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 explore the clinical characteristics,diagnosis,treatment and misdiagnosis matter of children with idiopathic pulmonary hemosiderosis(IPH).Methods The data of clinical characteristics,laboratory examination,treatment and follow-up of 21 children admitted from Jun.1993 to May 2007 were retrospectively analyzed,included 9 males,12 females,aged 1-14 years old,course of di-sease were 1-6 months.Twenty-one patients were diagnosed as IPH by chest X-ray radiography,CT scan,bone marrow biopsy,hemosiderin-laden macrophages in either sputum or gastric juice or bronchoalveolar lavage fluid.Then,therapy and prognosis of IPH were analyzed.Results All patients had varied degrees of anemia,11(52.38%) children had cough,9 (42.86%) children had fever,6(28.50%) cases had shortage of orexia,4( 19.05%) children had hemoptysis.Chest X-ray radiography and CT scan demonstrated diffuse patchy,nodular,reticulate pattern.Eighteen children received bone marrow biopsy and presented hyperplastic erythropoiesis,4(22.2%) cases were accompanied iron deficiency anemia.Nineteen (90.80%) cases shown the presence of hemosiderin-laden macrophages in either sputum or gastric juice or bronchoalveolar lavage fluid.Twenty-one misdiagnosed patients consisted of bronchopneumonia combined anemia(8 cases),lung tuberculosis combined anemia(5 cases),nulli-iron anemia(4 cases),hemolytic anemia(3 cases),myelodysplastic syndrome(1 case)and received corticosteroid therapy.Four cases of all patients were associatated with large-dose human-?-globulin and 3 cases were associatated with vincristine therapy.The therapeutic effect was significant.Eighteen patients were followed-up,3 patients were of which cured and had stopped treatment for over 2 years,11 patients presented clinically persistent remission,4 patients were recurred and aggravated.Conclusions Early diagnosis and long-term therapy of corticosteroid are very important for controlling acute onset,lessening the frequency of IPH recurrence and improving prognosis of the disease.

Background:Gastroesophageal reflux disease(GERD)is a common disorder of digestive system,however,some of patients are not responding to conventional 4-8 weeks proton pump inhibitor therapy. Aims:To investigate the effect of digital music gastric electrical pacing on clinical symptoms,anxiety and depression and esophageal motility in patients with refractory GERD. Methods:Fifty-three patients with refractory GERD from Jan. 2014 to Oct. 2015 at the Third Affiliated Hospital,the Third Military Medical University were recruited. All of them fulfilled the Montreal definition of GERD. Digital music gastric electrical pacing was performed for 15 days and the efficacy was evaluated by clinical symptom scoring,Hamilton anxiety scale( HAMA),Hamilton depression scale( HAMD)and esophageal motility manometry. Results:After 15-day treatment,the main symptoms,including heartburn,daytime and nocturnal acid reflux,upper abdominal pain,nausea,and sleep disorder were significantly improved(P < 0. 001). A great proportion of patients were complicated with anxiety and/ or depression at recruitment,and after treatment the scores of HAMA and HAMD were decreased significantly(P < 0. 001). Meanwhile,the lower esophageal sphincter resting pressure(LESP),distal wave amplitude,peristaltic wave duration,speed of peristaltic wave and distal contraction integral after treatment were significantly increased as compared with the baseline values(P < 0. 05). Conclusions:Digital music gastric electrical pacing is effective for treatment of refractory GERD with increase of LESP and esophageal body motility. The clinical symptoms and anxiety and depression are improved simultaneously. Digital music gastric electrical pacing is expected to be a new choice of non-medicine treatment for esophageal motility disorders.

