OBJECTIVE:To investigate the effects of small dose of bupivacaine lumbar-epidural block on related indexes inwomen underwent cesarean section. METHODS:124 singleton term primipara underwent elective cesarean section were randomly divided into observation group(62 cases)and control group(62 cases). Observation group received 0.5% bupivacaine 7.5 mg lum-bar anesthesia+1.6% lidocaine epidural block. Control group received 0.5% bupivacaine 10 mg lumbar anesthesia+1.6% lidocaine epidural block. HR,SBP,DBP,onset time of sensory block,fixation time of block level,operation start time,the occurrence of traction reaction and supine hypotensive syndrome,the application of ephedrine,Apgar score the occurrence of ADR were ob-served in 2 groups before anesthesia(T0),1(T1),3(T2),5 min(T3)after anesthesia,at skin incision(T4),after fetal disengage-ment(T5). RESULTS:There was no statistical significance in HR,SBP and DBP between 2 groups at T0(P>0.05). There was no statistical significance in HR,SBP and DBP of observation group at different time points(P>0.05). At T1-3,SBP and DBP of con-trol group were significantly lower than at T0 and observation group;HR was significantly higher than at T0 and observation group, with statistical significance(P<0.05);there was no statistical significance in HR,SBP and DBP of control group,compared to at T1-3(P>0.05);there was no statistical significance in above 3 indexes of control group at T4-5,compared to at To and observation group(P>0.05). The onset time of sensory block,fixation time of block level and operation start time in observation group were all longer than control group;the incidence of supine hypotensive syndrome,the number of ephedrine cases,the amount of ephed-rine,the incidence of nausea and vomiting,the incidence of postoperative urinary retention were significantly lower than control group;the incidence of traction reaction was significantly higher than control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of respiratory depression,Apgar score,overall incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:The small dose of bupivacaine lumbar-epidural block for women underwent cesarean section keep he-modynamics stable and reduce the incidence of supine hypotensive syndrome without increasing the incidence of ADR.

Objective To observe the short-term and long-term effect of mask bi-level positive airway pressure (BiPAP) combined with recombinant human brain natriuretic peptide (rhBNP) on acute heart failure.Methods One hundred cases of acute heart failure patients were divided into BiPAP combined with rhBNP group (51 cases) and conventional treatment group (49 cases) by random digits table.Conventional treatment group was given routine drug for heart failure treatment,and BiPAP combined with rhBNP group on the basis of routine treatment,was given BiPAP combined therapy with rhBNP.Arterial blood oxygen partial pressure (PaO2),arterial blood oxygen saturation (SaO2),and the change of clinical symptoms were recorded before and 30 min,2 h after treatment.All patients were followed up for 3 months,and cardiovascular events,related parameters of echocardiography and 6 min walking distance test were compared between two groups.Results Clinical symptoms (respiratory frequency and heart rate) and blood gas analysis index (PaO2,SaO2) were significantly improved after treatment in two groups,and BiPAP combined with rhBNP group improved more significantly.There was significant difference (P ＜ 0.05).After 3 months' follow-up,the incidence of cardiovascular events in BiPAP combined with rhBNP group was lower than that in conventional treatment group [17.6％ (9/51) vs.38.8％ (19/49),P ＜ 0.05].The left ventricular end-diastolic diameter (LVEDd),left ventricular ejection fraction (LVEF) in BiPAP combined with rhBNP group was better than that in conventional treatment group [(55.0 ± 6.1) mm vs.(63.3 ± 6.5) mm,(52.5 ±7.2)％ vs.(44.7 ± 6.8)％] (P ＜ 0.05).The 6 min walking distance test in BiPAP combined with rhBNP group was higher than that in conventional treatment group [(325.6 ± 36.4) m vs.(210.2 ± 34.1) m] (P ＜0.05).Conclusion BiPAP combined with rhBNP in short-term treatment of acute heart failure is effective and safe,and can improve the long-term prognosis of patients.

