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 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.

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.

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.

ObjectiveTo investigate the effects of 5(S),6(R),7-trihydroxyheptanoic acid methyl ester (BML-111) on pregnant mice with fetal growth restriction(FGR) induced by antenatal dexamethasone and its probable mechanism. MethodsThe mice were mated overnight,with day 1 of pregnancy designated as the day on which spermatozoa were presented in a vaginal smear.The pregnant mice were then randomly divided into control group,dexamethasone group and BML-111 group.From 9 to 14 days of pregnancy,pregnant ICR mice of control,dexamethasone and BML-111 group were treated separately with saline,dexamethasone(5 mg/kg) and dexamethasone at 8:00 am,and two hours later they were treated separately again with 1 mg/kg saline,saline and BML-111.On the day 18 of gestation,they were sacrificed after blood were collected from their eyeballs.The serum lipoxin A4 was measured with enzyme-linked immunosorbent assay. Fetuses were delivered by cesarean section; the placenta and uterus were immediately removed and frozen.Gene expressions of 11β-hydroxysteroid dehydrogenase 2 ( 11β-HSD2 ),interleukin-1β (IL-1β) in placenta and lipoxin A4 receptor-formyl peptide receptor 3 (FPR3)in uterine were detected by reverse transcriptionpolymerase chain reaction and compared with analysis of variance.The 11β-HSD2 protein in mice placenta was detected by immunohistochemistry. ResultsThe mean fetal weight of dexamethasone group was (0.823±0.054) g,lower than that of the control group and BML-111 group [(1.103±0.218) g and (0.992 ± 0.207) g] (t =- 4.108 and - 2.890,P ＜ 0.05 respectively).Protein expression of 11β-HSD2 in dexamethasone group (0.030±0.019) was weaker than that in control group (0.058±0.015,t=-3.107,P＜0.05) or in BML-111 group (0.049±0.026,t=-2.211,P＜0.05).The expression of 11β-HSD2 mRNA in dexamethasone group (0.457±0.062) was lower than that in control group (0.943±0.057,t=-9.418,P＜0.05) or in BML-111 group (0.698±0.071,t=-4.617,P＜0.05).Expression of IL-1β mRNA in dexamethasone group (0.543±0.103)was less than that in control group (0.710± 0.085,t=-3.736,P＜0.05) but more than that in BML-111 group (0.229 ±0.031,t=7.025,P＜0.05). The expression of FPR3 mRNA in dexamethasone group (0.323 ± 0.019) was less than that in control group (0.857 ± 0.057,t =-14.630,P＜0.05) or in BML-111 group (0.499 ±0.050,t=-4.822,P＜0.05).The serum concentration of lipoxin A4 in dexamethasone group was lower than that in control group [(64.463±22.144) pg/ml vs (101.610±24.916) pg/ml,t=3.152,P＜0.05].ConclusionsBML-111 regulate the expression of 11β-HSD2 and then protect against FGR resulted from too much prenatal application of dexamethasone.

Objective To investigate the expression and clinical significance of lipoxin A4,leukotrienc C4,lipoxygenase-5 in peripheral blood of pregnant women with different types of severe preeclampsia.Methods Forty-five singleton pregnant women who accepted antenatal care and delivered in First Affiliated Hospital of Wenzhou Medical College were enrolled in this study from December 2010 to June 2011.All objects were divided into normal pregnancy group (n=20),early onset severe preeclampsia group (n=10) and late onset severe preeclampsia group (n=15).Enzymelinked immunosorbent assay was used to detect lipoxin A4 and leukotriene C4 levels in peripheral blood.The level of lipoxygenase-5 mRNA in white blood cells was detected by real time fluorescence quantitative reverse transcription-polymerase chain reaction.The differences of lipoxin A4,leukotriene C4 and lipoxygenase-5 mRNA among groups were compared by analysis of variance and LSD-t test;and correlations among their expressions were analyzed by linear regression.Results Lipoxin A4 level in early and late onset severe preeclampsia group was (355.3±116.0) pg/ml and (389.7±117.5) pg/ml,which were both significantly lower than that in normal pregnancy group [(555.0±139.8) pg/ml] (t=-4.03 and-3.77,P＜0.05 respectively).The leukotriene C4 level in early and lateonset severe preeclampsia and normal pregnaney group was (591.3±185.5) pg/ml,(510.3±197.1) pg/ml and (496.9 ± 158.8) pg/ml,no statistical difference were found (F=0.889,P＞0.05) ; neither did the expression of lipoxygenase 5 mRNA,which was 4.2± 1.9 in normal pregnancy group,4.8 ± 2.0 in early onset severe preeclampsia group and 4.4 ± 1.2 in late onset severe preeclampsia group (F=0.311,P＞0.05).There was no correlation among the levels of lipoxin A4,leukotriene C4 and lipoxygenase-5 mRNA in each group (P ＞ 0.05).Conclusions Early and remarkable decreasing of lipoxin A4 level might contribute to the development of early onset severe preeclampsia.

Objective ① To Screen for the miRNAs differently expressed in the peripheral blood mono-nuclear cells (PBMCs) of rheumatoid arthritis (RA) by microarray experiments.② To further evaluate the expression of miR-155 in PBMCs of RA.③ To determine the relevance between the expression of miR-155 and clinical as well as laboratory features.④ To test whether inflammatory mediators can induce miR-155 expression in PBMCs of RA.Methods ① Total RNA was isolated from peripheral blood mononuclear cells obtained from 5 patients of RA and 5 normal controls.Expression profiling of miRNAs was performed in a microarray analysis.② MiR-155 was identified for further study by stem-loop real-time RT-PCR based on SYBR-Green.PBMC from 26 patients of RA and 23 normal controls were collected.③ Association between miR-155 and the clinical and laboratory features of RA was evaluated.④Induction of miR-155 following stimulation with TNF-α, IFN-γ and LPS of cultures of RA PBMCs was examined by real-time RT-PCR.Statistical analysis was done with student's t test, paired t test, and ANOVA, Spearman correlation.Results ① Expression profiling of miRNAs revealed significant differential expression of 14 miRNAs, of which signal intensity changed over two times.MiR-155 was up-regulated in PBMCs of RA than in normal controls (t=9.218, P=0.001).② The expression level of miR-155 had a positive correlation with serum CRP level (r=0.57, P=0.002).③ Expression of miR-155 was markedly up-regulated in PBMCs of RA after stimulated with TNF-α,IFN-γ and LPS, especially with TNF-α.Conclusions The expression of miR-155 is induced by stimulating with TNF-α, IFN-γ and LPS.MiR-155 may be a regulator in RA pathogenesis.Further studies are required to elucidate the function of miR-155.