Objective To investigate the nursing intervention of pregnant women with antiphespholipid syndrome(APS). Methods In experimental group 40 cases with APS positive and control group 40 cases with APS ACA-negative for comparison. Results The abortion occurred in 6 cases(15. 0%) ,2 cases of stillbirth(5.0%) ,loss of pregnancy(abortion+stillbirth) 8 cases (20. 0%) in experimental group. The abortion occurred in 2 cases (5.0%), no stillbirth in control group. The loss of pregnancy in experimental group were significantly higher than the control group (X2=9. 54, P＜0. 005 ). The rate of positive in ACA-IgG (40. 0%) after treatment lower than before treatment (52. 5 %) (X2 = 3.85, P＜0. 05). The rate of positive in ACA IgM (37. 5%) after treatment lower than before treatment(40. 0)% (X2=3.81 ,P＜0. 05 ). Conclusion The APS positive rate and the loss of pregnancy were closely related. The overall nursing intervention conld improve efficacy and reduce the complications.

Objective To investigate the efficacy to pregnant outcoule with antieardiolipin antibody(ACA) of qualitative and quantitative before treatment and after treatment in women pregnant with antiphospho-lipid syndrome (APS).Methods The heparin combined with aspirin therapy APS 40 patients before and after treatment to momtor the change of ACAIgG,IgM.Results 40 patients were treated 37 eases of live births,success rate were92.5%,the rate of pregnancy loss were3 cases(7.5%);The lever of ACA-IgG and ACA-IgM were(67.63±2.53)u and (49.40±3.64)u beforetreatment andlever of ACA-IgG and ACA-IgM were(23.87±1.54)u and(21.60±2.59)u after treatment.The lever after treatment were significandy Iower than the before treatment(P＜0.01);The level of ACA were overall downward in 40 cases after treatment by dynamic observation;The rate of positive in ACAIgG (40.0)% after treatment lower than before treatment(52.5)%(X2=3.85,P＜0.05);The rate of positive in ACA IgM(37.5)% after treatment lower than before treatment(47.5)%(X2=3.81,P＜0.05).Conclusion Hepfinar treatment combined with aspirinmay be a safe and effective method for patients with APS.

C-reactive protein(CRP)is the most sensitive indicator of acute phase proteins.A growing body of evidence suggests that atherosclerosis,as a main cause of cerebral infarction,is a chronic inflammtory process.The present studies have found that the CRP levels and genetic polymorphisms are associated with atherosclerosis and cerebral infarction.As compared with coronary artery disease,the association between high-sensitive CRP and ischemic stroke is more closely.This article reviews the advaces in research on the biological characteristics of CRP,the factors influencing CRP levels,the CRP levels and the correlation between genetic polymorphisms and cerebral infarction.

Objective To observe the preemptive analgesia effects of katamine and elonidine, and to find out the influence of preemptive on stress responses. Methods 36 patients with hysteromyoma undergone hysteromyomec-tomy were randomly assigned to three groups (n = 12 each group) :group Ⅰ , control group, without preemptive analge-sia,the patients in control group were given continous epidural analgesia with 2% lidoeaine 12 - 14ml. Group Ⅱ ,the patients were injected 0. 6mg/kg katamine into epidural analgesia 30 minutes before operation. Group Ⅲ,the patients were injected 0. 6mg/kg katamine and 1.5μg/kg clonidine into epidural analgesia 30 minutes before operation. The patients in three groups were recorded VAS score on 2h ,4h ,6h, 12h ,24h after operation, also recorded the change of epinephrine(E) and norepinephrine(NE) and sensation and movement recovery time after operation. The side effects such as dizziness nausea,vomit,and exited talking were observed during the operation. Results The VAS score were significantly different between group Ⅰ ,Ⅱ and Ⅲ. The levels of E and NE in plasma in group Ⅰ were increased more than group Ⅱ and Ⅲ within 24 hours after operation, also there is significant difference in group Ⅱ compared with group Ⅲ in T1 ,T2 ,T3. The time of sensation and movement recovery were remarkably longer in group Ⅲ com-pared with group Ⅰ and Ⅱ, showing significant difference. There were no significant difference in side effects after operation in three groups. Conclusion The preemptive analgesia of kutamine and colnidine can relieve the pain of lower abdominal surgery and stress response after operation,and it do not increase the side effects.

