Objective To determine whether it is necessary to execute pre-labor pubic shaving.Methods Women(336 cases)who received pubic shaving through vaginal delivery from 2003 to 2006 were set as the control group.Women(103 cases)who were waiting for delivery currently in our hospital were set as the test group.The test group only received perineal cleaning without pubic shaving.If episiotomy was needed during the operation,the perineal hair Was cut by scissors.The perineum infectious rate and postpartal infection Was compared in the two groups.We interviewed the patients attitude for pubic shaving and counted the numing time used for pubic shaving.Results The perineal infection in the test group was 5.8%,which was no statistically different from that of the control group(2.4%),U=0.33,P＞0.05.Totally 95% women in the test group support this method demonstrated humanization.In the telephone folow-up visit for patients in the control group they comphined itch and discomfort during the regeneration of pubes.The average numing time for pubic shaving Was(4.6±0.6)minutes.Conclusions No pubic shaving for pre-labor skin preparation was feasible.If operation was disturbed by pubes we could use scissors to cut it short.This method could reduce the skin infection and propagation of blood-derived infectious disease.It increased the comfort of parturient,saved time and proved to be a nursing method of humanization.

Objective To investigate the relationship between diabetes and bone metabolism and the potential epigenetic mechanisms. Methods BMSCs were cultured for 7 and 15 days in cell culture medium with different concentrations of glucose. The mRNA and protein expression of HDACs and osteogenesis-related genes were detected by RT-PCR and Western blot assay ,respectively. Moreover ,the combination of HDAC to the promoter region of Runx2 was tested by the chromatin immunoprecipitation (ChIP) assay. Results ThemRNA expression of osteogenesis-related genes ,incuding OCN(P < 0.05)and Col1(P < 0.05),in the bone marrow of diabetic mice was significantly reduced compared with the control mice. The mRNA and protein expression of ALP ,OCN ,Runx2 and OSX was gradually reduced with the increasing concentration of glucose ,while HDAC2 mRNA and protein expression was increased. The binding activity of HDAC2 to the upstream and downstream of Runx2 promoter region in 25mM glucose-treated BMSCs was higher than the control group(P < 0.05). Conclusoins Diabetes might repress osteogenesis of BMSCs via inhibiting the activity of Runx2 through upregu-lating the expression of HDAC2.

Objective To explore the feasibility and safety of dexmedetomidine sedation in interventional neuroradiology operations.Methods Eighty-five cases ASA grade Ⅱ-Ⅲ grade patients undergoing cerebral angiography according to age divided into two groups:old group(more than 60 years old,35 cases) and young group (18-59 years old,50 cases).The loading dose of dexmedetomidine were dexmedetomidine 0.5 μ g/kg in old group and 1.0 μ g/kg in young group,respectively.The loading dose was administered for 10 min followed by continuous infusion dexmedetomidine 0.5 μ g/ (kg· h).Blood pressure,heart rate (HR),peripheral oxygen saturation (SpO2) and respiratory rate (RR),Ramsay score and bispectral index(BIS) were monitored and recorded during the study.Results The BIS,Ramsay score after administration 10,15,30,45 min in two groups was significantly longer than that before administration [old group:84 ±22,83 ±22,85 ± 15,75 ±23 vs.94 ±5; (2.0 ±0.4),(2.3 ±0.6),(2.8 ±0.7),(3.0 ±0.7)scores vs.(1.7 ± 0.5) scores; young group:91 ± 8,89 ± 11,86 ± 12,81 ± 13 vs.96 ± 2; (1.9 ± 0.6),(2.3 ±0.7),(2.7 ± 0.9),(3.0 ± 0.9) scores vs.(1.6 ± 0.5) scores,P ＜ 0.05].The systolic blood pressure,diastolic blood pressure,mean arterial pressure (MAP) after administration 10,15,30,45 min in two groups was significantly longer than that before administration [old group:(152 ± 23),(144 ± 23),(140 ± 21),(135 ±21) mm Hg(1 mm Hg =0.133 kPa) vs.(165 ± 25) mm Hg; (87 ± 11),(83 ± 11),(78 ± 8),(75 ± 8) mm Hg vs.(89± 13)mm Hg;(106±14),(100±13),(99±12),(95±12)mm Hg vs.(113±16)mm Hg;young group:(131 ± 24),(127 ± 23),(124 ± 25),(124 ± 26) mm Hg vs.(142 ± 23) mm Hg; (81 ± 13),(79±13),(77±13),(76±13)mmHgvs.(86± 14) mmHg;(97±16),(94±16),(91±19),(92±20) mm Hg vs.(104 ± 19) mm Hg,P ＜0.05],but the decreases in blood pressure were ＜20％ from baseline.The HR,RR and SpO2 was no significant difference (P ＞ 0.05).Conclusions Continuous infusion of dexmedetomidine sedation during cerebral angiography has little effect on hemodynamics,no significant respiratory depression,is safe and effective.

