Objective To analyze the clinical effects of continuous epidural anesthesia and psychological intervention in painless labor. Methods From June 2016 to December 2016110 cases of maternal treatment in Ningbo city town of dragon longsai hospital as the research object, randomly divided into control group and observation group, control group of women to provide continuous epidural anesthesia, the observation group in continuous epidural anesthesia combined with psychological intervention measures. Results The two groups of pregnant women at different time scales VAS score, duration and other indicators, the data into the SPSS software, given the corresponding analysis and draw conclusions. Results The two groups of pain VAS score had no significant difference, the observation group each time after analgesia VAS score decreased than the control group(P<0.05); the first stage of the observation group was shorter than the control group (P<0.05), there was no significant difference between the 2 groups of second, third labor time. Conclusion Conclusion Epidural anesthesia and psychological intervention combined with painless labor have good analgesic effect and shorten the first stage of labor. .

Aim To observe the effect of sodium nitrop russide (SNP)on glial fibrillary acidic protein(GFAP) synthesis in the gerbil hippocampus. Method lmmunofluorescent histochemical staining method was used. Result SNP increased GFAP synthesis in rediatum layer,molecular layer and dentate gyrus.There were not GFAP positive cells in rediatum layer and mol ecular layer.Number of GFAP positive cells related to dose of SNP.Conclu sion SNP increased GFAP synthesis.

A vascular closure device (VCD) is a medical apparatus which is used for stopping bleeding at the puncture point after percutaneous vascular puncturing management. According to its principles , these devices can be categorized into active closure device, compression-assisted device and local hemostatic plaster. The use of these devices can shorten the time of hemostasis, the time of limb immobilization, and the time of hospitalization; it can also reduce the damage to the patient, improve patient’s comfort, and reduce the work load of the medical staff as well. But each VCD has its own applicable scope and learning curve , thus it might cause serious complications when it is improperly used. Therefore , in using VCD the interventional physicians should be familiar with the characteristics of each special VCD and have enough knowledge concerning the treatment of the common complications. This paper aims to make a comprehensive review of the closure device manufacturer data and the relevant literatures recently published so as to make a brief introduction of the principle, characteristics, scope of application and practical tips of several common vascular closure devices.

Objective To describe the CSP genotypic profile in clinical isolates of Aspergillus fumigates from different regions of China,and to investigate if there is a difference in antifungal susceptibility among A.fumigates of different CSP genotypes and from different regions.Methods Totally,112 A.fumigates strains clinically isolated from Fujian,Shanghai,Hebei and Beijing were included in this study,and identified according to macro-and micro-morphological characters,growth temperature and β-tubulin sequence.Classic A.fumigatus strains were typed according to CSP gene sequence.The minimal inhibitory concentrations (MICs) of voriconazole,itraconazole and amphotericin B to A.fumigates were determined in accordance with the National Committee for Clinical Laboratory Standards (NCCLS) M38-A protocol.Results All the strains were identified as classic A.fumigates,and fall into 11 CSP genotypes.The most common genotypes were t04A (n =32),t03 (n =17) and t01 (n =24) in all the strains,tl0,t04A and t01 in Fujian,t04A and t01 in Shanghai,t01,t03 and t04A in Hebei,t02,t04A,t01and t03 in Beijing.One A.fumigatus strain was identified as a new CSP type t25 in Fujian,which showed no obvious difference in morphology,growth rate or appropriate growth temperature from the other CSP genotypes of A.fumigatus strains.No statistical difference was found in the susceptibility to amphotericin B,itraconazole or fluconazole among different genotypes of A.fumigates,whereas the MICs of itraconazole were significantly lower in A.fumigates isolates from Fujian than in those from the other three regions.Conclusions The CSP genotypic profile of A.fumigates varies in clinical isolates from different regions.No significant difference is observed in the susceptibility to amphotericin B,itraconazole or fluconazole among different CSP genotypes of A.fumigates,but the susceptibility to itraconazole is somewhat different between A.fumigates strains from different regions.

