Objecttve To investigate the effects of snfentanil and ropivacaine used in labor combined spinalepidural analgesia(CSEA)and its influence on labor course and infants and its side effects.Methods 160 primiparas who chose deliver analgesia were randomly divided into two groups:group A intrathecal 5μg sufentanil plus saline up to 2.5ml,extradural 0.2μg/ml sufentanll plus 0.1% ropivacaine and saline up to 100 ml;group B extradural ropivacaine 1.5mg plus glucose 100g/L up to 2ml;group C have no analgesia.Then to investigate the effects of analgesia VAS scores,labor course duration,caesarean section rate,flooding volume,neonatal Apgar scores and its side effects.Results Compared with group C,the analgesia effects of group A and B were definitely(P＜0.05,P＜0.01);visual analogue score(VAS)at 5min,10min and 30min in group A were(3.4±1.2),(1.6 ±0.7)and(0.7 ±0.5)respectively,while in group B were(5.3±1.5),(4.3±1.8)and(3.1±1.7),which had significant difference in two groups(all P＜0.01);they all could reduce the first labor course duration,caesarean section rate,and there were no difference with group C(P＞0.05);and the flooding volume and neonatal Apgar scores had no differences(P＞0.05).Conclusion Sufentanil and ropivacaine combined used in CSEA has stronger effect and longer duration without prolonged labor coulee and poor side effects,which would be a more perfect analgesia worth clinical application in obstetrics.

Objective To observe the application of angiotensin Ⅱ receptor antagonist valsartan in reducing minim albuminuria in earlier period of the diabetes and kidney disease.Methotis 36 patients Who administered angiotenain Ⅱ receptor antagonist valsartan 80～160nag,qd,for 8 weeks.Compared with symptoms before the treatment,the blood pressure,the amount of the urinary albuminufia,and observed the change of the empty stomach blood sugar,the saccharified hemoglobin,the triglyceride,the total cholesterol,the endogenous creatinine clearance rate,etc.Results After the treatment,the urinary albumin drops obviously(P＜0.01),While the blood pressure,the empty stomach blood sugar,the saccharified hemoglobin,the triglyceride,the total cholesterol and the endogenous creatinine clearance rate have no obvious change.There is no obvious side effect during therapeutic process.Conclusion The application of angiotenain Ⅱ receptor antagonist valsartan can reduce the amount of the urinary albumin,is the effective way in treating the earlier period of the diabetes and kidney disease.

Objective To investigate the curative effect of different time of irrigating after endolacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing. Methods Seventy-five cases (75 eyes) of lacrimal duct obstruction, which received endo-lacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing were divided into three groups by random digits table with 25 cases in each group. Group A received irrigating: the first day postoperative, consecutive 3 days,followed by once a week till a month. Group B received irrigating:the third day postoperative, consecutive 3 days,followed by once a week till a month. Group C received irrigating:the sixth day postoperative, consecutive 3 days, followed by once a week till a month. Followed-up survey for 12 months at the ophthalmologic outpatient clinic,the curative effect in each group was compared. Results In 6 months after surgery, the comparison of the curative effect was no statistical difference between group B and group C (P＞ 0.05), while the curative effects in group B and group C was superior to that in group A (P ＜ 0.05). In 12 months after surgery, the curative effect in group C was better than that in group A and B, the difference were statistically significant (P＜0.05). But there was no statistical significance compared with group A and group B (P＞0.05). Conclusions Properly delayed irrigating may improve the curative effect after endo-lacrimal recanalisation surgery by Nd:YAG laser combining eye ointment stuffing, while easier irrigating can increase the incidence of re-blockage of lacrimal duct and reduce the efficacy.

Objective To establish a method of adsorption and thermal desorption-GC-MS and to study the component of organic pollutants in indoor air in newly decorated houses. Methods Used Tenax TA as an adsorbent, the qualitative analysis of the indoor air in two typical newly decorated houses had been done with adsorption-thermal desorption GC-MS method. Results More than sixty organic compounds were detected, besides volatile organic compounds such as acetic acid, glycol, toluene and semivolatile organic compounds such as acenaphthene, anthracene, octadecane, monocyclic aromatic hydrocarbons, polycyclic aromatic hydrocarbons, fatty hydrocarbons, oxygen contained hydrocarbons and so on were detected. Conclusion This method can be used for the qualitative analysis of pollutants in indoor air. The organic compounds detected in the air of newly decorated houses are complex of different components.

