Objective Observing the effect of general anesthesia (GA) with remifentanil on parturients undergoing cesarean section and Apgar score of child.Methods 40 parturients were divided into two groups,GA combined remifentanil (group A,n =20) and standard GA(group B,n =20).Observe the change of hemodynamics parameter and Apgar score of child.Results In group A than in group B maternal hemodynamic index smooth,two groups of intubation after lmin SBP,DBP,HR decreased,while the5 min after intubation returned to normal.SBP DBP,HR before induction,the difference between groups was not statistically significant (P＞ 0.05),the two group after induction,SBP,DBP,HR intubation after 1 min were (120.8 ± 19.6 mm Hg,80.6 ± 11.2 mm Hg,98.1 ± 17.1 BPM),(128.1 ± 17.5 mm Hg,98.9 ± 13.8mm Hg,108.7 ± 20.7 BPM) after intubation of 5 min were (98.3 ± 24.7 mm Hg 75.3 ± 13.8 mm Hg,79.9 ±22.6 BPM),(121.5 ± 16.2 mm Hg,88.6 ± 13.7 mm Hg,110.5 ± 17.4 BPM) had a significant difference (P ＜ 0.05),neonatal 1 min,5 min Apgar score,no significant differences between the two groups (P ＞0.05).Conclusion When remifentanil is used in the general anesthesia,its inducing is smoothly and it is no significant bad effect on the newborn.

OBJECTIVE:To observe the clinical efficacy and safety of sodium hyaluronate combined with glucosamine in the treatment of knee osteoarthritis. METHODS:1 220 patients with knee osteoarthritis were randomly divided into observation group and control group. The patients in control group were treated with Sodium hyaluronate injection alone,once a week;while the ob-servation group was additionally and orally treated with Glucosamine hydrochloride capsules two tablets,three times a day. The course of treatment was 5 weeks in both groups. The relevant physicotherapeutics and oral medication in the treatment of the dis-ease should be stopped. The clinic efficacy,visual analog scale(VAS)and lysholm knee score before and after treatment,and inci-dence of adverse reaction were observed. RESULTS:Total effective rate of observation group was significantly higher than control group,with statistically significant difference(P<0.05). After treatment,VAS and lysholm knee scores in both groups were signifi-cantly lower than before,and observation group was lower than control group,with significant differences(P<0.05). There were no severe adverse reactions during treatment. CONCLUSIONS:Sodium hyaluronate combined with glucosamine has more signifi-cant clinical efficacy in the treatment of knee osteoarthritis than sodium hyaluronate alone,with good safety.

Objective To investigate the carcinogeic role of miR-365 in cuntanerous squamous cell carcinoma (cSCC).Methods Normal HaCaT cells were divided into control and irradiation groups,the later was exposed by UVB irradiation (50 J/m2).MicroRNA expression profiles of the two groups were analyzed by microRNA array.The expression variations of miR-365 in HaCaT,A431,Tca8113 and HSC-1 cells were validated by qRT-PCR analysis.The colony-forming and invasion capacities were dectected by colony forming assay and Transwell migration assay in vitro,respectively.HaCaTpre-miR365-2 highly expressing miR-365 was constructed by retroviral vector infection.Tumorigenicity evaluation was carried out by subcutaneously inject of the cells at the right back flank of nude mice.Results There were 30 microRNAs differentially expressed in HaCaT cells after UVB irradiation and miR-365 was one of the most sensitive miRNAs(as high 6.7 times as control).Expression of miR-365 in all the cSCC cell lines A431,Tca8113 and HSC-1 were significantly higher than that in HaCaT cell,in which the maximum was A431 (15.67 ±1.12 times,P ＜ 0.01),and the minimum was TcaS113 (4.72 ± 0.85 times,P ＜ 0.05).Knockdown of miR-365 in cSCC cell lines significantly inhibited the colony forming ability (t =13.68,P ＜ 0.05) and cell migration (t =19.98,P ＜ 0.05) in vitro.HaCaT cells overexpressing miR-365 by transient transfection significantly increased the ability of colony formation (t =7.11,P ＜ 0.05) and cell migration (t =22.03,P ＜0.05) in vitro.In addition,HaCaTpre-miR-365-2 cell line stably expressing miR-365 could successfully establish tumors in nude mice.Conclusions MiR-365 is an oncogene for cutaneous squamous cell carcinoma.

