OBJECTIVE:To observe the effect of ondansetron on the anesthesia of cesarean section surgery with spinal-epidur-al anesthesia. METHODS:A total of 60 singletons full-term pregnancy were randomly divided into test group and control group. Test group was given 6% Hetastarch(130/0.4)electrolyte injection 500 ml by intravenous infusion 30 min before anesthesia,and Ondansetreon hydrochloric acid injection 4 ml by intravenous infusion 5 min before anesthesia;control group was given 6% Hetas-tarch(130/0.4)electrolyte injection 500 ml by intravenous infusion 30 min before anesthesia,and 0.9% Sodium chloride injection 4 ml by intravenous infusion 5 min before anesthesia. The clinic data was recorded,including the mean arterial pressure (MAP) and heart rate(HR)before anesthesia puncture(T1),after anesthesia maternal left side(T2),after fetal childbirth(T3)and at the end of surgery(T4),Apgar score and incidence of adverse reactions. RESULTS:MAP in control group at T2,T3 was obviously low-er than T1 and test group,HR was obviously higher than T1 and test group,the difference was statistically significant(P<0.05);there were no significant differences in the MAP and HR in test group at each time point(P>0.05). Apgar score of newborn after 1 min birth in test group was significantly higher than control group,the difference was statistically significant (P<0.05),and there was no significant difference in the Apgar score of newborn after 5 min birth between 2 groups(P>0.05). The ADR incidence in test group was significantly lower than control group(P<0.05). CONCLUSIONS:Ondansetron can effectively reduce the inci-dences of vomit vomitting and hypotension in on the cesarean section surgery with spinal-epidural anesthesia,with good safety.

Objective To study the effects of different doses of insulin in diabetic ketoacidosisin children.Methods 44 patients with diabetic ketoacidosis in children who were treated with insulin in our hospital were selected as research object,and they were divided into group A(low dose group)22 cases and group B(high dose group)22 cases, and the blood glucose, blood calcium, serum potassium, acidosis corrected time and the levels of serum IL-6,IL-12,IL-18 and TNF-α and incidence of hypoglycemia of the two groups were compared and studied. Results The blood glucose, blood calcium,serum potassium, acidosis corrected time and the levels of serum IL-6, IL-12, IL-18 and TNF-α of the two groups had no differences, there were no significant difference(all P ＞ 0. 05), but the incidence of hypoglycemia of the group B was lower than that of group A,there was significant difference(P ＜0. 05). Conclusion The effects of low dose of insulin in diabetic ketoacidosis in children was better, blood glucose placidity decreases, and was worthy of further studying and popularization and application.

The microfluidic channels integrated with microring resonator were designed. The salt coalescence on chip surface caused by liquid volatilization in open environment was avoided and only 30 μL of reaction solution was consumed. These channels significantly reduced the experiment cost. The design, fabrication and characterization of a highly sensitive and label-free silicon-on-insulator (SOI) microring optical resonator integrated with the microfluidic channels were demonstrated. The radius of the microring was 5 μm and the straight waveguide with a width of 450 nm was employed in the microring resonator. The microring resonator device had many advantages such as high sensitivity, label-free and real-time detection. Using different concentrations of ethanol solution with known refractive indices, the refractive index detection sensitivity was 76.09 nm/RIU and the volume refractive index detection limit was 5.25×10Symbolm_4 RIU. We also demonstrated the label-free quantitative specific detections of human immunoglobulin G (IgG) solutions using an antibody-modified microring resonator by measuring the resonance wavelength shift resulting from refraction index changes causing by the immobilization of antibodies and specific recognition between antibodies and antigens, respectively. The results showed that the microring optical resonator could real-time monitor the reaction between biological molecules, the resonator could be used in the quantitative detection and biological sensing.

Objective To analyze clinical and pathological data of IgA nephrology patients with microalbuminuria and investigate risk factors of its prognosis.Methods Clinical and pathological data of IgA nephrology patients with microalbuminuria were confirmed with renal biopsy and follow-up time with ＞ 6 months of trace was reviewed retrospectively;24-hour urine protein quantification ＞ 1 g, normal serum creatinine level when renal biopsy turned into abnormal level, or doubled serum creatinine level was defined as end point of follow-up.Renal survival was calculated with Kaplan-Meier survival analysis, and risk factors of progression were analyzed with univariate and multivariate Cox regression models.Results A total of 96 patients was followed up successfully, with an average follow-up time of (35.6 ± 22.7) months, and 34 cases (35.42％) entered the endpoint.The 12-, 24-, 36-, 48-, 60-, and 72-month renal survival rate was 97.92％, 92.71％, 86.45％ , 81.25％ , 71.88％, and 64.58％, respectively.Urine proteins, abnormal serum creatinine, Lee's Ⅲ～ V, renal interstitial fibrosis, glomerular sclerosis, and crescentic body were independent risk factors to affect prognosis of IgA nephropathy with microalbuminuria.Conclusions Early and active control of urinary microalbumin, and acute kidney injury caused by treatment of crescentic formation could slow the progress of IgA nephropathy.

