Objective Ritodrine hydrochloride(RH) combined with radix salviae mihiorrhisa(RSM) is ap- plied to treat fetal growth ristriction(FGR). Curative effect was recorded during observation. Methods 62 pregnant women with slowly growing fetuses were divided into two groups randomly. Group A(test group) :including 31 preg- nant women who received RH combined with RSM treatment. Group B(control group) :including the other 31 preg- nant women who only received RSM treatment. Group B received 250ml of fat emulsion injection. One time every three days within one week. At the same time,gronp B also received injection of 500ml 10 % dextrose, coenzyme A 100U ,ATP 40mg,vitamin C 2g,dextran-40 and compound salvia injection 10ml one time a day,ten days in all. Be- sides the above-mentioned medicament for group B, group A received RH 100ml injection every day. Ten days was a period of treatment. After the treatment, uterine height, abdominal circumference, weight were measured and bipari- etal diameter, head circumference, abdominal circumference were checked by B-type ultrasonic inspection. After birth,weight of the baby and weight of placenta were measured too. Results Measurement indexes from group A, weight of the new-born baby and weight of placenta are obviously higher than those from group B. Conclusion RH combined with RSM can obviously extend blood vessel, loose placenta, improve blood circulation, accelerate cell metabolism, make microeirculation better, reduce permeability of capillary vessel, keep placenta's function and help foetus' growth.

Objective To investigate the obstructive sleep apnea syndrome ( OSAHS) associated with nasal resistance.Methods 30 cases with obstructive sleep apneahypopnea syndrome ( OSAHS ) in the OSAHS group, 30 cases with snoring but without OSAHS in the snoring group and 30 cases with normal group based on polysomnog-raphy were detected the nasal resistance.Results The index of thsnoring index[(42.7 ±27.3),(19.4 ±18.5), AHI(38.7 ±30.2),(5.9 ±1.6)and Resl+r(1.63 ±1.11)Pa· s-1· mL-1,(0.72 ±0.31)Pa· s-1· mL-1] in OSAS group and snoring group were significantly higher than those of the normal group ( t=6.451,7.444,7.698,all P<0.05);The index of lowest oxygen saturation ( SaO2 ) ,Flowl+r in OSAS group and thsnoring group were lower than that in normal group(t=7.551,7.334,all P<0.05);There were significant differences among groups of nasal resistance (t=7.451,8.144,8.608,8.904,all P<0.05);There were positive correlation between nasal resistance and snore index (r=5.658,P<0.01);The index of nasal resistance correlated with AHI index (r=0.002,P>0.05),wake times (r=0.083,P>0.05) and lowest SaO2(r=0.105,P>0.05)were not significantly correlated;The cases with OSAS cephalometric.The results suggest majority snoring symptoms significantly more at supine posi-tion in OSAS.Conclusion Nasal resistance increased,which may be associated with the occurrence in patients with OSAHS.

Objective To evaluate the effect of nitrous oxide-inhale combined with lidocaine-injection by Ciliao and Uterine points and single therapy in labor analgesia,and the impact on maternal and child.Methods 400 cases were randomly divided into four groups.Observation group:100 cases take the therapy of Nitrous oxide-inhale combined with lidocaine-injection in Ciliao and Uterine points in the time of active period.Control group 1:100 cases take the therapy of gas mixture-inhale( 50％ Nitrous oxide and 50％ Oxygen) in the time of active period.Control group 2:100 cases take the therapy of lidocaine-injection in Ciliao and Uterine points in the time of active period.Control group 3:100 cases do not take any analgesia.Analgesic effects,labor time,mode of delivery,neonatal conditions,the amount of bleeding in every group were observed.Results There was statistically significant differences between the observation group with the control group 1,2,3 on analgesic effects ( x2 =48.513,P ＜ 0.05 ) labor time( F =782.88,1120.81,1104.57,all P ＜ 0.05 ),mode of delivery ( x2 =85.715,P ＜ 0.05 ),neonatal conditions,the amount of bleeding( F =422.66,P ＜ 0.05 ).Conclusion Combination therapy was more effective than the single treatment.

Objective To explore the influence and treatment methods of hysteromyoma pregnancy. Method Through case-control study on 116 cases of hysteromyoma pregnancy and the same number cases of normal pregnan-cy in the same period, in order to observe the outcome of two groups. Results There is no significant difference in the matter of amount of bleeding when hysteromyoma pregnant women give birth to their children, no matter how oper-ation group, non-surgical group and control group(P > 0.05); but there is significant difference between non-surgical group and control group(P <0.05), and in the field of asphyxia neonatorum rate, there is no significant difference in all groups(P > 0.05). Conclusions The amount of bleeding in hysteromyoma pregnant women are more than vagi-nal delivery non-hysteromyoma women. It suggests that myomectomy won' t increase the amount of bleeding when doctors give the hysteromyoma women caesarean section at the same time. And the difficulty of surgery won' t signifi-cantly increase when compared to non-pregnancy and pregnancy.

