Objective To establish the care model of vertical stratification, the safety and effectiveness of assisted reproductive technology has been made. Methods This study involved 708 infertile group from July 2014 to March 2015 of IVF treatment (control group) and 916 infertile group from April 2015 to December 2015 of IVF treatment (vertical stratification group). According to the clinical, the care works are divided into seven parts. Each part has three elements with the primary nurse, work instructions, regulations and quality control measures. Via the survey and test, to convey the awareness of patients, clinic visits, waiting times, the rate of clinical pregnancy, medical expenses. Results After the vertical stratification, compared with the control group, the score increased project of the observation group were causes of infertility, diagnosis, treatment choice, the treatment process, medication precautions, perioperative considerations, adverse reactions, follow-up requirements, the difference was statistically significant (χ2=7.39-159.94,P<0.01). Compared with the control group (10±2) times,(126± 20) min,(2.89±0.05) million,61.57%(564/916), the number of times to the hospital, the waiting time , the medical expenses and the percent of pregnancy were (15±5) times, (333±40) min, (3.21±0.08) million and 50.14%(355/708), the difference was statistically significant (t=-98.67-227.81, P<0.01). Conclusions To establish the care model of vertical stratification has help to improve work efficiency.

Objective To investigate the effects of Qili-Qiangxin capsule on cardiac and pulmonary functions in heart failure patients with chronic pulmonary heart disease. Methods A total of 64 heart failure patients with chronic pulmonary heart disease were divided into two groups with the method of random sampling: a treatment group (33 patients) and a control group (31 patients). The patients in the control group received conventional treatment, those in the control group received Qili-Qiangxin capsule on this basis the treatment group for 7 days. The changes of the cardiac and pulmonary functions, and plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) were compared between two groups. Results The total effective rate in the treatment group was significantly higher than that of the control group (90.90% vs. 77.42%; χ2=3.908, P<0.05). There were significant difference between two groups in left ventricular ejection fraction (50.73% ± 7.23%vs. 45.22%± 6.36%;t=3.229, P=0.002), stroke volume (63.64 ± 8.38 ml vs. 56.73 ± 8.15 ml;t=3.341, P=0.001), right ventricular end-diastolic diameter (48.39 ±5.56 mm vs. 52.61 ± 6.95 mm; t=2.690, P=0.009), mean pulmonary arterial pressure (21.73 ± 5.78 mmHg vs. 27.26 ± 6.16 mmHg; t=3.705, P=0.001), plasma NT-proBNP level (535.73 ± 175.78 pg/ml vs. 831.26 ± 228.26 pg/ml; t=5.824, P=0.000), forced expiratory volume in first second (60.32% ± 5.56% vs. 48.61% ± 4.67%; t=9.093, P=0.000), percentage of forced expiratory volume in first second to forced vital capacity (66.73%± 5.78%vs. 58.26%± 5.34%;t=6.078, P=0.000), arterial oxygen saturation (96.73%± 5.78%vs. 93.26%± 5.26%;t=2.507, P=0.015), arterial partial pressure of oxygen (82.73 ± 16.78 mmHg vs. 67.26 ± 13.26 mmHg;t=4.075, P=0.000) arterial partial pressure of carbon dioxide (46.73 ± 8.78 mmHg vs. 54.26 ± 9.26 mmHg; t=3.339, P=0.00). Conclusion Qili-Qiangxin capsule can improve cardiac and pulmonary functions in heart failure patients with chronic pulmonary heart disease.

ObjectiveTo compare the preventive effects oftramadol and ketamine on the patients with postoperative hyperalgesia after remifentanil-induced neurosurgical anesthesia.MethodsOne hundred and fifty patients undergoing craniotomy were assigned to tramadol group,ketamine group and normal saline group with 50 cases each by random digits table.Anesthesia was maintained with infusion of remifentanil [0.1-0.2μ g/( kg· min ) ],propofol and sevoflurane.Tramadol ( 1.5 mg/kg),ketamine (0.5 mg/kg) or normal saline was given before skin closing.The emergence time,trachea extubation time,patients required analgesia and tramadol consumption,reverse effect were recorded.The visual analog scale (VAS),Ramsay scores at 15,30,60,120 minutes after emergence were performed.ResultsPatients required analgesia and tramadol consumption in tramadol group and ketamine group were significantly lower than those in normal saline group (P ＜0.01 or ＜0.05 ).The occurrence of shiver in tramadol group was lower than that in normal saline group (P ＜0.05).VAS scores in tramadol group at 15,30 minutes and in ketamine group at 30 minutes after emergence were significantly lower than those in normal saline group (P＜ 0.05).Ramsay score in ketamine group at 15 minutes after emergence was higher than that in tramadol group and normal saline group [ (2.9 ±0.6) scores vs.(2.3 ±0.7) scores and (2.3 ±0.9) scores](P＜0.01).ConclusionTramadol has a goodpreventive effect for postoperative hyperalgesia induced by remifentanil in neurosurgery compared with ketamine.