Objective To evaluate the dosimetric differences of one RapidPlan Model on different Radiotherapy devices.Methods A RapidPlan Model was built based on 30 reoptimization IMRT plans of cervical cancer patients on typeA LA.Dosimetric differences of automatic optimized IMRT plans using this model on 4 different type LAs,named respectivelyA,B,C andD,were compared with 12 test cervical cancer cases.These four LAs were well commissioned in the treatment planning system (TPS).Student t test was applied for statistical analysis on dosimetric differences.Results Dosimetric differences between A vs.B,C and D were observed on Dmean,HI,CI of PTV50 and PTV45,as well as on V50,V40,V30 of rectum and bladder.Significant dosimetric differences were observed between A and D (P<0.05).Conclusions Automatic planning with RapidPlan model may result in dosimetric differences on different Radiotherapy devices.These differences should be aware of with caution in its clinical application.

Objective:To explore blood type distribution of newborns hemolytic disease ( HDN ) caused by maternal and neonatal blood type incompatibility and analyze the value of hemolysis three trials in the diagnosis of HDN.Methods:Hemolysis three trials of type O or Rh negative maternal cord blood samples and hyperbilirubinemia of the newborn blood samples from January 2014 to 2016 were detected by micro-column gel test cards.Then the results were statistically analyzed.Results:(1) There were 918 cases of maternal and neonatal blood type incompatibility in all 1350 cases.569 cases were detected HDN positive with the rate of 62%( 569/918).Among 569 cases,the positive rate of direct anti-globulin test,free antibody test and antibody released test were 27.9%(159/569),86.5%(492/569) and 100% respectively.There was statistical difference of the combination of direct anti-globulin test negative,free antibody test positive and antibody released test positive compared with other combinations ( P<0.05 ).( 2 ) There was statistical difference of HDN positive rate between ABO 73.8%(551/747) and Rh 10.5%(18/171)in 918 cases of blood type incom-patibility.(3)There was statistical difference between A positive rate of 80%(280/350) and B positive rate of 68.3%(271/397) in 747 cases of ABO incompatibility.(4)There was statistical difference among RhD positive rate of 17.7%(14/79),RhE positive rate of 6.8%(4/59) and RhC positive rate of 0(0/33).Conclusion: Antibody released test was the most sensitive test in hemolysis three trials to diagnose HDN.The probability of HDN positive caused by maternal and neonatal ABO blood type incompatibility was significantly higher than Rh.The probability of HDN positive with type A newborns was significantly higher than type B.The probability of HDN positive caused by RhD blood type incompatibility was significantly higher than RhE and RhC.

Objective To study the reason and preventive measures of inconformity of the extraction appeared in the process of transfusion blood specimens with the patient's blood type.Methods The reasons of transfusion errors why extracting required blood type was not consistent with the patient's blood type examplesa in Zhengzhou transfusion of hospital from 2008 to 2012 were retrospectively analyzed.Results The experimental results showed that blood specimen inconformity was 49.60%,the error rate of blood extraction and blood infusion was 31.20%,infusion error only was 15.20%,blood type change after stem cell transfusion was 4.00%.Reasons of blood type change after stem cell transplantation to extract blood samples mainly included the blood center or blood did not accord with logo type blood stations provided (16.13%),blood use application form to fill in error(20.97%),check the wrong blood type (6.45%),blood samples taken(29.03%),the blood sample tag(27.42%).Conclusion In order to ensure the safety for clinical use must adopt measures to prevent resolutely put an end to a blood transfusion errors.

Objective To systematically evaluate the effectiveness of Chinese medicine(CM) combined with chemotherapy in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis. Methods Databases of PubMed, EMBase, Cochrane Library, China National Knowledge Information(CNKI), VIP Database, Wanfang Database, and SinoMed were retrieved to collect randomized controlled trials(RCTs) of CM combined with chemotherapy in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis. And then the quality of the included RCTs was evaluated systematically. Results Seven RCTs involving 700 cases of stageⅡ-Ⅲ colorectal cancer patients were included, 355 patients in treatment group were treated with CM combined with chemotherapy, and 345 patients in control group were treated with chemotherapy alone. The results of Meta-analysis showed that treatment group was superior to the control group in preventing the recurrence and metastasis of colorectal cancer one , 2 and 3 year(s) after the radical surgery, showing statistically significant differences(P < 0.05), while the difference of five-year recurrence and metastasis rate was not statistically significant between the two groups(P > 0.05). At the same time, CM combined with chemotherapy had better effect than chemotherapy alone on prolonging the time for recurrence and metastasis, improving performance status and relieving the symptoms, the difference being significant(P<0.05). Conclusion CM combined with chemotherapy exerts better effect than chemotherapy alone in preventing stageⅡ-Ⅲ colorectal cancer patients from postoperative recurrence and metastasis and onimproving the quality of life of the patients. However, for the low methodological quality of the included trials, the conclusion still needs more large-size sample, multiple-center, and high-quality clinical trials to be confirmed.