Objective To understand the levels of plasma endothelin (ET) and calcitonin gene-related peptide (CGRP) in cough variant asthma(CVA) patients, and to investigate their correlation and clinical implications. Methods Thirty CVA patients,30 typical bronchial asthma patients and 25 healthy controls were recruited. Three milliliter limosis venous blood were drawn from each patient to measure the levels of plasma ET and CGRP by radioimmanity. Results ①The levels of ET in the CVA group and typical bronchial asthma group were higher than that in healthy controls (P < 0.01). Their values were (103.58±28.66) ng/L, (129.37±27.28) ng/L and (72.63±21.52)ng/L, respectively. The levels of CGRP in the CVA group and typical bronchial asthma group were (7.62±2.56) ng/L and(6.63±2.09)ng/L The level of CGRP in the healthy controls group was (21.60±3.29) ng/L. The first two groups were lower than the latter(P < 0.01). However, there was no significant difference between the CVA group and typical bronchial asthma group(P >0.05). ②ET and CGRP were negatively correlated in both CVA group(r= -0.819,P<0.05) and typical bronchial asthma group(r= -0.738,P<0.05). Conclusions ET and CGRP were negatively correlated in both CVA group and typical bronchial asthma group, which means that ET and CGRP were a couple of antagonistic factors participated in the regulation of CVA, and may play an important role in the process of CVA.

Objective To investigate the HBV- positive pregnant women about the knowledge of the route of hepatitis B transmission, hepatitis B hazards, health care during pregnancy, announcements of child- care to explore targeted and effective health education model with self- designed question-naires. Methods Nurses in obstetrics department carried out this questionnaire investigation in the outpa-tients of HBV- positive pregnant women, after that the results underwent statistic analysis. Results The overall knowledge of HBV- positive pregnant women in announcements of child- care, health care during pregnancy and hepatitis B hazards was not very well, and the announcements of child- care was the lowest, followed by health care during pregnancy and hepatitis B hazards. The route of hepatitis B transmission was better, but still not satisfactory. The education should highlight these areas. Well- educated women were better than those who lack education. The age between 20 to 30 years old was better. Conclusions The HBV-positive pregnant women is lack of heath knowledge, so we should gave health intervention in a multi- level, multi- stage standardized and a variety of ways.

Objective To investigate the sonographic features of follicular variant of papillary thyroid carcinoma (FV-PTC) and to decrease misdiagnosis rate. Methods Thirty-one patients with 35 FV-PTCs and 66 patients with 75 conventional PTCs (C-PTCs) were enrolled in this study. The sonographic features were reviewed retrospectively between the two groups with universally accepted standards. Results The sonographic features of 35 FV-PTCs included irregular shapes (6/35), anteroposterior to transverse diameter ratio A/T > 1 (7/35), spiculated margins (25/35), marked hypoechogenicity (0/35), hypoechogenicity (18/35), isoechogenicity (16/35), no calcification (15/35), microcalcifications (11/35), macrocalcification (9/35), color Doppler lfow patternⅠ(20/35), color Doppler lfow patternⅡ(10/35), color Doppler lfow patternⅢ(5/35). Irregular shapes, A/T>1, spiculated margins, marked hypoechogenicity, microcalciifcations, and color type Ⅱ were rarer in FV-PTCs than in C-PTCs, while isoechogenicity, no calciifcation, macrocalciifcation, and color type Ⅲwere more frequent in FV-PTCs than in C-PTCs. The differences of the above features were statistically significant [χ2=4.276, P=0.039; χ2=8.125, P=0.004; P=0.009 (Fisher′ s exact test); χ2=8.548, P=0.003;χ2=4.898, P=0.027,χ2=7.796, P=0.005;χ2=5.462, P=0.019;P=0.001 (Fisher′s exact test)] . During the preoperative ultrasonography, 20 of 35 FV-PTCs were diagnosed as malignancy, and others were misdiagnosed as benign nodules (misdiagnosis rate was 43%). The lymphatic metastasis rate of FV-PTCs was 29%(9/31), significantly lower than C-PTCs [62%(41/66),χ2=9.246, P=0.002]. In terms of the sonographic features of metastatic lymph nodes, there was no marked difference between FV-PTCs and C-PTCs. Conclusions Some FV-PTCs are lack of malignant features, and tend to be misdiagnosed frequently when coexisting with benign thyroid nodules. Observing the echogenicity, color lfow characteristics and other features of each thyroid nodule and cervical lymph node with multiple views may decrease the misdiagnosis rate.

