Objective To analyze the application of non-protective midwifery in China so as to provide a theoretic basis for the develop-ment of this technique. Methods The full-text literatures of non-protective midwifery published in China during January 2004 and January 2014 were searched and obtained in China National Knowledge Infrastructure ( CNKI) ,Wanfang Database and VIP Database via computer. All searched literatures were analyzed with the literature study method. Results Totally 21 literatures were obtained by search. They were centrally from the coastal areas and mainly the controlled studies,and focused on the comparison of non-protective midwifery vs. protective midwifery in perineal laceration,second birth course and intrapartum bleeding volume. Conclusion The literatures show that non-protective midwifery is significantly beneficial for patients,though it develops later and concentrates at partial areas. Such midwifery technique shall be popularized all around the country.

Objective To study clinical value of blood glucose, AFP and cholinesterase levels on the diagnosis and prognosis of severe hepatitis. Methods Retrospective analysis of chronic hepatitis B, cirrhosis, chronic severe hepatitis, subacute severe hepatitis was carried out. In severe hepatitis patients, between the improved group and death group, blood glucose, AFP, cholinesterase differences, evaluate blood glucose, alpha-fetoprotein, cholinesterase levels on the diagnosis and prognosis of severe hepatitis value were compared. Results Subacute severe hepatitis, chronic severe hepatitis patients and blood cholinesterase levels were significantly lower than that in patients with chronic hepatitis B and liver cirrhosis(all P ＜ 0.05) ;and alpha-fetoprotein level was significantly higher than the level of chronic hepatitis B patients(P ＜ 0. 01) ;improved levels of blood glucose in patients with severe hepatitis, AFP, cholinesterase levels were significantly higher than the level of death group (all P ＜ 0.05). Conclusion Blood glucose, AFP, cholinesterase levels of liver disease progression and prognosis were important to determine the value.

OBJECTIVE:To analyze the effect of precision filtration infusion apparatus and other methods on reduction of ADR induced by Acanthopanax injection. METHODS:532 patients receiving intravenous infusion of Acanthopanax injection were randomly divided into observation group and control group;observation group used disposable precision filtration infusion appara-tus,while control group used disposable ordinary infusion apparatus. The occurrence of ADR were compared between 2 groups. RE-SULTS:The incidence of ADR in observation group(2.68%)was significantly lower than in control group(7.75%),with statisti-cal significance(P<0.05). CONCLUSIONS:Intravenous infusion of Acanthopanax injection with disposable precision filtration in-fusion apparatus can effectively reduce the occurrence of ADR.

24 hours. Results There were totally 192 patients met the criteria for the investigation. Group A consisted of 76 patients, group B 116 patients. No significant differences between the two groups were found in terms of associated injury, ISS, ICU length of hospital stay,complication or mortality, while significant difference existed between two groups in terms of associated shock (?2=6.078,P

As locking plate is widely used in periarticular and comminuted fractures as well as in fixation of osteoporotic bone,the events involving difficulty in removal of a locking plate increase gradually.Little research addresses the difficulty in implant removal.Stripping of the recess of the screw head,cross-threading between threads in the screw head and screw hole and cold welding are the main causes for difficulty in removing screws from a locking plate.Skills for implant removal include simple ones that require no use of special devices and complex ones that require use of special devices.Difficult implant removal will result in lengthened operation time,increased risk of secondary invasive surgery,residues of metallic shavings and so on.Prevention is the most effective countermeasure.This review summarizes the cause for difficult removal of locking plate and screws as well as the removing skills to help orthopedic surgeons prevent and respond to the difficulties intraoperatively.

We often have to choosea between amputation and salvage after severe injuries in lower limbs of children.We have established the score scale and discriminatory equation in judging the severity of low limb injury in children.Through medical ethical analysis,the author makes a conclusion that the score scale and the discriminatory equation is valuable in determining severity of lower limbs injury in children.

