Objective To investigate the appropriate timing of B-lynch suture in the treatment of atonic postpartum hemorrhage during cesarean section.Methods A total of 90 patients with atonic postpartum hemorrhage during cesarean section from January 2012 to December 2014 in our hospital were included in the study.They were divided into two groups, early suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 500 ml, n=66 cases) and late suture group (applying B-lynch suture when the amount of postpartum hemorrhage reaching 1000 ml, n=24 cases).The hemostatic effect, amount of bleeding, blood transfusion rate, incidence of DIC, duration of hospitalization, and the puerperal morbidity were compared between the two groups.Results All the 90 patients were successfully treated and were discharged after comprehensive treatment.The amount of postpartum hemorrhage of the early suture group was (656±118) ml, which was significantly less than that of the late suture group [(1550±432) ml, t=-10.003, P=0.001].The rate of blood transfusion of the early suture group was 3.0% (2/66), which was significantly lower than that of the late suture group [(50.0%, 12/24), x2=26.092, P=0.000].There was no case of DIC in the early suture group, and the incidence of DIC in the late suture group was 16.7% (4/24), with the difference statistically significant (Fisher''s exact test, P=0.004).The puerperal morbidity in the early suture group was 3.0% (2/66) and that of the late suture group was 25.0% (6/24), with statistically significant difference (x2=7.952, P=0.005).There was no statistically significant difference in the hospitalization stay between the two groups (P>0.05).Conclusions B-Lynch suture is an effective method in the treatment of atonic postpartum hemorrhage during cesarean section, and early use of it can get better curative effect, such as less bleeding amount and lower rates of blood transfusion, DIC and complications like puerperal morbidity.In case the bleeding volume reaches 500 ml and the general conservative hemostatic methods are ineffective, B-Lynch suture is recommended immediately.

The paper analyzes the orientation of health management function of government under the perspective of new public service theory, tries to reveal the unimplementation, dislocation, offside and absence of government function at four aspects including health service system, health organization operating mechanism, health management system and health service supervision system, and puts forward six approaches for transformation of government function of health management.

Hepatitis B virus(HBV) infection is a severe health problem in the world.However,there is still not a satisfactory therapeutic strategy for the HBV infection.To search for new anti-HBV agents with higher efficacy and less side-effects,the inhibitory activities of traditional Chinese medicine Rheum palmatum L.ethanol extract(RPE) against HBV replication were investigated in this study.Quantitative real-time polymerase chain reaction(PCR) was employed to analyze the inhibitory activity of RPE against HBV-DNA replication in a stable HBV-producing cell line HepAD38; the expression levels of HBV surface antigen(HBsAg) and e antigen(HBeAg) were also determined by enzyme linked immunosorbent assay(ELISA) after RPE treatment.RPE could dose-dependently inhibit the production of HBV-DNA and HBsAg.The concentration of 50% inhibition(IC50) was calculated at 209.63,252.53 μg/mL,respectively.However,its inhibitory activity against HBeAg expression was slight even at high concentrations.RPE had a weak cytotoxic effect on HepAD38 cells(CC50 = 1 640 μg/mL) and the selectivity index(SI) was calculated at 7.82.Compared with two anthraquinone derivatives emodin and rhein,RPE showed higher ability of anti-HBV and weaker cytotoxicity.So Rheum palmatum L.might possess other functional agents which could effectively inhibit HBV-DNA replication and HBsAg expression.Further purification of the active agents,identification and modification of their structures to improve the efficacy and decrease the cytotoxicity are required.

Objective To analyze the clinical features and causes of benign paroxysmal positional vertigo(BPPV).Methods The clinical data of 521 patients with BPPV were collected.The percentage of patients with BPPV in all the outpatients with dizziness and vertigo,the clinical characteristics of BPPV,and the prevalence of comorbidity with migraine were analyzed.Results BPPV accounted for 35.7% of patients with vertigo and 12.1% of patients with dizziness.Among the 521 patients with BPPV,158(30.3%)were male and 363(69.7%)were female,with an average age of(57.5?12.8)years old(20 to 93 years old).Right semicircular canals were involved in 323 cases(62.0%),and left semicircular canals in 187 cases(35.9%).The latency period of nystagmus of vertical canals was(3.22?2.37)s,and time of persistence was(8.31?7.98)s.The latency period of nystagmus of horizontal canals was(2.33?1.50)s,and the time of persistence was(14.77?11.40)s.There were significant differences in the latency period of nystagmus and time of persistence between the vertical and horizontal canals(P=0.001 and P=0.000).Fifteen patients(2.9%)had a history of head trauma and 39(7.5%)were complicated with migraine.Conclusion BPPV is prevalent in patients with dizziness and vertigo,and misdiagnosis and missed diagnosis should be avoided.