Colorectal cancer(CRC)ranks the third in incidence and mortality rate among human tumors. Tumor relapse,me?tastasis and drug resistance remain the main obstacle to the success of CRC treatments. Compared to traditional chemotherapy ,target therapy seems to treat tumors in more precise and rational fashion with good response and often less toxic side-effect. Although target agents provide hope for more effective therapy,recent clinical studies have shown only modest benefit from target therapy similar to tra?ditional chemotherapy. Primary and secondary resistance to target agents is still observed and contributes to CRC treatment failure. The review summarizes research progress in the mechanism of drug resistance to target therapy in CRC treatment.

Objective To investigate the effect of dynamic regulation of negative pressure values in vacuum sealing drainage (VSD) on healing of soft tissue wounds.Methods From January 2013 to December 2015,115 patients were treated at our institute for open soft tissue defects of Gustilo-Anderson type ⅢaⅢc.They were 69 males and 46 females,aged from 17 to 76 years (average,44.7 years).They were divided into 4 groups to be subjected to different negative pressure values.Group A (n =29) was subjected to negative pressure values from-40 to-20 kPa,group B (n =29) to values from-80 to-60 kPa,group C (n =29) to values from-40 to-20 kPa for the first 72 hours followed by values from-80 to-60 kPa,and group D (n =28) to values from-60 to-80 kPa for the first 72 hours followed by values from-40 to -20 kPa.The 4 groups were compared in terms of drainage volume,wound shrinking,cleaning time,healing time and complications.Results The drainage volumes on the 7th day in groups B and D (4.89 ± 0.66 mL/cm2 and 4.33 ± 0.96 mL/cm2) were significantly higher than those in groups A and C (2.90 ± 0.67 mL/cm2 and 2.99 ±0.56 mL/cm2);the wound shrinking areas on the 14th day in groups B and D (14.16 ± 1.77 cm2 and 13.84 ± 1.65 cm2) were significantly larger than in groups A and C (12.57 ± 1.92 cm2 and 10.95 ± 1.37 cm2) (P ＜ 0.05).The cleaning time in group A was significantly longer than in the other 3 groups (P ＜ 0.05).The healing time in groups A and C was longer than in groups B and D (P ＜ 0.05).The incidences of pain in groups B and C were significantly higher than in groups A and D (P ＜ 0.05).The incidences of infection and blocking in group A were higher than in the other 3 groups (P ＜ 0.05).Conclusion Dynamic regulation of negative pressure values from-80 to-60 kPa for the first 72 hours followed by values from-40 to-20 kPa is an optimal choice for VSD management of soft tissue defects due to adequate drainage,obvious wound shrinking,quick cleaning and healing,and limited complications.

