Objective To investigate the effect of ropivacaine and sufentanil alone or in combination with continuous subarachnoid block for labor analgesia.MethodsIn this experiment, 63 cases of spontaneous delivery of labor in First People's Hospital Jiande City from June 2015 to December 2016 were randomly divided into experimental group and control group according to the time of hospitalization.Each 21 cases.In the control group, 1 mg of ropivacaine was treated with 1 mg of ropivacaine (15 mg) and 5μL of sufentanil.The control group 1 was treated with 1% ropivacaine alone.The control group 2 was treated with 6μl of sufentanil.ResultsIn this experiment, the effect of subarachnoid analgesia was VAS score≤3 points, the experimental group was significantly faster than the control group 1, 2 (P<0.05), the first PCEA administration time is subarachnoid The effective duration of analgesia in the experimental group was statistically significant (P<0.05).In addition, VAS score was statistically significant.There was no significant difference between the three groups.In addition, the three groups of maternal active period, the second labor time difference was not statistically significant.ConclusionCompared with the original single use of agents, ropivacaine and sufentanil continuous subarachnoid analgesia for labor analgesia had better effects on maternal effects on labor.

Autogenous vein graft is one of the frequent methods to treat ischemia in Vascular Surgery.However, the patency rate of vein grafts is unhappy because of the injury, the difference structure between arteries and veins, and the change of hemedynamics after grafted. The restenosis of vein graft contains three syntrophic component elements-thrombosis, intima hyperplasia, and scleratheroma. In this article, we will discuss the relationship between the changed hemodynamics and the restenosis of the vein grafts.

Objective To investigate the incidence and influence factors of stress ulcer SU) in traffic injury patients. Methods Clinical data of 362 traffic injury patients were studied retrospectively.Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) score was carried out for all the patients.All the patients had gastroscopy and a comparative analysis was done on the SU patients with or without bleeding and the patients without SU. Results The patients with extensive burn in traffic injury were more susceptible to SU as compared with other trauma patients,with statistical difference ( X2 =7.028,P ＜ 0.05 ).The incidence of SU or hemorrhage was increased with higher APACHE Ⅱ score.The incidence of SU hemorrhage in patients with diabetes or cardiopulmonary disease was significantly higher than that in patients without diabetes or cardiopulmonary disease ( P ＜ O.05 ). Conclusions Traffic injury patients should receive routine gastroscopy.APACHE Ⅱ score has some predictive value for SU or hemorrhage.The incidence of SU hemorrhage is also determined by combined factors of underlying diseases and treatment methods.

Rhabdomyosarcoma is the most common soft tissue sarcoma in childhood.Radiation therapy has been integrated into the primary treatment of most patients with rhabdomyosarcoma, but which in turn potentially induces severe acute and late toxicities.Proton therapy in recent years has been more and more used in the treatment of rhabdomyosarcoma, which is safe and effective, with no serious adverse events.Compared with conventional photon therapy, proton therapy has distinct physical advantages and enables greater precision in the delivery of tumoricidal radiation doses with reduced irradiation of normal tissues, and improves quality of life for patients.Additional follow-up and prospectively studies are needed to determine whether proton therapy truly reduces the incidence and severity of late effects in comparison to patients treated with modern photon techniques.

BACKGROUND: The repair of periodontal tissue is dependent on the number and proliferation and differentiation abilities of periodontal ligament (PDL) cells. PDL cells have the potentiality of multi-directional differentiation such as cementoblast,osteoblast and fibroblast to fonn cement, alveolar bone and periodontal ligament and finally achieve periodontal tissue regeneration.OBJECTIVE:To observe the effects of Shuanghuangbu extract on the proliferation and differentiation of PDL cells.DESIGN:Observation trail.SETTING:Central Laboratory of Wuxi Third People's Hospital. MATERIALS: Periodontal tissue was provided voluntarily by the healthy young patients with deformity correction, and golden thread,skullcap,and rhizoma drynariae by the National Institute for the Control of Pharmaceutical and Biological Products.METHODS: The experiment was conducted in the Central Laboratory of Wuxi Third People's Hospital from July to October 2003.The crushed golden thread.skullcap,and rhizoma drynariae were mixed with distilled water at ratio of 1:10 (m:V),and refluxed in boiling water for 5 hours.The extract was collected,and after colation,the residue was refluxed in boiling water for another 3 hours. Both extract was blended, rotary evaporated and condensed, finally the liquid extract of 3 kg/L was obtained.There were 8 groups in the study including golden thread group, skullcap group,rhizoma drynariae group,golden thread plus skullcap group,golden thread plus rhizoma drynariae group, skullcap plus rhizoma drynariae group, Shuanghuangbu group and control group. PDL cells were cultured/n vitro assisted with Shuanghuangbu.The proliferation of cells was detected with MTT method and the ratio of collagen content in total protein was evaluated with hydroxyproline (HP).MAIN OUTCOME MEASURES:A value of proliferated PDL cells and the proportion of collagen protein in total protein.RESULTS:①Proliferation of PDL cells:Except golden thread group,all Chinese medicine promoted the proliferation of PDL cells significantly compared with control group (P＜0.05). The A value of Shuanghuangbu group was significantly increased.A value was increased with time and reached the peak on day 5.There were significant differences among each group at different time (P＜0.05).②Ratio of collagen content in total protein:Except golden thread group,the percentage was significantly increased by other Chinese medicines compared with control group (P＜0.05), especially Shuanghuangbu. The percentage was increased with time and reached the peak on day 5. There were significant differences among each group at different time (P＜0.05). CONCLUSION:The findings suggest that as a traditional Chinese herb,Shuanghuangbu can significantly stimulate the proliferation and differentiation of PDL cells.and increase the proportion of collagen content in total protein.It may act as an ideal Chinese medicine helper factor for the regeneration of PDL cells.