Objective To study the localizations and the quantity of GnRH receptor in stomach of Sprague-Dawley (SD) rats under stress.Methods The model of stress SD rats was established by fear. Then, stomachs were taken from the rats in acute stress group (2h-12h), chronic stress group (1d-4w) and the control group respectively.The localizations and the quantity of GnRH receptor in stomachs were detected using immunohistochemistry and Western blotting.Results The results of immunohistochemistry showed that immunoreactivity of GnRH receptor was displayed in the gastric parietal cells and the epithelial cells of the gastric pits in stomachs of rats in all groups. The immunoreactive materials were distributed in membrane and cytoplasm of all positive cells, but not in nuclei. Meanwhile, the results of Western blotting showed that the number of GnRH receptor decreased significantly when SD rats were in stress from 2h to 2w (P

Objective To screen and analyze nucleotide variants in 5'-untranslated region(5'-UTR)in voltage-gated sodium channel α1-subunit gene(SCN1A)in patients with Dravet syndrome and to evaluate the association of the variants with disease.Methods Peripheral blood of 24 patients with Dravet syndrome and 100 unrelated normal persons were collected and genomic DNA was extracted.PCR-sequencing of SCN1 A 5'-UTR in these DNA was performed.To evaluate the possibility of mutation inducing disease,bioinformatics analysis was applied to analyze the conservation of the sequences around the mutation site and predict the potential transcription elements.Results The nucleotide variant of 166.642.520G→A in exon 2 was identified in two patients,but not in normal controls.The mutation was a de novo mutation in a patient with early-onset.In the second proband,the mutation was also carried by his clinically asymptomatic mother.The nucleotide site 166.642.520 was moderately conserved in mammals(62.5%).The average nucleotide identity rate between human and other mammals species in the region adjacent to 166.642.520 was 88.5%.Two potential transcription regulatory elements were predicted on the sequence with the mutation of 166.642.520G>A,and only one on the sequence with wild-type.Conclusions The mutation 166.642.520G>A may be associated with Dravet syndrome and further studied should be performed to verify it and demonstrate its pathogenic mechanisms.

Objective: To explore the effect of social support and rumination on posttraumatic growth of patients with human immunodeficiency virus (HIV). Methods: A total of 1 152 patients with HIV from Shanghai Public Clinical Center were investigated using General questionnaire, Perceived Social Support Scale, Event Related Rumination Inventory and Posttraumatic Growth Inventory by cross-sectional survey method from January 2018 to October 2018. The path of social support and rumination on post-traumatic growth was established by correlation analysis and structural equation model. Results: The total score of posttraumatic growth in patients with HIV was (47.93±23.55) points, which was at the low-middle level. Correlation analysis showed that posttraumatic growth was positively correlated with comprehension of social support (r=0.234, P<0.01), positively correlated with rumination (r=0.352, P<0.01). Structural equation model showed social support had directly positive effect on posttraumatic growth, path coefficient were 0.55. Rumination had a partial mediating effect between social support and posttraumatic growth, and mediation effects account for 11.65% of the total effect. Conclusions The posttraumatic growth level of patients with HIV needs to be improved. Health care providers should help patients get as high a level of social support as possible, as well as focus on guiding patients to think positive about the disease.

Objective To produce a plastic ampoule with an opening that fits syringe adapters to allow solutions to be drawn up without needles (to avoid needle stick and sharps injuries) and to test the effectiveness of the new design in terms of residual fluid volume and risk of microorganism contamination. Methods Evaluation study based on laboratory research was adopted. For the experimental group, 30 ampoules based on the new design were produced by 3D printing. The ampoules were sterilized and filled with 2 ml sterile water. The sterile water was drawn up without the use of needles, and the wastage fluid (i.e., 2 ml minus the quantity drawn up) was calculated. A 1 ml aliquot of sterile water from each ampoule was dropped onto a nutrient agar plate, and the number of colony-forming units was assessed after 48 h. For each ampoule, the experiment was performed twice. Sixty 2 ml glass-packaged sterile water injections constituted the control group. The fluid was drawn up with a needle, and the superfluous fluid and number of colony-forming units were assessed, as in the experimental group. Results The mean wastage fluid was 0.06 ml, 95% CI was 0.05-0.07 ml in the experimental group and the superfluous fluid was 0.06 ml, 95% CI was 0.06-0.07 ml in the control group, there was no significant difference between the two groups (Z=-1.194, P=0.233). The number of colony-forming units was 8 in the experimental group and 4 in the control group, there was no significant difference between the two groups (P=0.224). Conclusions The newly designed plastic ampoule opening could help health workers to avoid needle stick and sharps injuries when drawing up solution. The wastage fluid and microorganism contamination levels met the required standards, indicating that the new design is suitable for clinical application.