Objective To investigate the analgesic effect of epidural labor analgesia with contin-uous background infusion and its impact on obstetric outcome.Methods This was a retrospective co-hort study.In the two months of march 2014 and march 201 5,503 nulliparas women who had re-ceived epidural analgesia for labor were enrolled and assigned to two different study groups according to their analgesic protocol.Two hundred and fifty-eight nulliparas in group C received only patient-controlled analgesia while two hundred and forty-five nulliparas in group P received patient-controlled analgesia with continuous background infusion.The basic and perinatal data of all enrolled nulliparas women were collected and analyzed to compare the analgesic effect and the impact on obstetric risk of two different analgesic protocol.Results The NRS pain score during the second labor stage was lower in group P [3 (3-4)scores vs.5 (4-5)scores](P <0.001).The second stage prolonged [50 (29-82) min vs.38 (24-62)min](P =0.001)and intrapartum hemorrhage increased [200 (100-250)ml vs. 1 50 (100-200)ml](P =0.003)in group P.There were no significant differences between the two groups with regard to the delivery mode (P =0.656)and the morbidity of postpartum hemorrhage (9.8% vs.10.9%,P =0.697).Analgesic protocol with background infusion was not associated with postpartum hemorrhage,instrumental delivery risk and cesarean risk.Conclusion Epidural labor an-algesia with continuous background infusion provided more effective analgesia in nulliparas,without additional obstetric risk.

ObjectiveTo explore the correlation of characteristic symptoms and indexes of brain collateral damageat acute stage of stroke.MethodsSeventy cases who got stroke within 72 hours were included.Five nonspecific symptoms and 6 indexes were observed at two time points.ResultsThere were positive correlations between the number of nonspecific symptoms and the value of Hs-CRP,IL-6,OX-LDL,NSE.The correlation coefficients were 0.307,0.289,0.342,0.253 and P＜0.05.Nonspecific symptoms appeared in 1 to 3 groups,altogether 40 cases were involved,and the groups had significant deviation compared with the groupwithoutnonspecificsymptomsonOX-LDL(32.37 ± 31.17)μg/l, NSE(2.82 ± 1.25)ng/ml,MMP-9 (214.97± 137.88) ng/ml and P＜0.05.Single symptom especially dull expression and hypersomnia were proved to be related with the indexes.For example,the correlation coefficient was 0.318 between hypersomnia and Hs-CRP.The correlation coefficient was 0.384 between dull expression and IL-6.Conclusion Characteristic symptoms were well correlated and ganged with the indexes from different view or level.It acted as representative combination of brain collateral damage syndrome.

Objective To discuss the relationship between pulse pressure and blood uric acid and the effect of simvastatin on pulse pressure and blood uric acid in aged primary hypertension (PH) patients with normal cholesterol.Methods Eighty-five patients with PH were divided into two groups randomly,routine group (using drugs only to lower blood pressure) and simvastatin group (simvastatin was added).Six months later,blood uric acid and pulse pressure was measured again.Results With the development of hypertension,there was statistical difference on pulse pressure and blood uric acid between hypertension grade 3 and grade 1 or grade 2 (P < 0.05).With the increase of pulse pressure,the trend of blood uric acid increase was distinct,and blood uric acid level was positively related with pulse pressure by correlation analyses(r = 0.87,P< 0.05).The pulse pressure and blood uric acid was decreased after treatment compared with that before treatment in simvastatin group (P < 0.05),but there was no significant difference before and dter treatment in routine group (P >0.05).There was significant difference after treatment between two groups (P< 0.05).Conclusions With the increasing of pulse pressure,there is a significant raise in blood uric acid.Blood uric acid is positively related with pulse pressure by correlation analyses.Simvastatin is a drug used to lower cholesterol,and it could also be used to reduce pulse pressure and blood uric acid in aged PH patients with normal cholesterol.

The paper explains factors that restricting the development of the mobile healthcare information system in small and medi -um hospitals , summarizes strategies for constructing the mobile healthcare information system in small and medium hospitals , and analy-zes advantages of the Android system as the development platform of the healthcare information system .On the basis of above , it designs a model suitable for the mobile healthcare information system in small and medium hospitals and introduces the system in details including the design principles , structure and service modes for clients , etc.

