Objective To observe the postoperative analgesic effects of ultrasound-guided transversus abdominis plane block after cesarean section. Methods Forty patients having underwent cesarean section under intraspinal anesthesia were selected, and they were divided into experiment group and control group by random digits table method with 20 cases each. All the patients were given ultrasound-guided transversus abdominis plane blocks when surgery finished. The patients in experiment group were injected 0.25%ropivacaine 20 ml, and the patients in control group were injected 0.9% sodium chloride 20 ml. All the patients received patient controlled intravenous analgesia (PCIA) pump after surgery. The movement and resting visual analog score (VAS), incision VAS at 4, 8, 12 and 24 h after surgery, and the compression time of analgesis pump were compared between 2 groups. The correlated adverse reaction of transversus abdominis plane block were recorded. Results The movement VAS at 4 and 8 h after surgery in experiment group were (4.1±1.7) and (5.3±1.8)scores, and in control group were (6.3±2.0) and (7.0±1.2) scores, and there were statistical differences (P<0.05). The incision VAS at 4 and 8 h after surgery in experiment group were (0.9±0.4) and (1.2±0.8) scores, and in control group were (3.6±2.1) and (6.8±2.4) scores, and there were statistical differences (P<0.05). The compression time of analgesis pump in experiment group was significantly lower than that in control group: (2.8± 1.4) times vs. (4.0±1.9) times, and there was statistical difference (P<0.05). The using dose of tramadol in experiment group was significantly lower than that in control group:(214±12) mg vs. (224±15) mg, and there was statistical difference (P<0.05). All the patients did not appear the correlated adverse reaction of transversus abdominis plane block. Conclusions Ultrasound-guided transversus abdominis plane block is accurate and easy. It provides effectual post-cesarean section analgesia with lower adverse reaction, which is a better choice of multimodal analgesia for cesarean section.

Objective To investigate the safety and efficiency of radiofrequency ablation (RFA) in the treatment of complicated multifetal gestations.Methods There were 6 multifetal pregnant women (gestational age ranged from 14+6 to 27 +2 weeks) diagnosed in the Department of Obstetrics,Provincial Hospital Affiliated to Shandong University:two with twin-twin transfusion syndrome (TTTS) stage Ⅳ,one with reversed arterial perfusion sequence,one with dichorionic triamniotic triplets,one with absence of a lower limb,one with severe intrauterine growth restriction.All of them accepted ultrasound-guided selective fetocide by RFA.Results (1) Blood flow of three reduced fetuses stopped completely after one RFA circulation,whereas the other three stopped after two circulations.One reduced fetus stopped heartbeating in 10 minutes after RFA; three reduced fetuses' heartbeats slowed down and stopped completely in 35 minutes after RFA ; and the heartbeats of the other two cases stopped completely within 3 to 7 minutes after RFA.The heartbeats of the reserved fetuses were normal.All of the operations succeeded.(2) The reserved fetuses received a series of ultrasound examinations after the operations.In Case 1,the ascites of the reserved fetus,which was 4.0 cm× 2.3 cm before RFA,disappeared two weeks later; and the umbilical artery systolic/diastolic (S/D) ratio,which was 3.35 before the operation,decreased to 2.70 six weeks later.Amniotic fluid depth decreased from 44.6 cm to normal two weeks after RFA.The reserved fetus received brain MRI three weeks after RFA and no abnormality was detected.In Case 2,the increased heart size (cardiothoracic ratio ＞ 0.35) of the reserved fetus recovered to normal size ten days after the operation ; and the umbilical artery S/D decreased from 4.69 to 3.39 seven days after the operation.Reserved fetuses of the other three cases were normal on ultrasound and MRI after the operations.In Case 6,the ascites of the reserved fetus,which was 2.3 cm × 1.5 cm before RFA,disappeared sixteen days after the operation.The brain MRI suggested normal three weeks after the procedure.Amniotic fluid depth reduced from 11.0 cm to normal two weeks after the operation.(3) Three women delivered normal premature babies,and the other three got healthy mature infants.At present,all children are still in follow-up,and their physical examinations suggest normal.Conclusions RFA is a safe,efficient,minimal invasive treatment,which provides a new choice for fetocide,especially for complicated monochorionic multifetal gestations.Fetocide by RFA can effectively improve the life quality of the reserved fetuses.

60 years old,severe underlying disease,abuse application of antibiotics,hormones,immunosuppressors and radio-and chemotherapy,invasive operation,and so on.CONCLUSIONS It is important to find out nosocomial fungus infection earlier,and to treat it in time.We must strengthen the education about nosocomial fungus infection,(apply) the antibiotics regularly and rationally,and pay attention to result of culturing from the(microbiological)(laboratory).

The paper analyzes different expressions of indirectly associated strong-weak connection in the process of biomedical literature knowledge discovery,defines the effect and function of strong-weak connection on literature knowledge discovery,and indicates that the accuracy rate of the discovery of potential connection through strong connection is obviously higher than the accuracy rate obtained through weak connection,and strong connection can serve as an important factor for improving the application effect of literature knowledge discovery.

Academic Inspection is not only an important part of clinical teaching,but also a vital tache of improvement for medical treatment quality.Unlike internal medicine and surgery,acdemic inspection of ICU has its own characteristics.PBL teaching method on acdemic inspection of attending doctor in ICU is explored in this article.