Objective To discuss the significance of near infrared spectroscopy (NIRS) in evaluation of intrapartum hypoxic-ischemic cerebral injury, and to provide a method to evaluate neonatal brain damage objectively and quantitatively. Methods A total of 63 neonates with fetal distress were divided into hypoxic-ischemic encephalopathy(HIE) group and non-HIE group. Thirtyfive newborns with no fetal distress were chosen as controls. Using NIRS, the brain regional oxygen saturation(rSO2) in these neonates were measured. Evaluation of brain rSO2 in the diagnosis of HIE was analyzed with receiver operating characteristic (ROC) curve. Results At the time of fetal head visible on vulval gapping and 5 min after birth, the HIE group showed decreased brain rSO2[(36. 6±5.0)% and (52. 0±4. 2)%], comparing with control group[(45. 9±4. 6)% and (59. 6±4. 4)%]and non-HIE group[(44.1±3.1) % and (57. 6±3. 5) %](P<0. 01) . The brain rSO2 was positively correlated with the pH and oxygen saturation of umbilical artery blood in all groups (P<0. 01). When the cut-off value of brain rSO2 was <39. 5% at fetal head visible on vulval gapping, the sensitivity and specificity of assessing HIE were 67% and 93%, respectively, while 70% and 86% when the cut-off value was <53. 5% at 5 min after birth. Conclusions The brain rSO2 obtained by NIRS could be used to evaluate brain oxygenation, and may be useful in predicting HIE in neonates with fetal distress.

Objective To investigate the effects of puerarin on the expression of human umbilical vein endothelial cells (HUVECs) tissue factor (TF) and tissue factor pathway inhibitor (TFPI) induced by oxidized low-density lipoprotein (ox-LDL).Methods After HUVECs were incubated with different concentrations of puerarin and 50 mg/L ox-LDL,the expression of TF and TFPI mRNA and protein were detected by real-time fluorescent quantitative PCR and Western blot respectively.Results Compared with control,treatment with ox-LDL caused the augment of TF mRNA and protein expression (P<0.01),and the decrease of TFPI mRNA and protein expression.However,50,100,and 200 μmol/L puerarin blunted the augment of TF mRNA and protein expression and weakened the inhibition of TFPI mRNA and protein expression induced by ox-LDL(P<0.01).Conclusions Puerarin reduces HUVECs TF and TFPI mRNA and protein induced by ox-LDL.

Objective To explore and compare the therapeutic effects of Fufangkushen injection and Aidi injection on improving quality of life for patients with advanced lung cancer. Methods 60 patients in late stage of lung cancer with pathological diagnosis were split into two groups randomly. 30 patients in Kushen group received Fufangkushen injection plus base therapy, 30 patients in Aidi group received Aidi injection plus base therapy.The data was analyzed on term of tumour size,clinical symptoms,Karnofsky score,cancer marker CA125,CEA,before and after treatment in two groups.The therapeutic effects were evaluated after two circles of treatment. Results Compared the short term therapeutic effect, Kushen group had the stability rate for 83.3 ％(25/30),and 80.0 ％(24/30) for Aidi group.There was no significant difference.(P＞0.05).Compare the clinical therapeutic effect,Kushen group had the improving rate for 83.3 ％(25/30),and 80.0 ％(24/30) for Aidi group.There was no significant difference(P＞0.05).Compare the Karnofsky score,two groups had equal increasing stability rate (P＞0.05). Compare decreasing ratio of CEA and CA125 after treatment in two groups,there was no significant difference (P＞0.05). Conclusion Fufangkushen injection and Aidi injection both have acceptable therapeutic effects in the treatment of patients with later stage lung cancer.The result is equal. As well as they have some other characters themselves to improve lung cancer related symptoms. Fufangkushen injection is better to improve symptoms of heat toxin, and Aidi injection is better to improve symtoms of deficiency Qi. For Fufangkushen injection, it can also adjust disorder of liver function and relieve pain.

