Visualization technology is more and more widely used in clinical anesthesia.Nerve block in pediatric anesthesia assisted by visual technique of ultrasound not only achieved the similar curative effect as traditional blind operation but also had lower incidence of complications,so this technology is more and more useful in pediatric anesthesia.This article reviewed the progress of the application of ultrasound guided nerve block in pediatric anesthesia.

Objective The clinical distribution and drug resistance of isolated Acinetobacter Bauman strains were retrospectively analyzed in Xiangya Hospital Central South University in 2015,and its resistant transitions in ten years were also analyzed,to provide theoretical guidance for clinical rational use of antibiotics and control of infection.Methods 534 Acinetobacter Bauman strains were collected at Xiangya Hospital in 2015,the clinical distribution characteristics and drug resistance of Acinetobacter Bauman strains were analyzed according to specimen type,department,age and drug resistance result.Meanwhile,the drug resistance situation was compared with that in 2006 and 2011.Results The isolation rate of Acinetobacer Bauman from respiratory tract specimen was 76.78％,the tolal isolation rate from ICU,respiratory department of internal medicine,neurology department of internal medicine and neurosurgery department ward was 57.87 ％,and the infection patients over the age of 61 occupied 37.83 ％.Risperidone/Shubatan showed the best antibiotic activity with the resistance rate 3.02 ％ in ten drugs,the Acinetobacter Bauman strains were resist to other nine drugs in different level,with the percent from 50.0％ to 85.0％.The drugs of tobramycin and imipenem showed the greatest growth,with the resistance rate of 1.87％ and 11.70％ in 2006 in Xiangya hospital,increased to 69.85％ and 80.53％ in 2015,respectively.The drug of levofloxacin and cefepime also showed great growth in ten years with the increase of 58.81％ and 55.98％,respectively.Conclusion The clinical isolates of Acinetobacter Bauman strains mainly derived from respiratory tract specimen,and mainly distributed in ICU,the most infection people were from the older.The resistance rate of common drugs showed a significant increase in ten years,especially for cephalosporins and carbapenems.With the increase of multiple drug resistant strains,the monitoring of drug resistance of Acinetobacter Bauman and use of antibiotics rationally should be strengthened.

Objective To investigate the effect of FTY720 and gemcitabine on the proliferation and apoptosis of H520 and A549 cells in non-small cell lung cancer(NSCLC) cell line.Methods The interventional influence on the in vitro cultured NSCLC A549 and H520 cells was performed by selecting 0,2,4,6,8,10 μmol/L concentrations of FTY720,then the absorbance value was detected at 24,48,72 h after culture and the proliferation inhibiting effects of FTY720 on A549 and H520 were observed under the condition of different concentration of FTY720;adding single 7 μmol/L of FTY720,single 0.2 μmol/L gemcitabine and 37 μmol / L FTY720 combined with 0.2 mol/L gemcitabine into A549 and H520 cells lines,then the differences of inhibition and apoptosis after 48 h in the cells of each group were observed.Results The inhibitory effect of different concentrations of FTY270 on NSCLC A549 and H520 cell lines was statistically significant difference (P＜0.05).The proliferation inhibiting effect of FTY720 on NSCLC H520 and A549 cell lines had the correlation with the concentration and time.The apoptosis rate of FTY720 combined with gemcitabine on A549 and H520 cells was significantly higher than that of single use in these two drugs (P＜0.05).Conclusion FTY720 combined with gemcitabine can significantly inhibit the proliferation of A549 and H520 in human NSCLC,and can effectively promote the apoptosis of cancer cells,and has the higher clinical value.

Objective To evaluate the change of cellular immunity and its clinical significance in JRA.Methods 7 lymphocyte swbpopulation was analyzed by immunofluorescein and interleukin 2 (IL-2) produced by peripheral blood mononuclear cells in vitro by MTT colorimetric assay. 29 times of various stage with JRA were examined, including 14 clinically active patients, 8 posttreatment or 7 clinically inactive ones. There are 19 healthy children of similar age in control group.Results In active patients, the number of OKT8, OKT4, the ratio of OKT4/OKT8 and the level of IL-2 decreased significantly compared with normal controls. These changes recovered matkedly in remission patients though they did alter affective treatment for (2～4) weeks.Conclusion Patients with active JRA are characterised by aberration of cellular immunity and the aberration reverses obviously slow in comparision with the clinical manifestetions and the routine laboratory investigation.

Objective To analyze and explore the value of the mutislice spiral CT (MSCT) scanning,its reconstructive technology and MRI scanning for applying to the identifying diagnosis of new and old vertebral compresion fracture.Methods One hundred and sixty-seven cases with the new and old vertebral compresion fracture who have 189 vertebrae in total were examined using the MSCT scanning,their imaging information were postprocessed with 2D and 3D reconstruction at the work station.Thirty-four patients with overall 43 vertebrae were carried out by MRI scanning and their images were compared with those of MSCT.Results They had the highest proportion of vertebrae in L1 with accounting for 27.68% (31/112) and 35.06% (27/77) among the patients with new and old vertebral compresion fracture,respectively.The next was T12,L2 and T11.There were statistically significant differences between new and old cases in such appearance as fracture line clear and sharp(102 and 21),contusion and hemorrhage of spinal cord(15 and 0),parenchyma shadow beside vertebrae(103 and 11),appendant fracture(26 and 5),organ's lacerated wound around vertebral body(30 and 0),discus intervertebrales vacuum(10 and 36),derangement and hardening of vertebral bone trabecularism(29 and 51) (P＜0.01).Twenty-six vertebrae with the uneven low T1 WI signal,27 vertebrae with the T2 WI fat-suppresion irregular high signal were demonstrated in MRI scanning among 27 vertebrae of 21 cases with new vertebral compresion fracture.While 16 vertebrae with the T1WI and T2WI signals were the same as those of the normal vertebrae,16 vertebrae were the T2WI fat-suppresion low signal among 13 cases with old vertebral compresion fracture.Conclusions The MSCT plays an important role in identifying diagnosis for the most of the patients with the new and old vertebral compresion fracture, while MRI scanning may reflect the pathophysiological characteristics in diagnosis of the spinal cord and the ligament lesion.Therefore,the MSCT and MRI scanning should be integrated to be used to enhance remarkably the accurate rate of the diagnosis.

