Objective To compare the clinical efficacy of programmed intermittent epidural bollus (PIEB)+patient controlled epidural analgesia (PCEA)and continuous epidural infusion (CEI)+PCEA for labor analgesia.Methods One hundred nulliparous parturients with cervical dilation of 2-3 cm were randomly assigned to PIEB group or CEI group for labor,with 100 parturients in each group.The background infusion in PIEB group delivered 8 ml bolus at a rate of 6 ml/min per 1 hour, in group CEI at 8 ml/h.Blood pressure,VAS score and modified Bromage score before labor anesthe-sia (T0 ),10 min after labor anesthesia (T1 ),30 min after labor anesthesia (T2 ),1 h after labor an-esthesia (T3 ),2 h after labor anesthesia (T4 ),the uterus opening to the full extent (T5 ),childbirth (T6 ),1 h after childbirth (T7 ),proportion of PCEA request,hourly ropivacaine and sufentanil con-sumption,uterine contraction,fetal heart,total delivery time,analgesic time,delivery mode,number of cases using oxytocin,adverse reactions,neonatal Apgar score,maternal satisfaction score were ob-served.Results The VAS score of PIEB group was significantly lower than that of CEI group at T4-T6 (P <0.01).Compared with the CEI group,protortion of PCEA request,the dosage of drug was de-creased obviously in group PIEB (P <0.05),the maternal satisfaction of PIEB group was significantly higher than that of CEI group (P <0.05).There was no significant difference in the blood pressure, duration and interval time of uterine contraction,fetal heart,total delivery time,analgesic time,deliv-ery mode,number of cases using oxytocin,adverse reactions,neonatal Apgar score and weight among two groups.Conclusion Compared with the CEI+PCEA,the need of PCEA and the dosage of drug was decreased obviously,the VAS score was significantly lower,the maternal satisfaction was signifi-cantly higher and adverse reactions did not increase in the PIEB+PCEA.

Objective To investigate the correlation between antiphospholipid antibody syndrome and the early onset of preeclampsia. Methods From May 2010 to July 2013, one hundred and threecases in-patient treatment of the early onset preeclampsia were enrolled in this study. The maternal serum anticardiolipin antibodies(ACA)and anti-β2-glycoproteinⅠantibody (Aβ2-GPⅠ) were detected by ELISA method. 58 cases of pregnant women were randomly divided into the routine treatment group (30 cases) and the anticoagulant therapy group (28 cases). Results ACA positive predictive value of the early onset preeclampsia value was 3.9%. No significant difference was found in the prolonged anticoagulation of early onset preeclampsia time between the control group and the treatment group. Conclusion ACA may not be used to predict the early onset preeclampsia. Anticoagulation therapy can′t extend the early onset preeclampsia time and improve the outcome of pregnancy.

Objective To explore the application value of high frequency ultrasound and MRI in knee osteoarthritis.Methods 94 patients with knee pain as the main clinical manifestations in our hospital from January to December 2017 were retrospectively analyzed. All patients underwent high-frequency ultrasound, MRI, and arthroscopy. The results of arthroscopy were used as the gold standard, and the signs of high-frequency ultrasound and MRI examinations were summarized and compared with the results of arthroscopy. The sensitivity and specificity between high-frequency ultrasound and MRI in the diagnosis of knee osteoarthritis were compared. Results Consistency analysis showed that highfrequency ultrasound, MRI examination with arthroscopy consistent results were good (Kappa=0.63, 0.61, P<0.05). The sensitivity and specificity of high-frequency ultrasonography for knee osteoarthritis were 86.5％ and 85.0％, respectively, and the sensitivity and specificity of MRI was 89.2％ and 75.0％, respectively.The difference between high-frequency ultrasound and MRI was not statistically significant (P>0.05). Conclusion High-frequency ultrasound and MRI have good application value in the diagnosis of knee osteoarthritis, and the results are consistent with that of arthroscopy.Compared with MRI, high-frequency ultrasound diagnosis of knee osteoarthritis has no difference in sensitivity and specificity, and can be used for routine screening of knee osteoarthritis.