Background miRNAs are a group of non-coding small RNA molecules,and they play an important role in regulating the apoptosis of LECs.The biological effects and mechanisams of miRNAs on LECs in agerelated cataract still need to be further elucidated.Objective This study was to investigate the anti-oxidative effects of miR-204 on age-related cataract in vitro.Methods The specimens of anterior lens capsules from agerelated cataract patients and normal donors were collected in Shandong Eye Institution and 20 subjects for each.The expression level of miR-204 was detected and compared between cataractous eyes and normol eyes by real-time fluorescence quantitative PCR (RT-qPCR).HLE-B3 cells,a human LEC line,were cultured,and the oxydative stress models of LECs were established by adding 200 μmol/L H2 O2 in the medium.The models were divided into model control group,miR-204 agomir group,agomir negative control group,miR-204 antgomir group and antagomir negative control group according to the difference of tranfected agents,and normal cells served as the control group.Twenty-four hours after transfection,the expression levels of miR-204 mRNA in the cells of various groups were detected by RT-qPCR to varify the transfection rate.Apoptosis rate of the cells was assayed by flow cytometry.The relative expression levels of TP53INP1 mRNA and p53 mRNA as well as their proteins were detected by RT-qPCR and Western blot,respectively.Results The mean expression level of miR-204 was significantly lower in the anterior lens capsules of cataractous eyes than that in the normal eyes (t=14.21,P＜0.05).The mean apoptosis rate of cells was 1.31±0.12,4.90±0.28,2.60±0.15,4.39±0.20,5.74±0.13 and 4.34±0.63 in the normal control group,model control group,miR-204 agomir group,agomir negative control group,miR-204 antgomir group and antagomir negative control group,respectively.The apoptosis rate was significantly increased in the model control group compared with the normal control group (t =-20.69,P＜0.01) and the apoptosis rate was also increased in the miR-204 antagomir group compared with antagomir negative control group (t =3.79,P＜0.05);while the apoptosis rate in the miR-204 agomir group was significantly declined in comparison with agomir negative control group (t=-12.20,P＜0.01).The relative expression levels of TP53INP1 and p53 mRNA and proteins in the cells were significantly higher in the model control group than those in normal control group (mRNA:t =6.44,11.71,both at P＜0.0I;protein:t =10.72,19.40,both at P＜0.01),and so were between the miR-204 antagomir group and antagomir negative control group (mRNA:t =4.07,3.74,both at P＜ 0.05;protein:t =7.18,10.58,both at P＜0.05).However,the expression levels of TP53INP1 and p53 mRNA and protein were significantly reduced in the miR-204 agomir group in comparison with the agomir negative control group (mRNA:t =-19.28,-10.58,both at P＜0.05;protein:t=-6.50,-6.36,both at P＜0.05).Conclusions miR-204 induces oxidative damage of age-related cataract via targeting TP53INP1,which suggests that the activation of TP53INP1-p53 signaling may be involved in the development of age-related cataract.

Objective To describe postmedial approach to the knee and discuss the main technique using it to repair and reconstruct posterior cruciate ligament (PCL). Methods 24 patients with PCL injury were operated on with the postmedial approach. 13 cases were repaired directly using the technique of pulling out steel wire and 11 cases were reconstructed by semitendinosus. Prone position was adopted in 16 cases and supine position in 8 cases (21 cases had been followed up over six months). Applied anatomy, main techniques and clinical results were evaluated. Results The postmedial approach saved 30～60 minutes compared with the posteior approach, and was not restricted by body posture. Neurovascular structure did not need to be dissected, PCL repair and reconstruction could be finished in one incision.By a six month follow up evaluation, no symptoms of instability occured and they were completely stable on physical examination. Conclusion The postmedial approach is simple, safe, and yields excellent exposure. It's an ideal approach for repair and reconstruction of the PCL.The technique of pulling and steel wire and semitendinosas drawn out "U" shaped pins fixation are essential methods to repair and reconstruct the PCL.

0.05). JOA scores of group A is higher than those of group B on 1, 2, 4 weeks postoperatively and the difference is of statistical significance (P

Objective To evaluate the efficacy of anatomical locking titanium plate via the posterior elbow approach in the treatment of comminuted fractures of proximal ulna.Methods From January 2011 to December 2013,22 comminuted fractures of proximal ulna were treated by anatomical locking titanium plate via the posterior elbow approach.They were 14 men and 8 women,from 21 to 57 years of age (average,42.7 years).Nine cases were on the left side and 13 on the right.All were unilateral closed fractures.By the Schatzker classification,12 cases were type Ⅲ A,6 type Ⅲ C and 4 a combination of type Ⅲ A and type Ⅲ C.The Broberg & Morrey criteria were used to evaluate the elbow function one year postoperation.Results The follow-ups for the 22 cases ranged from 12 to 24 months (average,16 months).All the cases obtained clinical healing after 10 to 16 weeks (average,13 weeks).According to the Broberg & Morrey criteria,12 cases were evaluated as excellent,7 as good,and 3 as fair,yielding an excellent to good rate of 86.4％.No such complications as infection or necrosis of soft tissues,elbow stiffness,or obvious pain were observed during the follow-up period.Conclusion It is an effective treatment of comminuted fractures of proximal ulna with anatomical locking titanium plate through the posterior elbow approach.