Objective To evaluate the feasibility of endovascular repair for retrograde type A aortic dissection.Method 35 patients of retrograde type A aortic dissection admitted to Peking University People's Hospital from December 2001 to March 2014 were treated with endovascular repair.There were 33 males and 2 females with mean age of 46 ± 9 years.29 were on acute stage,2 on subacute stage and 4 on chronic stage.The entry tear was in the descending thoracic aorta in 32 cases,between the left subclavian artery and the left common carotid artery in one,and between the left common carotid artery and the innominate artery in two.Results Entry closure was achieved in all patients with a covered stent.2 patients died in 30 days postoperatively (5.7％).1 patient with two chimney developed acute renal artery embolized which was infused by false lumin (2.9％).One patient developed transient paraparesis after graft deployment(2.9％).During the follow-up period,the aortic remodeling is perfect,no entry tear was noted in the ascending thoracic aorta.All the endografts for preserving supra-aortic branches were patent.Conclusions The endovascular repair for retrograde type A aortic dissection is feasible and effective.

Objective To evaluate the application of percutaneous suture-mediated closure device (Perclose ProGlide) in patients undergoing percutaneous endovascular aortic procedures.Method From Apr 2011 to Jun 2012,23 patients underwent percutaneous endovascular aortic procedures.The stent delivery system used included one 24Fr,twelve 22Fr,two 20Fr,one 18Fr,two 16Fr,four 14Fr,one 10Fr and four 6Fr.The success rate,complications and the technical feasibility was analyzed.Result The success rate was 93.3％ (28/30),in which two patients were converted to open surgery because of severe stenosis and bleeding of femoral artery.There was no hemorrhage,hematoma,false aneurysm,thrombosis,and serious artery stenosis during the follow-up period ( 8 ± 4 months).Conclusions Percutaneous suture techniques is safe and effective in patients undergoing percutaneous endovascular aortic procedures.Percutaneous suture techniques can be safely used to the branch of aortic arch.

Objective To summarize our experiences of endovascular treatment for abdominal aortic aneurysm (AAA) with common iliac artery aneurysm (CIAA) by using bell-bottom technique (BBT).Methods From February 2009 to June 2014,endovascular aortic repair (EVAR) was performed on 17patients with AAA with CIAA using BBT,including 16 patients with bilateral and 1 patient with unilateral CIAA.Among them,patients with common iliac artery (CIA) of less than 25 mm in diameter without involvement of the internal iliac artery and external iliac artery aneurvsm were treated with BBT.Results All procedures were successfully completed.There were 3 bilateral and 14 unilateral BBT.Type Ⅰa endoleak was noticed intraoperatively in 3 cases and balloon dilation were applied,the endoleak disappeared after dilation in 2 cases and in 1 case the diminished endoleak disappeared during the follow-up period.The median follow-up of the 17 cases was 28 months (ranging,4-68 months).During follow-up no AAA or CIAA rupture and no endoleak occurred,and no dilation of the CIAA was observed.None of them had BBT graft occlusion or buttock claudication.Conclusion AAA with CIAA can be successfully treated with EVAR and BBT,which can preserve internal iliac artery patency.