BACKGROUND:Excessive apoptosis and decreased infiltration of cytotrophoblasts are essential causes for hypertension in pregnancy. Human placenta-derived mesenchymal stem cels contribute to damage repair, which has been shown in many studies, and moreover, human placenta-derived mesenchymal stem cels have a certain endocrine function and can act on the other tissues in an autocrine or paracrine manner. Therefore, we attempt to explore whether the human placenta-derived mesenchymal stem cel can repair damaged cytotrophoblasts, and then to gestational hypertension.
METHODS/DESIGN:This is a randomized controled cytological experiment. Human placenta-derived mesenchymal stem cel culture medium is colected and filtrated as human placenta-derived mesenchymal stem cel conditioned medium. Human cytotrophoblasts, JEG-3 cels, are cultured and randomized into three groups:15% normal pregnant serum is added in control group; 15% serum from severe pre-eclampsia patients is added in gestational hypertension model group; and in condition medium group, 15% serum from severe pre-eclampsia patients is added for 24 hours of culture, and then human placenta-derived mesenchymal stem cel conditioned medium containing 15% serum from severe pre-eclampsia patients is used instead. Flow cytometry is used to detect cel apoptosis rate.
DISCUSSION: This study wil help to find the feasibility of cel transplantation for gestational hypertension by exploring the effect of human placenta-derived mesenchymal stem cels on cytotrophoblasts function in gestational hypertension.
ETHICAL APPROVAL: The protocol is approved by the Ethics Committee of Shenyang Central Hospital of Shenyang Medical University. Informed consent is obtained from normal and pre-eclampsia women in pregnancy.

Objective:This study aims to investigate the method and clinical outcomes of feeding tube placement and periopera-tive nutritional support for esophageal carcinoma patients. Methods:A total of 513 esophageal carcinoma patients who have undergone radical resection and reconstruction by a single operating group between January 2012 and December 2013 participated this study. Feed-ing tubes were inserted via the nasal path of 497 cases and by jejunostomy in 16 cases. Early enteral nutrition (EN) was administered through the feeding tubes 24 h postoperatively with a stepwise increase, whereas supplementation of parenteral nutrition (PN) was ter-minated until total EN. Results:Feeding tubes were successfully inserted in all patients during operation. No death or nutritional and metabolic disorders were documented during the observation period. No differences in anastomotic fistula, pulmonary complication, and incision infection were identified between the nasointestinal and jejunostomy groups (P>0.05). A higher incidence of intestinal ob-struction was observed in the jejunostomy group than in the nasointestinal group (P<0.05). Conclusion:Effective placement of nasoin-testinal tube and early enteral feeding are safe and effective methods for patients who have undergone esophagectomy for esophageal carcinoma.

Objective To study the clinical value of mammography and ultrasound needle localization biopsy technique in clinical nonpalpable breast disease.Methods 148 patients with negative clinical palpation were operated only because of the mammography or ultrasound findings of lesions.They were undergone localized excision biopsy and derived definite pathological diagnosis.By histopathology diagnosis,benign and malignant lesions,lesion size,complete resection rate were statistically analyzed.Results 21 cases in 148 cases were malignant lesions(14.2％),which were all early breast cancer.The other 127 cases were benign breast disease(85.8％).147 cases were successfully resected at the first time and 1 case was successfully resected at the second time.Conclusion Mammography and Ultrasound fine needle localized biopsy in nonpalpable breast disease diagnosis and treatment has great significance,which can raise early diagnosis rate of breast cancer without mass,and this method is simple and easy for promotion.

China ; Humans ; Occupational Health Services

Objective The paclitaxel loaded solid lipid nanoparticles (PTX-SLNs) were prepared by an ultrasonic-dispersion emulsification technique. The stability of PTX-SLNs was investigated in this study. Methods The technology was preferenced by stability, Zeta potential, particle diameter, and entrapment efficiency as indexes. The doses of lipid materials and coemulsifier, the ultrasonic time, and the ultrasonic power were investigated in detail. Results The optimum prescriptions were definited by one-factor and orthogonal test. The adjuvant: glyceryl monostearate (100/150 mg), Fabaceous Lecithin (100 mg), coemulsifier Pluronic F68∶Tween 80 (2∶1). The samples were sonicated with an energy output of 300 W in 20 min after emulsified at (75?5) ℃. Conclusion The PTX-SLNs are successfully prepared and PTX-SLNs with high stability are fairly dispersed in colloidal solution. This technology has a nice prospect with safety and reliability.

Objective To observe the regulating effect of inhaling glucocorticoid on imbalance of IL-4/interferon-?(IFN-?) cytokines in children with first onset wheezing .Methods IL-4 and IFN-? levels were examined in separated serum of 60 children wheezing with first onset wheezing,they were divided into abnormal level of IL-4/IFN-? group (n=38) and normal level of IL-4/IFN-? group(n=22,group C) depending on the level of IL-4/IFN-?,and 38 cases with abnormal level of IL-4/IFN-? were randomly divided into group A and B.Group B and C were given routine treatment without intervening treatment,while group A inhaled beclomethasone dipropionate aerosols for 3 months after routine treatment.Twenty healthy children for routine physical examinations in the same period were selected as healthy control group,who were examined for IL-4 and IFN-? with the same methods.Results Before treatment,the levels of IL-4 and IL-4/IFN-? in group A and B were significantly higher than those in group C and healthy control group(Pa