Objective To observe and research the influence of vaginal delivery and cesarean section by two kinds of mode of delivery on maternal infant outcome of re-pregnancy after cesarean section.Methods 258 patients with re-pregnancy after cesarean section were selected,they were divided into vaginal delivery group(73 cases) and cesarean section group(185 cases) according to the different delivery mode.The maternal puerperal infection rate,24h postpartum hemorrhage volume,days,cost of hospitalization,lochia time and neonatal in hospital of both two groups were compared.Results The success rate of vaginal delivery was 69.52％,the rate of cesarean section was 71.71％.In vaginal delivery group,maternal puerperal infection rate,24 h postpartum hemorrhage volume,length of hospital stay,cost of hospitalization,lochia time were 1.73 ％,(201.54 ± 107.54) mL,(3.41 ± 0.09) d,(1 540.12 ±117.21),(21.36 ± 13.12) d,which were significantly better than the second cesarean section group [8.11％,(354.64 ± 215.54) mL,(7.45 ± 0.32) d,(4 932.62 ± 786.35),(27.11 ± 17.04) d],the differences were statistically significant (x2 =4.08,t =4.75,7.24,8.91,3.98,all P ＜ 0.05).Delivery of two kinds of mode of delivery of the newborn had no significant differences in birth weight,Apgar score,the rate of infection,intracranial hemorrhage rate and the asphyxia rate(t =0.15,0.09,0.46,0.00,x2 =0.03,all P＞0.05).Conclusion Re-pregnancy after cesarean section is not the choice of cesarean section delivery clinical indications of operation,when the pregnant women with indications of trial production,in strict monitoring downlink vaginal delivery.

Objective To investigate the expression and localization of S100B protein in the placenta and umbilical cord tissue of the pregnant women at different gestational ages. Methods The placenta and umbilical cord tissues were obtained from 60 healthy pregnant women at different gestational ages:13～27 weeks (a = 20),28～36 weeks (n = 20),37～41 weeks (n = 20). The localization and expres-sion of S100B protein was detected by S-P immunochemical method and Western blotting. Results In the placenta,the S100B protein lo-cated in the trophoblast.myofibroblasts.macrophages and smooth muscle cells. The intensity of immunostaining and protein concentration in-creased with advancing gestation. In the umbilical cord,the S100B protein was found in the smooth muscle cells,myofibmblasts,amnion ep-ithelium, macrophages and monocytes. S100B piotein expression showed no significant difference in the different cells of the umbilical cord. Conclusion S100B protein expression in the placenta and umbilical cord tissues is throughout the gestation and increases with advancing gestation in the placenta.

Polymeric micelles as effective drug carriers have been paid wide attention. They have many considerable advantages in cancer therapy, such as high efficiency, long acting and high drug loading etc. The paper reviewed the type, preparation materials and drug lording methods of polymeric micelles, especially discussed the targeting strategy of tumor-targeting drug delivery systems and the ap-plication examples of polymeric micelles in targeting drug delivery systems.

College students' employment viewpoint has transferred ultimately from traditional"government-planning assignment" to modern job-seeking mechanism of "two way choice and independent option".Recently,medical college has reformed clinical teaching in 5-years program.But some problems still exist in clinical teaching reflected from the employment situation of medical graduates and the evaluation of recruiting employers.Some work can be done to solve problems existing in medical students' employment.It is an important issue in adapting social requirement through reforming the model of clinical teaching and arranging the period of clinical training reasonably.

With the development of social education,the examination system becomes standardized.The fairness of test paper evaluation,which is a last procedure,becomes more and more important.Aiming at the shortcomings of the existing test paper evaluation,educator should pay more attention and take many effective measures to form good response mechanism in order to embody the fairness about test paper evaluation and give play to the initiative.

The development of new drug is not only the main driving force for the development of pharmaceutical industry, but also plays a very important role in the social development. However, with the increasing demands, new drug development is facing great difficulties in recent years. The hypothesis of highly selective single-target is meeting the challenges because of its limitations. Network pharmacology has been one of the new strategies for new drug discovery based on single-target drug research in recent years. This paper focused on the basis of network pharmacology and its research progress, discussed its development direction and application prospects, and analyzed its limitations and problems as well. The application of network pharmacology in new drug development is discussed by comparing its guidelines with those of traditional Chinese medicine theory and Effective Components Group hypothesis of Chinese medicines.

