Objective To study previous cesarean section effects on re-eesarean section, and to seek better operation way of cesarean section. Methods The conditions of entrance into abdominal cavity and adhesion of 452 cases of abdominal cavity were retrospectively analyzed. The information about initial operation was investigated, dis-covering 104 cases underwent new type,and 348 cases underwent improved cesarean section. Results Time of en-trance into abdominal cavity once more by new type of cesarean section were (9.25±2.27) min and the incidence of adhesion in abdominal cavity was 18.27%,while time of entrance into abdominal cavity once more by improved cesarean section were (7.23±2.21) min and the incidence of adhesion indominal cavity was 9.87% (u=8.016, P<0.05; χ25.57,P<0.05). Conclusion New type of improved cesarean section has little effect on re-cesarean section, worthing more clinical practice.

BACKGROUND: The cerebral edema after brain injury is associated with the generation of oxygen-derived free radicals after ischemia reperfusion.Hyperbaric oxygen can relieve the cerebral edema and ameliorate the tissue hypoxia.OBJECTIVE: To observe the influence of hyperbaric oxygen on cerebral edema and the lipid peroxide after brain injury in rats.DESIGN: A random controlled trial.SETTING: Institute of Field Surgery, Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: The experiment was carried out in the Department of Hyperbaric Oxygen and the Fourth Room of the Institute of Field Surgery,Daping Hospital of the Third Military Medical University of Chinese PLA between March and June 2004. Fifty-eight 3-month-old Wistar rats of clean degree with the body mass of (256±23) g were used.METHODS: The 58 rats were randomly divided into control group (n=17),brain injury group (n=22) and hyperbaric oxygen group (n=19). The struck test was not conducted in the control group. The rats in the brain injury group and hyperbaric oxygen group were anesthetized, then the right calveria was struck with the BIM-Ⅲ striker, and closed brain injury was duplicated. After brain injury, rats in the hyperbaric oxygen group were placed into a hyperbaric oxygen chamber of 2 absolute atmospheric pressures for 2 hours, and the rats were killed at 24 hours after injury by taking blood from heart.MAIN OUTCOME MEASURES: The water content of brain tissue, content of Evans blue, and the contents of the lipid peroxide malondialdehyde (MDA) in brain and plasma after brain injury were observed.RESULTS: Totally 41 rats were injured, and 7 died after 24 hours, including 2 in the hyperbaric oxygen group and 5 in the brain injury group, and brain tissue: The water content of right brain in the brain injury group was obviously higher than that in the hyperbaric oxygen group and control group [(79.06±0.52)%, (78.38±0.37), (78.21±0.25)%, t=3.022-3.285, P ＜ 0.01]. In the brain injury group, the water content of right brain was obviously higher than that of left brain [(79.06±0.52), (78.57±0.14)%, t=2.651, P ＜ 0.05].injury group was obviously higher than that in the hyperbaric oxygen group and control group [(197.28±31.49), (167.65±25.88), (145.07±30.45) nmol/g,t=2.231-3.347, P ＜ 0.01-0.05]. In the brain injury group, the MDA content of right brain was obviously higher than that of left brain [(197.28of MDA: It was markedly higher in the brain injury group than in the control group [(2.69±0.54), (1.94±0.40) μmol/L, t=2.473, P ＜ 0.05].CONCLUSION: The hyperbaric oxygen therapy after brain injury can obviously decrease the water content and MDA content in brain tissue of the injured side, and such is the case with the MDA content in plasma,which is indicated that hyperbaric oxygen has a therapeutic effect on brain injury.

BALB/C mice were immunized by intraperitoneal injection with A-group erythrocytes, B-group erythrocytes and saliva of A-group,B-group secretor. Immune spleen cells were fused with sp2/0 murine myeloma cells. The supernatants from each well were examined for antibodies by hemagglutination using A-,B-, O-group RBC.3 hybridoma cell lines of secreting anti-A antibodies and 3 hybridoma cell lines of secreting anti-B antibodies were established.These hybridoma cells have maintained and produced antibodies possessing higher specificity and titer.The agglutination titer of supernatants reached 2048-fold. These antibodies were used in the field of forensic science.