Objective To discuss the effect of C-reactive protein(CRP)levels in pregnant women with gestational diabetes meatus(GDM).Methods To select 96 GDM women with 75 grams oral slum tolerance test(OGTF)and 64 pregnant women with impaired gluccose tolerance(IGT)respectively,and choose 160 normal pmgnant women with normal slucose tolerance(NGT)randomly as control group,then observe their serum CRP level at the same time.Results The serum CRP level in GDM group was significantly higher than IGT group and control group (P＜0.05).The sermn CRP level is positively related with pre-pregnancy body mass irdex(BMI),fasting bloodslope and fasting insulin,and the correlation coefficients are 0.338,0.163 and 0.283 respectively,and P values are 0.00001,0.0169 and 0.0003 respectively.Conclusion The blood sertlm C-reactive protein is closely related to GDM and involved in the pathogenesis of GDM.

Objective To assess the clinical application value of color Doppler ultrasound guided puncture in peripherally inserted central catheter (PICC). Methods Thirty-two patients needed long-term intravenous infusion underwent PICC. Color Doppler ultrasound was used to select the puncture vascular,the best puncture point and angle, and the entire process was monitored and guided dynamically, and the initial position of the catheter tip was located. Results Color Doppler ultrasound-guided puncture was successful in all 32 patients, and the successful rate was 100%. The guided puncture time was 22 s to 19 min, and the first puncture succeeded in 30 patients (93.75%). Conclusion Color Doppler ultrasound-guided puncture in PICC can obviously raise the success rate of puncture, shorten puncture time and reduce the complications. It is an easy, safe and certain method.

Objective To observe the influence of acupuncture treatment on parturition process.Methods 545 pregnant women delivered in our hospital were selected,excluding those with cesarean section indication.On voluntary principle and randomized principle,primipara aged from 22 to 30 who agreed with natural labor were divided into two groups:observation group and control group.Pregnant women in observation group were received acupuncture treatment during latent phase.The following indexes of the two groups were recorded and compared:labor time of the first stage and the second stage,the case for inertia of uterus,cesarean sections,postpartum hemorrhage amount and Apgar score of new-born.Results The labor time of the first stage and the second stage of the control group were (178.55 ± 56.87) min and (130.70 ± 77.22) min,and which of the observation group were (53.87 ±22.33) min and (33.25 ± 15.55) min,there was significant differenec between the two groups(t =3.97,4.11,all P ＜0.05).The differences in the pilot failed to cesarean section rate(14.2％ and 13.6％),postpartum hemorrhage and the perinatal outcome were not significant between the two groups.Conclusion Acupuncture and moxibustion can accelerate labor.

Objective To compare the effects,stress reaction and concentration of ropivacaine in umbilical cord blood of patients who accepted combined spinal epidural analgesia or patient controlled epidural labor analgesia in latent and active phase.Methods After approved by the ethics committee and informed consents from 80 nulliparous parturients who were admitted to Beijing Friendship Hospital,Capital University of Medical Sciences between January to June 2009,and who were term,single,cephalic presentation delivery and ASA Ⅰ-Ⅱ,were divided into two groups randomly:latent phase group (Group L,cervical dilation 0.5-2.5 cm,n=40) and active phase group (Group A,cervical dilation ≥3.0 cm,n =40).Ropivacaine 2 mg and fentanyl 10 μg was administered in subarachnoid space of all patients.Then,patient controlled epidural infusion of 0.1 ％ ropivacaine plus fentanyl 2 μg/ml were administered.Pain scores (visual analogue score,VAS),lower extremity muscle strength,duration of labor,delivery mode,total dosage used,maternal satisfaction,Apgar score (1 min and 5 min) were evaluated; concentration of ropivacaine (high performance liquid chromategraphy) in cord blood,and concentration of cortisol (radioimmunoassay) in maternal venous blood and cord blood were detected.Forty nulliparous parturients without labor analgesia were taken as control group (Group C).Chi-square test and one way analysis of variance was applied for statistical analysis.Results (1) VAS in Group L and Group A were lower than that of Group C when cervix dilated at 7.0-8.0 cm (2.9± 1.4,2.6± 1.5 vs 9.2±0.7,F=201.50,P＜0.01) and fully dilated (4.7±2.2,3.6±2.0 vs 9.1±0.7,F =-62.07,P＜0.01,respectively).(2) Tbe concentration of cortisol in maternal venous blood right after delivery was higher than that before analgesia in all groups,and the change in group C was significantly greater than that in group L and group A [(902±172) μg/L vs (761±125) μg/L and (731±184) μg/L,t =-3.491 and-3.483,all P＜0.01],moreover there was no significant difference between group L and group A (P＞0.05).There were no difference in cortisol concentration of umbilical blood among the three groups [(168±46) μg/L,(159±49) μg/L and (170±86) μg/L,F=0.23,P＞0.05].(3) There was no difference between ropivacaine concentration in umbilical blood of group L and group A [(0.21±0.10) mg/L vs (0.20±0.03) mg/L,t=0.557,P＞0.05].(4) No significant differences was shown among the three groups in the duration of first and second stage of labor,rate of augmentation,neonatal birth weight,Apgar score at 1 min and 5 min (all P＞0.05).Compared with group C,group L and group A had higher rate of vaginal delivery (52.5％ vs 75.0％ and 85.0％,P＜0.05) and lower rate of cesarean section (45.0％ vs 20.0％ and 15.0％,P＜0.05).The duration of analgesia in group L was longer than that in group A [(215±143) min vs (118±50) min,t =3.722,P＜0.01] and the dosage of fentanyl was also higher [(28± 11) μg vs (17±6) μg,t =5.084,P＜0.01].Conclusions Labor analgesia with combined spinal epidural could decrease cesarean section rate and maternal stress reaction without prolonging the duration of labor and inhibiting neonatal stress reaction.Labor analgesia start from latent phase would not increase the concentration of ropivacaine in cord blood.