A novel method for simultaneous determination of 3 rat poisons ( tetramine, bromadiolone, brodifacoum) and 5 toxic alkaloids ( hyoscyamine, scopolamine, gelsemine, strychnine, brucine ) in toxic samples by dispersive liquid-liquid micro-extraction ( DLLME ) coupled with gas chromatography-mass spectrometry was established. A mixture extractant containing 100 μL trichloromethane and 600 μL methanol was injected into the prepared sample to form an emulsion and the extraction process was accomplished. After centrifuged at 8000 r/min for 5 min, the settled drop of trichloromethane solvent was transferred to a conical insert within a GC autosampler vessel, and analyzed by GC-MS. Factors affecting extraction efficiency such as the type and volume of extractant, dispersive agent, extraction time, pH value and salt concentration of extraction system were studied. The limits of detection(LODs) were from 0. 003 to 1 μg/L in water sample, urine sample and rice wine sample. LODs were from 0. 002 to 0. 2 μg/kg in rice sample. The recoveries of toxic samples were in the range of 81. 0%-110%. The relative standard deviations( RSDs) were lower than 7%. The proposed method was sensitive, effective, and suitable for the simultaneous determination of toxic alkaloids and rat poisons in food poisoning sample.

Objectives To study the value of CT and MRI in diagnosing focal nodular hyperplasia (FNH).Methods The CT and MRI findings of 16 patients with FNH confirmed histopathologically were analyzed retrospectively.Both plain and dynamic enhanced CT scannings were performed in all the patients.Plain and dynamic enhanced MRI were carried out in 9 patients.Results (1) There were 16 patients with 19 lesions,and 8 lesions were in the left lobe,5 lesions in the right lobe,4 lesions between the left/right lobes and 2 lesions in the caudate lobe.The morphology of the lesions showed 15 lesions to have clear boundaries and 4 lesions to have fuzzy boundaries.The tumor diameters varied from 2.2 to 9.6 cm,(average 4.3 cm).(2) Sixteen patients underwent CT examination.On plain CT,the lesions were isotonic (n＝ 5),or slightly low-density (n=11).In 7 lesions,there was a slit-like,stellate-shaped low density central scar.Nine patients underwent MRI examination.On T2WI,6 lesions showed slightly higher signal while the remaining 3 lesions showed iso-signal.On T1WI,4 lesions showed slightly lower signal,3 lesions showed iso-signal and 2 lesions showed slightly higher signal while in 1 lesion the local signal showed reduction in anti-phase 1.A central scar was seen in 6 lesions which showed high signal on T2WI,and low signal on T1WI.(3) Enhanced CT: 15 lesions were significantly enhanced and 1 lesion showed mild enhancement at the arterial phase.For the patients with mild enhancement,the scar in the center of the lesion showed no enhancement.In all lesions,the central scar did not enhance.In 5 lesions,enhancements of thickened and torturous arteries were seen.In all the lesions with enhancement,the enhancement was reduced at the portal venous phase,with 12 lesions showing slightly higher density,3 lesions isodensity and 1 lesion low-density.Three lesions showed mild enhancement of the central scar.All the substantial parts of the lesions with enhancement declined at the delay phase,with 3 lesions showing slightly higher density,9 lesions of isodensity and 4 lesions slightly low density.In 7 lesions with central scar delayed enhancement,they showed slightly higher density.Nine patients underwent MRI enhancement and the enhancement characteristics were similar to CT,but the arterial phase magnitude was higher than that of CT.In 4 lesions,the central scar began to enhance at the portal venous phase,while 6 lesions continued to enhance,thus showing slightly higher signal at the delay phase.In a large lesion,there was persistent delayed enhancement in the capsule.(4) On DWI,6 lesions showed inhomogeneous,slightly hyperintensity with the center showing a slit-like low signal area.Three lesions showed iso-signal.The ADC values of the lesions were (1.31±0.08)× 10-3 mm2/s,and the normal liver parenchyma were (1.22± 0.14)× 10-3 mm2/s,(difference not statistically significant).Conclusions CT and MRI using plain and dynamic enhanced scans could show fully and accurately the pathological features and the characteristics of blood supply of FNH.The characteristic signs on both CT and MRI make an accurate diagnosis of FNH.MRI when compared with CT was slightly better.A combined use of both CT and MRI has an important value in the diagnosis of FNH.