The more and more application of assistive technology in special education not only makes education placement of student with disability diversification, but also provides more opportunity for them to participate in instruction. However, there are some problems remained, such as the application is still in low level, the lack of the systematic evaluation for their efficacy and so on. It is necessary to pay more attention on the assistive technology, cultivate more specialists and other related persons on assistive technology, create assistive technology system, and perfect the service system.

Objective To explore the effect and mechanism of glucose regulated protein 78 (GRP78) on autophagy and apoptosis in ovarian carcinoma, and to investigate the influence on the growth and sensitivity to cisplatin on the ovarian cancer cells.Methods The human ovarian cancer cell line SKOV3 were treated by the GRP78 regulator BAPTA-AM and A23187, which were used to decrease or increase the expression levels of GRP78, respectively.The experiment were divided into three groups.Cells in the group of BAPTA-AM were treated by BAPTA-AM at the final concerntration of 40 μ mol/L for 1 hour.Cells in the group of A23187 were treated by A23187 at the final concerntration of 4 μmol/L for 24 hours.While, cells in the control group were treated by culture medium without any GRP78 regulator for 24 hours.The expressions of GRP78, beclin1, Bcl-2 and CHOP mRNA and protein were detected by reverse transcription (RT)-PCR and western blot.The autophagy levels was observed by green fluorescent protein-microtubule-associated protein 1 light chain 3-Ⅱ (GFP-LC3-Ⅱ) fluorescence staining.The flow cytometry was used to analyse the apoptosis rates of cells.The effect on cell growth and the sensitivity to cisplatin of SKOV3 were accessed by methyl thiazolyl tetrazolium (MTT).Results (1)The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of BAPTA-AM were 0.583±0.025, 0.860± 0.055, 0.714±0.032 and 0.811±0.004, respectively.The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of A23187 were 0.840± 0.044, 0.654 ± 0.065, 0.908 ± 0.047 and 0.620 ± 0.062, respectively.The mRNA expressions of GRP78, beclin1, Bcl-2 and CHOP in the control group were 0.687± 0.032, 0.772 ±0.029, 0.845 ±0.018, 0.712 ± 0.077, respectively.While the protein expressions of GRP78, beclin 1, Bcl-2 and CHOP in the group of BAPTA-AM were 0.423±0.035, 0.952±0.022, 0.385±0.032, 0.681± 0.095, respectively.The protein expressions of GRP78, beclin1, Bcl-2 and CHOP in the group of A23187 were 0.743 ±0.032, 0.638±0.025, 0.596±0.029, 0.431 ±0.095, respectively.The protein expressions of GRP78, beclin1, Bcl-2 and CHOP in the control group were 0.617±0.031, 0.789±0.083, 0.492±0.036, 0.531 ± 0.003, respectively.The mRNA and protein expressions of beclin and CHOP in the group of BAPTA-AM were both higher than those in the control group (P＜0.05).While, the mRNA and protein expressions of beclin and CHOP in the group of A23187 were both lower than those in the control group (P＜ 0.05).(2) The autophagy fluorescence of SKOV3 in the group of BAPTA-AM, A23187 and the control group were 706±117, 473±128, 595± 126, respectively, in which there were significant differences among three groups (P＜0.05).(3) The apoptosis rate of SKOV3 in the group of BAPTA-AM was (27.4±2.2)％, which was higher than that in the control group [(19.6± 1.4)％, P＜0.05].The apoptosis rate of SKOV3 in the group of A23187 was (12.2± 1.9)％, which was lower than that in the control group (P＜0.05).(4) The comparison of the sensitivity to cisplatin in 3 groups of SKOV3.The 50％ inhibition concentration (IC50) of SKOV3 to cisplatin was (3.02±0.62) mg/L.After treated by BAPTA-AM + cisplatin, the IC50 was (2.00±0.17) mg/L and the sensitivity of SKOV3 to cisplatin was increased by 33.8％, and there was significant difference (P＜0.05), compared with the control group.And after treated by A23187 + cisplatin, the IC50 was (4.91±2.52) mg/L and the sensitivity of SKOV3 to cisplatin was decreasd by 62.6％;and there was significant difference (P＜0.05), compared with the control group.Conclusion GRP78 could regulate autophagy and apoptosis of ovarian cancer cells by regulating the expressions of beclin1, Bcl-2 and CHOP, thereby affecting the sensitivity to cisplatin in ovarian carcinoma, which may be a new method for the treatment and improvement of the sensitivity to cisplatin in ovarian carcinoma.

