Clinical data of 12 patients with pernicious placenta previa admitted in our hospital from October 2015 to July 2016 were retrospectively reviewed.Bilateral internal ilia artery balloons were placed percutaneously before cesarean section.After cesarean delivery normal saline was applied to fill the balloon for temporary occlusion of bilateral iliac arteries,then placental separation and hysterorrhaphy were performed.The average volume of bleeding during cesarean section was 1 146 ml.There were no hysterectomy,pelvic organ necrosis,lower limb artery thromosis and other complications.The application of temporary internal iliac artery balloon occlusion can significantly reduce the intraoperative bleeding in cesarean section for patients with pernicious placenta previa.It provides a clear operational field for obstetricians to perform the placental separation and hysterorrhaphy,facilitating the uterine reservation.

Objective To observe the effect of electroacupuncture (EA) pretreatment of different durations on the expressions of AQP4 and CLN5 in the blood-brain barrier after cerebral ischemia and reperfusion Methods Sixty-four male Sprague-Dawley (SD) rats were randomly divided into a model group,a sham operation group,a 7-day EA-pretreatment group (EAP-7 group) and a 15-day EA-pretreatment group (EAP-15 group),each of 16.After EA-pretreatment on the baihui and shuigou acupoints for 7 days or 15 days,a model of unilateral middle cerebral artery embolism (MCAO) model was induced in the rats of the model,EAP-7 and EAP-15 group using a modified Longa method.In the sham operation group the carotid artery was separated without middle cerebral artery embolism.The reperfusion was begun 90 min after the MCAO modeling.Immunohistochemical methods and fluorescence quantitative PCR were applied to detect the expression of AQP4,CLN5 and their mRNAs expression in the blood brain barrier (BBB) 24h after the operation.Results Compared with the sham operation group,the expression of AQP4 positive cells and AQP4 mRNA in the BBB in the other three groups had increased significantly,while the expression of CLN5 positive cells and CLN5 mRNA was significantly less.Compared with the model group,the expression of AQP4 positive cells and AQP4 mRNA in the EAP-7 and EAP-15 groups was significantly reduced,while the expression of CLN5 positive cells and CLN5 mRNA was significantly increased.Moreover,the expression of AQP4 positive cells and AQP4 mRNA in the EAP-15 group were significantly higher than in the EAP-7 group,while the expression of CLN5 positive cells and CLN5 mRNA were significantly lower.Conclusions EA-pretreatment on the baihui and shuigou acupoints can restrain the expression of AQP4-positive cells and AQP4 mRNA and promote that of CLN5-positive cells and CLN5 mRNA in the BBB after cerebral ischemia and reperfusion,at least in rats.The BBB protection effect is better when the EA-pretreatment lasts longer.The mechanisms of cerebral ischemia tolerance may be related to the regulation of AQP4,CLN5 and their mRNAs in the blood-brain barrier after cerebral injury.

Objective To discuss the effect of skill training for staff working in washing rooms of sterilization and supply center after application of centralized management model.Methods The training objects included all the working staff in the washing rooms and the training procedure covered four steps：preparation,discussion,implementation and evaluation.The evaluation indices involved level of post skill,cleaning and sterilization effect of instruments and satisfaction degree of staff.Results After training the level of post skills were increased dramatically(P＜0.01).The cleaning and sterilization effect of instruments was also improved(P＜0.01).96％ of staff considered their post ability elevated after training.Conclusion After skill training for staff working in washing rooms,the post skill and cleaning and sterilization quality of instruments were both enhanced.It proved valuable for guarantee of cleaning and sterilization quality of medical instruments and improvement of professional skills for staff working in washing rooms of sterilization and supply center.

OBJECTIVE To analyze problems of hospital infection monitoring and its strategies.METHODS Having investigated hospital infection cases during 2005 and statistically to analyze the data of infection monitoring.RESULTS Both of the missed report rate of hospital infection and the rate for detection of microbe samples were decreased.Antibiotics were misused.CONCLUSIONS Strengthening the training about hospital infection knowledge for increasing the rate for detection,strengthening the infection monitoring,checking the infection control strictly,and raising the antibiotics control policy and practice are important.

Now,with the dramatic increase in Internet technology,we should focus on innovation teaching and learning,so it is necessary to set up a platform of Internet resources for education in order to reach optimization of teaching.

Objective To observe the expression of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway in substantia nigra in rats with Parkinson's disease (PD). Methods A total of 96 Sprague-Dawley rats were randomly divided into sham group, model group, PI3K inhibitor LY294002 group and mTOR inhibitor rapamycin group. Each group was divided into 4 days and 8 days subgroups after the model. PD model was established by injecting rotenone subcutaneously. The expres-sion of PI3K, p-Akt and p-mTOR in substantia nigra was detected with immunohistochemistry and Western blotting. Results Compared with the sham group, the expression of PI3K, p-Akt and p-mTOR increased in the model group (P<0.05), and was more in 8 days subgroup than in 4 days subgroup (P<0.05). Compared with the model group, the expression of p-Akt and p-mTOR reduced in the LY294002 group (P<0.05), while the expression of PI3K varied little (P>0.05);the expression of p-mTOR decreased in the rapamycin group (P<0.05), while the expression of PI3K and p-Akt varied little (P>0.05). Conclusion PI3K/Akt/mTOR signaling pathway is over activated in substantia nig-ra in rats with Parkinson's disease, which may play an important role in occurrence and development of the disease.