Objective:To investigate the effects of acupuncture of Shenshu(BL 23),Huiyang (BL 35)and Shenshu(BL 23)plus Huiyang(BL 35)on the main symptoms of unstable bladder (USB)and explore the specificity of different points in treating USB through a clinical randomized controlled trial.Methods:Eighty-nine USB patients were allocated to three groups:Shenshu(BL 23),Huiyang(BL 35)and Shenshu(BL 23)plus Huiyang(BL 35).I-PSS was used as an observation index.The effects were evaluated and a comparison was made between the groups after three and six treatments.Resuits:I-PSS significantly improved in all Shenshu (BL 23),Huiyang(BL 35)and Shenshu(BL 23)plus Huiyang(BL 35)groups of USB patients (P＜0.05).The effect was significantly beaer in the Huiyang(BL 35)and Shenshu(BL 23)plus Huiyang(BL 35)groups than in the Shenshu(BL 23)group(P＜0.05).The efficacy rate was 50.0% in the Shenshu(BL 23)group,82.8% in the Huiyang(BL 35)group and 90.0% in the Shenshu(BL 23)plus Huiyang(BL 35)group.It was significantly higher in the Huiyang(BL 35)and Shenshu(BL 23)plus Huiyang(BL 35)groups than in the Shenshu(BL 23)group(P＜0.05).Conclusion:Points Shenshu(BL 23),Huiyang(BL 35)and Shenshu(BL 23)plus Huiyang(BL 35)can all regulate voiding dysfunction and improve quality of life in USB patients.Shenshu (BL 23)plus Huiyang(BL 35)has the most marked therapeutic effect.

ObjectiveTo investigate the incidence of postoperative residual paralysis and respiratory function of patients undergoing neurosurgical anesthesia.Methods Three hundred andtwenty-eight patients undergoing neurosurgical anesthesia (ASA Ⅰ - Ⅱ ) were divided into vecuronium group (135 cases) and rocuronium group (193 cases) by random digits table.Anesthesia was maintained with propofol in combination with sevoflurane and intermittented intravenous infusion boluses of muscle relaxatant.Extubation of the intratracheal tube in operation room was performed under clinical criteria.The neuromuscular function were detected by acceleromyography with supramaximal train-of- four(TOF) stimulation of the ulnar nerve,and pulmonary function were measured in postanesthesia care unit(PACU).The TOF ratio and pulmonary function were compared between two groups.ResultsThe incidence of postoperative residual paralysis was 31.9％(43/135) in vecuronium group,and 14.5％(28/193) in rocuronium group.Hypoxemia and hypercapnia occurred in vecuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥0.9[7.0％(3/43) vs.4.3％(4/92) and 44.2％(19/43) vs.18.5％(17/92),P ＜ 0.01 ],while in rocuronium group with TOF ＜ 0.9 were higher than in those with TOF ≥ 0.9 [ 3.6％( 1/28 ) vs.1.2％ (2/165) and 39.3％( 11/28 )vs.17.0％ (28/165),P ＜ 0.01 ].ConclusionsThere is a high incidence of postoperative residual paralysis according to the clinical criteria of recovery of neuromuscular function of patients undergoing neurosurgical anesthesia,which would impair respiratory function.

ObjectiveTo observe the incidence and mechanism of postoperative hypoxemia in the patients after transsphenoidal pituitary tumor resection.Methods579 postoperative patients in postanesthesia care unit (PACU) in March, 2009～June, 2010 were investigated retrospectively using PACU databank. The incidence and mechanism of hypoxemia were analyzed.ResultsThe incidence of hypoxemia was 5.2%. Upper airway obstruction, change of breath mode, residual effects of anesthetics, bronchiospasm, aspiration, acute pulmonary edema and lung disease were the main reasons of postoperative hypoxemia after transsphenoidal pituitary tumor resection.ConclusionCareful monitor and treatment are the key to prevent hypoxemia after transsphenoidal pituitary tumor resection.

In this study, we prepared various matrices of hydrogel patches and studied their cross-linking mechanism by observing their rheological properties, which could provide theoretical basis and deep technical support for further industrial development of hydrogel patch. Rheology method was used to do the amplitude scanning and single-frequency scanning for various hydrogel matrix, under the condition of oscillation mode of the rheometer. Then the linear viscoelastic region, composite modulus value, as well as changes in slope with time of the composite modulus and phase angle of various hydrogel matrix were analyzed in detail. The results showed that the stability of matrix was mainly determined by hydrogel frame; only in acidic environment, the cross-linking reaction between cross-linker and hydrogel frame can occur; elasticity of matrix can be decreased by organic acid and the effect level was related to the ratio of the number of carboxyl and hydroxyl (-COO(-)/-OH) in adjusters: if the ratio was not equal, the higher -COO(-)/-OH in adjusters would be the less elasticity of matrix decreased; the cross-linking speed of matrix was determined by adjuster, the cross-linking speed of matrix contain different adjusters was ranged in following order: matrix containing tartaric acid > matrix containing lactic acid > matrix containing malic acid > matrix containing citric acid; the cross-linking speed of matrix was not uniform in the whole cross-linking process.

