Objective To explore the clinic value of blood loss during and after cesarean section in women with scarred uterus. Methods From July 2007 to December 2008, thirty-six women with scarred uterus received weighing methods to evaluate the actual blood loss during and after cesarean section in Yuhuangding hospital, while 98 cases without pregnant complications were chosen as control. Results In women with scarred uterus, the blood loss during operation Was (372.4 ± 180.0) ml, and the total amount after 2 hours and 24 hours were (444.7± 228.2) ml and (527.4 ±251.6) ml respectively, which were higher than corresponding values in control group (P < 0. 05). The incidence of postpartum hemorrhage in scarred uterus was 47.2%, higher than that in control group (P < 0. 05). There were no significant differences between two groups in the tests of hemoglobin and coagulation functions (P > 0. 05). Conclusions Scarred uterus may be one of the important reasons which lead to postpartum hemorrhage. The clinical treatment of pregnant women with scarred uterus should focus on the prevention of blood loss during the cesarean section.

Objective To investigate the effect of tramadol combined with sufentanil on postop-erative analgesia in patients received upper-abdominal surgery.Methods One hundred and fifty pa-tients scheduled for selective upper-abdominal operation were randomly divided into five groups (n=30 each):Tramadol group (T);large dose sufentanil combined small dose tramadol group (TS1 );balanced tramadol and sufentani group (TS2 );small dose sufentanil combied large dose tramadol group (TS3);sufentanil group (S).Postoprative VAS scores were recorded respectively at 1,4,8, 12,24,36,48 h when be in quiet and turning 90 degree,Ramsay sedation score,analgesia pump pressing times and side effects were also recorded.Results VAS scores in group TS2,group TS3 and group S at each time point both be in quiet and turning 90 degree were significantly lower than that of group T and group TS1 (P <0.05).Group S sedation score significantly higher than group T (P <0.05).No significant difference in other groups.Conclusion Balanced tramadol and sufentanil group has best analgesic effect and least side effects.With the increasing doses of sufentanil,its analgesic effect was not obvious enhancement.

Objective To investigate the effect of TanshinoneⅡA on nerve conduction of oxaliplatin induced peripheral neuropathy in rats. Methods Fifty Wistar rats were randomly divided into normal control group, model group, treatment group, prevention group, prevention and treatment group. Except for those in model group, Wistar rats were injected i.p. with oxaliplatin (20 mg/kg). The electrophysiological instrument were employed to detect the sciatic nerve conduction velocity, latency, amplitude 6 h, 24 h, 72 h and 7 d after modeling. Results In the model group, velocity of sciatic nerve conduction slowed, and latency prolonged 24 h after modeling (P<0.05) which continued to slow and prolong until 7 d after modeling (P<0.05). After the application of Tanshinone ⅡA, nerve conduction velocity became faster and latency shorter significantly (P <0.05), especially in the prevention and treatment group, in which no significant difference was found when compared with those in the normal control group (P > 0.05). Conclusions During the chemotherapy with oxaliplatin , TanshinoneⅡA can increase the conduction velocity of sciatic nerve , shorten the disease duration and play a protective role for peripheral nerve.

ITS2 sequence was used as a barcode to identify Viticis Fructus and its adulterants. The study collected 46 samples include Viticis Fructus and its adulterants. The sequences were obtained by extracting DNA, amplification, sequencing bi-direstionlly, and then assembling with CodonCode Aligner. To identify Viticis Fructus and its adulterants, the study used the methods of computing the genetic distances by Kimura 2-Parameter (K2P) model and constructing the Neighbor-joining (NJ) phylogenetic trees using MEGA5.0. The results showed that the maximum inter-specific K2P distance of Viticis Fructus was less than the minimum inter-specific K2P distance of Viticis Fructus and its adulterants and the NJ tree indicated that the Viticis Fructus and its adulterants could be distinguished clearly. Therefore, using ITS2 barcode can distinguished Viticis Fructus and its adulterants accurately.