Objective:To explore the significance measuring serum levels of high sensitive C reactive protein (hsCRP),ho-mocysteine (Hcy)and carotid atherosclerosis lesion in patients with coronary heart disease (CHD)complicated atrial fibril-lation (AF).Methods:A total of 84 CHD + AF patients (CHD + AF group),42 CHD patients with sinus rhythm (sinus rhythm CHD group)and 40 healthy subjects (healthy control group)were selected.CHD + AF group was further divided into paroxysmal AF group (n=31),persistent AF group (n=27)and permanent AF group (n=26).Serum levels of hsCRP and Hcy and carotid intima-media thickness (IMT)were measured in all groups,and Crouse integral of atheroscle-rotic plaques was calculated.Results:Compared with healthy control group,there were significant rise in serum levels of hsCRP [(4.97±2.14)mg/L vs.(8.96±3.75)mg/L vs.(6.83±2.91)mg/L],Hcy [(15.48±4.36)μmol/L vs.(23.64 ±7.06)μmol/L vs.(17.76±4.83)μmol/L],IMT [(1.21±0.15)mm vs.(1.71±0.19)mm vs.(1.36±0.17)mm]and plaque Crouse integral [(4.13±1.06)scores vs.(7.89±1.35)scores vs.(4.96±1.21)scores]in CHD + AF group and sinus rhythm CHD group,P <0.05 or <0.01;and those of CHD + AF group were significantly higher than those of sinus rhythm CHD group,P <0.01 all,compared with paroxysmal AF group,there were significant rise in serum levels of hsCRP,Hcy,IMT and plaque Crouse integral in permanent AF group and persistent AF group (P <0.05 or <0.01),and those of permanent AF group were significantly higher than those of persistent AF group (P <0.05 or <0.01);Pearson correlation analysis indicated that in CHD + AF group,serum levels of hsCRP and Hcy were positively correlated with AF duration (r =0.619,0.527,P<0.05 both),and positively correlated with Crouse integral of carotid plaque (r =0.438, 0.561,P<0.05 both),and Crouse integral of carotid plaque was positively correlated with AF duration (r =0.624,P <0.05).Conclusion:Inflammatory reaction,oxidative stress and carotid atherosclerosis are more severe in CHD + AF pa-tients,and they aggravate along with AF duration prolongs.

Objective To compare the efficacy and complications of early transabdominal preperitoneal patch (TAPP) implantation and open tension-free repair in the treatment of adult inguinal hernia .Methods 84 adult patients with inguinal hernia were divided into two groups by random number table ,and 42 cases in each group .The control group was given Lichtenstein technique ,while the observation group underwent TAPP .The surgery situation, postoperative visual analogue scale (VAS) scores,postoperative morbidity and recurrence rate were compared between the two groups.Results The operative time,ambulation time,average length staying hospital and postoperative VAS scores of the observation group were (42.21 ±3.13) min,(1.13 ±0.21) d,(4.28 ±0.62) d and (2.28 ±0.22) points,which were significantly less than (65.72 ±3.62)min,(2.03 ±0.30)d,(7.87 ±0.83)d and (4.56 ±0.31) points of the control group(t=7.29,8.02,8.32,9.29,all P<0.05).The incidence rate of postoperative complica-tions and recurrence rate of the observation group were 11.90% and 2.38%,which were significantly lower than 26.19%and 16.66%of the control group(χ2 =12.52,14.39,all P<0.05).Conclusion The effect of TAPP in the treatment of adult inguinal hernia is remarkable ,and it is safe and minimally invasive ,which is easy to operate ,it has low recurrence rate ,rapid postoperative recovery and has better clinical value .

Objective:To evaluate the curative effect of electroacupuncture on postapoplectic incontinence of urine.Methods:One Hundred and fifty-five patients were randomly allocated into a treatment group of 102 cases and a control group Of 51 cases.The treatment group was treated with electroacupuncture and the control group with Wlestem medicine.The curative effects were evaluated after 1-2 months.Resuits:The basic cure rate.marked eriective rate,effective rate and inelyective rate were 47.0%,27.5%,1 8.6% and 6.9% respectively,with a total effective rate of 93.1%in the treatment group and 7.9%,1 7.6%,1 7.6% and 56.9% respectively,with a total effective rate of 43.1% in the control group.There was a statistically significant difference in curative effect between the two groups(P＜0.05).The curative effect was significantly beaer in the treatment group than in the control group.Conclusion:Electroacupuncture has a good curative effect on postapoplectic incontinence ofurine.

Objective To investigate the effects of Yindan-Xinnaotong combined with aspirin on lipidemia levels and hemorrheology in patients with stroke. Methods A total of 62 patients with stroke were randomized into a treatment group (31 cases) and a control group (31 cases). The patients in the control group were treated with aspirin and those in the treatment group were treated with aspirin and Yindan-Xinnaotong capsule (4 capsules each time, 3 times/d) for 30 days. The lipidemia levels and hemorrheology were evaluated before and after the treatment. Results After the treatment, whole blood viscosity (4.15 ± 0.14 mPa?s vs. 5.25 ± 0.40 mPa?s;t=14.452, P<0.01), plasma viscosity (1.70 ± 0.30 mPa?s vs. 2.70 ± 0.25 mPa?s;t=14.258, P<0.01), fibrinogen (3.71 ± 0.51 g/L vs. 5.80 ± 0.41 g/L;t=17.783, P<0.01) and thrombosis index (0.75 ± 0.31 vs. 1.30 ± 0.21;t=8.178, P<0.01) in the treatment group were significantly lower than those in the control group. After the treatment, the serum levels of total cholesterol (3.31 ± 1.19 mmol/L vs. 5.04 ± 1.30 mmol/L;t=5.465, P<0.01), triacylglycerol (0.63 ± 0.31 mmol/L vs. 1.34 ± 0.05 mmol/L;t=12.589. P<0.01) in the treatment were significantly lower than those in the control group, the serum level of high-density lipoprotein cholesterol in the treatment group was significantly higher than that in the control group (1.83 ± 0.49 mmol/L vs. 1.28 ± 0.45 mmol/L;t=4.603, P<0.01), and there was no significant difference in the serum level of low-density lipoprotein cholesterol between the two groups (2.22 ± 0.61 mmol/L vs. 2.11 ± 0.95 mmol/L; t=0.543, P>0.05). Conclusion Yindan-Xinnaotong combined with aspirin can improve the lipidemia and hemorrheology in stroke patients.