Objective To explore the effect of low dose midazolam on maternal cognition function after cesarean section.Methods According to the digital table,60 women with cesarean section operation,who graded Ⅰ to Ⅱ according to America anesthesiologists (ASA),were randomly divided into the control group and observation group,30.cases in each group.The control group was given intravenous injection of 0.9％ sodium chloride injection 5mL after the fetal removed,and the observation group was given small dose of midazolam intravenous injection (0.03mg/kg,diluted to 5mL).The bad memories of the maternal operation process of the two groups were observed after the operaion.Results In the control group,0 case was completely forgotten,the completely forgetting rate was 0.0％ ;29 cases in the observation group were completely forgotten,the completely forgetting rate was 96.7％.The completely forgetting rate of the two groups had significant difference(x2 =19.73,P ＜ 0.01).Conclusion The small dose of midazolam can effectively eliminate the mothers during anesthesia and operation in the bad memories.

Fulminant myocarditis (FM)is a clinical accidant and emergency,and often endenger the lives of patients.Myocardium damage by virus infection and immune-mediated cellular damage are important for the development of FM.This paper discussed the role of the immune system in the FM,involving cellular immunity,humoral immunity and cytokine.Also this paper discussed the treatment of FM about the immunol-oregulation and immunosuppression.

Objective To evaluate the efficacy of potassium sodium dehydroandroan drographolide succinate (PSDS) combined with routine therapy for rotavirus enteritis in children.MethodsA total of 148 children with rotavirus enteritis were included and divided into an observation group and a control group by random number table method, 74 in each group. The children in the observation group were treated with intravenous PSDS combined with routine therapy, and those in the control group with intravenous ribavirin combined with routine therapy. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by enzyme-linked immunosorbent assay, and plasma lactate dehydrogenase (LDH), creatine kinase (CK), and creatine kinase-MB (CK-MB) were determined using standard clinical laboratory procedures. The clinical efficacy was evaluated. Results The total efficacy rate in the observation group was significantly higher than that in the control group (91.9%vs. 78.4%;χ2=2.314,P<0.05). After the treatment, the serum levels of IL-6 (18.24 ± 3.62 ng/mlvs. 25.36 ± 5.25 ng/ml; t=2.425,P<0.05) and TNF-α (20.86 ± 4.28 ng/mlvs. 31.22 ± 7.15 ng/ml;t=2.503,P<0.05), and the plasma levels of LDH (104.25 ± 22.06 U/Lvs. 150.26 ± 37.22 U/L;t=2.316,P<0.05), CK (84.25 ± 13.57 U/Lvs. 107.88 ± 16.28 U/L;t=2.327,P<0.05) and CK-MB (22.30 ± 4.24 U/Lvs. 32.26 ± 7.14 U/L;t=2.426,P<0.05) in the observation group was significantly lower than those in the control group. The time to diarrhea resolution (2.42 ± 0.53 dvs.3.56 ± 0.78 d;t=2.316,P<0.05) and the time to fever resolution(2.11 ± 0.32 dvs.2.63 ± 0.43 d;t=2.472,P<0.05) in the observation group were significantly delayed than those in the control group, and the hospital length of stay longer (6.23 ± 1.42 dvs. 4.35 ± 0.96 d;t=2.413,P<0.05).Conclusions PSDS combined with routine therapy may reduce inflammatory response, protect from myocardial injury, and promote recovery in children with RVE.

OBJECTIVE:To improve automatic outpatient pharmacy drug delivery system in our hospital,and to promote the efficiency of automatic drug delivery. METHODS:The outpatient pharmacy automation system of our hospital was introduced in terms of main structure,working process and application. The work efficiency,safety and error were compared between automatic drug delivery mode and manual drug delivery mode. Drug delivery machine was improved to increase the rate of drug delivery. RE-SULTS:The outpatient pharmacy automation system of our hospital included 2 boxed drug delivery machine and 1 drug dispensing machine,etc. Compared with manual drug delivery mode,automatic drug delivery mode improved drug delivery efficiency,health security and use security,and reduced drug delivery error. Through adjusting the time setting and step of drug delivery of gearing in drug delivery machine,idle time of transmission equipment was utilized effectively,and the quantity of delivered prescriptions was increased,increasing from 220 to 320 each hour. CONCLUSIONS:The reasonable improvement of outpatient pharmacy auto-mation system makes outpatient pharmacy automation system play a bigger role,and further optimize resources.

Assay"'of Epstein-Barr virus (EBV) DNA was conducted in the tissues of 60 patients with nasopharyngeal carcinoma (NPC), 30 patients with chronic inflamation of nasopharyngeal mucous membrane and 40 patients with other malignant epithelial tumor respectively using DNA in situ hybridization method. The positive rate of EBV-DNA in patients of NPC was 71.6%, while it was negative in pat ents with other malignant tumors a small number of EB-VDNA positive cells were also discovered in the epithelial cells of paratumours and chronic inflamation of nasopharyngeal mucous membrane. Significant correlation was found in the study of serum EBV-antiby in patients of NPC and EBV-DNA in cancer cells. The results suggest that EBV may be of etiologic significance in the pathogenesis of NPC.

The treatment strategy for infected acute necrotizing pancreatitis is that enables recovery but at the same time limits the morbidity and mortality.The current gold standard remains open necrosectomy.Recent literature contains scattered reports of percutaneous drainage,endoscopic,and laparoscopic approaches to managing patients with this condition.This review addresses the role of minimally invasive approaches and treatment strategy in patients with infected acute necrotizing pancreatitis.

