ObjectiveTo analyze the impact of combined use of motherwort injection with oxytocin on hemorrhage in cesarean section and postoperative stage.Methods512 pregnant women after processing cesarean section were randomly divided into an experimental group (n=256) and a control group (n=256).The experimental group used motherwort injection and oxytocin,and the other group only used oxytocin.Intraoperative and postoperative bleeding and adverse drug reactions were observed.ResultsBleeding volume in the experimental group was less than the control group [ (210.43 ± 50.38)ml,(35.84 ±29.24)ml,(61.62 ±35.32) ml vs (234.14 ±16.91) ml,(52.37 ± 32.15) ml,(86.18 ± 36.67) ml],P＜0.05).There were no significant adverse reactions.ConclusionMotherwort injection and oxytocin used together can be more effective in reducing bleeding in cesarean section and postoperative stage.

Objective To study the chemical constituents from alcohol extract and water extract in Lepidozia vitrea in order to find out their bioactive compounds.Methods The chemical constituents were isolated by various column chromatographic methods and the structures of the compounds were elucidated by spectral analysis.Results Six compounds were obtained and their structures were identified as phytol (Ⅰ),7-hydroxycalamenene(Ⅱ),daphnetin(Ⅲ),and daucosterol(Ⅳ) from the alcohol extract,D-glycero-D-galacto-heptitol(Ⅴ) and D-erythro-L-galacto-octitol(Ⅵ) from the water extract.Conclusion Compounds Ⅰ-Ⅵ are isolated from this plant for the first time.

Objective To study the diagnosis and treatment of restless legs syndrome(RLS)in the elderly.Methods The diagnosis of RLS was based on criteria proposed by the International Restless Legs Syndrome Study Group.Ten elderly patients with RLS were enrolled in the research. The clinical presentation and treatment results were analyzed retrospectively.Results All 10 patients were complained of compelling urge to move their limbs.The sensory symptoms were involved in the 4 patients' legs,involved both arms and legs in another 5 patients.It occurred unilaterally in the left of I patient.All patients complained of syndromes aggravated in the night, other three patients also had distinct syndromes in the daytime.Three patients had family history of RLS.The unpleasant sensations were partially or totally relieved by movement.Neurophysiological tests in 5 patients were normal.The iron deficiency occurred only in 1 patient with low serum ferritin and iron levels,Rebound and augmentation were observed in 1 patient in the course of three years treatment with Sinemet.All patients administered a dopamine receptor agonist(pergolide)and showed positive results.Oral administration of iron improved RLS symptoms in a patient with iron deficiency. Conclusions The diagnosis of RLS is usually based on the patient's clinical presentation,which has characteristic feature in the elderly.Rebound and augmentation are serious side-effects in the course of long-term treating with L-DOPA.Therapy of RLS with dopamine receptor agonists is firstly chosen.

AIM:To observe and analyze visual quality changes of the patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection, including the change of the best corrected vision acuity ( BCVA ) , total high- order aberration ( tHOA ) , and the modulation transfer function ( MTF) .
METHODS:In this prospective observational study, 100 cases of patients ( 100 eyes ) with posterior cataract underwent Nd:YAG laser posterior capsular dissection ( posterior capsular diameter dissected was 5mm or higher). The mean age was 65. 52±7. 01 years old. The change of the BCVA was collected. The tHOA and MTF under the 3mm and 5mm pupil diameter were assessed by iTrace respectively before and after Nd:YAG laser posterior capsular dissection.
RESULTS:All the surgery went well without obvious intraoperative and postoperative complications happened. The preoperative BCVA was 0. 451 ± 0. 023 while the postoperative BCVA was 0. 763±0. 025. The difference of BCVA before and after Nd: YAG laser surgery was statistically significant (P<0. 01). At 3mm pupil diameter, the tHOA preoperative was 0. 551 ± 0. 031 while the postoperative tHOA was 0. 214± 0. 011, the differences were significance (P<0. 05). At 3mm pupil diameter while the spatial frequencies ( 5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd ) respectively, the MTF tHOA value postoperative (0. 644±0. 023, 0. 49±0. 011, 0. 311±0. 015, 0.202±0. 018, 0. 056±0. 027, 0. 041±0. 011) were significantly higher than that preoperative (0. 401±0. 021, 0. 261±0. 026, 0. 179±0. 012, 0. 108±0. 014, 0. 031±0. 016, 0. 022±0. 021), and the difference has statistical significance (P<0. 05). At 5mm pupil diameter, the tHOA preoperative was 0. 752±0.028 while the postoperative tHOA was 0. 361±0. 014, the differences were significance (P<0. 01). At 5mm pupil diameter while the spatial frequencies ( 5cpd, 10cpd, 15cpd, 20cpd, 25cpd, 30cpd) respectively the MTF tHOA value postoperative (0. 426±0. 027, 0. 209±0. 018, 0. 172±0. 013, 0. 116±0. 015, 0. 049±0. 010, 0. 034±0. 014 ) were significantly higher than that preoperative (0. 234±0. 021, 0. 102±0. 019, 0. 088±0. 016, 0. 058±0. 022, 0. 021±0. 014, 0.016 ± 0. 011 ), and the difference had statistical significance (P<0. 05).
CONCLUSION: Patients with posterior capsule opacification ( PCO ) Nd:YAG laser posterior capsular dissection can help improve BCVA, reduce tHOA, increase MTF tHOA values, and significantly improve visual quality of patients.

