Objective:To observe the effects of auricular point sticking on pain and anxiety during the latent period of the first stage of labor in primiparas. Methods:Primiparas meeting eligibility criteria were recruited.The participants were randomized into an auricular point group,a placebo group,and a control group.The control group received daily care.The auricular point group received 120 min of auricular point sticking therapy.The placebo group received the same auricular plasters as the auricular point group but without pressing.Participants'pain,anxiety,and uterine contractions were measured at enrollment and 30,60,and 120 min of interventions. Results:Data from 78 participants were analyzed in this study.After uterine contraction was adjusted as a covariate,there was no significant difference among groups in the baseline anxiety,baseline pain,and anxiety at 30-min intervention(P>0.05),and no significant difference between the placebo group and the control group in each indicator at each time point(P>0.05).The anxiety scores of the auricular point group at 60 min and 120 min were lower than those of the placebo group and the control group(P<0.05).The pain in the auricular point group was less than that in the placebo group and the control group at 30,60,and 120 min of interventions(P<0.05). Conclusion:Auricular point sticking therapy can relieve anxiety and pain in women during the latent period of labor.Moreover,the effect is fast-acting.It can be used as a safe and effective complementary therapy.

Heart Diseases ; genetics ; Humans ; Proteomics

Objective To investigate the mutations of CLCNKB gene in a family with classic Bartter syndrome. Methods Genetic DNA was extracted from peripheral blood leucocytes of family members.The coding exons and intron exon junctions of CLCNKB gene were amplyfied by PCR and sequenced directly.Fifty unrelated healthy subjects were selected to exclude the possibility of polymorphism. Results A heterozygous(missense)mutation(482T>G,L161R)was detected in the exon 4 of patients.The hetemzygous mutation(L161R)was found in the mother,while no mutation was found in the father of this family.L161R had not been reported and was a novel mutation when referring to literatures and human genomic database home and abroad.Conclusion A new CLCNKB gene mutation(L161R)is identified for the first time.

Objective To systematically evaluate the application of problem-based learning (PBL)in the teaching process of health management major in China.Methods Databases including CNKI (1979 to December the 2015),VIP (1989 to December the 2015),Wanfang (1982 to December the 2015) and PubMed were systematically retrieved.Any literature about PBL of health management major was included.Seffdeveloped data extraction form was used for collecting the information.Data were input and analyzed using Excel 2007.Results 15 papers were included in the analysis.The first author mainly came from the northeast region of China (7).Most (10) papers did not get the funding support.No paper was published in the journals contained in the Guide to the Core Journals of China.6 papers of experimental studies compared the performance difference of students of the PBL and lecture-based learning (LBL),which was statistically significant.Conclusion PBL is superior to the LBL.However,due to the large difference in the quality of literature,more studies were needed to determine the effect of PBL.Moreover,we should pay attention to the combination of PBL and LBL.

Objective To investigate the application value of DWI based on biexponential signal decay model with extended b-fac-tor range in differential diagnosis of benign and malignant breast lesions.Methods A total of 57 patients with breast tumor under-went DWI based on the biexponential model with 12 b-factors (0,10,20,50,100,200,400,600,800,1000,1 200 and 1 500 s/mm2 ), including benign lesions in 1 9 patients (24 breast tumors,defined as benign group)and malignant ones in 38 (47 tumors,defined as malignant group ).The values of slow apparent diffusion coefficient,fast apparent diffusion coefficient and fraction of fast ADC of le-sions were measured at a workstation (Advantage Windows 4.5).Differences in these parameters between the benign and malignant groups were compared.Results The ADCslow,ADCfast and ffast were(1.434±0.291)×10 -3 mm2/s,(2.744±0.050)×10 -3 mm2/s and (0.677±0.130)% in benign group,and (0.614±0.196)×10 -3 mm2/s,(2.692±0.068)×10 -3 mm2/s and (0.446±0.112)% in malig-nant one,respectively.The statistical differences in ADCslow and ffast were found between two groups (P <0.05),whereas no difference in ADCfast was found.Conclusion Biexponential signal decay model of DWI with extended b-factor range can provide helpful tissue characterization parameters for the differential diagnosis of benign and malignant breast lesions.

Objective To investigate the effect of preoperative oral midazolam on emergence agitation after sevoflurane anesthesia in children.Methods Sixty children,34 males,26 females, aged 2-7 years,ASA grade Ⅰ or Ⅱ,receiving sevoflurane for tonsillectomy/adenoidectomy were ran-domly divided into low dose midazolam group (group M1),high dose midazolam group (group M2) and control group (group C)(n=20 each).The 5 ml mixture of midazolam 0.5 mg/kg,0.75 mg/kg and 10% glucose was taken orally 30 min before anesthesia in group M1 and group M2,respectively. While 5 ml of 10% glucose was given in group C.Anesthesia was induced with inhalation of 8%sevoflurane and maintained with intravenous infusion of remifentanil and inhalation of sevoflurane. Scores of parental separation anxiety scale(PSAS),pediatric anesthesia emergence delirium scale (PAED scale),FLACC scale were compared.Times to extubation and discharge from PACU were al-so recorded.Results Group C showed significantly higher incidence of separation anxiety(P <0.05). The incidence of emergence agitation,peak PAED scores,FLACC scores,time to extubation were similar among three groups.Discharge time from PACU was longer in group M2 (P < 0.05). Conclusion Preoperative oral midazolam 0.5 mg/kg or 0.75 mg/kg can effectively reduce parental separation anxiety.This,however,dose not result in a reduced incidence of emergence agitation after sevoflurane anesthesia.Midazolam 0.75 mg/kg can extend the discharge time from PACU.

