Objective To investigate the relationship between absent end-diastolic velocity (AEDV) in umbilical artery and perinatal outcome,and to explore the effect of termination time of pregnancy on perinatal outcome. Methods Data of thirty five pregnant women with AEDV admitted into Beijing Obstetrics and Gynecology Hospital from January 2008 to December 2009 were retrospectively analyzed.According to gestational age and treatment,they were divided into four groups.Group 1:AEDV was identified before 28 weeks without treatment (n=5); Group 2:AEDV was found before 28 weeks,and then was treated (n=13); Group 3:AEDV was found after 28 weeks,and was not treated (n=11); Group 4:AEDV was found after 28 weeks,and then was treated (n=6). Except for three patients in Group 2,all patients had complications.Data were presented by frequency,rate or mean±SD. Results Among the 35 patients,19 (54.3％) delivered and 23 living children were born.When AEDV was found,the gestational age was less than 28 weeks and the mean gestational age was (22.8 ± 2.2) weeks in Group 1,(24.2 ± 2.0) weeks in Group 2,however,the gestational age was over 28 weeks and the mean value was (30.9± 2.8) weeks in Group 3 and (29.5±0.8) weeks in Group 4.Treatment was given to women in Groups 2 and 4,but not in Group 1 and 3.In Group 1,one patient complicated with twin-twin transfusion syndrome; one with hemolysis,elevated liver enzymes and low platelet syndrome and placental abruption; three recovered after two weeks and babies survived.In Group 2,the termination time was (31.4 ± 5.5)gestational weeks and the duration of treatment was (10.7± 5.5) days.AEDV of six patients were not improved after treatment,among which five accepted induced abortion,one had preterm delivery.The rest six women underwent cesarean section and one term delivered.Babies survived except for one preterm neonate and one lost in follow-up.In Group 3,the termination time was (31.2 ± 2.9)gestational weeks.Five patients accepted artificial abortion for severe complications of mother or babies; the other six patients accepted cesarean section,among which one complicated with placental abruption and baby died.The rest five babies survived.In Group 4,the pregnancies were terminated at an average of (32.8±2.9) gestational weeks and the duration of treatment was (10.8±6.7) days.Two accepted induction after treatment and four recovered to normal after treatment and accepted cesarean section with four wellbeing babies. Conclusions Perinatal outcomes of patients with AEDV complicated with severe complications after active treatment might relate to the termination time.Some patients with AEDV without severe complications might recover spontaneously with good prognosis.

Objective To analyze the changes of cesarean section rate (CSR) and indications of cesarean section (CS) after implementation of responsible system of attending physician (RSAP) and new partogram.Methods Totally,11 814 women,who delivered in the Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University in the fourth quarter of 2012,2013 and 2014,were chosen.The mode of delivery,CSR,CS indications and matemal and fetal outcomes of these women were analyzed with Chi-square test.The RSAP was started in 2013,and both RSAP and the new partogram were applied in 2014 in our hospital.Results The CSRs in the fourth quarter of 2012,2013 and 2014 were 46.4％(1 502/3 235),40.4％(1 524/3 770) and 33.5％(1 612/4 809) (x2=138.312,P＜0.05),and the converting CSR in the delivery room were 10.9％(212/1 945),7.8％(189/2 435) and 6.1％(208/3 414),respectively (x2=39.765,P＜0.05).The proportion of assisted vaginal delivery in the fourth quarter of 2014 was higher than those of the former two years [4.9％(237/4 809) vs 3.4％ (108/3 235) and 3.5％(131/3 770),x2=17.041,P＜0.05].More and more CS deliveries emerged due to scarred uterus,multiple pregnancy,comorbidities and complications during pregnancy year by year,while those CS deliveries because of macrosomia,narrow pelvis,social factors,elderly primipara,umbilical cord entanglement,precious fetus and high myopia gradually decreased (all P＜0.05).In the fourth quarter of 2014,the proportions of CS with fetal distress,abnormal labor,cephalopelvic disproportion and intrauterine infection were lower than those in 2013 (all P＜0.05).No significant difference was shown in the proportion of postpartum hemorrhage and neonatal asphyxia among the three years (both P＞0.05).In 2014,smaller percentage of neonates were transferred to the Pediatrics Department after birth than in 2012 and 2013 [10.2％(491/4 809) vs 12.0％(388/3 235) and 13.7％(516/3 770),x2=24.681,P＜0.05].Conclusions The implementation of RSAP and the application of new partogram effectively reduce the CSR through strict control on indications of CS.

