OBJECTIVETo explore a safe and effective scheme of analgesic for labor.

METHODSEighty-four primiparas without contraindication of vaginal delivery were divided into an observation group and a control group, 42 cases in each one. In the observation group, the acupoint injection was given at Zusanli (ST 36) combined with electroacupuncture (EA) at Hegu (LI 4) and Sanyinjiao (SP 6) till the cervical opening at the end of first stage labor. In the control group, the routine respiratory instruction was applied. In 5 min, 10 min and 60 min of acupuncture (the same time points in the control group) as well as at the end of the first and second stage labor, the analgesic effect was assessed for the primiparas of the two groups. The labor stages, adverse reactions, postpartum hemorrhage, postpartum urine retention, newborn asphyxia rate and usage rate of oxytocin were compared between the two groups.

RESULTSIn the observation group, in 5 min, 10 min and 60 min of acupuncture as well as at the end of the first and second stages, the visual analogue scale (VAS) was lower apparently as compared with the control group at the corresponding time points (all P < 0.05). The differences in the time limit in the active period, the second and third stages were not significant between the two groups (all P > 0.05). The incidence of adverse reactions and the usage rate of oxytocin were lower than those in the control group [2.4% (1/42) vs 31.0% (13/42); 2.4% (1/42) vs 23.8% (10/42), both P < 0.05]. The differences in postpartum hemorrhage, postpartum urine retention and newborn asphyxia rate were not significant between the two groups (all P > 0.05).

CONCLUSIONThe combination of acupoint injection and EA is the effective analgesic scheme for labor. This scheme effectively alleviates labor pain and has no maternal and child complications.

Acupuncture Analgesia ; Acupuncture Points ; Adult ; Analgesics ; administration & dosage ; Combined Modality Therapy ; Electroacupuncture ; Female ; Humans ; Labor Pain ; drug therapy ; therapy ; Labor, Obstetric ; Pregnancy ; Young Adult

Objective To evaluate the potential utility of temporal temperature gradient gel electrophoresis (TTGE) in detecting homoplasmic and heteroplasmic mtDNA mutations in patients with cancers. Methods The entire mtDNA of tumor and corresponding normal tissues from total 117 patients were amplified by PCR, and the somatic mutations were screened by TTGE. DNA fragments showing different band patterns in normal and tumor tissues in TTGE were sequened to identify the exact mutations. Results 160 fragments harbouring mtDNA mutations were found by TTGE in total 3 654 fragments. Compared with the direct squencing results, the sensitivity and specificity of TTGE in mutation detection were 96.27% and 94.05% respectively. Conclusion TTGE is an effective method for screening acquired homoplasmic mitochondrial gene mutation and its different percentage.

Objective To investigate the application of strain rate imaging in quantitative assessment of left ventricular regional diastolic function after intracoronary stent implantation.Methods Fifty-six healthy person and 60 patients with coronary artery disease were performed quantitative assessment of left ventricular regional diastolic function by apical four chamber view,apical two chamber view and left ventricular long axis view before and after intracoronary stent implantation using strain rate imaging.Results Compared with those of normal myocardium,the peaks of strain rate curve at diastole of ischemic myocardium were reduced,and were increased after operation (P ＜ 0.05).Conclusions Intracoronary stent implantation can significantly improve the blood supply to the ischemia myocardium.Strain rate imaging can quantitatively analyze the changes of left ventricular regional diastolic function.

Objective To explore the effect of video-based teaching of Lamaze method on delivery among primiparae.Methods One hundred and twenty pregnant women were randomly assigned to the intervention group and the control group with 60 in each.The intervention group received additional train-ing by using the video-based teaching of Lamaze method besides routine antepartum education,while the control group received only routine antepartum education.The cesarean section rate,labor course and neonatal asphyxia were compared between the two groups.Results The rate of natural delivery in the in-tervention group was significantly lower,and the rate of cesarean section caused by social factors decreased,which were all better than those in the control group.Neonatal asphyxia showed no difference between the two groups. Conclusions The video-based teaching of Lamaze method can promote natural delivery,shorten Labor course and worthy of wide application in pregnancy school.

