Objective To observe and compare the efficacy and safety of chloroprocaine and ropivacaine for epidural labor analgesia.Methods 86 cases of voluntary acceptance of maternal painless natural childbirth were selected in the study.43 cases were given chloroprocaine epidural analgesia (chloroprocaine group),and the other 43 cases were given ropivacaine epidural analgesia (ropivacaine group).The pain (VAS score),lower limb motor block degree(MBS score),fetal heart rate(FHR) and contractions duration of maternal prenatal and medication immediately after 10min,20min,40min,80min were compared between two groups.The first,second and third stage of labor and fetal output after 1 min,5min,10min Apgar score were compared.The incidence of adverse events were observed.Results In the chloroprocaine group,the 10min VAS score was (2.10 ± 1.02),which was significantly lower than (4.31 ± 1.13) in the ropivacaine group (t =4.565,P ＜ 0.05).In the chloroprocaine group,analgesia 20min MBS score was (0.24 ± 0.03),which was significantly higher than (0.11 ± 0.04) in the ropivacaine group (t =4.126,P ＜ 0.05).In the chloroprocaine group,4 cases occurred nerve injury,which was more than the ropivacaine group (1 case),the difference was statistically significant (x2 =4.263,P ＜ 0.05).Conclusion Chloroprocaine and ropivacaine for epidural labor analgesia have superior efficacy and the clinical efficacy is similar.Chloroprocaine has the advantage of quick results,but the medication about 20min time period that the drug might lead to a greater degree of lower limb motor block,and has the risk of nerve injury,pregnant women can choose according to their medication.

Objective To investigate the distribution and drug resistance of clinical common isolated bacteria from our hospital in 2013.Methods The antimicrobial susceptibility testing was carried out by using the automated systems with the MIC method and Kirby-Bauer method.The WHONET 5.6 software was adopted to conduct the data analysis according to the CLSI standard in 2013 version.Results A total of 4 168 strains of bacteria were clinically isolated in 2013,in which Gram-positive bacterial strains ac-counted for 21 .8%(907/4 168)and Gram-negative bacterial strains for 78.2%(3 261/4 168).The prevalence of methicillin-resist-ant strains in S.aureus and coagulase negative staphylococcus was 48.7% and 80.9% respectively.No staphylococcal strain with resistant and intermediate to vancomycin and linezolid was found.Penicillin-resistant S.pneumonia strain was not found.And 1 strain of vancomycin- resistant E.faecium was found.The prevalence of ESBLs - producing strains was 58.8% in E.coli and 35.8% in K.pneumonia.Non-fermentative bacilli accounted for 37.5% in all bacterial isolates.The percentage of P.aeruginosa re-sistant to imipenem and meropenem was 19.3% and 14.2% respectively,the percentage of A.baumannii resistant to imipenem and meropenem was 68.9% and 67.0% respectively.Conclusion The isolation rate of non-fermentative bacilli is increased,the drug re-sistance rate of P.aeruginosa and A.baumannii is declined than that in 2012.Strengthening the surveillance of bacterial drug resist-ance in hospital has important significance for guiding rational selection of antimicrobial agents in clinic.

Hospital-acquired pneumonia (HAP) is a very common complication in patients with neurological diseases.Its incidence and mortality are very high and result in a prolonged hospital stay and an increase in hospitalization costs.Therefore,how to effectively prevent HAP has become the focus of attention by neurologists.There are many risk factors for HAP,such as advanced age,conscious disorders,dysphagia,body position,oropharyngeal colonization,mechanical ventilation,enteral nutrition,and stress ulcer prevention drugs,etc.Clearing the risk factors for HAP and taking appropriate measures to strengthen protection may reduce the occurrence of HAP and improve the prognosis of patients.

Objective To study the efficacy of recombinant human thrombopoietin (rhTPO)for the treat-ment of chemotherapy -induced thrombocytopenia with leukemia.And to explore its security.Methods 80 thrombo-cytopenia of acute leukemia after chemotherapy were selected.All patients were randomly divided into the research group and the control group according to the single and double of order registration number in clinic,40 cases in each group.The control group was treated with recombinant human interleukin -11 (rhIL -11),the research group was applied rhTPO treatment.The platelet (PLT)level of two groups,and other indicators of change were detected,and adverse reactions were observed.Results PLT resuming maximum value of the research group was (217.4 ±52.7) ×109 /L,which was significantly higher than the control group,the difference was statistically significant (t =15.63, P <0.05).The time of PLT recovery to 100 ×109 /L of the research group after chemotherapy was (15.6 ±3.6)d, which was significantly lower than the control group,the difference was statistically significant (t =10.72,P <0.05). The adverse reactions incidence of the research group was 12.5%,lower than 35.0% of the control group,the differ-ence was statistically significant (χ2 =9.87,P <0.05).Conclusion The treatment effect of RhTPO for thrombocy-topenia of the acute leukemia after chemotherapy is better than that of rhIL -11,can significantly improve the throm-bocytopenia,and has less adverse reaction and higher security.It is worthy of clinical popularization and application.

Physical activity is limited in maintenance hemodialysis (MHD) patients, and higher level of physical activity may result in less risk of death, milder depression or ahypnosis, less fatigue and better quality of life. Physical activity may relate with many factors. MHD patients may be benefited from exercise to improve the physical activity, mainly with aerobic exercise and resistance training during hemodialysis. Nurses can do more in health education and direction of exercise for MHD patients.