Objective To investigate the relationships between serum osteocalcin levels of fasting plasma glucose(FPG),fasting serum insulin(FINS),insulin resistance,β-cell function as well as lipid metabolism in male traumatic patients.Methods A prospective cohort study was carried out in the Emergency Room of Shanghai Sixth People's Hospital from April to October of 2015.The male adult traumatic patients without traumatic brain injury,shock and the medical history such as the fractures,diabetes were enrolled as trauma group,and then patients' age,body mass index(BMI),injury severity score(ISS), admission time after trauma and fluid resuscitation volume before testing(FRVT) were recorded.A total of 80 heathly male adult subjects were enrolled from the physical examination center as control group with matched age and BMI.Comparison of biochemical characteristics were carried out between two groups, and relationships between serum osteocalcin levels and glycolipid metabolism in trauma group were analyzed.Insulin resistance and β-cell function were calculated by Homeostasis model assessment-insulin resistance(HOMA-IR)and Homeostasis model assessment of β-cell function(HOMA-β).Results A total of 102 male adult traumatic patients mostly subjected to traffic accident (56.9%) with FRVT (208.78±98.68)mL and ISS(9.30±3.67)were enrolled in trauma group.Serum OC levels,HOMA-β,total cholesterol(TC),high density lipoprotein(HDL-c)and low density lipoprotein(LDL-c) were lower,but FPG,FINS,C-peptide(C-P),HOMA-IR were higher compared with control group(P<0.05).Serum OC levels wer were negatively correlated with FPG and TC(P<0.05),and positively correlated with FINS,HOMA-IR,and HOMA-β(P<0.05),but there were no correlation of OC with FRVT and ISS.By multiple linear regression analysis after adjusting for age,BMI,FRVT and ISS,serum osteocalcin levels were significantly related to TC in traumatic patients (β=-0.812,P=0.024).Conclusion The glycolipid metabolism may be impacted by the serum level of osteocalcin after trauma.

BACKGROUND: The human leukocyte antigen (HLA) has undergone long-term evolution to form diverse polymorphisms. In recent years, due to the increase in the number of examinees and the rapid development of HLA typing technology, novel HLA alleles have been discovered constantly. OBJECTIVE: To analyze the full-length sequence and 18 point mutations of HLA-B gene in a leukemia patient and her family using the next-generation sequencing technology. METHODS: Polymerase chain reaction and sequence-specific oligonucleotide probes (PCR-SSOP) and polymerase chain reaction-sequence based typing (PCR-SBT) revealed abnormalities in the patient’s HLA-B. To identify the genotype, we sequenced the full length of the gene by next-generation sequencing technology and collected blood samples from the patient’s father, mother and two sisters for genetic analysis of HLA genes. RESULTS AND CONCLUSION: Both PCR-SSOP and PCR-SBT indicated that the HLA-B sample had no perfectly matched genotype. Further detection using the next-generation sequencing technology revealed that the novel allele had 18 base mutations in the exon, intron and 3’UTR compared to the most homologous allele B*15:09:01. Five exon base mutations were located in the exons 3 and 4, which were: 486G→C, 583T→C, 636T→C, 652A→G, 756C→T, resulting in changes in the five corresponding codons, including 171 tyrosine (Tyr) → histidine (His) and 194 isoleucine (Ile) → valine (Val). A pedigree survey found that the patient’s novel HLA B allele was inherited from her father. The novel allele sequence was submitted to the Genbank database (MG595995). A novel HLA-B allele was confirmed by the next-generation sequencing, which was officially named HLA-B*15:435 by the World Health Organization HLA Factor Nomenclature Committee in December 2017.