Objective To investigate the effect of morphine combined with cisplatin on inva-sionon and migration of human lung adenocarcinoma cell A549.Methods Human lung adenocarcino-ma A549 cells were inoculated on cultured for 24 h,then were randomly divided into 5 groups:control group (group CON),cisplatin group (group CIS),morphine 0.3 μg/ml+ cisplatin group (group MT1),morphine 3 μg/ml+ cisplatin group (group MT2),morphine 30 μg/ml+ cisplatin group (group MT3).Cisplatin concentration was 4μg/ml.Each group was medicated immediately after 48 h incubation,invasion detection cells by Transwell assay,cell scratch assay cell migration ability, Western-blot detection of matrix metalloproteinase-2 (MMP-2),the expression of MMP-9,Ezrin protein and Fascin protein.Results Compared with group CON,group CIS and morphine combined with cisplatin group reduced tumor cell invasion and migration ability,group MT3 and CIS down-reg-ulated MMP-2,MMP-9,Ezrin and Fascin expression (P<0.05).Compared with group CIS,com-bined with cisplatin group enhanced tumor cell invasion and migration ability group MT3,up-regula-ted MMP-2,MMP-9,Ezrin and Fascin expression (P<0.05).Conclusion Morphine may dose de-pendently reduce cisplatin on invasion and migration of human lung adenocarcinoma cell line A549, and up-regulation of MMP-2,MMP-9,Ezrin,Fascin expression is one of its possible mechanisms.

Objective To assess the effects of fluvastatin retard tablets on the elder patients of acute coronary syndrome(ACS) complicated with diabetes mellitus(DM) undergoing percutaneous coronary intervention (PCI) and the safety of drugs.Methods From December 2009 to December 2011,78 elderly patients (age≥65 years) of ACS complicated with DM who underwent PCI were enrolled in this study.They were all treated by drug elution stents.They were divided into group A(fluvastatin retard tablets 80 mg/d) and group B (fluvastatin retard tablets 160 mg/d) with 39 cases each by random digits table method.The plasma levels of high sensitivity C reactive protein (hs-CRP),matrix metalloproteinase proteinase 9 (MMP-9),monocyte chemoattractant protein 1 (MCP-1) and lipid levels were measured before and after treatment of 24 h,7 d and 180 d.All the patients were followed up for 180 d,and the adverse reaction of drug and the incidence of cardiovascular event were detected.Results Blood lipid levels had no significant changes in the two groups before and after treatment (P ＞ 0.05).The plasma levels of hs-CRP,MCP-1,MMP-9 were higher after treatment of 24 h than those before treatment in two groups [group A:(12.14 ± 2.71)mg/L vs.(8.76 ±2.25) mg/L,(491.75 ± 19.29) ng/L vs.(440.56 ± 13.15) ng/L,(449.6 ±11.8) μmol/L vs.(353.8 ± 16.0) μ mol/L;group B:(11.39 ± 2.38) mg/L vs.(9.30 ± 1.99) mg/L,(488.56 ± 17.61) ng/L vs.(436.06 ± 15.36) ng/L,(444.9 ± 19.1) μ mol/L vs.(349.8 ± 13.6) μmol/L],and there were significant differences (P ＜ 0.05).The plasma levels of hs-CRP,MCP-1,MMP-9 decreased significantly after treatment of 7,180 d compared with that after treatment of 24 h in two groups (P ＜ 0.05).Compared with those in group A,the plasma levels of hs-CRP,MCP-1,MMP-9 decreased even lower in group B[after 7 d:(4.51 ±1.16) mg/L vs.(5.43 ± 1.44) mg/L,(306.06 ± 18.49) ng/L vs.(384.64 ± 13.23) ng/L,(206.2 ± 16.8)μ mol/L vs.(263.4 ± 15.4)μ mol/L;after 180 d:(4.23 ± 1.08) mg/L vs.(4.68 ± 1.46) mg/L,(280.16 ± 14.54) ng/L vs.(354.64 ± 11.32) ng/L,(187.2 ± 14.2)μ mol/L vs.(225.4 ± 12.7) μ mol/L],and there were significant differences (P ＜ 0.05).After followed up for 180 d,there was no serious adverse reaction in two groups,and the total incidence of cardiovascular event in group B was lower than that in group A [7.7％(3/39) vs.25.6％ (10/39)],and there was significant difference (P ＜ 0.05).Conclusion Intensive lipid lowering therapy can reduce the level of inflammatory factors and cardiovascular event of the elder patients of ACS complicated with DM undergoing PCI and has good security.