Objective To investigate the effects of respiratory training on motor function in patients with acute stroke. Methods From 2012 to 2014, 80 patients with acute stroke were randomly assigned into treatment group and control group equally. The control group re-ceived routine rehabilitation training, while the treatment group received respiratory training in addition. All the patients were assessed with Fugl-Meyer Assessment (FMA) and modified Bathel Index (MBI) before and eight weeks after treatment. Results The scores of FMA and MBI improved more in the treatment group than in the control group (t>3.938, P<0.001) after treatment. Conclusion Respiratory training may promote the recovery of motor function in acute stroke patients.

Objective To explore the curative effect and prognosis of traditional Chinese medicine combined with western medicine in the treatment of silicosis patients.Methods 74 patients with silicosis were selected as the research subjects.According to the admission time,the patients were divided into the observation group and the control group,37 patients in each group.The control group was treated with conventional western medicine,the observation group was given the combined treatment of traditional Chinese medicine and western medicine.The clinical curative effect,pulmonary function index,symptoms improved time and the reduce of lung shadow were observed and compared.Results The reduction rate of lung shadow in the observation group was 75.67％,which in the control group was 62.16％,there was statistically significant difference between the two groups (u =2.419,P =0.015).The total effective rate of the observation group was 86.49％,which of the control group was 67.57％,there was statistically significant difference between the two groups (u =2.116,P =0.034).After treatment,the vital capacity (VC),forced vital capacity(FVC) and the first second forced expiratory volume (FEV1) in the observation group were (69.15 ± 18.34)％,(71.08 ± 16.93)％,(68.91 ± 18.75)％,respectively,which in the control group were (63.37 ± 20.53) ％,(63.13 ± 18.69) ％ and (55.47 ± 17.58) ％,respectively,which in the two groups were higher than those before treatment,which in the observation group increased significantly,there were statistically significant differences between the two groups (t =6.778,P =0.000,t =8.836,P =0.000,t =10.133,P =0.000).The wheezing,cough,pulmonary rales and other symptoms improved time in the observation group were shorter than those in the control group,the differences were statistically significant (t =8220,P =0.000,t =6.836,P =0.000,t =6.909,P =0.000).Conclusion Traditional Chinese medicine combined with western medicine in the treatment of silicosis has higher reduction rate of lung shadow,lung function improved significantly,shorter improved time of cough,wheezing and other symptoms,its curative effect is better than western medicine.

Th17 lymphocytes have been recently identified as a novel subset of CD4+ cells. It has been defined that IL-17,the main product of Th17, plays an important role in immunity against parasitic infection. There is a two-way influence between Th17 and cytokine network: on one hand Th17 consummates cytokine network, on the other hand many cytokines regulate Th17's activity in parasitic infection. In the anti-parasitic infection process, Th17 cells protect host or promote inflammation, even cause immune pathogenesis in different cases, which comprise host's immune state, the burden of parasitic infection, as well as the treatment.

ObjectiveTo investigate the effect of preoperative sleep disturbance on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.MethodsNinety-six ASA Ⅰ or Ⅱ patients of both sexes aged 20-60 yr weighing 50-80 kg undergoing endoscopic nasal surgery were enrolled in this study.Pittsburg sleep quality index was used to evaluate long-term sleep quality before hospitalization and Athens sleep quality index was used to evaluate short-term sleep quality in hospital.The patients were divided into 4 groups according to the types of preoperative sleep disturbance ( n =24 each):group Ⅰ no sleep disturbance;group Ⅱ long-term sleep disturbance; group Ⅲ acute short-term sleep disturbance; group Ⅳ long-term + acute short-term sleep disturbance.Anesthesia was induced with sufentanil,propofol and cis-atracurium and maintained with iv infusion of remifentanil and propofol.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 30-35 nun Hg.Controlled hypoteasion was performed with nicardipine,MAP was maintained at 50-70 mm Hg and HR at 60-90 bpm during operation.The patients received iv flurbiprofen 50 mg at 15 min before the end of operation for postoperative analgesia.When VAS score was more than 3 during the fnrst 6 h after operation,flurbiprofen 50 mg was given iv as rescue analgesic.ResultsThe incidence of rescue analgesic administered after operation was significantly larger in groups Ⅱ,Ⅲ and Ⅳ than in group Ⅰ,and in group Ⅳ than in groups Ⅱ and Ⅲ.There was no significant difference in the incidence of rescue analgesic administered during the first 6 h after operation between groups Ⅱ and Ⅲ.ConclusionPreoperative sleep disturbance has adverse effect on the efficacy of flurbiprofen for postoperative analgesia in patients undergoing endoscopic nasal surgery.

The fast transmission and large range of emergence of infectious diseases jeopardize human health, social and economic development, which is a great threat to global public health. World Health Organization for the new features of infectious diseases on theInternational Health Regulations was revised to help member countries improve the ability to respond to public emergencies. Our government promptly revised theCommunicable Disease Prevention Act, enacted a series of laws and strategies to promote the establishment of infectious disease surveillance and response systems. Chinese medicine was included in the country infectious disease prevention and control system. After nearly 10 years of development, the prevention and treatment of Chinese medicine on emergence of infectious diseases, the clinical medicine and research capacity of respond infectious diseases has been significantly improved, and become an important part of our system of infectious disease prevention and control.