Purpose To investigate the clinicopathologic characteristics, differential diagnosis, treatment and prognosis of differentia-ted-type vulvar intraepithelial neoplasia ( dVIN) . Methods Clinicopathologic findings and immunophenotypes of 6 cases diagnosed as“dVIN” were retrospectively analyzed, and the relevant literatures were also reviewed. Results 6 patients were all female ranged 53~80 years old with mean age of 62 years old. Clinical aspects included leukoplakia vulvar, pruitis, irritation, pain, ulcer and so on. The histopathological features were hyperplasia of basal and parabasal layer with elongation and anastomosing reteridges. Cells were marked atypia with obvious nucleoli, atypical mitosis, and dyskeratosis. In the middle and surface layer, cells were well differentiated with pronounced intercellular bridges, and eosinophilic cytoplasm, hyperkeratosis and parakeratosis. Oedema and band of infiltration of chronic inflammatory cells of subepidermal could been seen. Immuohistochemistry showed the expression rates of p53 and p16 in totally 6 cases were 83. 3% (5/6), 0 (0/6), respectively. The Ki-67 index was more than 90% in basal and parabasal cells. Four patients were followed up ( mean follow-up 17 months, range 6~36 months) , one patient died at 9 months later after surgery, another patient recurred at 6 months later after surgery, both of the 2 cases were all with invasive lesions after resection, and the rest two cases had no recur in 18 months and 36 months after surgery, respectively. Conclusion dVIN is a high grade squamous intraepithelial lesions of vulvar with low incidence rate, but had more risk of progression. p53, p16 and Ki-67 stain were useful in the diagnosis of dVIN.

Objective:To investigate the prevalence and clinical characteristics of pruritus in adult patients with psoriasis vulgaris, and to evaluate the effect of pruritus on sleep and quality of life.Methods:From January 2020 to December 2020, 291 patients with psoriasis vulgaris were enrolled in Lanzhou University Second Hospital, and characteristics of pruritus as well as quality of sleep and life were evaluated by physicians directly or through a questionnaire. Binary logistic regression analysis was performed to analyze risk factors for pruritus, and multivariate linear regression to analyze factors affecting sleep and quality of life.Results:Among the 291 patients with psoriasis vulgaris, 184 (63.23%) were males and 107 (36.77%) were females, with the age ( M [ Q1, Q3]) being 37.00 (28.00, 50.00) years; 258 (88.64%) had the itching symptom, and the severity of itching was usually moderate. The severity of skin lesions was the main risk factor for pruritus ( OR = 1.252, 95% CI: 1.114-1.407, P < 0.001) . Psoriasis area and severity index was positively correlated with pruritus numerical rating scale (NRS) score ( r = 0.65, P < 0.001) , 5-D′S score ( r = 0.65, P < 0.001) , Pittsburgh sleep quality index (PSQI) score ( r = 0.48, P < 0.001) and dermatology life quality index (DLQI) score ( r = 0.63, P < 0.001) , the pruritus NRS score was positively correlated with the DLQI score ( r = 0.61, P < 0.001) and PSQI score ( r = 0.55, P < 0.001) , and the 5-D′S score was positively correlated with the DLQI score ( r = 0.62, P < 0.001) and PSQI score ( r = 0.64, P < 0.001) . Conclusion:Most adult patients with psoriasis vulgaris have moderate pruritus; the severity of disease markedly affects the severity of pruritus, and pruritus exerts considerable impact on sleep and quality of life.

OBJECTIVE:To study in vitro bacteriostatic activity of the extracts from Miao medicine Polygonum runcinatum. METHODS:Using chloramphenicol and fluconazole as positive control,the inhibitory effects of water extract,95％ ethanol extract and its ethyl acetate and n-butanol fraction on 9 kinds of strains were determined by cup plate method, such as Staphylococcus aureus,Escherichia coli,Shigella flexneri,Salmonella typhi,Bacillus subtilis,Pseudomonas aeruginosa,type B Hemolytic streptococcus,Candida albicans and Cryptococcus neoformans. The parts with bacteriostatic activity and trial strains sensitive to drug were screened. Micro-broth dilution method and agar culture medium plate method were used to determine MIC and MBC of 95％ ethanol extract and its fractions of P. runcinatum to sensitive strains. RESULTS:The water extract of P. runcinatum almost had no inhibitory effect. 95％ ethanol extract showed different degrees of bacteriostatic activity to strains;bacteriostatic effects of it to 6 kinds of bacteria as S. typhi was better than that of type B H. streptococcus and 2 kinds of fungus. The ethyl acetate and n-butanol fraction of 95％ ethanol extracts showed good bacteriostatic effect and the ethyl acetate fraction had stronger effect,while all the fractions of 95％ ethanol extracts showed no inhibitory effect on fungus. MIC and MBC of 95％ethanol extract to above 6 kinds of bacteria were 6.25-12.5 and 12.5-25 mg/mL,respectively;MIC and MBC of ethyl acetate fraction were 3.13-6.25, 6.25-12.5 mg/mL; MIC and MBC of n-butanol fraction were 6.25-12.5, 12.5-25 mg/mL. CONCLUSIONS:95％ ethanol extract,ethyl acetate and n-butanol fractions of Miao medicine P. runcinatum have obvious in vitro bacteriostatic activity to 6 common bacterias as S. typhi.