ObjectiveTo explore the best treatment method of cerebral artery dissection.Methods This study included eight patients who were definitely diagnosed as cerebral artery dissection by the cerebral angiography in our department of neurology during Oct.2009 and Nov.2011.They were all treated by the anticoagulation or anti-platelet methods.Some patients received the stent therapy.All patients' were followed for at least three months. The treatment effect was assessed by NIHSS,mRS and by the cerebral angiography.ResultsSix patients had carotid artery dissection,2 had vertebral artery dissection.Four patients were given anticoagulant therapy and the other 4 were given anti-platelet therapy. The reexamination by angiography 10-14 days after admission showed that in 3 patients,the stenosis was aggravated or the infarction occurred.They were diagnosed as having repeated transient ischemic attack (TIA) during pharmacotherapy and received stents for treatment.There was no TIA and cerebral infarction in the follow-up period after individualized therapy.Mean NIHSS scores of 8 patients between pre and post treatment were 5.9,1.6 respectively. Mean mRS scores pre and post treatment were 2.5,0.9respectively.Conclusion The treatment for patients with cerebral artery dissection should be individuated.The patients in acute stage should get anticoagulation,anti-platelet therapy and angiography re-examination.According to the clinical manifestation and cerebral angiography,the next step for the treatment should be done.

OBJECTIVE: Using the method of lactate dehydrogenase (LDH) assay, to observe the activities of rat cerebral microvascular endothelial cells (CMECs) intervened by Tongluo Jiunao Injection (TLJNI), a traditional Chinese compound drug removing toxin to dredge brain collaterals, and then further study the effects of different kinds of conditioned mediums (CMECs-CM) of cerebral microvascular endothelial cells on ischemia and ischemia/reperfusion cerebral cortex cells, and to probe into the drug pharmacological mechanisms of CMECs in modulating the neurons. METHODS: Three kinds of CMECs (normal, ischemic and ischemic/reperfusional) were all treated by TLJNI previously, and then the three pairs of CMECs-CM without serum were collected respectively for LDH assay. Rat cerebral cortex neurons were also primarily cultured and then divided into similar three groups (normal, ischemic and ischemic/reperfusional). The neuron responses caused by CMECs-CM at different concentrations were observed by using LDH transudation rate assay. RESULTS: The LDH release values of ischemic and ischemic/reperfusional CMECs with TLJNI treatment were obviously reduced (P<0.01) compared with the same kinds of CMECs untreated. For ischemic neurons, both conditioned medium of ischemic CMECs (Is-CM) and conditioned medium of ischemic CMECs with drug treatment (IsT-CM) in high concentration of 100% increased the LDH transudation rate (P<0.01), while in low concentration of 10%, IsT-CM reduced the transudation rate (P<0.05). For ischemia/reperfusion neurons, all kinds of CMECs-CM reduced the transudation rate respectively (P<0.05 or P<0.01). As far as each group concentration was concerned, 10% or 50% showed relatively stronger effects, and both conditioned medium of normal CMECs (N-CM) group and conditioned medium of ischemic/reperfusional CMECs (Rp-CM) group had statistical significance (P<0.05 or P<0.01). For normal neurons, all kinds of CMECs-CM increased the transudation rate respectively (P<0.05 or P<0.01). As far as each group concentration was concerned, only conditioned medium of normal CMECs (N-CM) had statistical significance (P<0.05 or P<0.01). CONCLUSION: The study shows that TLJNI is capable of preventing the damage of CMECs from both ischemia and ischemia/reperfusion states. Chinese drug can restrain the brain ischemia and ischemia/reperfusion damage by the media that CMECs modulate the neurons, demonstrating the pharmacological mechanisms of TLJNI. This work also indicates that there exist some active substances against ischemia/reperfusion injury secreted from CMECs-CM with TLJNI treatment.

OBJECTIVE: To observe the effects of electroacupuncture treatment on nitrergic neurotransmitter in bladder neck and detrusor of rats with unstable bladder. METHODS: Rat models of unstable bladder were established by operation to induce urethral obstruction. Electroacupuncture treatment was given by acupuncturing Huiyang and Zhonglushu points for a week. Then the neuronal nitric oxide synthase (nNOS)-, endothelial nitric oxide synthase (eNOS)- and inducible nitric oxide synthase (iNOS)-positive cells in bladder neck and detrusor of the rats were observed. RESULTS: The nitrergic neurotransmitter in bladder neck and detrusor were obviously decreased in rats with unstable bladder. The electroacupuncture treatment could significantly increase the contains of NOS in bladder tissue. CONCLUSION: To promote the synthesis and secretion of nitrergic neurotransmitter in bladder tissue may be one of the mechanisms of acupuncture in adjusting bladder function.