Epidural analgesia is the most effective form of pain relief available to labouring women.In this review,the author highlights the latest progress in the researches on the mechanism of epidural analgesia for labour,the choice of administration mode,the choice of local anaesthetics and opioids,and the impact of epidural analgesia on the parturient and fetus.

Biomedical Research ; methods ; Drug Therapy, Combination ; Humans ; Medicine, Chinese Traditional ; methods ; trends ; Research Design

Adult ; Humans ; Male ; Maxillary Sinus ; Tooth Eruption, Ectopic

Objective: To extract the syndrome elements of CHD angina pectoris with entropy-based complex system partition method and to analyze the distribution of the syndrome elements, in an effort to study the pathogenetic characteristics of CHD angina pectoris. Methods: The clinical data of 403 patients with CHD angina pectoris were collected by clinical epidemiological survey. Entropy-based Complex System Partition was used to extract the syndrome elements, contribution degree of symptoms to syndrome and diagnostic threshold. The combination rule of the syndrome elements was also analyzed. Results: CHD angina pectoris had the following basic syndromes: Qi Deficiency syndrome, Qi Stagnation syndrome, Blood Stasis syndrome, Phlegm Turbid syndrome, Phlegm-fire syndrome, Stagnation-fire syndrome, Yin Deficiency syndrome and Yang Deficiency syndrome. With the increase of syndrome elements, the frequencies of Qi Deficiency syndrome, Yin Deficiency syndrome, Qi Stagnation syndrome, Blood Stasis syndrome, and Phlegm turbid syndrome also increased. Qi Deficiency syndrome and Blood Stasis syndrome were the two syndrome elements seen most frequently. Conclusions: The syndrome elements extracted by entropy-based complex system partition method and their distribution rule can reflect the pathogenic characteristics of angina pectoris, which lays a base of quantify the diagnostic criteria of the angina pectoris syndrome.

Objective: To study the correlations between galectin-3, soluble ST2 (sST2) levels and chronic heart failure (CHF) classiifcation, traditional HF indicator and short-term death in relevant patients. Methods: This research included 2 groups: CHF group, containing 142 relevant patients treated in our hospital from 2014-02 to 2015-10 and Control group, containing 85 normal subjects from physical examination at the same period of time. Based on NYHA criterion, the patients were classiifed in NYHA grade II, III and IV respectively. Blood levels of N-terminal brain natriuretic peptide (NT-ProBNP), high-sensitivity C reactive protein (hs-CRP) and ultrasonic morphology were examined upon admission; protein expressions of galectin-3 and sST2 were assessed by ELISA. Results: The patients with NYHA grade III and IV had increased levels of galectin-3 and soluble sST2; galectin-3, sST2 were positively related to NT-ProBNP, hs-CRP and LVEDD, while negatively related to LVEF. Logistic regression analysis indicated that galectin-3 and sST2 were related to short-term death in CHF patients,P<0.05. Area under ROC curve of galectin-3 and sST2 for diagnosing CHF were 0.738 and 0.771,P<0.01. Conclusion: Galectin-3 and sST2 levels were related to traditional HF indicator and could be used for CHF diagnosis in relevant patients.

Objective To evaluate the effect of ulinastatin on hepatic ischemia-reperfusion injury in patients with hepatic alveolar echinococcosis in plateau region.Methods Sixty patients with hepatic alveolar echinococcosis in plateau region,weighing 45-75 kg,aged 30-55 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective partial hepatectomy,were divided into control group (C group) and ulinastatin group (U group) using a random number table,with 30 patients in each group.Ulinastatin 12 000 U/kg (in 100 ml of normal saline) was infused intravenously at 20 min before occlusion of hepatic portal in group U,and normal saline 100 ml was given instead in group C.Before operation,at 10 min after occlusion of hepatic portal,at 20 min and 1 h after unclamping hepatic portal and at 12 h after operation,blood samples were collected from the right internal jugular vein for determination of the levels of serum alanine aminotransferase,aspartate aminotransferase and malondialdehyde.Results Compared with group C,the levels of serum alanine aminotransferase,aspartate aminotransferase and malondialdehyde were significantly decreased at 20 min and 1 h after unclamping hepatic portal and 12 h after operation in group U (P＜0.05).Conclusion Ulinastatin can attenuate hepatic ischemia-reperfusion injury in patients with hepatic alveolar echinococcosis in plateau region.