Objective To explore the main problems of ultrasonic quality management in Qinghai Province.Methods The ultrasound departments of 19 tertiary hospitals and 51 secondary hospitals in Qinghai Province were investigated.The x2 test was carried out to analyze the setting of departments,subspecialty,instrument status,ultrasonic quality control,workload,and personnel specialty and educational composition ratio.Results There was a statistically significant difference between tertiary and secondary hospitals in department settings,sub-specialty,instrument status,ultrasound quality control,workload,personnel specialty,and personnel qualifications (x2=30.49,38.208,36.87,7.913,28.518,7.111 and 322.363,respectively,P ＜ 0.01 for all).Conclusions The above-mentioned observation indexes are better in the 19 tertiary hospitals than in the 51 secondary hospitals in Qinghai Province.Strengthening construction from these aspects and improving ultrasound quality control management play an important role in improving the level of ultrasound diagnosis and promoting the homogeneity of ultrasound diagnosis.

Objective:To explore the difference of high-risk factors between early-onset and late-onset pre-eclampsia, and to further understand high-risk factors of pre-eclampsia.Methods:Clinical data of pre-eclampsia pregnant women in 160 medical institutions in China in 2018 were retrospectively analyzed, including 8 031 cases of early-onset pre-eclampsia and 12 969 cases of late-onset pre-eclampsia. The proportion of high-risk factors, different body mass index (BMI) and age stratification between early-onset group and late-onset group were compared.Results:(1) Univariate analysis of high-risk factors: the proportions of high-risk factors in early-onset group and late-onset group were compared, and the differences were statistically significant (all P<0.05). Among them, the proportions of primipara and multiple pregnancy in early-onset group were lower than those in late-onset group, while the proportions of pregnant women with advanced age, irregular antenatal examination, obesity, family history of hypertension, pre-eclampsia, diabetes, kidney diseases, immune system diseases and assisted reproductive technology were higher than those in late-onset group. (2) Hierarchical analysis of BMI: the proportion of pregnant women with BMI≥24 kg/m 2 in early-onset group [48.2% (2 828/5 872) vs 45.5% (4 177/9 181), respectively; P=0.001] and the proportion of pregnant women with BMI ≥28 kg/m 2 in early-onset group [19.5% (1 143/5 872) vs 18.0% (1 656/9 181), respectively; P=0.028] were significantly higher than those in late-onset group. (3) Age stratification analysis: the proportion of pregnant women aged 35-39 years in the early-onset group [21.8% (1 748/8 023) vs 17.5% (2 110/12 068), respectively; P<0.01], the proportion of pregnant women 40-44 years old [6.8% (544/8 023) vs 5.4% (648/12 068), respectively; P<0.01], and the proportion of pregnant women ≥45 years old [0.7% (58/8 023) vs 0.5% (57/12 068), respectively; P=0.021] were significantly higher than those in the late-onset group. (4) Multivariate analysis: advanced age (≥35 years old), multiple pregnancy, irregular antenatal examination or transfer from other hospitals, family history of hypertension (including paternal, maternal and parental lines), previous history of pre-eclampsia, kidney diseases, immune system diseases (systemic lupus erythematosus, antiphospholipid antibody syndrome) and assisted reproductive technology pregnancy were the risk factors affecting the severity of pre-eclampsia (all P<0.05). Conclusion:Pregnant women with high risk factors such as age ≥35 years old, BMI ≥24 kg/m 2 before pregnancy, family history of hypertension, history of pre-eclampsia, chronic kidney diseases, immune diseases (mainly including systemic lupus erythematosus and antiphospholipid syndrome) and assisted reproductive technology are more likely to have early-onset pre-eclampsia.