Objective To investigate the clinical characteristics,surgical resection extent and prognosis influencing factors of pri-mary high-risk gastrointestinal stromal tumors(GIST).Methods The clinicopathological and follow-up data of 48 patients with pri-mary resectable high-risk GIST in this hospital from January 2005 to January 2013 were retrospectively analyzed.The influence of three kinds of different surgical resection methods on the prognosis of GIST was analyzed.Results 34 cases were treated by R0 re-section(70.83%),6 cases by R1 resection(11.50%)and 8 cases by R2 resection(16.67%).All cases were given the postoperative adjuvant therapy of imatinib mesylate.The average medication time was(26.5±13.6)months.The occurrence rate of adverse drug reactions was 100%,and the main symptoms were swelling and leukopenia.The 5-year survival rates in 3 kinds of resection modes were 97.06%,66.67% and 25.00% respectively.The univariate and multivariate prognostic analysis showed that the surgical re-section extent and the tumor rupture were the independent prognostic factors in the high-risk GIST patients.Conclusion The intact operative resection and preventing the tumor rupture are the keys to increase the postoperative survival rate of GIST patients.

Objective To compare the efficacy of pressure-controlled ventilation and volume-controlled ventilation in patients undergoing lumbar surgery in prone position.Methods Sixty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,weighing 45-90 kg,scheduled for lumbar surgery in prone position,were randomly divided into 2 groups (n =30 each) using a random number table:pressure-controlled ventilation group (group P) and volume-controlled ventilation group (group V).Anesthesia was induced with dexamethasone 10 mg,etomidate 0.3 mg/kg,sufentanil 0.4 μg/kg,and rocuronium 0.6 mg/kg and maintained with propofol 2-4 mg· kg-1 · h-1,remifentanil 6-10 μg· kg-1 · h-1 and vecuronium 0.08 mg· kg-1 · h-1.The i-gel laryngeal mask airways were inserted after induction and the patients were mechanically ventilated.A gastric tube was inserted through the drain tube of i-gel.The maximum inspiratory pressure was adjusted to reach the tidal volume (VT) of 8 ml/kg in group P and the VT was set at 8 ml/kg in group V.PTrCO2 was maintained at 30-40 mm Hg.The mean airway pressure (Pmean) and peak airway pressure (Peak) were recorded immediately after insertion of i-geal (T0),immediately after the patients were turned to prone position (T1),immediately before skin incision (T2),30 min after the beginning of surgery (T3),immediately after the end of surgery (T4) and immediately after the patients were turned to supine position (T5).While dynamic lung compliance (Cdyn) was calculated.Arterial blood samples were taken at the same time points for blood gas analysis.Oxygenation index (OI) and respiratory index (RI) were calculated.Results Compared with group V,Pmoan and Ppeak were significantly decreased at T0-5,Cdyn and OI were increased,and RI was decreased at T1-4 in group P (P ＜ 0.05).Conclusion Compared with volumecontrolled ventilation,pressure-controlled ventilation can better improve the ventilatory efficacy and reduce prone position-induced effect on respiratory function in patients undergoing lumbar surgery.

Objective:To study the relationships of portal hypertensions to vasoactive substances-angiotensin(AT-Ⅱ)in cirrhosis patients.Methods:48 patients with liver cirrhosis(LC)(including 18 patients with compensated LC and 30 patients with decompensated LC) and 32 normal controls(NC) were studied. Color duplex doppler ultrasonography was used to study portal venous and splenic venous blood flow(PVBF and SVBF).Also,the blood concentration of AT-Ⅱ was detected.Then,analyze the correlation between PVBF and SVBF to AT-Ⅱ.Results:Portal hyperdynamic exists in cirrhosis patients from beginning to the end. Low level of AT-Ⅱ in compensated LC patient has no relation with portal hyperdynamic, high level of AT-Ⅱ in decompensated LC has positive relation with portal hyperdynamic.Conclusion:This study has directed significance of clinical treatment and diagnosis.