Objective To observe the effect of electroacupuncture(EA) in combination with small dose of clozapine on clinical symptoms of refractory schizophrenia patients so as to evaluate its validity and security.Methods Eighty schizophrenia patients were randomized into medication group and EA+medication group(n=40/group).Patients of medication group were treated with conventional oral administration of clozapine(50-100 mg/d to 200-500 mg/d,for 8 weeks) and those of EA+ medication group treated by EA of Baihui(GV 20) and bilateral Taiyang(EX-HN 5) and oral administration of clozapine(50 mg/d to 100-150 mg/d).EA was given to the patients,3 times a week for 8 weeks.Scores of the Positive and Negative Symptom Scale(PANSS) and the Untoward Effect Symptom Scale(TESS) were used to assess the therapeutic effect.Results Following treatment,PANSS scores for positive symptoms and the common psychiatric symptoms of the medication and EA+medication groups all decreased evidently from the 2rd week on(P0.05).But TESS score of EA+medication group was evidently lower than that of medication group(P

Objective:To explore the effects of clinical pharmacist on the rational drug use in the patients with membranous ne -phropathy complicated with drug-induced liver injury .Methods:The whole drug treatment process of one patient with membranous ne-phropathy complicated with drug-induced liver injury was analyzed , pharmaceutical care on the use of glucocorticoids , hepatoprotective agents, anticoagulants and antihypertensive drugs was performed , and the precautions and suggestions on the drug use were put for-ward.Results:Clinical pharmacist participated in the clinical treatment and provided the pharmaceutical service for doctors , nurses and patients directly , which could enhance the therapeutic efficacy and reduce the adverse drug reaction .Conclusion: Through the participation in clinical practice , clinical pharmacist plays an important role in the rational drug use , which provides better pharmacy service for patients .

Objective To evaluate the safety limits of amygdalin in the Chinese patent medicines and Chinese herbal medi-cines,so as to provide reference for establishing the standard in the safety limits of endogenous cyanide glycosides as toxic ingredients. Methods The toxicity differences between D-amygdalin and L-amygdalin were explored by CCK-8 assay. The daily safe dose of amyg-dalin was deduced by the no-observed-adverse-effect level(NOAEL)of cyanide. Based on the deduced results,the safety limits of amygdalin in thirty-six Chinese patent medicines and three different kinds of Chinese herbal medicine were calculated. Results The half maximal inhibitory concentration of D-amygdalin and L-amygdalin was(3.5±2.0)and(6.6±0.4)mmol/L,respectively,and the daily safe dose of amygdalin was 104.30 mg. Conclusion The toxicity of D-amygdalin was approximately two times that of L-amygda-lin. To establish the safety limits of amygdalin,the sum content of the epimer could be regarded as the D-amygdalin itself to enlarge the safety scope. The content of amygdalin of three Chinese patent medicines was determined to exceed the maximum safety limit for all measured batches,indicating some kind of safety risk. Moreover,in the researches on safety limit establishment,the toxicity-alleviat-ed processing effect should be included.

Objective:To investigate the influence and mechanism of Portulaca extracts on Tumor Necrosis Factor -α(TNF-α), Interleukin-4(IL-4) in skins of rats with atopic eczema (AE).Methods:40 SD rats were randomly divided into normal control group , model group,Cortex Phellodendri group and Porulaca group.2,4-dinitrochlorobenzene was used on the right back of rat for making atopic eczema.21 days later , all animals were sacrificed , compared the weight of the same size of the eczema and healthy skin.The levels of TNF-αand IL-4 in rats skins were detected by immunohistochemical method.Results:The right back of rats in model group appeared obvious erythema ,erosion and leakage ,which meant the modeling succeeded.Compared with model group ,the swelling degree of Cortex Phellodendri group and Purslane group were significantly decreased ( P<0.01 ) ,compared with Cortex Phellodendri group ,the swelling degree of Purslane group were less than them ( P<0.05 ).The levels of TNF-α, in rats skins of normal control group , model group,Cortex Phellodendri group and Portulaca group were (6 652.66±1 190.94 ),(19 927.10±5 494.21 ), (7 515.13±877.66 ), (6 809.93±1 385.54).The levels of IL-4 were (5 378.44±1 685.01),(26 334.89±3 993.48),(7 814.84±1 751.38),(8 246.57± 975.08 ).Compared with model group ,the levels of TNF-α,IL-4 in rats skins of Cortex Phellodendri group and Purslane group were sig-nificantly decreased(P<0.01).Compared with positive drug group,the levels of TNF-α,IL-4 in rats skins of Purslane group were a little decreased(P<0.05).Conclusion:Purslane extracts has effect to treat atopic eczema ,its possible mechanism is by erducing the proinflammatory factor ,and moderating the anti-inflammatory factor and the ratio between them.