Objective To explore the abnormalities in the posterior cingulated cortex structure by voxel based morphometry(VBM)and changes of functional connectivity by resting-state functional magnetic resonance imaging(fMRI)in long-term heroin addictions.Methods High-resolution volumetric T1-weighted images and resting state fMRI examination were performed on 13 long-term heroin addicts and 14 matched healthy volunteers.The T1-weighted images were processed using optimized voxel-based morphometry to investigate abnormalities in the gray matter,at the sarne time,the posterior cingulated cortex was setted as the region-of-interest(ROI)seed,with which a whole-brain voxel temporal correlation in low frequency fMRI fluctuations was calculated,to find changes of the posterior cingulated cortex functional connectivity.Results Compared with the control group,gray matter concentration significantly decreased in the posterior cingnlated cortex,at the same time,the functional connectivity between the left posterior cingulated cortex and the right temporal lobe was increased,but the functional connectivity between the left posterior eingulated cortex and the left thalamus,the left parietal lobe,the left cerebrum were all decreased in heroin addicts.At the same time,the functional connectivity between the fight posterior cingulated cortex and the left thalamus,the left parietal lobe,the left frontal lobe were decreased in heroin addicts(t testing,P<0.01).Conclusion The structure and the functional connectivity in posterior cingulated cortex in long-term heroin addicts are changed,which may affect the dysfunction of the addictive brain and the function of reward mechanism.

Objective:To investigate the effect of enhanced external counterpulsation(EECP)on heart failure with preserved ejection fraction(HFpEF)and hemodynamics in elderly patients.Methods:Clinical data of 66 elderly HFpEF patients admitted to the enhanced external counterpulsation center of our hospital from January 2018 to December 2019 were retrospectively analyzed.The primary assessment parameter was the six-minute walk distance, and the secondary parameters included the Minnesota Living with Heart Failure Questionnaire(MLHFQ). Noninvasive hemodynamic parameters including the cardiac index(CI), stroke volume(SV), isovolumic relaxation period(A2-mitral valve opening, A2-O), pulmonary capillary wedge pressure(PCWP)and total peripheral resistance(TPR)were monitored and mean arterial blood pressure(MAP)was calculated.Results:After EECP treatment, the six-minute walk distance increased(372±87 m vs.341±85 m, P<0.05), the score of MLHFQ decreased(47.0±16.0 vs.50.0±17.0, P<0.05), CI increased(2.8±0.7)L·min -1·m -2vs.(2.6±0.6)L·min -1·m -2( P<0.05), SV, PCWP and A2-O did not show significant change(73.3±16.4 ml vs.71.5±17.1 ml, 10.0±3.3 mmHg vs.11.0±3.6 mmHg, 1 mmHg=0.133 kPa, 98.0±29.5 ms vs.91.0±29.1 ms, P>0.05), TPR decreased(1 719.0±427.0 DS/cm 5vs.1 821.0±508.0 DS/cm 5, P<0.05), and there was no significant change in MAP(96.9±10.7 mmHg vs.98.8±13.1 mmHg, P>0.05), compared with pre-EECP treatment levels.Compared with patients without hypertension, MAP decreased in patients with hypertension(14 cases), when stratified by the initial MAP( P<0.05). Conclusions:For elderly patients with HFpEF, EECP can increase the six-minute walk distance, improve the quality of life and hemodynamic parameters, and is a safe adjuvant treatment.

Objective To examine the relationship between quetiapine serum concentration,dose,therapeu-tic efficacy and side effects in male patients with schizophrenia.Methods Sixty-three male patients with schizo-phrenia were collected.They were treated openly for 8 weeks with quetiapine,the dose was adjusted according to clini-cal improvement and tolerance.The plasma quetiapine concentrations,therapeutic efficacy and adverse drug reactions were observed after the 4 -week treatment period,and at the end of the 8 weeks of the treatment.Results After 4 weeks,the serum concentration had significant correlation with age,the disease duration and education level.After 8 weeks,there was significant correlation between serum concentration and age.We found a correlation between dose and serum concentration of quetiapine,and no relationship between serum concentration and PANSS scores.Side effects were correlated with 4 weeks′serum concentrations.Conclusion Quetiapine is effective for male patients with schizophrenia.Age,quetiapine dose and side effects have significant correlations with the serum concentration.It appears that plasma quetiapine concentration has no effects on therapeutic efficacy.

Objective To investigate the potential role of T follicular helper cells (Tfh) in the pathogenesis of autoimmune thyroid diseases by comparing the expression of C-X-C chemokine teceptor type 5 (CXCR5) and CD57 in Hashimoto's thyroiditis (HT) and Graves' disease (GD) thyroid tissues.Methods The expression of CXCR5 and CD57 proteins was determined by immunohistochemical analysis in 15 HT thyroid samples,18 GD samples and 10 normal thyroid samples.Results Immunohistochemical staining showed that CXCR5 and CD57 were mainly positive in cytomembrane and cytoplasm of the infiltrated lymphocytes both in HT and GD tissues,with much higher levels than that of normal thyroid tissues ( P ＜ 0.05 ).Both CXCR5 and CD57 were not significantly different between the HT and GD tissues.Conclusion CXCR5 and CD57 expressions were increased with a similar expression pattern in both of the two main autoimmune thyroid diseases( AITD),indicating that Tfh may participate inthe development and progression of AITD.