Objective To investigate the inducing effects of selenium dioxide(SeO2 ) on the apoptosis in human cervical carcino-ma cell line Hela and its influence on the expression of apoptosis-related proteins caspase-3 and P53 .Methods Hela cells were trea-ted with different concentrations of SeO2 for 24 h in vitro ;the morphological changes of Hela cells were observed by the optical mi-croscope;the influence of SeO2 on the cell proliferation and vitality was examined by the MTT assay ;the flow cytometry was em-ployed to detect the cell apoptosis rate ;the expressions of caspase-3 and P53 proteins in Hela cells were determined by the Western blot analysis .Results Under the optical microscopy ,SeO2 generated the obvious influence on the cell growth morphology ,a large number of cells became rounded and shrunken ,and lost the normal form ,while the adherence cell number was evidently decreased and the proliferation was slowed down ;the MTT results showed that SeO2 markedly inhibited the cell proliferation and viability in a dose-dependent manner ,in which ,the cell apoptosis rates induced by the 0 ,1 .875 ,3 .750 ,7 .500 ,15 .000 and 30 .000 μmol/L con-centrations of SeO2 were 3 .12% ,30 .56% ,33 .42% ,37 .50% ,45 .43% and 69 .38% respectively ,which revealing the obviously in-creasing trend;the Western blot assay revealed that SeO2 could up-regulate the caspase-3 and P53 levels ,and reached the peak value at the concentration of 7 .500μmol/L .Conclusion SeO2 could induce the cervical cancer cell apoptosis possibly by up-regulating the expressions of caspase-3 and p53 in Hela cells .

Objective To explore the level of patient safety culture of nurses, so as to provide more objective information for the developmental measures to improve patient safety culture. Methods 1 866 nurses from six grade-3 hospitals of a province were investigated by patient safety culture assessment scale. Results The total scores of patient safety culture of nurses was 3.57 ± 0.42, belongs to the middle-level. 5 factors in descending order according to the questionnaire scores was teamwork climate, safety climate, job Satisfaction,perception of management and stress recognition. The lower scores were the punishment of adverse events, job stress, work intensity, the staffing and so on. Conclusions It is very important that nurse managers should focus on improving a safer system in nursing, find out the potential risks, create a positive patient safety culture,and reduce or prevent adverse events of nursing in order to promote patient safety.

Objective To clone the human Islet neogenesis associated protein(rhINGAP)gene,express the gene extraeellulary in Pichia yeast for.further study on biological function and animal test on INGAP.Methods INGAP gene Was amplified with PCR and inserted into the recombinant plasmidα/pUC18.Then,the fusion gene of α and INGAP was digested and inserted into the expression plasmid pPIC9K.The positive recombinant plasmid which integrated INGAP Was confirmed by restriction enzyme digestion and sequencing,and it Was linearized with Sal Ⅰ digestion and transfered into the yeast host strain GS115 through electroporation.The yeast transformants that harbor the desired gene INGAP with high copy were selected by the auxotroph mediam G418,and verified by PCR.The condition of hake-flask culture was optimized,and the recombinant human INGAP Was induced expression with methanol as the only Carbone source.The antigen activity of the desired protein Was detected by Western blotting and ELISA method.Results Recombinant plasmid αINGAP/pPIC9K were successfully constructed and three positive Pichia yeast transformants were obtained.The expressed protein had satisfactory antigen activity,which Was confirmed by the Western blotting and ELISA method.Conclusions Pichia yeast expressing human Islet neogenesis associated protein (rhINGAP)gene was successfully constructed.

AlM: To evaluate the effectiveness and security of lift and squeeze technique in phacoemulsification of hypermature cataract.
METHODS: From June 2010 to June 2013, totally 156 eyes with hypermature cataract, which received phacoemulsification in our hospital, were enrolled. Lift and squeeze technique was used to chop the nucleus, and 1g/L Trypan blue was used for capsulorhexis. Average time of phaco complication, corneal edema and visual outcome were recorded.
RESULTS: The best-corrected visual acuity ( BCVA ) was 0. 1-0. 4 in 15 eyes (9. 6%), 0. 5-0. 7 in 82 (52. 6%) eyes, and 0. 8-1. 0 in 59 ( 37. 8%) eyes at 3mo after surgery. The phaco time was 25-56s (average 42±10s), the maximum phaco power was 30%. Posterior capsular rupture and vitreous loss happened in 2 eyes (1. 3%), and the lOLs were implanted in the sulcus. Corneal edema classified at grade Ⅰ were seen in 12 eyes (7. 7%), and 5 eyes (3. 2%) at gradeⅡ, no eye at gradeⅢ and gradeⅣ. The mean endothelial cell loss was 8. 7%at 3mo.
CONCLUSlON: Crystalline lens capsule staining with Trypan blue increase the success rate of intact continuous curvilinear capsulorhexis ( CCC ) . The lift and squeeze technique reduces the stress on the zonules and capsule, and decreases the phaco time and phaco power.