Background Medical refraction after cycloplegia is the preferable choice for precise measurement of degree of refractive error.Drugs used in China for cycloplegia include atropine and tropicamide,and the use of cyclopentolate is an alternative for ophthalmologist.However,the data for the evaluation and comparison of efficacy of the available drugs in cycloplegia is still lacking.Objective This system analysis was to evaluate the difference between atropine and cyclopentolate in cycloplegia in children.Methods A systematic literature retrieval was conducted in MEDLINE,EMbase,Google residual accommodation after cycloplegia by atropine and cyclopentolate were compared.Statistical analysis was performed using the RevMan 5.1.0 software.Results A total of 7 studies were included in this meta analysis,including 6 cohort study design and 1 randomized,doubleblinded clinical trial and 1232 eyes.For retinoscopic evaluation after cycloplegia,no significant differences were found between cyclopentolate and atropine in children with hyperopia and myopia (WMD =-0.21,95％ CI:-0.47-0.06,P=0.13 ; WMD =-0.10,95％ CI:-0.36-0.15,P =0.43).For residual accommodation after cycloplegia,no significant difference was seen between cyclopentolate and atropine in ammetropic children (WMD =0.30,95％ CI:-0.10-0.71,P =0.15).Conclusions Cyclopentolate shows the same effect on the cycloplegia as atropine in children,and it can take the place of atropine in cycloplegia in childhood.

Objective To estimate the current quality of the reporting of randomized controlled trials (RCTs) related to digestive diseases in China. Methods All the papers related to RCTs published in Chinese Journal of Digestion from 1999 to 2008 were hand-searched by professional staff then evaluated and analyzed them according to the international reference standard. ResultsIn the 3298 issues of the recent ten years, there were 92 research papers of RCTs which was accounting for 2.8%. The sample size ranged from 18 to 5241. Sixty-one (66.0%) trials included the exact standard of internalize and exclusion. Sixteen (17.4%) trails told the specific method of random allocation and 22(23.9%) were double-blinded. Fifty-eight (63.0%) trials compared the baseline condition of each groups. Seventy-three(79.3%) trails showed the specific approach of statistic. In the end, only 7(5.7%) trails were identified as the strictly-designed RCTs. Conclusions The quantity and quality of the clinical RCTs can not satisfy the demand of clinical practice. Strictly-scientific designed, multicentered, large sample prospective clinical RCT should be advocated.

OBJECTIVETo systematically review the effectiveness of minimally invasive total hip arthroplasty (MIS-THA) versus traditional total hip arthroplasty (THA) in patients with hip diseases.

METHODSThrough a method of combining Free words and keywords,we searched databases including PubMed,The Cochrane Library, EMbase,Web of Science, CBM , CNKI and Wanfang Data for randomized controlled trials (RCTs) on the comparison between MIS-THA and THA for hip disease from inception to June, 2014. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies according to the "bias risk assessment" tool recommended by Cochrane Handbook 5.0 for Systematic Reviews. Then, meta-analysis was performed using RevMan 5.3 software.

RESULTSThirteen RCTs involving 1 213 cases of surgeries and total 1 284 hips (MIS-THA: n = 631; THA: n = 653) were identified. The results of meta-analysis showed that statistically significant differences were found in Harris hip score on the 3rd month after operation [MD = 8.37, 95% CI (6.02,10.72)], Hematocrit [MD = 0.02, 95% CI (0.01, 0.03)] and Hemoglobin [MD = 0.50, 95% CI (0.16, 0.85)] at the 48th hour after operation, changed value of femoral offset [MD = 0.30, 95% CI (0.04, 0.56)] between two groups. In the change value of femoral offset, THA was better than MIS-THA; There were no statistically significant differences between two groups in Harris hip score at 1st year after operation [MD = 3.26, 95% CI (-3.25, 9.76)], WOMAC score [MD = -0.53, 95% CI (-3.67, 2.60)] and Oxford score [MD = 1.34, 95% CI (-3.46, 6.13)] at the 6th week after operation, Hematocrit at the 8th hour after operation [MD = -0.01, 95% CI (-0.02, 0.00)], the incidence of hip varus [RR = 0.82, 95% CI (0.45,1.52)] and dislocation [RR = 1.40, 95% CI (0.48, 4.12)].

CONCLUSIONTHA brings less trauma, less hemorrhage and better early clinical outcome compared with MIS-THA, but the difference of the complication rates between the two groups is similar.