Objective To explore the genetic prenatal diagnosis method for acbendroplasia (ACH).Methods During May to November 2007, three ACH pedigrees were diagnosed at the Prenatal Diagnosis Center, Department of Obstetrics and Gynecology, Affiliated Drum Tower Hospital of Medical College, Nanjing University. In family 1, there was a 6-month-old male ACH infant. In family 2, the expectant mother, with 18 weeks of pregnancy, was an ACH patient. Amniocentesis was performed for prenatal diagnosis. The fetus of family 3 was diagnosed as ACH by ultrasound examination on the 39th week of gestation. Umbilical cord blood of this fetus was collected for examination. Totally, three methods, restriction enzyme (Sfc Ⅰ and Msp Ⅰ ) digestion analysis, denaturing high performance liquid chromatography (DHPLC) and sequencing analysis were performed simultaneously to detect the pathogenic mutation of flbroblastic growth factor receptor 3 (FGFR3) for the three ACH families. Results ( 1 ) The DHPLC detection: heteroduplex was detected in the patient of family 1 ; beth the patient and the fetus of family 2 showed heteroduplex results; the result of the fetus of family 3 was also heteroduplea. (2) The enzyme digestion analysis for the PCR products of 10 exon of FGFR3: after Sfc Ⅰ digestion, the PCR products of patients and the fetus of family 1 and 2 showed not only the band of 247 bp, but also bands of 162 bp and 85 bp. But their PCR products could not be digested by Msp Ⅰ , and it only showed the band of 247 bp. For the fetus of family 3, the PCR products could not be digested by Sfc Ⅰ , while after digestion by Msp Ⅰ , bands of 162 bp and 85 bp were shown up. The PCR products of the normal control could be digested by neither Sfc Ⅰ nor Msp Ⅰ. (3) The sequencing results: the heterozygote mutation of 1138 C→A was confirmed in the patient of family 1. The pregnant woman and her fetus in family 2 showed the same result. The heterozygote mutation of C→C was confirmed in the fetus of family 3. The site of 1138 was G homozygote in the normal control The three detection results of the fetus in family 2 were the same as that of the mother, which means that the fetus inherited the same pathogenic mutation from his or her mother. Conclusions Both DHPLC and restriction enzyme digestion analysis could detect the mutation of FGFR3 gene, but DHPLC is more rapid, convenient and sensitive. So DHPLC can be applied to genetic diagnosis and prenatal diagnosis for ACH patients.

Aim To observe the changes of diaphragm contractility and cytoskeletal proteins titin,nebulin and sarcoplasmic reticulum Ca~(2+)-ATPase gene expressions in adriamycin-induced cytotoxicity in rats.Methods The animal models of diaphragm damage were duplicated by injecting adriamycin into abdominal cavity one time.Forty male sprague-dawley rats were randomly divided into four groups(n=10):Three groups received adriamycin in low,middle and high dosage(10,20 and 40 mg·kg~(-1))respectively.Meanwhile,the normal saline was given to rats in control groups.Three days later,these rats were killed,and the diaphragm was removed by thoracotomy.The diaphragm contractility was assessed in isolated diaphragm strips perfusion by these paramemters including peak twitch tension(Pt),maximum tetanic tension(Po),time to peak contraction(CT),half relaxaion time(1/2RT),maximal rates of contraction(+dt/dt_(max))and maximal rates of relaxation(-dt/dt_(max)).The expressions of titin,nebulin and sarcoplasmic reticulum Ca~(2+)-ATPase(SERCA)at mRNA level were detected by RT-PCR analysis.Results In contrast to those in control group,Po,Pt,±dt/dt_(max) in the adriamycin group were lower(P<0.01);CT,1/2RT in the adriamycin group increased significantly(P<0.01).The levels of titin,nebulin and SERCA gene expressions in middle-dose group were lower than those in control group(P<0.01).Conclusions The mRNA levels of titin,nebulin and SERCA of diaphragm are down-regulated in adriamycin-induced cytotoxicity in rats.It may be associated with the decline of diaphragm contractility.

Objective To calibrate the dose of 12MeV high-energy electron for Siemens MD7745 medical linear accelerator.Methods The international protocols,contents and technical standards were expatiated.Some existing problems in dose calibration of high-energy electron were analyzed.Results The working precision met the requirement of quality assurance in radiotherapy by WHO.Conclusion In order to improve the therapeutic effect,the dose must be calibrated,and the error in dose calibration of high-energy electron should be reduced to the lowest.

OBJECTIVE To investigate the clinical characteristics,risk factors and preventive measures for nosocomial pneumonia in patients with post-hepatitis liver cirrhosis.METHODS A prospective and retrospective study was carried out to investigate the clinical data of 495 patients with post-hepatitis liver cirrhosis in Department of Infectious Diseases during Jan 1,2005 to Dec 31,2007.RESULTS The incidence rate of the nosocomial pneumonia in post-hepatitis liver cirrhosis patients was 13.50 %.The death rate was 25.40 %,which was obviously higher than 6.8% of patients without no nosocomial infection(?2=23.77,P