Objective To assess the effects of dynamic monitoring of plasma Pro-B-type Natriuretic Peptide(Pro-BNP) in the evaluation of prognostic value and myocardial dysfunction in patients with septic shock.Methods The levels of plasma Pro-BNP were tested in 102 patients with septic shock on the 1,3,and 5 days.Data on ICU mortality and 28-day mortality were collected.The patients were divided into non-dysfunction group (CI＜3.0) and cardiac dysfunction group (CI≥3.0) according to levels of hemodynamic variables ( CI level).The prognostic value of plasma Pro-BNP was analyzed.Results Plasma Pro-BNP levels on the 1,3 and 5 days in 28-day survivors have a significant declining trend [( 1649.0 ± 257.5 ) ng/L,( 1867.6 ± 291.7 ) ng/L vs.(1229.9 ± 194.5) ng/L),while plasma Pro-BNP levels in non-survivors have an increasing trend [(4128.8 ± 1051.1),( 5315.9 ± 925.4 ) vs.( 6899.9 ± 1327.9 ) ng/L].There is statistical significance of plasma Pro-BNP levels at day 1,3 and 5 for the two groups ( t=3.057,5.083,and 6.290 respectively,P＜0.01 ).The 28-day mortality and Plasma Pro-BNP levels in cardiac dysfunction group were higher than of non-dysfunction group ( 28-day mortality:62.1％ vs.20.0％;Pro-BNP1:( 1592.8 ± 362.2 )ng/L vs.( 4556.6 ±732.7 ) ng/L;Pro-BNP3:( 2933.6 ± 421.7 ) vs.( 5768.5 ± 793.7 ) ng/L,Pro-BNP5:( 3014.5 ± 587.5 ) ng/L vs.(8873.9 ± 1670.1) ng/L ( x2=20.635,P=0.000,t=3.626,3.154,3.310,P＜0.01].Pro-BNP level greater than 3053 ng/L on the 5-day was an independent prognostic indicator of 28-day mortality ( sensitivity:88.4％;specificity:91.5 ％ ).Pro-BNP level greater than 2378 ng/L on the 5-day was an independent prognostic indicator of hospital mortality ( sensitivity:84.9％;specificity:91.8％ ).In multivariate logistic regression analyses,Pro-BNP level and APACHE score were independent predictors of 28-day mortality and hospital mortality.Conclusion Plasma Pro-BNP level shows obvious significance in evaluation of sepsis-induced myocardial depression severity in patients with septic shock.Pro-BNP level in ICU at day 5 after inclusion is an independent prognostic marker of mortality in septic shock.

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

The general situation of the approved and concluded projects of National Natural Science Foundation of China in the field of processing Chinese Materia Medica in recent five years has been reviewed. The progresses and achievements of some projects have been summarized in accordance with research area such as the processing principle, the processing technology, quality evaluation, toxicity and safety evaluation, etc. The researchers and project support units of the funded projects have been analyzed, and the problems of the applications have been also summarized.
Biomedical Research ; economics ; organization & administration ; Chemistry, Pharmaceutical ; economics ; organization & administration ; China ; Financing, Organized ; economics ; organization & administration ; Humans ; Materia Medica ; economics ; Medicine, Chinese Traditional ; economics

Objective To investigate influence of preservation of remnant ligament on vascularization of grafts in anterior cruciate ligament (ACL) reconstruction.Methods Seventy-eight New Zealand rabbits were involved and both knees of the rabbits received one-stage ACL reconstruction simultaneously.One knee was reconstructed with preservation of residual fibers (remnant preservation group),and the contralateral one was treated with conventional debridement of residual fibers (remnant removal group).Blood flow of grafts was evaluated in vivo by laser doppler flow meter,expression of CD34 in vessels of grafts was measured by immunofluorescence method,growth of vessels surrounding grafts was observed with ink perfusion under stereomicroscope at 6,12,18,and 24 weeks after reconstruction.Results Laser doppler flow meter showed blood flow of grafts was significantly larger in remnant preservation group than in remnant removal group (P ＜ 0.01).Immunofluorescence testing revealed positive expression of CD34 of grafts was notably higher in remnant preservation group than in remnant removal group (P ＜ 0.05).Ink perfusion showed that the number of vessels surrounding grafts was much more in remnant preservation group than that in remnant removal group (P ＜ 0.05).Conclusion Remnant preservation benefits the vascularization of grafts in early stage after ACL reconstruction.

Successful pain management of perioperative shoulder arthroscopy may allow patients to go home earlier, improve the quality of life in perioperative period, and facilitate rehabilitation. A comprehensive method to perioperative pain control has three stages including preoperative, intraoperative and postoperative phase. Successful pain reduction should begin preoperatively because of an excellent communication between patient and physician, moreover, preoperative analgesia also should be administered. Intraoperative efforts should include local wound infiltration and the administration of anesthetic medication intra-articularly. Postoperative management should include oral analgesics, constant infusion devices, Patient Controlled Analgesia (PCA), sedative-hypnotic drug, continuous cryotherapy and vicarious treatment.
Acupuncture Analgesia ; Analgesia ; methods ; Analgesia, Patient-Controlled ; Arthroscopy ; Humans ; Pain, Postoperative ; therapy ; Perioperative Period ; Shoulder Joint ; surgery ; Transcutaneous Electric Nerve Stimulation