This study was aimed to explore the mechanism of Jia-Yan-Kang-Tai (JYKT) on Th1/Th2 immune cell imbalance in rats with autoimmune thyroiditis (AIT).A total of 40 Lewis rats were made into AIT rat model.Six week later,AIT rats were randomly divided into the model group,low-dose,middle-dose and high-dose JYKT group,with 10 rats in each group.Intragastric administration of deionized water,0.708 g· kg-1,1.417 g· kg-1 and 2.834 g· kg-1 JYKT was given to rats in each group,respectively for 8 consecutive weeks.Serum TgAb and TPOAb were detected.The ratio of Th1 cell,Th2 cell and Th1/Th2 was measured.Contents of IL-4,IL-5,IFN-γ,TNF-α and IL-1oα in plasma were detected.The pathology of thyroid tissues was observed by HE dyeing.The protein expressions of IFN-γ and IL-4 in thyroid tissues were observed under immunohistochemical staining.The results showed that high-dose JYKT group can reduce the level of TPOAb and TGAb,the incidence of thyroiditis,the ratio of Th1 cell,Th2 cell and Th1/Th2;decrease contents of IFN-γ,TNF-α,IL-1α,IL-4 and IL-5 in plasma;reduce the protein expression of IFN-γ and IL-4 in thyroid tissues.It was concluded that JYKT was able to suppress thyroid autoantibodies of AIT rats,which may be related to the regulation of cytokine level and Th 1/Th2 immune cell imbalance.

Objective:To study the relationship between the expression of carnitine palmitoyltransferase 1α (CPT1α) and progression of renal interstitial fibrosis and chronic kidney disease (CKD), and to evaluate the value of CPT1α as a biomarker in pathological diagnosis of renal interstitial fibrosis and CKD.Methods:As a retrospective cohort study, information of CKD patients dignosed with tubulointerstitial fibrosis by renal biopsy and receiving follow-up from March 1, 2010 to July 30, 2017 in the Second Affiliated Hospital of Nanjing Medical University were collected. Renal tissues were stained by immunohistochemistry to detect the expression of CPT1α protein and then divided into three groups according to the quartile of proportion of CPT1α positive staining cells, including group Q1(>67.89%), group Q2(49.84%-67.89%) and group Q3(<49.84%). The degree of renal interstitial fibrosis was measured by Masson staining and lipid deposition was represented by Bodipy staining. Messenger RNA of CPT1α and collagen as well as other extracellular matrix genes were detected by real time-PCR. Relationships between proportion of CPT1α positive staining cells and renal interstitial fibrosis and renal function were analyzed by linear regression analysis. The relationship between CPT1α positive cell number ratio and renal function progression was measured by Pearson correlation analysis and generalized linear model. The effect of lipid-lowering medicine on renal function of CKD patients was analyzed by paired comparative analysis.Results:Ninety patients with CKD were included in this study. Renal interstitial fibrosis and lipid droplets deposition area increased in Q2/Q3 group compared with Q1 group by Masson and Bodipy staining (all P<0.05). Messenger RNA level of extracellular matrix-related proteins increased in Q2/Q3 group by real time-PCR than those of Q1 group (all P<0.05). Linear regression analysis showed that fibrosis area was negatively correlated with the proportion of CPT1α positive staining cells ( r=-0.309, P<0.01). The baseline expression of CPT1α in renal issues was negatively related with serum creatinine (Scr) ( r=-2.801, P<0.001), positively related with estimated glomerular filtration rate (eGFR) ( r=1.240, P<0.001). After a medium follow-up of 3.47 years, CPT1α positive cell number ratio was positively correlated with eGFR change rate by Pearson analysis ( r=0.220, P=0.038). Paired stratified analysis showed that taking lipid-lowering medicines attenuated the decrease of eGFR in Q2 group and Q3 group but not in Q1 group (both P<0.05). Conclusions:The decline of CPT1α in renal tissues of CKD patients is associated with the increase of Scr, the decrease of eGFR and renal interstitial fibrosis. CPT1α is a promising molecular marker to evaluate the degree of renal fibrosis and the progression of CKD.