Objective To develop a new way to prevent vascular anastomotic intimal hyperplasia, we applied surgical suture soaked in c-myc antisense oligodeoxynucleotide solution to perform vascular anastomosis in rabbits. Methods8/0 sutures (coated Vicryl) soaked in antisense, sense and mismatched c-myc oligomer solution respectively were applied to accomplish vascular anastomoses in rabbits with interposition of external jugular veins between common carotid arteries. Twenty-four animals were randomly divided into four groups: control group, antisense group, sense group and mismatched group. Four weeks later, angiography was made to scrutinize the patency of anastomosis and specimens were harvested for microscopy, the image was digitalized by computer video analysis system, the intimal thickness and area, medial thickness and area and their ratios were calculated and analyzed statistically among groups. Resultsall the anastomoses were normal and patent. The intimal thickness, intimal/medial ratio and intimal area, intimal/medial area ratio in antisense group were significantly lower than those in other groups(P

Objective To compare the difference between intermittent epidural bolus(IEB) combined with patient controlled epidural analgesia(PCEA)and continuous epidural infusion(CEI)combined with PCEA mode in labor analgesia. Methods It was a retrospective cohort study ,which subjects were assigned to CEI+PCEA and IEB + PCEA group. Correlated data were collected to compare the effect of the two analgesic mode on perinatal events. Results There were less consumption of ropivacaine and sufentanil per hour ,less PCEA request and actual bolus in IEB + PCEA group. There were no significant difference between the delivery mode and the percentage of low Apgar score in neonates. Conclusion IEB+PCEA mode has better analgesic effect ,meanwhile doesn't disturb the delivery mode has no effect on the neonate outcome.

Objective: To investigate the effect of fusion protein tick anticoagulant peptide (TAP)-staphylococcus aureus superantigen-like protein 5 (SSL5) on the formation of atherosclerotic plaque in ApoE knockout (ApoE-/-) mice.Methods: Totally 21 male 12-week-old ApoE-/-mice were randomly divided into three groups: TAP-SSL5 (3 mg·kg-1·d-1) group, SSL5 (2 mg·kg-1·d-1) group and the blank control group (pH 7.4 phosphate buffer), ip, qd, for 12 weeks.The changes of body mass were observed.The mice were fed with high cholesterol diet for 12 weeks, and then the levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) in plasma were detected.The aorta of mice was subjected to paraffin section and routine HE staining.The formation of atherosclerotic plaque in the aortic root was analyzed.The distribution of atherosclerotic plaques was observed by oil red O staining of the aorta.Results: Compared with that of the blank control group, the increasement of body weight of TAP-SSL5 group and the level of TC significantly decreased (P <0.001), while TG, HDL-C and LDL-C did not change significantly.The HE staining results showed that the plaque area of root slice in the aorta in TAP-SSL5 group was significantly lower than that in the blank control group (P<0.05).The red O staining of aorta showed that the formation of atherosclerotic plaque in TAP-SSL5 group was significantly smaller than that in the blank control group.Conclusion: TAP-SSL5 can significantly inhibit the formation of atherosclerotic plaques in the arteries of ApoE-/-mice.

In order to explore the possibility and feasibility of administering antisense oligodeoxynucleotide to vascular adventia delivering by fibrin tissue adhesive, the authors first observed the physical characteristics of the adhesive, then the blue dye (methylenophin) was dissolved in the adhesive and the color change of the supernate was monitored. The adhesive with antisense oligomer inside was immerged in saline and the optical density (OD) value of the released oligomer was measured by ultraviolet spectrophotometer at different time points, then the in vitro controlled releasing curve was made. The preliminary in vitro test found the adhesive clot in 10 seconds when the two kinds of solution were mixed together, and the surface was membrane like under microscope, the clot inside was silk protein like configuration and was filled up with particle like liquid. The clot was elastic and had some reabsorbable property like that of sponge. The blue dye inside the clot gave a more and more significant dyeing of the supernate with time going. The in vitro releasing curve indicated that most oligomer was released within 72 hours. This implied that the adhesive clot is like a sponge reservoir of drugs, it could elongate the action time of antisense drug at vascular adventia.