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.

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.

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.

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.

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.

Angiogenesis is a fundamental physiological and pathological process in human body.Angiogenesis is regulated by integrins,a family of cell surface receptors.After binding with their ligands such as extracellular matrix proteins and immunoglobulin superfamily molecules,integrins can promote the proliferation and migration of endothelial cells during angiogenesis.Several integrin-targeted therapeutic agents are currently used in clinical trials for the therapy of angiogenesis related diseases.Here,there will show the roles of integrins in angiogenesis and clinical application.

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 explore the effect of gemcitabine combined with cisplatin on ER , MMP-9 and estrogen in patients with stage III breast cancer.Methods 93 patients with breast cancer were collected and randomly divided into control group and experimental group.Two groups were all under breast cancer surgery, control group was treated with cisplatin chemotherapy,1st day of intravenous infusion of cisplatin 90 mg/m2 , 21 days for a course of treatment, continuous treatment of 6 courses.Experimental group were treated with cisplatin combined with gemcitabine chemotherapy , 1st and 8th days of intravenous infusion of 1000 mg/m2 gemcitabine, 3 ~5d, intravenous drip of cisplatin 90 mg/m2 , every 28 days a cycle, continuous administration of 2 cycles,After treatment, the clinical efficacy of the two groups, the level of ER, MMP-9, estrogen and the incidence of adverse reactions were compared.Results Compared with before treatment,the levels of serum MMP-9,E1, E2, ER were decreased (P<0.05), and the level of LH and FSH were increased (P<0.05) of two group post-treatment.Compared with control group post-treatment, the levels of serum ER, MMP-9, E1, E2 were lower in experimental group (P<0.05), and the LH and FSH levels were higher (P <0.05).The incidence of adverse reactions of experimental group was 6.38%, and control group was 15.22%, the incidence of adverse reactions in the two groups was no significant difference . Conclusion Gemcitabine combined with cisplatin in the treatment of patients with breast cancer has a significant effect, and can improve the clinical symptoms, reduce the serum ER, E1, MMP-9, E2 levels, improve FSH, LH level.

Infantile spasms constitutes an unique,age-specific epilepsy syndrome of early infancy characterized by epileptic spasms often accompanied by neurodevelopmental regression and an electroencephalograph finding of hypsarrhythmia.For the complex and various etiologies,the pathogenesis remains unclear.Although the relevant guidelines and consensuses are being updated all the time,but proven therapies are still limited because of efficacy,tolerability,at times even availability.In this paper,the current findings regarding up-to-date advances in the treatment of infant spasms were reviewed,especially in use of the corticosteroid and vigabatrin as well as the quality-of-care indicators for infantile spasms.

Anti-Inflammatory Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Ear Cartilage ; Female ; Humans ; Integrative Medicine ; methods ; Middle Aged ; Panniculitis ; complications ; drug therapy ; Phytotherapy ; Polychondritis, Relapsing ; complications ; drug therapy ; Prednisone ; therapeutic use ; Treatment Outcome