ObjectiveTo explore the diagnostic and differential diagnostic points in a patient with rheumatoid arthritis (RA) complicated with fever and pulmonary diseases. MethodsFull clinical analysis was performed for a 55-year old patient with arthritis, fever, and wheeze. ResultsThe clinical pictures of the patient were consistent with those of RA. Computed tomography(CT) revealed interstitial lung diseases and intrapulmonary cavities. Antifungal agents were given experimentally, and the intrapulmonary cavities disappeared finally, thus the patient was diagnosed as RA, concurrently complicated with interstitial lung disease and pulmonary fungal infection. ConclusionThe possibility of pulmonary fungal infection should be considered in RA patients who presented with fever and intrapulmonary cavities.

Objective To analyze the CT findings of benign lymphoepithelial lesion (BLEL) of major salivary glands.Methods The CT findings of 11 cases with BLEL which were clinically and pathologically confirmed were analyzed.The relevant literatures were reviewed.All the patients received plain CT.Among them,5 patients had contrast CT as well.The location,number,shape,margin,density,and enhancement characteristics of the lesions were observed.Results Of 11 BLEL,8 lesions were located in the parotid gland,three in the submandibular gland.There were 7 cases with bilateral multiple lesions,and 4 cases with unilateral solitary lesion.BLEL of major salivary gland could be classified into three types according to the CT findings,including multinodular type,solitary mass type,and diffusely infiltrating type.Multinodular type was the most common type.The typical CT findings of the lesion included diffusely enlargement of bilateral parotids and (or) submandibular glands,heterogeneous increase of density of the parenchyma with multiple soft tissue density nodules,and multiple cystiform hypodense.On contrast-enhanced CT,the lesions mostly manifested as heterogeneous enhancement.The solid part of the nodules showed moderate or marked enhancement.However,the cystiform hypodense showed no enhancement.Conclusion Although the CT findings of BLEL of major salivary glands are variable,they still share some common characteristics,which are useful in the clinical diagnosis.

Objective To evaluate the efficacy of parecoxib sodium for preemptive analgesia.Methods PubMed,EMBASE,Cochrane Library,and CNKI database were searched for randomized placebo-controlled trials involving the efficacy of parecoxib sodium for preemptive analgesia.The modified Jadad scale was used for quality assessment.Evaluation indexes included VAS scores at 1,6,12 and 24 h after operation,consumption of morphine within 24 h after operation,and incidences of nausea and vomiting after operation.Meta-analysis was conducted using the Cochrane Collaboration's RevMan 5.0.2 software.Results Fourteen randomized placebo-controlled trials involving 1086 patients were included in our meta-analysis.The modified Jadad scale scores for the 14 studies were ≥ 4.The patients were divided into 2 groups:placebo group and parecoxib sodium 40 mg injected before operation group.The results of meta-analysis showed that VAS scores at 1,6,12 and 24 h after operation were significantly decreased,the consumption of morphine within 24 h after operation was reduced,and the incidences of nausea and vomiting after operation were decreased in parecoxib sodium 40 mg injected before operation group as compared with placebo group (P ＜ 0.05).Conclusion Intravenous injection of parecoxib sodium 40 mg before operation can produce significant preemptive analgesic efficacy and is helpful in decreasing the adverse effect of postoperative analgesia.

Objective To discuss the necessity and rationality of regional pancreatoduodenectomy combined vas-cular reconstruction in the treatment of chronic pancreatitis with lump in the head. Methods Thirteen patients who suffered from pancreas with lump in the head, were operated in our department from January 2000 to March 2006. The clinical data were analyzed retrospectively,there were 10 men and 3 women with an age ranging from 37 to 71 (mean = 51 ), all the patients underwent pancreatoduodenectomy combined PV and SMV reconstruction. Results All thirteen patients were pathologically confirmed chronic pancreatitis without postoperative deaths, in which stom-ach empty disorder and pancreatic fistula occurred and were cured conservatively in one case. All the 13 patients who were followed up 19～86 months had no pain and jaundice at all after the operation. Conclusion Combined vascular reconstruction to treat the lump in the head of the pancreas that packages blood vessel and hard to separa-tion is proved to be a safe and reliable method, being capable of raising lump resection rate, which can improve quality of life of patients remarkably to avoid omit minimum cancer in lump to result in lose the curative opportunity.

Objective To observe the function improvement of deep venous valve after superficial vein surgery of lower extremity by ultrasound.Methods Sixty patients(70 lower limbs)with primary deep venous insufficiency were enrolled tO accept surgical management of vein systems.All Datients were detected with color Doppler ultrasonography,their deep venous hemodynamics indices were measured and recorded before operation and 6 months after operation. Results The total improvement rate of the deep venous hemodynamics after superficial vein surgery was 65.7%.The valve function of suPerficial femoral vein and popliteal vein were improved after operation,and there was no significant difference between the two veins in effectiveness.The improvement for deep venous reflux had no significant difference between two surgical methods. Conclusions The superficial vein surgery of lower extremity can improve deep vein valve function in some extent.