Objective: To evaluate the effect of recombinant factor VIIa (rFVIIa) on the early recovery of patients undergoing cardiac valve replacement (CVR) under cardiopulmonary bypass (CPB). Methods: Twenty-two patients receiving CVR under CPB were randomized into rFVIIa (40 μg/kg) and placebo group. Patients in rFVIIa group received 40 μg/kg rFVIIa after protamine reversal of heparin and those in placebo group received placepo. Blood samples were collected before operation, after intra-operation heparinization, before protamine reversal of heparin, before and 15 min, 45 min, 2 h, 24 h, 120 h after application of rFVIIa for blood routine and coagulation analysis. Blood samples were also collected from the placebo group at the same time points. The postoperation thoracic drainage, postoperation blood transfusion, period of mechanical ventilation, period of ICU stay, and hospitalization costs were recorded and compared among all patients. Results: Patients in rFVIIa group had satisfactory hemostasis outcomes and there were no thrombotic complications, cardiac ischemic events, or death. The prothrombin time (PT) was (14.1±3.0) s 15 min after the rFVIIa injection,(13.5±1.7) s after 45 min, and (11.6±1.2) s after 2 h, all with significant differences when compared to those of the corresponding 3 time points in placebo group (P<0.01). The international normalized ratio (INR) was 1.05±0.26 15 min after rFVIIa injection, 0.93±0.16 after 45 min, and 1.04±0.19 after 2 h, all with significant differences when compared to those of the corresponding 3 time points in placebo group (P<0.01). The thoracic drainage, blood transfusion, period of mechanical ventilation, and the period of ICU stay were obviously decreased in rFVIIa group compared with those in placebo group; the hospitalization costs were similar in the 2 groups. Conclusion: rFVIIa can effectively improve the coagulation function in patients receiving cardiac valve replacement under CPB and reduce the need for blood transfusion, without significant adverse effect.

OBJECTIVE:To investigate the improvement effect of Prostatitis capsule on chronic non-bacterial prostatitis(CNP) model rats. METHODS:60 rats were randomly divided into sham operation group (distilled water),model group (distilled wa-ter),Pule'an tablet group(positive control,2 g/kg)and Prostatitis capsule high-dose,medium-dose,low-dose groups(16,8,4 g/kg). Except for sham operation group,other 5 groups were injected Xiaozhiling injection 0.2 mL to reduce CNP model. After 7 d of modeling,they received related medicines,ig,once a day,for 45 d. After 24 h of last administration,prostate lesions were ob-served by eyes and wet quality was weighed. White blood cell(WBC)count and lecithin body(SPL)count were conducted under microscope,and prostate tissue slices were pathologically observed. RESULTS:Compared with sham operation group,prostate showed gray nodules,adhesion in glands and surrounding tissue;wet quality of prostate and WBC,SPL count in prostate tissue were significantly increased(P<0.01);under microscope,there were significant congestion,edema and a variety of inflammatory cell infiltration in prostate interstitial. Compared with model group,gray nodules in prostate in Pule'an tablet group and Prostatitis capsule group were reduced,as well as adhesion degree in prostate and surrounding tissue;wet quality of prostate and WBC,SPL count in prostate tissue were significantly decreased(P<0.01);pathological changes had improved to varying degrees under micro-scope,especially the changes in Prostatitis capsule high-dose group,and prostate tissue only showed mild congestion,edema and little inflammatory cell infiltration. CONCLUSIONS:Prostatitis capsule has a certain improvement effect on CNP model rats.