Objective To investigate the protective effect of trichostatin-A (TSA) on cerebral ischemia/reperfusion injury via Janus kinase/signal transducer and activator of transcription (JAK/STAT) signal pathway.Methods 36 male SD rats were randomly (random number) divided into 3 groups:shamoperated group,ischemia/reperfusion (I/R) group and TSA group.Rat model of middle cerebral artery occlusion/reperfusion (MCAO) was established using a modified filament method.No occlusion was applicated to the sham-operated group.TSA group was injected with TSA 0.05 mg/kg via penile vein,20 minutes before operation.Reperfusion was carried out 24 hours after modeling.Longa 5 score was used to assess the neurological function,and TTC staining was applied to calculate the percentage of cerebral infarction area,The expression of JAK2 and p-JAK2 proteins was detected by Elisa.Results The low expression of JAK2 was observed in each group,and there was no statistical difference between groups (P =0.266).Compared with I/R group,TSA group had lower score in cerebral ischemia-reperfusion injury assessment (P=0.019),smaller area of cerebral infarction (P ＜0.01),reduced expression of p-JAK2 (P =0.009),all of which were of significant difference.Condusions TSA can reduce the cerebral ischemia/reperfusion injury via JAK/STAT signal pathway by down regulating p-JAK2 expression.

Translational medicine, a kind of medical scientific practice oriented by patients'demands, emphasizes that basic theoretical study helps enhance clinical effect, transform into new drugs as well as meet major needs of social development and human health. It follows disciplinary development rules of TCM, persists in five-in-one (theory-clinic-new drug-experiment-evidence based) innovative new mode of TCM translational development, accelerates internal transformation of research findings, and promotes clinical effect and disciplinary development driven by the oretical innovation of collateral disease. In terms of the oretical research, establishment of new discipline of TCM collateral disease theory has become a practitioner and typical representative for promotion of TCM industry development. Important position and guiding role of theoretical innovation in disciplinary development has been valued. Systematically constructing ″collateral disease treatment based on syndrome differen?tiation″ and ″meridian-collateral theory″ lay a theoretical foundation for establishment of the discipline. With regard to clinical research, under the guidance of TCM theory-collateral disease theory, systematic researches on Chinese medical pathogenesis, intervention strategy and effective formula of major diseases are conducted; series of innovative Chinese medicines are developed. Through pharmacody?namics study, relevant action mechanisms are investigated and revealed in- depth. Evidence- based medical researches prove that representative activating-collateral drugs developed under guidance of collateral disease theory have great application values in prevention and treatment of major refractory diseases such as ischemic cardio-cerebrovascular disease, arrhythmia, chronic heart failure, influenza, tumors and diabetes, bringing about significant economic and social benefits. In this way, international cooperation is promoted and internationalization process of innovative Chinese medicine is accelerated. USA FDA phase-Ⅱ clinical research of Lianhua Qingwen Capsules has been successfully launched. Guided by inheritance and innovation of conventional theory of TCM, the new five- in- one mode of development is established. Such a mode conforms to disciplinary development rules of TCM, suffi?ciently exerts core driving effect of TCM theory, realizes combination of theoretical innovation with clinical practice, specialty construction with disciplinary development and clinical research with original new drug, as well as powerfully promotes progress of TCM collateral disease discipline.

Objective To investigate the effect and significance of hyperbaric oxygenation in down-regulation of platelet membrane glycoproteins CD31 and CD62p in rats of traumatic brain injury (TBI).Methods Fifty-six SD rats were randomly distributed into TBI group,hyperbaric oxygenation group,and sham group by the lottery method.Furthermore,TBI group and hyperbaric oxygenation group were subgrouped at 6,48,and 96 hours.There were 8 rats per group.The rat models of severe TBI were induced by lateral fluid percussion.Levels of CD31 and CD62p were measured in all groups by flow cytometry.Results At 6,48 and 96 hours,expressions of CD31 (30.8 ± 8.9,32.5 ± 9.2 and 29.0 ±5.0) and CD62p (34.5 ±9.1,33.9 ±7.5 and 30.4 ±6.4) in TBI group were significantly higher than those (18.9-± 5.5,19.5 ± 6.1) in sham group (P ＜ 0.05).At 96 hours,expression of CD31 (22.7 ±5.5) in hyperbaric oxygenation group was significantly lower than 29.0 ± 5.0 in the TBI group (P ＜0.05).At 48 and 96 hours,expressions of CD62p (26.1 ± 5.8,23.6 ± 5.7) in hyperbaric oxygenation group were significantly lower than 33.9 ± 7.5 and 30.4 ± 6.4 in TBI group (P ＜ 0.05).Conclusions Platelet activation is enhanced in the acute phase after TBI.But platelet activation may be relieved with hyperbaric oxygenation,which is conducive to inhibiting microthrombosis and mitigating secondary brain injury after TBI.

Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; microbiology ; prevention & control ; Mycoses ; diagnosis ; prevention & control