BACKGROUND:Adherent migration of vascular smooth muscle cells and proliferated remodeling of vessel walls following vascular endothelial injury play a key role in onset of restenosis after percutaneous transluminal coronary angioplasty,while expression and phosphorylation activation of focal adhesion kinase are attacked during this period.OBJECTIVE:To observe the interventional effect of angiotensin receptor antagonist,telmisartan,on the expression and activation of focal adhesion kinase during vascular-injured remodeling.DESIGN:Randomized controlled animal study.SETTING:Shenzhen Center for Chronic Disease Control and Prevention;Department of Cardiology,Affiliated Hospital of Xianning Medical College;Department of Cardiology,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology.MATERIALS:The experiment was carded out in the Cardiovascular Laboratory,Wuhan Tongji Hospital from March to May 2005.A total of 36 male Wistar rats weighing 300-360 g were randomly divided into control group,model group and treatment group with 12 in each group.METHODS:Aortal restenosis models were established after endothelial denudation.Foley's tube technique was used to strip vascular endothetium of rats in the model group and the treatment group;while,rats in the control group and the model group were fed and drunk normally; in addition, rats in the treatment group were also given 5 mg/(kg·d) telmisartan solution.Thirty clays after successive administration,vessels at injured sites were collected to observe the morphological changes and extract RNA and protein.Reverse transcriptase polymerase chain reaction (RT-PCR) was used to measure mRNA expression of focal adhesion kinase and Westem blot technique was USod to measure total protein and phosphorylated protein of focal adhesion kinase.MAIN OUTCOME MEASURES: Proliferation of vessel wall at injured sites; mRNA expression, total protein and phosphorylated protein of focal adhesion kinase at injured sites at 30 days after administration.RESULTS:A total of 36 rats Were involved in the final analysis.Thirty days after operation, aortic tunica intima was thickened in the model group, mRNA expression of focal adhesion kinase was increased, and total protein and phosphorylated protein were higher in the model group than those in the control group;however,proliferation of tunica 5ntima vasorum was lightened in the treatment group, activity of mRNA expression of focal adhesion kinase was decreased, and total protein and phosphorylated protein were lower in the treatment group than those in the model group.CONCLUSION: Telmisartan can remarkably relieve proliferation of tunica intima after denudation and inhibit expression and activation of focal adhesion kinase after vascular injury.Effect of telmisartan on vascular-injured remodeling may be related to inhibiting expression and activation of focal adhesion kinase.

BACKGROUND: In the past, a lot of researches used one-time lead level in umbilical cord blood at birth for investigations,however, one-time lead level in umbilical cord blood at birth can not represent lead caused cumu lative injury to neonatal nervous system during the whole period of preg nancy. Lead in meconium is mainly from digestive juice secreted by fetal alimentary tract, exfoliative epithelia from neonatal intestinal tract and am niotic fluid and sebum cutaneum swallowed by fetus, which is excreted from the very start of pregnancy to 24 hours after birth of neonates and re flects the lead deposit in neonatal intestinal tract during the whole period of pregnancy. OBJECTIVE: To explore the relationship between neurobehavioral devel opment in neonates with intrauterine exposure to lead at low level and the lead level in umbilical cord blood (CBPb) and meconium (MPb). DESIGN: Take lead levels in umbilical cord blood and meconium as neonatal intrauterine exposure indicators and scores of neonatal neurobe havioral development as effect indicators, and descriptive analysis is used to evaluate the correlativity. SETTING: Wuhan University of Science and Technology; Laboratory of Occupation Disease and Epidemiology, Tongji Medical College, Huazhong University of Science and Technology; Wuhan First Metallurgical Con struction Company Hospital for Workers and Staff. PARTICIPANTS: A total of 103 cases of full-term and healthy neonates were selected as objects of observation. The neonates were born in Depart ment of Gynecology and Obstetrics, Wuhan First Metallurgical Constrction Company Hospital, Qingshan District of New Industrial District of Wuhan from January to October 1999. Their parents were agreed to participate in the study and filled in the questionnaire, and provided neonatal meconium and performed neonatal tests on schedule. METHODS: ① Collection and assay of sample: 5 mL umbilical cord blood were collected and reserved in refrigerator at -4 ℃. Meconium with in 24 hours after birth, with dry weight between 5 to 10 g was collected, the lead levels in umbilical cord blood and meconium were assayed with the method of graphite furnace atomic absorption spectroscopy. ② Group ing: The neonates were divided into two groups with high and low-exposure to lead based on the cutoff value of CBPb of 0.483 μmol/L and MPb of 127.78 mg/kg. ③ Neonatal neurobehavioral development examination: Neonatal neurobehavioral development examination method was used for examination 3 days before delivery. Meanwhile, self-designed questionnaire was used to conduct a survey in puerperas. MAIN OUTCOME MEASURES: ① Lead levels in neonatal umbilical cord blood and meconium. ② Scores of neurobehavioral development of neonates with different lead levels of umbilical cord blood and meconium. RESULTS: All the 103 cases of neonates entered results analysis. ①There was significant difference only in scores of neonatal behavioral neurological assessment (NBNA) and biological visual and auditory orientation reaction (BVAOR)between groups with high and low-exposure to lead in umbilical cord blood (P ＜ 0.05). However, there was no rank correlativity between lead level in umbilical cord blood and scores of NBNA,non-biological auditory orientation reaction (NBAOR), non-biological visual orientation reaction (NBVOR) and biological visual and auditory orientation reaction (NBVOR). ②here was significant difference in scores of NBNA,NBAOR, NBVOR and BVAOR between groups with high and low-exposure to lead in meconium (P ＜ 0.05-0.01). The lead level in meconium clearly correlated reversely with scores of NBNA, NBVOR and BVAOR.CONCLUSION: Lead level in meconium is more sensitively related to the scores of neonatal neurobehavioral development, which could be used as indicator for lead deposit in the fetal body during the period of pregnancy.