Objective To discuss the relationship between hepatitis B virus (HBV) genotype and HBV DNA ,liver fibrosis ,liver function and HBeAg .Methods HBV genotypes ,HBV DNA ,liver fibrosis indicators and alanine aminotransferase(ALT ) ,aspartate aminotransferase(AST ) ,total bilirubin(TBIL) ,albumin(ALB) and HBV e antigen(HBeAg) were detected in patients with serum hepatitis .All data were statistically analyzed .Results There was no significant difference of HBV DNA ,ALT ,AST ,TBIL ,ALB , procollagen- Ⅲ -peptide ,type Ⅳ collagen ,hyaluronic acid and laminin between patients with B and C genotype infection (P> 0 .05) . However ,HBeAg level in patients with C genotype infection was higher than that in patients with B genotype infection (P< 0 .05) . Conclusion There might be no significant difference of HBV DNA ,liver function and liver fibrosis between patients with B and C genotype infection ,but HBeAg level in patients with C genotype infection could be higher than patients with B genotype infection .

The paper described practices in QC management pathway of death cases of the hospital.These refer to intensive education,clarification of access standard,death cases quarterly readings and administrative investigation,strict supervision among others.Authors pointed out that QC pathway can improve quality of care significantly,yet QC pathway calls for fair accountability,systemic care for patient safety,and all-staff involvement in QC improvement.

Objective:Human sera ACA was detected by ELISA method and some factors including the dilution rate of sera, blocking materials, temperature,ionic strength and interval time between blocking and detection,which could probablly influence the detective level of sera ACA were investigated.Methods:Human sera ACA was detected by ELISA.Results:10% NBS/PBS was more feasible than 1% bovine albumin/PBS for blocking non specific binding;the ACA titer of the same sample detected at 37℃ was lower than that of 22℃ and 25℃,the dilution rate 1∶50 for sera was suitable for the detection; time internal between blocking and detection could influence ACA level when it exceeding 2 weeks;the blinding ability of Ag with Ab was signicantly inhibited when the NaCl inonic strength was higher than 1.5 mol/L.Conclusion:The detected results of human sera ACA influenced by the dilution rate of sera,blocking materials,temperature ionic strength and internal time between blocking and detection.

This paper aims to investigate the regulatory mechanism of blood-activating and stasis-dissipating drugs on fecal metabolic characteristics of rhubarb-peach kernel in mice with adenomyosis (AM) using fecal metabolome method. Adenomyosis was modeled by pituitary transplantation, and after the end of modeling administration, fecal samples were collected from mice. Non-targeted metabolomics studies were performed using liquid chromatography-mass spectrometry (LC-MS) to compare the metabolic characteristics of the feces of mice in each group and to find intestinal differential metabolites and potential differential metabolic pathways. The results showed that compared with the normal group, 5-hydroxy-L-tryptophan, histidine, L-acetylcarnitine, 16-hydroxy hexadecanoic acid, thromboxane B₂, etc. were significantly up-regulated, L-urobilin and prostaglandin D₃ were down-regulated in the feces of the model group, and were reversed after treatment with the rhubarb-peach kernel. The results of metabolic pathway enrichment analysis showed that tryptophan metabolism and histidine metabolism were the main intervention pathways of the rhubarb-peach kernel on AM intestinal metabolism. This study found that the underlying mechanism of the rhubarb-peach kernel in the treatment of AM is related to the intervention of intestinal metabolism of tryptophan, histidine, bile acid, choline and arachidonic acid, and the regulation of pro-inflammatory microenvironment and fatty acid metabolic homeostasis. This study has been approved by the Experimental Animal Ethics Committee of China Three Gorges University (No. 20190801).

Objective To explore the inhibitory effect of melatonin(MT) on expression of glial fibrillary acidic protein in infant rats with brain injury induced by lipopolysaccharide(LPS).Methods One hundred and sixty Spragne-Dawley rats(1 month) were randomly divided into 4 groups:9 g/L saline group(NS group),LPS group,MT protective A group(MT plus LPS,MT was given 15 minutes earlier),and MT protective B group(MT plus LPS,MT was given immediately).Forty rats in each group,then every group was subdivided into 2 subgroups according to observe time point at 24 h and 48 h with 20 rats,respectively.Half of them in all subgroups were not injected Evans blue(EB).Rats were sacrificed at 2 time points to take brain tissue samples,respectively.EB content of brain tissue was meteraged by the formamide methods.Immunohistochemistry technology and computer assisted image analysis system methods were applied to observe the expression of the positive apoptosis cell of brain tissue.Results Both EB content and the expression of GFAP showed significant difference between LPS group and NS group(Pa0.05).Conclusions LPS can induce the expression of GFAP in infectious brain injury of rats induced by LPS,and MT can inhibit the expression of GFAP;MT may play a role in dealing with infectious brain injury.