Objective:To explore the digital network platform construction of morpghology of laboratory medicine and its effects on clinical teaching.Methods:Laboratory morphological inspection pictures of peripheral blood, bone marrow slices, urinary sediments, parasites, secretions, cavity effusion, medical microorganisms and chromosome specimens were collected to build a digital network platform for online learning, practical training, and examination by applying Authorware multimedia software, Access database, and Web interface. Afterwards thirty interns on laboratory medicine were randomized into two groups: traditional teaching group and software teaching group for morphological assay examination. The differences in theoretical scores, exam time, practical operation scores, and satisfaction rates between two groups were statistically analyzed by t test and Pearson Chi-square test using SPSS 13.0. Results:The software teaching group showed significantly higher theoretical and practical scores [(88.0 ± 6.4); (85.3 ± 7.1)] than traditional teaching group [(76.3±8.1); (80.3±7.9)] (both P=0.000 1), and its theoretical exam time [(93.7 ± 10.5) minutes] was significantly shorter than traditional teaching group [(115.8±16.2) minutes] ( P=0.033 8). The questionnaire survey results showed that software teaching group showed higher satisfaction rates in the aspect of teaching content systematization, diversity of teaching methods, clinical learning interest and fairness of assessment than traditional teaching group, with statistical significance ( P<0.05). Conclusion:The software teaching model could improve quality and efficiency in teaching morphological assay, enhance students' learning autonomy and professional skills, and provide a powerful platform to adapt to vocational innovation of laboratory medicine education.

Objective To explore the development and validation of a prediction model for severe communi-ty-acquired pneumonia in adults based on peripheral blood inflammatory indicators.Methods Venous blood samples of 204 community-acquired pneumonia in adults patients admitted to 7 hospitals in Chongqing area from April 2021 to August 2022 were collected to detect C-reactive protein(CRP),peripheral white blood cell count(WBC),neutrophil to lymphocyte ratio(NLR),cytokines,lymphocyte subgroups and neutrophil CD64 index.All of patients were divided into a training group and a validation group according to the time of admis-sion.Univariate and multivariate Logistic regression were used to analyze the data of the training group,the characteristic factors of severe progression for pneumonia were selected to construct the nomogram model,and the data of the validation group was used to verify the model.The receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were used to evaluate the prediction ability of the model for severe community-acquired pneumonia in adults.Results Logistic regression analysis showed that age,CRP,WBC,interleukin(IL)-4/interferon gamma ratio and IL-6/IL-10 ratio were independent risk factors for severe community-acquired pneumonia in adults.The area under the ROC curve of the nomogram model in the training group and the validation group was 0.893 and 0.880,respectively.The calibration curve and DCA results shown that the model had a good prediction effect for severe community-acquired pneumonia in adults.Conclusion The inflammatory indicators included in this model are simple and easy to obtain clinically.This model with good differentiation and accuracy,it can be used as a practical tool to predict severe community-ac-quired pneumonia in adults,and has certain clinical application value.

Objective To investigate the comprehensive improvement of multi-system diseases in elderly patients treated with enhanced external counterpulsation(EECP).Methods Clinical data of an elderly patient with multiple systemic diseases were collected and analyzed.The therapeutic effect of EECP was assessed and EECP-related literatures were reviewed.Results The 62-year-old male patient was diagnosed with coronary atherosclerotic heart disease,unstable angina,New York Heart Association(NYHA)functional class Ⅱ,hypertension(grade 3,very high risk),type 2 diabetes,acute cerebral infarction (recovery period)and benign prostatic hyperplasia.After two courses of EECP treatment,angina in the patient was significantly relieved,cardiac systolic and diastolic function was improved,activity tolerance was increased and the corresponding dosage of therapeutic drugs was reduced.In addition,the patient's blood pressure and blood glucose levels were decreased after versus before treatment and the retinal superficial blood flow was enhanced in both eyes assessed by optical coherence tomography.The frequency and volume of nocturia were reduced.The symptoms of numbness on the left side were improved.Conclusions EECP treatment has shown significant therapeutic effects on multi-system diseases in the elderly patient.EECP is safe,effective and simple and has a broad application prospect in geriatrics.