Objective To analyze the separation and displacement of bone fragments in sagittal fracture of the mandibular condyle (SFMC),understand the motion type and guide clinical treatment and development of related surgical instruments.Methods Forty-five patients (52 sides) with SFMC treated between October 2008 and October 2012 were enrolled; 32 patients (36 sides) were males and 13 patients (16 sides) were females.According to the Neff classification,there were 20 sides with type A,28 sides type B and 4 sides type M.All the patients underwent CT scan and were classified based on measurements of distance and angle of displaced bone fragments.Results Patients were categorized into type Ⅰ on 20 sides (type Ⅰ A on 14 sides and type Ⅰ B on 6 sides),type Ⅱ on 27 sides (type Ⅱ A on 11 sides and type ⅡB on 16 sides),type ⅢB in 1 side and type Ⅳ in4 sides.Mean displacement of bone fragments was 12 mm (range,4-16 mm) ; mean deviation angle was 34°(range,11°-43°) ; mean descending distance was 13 mm (range,6-18 mm).Conclusion CT analysis results show that,mast bone fragments in SFMC move slightly.

Objective To evaluate the effect of internal iliac artery or abdominal aorta blockade on the pressure of internal iliac artery net in order to provide theoretical basis for reasonable option of arterial blockade in management of arterial bleeding of pelvic fractures.Methods Five goats were included in the study.The measurement of the pressure of internal iliac artery net was made in the following steps:( 1 ) measurement of the pressure of normal internal iliac artery,(2) measurenent of the pressure following blockade of unilateral internal iliac artery,(3) measurement of the pressure following blockade of bilateral internal iliac arteries,(4) measurement of the pressure following blockade of abdominal aorta and bilateral internal iliac arteries simultaneously,(5) measurement of the pressure following blockade of abdominal aorta only.Results The normal internal iliac artery pressure was ( 57.84 ± 13.46 ) mm Hg.The pressures following the blockade of unilateral internal iliac artery,bilateral internal iliac arteries,abdominal aorta and bilateral internal iliac arteries sinultaneously,and abdominal aorta only were (38.40±17.39) mm Hg,(29.70 ± 12.16) mmHg,(32.80 ± 17.02) mm Hg and (29.20 ± 18.52) mm Hg,respectively.All the blocking designs had obvious effect on the pressure of normal internal iliac artery ( P ＜ 0.05 ),while the various blockade modes themselves showed no statistical differences (P ＞ 0.05). Conclusion The upper described four modes of blockade are similar in decreasing the pressure of the internal iliac artery net.Thereby,only one of them is enough in management of artery hemorrhage following pelvic fractures.