Objective: To observe the effects of tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder on pain and shoulder joint function in subacromial impingement syndrome (SIS). Methods: Eighty patients with SIS were recruited and divided into a control group and a treatment group by the random number table method, with 40 cases in each group. The control group was given JIN's three-needle therapy for the shoulder, and the treatment group received additional tendon-regulating and stretching manipulation. The visual analog scale (VAS) score and constant-Murley score (CMS) were observed before and after the intervention, and the total effective rate was also observed. Results: The total effective rate was 92.5％ in the treatment group versus 70.0％ in the control group, and the difference was statistically significant (P<0.05). The VAS score and CMS changed notably after treatment in both groups (P<0.05), and the improvements were markedly greater in the treatment group than in the control group (P<0.05). Conclusion: Tendon-regulating and stretching manipulation plus JIN's three-needle therapy for the shoulder can facilitate the relief of pain and the improvement of shoulder joint function in SIS patients.

Objective To explore the effect of computer-aided cognitive training on cognitive function and auditory event-related potential P300 in patients with vascular cognitive impairment no dementia (VCIND).Methods Sixty VCIND patients were randomly divided into two groups namely a training group and a control group,each of 30.Both groups were given routine drug treatment and the traditional rehabilitation training.At the same time,the training group was additionally given 40min computer-aided cognitive training once a day,six times a week,lasing 4 weeks.Before and after four weeks of treatment,the cognitive function,the ability of daily life (ADL) and P300 of the two groups were assessed using mini-mental state examination(MMSE),the Montreal cognitive assessment (MoCA),Barthel Index (BI) and Motor evoked potential instrument respectively.Results Before treatment,no significant difference was found in the average MoCA,MMSE and BI scores of the two groups.After treatment,improvement was observed in the total MoCA scores (22.40 ± 4.38),as well as the average score,of visual space and executive function (3.27 ± 0.58),attention (4.30 ± 1.60),language (2.67 ± 0.48),delayed memory (3.67±0.80),MMSE (22.03 ±3.55) and BI (82.17±11.28) in the training group compared with the control group.Before treatment,there was no significant difference in the P300 latency and amplitude between the two groups.After treatment,however,the P300 latency of the training group decreased to(352.1 ± 30.68) ms,significently lower than the control group [(356.45 ± 40.30) ms] and that before treatment.Meanwhile,the amplitude rose to(8.65 ± 1.18)μV,significantly higher than the control group [(8.65 ± 1.18) μV] and that before treatment.Conclusion Computer-aided cognitive training can effectively improve the cognitive function of patients with VCIND and promote their ADL.

Objective To explore the possible risk factors that influence bone mineral density (BMD) in the elderly man with type-2 diabetes.Methods Sixty elderly man with type-2 diabetes were subjected to dual-energy X-ray absorptiometry to evaluate the BMD at lumbar spine ( LS),and femoral neck (FN).Fasting blood and urine samples were taken to check the biochemical levels about bone metablism and blood sugar.The correlations between BMD and other factors were analyzed.Results In this group of patients,the percentage of osteoporosis and osteoponia was 20％ and 53.3％ in LS or FN site,respectively.Age,Weight,and HbA1c were correlated with BMD.Weight of them had the best correlation with BMD at LS( r =0.254,P ＜0.01 ),whereas,HbA1c had the best correlation with BMD at FN( r =-0.224,P ＜0.01 ).Conclusions Age,Weight,and HbAlc c were correlated with BMD of elderly man with type-2 diabetes.

Objective To explore the impact of calciotropic hormones,such as parathyroid hormone (PTH)and vitamin D,on bone mineral density(BMD)in the old men with type 2-Diabetes.Methods Sixty elderly men with type 2-Diabetes were submitted to dual-energy X-ray absorptiometry to evaluate the BMD at lumbar spine and hip.Fasting blood samples were collected to evaluate the indexes of bone metablism and blood glucose.PTH and 25-(OH)-Vitamin D3 were measured and analyzed for their correlation with BMD at different sites.Results In all patients,the percentage of osteoporosis and osteopenia accounted for 20.0％ and 53.3％ of the patients according to BMD at lumbar or hip.Compared with the patient group with normal BMD,serum PTH was significantly higher in the patient group with osteopenia or osteoporsis([44.87 ± 10.62]μg/L vs[36.96 ±12.36]μg/L,P ＜ 0.05 ;[50.24 ± 20.32]μg/L vs[36.96 ± 12.36]μg/L,P ＜ 0.05).But there was no difference in 25-(OH)-Vitamin D3 levels between all groups.PTH was correlated negatively with BMD at hip (r =-0.224,P ＜ 0.05),but not significantly correlated with BMD at lumbar(r =-0.187,P ＞ 0.05)Conclusions Serum PTH was correlated negatively with BMD at hip in elderly man with type 2-Diabetes.