Abstract: Objective　To compare the efficiency of lung-microscopy and tissue homogenate in the detection of Angiostrongylus cantonensis larvae from Pomacea canaliculate, with the amin of finding a simple and rapid method suitable for different scenarios. Methods　Pomacea canaliculata was caught and collected from ponds, ditches, rivers and other environments in the confirmed epidemic areas reported by predecessors. After each snail was weighed one by one, and dissected into two parts: lung sac and muscle. Firstly, each snail lung sac was check for nodules with lung-microscopy, and the nodules were picked out with anatomical needle and press them separately. Then, the worm was found and identified for worm species under microscope, and the lung sac and snail meat then was rechecked with tissue homogenate. Results　A total of 330 snails were detected, with 19.1% (63/330) snails with Angiostrongylus cantonensis stage Ⅲ larvae were detected by tissue homogenate and 15.8% (52/330) snails with nodules were detected by lung-microscopy. Among them, 36 snails with nodules and larvae were detected by the lung-microscopy, and all of them were positive by the tissue homogenate, with a coincidence rate of 100% (36/36); 16 snails with nodules but no larvae, among which 6 snails were positive and 10 snails were negative by the tissue homogenate, The false detection rate was 19.2% (10/52). 278 snails with no nodules, but 21 of them were detected by the tissue homogenate, the missing rate was 7.6% (21/278). There was no significant difference between tissue homogenate and lung-microscopy (taking the positive determination of nodules as the standard) (χ2=1.27, P=0.26, P>0.05). There was significant difference between tissue homogenate and lung-microscopy (taking the detection of larvae as the standard)(χ2=8.66, P = 0.003, P<0.01). There was no significant difference between the two methods and tissue homogenate in the detection rate of large snails ( ≥25 g, χ2=0.08，P=0.777; χ2=2.58, P=0.108), but there was significant difference between the two methods and tissue homogenate in the detection rate of small snail (≤10 g, χ2=5.63, P=0.02). Conclusions　Compared with the tissue homogenate, lung-microscopy is simple in the detection of large snails, requires less instruments and equipment, and its detection speed is faster. It is suitable for the field investigation of the natural focus of Angiostrongylus cantonensis. The tissue homogenate has high sensitivity, can directly display the insect state and activity, has strong insect vitality and high detection rate, it's more suitable for food safety risk monitoring.

Hemorrhoids ; Humans ; Male ; Mucous Membrane

ObjectiveTo investigate the iodine nutritional status of residents in Shanxi province,and to provide a scientific basis for adjustment of control strategies and measures to iodine deficiency disorders (IDD).MethodsIn the 11 cities and 119 counties(cities,districts),except high water iodine townships,9 townships were selected in each county according to their sub-area positions of east,west,south,north and center,4 villages were sampled in each chosen township,and 8 households were selected in each chosen village in every chosen county (cities,districts ) with 9 or more townships.In every chosen county (cities,districts) with 6 to 9 townships,1 township was selected respectively in east,west,south,north and center sub-areas of the township,4 villages were sampled in each chosen township,and 15 households were selected in each chosen village.In the county (cities,districts) with 5 or less townships,all township were selected,4 villages were sampled in each chosen township,and 15 households were selected in each chosen village.Edible salt samples from these households were collected; iodized salt was determined by direct titration.In the 119 counties(cities,districts),1 township was selected,respectively,in east,west,south,north and center sub-areas in each county,and 20 children aged 8 - 10 in each of the selected townships were selected to collect urine samples and urinary iodine was determined by As-Ce catalytic spectrophotometry.Evaluation criteria:median urinary iodine ＜ 100 μg/L was iodine deficiency,100 - 199 μg/L as appropriate,200 - 299 μg/L as more than appropriate,and ≥ 300 μg/L as iodine excess.ResultsMedian iodine of the 34 808 household salt samples was 31.55 mg/kg.The coverage rate of qualified iodized salt was 99.18％(34 521/34 808) and the consumption rate of qualified iodized salt was 97.12％(33 805/ 34 808).In the 11 cities,119 counties(cities,districts),the median of urinary iodine of 11 967 children aged 8 -10 was 244.0 μg/L,of which ＜ 50 μg/L acoounted for 2.6％(312/11 967),50 - 99 μg/L accounted for 6.9％(823/11 967),100- 199 μg/L accounted for 26.3％(3145/11 967),200 - 299 μg/L accounted for 28.7％(3440/11 967),and 300 μg/L or higher accounted for 35.5％(4247/11 967).The medians of urinary iodine in the 9 municipal cities were 200 - 300 μg/L,and other 2 cities were 300 - 400 μg/L At the county level,the medians urinary iodine of children of the 119 counties(cities,districts) were 100 - 199 μg/L that accounted for 15.1％(18/119),200 - 299 μg/L accounted for 63.9％(76/119),and 300 μg/L or higher accounted for 21％(25/119).Conclusions The iodine nutrition level of residents in Shanxi province is more than appropriate.The salt iodine concentration in Shanxi province needs to be reduced,but the space is not wide.

