F =4.651 4,2.852 5,5.681 4,all P <0.05).The incidence rate of complications in group A was 7.50%,which in group B was 10.00%,which in group C was 15.00%,there was statistically significant difference among the three groups(χ2 =0.4571,P >0.05).Conclusion Using 1.5g/L ropivacaine combined with sufentanyl in labor analgesia is remarkable,high safety,neonatal and maternal prognosis is good,and therefore should be preferred to 1.5g/L ropivacaine combined with sufentanyl in labor analgesia.

Objective To study the characteristics of its pathologic and neurophysiologic changes of a ani-mal model of cervical spinal cord compression, and to explore the relationship between the severity of spinal cord inju-ry and its functions. Methods Thirty-two rabbits were divided into 4 groups randomly. A catheter was inserted intothe vertebral canal and a balloon was inflated to compress spinal cord in epidural space. According to the diameter ofballoon, the animals were divided into 4 groups (A, B, C, D group), Each group consisted of 8 rabbits. The corti-cal somatosensory evoked potential (CSEP) and motor evoked potential (MEP) were used to assess neurologicalfunction. Motor function behavior was scored before and on 1, 3, 7 and 14 days after surgery. Histological observa-tions were performed, pathological changes were observed by light and electron microscope. Results Spinal cordcompression resulted in a gradual increase of the peak latency and significant decrease of the peak amplitude. The la-tency and amplitude of MEP were changed more dramatically than those of CSEP. The result indicated that MEP wasmore sensitive than CSEP to the compression. Analysis also revealed that the severer the pathologic changes, the lon-ger the latency and the lower the amplitude of the evoked potentials. Conclusion The animal model presented inthis paper was simple and standardized. Evoked potentials as a noninvasive technique have great value in monitoringspinal cord function. The variance of amplitude and the latency in significantly correlate with the degree of compres-sion of the spinal cord.

Objective To compare the effect of different concentrations of ropivacaine in epidural analgesia of childbirth.Methods According to the digital table,300 cases of our hospital childbirth puerpera were randomly divided into A,B,C three groups.A group was given 0.125％ ropivacaine compound fentanyl analgesia,B group was given 0.1％ ropivacaine compound fentanyl analgesia,group C was not required analgesia childbirth.The childbirth of three groups was observed.Results In group A,the labor time was (261.38 ± 19.87) min,postpartum 2h blood loss was (241.03 ± 34.57) mL.In group B,the labor time was (260.09 ± 19.69) mnin,postpartum 2h blood loss was (238.66 ± 35.01) mL.In group C,the labor time was (270.46 ± 20.86) min,postpartum 2h blood loss was (251.75 ± 36.79) mL.Statistical analysis showed that there was no significant difference (t =0.472,1.035 ; all P ＞ 0.05).In group A,the fetal heart rate was (142.34 ±21.57)times/min,neonatal Apgar score was (9.77 ± 0.21),and umbilical artery blood pH value was (7.27 ± 0.06).In group B,fetal heart rate was (145.21 ± 21.49) times/min,neonatal Apgar score was (9.79 ± 0.20),and umbilical artery blood pH value was (7.26 ± 0.08) ; Fetal heart rate of group C was (143.78 ±22.01)times/min,neonatal Apgar score was (9.64 ±0.24),and umbilical artery blood pH value was (7.28 ± 0.07).The differences among three groups were not statistically significant (t =0.763,0.360,0.114,all P＞ 0.05).Analgesic effect time of group A was (12.13 ± 1.76) min,pain score was (1.03 ±0.46) points,analgesic harem duration was (22.39 ± 3.21) s,analgesic harem time interval was (3.26 ± 1.49) min,the cesareandelivery rate was 8.00％.In group B,the analgesic effect time was (12.04 ± 1.69mnin),pain score was (1.01 ± 0.52) points,analgesic harem duration was (21.04 ± 3.18) s,analgesic harem time interval was (3.4.9 ±1.51)min,the cesarean delivery rate was 9.00％ ; Duration of the analgesic effect of group C was (16.77 ±16.77) min,pain score was (3.76 ± 1.23) points,analgesic harem duration was (26.98 ± 5.87) s,analgesic harem time interval was (2.65 ± 0.75) min,the cesarean delivery rate was 48.00％.The differences between groups were statistically significant (chi square or t =6.148,8.522,5.749,4.095,61.316 ;P ＜ 0.05).Conclusion Application of 0.1％ ropivacaine compound fentanyl anesthesia can effectively relieve patients'pain,shorten labor and reduce postpartum 2h blood loss,impact less on contractions at the same time,reduce the incidence of cesarean delivery,has no influence on the neonate,which is worth popularization and application in clinic.

ObjectiveTo investigate the population with an advantage of clinical cure previously treated with nucleos(t)ide analogues (NAs), and to provide more methods for clinicians in pursuing the clinical cure of hepatitis B. MethodsA total of 42 chronic hepatitis B patients with low-level HBsAg who received NAs treatment in Hebi Third People’s Hospital from October 2017 to October 2019 were enrolled as subjects and divided into combination treatment group (group A) and NA monotherapy group (group B). The 22 subjects in group A were treated with NAs combined with PEG-IFN antiviral therapy for 48 weeks, and some patients withdrew from PEG-IFN after 24 weeks and continued to receive NA monotherapy, while the 20 subjects in group B received NA antiviral therapy alone. Both groups were observed till week 48, and the five makers for hepatitis B were measured to evaluate clinical outcome. The t-test was used for comparison of continuous data between two groups, and the Fisher’s exact test was used for comparison of categorical data between two groups; a multivariate logistic regression analysis was used to perform a multivariate analysis. ResultsCompared with group B at the 48-week treatment endpoint, group A had significantly higher HBsAg clearance rate (45.5% vs 0, P＜0.01) and HBsAg seroconversion rate (31.8% vs 0, P＜0.01). The population with HBsAg ＜1000 IU/ml, ＜500 IU/ml, ＜100 IU/ml, and ＜10 IU/ml had an HBsAg clearance rate of 52.6%, 61.5%, 66.7%, and 100%, respectively, and the population with an HBsAg level of 500-1000 IU/ml, 100-500 IU/ml, 10-100 IU/ml, and ＜10 IU/ml had an HBsAg clearance rate of 33.3%, 50%, 40%, and 100%, respectively. The 4 patients with baseline HBsAg ＜10 IU/ml (accounting for 18.2% in group A) achieved clinical cure at week 12 of combined treatment, and after observation to week 48, 2 patients had an anti-HBs level of ＞100 IU/ml and 2 had an anti-HBs level of ＞1000 IU/ml. The multivariate logistic regression analysis of HBsAg clearance showed that age at the initiation of combined treatment affected HBsAg clearance (odds ratio ［OR］=0.877, 95% confidence interval ［CI］: 0.781-0.985, P=0.026), and most of the patients with HBsAg clearance had an age of 36-49 (44.20±4.49) years; baseline HBsAg level also had an impact on HBsAg clearance (OR=0.996, 95% CI: 0.992-1.000, P=0.050). ConclusionThe addition of interferon therapy in chronic hepatitis B patients with low-level HBsAg previously treated with NAs can significantly improve the clinical cure rate. The younger the age and the lower the HBsAg level, the shorter the duration of combined treatment. Age and baseline HBsAg level are more important than the duration and type of NA medication.