Objective To improve the different diagnosis between autoimmune pancreatitis(AIP) and pancreatic cancer(PC) by a retrospective analysis of clinical symptoms and serological features.Methods The analysis included 36 patients who had postoperative pathological,serological findings consistent with Asian AIP standards and 95 patients who had postoperative pathological consistent with PC pathological standards.All patients were admitted by the surgery department of our hospital from January,2003 to October,2011.A retrospective comparative analysis of the clinical manifestations,serology data of these AIP and PC patients was conducted.And summary the differential diagnosis characteristics of AIP and pancreatic cancer in the clinical symptoms,the serology.Results The features of different diagnosis:(1) The age of patients with PC was higher than AIP((60.9 ±9.0) years vs.(53.56 ± 14.6) years,t =3.48,P ＜0.05),and AIP preferred to male groups (x2 =2.88,P =0.09).(2) The clinical features of AlP and PC with the age characteristics were easily confused.Both clinical features were relatively typical in younger age which could be found earlier and relatively insidious in the older age which might be found with delay.(3) AIP were often complicated by biliary system inflammations(AIP =47.2％,PC =12.6％,x2 =18.12,P ＜ 0.05),while PC were usually complicated by the cysts in liver and kidney (PC =29.5％,AIP =0,x2 =13.50,P ＜ 0.05).(4) The high titer in CA199 had a higher value in the diagnosis of PC (concentration:group AIP =20.51 (9.55,86.5) kU/L,group PC =326.50 (94.38,10393.00) kU/L; positive rate:group AIP =35.70％ (10/28),group PC =86.70％ (65/75),P =0.000).The high titers in amylase (concentration:group AIP =103.50 (72.00,252.00) U/L,group PC =46.50 (21.65,96.90) U/L; positive rate:group AIP =45.00％ (9/20),group PC =19.40％ (7/36),P =0.043),lipase(concentration:group AIP =340.50(152.05,495.80) U/L,group PC =107.40(23.40,177.26) U/L,P =0.005 ; aspartate aminotransferase (positive rate:group AIP =75.00％ (27/36),group,PC =55.90％ (52/93),P =0.046) andγ-glutamyltranspeptidase (positive rate:group AIP =79.40％ (27/34),group PC =57.10％ (52/91),P =0.022) had higher values in the diagnosis of AIP.The significant increases in CA199 were not the basis which excluding AIP.Conclusion AIP as a unique type of chronic pancreatitis can be distinguished from PC on distinctive clinical,serological characteristics.

Objective　To analyze the effects of flexible ureteroscopic Holmium laser lithotripsy on renal function in the treatmen of renal calculi.　Methods　From October 2010 to March 2012,41 cases of solitary renal calculi (24 males and 17 females) were treated with flexible ureteroscopic Holmium laser lithotripsy ( FURL).Patient's mean age was 51.9 ± 15.9 years ( range from 31 to 88 years).Locations of renal calculi detected by image study were 22 cases in middle and upper calyx,9 cases in lower calyx,10 case in renal pelvis.The mean size of calculi was 16.9 ±6.0 mm (range from 10 to 28 mm).Blood samples (2 h pre-operatively,and then 2 h,12 h,24 h,48 h,72 h post-operatively) were collected and serum　NGAL,serum Cys-C were tested　Results　The measured levels of pre-operative NGAL and Cys-C were 3.5 ± 0.6μg/L,501.7±121.3 μg/L,and levels of post-operative NGAL at 2 h,12 h,24 h,48 h and 72 h were 4.2±0.8 μg/L,5.0±1.0 μg/L,4.9±1.4 μg/L,4.3± 1.1 μg/L and 3.8 ±0.1 μg/L,while the according levels of Cys-C were ( 516.4 ± 126.2 ) μg/L,( 723.8 ± 134.8 ) μg/L,( 770.4 ± 162.8 ) μg/L,(671.7 ± 138.3 ) μg/L and 574.0 ± 116.7 μg/L.Serum NGAL began to increase 2 hours after operation (P ＜0.05,and reached the peak in 12 hours,it began to decline 12 hours after surgery,but it was still higher at 72 hours than pre-operative level (P ＜ 0.05.Serum Cys-C showed no obvious ascent 2 hours after operation in FURL group ( P ＞ 0.05 ),but increased obviously 12 hours after operation and lowered down after the peak that occurred 24 hours after surgery.Serum Cys-C still remain above the baseline 72 hours after operation (P ＜0.05).　Conclusions　Flexible ureteroscope lithotripsy can cause reversible damage to renal function after surgery.