Objective To explore the influence of network intervention on lifestyle and behaviors habit of the middle -aged patients with hypertension.Methods All 300 middle -aged patients with hypertension were randomly assigned into the study group and the control group.Each group had 150 cases.All patients in the both two groups were given hypotensive drugs according to treatment specification of hypertension.The patients in the study group received a network intervention for 2 years,while the patients in the control group received an outpatient service follow-up.The difference of lifestyle and behaviors habit of the patients in the two groups were observed and compared. Results There were no significant differences with all items of the lifestyle and behaviors habit of the patients between the two groups before intervention(P >0.05 ).In the 12th end of month after intervention,there were no significant differences between the two groups with the items of smoking control,working and resting regularly,hobby and psychological balance(P >0.05),but other items in the study group were significantly better than those in the control group(Z =-3.062,-2.509,-2.239,-2.056,-2.126,-2.045,-2.023,all P <0.05).In the 24th end of month after intervention,all items in the study group were significantly better than those in the control group (Z =-4.078,-3.792,-2.080,-2.098,-1.985,-2.478,-2.173,-2.478,-3.290,-2.514,-2.730,all P <0.05 ).Conclusion The network intervention can significantly improve lifestyle and behaviors habit of the middle -aged patients with hypertension.Its effect is much better than that of outpatient service follow -up.

Objective To observe the effect of advanced oxidation protein products (AOPPs) on articular and synovial in a rabbit model of osteoarthritis (OA).Methods 48 male New Zealand rabbits were randomly divided into 3 groups:AOPPs group,PBS group and sham-operated group.OA model were created in AOPPs group and PBS group by anterior cruciate ligament transection and medial meniscus resection (ACLT+MMx).then intra-articular injection of 1 ml AOPPs or PBS were performed once every other day in AOPPs group and PBS group,respectively.In sham-operated group,the anterior cruciate ligament was just exposed without transection,and then the incision was sutured.All rabbits were saerificed after 4 and 8 weeks of intervention,respectively.Results The India ink seore of 4 and 8 weeks were 4.19±0.60,5.75±0.60 in AOPPs group,and 1.06±0.18,1.38±0.60 in sham-operated group,2.50±0.46、3.06±0.62 in PBS group,respectively.In addition,the differences were statistically significant among the three groups.The Mankin score of 4 and 8 weeks were 8.19±0.70,11.94±0.90 in AOPPs group,and 0.75±0.53,1.06± 0.73 in sham-operated group,4.25± 1.46、4.50±0.89 in PBS group,respectively.The differences were statistically significant among the three groups.Meanwhile,the protein expression level of matrix metalloproteinases (MMP)-3 on synovial at 4 and 8 weeks in AOPPs group were 1.006±0.080,1.098±0.088;0.065±0.006,0.053±0.011 in sham-operated group;and 0.552±0.024,0.839±0.084 in PBS group,respectively.The proteiu expression level of MMP-13 on synovial at 4 and 8 weeks in AOPPs group were 0.966±0.080,1.621 ±0.041;0.101±0.022,0.367±0.033 in sham-operated group;and 0.564±0.030,1.322±0.085 in PBS group,respectively.The differences were statistically significant among the three groups at two times.Conclusion AOPPs participate in the occurrence and development of artieular cartilage by upregulating the protein expression of MMP-3 and MMP-13 on synovial.

Objective To explore the self-disclosure characteristics of gynecologic cancer patients,and compare psychological distress of each latent class.Methods A total of 177 gynecologic cancer patients from 8 tertiary hospitals were investigated by demographic questionnaire,the Distress Disclosure Index (DDI) and the Distress Thermometer (DT).Results The result showed that 3 latent classes model of self-disclosure was supported,including" High level-willing to disclosure to various people" (39.55％)," Medium level-willing to disclosure to spouse" (20.90％) and " Low level-not willing to disclosure to anyone" (39.55％).Significant differences were found in the effect of residence (x2 =9.341,P＜0.05),education level (x2=16.862,P＜0.05) and cancer type(P=0.009) on the latent class among these groups.Moreover,the psychological distress scores of the 3 latent classes were 6.61± 1.78,4.59± 1.57 and 3.67± 1.14,and the differences were statistically significant (x2 =83.56,P＜0.05).Conclusion The self-disclosure of gynecological cancer patients can be divided into three classes and their psychological distress is different.So the specific intervention methods can be developed to improve the level of self-disclosure and psychological distress of gynecological cancer patients.

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.