Objective To explore the related factors of anxiety and gloomy mentality people aged 60-80 years and investigate the effectiue methods to intervention.Methods A follow-up study was proportional and carried out in Xicheng district of Beijing.Multi-phase,stratified,unequal cluster sampling was adopted to investigate old people in 2011 with WHO-QOL,Memorial University of Newfoundl and Scale of Happiness,Social Support Rating Scale,Self-Rating Anxiety Scale and Self-rating Depression Scale.2342 old people were randomly divided into control group and trial group.The trial group received health education,community social support,lightening the psychological stress in face to face,psychology guiding and group discussion.The control group received general observation only.Results Among 2342 old people,126 (5.3％) obtained anxiety and 201(8.6％) had gloomy mentality.The anxiety in the elderly was significantly related to age,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,keeping pets,character,training,feeling adjusting,life quality,subjective well-being,social support,depression (all P ＜ 0.05).The depression in the elderly was significantly related to gender,marriment,culture,job,family type,family relationship,housing,income,medical insurance,retirement type,reading,watching plays,character,feeling adjusting,drinking,training,life quality,subjective well-being,social support,anxiety (all P＜0.05).Scores of two groups had no significant difference before intervention.The change in scores of anxiety and depression in the trial group was obviously lower than in control group (P＜0.05).Conclusions The anxiety and gloomy mentality are common in old people aged 60-80 years in Xicheng District,which independently associated with related factors such as life quality,subjective well-being,social support and so on.After 6 months of treatment,the scores of anxiety and depression in the trial group is obviously lower than in control group.

Objective To evaluate the clinical therapeutic efficacy and adverse reactions of Coix Seed Extract combined with transcatheter arterial chemoembolization(TACE) in the treatment for hepatic metastases and to compare the levels of serum VEGF of the patients before and after the treatment.Methods FromJuly 2009 to July 2011, 62 patients with hepatomatic metastases were enrolled in this study and were randomized into combining group and control group.The combining group were treated by TACE combined with Coix Seed Extract, and the control group were treated with TACE only. Both groups underwent TACE at least twice.Before and after the treatment,the enzyme linked immunosorbentassay(ELISA)was used to examine the change of VEGF. Results Among 62 assessable patients, overall response rate was 61.3 ％(19/31) in combining group and 45.2 ％ (14/31)in control group respectively (P＞ 0.05).The disease control rate was 80.6 ％(25/31) in combining group and 54.8 ％ (17/31) in control group(P＜0.05).The 1-year survival rates were 67.7 ％(21/31) in combining group and 38.7 ％(12/31) in control group(P ＜ 0.05).The median PFS(progression free survival time) was 7.0 months in combining group and 5.1 months in control group (P＜ 0.05).The levels of serum VEGF in combining group were significantly decreased after treatment (P ＜ 0.05). There was no significant difference between the levels of serum VEGF before and after treatment in control group(P＞ 0.05).The levels of serum VEGF in combining group after treatment were lower than that in control group after treatment (P ＜ 0.05). Adverse reactions in both groups were grade Ⅰ to Ⅲ.The fatigue,anorexia and the right upper quadrant pain was significantly superior in combining group. Conclusion Coix Seed Extract combined with transcatheter arterial chemoembolization in the treatment of hepatomatic metastases can improve disease control rate,decrease the levels of serum VEGF,improve clinical symptoms,prolong the PFS and 1-year survival rate.