Objective To explore the relationships among posttraumatic growth (PTG),social support,and coping style in women with infertility.Methods 182 women with infertility were recruited in one public hospital department of assisted reproduction technology.Measures included Posttraumatic Growth Inventory (PTGI),Perceived Social Support Scale (PSSS),and Simplified Coping Style Questionnaire (SCQ).Results ① The PTG score of women with infertility was 42.55 ± 16.83,lower than the average level.② Compared with the lower PTG group,the higher PTG group scored significantly higher in social support,positive coping,and negative coping (t =3.867,P＜ 0.01 ; t =8.452,P＜ 0.01 ; t =2.817,P＜ 0.01).③ There were significantly positive correlations among PTG,social support and positive coping (r =0.295-0.515,P ＜ 0.01).④ Positive coping served as a total mediator in the relationship between social support and PTG.Conclusion There are closely correlations among PTG,social support,and positive coping style.Positive coping style significantly mediate the relationship between social support and PTG.

Objective To analyze the relationship between different rectal volume,bladder volume and dose of organs at risk (OARs) in intracavitary brachytherapy for cervical cancer.Methods A total of 47 patients with cervical cancer were selected.All of them were treated with high dose rate (HDR) intracavitary brachytherapy with a 600 cGy dose for the dosage point.The effects of different volume of rectum bladder and small intestine for corresponding exposure dose under the standard planning were evaluated using a dose-volume histogram (DVH).According to bladder volume,patients were divided into three groups,＜ 80 cm3 group,80-120 cm3 group and ＞ 120 cm3 group.And according to rectum volume,patients were divided into ＞ 60 cm3 group and ≤ 60 cm3 group.The relationship between the volume and dosage were analyzed.The ANOVA test and t test were used for analyzing D1 cm3,D2 cm3,D30％ and D50％.Results Compared with the group with ＜ 80 cm3 bladder volume,D30％,D50％ value of bladder in groups with 80-120 cm3 and ＞ 120 cm3 of bladder volume increased (F =5.074,5.088,P ＜ 0.05).The difference of D1 cm3 and D2 cm3 value of the small intestine between 80-120 cm3 and ＞ 120 cm3 bladder volume groups were not statistically significant (P ＞ 0.05).D1 cm3 of rectum in groups with ≤ 60 cm3 rectum volume was decreased than that of ＞ 60 cm3 group (t =-2.045,P ＜ 0.05).Conclusions Keeping an appropriatly full bladder and reducing rectal volume in cervical cancers treated with intracavitary brachytherapy can make the exposure dose of bladder,rectum and small intestine relatively small,and reduce the adverse reactions of radiotherapy.

Objective To investigate the risk factors for prognosis of severe acute pancreatitis (SAP).Methods The clinical data of 563 patients with acute pancreatitis (AP) treated from January 2008 to December 2014 were analyzed retrospectively.There were 334 patients with mild acute pancreatitis (MAP),and 198 patients with moderately severe acute pancreatitis (MSAP),and 31 patients with severe acute pancreatitis (SAP).Risk factors associated with MAP and MSAP + SAP group,MSAP and SAP group were determined by univariate logistic regression,and multivariate analysis was used to determine the risk factors for severity of AP.Results Univariate logistic regression analysis showed that age,WBC,serum glucose,calcium,urea nitrogen arterial partial pressure of oxygen (PaO2),SIRS,pleural effusion,peripancreatic fluid collection were associated with severity of AP in MAP and MSAP + SAP patients;age,serum calcium,PaO2,SIRS,pleural effusion,peripancreatic fluid collection were associated with severity of AP in MSAP and SAP patients.Multivariate logistic regression analysis showed that age,serum calcium,PaO2 and peripancreatic fluid collection were risk factor of MSAP and SAP;age,serum calcimm and SIRS were risk factors of SAP patients for persistent organ failure and pancreatic necrosis.Conclusions For elderly AP patients,measurement of arterial partial pressure of oxygen and serum calcium,peripancreatic fluid collection can help evaluate the severity of AP and early recognition.For SAP patients,the presence of SIRS,high serum urea nitrogen,and low serum calcium and peripancreatic fluid collection raise the concerns of persistent organ failure and pancreatic necrosis.