BACKGROUND:Reduction quality is essential for the healing and function of limb. Traditional X-ray and CT scans have some limitationsin quantitatively and visualy observing the reduction quality of the remnant fracture in three-dimensional displacements. Mimics have advantages in bone rapid modeling and three-dimensional measurement, which offers the chance in quantifying the reduction quality of the displacement in three-dimensional methods.
OBJECTIVE:To measure residual displacement in femoral neck fracture patients with satisfactory reduction by using three-dimensional measurement method, and to evaluate the association between residual displacement and femoral head necrosis.
METHODS:We enroled 141 patients with femoral neck fracture, who were treated in the Third Department of Joint, Affiliated Hospital of Logistics University of People’s Armed Police Force from January 2012 to December 2013. Al patients were divided into undisplaced fracture group (n=44; Garden1&2) and displaced fracture group (n=97; Garden3&4). Based on DICOM data of CT files, three-dimensional models were constructed in each patient. Three parameters were measured: displacement of femoral head’s center, fossa capitis femoris and rotational displacement. Femoral head necrosis was folowed up. The correlation between residual displacement and femoral head necrosis was explored.
RESULTS AND CONCLUSION:(1) The duration of folow-up in those patients ranged from 25 to 43 months. Femoral head necrosis occurred in 7 cases from the undisplaced fracture group and 21 cases from the displaced fracture group. (2) The three parameters (displacement of femoral head’s center, fossa capitis femoris and rotational displacement) were respectively (7.44±2.84) mm, (11.75±4.12) mm and (17.68±8.99)° in the undisplaced group, and (6.51±3.75) mm, (9.34±5.27) mm and (14.67±7.43)° in the displaced group. Except displacement of femoral head’s center, significant differences in the other two parameters were detected between the two groups (P< 0.05). (3) These findings suggest that poor reduction quality is the main factor causing femoral head necrosis. X ray is insufficient to describe the spatial shift and the angle, and has limitations in assessing the reductionquality of femoral neck fracture. Three-dimensional measurement has certain advantages to assess quality of fracture reduction.

Objective To investigate the effect of vitrification on the biomechanics of tendon tissue in rabbit.Methods Two frozen methods were adopted.The first group was treated with Cryoprotective Agent,which was composed of 18.64%DMSO(V/V),13.37% Acetamide(V/V),9.17% 1,2 Propylene glyco(V/V),0.10mmol/LTrehalose and 10% Calf serum.The tendon tissue with three steps of preliminary treatment,preserved in Cryoprotective Agen was conserved in liquid nitrogen(-196℃)for 14 days;The second group treated with 15% DMSO and 10% Calf serum served as control group.Transmission electron microscope was used to observe the Histiooytic shape of tendon.Each group was performed with tendon tensile test,which could detect maximum load,the maximum shifting quantity and Young's Elastic Modulus.Results There was no significant damage in the tissue's micromechanism of vitrified tendon.But in cryopreservation group,the tissue's micromechanism was apparently damaged.There was no significant difference between test group and control group in maximum load(P=0.256).The same was the maximum shifting quantity(P=0.065).There was significant difference between test group and control group in Young's Elastic Modulus(P=0.006).Conclusion The damage of vitrification to tendon is less than that of profound hypothermia preservion,especially to tendon's corpuscular shape,but there is no significant difference between test group and control group in tendon's biomechanics.

Objective To study the expressions of survivin and caspase-9 in human primary hepatocellular carcinoma(HCC) tissues and their relationship with apoptosis.Methods Immunohistochemical staining was uesed to detect the expressions of survivin and caspase-9 in paraffin sections of 96 cases including 42 HCC tissues,42 paired adjacent noncancerous tissues and 12 normal liver tissues. Apoptosis was detected by TUNEL.Results No immunoreactivity of survivin was seen in normal liver tissues.The positive rates of survivin in HCC and paired adjacent noncancerous tissues were 73.81% and 4.76%,respectively,there was significant difference between two groups(P0.05).The expressions of survivin and caspase-9 in HCC tissues were not associated with age,sex and the size of tumor,but they were directly associated with tumor histological grade and metastasis.Conclusion High expression of survivin in HCC may inhibit apoptosis through depressing the expression of caspase-9,and it is an indicator of independent poor prognosis.

Objective To identify the changes of outpatients/emergency visits at Nanjing Children′s Hospital since introduction of the general pricing reform at public hospitals.Methods Fluctuations of outpatients/emergency visits at Nanjing Children′s Hospital before and after the reform in 2015 were compared,and an empirical analysis was made in view of the overall structural changes,demand price elasticity and cross-price elasticity of various outpatients/emergency visits.Results The change of total outpatients/emergency visits was minimal,yet the composition registered significant changes.Monthly average of common outpatients totaled 7 072 visits,a growth of 12.6%;that of senior specialists totaled 3 035 visits,a growth of 48.4%.The price elasticity was<1,while the demand for various outpatients/emergency visits services and cross-price elasticity appeared inelastic.Conclusions The one year reform has witnessed the hospital in smooth operations as yet.Given the sizable rise of examination prices for both outpatients/emergency visits,patient volume remains stable instead of drastic decrease,evidencing the strong demand for children′s medical services.