Objective:To compare total percutaneous access using preclose technique with femoral ar-tery cut-down in endovascular aneurysm repair (EVAR)and assess the safety and feasibility of preclose technique.Methods:In the study,81 cases undergoing EVAR from Dec.2011 to Nov.2014 in Peking University People’s Hospital were retrospectively reviewed.Preoperative CT angiography (CTA)showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases.The maximum diameter of aneurysm >4.5 cm met the indications for surgical treatment.The conditions of bi-lateral femoral artery and iliac artery CTA showed were good,and there was no moderate or severe steno-sis,nor was there any severe calcification in anterior wall of femoral artery.Not only were the cases fit for percutaneous endovascular aortic aneurysm repair (PEVAR),but also feasible with open endovascular aneurysm repair (OEVAR).According to the intention of the patients about the surgical incision,the ca-ses were divided into group PEVAR and group OEVAR.The data of the general situation,operation time,blood loss,technical success rate,length of hospital stay after procedure and wound complications were analyzed statistically.Results:In the study,44 cases (78 incisions)were enrolled in group PEVAR and 37 cases (65 incisions)in group OEVAR.There was no significant difference between the two groups in age,gender,body mass index (BMI),accompanying diseases,average number of stents and outer diameter of stent delivery system.Average operation time of group PEVAR was less than that of group OEVAR [(119.1 ±102.0)min vs.(163.6 ±61.9)min,P =0.025].The blood loss in group PEVAR was less than that in group OEVAR [(64.7 ±97.0)mL vs.(98.6 ±88.3)mL],but there was no significant difference (P =0.106).There was no difference in the technical success rate (94.9% vs. 95.4%,P =1.000).The average length of hospital stay after procedure was significantly shorter in group PEVAR [(7.8 ±2.8)d vs.(12.3 ±7.2)d,P <0.001].There were 2 cases with subcutaneous hematoma of wound in group PEVAR and 7 cases of wound complications that occurred in group OEVAR including 3 cases with lymphatic leakage,3 cases with lower limb ischemia and 1 case with subcutaneous hematoma.The analysis showed that PEVAR could reduce the wound complications (2.6%vs.10.8%), but there was no significant difference between the two groups (P =0.079).Conclusion:Using preclose technique in EVAR is safe and effective.It can shorten the operation time and length of hospital stay after procedure.

AIM: To evaluate the different conditions inducing mouse embryonic stem cells (ESC) in vitro to differentiate into cardiomyocytes. METHODS: BRL conditioned medium was used to promote the growth of ESC and maintain them in an undifferentiated state. During the inducing process, retinoic acid (RA), DMSO, activin-A and TGF-? 1 were used as inducing reagents, and made up six kinds of differentiating medium. Then a three-step method inducing ESC cultured in hanging drops, in suspension and in plating was used to induce the differentiation of ESC. RESULTS: ESC were induced in vitro to differentiate into cardiomyocytes. Of all groups, the highest differentiating rate was observed in the group induced by activin-A (20 ?g/L) and TGF-? 1 (2 ?g/L). CONCLUSION: The inducing conditions including activin-A (20 ?g/L) and TGF-? 1 (2 ?g/L) is very valuable in inducing ESC differentiation into cardiomyocytes. [

Objective To investigate risk factors of the prognosis of patients with severe fever with thrombocytopenia syndrome (SFTS).Methods From May 2012 to July 2014,17 cases of severe fever with thrombocytopenia syndrome in Renmin Hospital of Wuhan University were treated.Clinical data including history of epidemiology,clinical manifestations,complications,physical examination and laboratory test results on admission and the third day after admission were retrospectively analyzed and compared with the death group and recovery group by application of Spearman correlation analysis.Results Elderly male patients with neuropsychiatric symptoms,or abnormal liver function,or abnormal blood clotting function had higher risk of the poor prognosis.In SFTS patients,AST,ALT was significantly increased,AST 539 U/L (229.73,545.4) U/L (r =0.597,P =0.015) was a risk factor affecting prognosis.Elevated blood ammonia indicated serious liver dysfunction and neurological dysfunction which were manifested as irritability,delirium,and trembling limbs.In SFTS patients,platelets were significantly decreased accompanied with mouth ulcers / bleeding gums,gastrointestinal bleeding.PLT 24.88 × 10 9/L-1 (12.75,35.00) ×10 9/L-1 (r=0.557,P=0.005) or APTT 86.06 s (66.88,114.18) (r=0.798,P=0.001) or D-dimmer 9.79 mg / L (4.09,16.51) mg/L (r =0.597,P =0.015) are risk factors affecting poor prognosis.Conclusions On the third days after admission,AST,WBC,PLT,APTT,Ddimmer are risk factors for prognosis of patients with severe fever with thrombocytopenia syndrome infected by a novel bunyavirus.