OBJECTIVE:To establish the quality standard for Prostatitis capsules. METHODS:TLC method was performed to qualitatively identify Pseudostellaria heterophylla,Acortw tatarinowii,Sargentodoxa cuneata,Rubia cordifolia and Vaccaria segeta-lis in the preparation. HPLC method was adopted to determine the content of leonurine in the preparation. The determination was performed on Agilent Eclipse XDB-C18 column with mobile phase consisted of methanol-0.025 mol/L potassium dihydrogen phos-phate(pH adjusted to 2.5)(24 : 76,V/V)with phosphoric acidat the flow rate of 1.0 mL/min. The detection wavelength was set at 277 nm,and column temperature was 30 ℃. The sample size was 10 μL. RESULTS:The TLC spots of P. heterophylla,A. tatari-nowii,S. cuneate,R. cordifolia,and V. segetalis were clear and well-separated without interference from negative control. The lin-ear range of leonurine were 4.05-81.00 μg/mL(r=0.9999). RSDs of precision,stability and reproducibility tests were all lower than 2.0%. The recovery was 98.47%-103.83%(RSD=2.04%,n=9). CONCLUSIONS:Established standard can be used for quali-ty control of Prostatitis capsules.

Objective To explore the efficacy of laparoscopy in acute abdominal pain. Methods From March 2002 to March 2007,306 patients with acute abdominal pain were explored and treated by laparoscopy in our hospital. The patients were diagnosed with acute appendicitis in 105 cases,unidentified abdominal pain in 34,acute cholecystitis complicated with cholecystolithiasis in 64,gastrointestinal tract perforation in 51,common bile duct stones complicated with acute cholangitis in 5,intestinal obstruction in 33,and severe acute pancreatitis in 5; 9 patients were confirmed as having trauma. Results All the 306 patients were unequivocally diagnosed during the operation. Laparoscopy was successfully completed in 275 cases,including 123 cases of appendectomy,57 cases of cholecystectomy,48 cases of gastrointestinal tract perforation neoplasty,13 cases of enterodialysis,4 cases of intestinal replacement combined with indirect hernia repair,4 cases of radical resection of the sigmoid colon with precolon anastomosis,1 case of small-incision segmental resection of the small bowel,3 cases of common bile duct resection and calculus removal,2 cases of neoplasty for right-lobe hepatorrhexis,3 cases of haemostasis for splenic rupture,5 cases of debridement and clysis and drainage for severe acute pancreatitis ,and 12 cases of laparoscopic abdominal exploration (2 cases of mesentery contusion and laceration,1 case of abdominal wall punctured wound with contusion of the greater omentum,8 case of primary peritonitis,and 1 case of abdomen-type allergic purpura). The remaining 31 patients were converted to open surgery because of difficulties in laparoscopy. The patients were followed up for 1 to 18 months,during which no one showed intra-or post-operative complications.Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal pain with unknown causes,but also treat the cases simultaneously. Moreover,it is of great help in guiding abdominal resection and making a suitable operative incision,even if the patients can not be treated by laparoscopy alone.

Objective To explore advantages of combined laparoscopic surgery(CLS).Methods The clinical data of 728 cases of CLS from July 1992 to March 2006 were analyzed retrospectively,including 586 cases of laparoscopic cholecystectomy(LC) combined with fenestration drainage of hepatic cysts,80 cases of LC combined with appendectomy,46 cases of LC combined with oophorocystectomy,16 cases of LC combined with unroofing and drainage of renal cysts.Results 726 cases of CLS were successfully performed,and 2 cases were converted to open surgery for abdominal adherence,with no complications such as bile duct injury,hemorrhea,infection and death occurred.During a mean follow-up period of 16 months(range,2-60 months) in 512 cases,no biliary calculi,recurrence of liver,kidney and ovarian cysts occurred.Conclusions CLS for two kinds or more abdominal diseases in one operation is safe and effective,with advantages of minimal invasion,less pain,and quicker recovery and so on.

Optimization of sedation depth has become one of hot spots for critical care medicine research.Previous multiple studies have demonstrated that deep sedation is associated with poor outcomes in patients with mechanical ventilation.But unnecessary deep sedation remained not rare in our clinical practices owing to complex reasons (partially unknown).Maintaining light rather than deep sedation stragey for patients with mechanical ventilation,therefore,was highly recommended.Meanwhile,it was concerned that the depth of sedation was probably proscribed inappropriately in some of lightly sedated patients largely due to lack of well-predefined contraindications,which even likely increased risk of adverse events in our clinical practices.In addition,increasing publications updated the impacts of analgesia/sedation on immune,gastrointestinal and neural-muscular function in the patients with chronic critical illness,a highly concerned critically ill population.Based on available data,less sedatives and opioids were suggested for these patients.Moreover,eCASH concept,a patient-centered,adequate analgesia and light sedation based and humanistic care strengthened comprehensive management strategy was currently proposed to improve the long-term outcomes for patients with mechanical ventilation.It provided us valuable information,in either optimization of clinical practices or research interests,on promoting our medical behaviors and cognition in order to improve patient comfort,safety and clinical outcomes.However,future high-quality clinical researches are needed to verify its feasibility and validity.