Objective Adenosine receptor agonist NECA has a certain myocardial protection, but the specific mechanism is not clear.This paper aimed to study the effect and mechanism of NECA inhibiting endoplasmic reticulum stress to against myocardial ischemia reperfusion injury in rats.Methods 56 Wistar rats of SPF grade were selected and divided into Sham group, I/R group, NECA group and TUDCA group through random number table method.We established the isolated rat heart ischemia reperfusion model by using the Langendorff device.Sham group: heart threaded but not ligated, Kerb-Henseleit buffer continuous infusion 170min;I/R group: heart stability 20min, ischemia 30min, reperfusion 2h;NECA group and TUDCA group: heart stability 20min, ischemia 30min, reperfusion 2h, perfusion solutions containing 0.1μmol/L NECA and 30μmol/L TUDCA were respectively given at 5min before reperfusion, and ended at 30min after reperfusion.Transmission electron microscope was used to evaluate alterations of the myocardial ultrastructures.Western blot analysis was used to detected the expression levels of endoplasmic reticulum stress IREl-XBPl signaling pathway marker protein IRE1α, XBP1s.Immunohistochemical staining was used to detect the expression of IRE1α.Results The results of transmission electron microscopy showed that most of the myofilament ruptured, sarcomere contracture deformation, visible mitochondrial vacuoles degeneration in I/R group, and injury in NECA group and TUDCA group were less than the I/R group, appeared as the filaments arranged more neat, sarcoma only had mild contracture.Immunohistochemical results showed that IRE1αpositive staining was not found in the sham group, and the area of positive staining of IRE1α in I/R group was significantly increased, while the NECA group and TUDCA group were significantly decreased.Compared to the Sham group, the expression level of IRE1α and XBP1s was significantly increased in I/R group(P<0.05);but compared with the expression level of IREα and XBP1s in I/R group(1.72±0.27, 0.97±0.19), the NECA group(1.14±0.16, 0.6±0.13) and the TUDCA(1.07±0.27, 0.58±0.15) group were significantly decreased(P<0.05).Conclusion NECA can reduce endoplasmic reticulum stress through inhibiting IREl-XBPl pathway to protect the myocardium.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Catgut ; Female ; Humans ; Male ; Middle Aged ; Phlebotomy ; Trigeminal Neuralgia ; therapy

This paper introduced and analyzed the unique geographical location and diverse climatic conditions in the yunnan region, its rich reservation of regional medical plant resources, and the local history, doctors, literatures and medical schools of Traditional Chinese Medicine (TCM). Besides, we combined the characteristics with the current national development strategy "The Belt and Road Initiative" , "cultural soft power" and the Yunnan’s development strategy "big health industry" and "healthy life destination" . This paper discussed the current situation and development prospect of the international development of TCM in Yunnan and the results helped to provide suggestion for the internationalision of TCM in Yunnan.

ObjectiveTo investigate the effect of clinical pathway teaching methord in nursing practice teaching. Methods80 junior college nursing students were randomly divided into control and experimental groups. Traditional clinical teaching method was given to control group, while the clinical pathway teaching method was given to observation group. Scores of comprehensive quality after departmental rotation and satisfaction rates of nursing students to teaching method in these two groups were evaluated. ResultsThe experimental group was significantly better than the control group ( P＜0.05 ), and the difference was statistically significant. ConclusionThe clinical pathway can significantly improve the quality of nursing practice teaching.

Endotoxins are lipopolysaccharides ( LPS) , major component of out wall in Gram-negative bacteria. Often they are considered as "prime criminals" of triggering systemic inflaming reaction such as sepsis, bacteremia and so on. It was found in recent years that bactericidal/permeability-increasing protein, a 55kDa member of lipid-related protein family, was a kind of natural molecule of anti-infection and it has special endotoxin-neutralising activity and antibacterial activity. Comprehensive phase II/III clinical trials demonstrated the feasibility and safety of recombinant BPI. So pharmaceutical corporations are attracted to try to apply it to therapy.

The teaching method, teaching process and teaching model of programming course were reformed in Beijing University of Traditional Chinese Medicine by combining task-driven and flipped classroom teaching con-cept with BB network platform to provide a free and open environment for students in order to train their capability of analyzing and solving problems and the skills of independent learning and life-long learning. Good results were achieved in two rounds of task-driven plus flipped classroom teaching, which are of significance for the teaching model and teaching structure reform of other courses.

Objective To investigate the surgical efficacy for the treatment of ruptured anterior communicating artery aneurysms with different dome projections in acute phase via supraorbital lateral approach.Methods From January 2014 to March 2017,the clinical data of 79 patients with acute ruptured anterior communicating artery aneurysm with different dome projections in acute phase treated via supraorbital lateral approach in the First Affiliated Hospital of Soochow University were retrospectively analyzed.The operative efficacy was analyzed.The Glasgow outcome scale (GOS) score was used to evaluate the prognosis at 3-36 months after procedure.Results In the 79 patients,34 were superior dome projections,37 was inferior dome projections,and 8 were complicated dome projections.All the anterior communicating artery aneurysms were successfully clipped.The patients were followed up for 3-36 months after procedure.GOS showed good prognosis in 70 cases (88.6％),of which 26 were superior dome projections,36 were inferior dome projections,and 8 were complicated dome projections;9 suffered mild disability (11.4％),of which 8 were superior dome projections and 1 was inferior dome projection.There were no severe disability,persistent vegetative state,and death.The prognosis in patients with inferior dome projection was better than that of superior dome projection (97.3％ [36/37] vs.76.5％ [26/34]).The difference was statistically significant (χ2=5.19,P<0.05).Conclusions The lateral supraorbital approach is an effective option for treating ruptured ACoAA with different dome projections in acute phase.The prognosis in patients with inferior dome projection is better than that of superior dome projection.