Objective To evaluate the toxicological safety of Shanze weight-reducing food in order to provide some toxicological data for its application. Methods According to the national standard of safety evaluation, the following experiments of acute toxicity test through mouth in rats, the genetic toxicity test, thirty days feeding test and teratogenicity test in mice were performed. Results LD 50 was more than 20.0 g?kg -1, equivalent to 467 times of the recommended dosage, in acute toxicity test through mouth in both male and female rats, which fell into the scale of non-toxicity. Under the dosage range of 1.05 g?kg -1 to 4.20 g?kg -1, equivalent to 100 times of the recommended, the negative results were observed in the genetic toxicity test of micronucleus test of bone marrow cells, sperm shape abnormality test in mice and the Ames test. The negative impacts on the growth, development, hematology, biochemistry, histology and the ratio of organ to whole body were not found on the experimental rats of thirty days feeding. Under the same dosage range, no teratogenic effects were found in the experiments of teratogenicity test. Conclusions Shanze can be used as a kind of health weight-reducing food with toxicological safety under the experimental dosage range of 1.05 g?kg -1 to 4.20 g?kg -1.

Objective To evaluate the effect of laparoscopic myomectomy. Methods Clinical data of 62 cases of laparoscopic myomectomy were analyzed retrospectively. Results Success was achieved in all the operations.Of the 62 cases,intramural myoma was confirmed in 45 cases,and subserous myoma,17 cases (non-pedicled,10 cases; pedicled,7 cases).A total of 101 myomas were removed,with a diameter of 1～9 cm (mean,6 8 cm).The mean operative time was 25～270 min (mean,99 min),and the intraoperative blood loss,10～400 ml (mean,63 ml).The postoperative hospital stay was 2～8 days (mean,4 7 days) and the overall complication rate was 25 8% (16/62).Follow-up observation in 42 cases for 2～36 months (mean,9 months) found recurrence in 2 cases and full-term pregnancy in 2 out of 10 cases with infertility. Conclusions Laparoscopic myomectomy has advantages of safety,quick recovery,short hospital stay and fewer complications.

[Objective] To explore the in-vitro determination method for the recovery rate of sinomenine in microdialysis probe and to investigate the influencing factors. [Methods] The recovery rate of sinomenine was detected by concentration difference method (by gain and by loss) and zero-net flux method. [Results] The recovery rate detected by increment method was as the same as that by decrement method; the recovery rate had no correlation with the sinomenine concentration in the solvent. Sinomenine recovery assessed by concentration difference method had a good intra-day stability and intra-day reproducibility. Sinomenine concentration and recovery in the solvent could be determined accurately by zero-net flux method. [ Conclusion ] Microdialysis sampling can be used for the pharmacokinetic study of sinomenine and decrement method (ie. retrodialysis) can be used for the determination of recovery rate of sinomenine.

[Objective]To explore new directions for traditional Chinese medicine(TCM) scientific research. [Method]Reviewing RWS overseas in recent years, with a randomized control ed trial(RCT) contrast, this study summarized the RWS features and discussed the limitations and advantages of RCT and RWS when carrying out the TCM scientific research.[Result] RWS is different from RCT in research purpose, brings into exclusion criteria, sample size, intervention and evaluation index, evaluation time, data col ection, management and statistical analysis method, etc. [Conclusion] Compared with RCT, RWS more fits the basic characteristics of TCM cal ed holistic concept and syndrome differentiation, is advantageous to the preservation of TCM, indicat-ing the new direction for TCM scientific research.

In current research and development of new drugs,the demand for toxicological study using neonatal and juvenile animals is becoming increasingly urgent. In this paper,we discussed the characteristics,importance and necessity of nonclinical safety evaluation for pediatric drugs,considerations for research design,selection of animal species and age,route and duration of drug administration and evaluation indexes. In addition,the characteristics of nonclinical safety evaluation of new traditional Chinese materia medica used for children were analyzed. It is hoped that these studies will not only provide support and reference for nonclinical safety evaluation of pediatric drugs but help accumulate material in formulating relevant guidelines.